1st Case Research Articles

Pyléphlébite chez l’enfant : un diagnostic difficile

Pylephlebitis or septic thrombophlebitis of the portomesenteric veins is a complication of intra-abdominal infections. The disease is rare in children and the diagnosis is often delayed. The morbidity of pylephlebitis is relatively low, although there is a risk of residual thrombosis. We report on 2 cases of pylephlebitis in a 12-year-old girl and a 13-year-old boy, following undiagnosed appendicitis. In the 1st case, the young girl had been misdiagnosed with Salmonella infection and was given antibiotics; in the 2nd case, the boy had retrocecal appendicitis that was clinically subacute. An accurate diagnosis was finally made in both cases by CT scan. Both children evolved satisfactorily following appendectomy, long-term antibiotics, and anticoagulation. Clinically, the severe sepsis associated with pylephlebitis is at the forefront. Physical examination is often normal and therefore of little help; the knowledge of a preceding abdominal infection leads to further radiological investigations. Biologically, there are pronounced signs of infection. CT is the preferred exam for diagnosing pylephlebitis, as it can also show the underlying cause of the intra-abdominal sepsis or possible complications. Doppler sonography is recommended more for follow-up of the portal vein thrombosis. Treatment of pylephlebitis associated with appendicitis always includes long-term antibiotics. An appendectomy is always performed either at the time of diagnosis or later. The need for anticoagulation therapy in children is controversial. However, most pediatricians recommend its use, beginning as soon as possible, to be continued until normalization of portal vein flow.

A reflective cognition aspect of speaking performance process - Highschool 1st graders' cases a speaking in a public place

A reflective cognition aspect of speaking performance process - Highschool 1st graders' cases a speaking in a public place

Immune reconstitution inflammatory syndrome after cessation of the tumor necrosis factor α blocker adalimumab in cryptococcal pneumonia

Tumor necrosis factor α antagonists have proven efficacious for a variety of autoimmune-mediated diseases. However, recent data have highlighted the risk of invasive fungal infections with their use. These agents are typically discontinued when infectious complications occur during therapy; however, the immune reconstitution inflammatory syndrome (IRIS) may be seen after drug cessation. We describe the 1st case of IRIS secondary to cryptococcal pneumonia after cessation of adalimumab.

Effectiveness on post-exposure vaccination of varicella and its influencing factors in elementary schools in Beijing

To evaluate the effectiveness of post-exposure varicella vaccination in elementary schools in Beijing and to explore its influencing factors. From May to July 2007, varicella cases from 49 elementary schools in 4 districts in Beijing were observed prospectively. The study included 7882 children who were from the same classrooms, same floor or same bungalow areas with the varicella cases. Vaccination status, history on varicella and onset of rashes were collected to calculate the secondary attack rate among those children under observation and then the effectiveness of vaccine was calculated. The protection rate on post-exposure vaccination among children under observation was 85.26%. The rates were higher when the 1st case had received varicella vaccine before the onset, vaccines were administered soon after the exposure or there were less varicella cases occurred in the schools. For children in the same class, same floor or bungalow with varicella cases before post-exposure vaccination, the average rates of protection by vaccination were 84.26% and 87.06%, respectively. When the 1st case had received varicella vaccine prior to the onset, the post-exposure protection rates reached 92.09% and 93.06%, respectively, higher than that of the case when the 1st case had received no vaccination. When the administration of vaccine right after the occurrence of first varicella case, the rates of the effectiveness of vaccine were 83.09% and 93.02%, both of which were higher than that of vaccine administered after the occurrence of 2 or 3 cases. When the vaccine administration of vaccination combined with the isolation of the already infected cases or within 5 days after the onset of the 1st case, the vaccine effectiveness could reach 86.60% and 92.73%, both were higher than otherwise. However, in those schools that bungalows were used as classrooms but without bus, canteen from school or student lodgings, it seemed that post exposure vaccination was more effective in preventing varicella from occurring. Varicella vaccination after exposure in elementary schools in Beijing was effective in prevention and control of the disease. Immediate administration together with the isolation of cases could maximize the effectiveness of the vaccine.

Bioboard

AUSTRALIA – World-Class Cancer Center to be Built in Parkville. AUSTRALIA – Cure Found for Devastating Muscle Disease. AUSTRALIA – HIV Test to Help Monitor Sufferers. AUSTRALIA – Radium Weed Weeds Out Sun Spots, Skin Cancer. AUSTRALIA – Kava Safe and Effective in Reducing Anxiety. CHINA – CAS Develops New Salt-tolerant Wheat. CHINA – Search for Passengers on Flights with Flu Case. HONG KONG – Hong Kong Confirms Asia's 1st Swine Flu Case. INDIA – Indian Healthcare Market to Grow Despite Slowdown. INDIA – WHO Lifts Vaccine Embargo on India. JAPAN – Scientists Create World's First Transgenic Monkeys. JAPAN – Japan Swine Flu Cases Surge. NEW ZEALAND – New Frontiers in Gene Behavior. NEW ZEALAND – Innovative Pet Food Research Consortium Launched. SINGAPORE – 50 Receive Healthcare Humanity Awards. SINGAPORE – No-Go for Swine Flu Parties. SINGAPORE – Asia's First Combined Heart and Liver Transplant. SINGAPORE – Singapore to Host Conference on Tobacco or Health. SINGAPORE – Diabetes Hits Asia's Youth. SOUTH KOREA – $14.6 mn for Fight Against New Flu. TAIWAN – Flu Vaccine to be Available by End of Year. TAIWAN – Mutation in Gene allows Cancer to Spread. TAIWAN – Scientists Find Ways to Improve Cancer Drugs. TAIWAN – Team Makes Discovery in Search for New Antibiotic. TAIWAN – Taiwan Tags Sixteen Countries with Yellow Travel Alert Over Flu. TAIWAN – Team Makes Breakthrough in Therapy for Childhood Cancer. THAILAND – Thailand Tries to Become Starch-Production Hub. THAILAND – Thailand and Taiwan to Begin Biotech Cooperation Plan. VIETNAM – US gives Vietnam Protective Bird Flu Equipment. OTHER REGIONS — UNITED STATES – Over 52's May Be Better Protected.

Rare Tumor of the Tongue in a Child: Alveolar Soft Part Sarcoma

Alveolar soft part sarcoma (ASPS) is a rare, malignant tumor of uncertain histogenesis that has no benign counterpart. In some cases, a structural rearrangement of chromosome 17 involving band q25 has been reported. The neoplasm occurs most frequently in female adolescents and young adults, where it arises predominantly in the extremities. In contrast, the most common sites of occurrence in infants and children are the orbit (41%) and the tongue (25%). The primary therapeutic option is a complete surgical excision. Because of the indolent growth and lack of pain associated with the mass, 20% of patients have metastases at the time of initial diagnosis. Median survival time reported for all sites of the body is 79 months. When ASPS presents in the tongue region, however, the patients involved are usually children and have a better prognosis than patients affected in the extremities. The utility of adjuvant chemotherapy or radiation therapy in children is open to question. Because metastases may occur after several decades, children with ASPS should be followed throughout adolescence and well into adulthood. Only 10 cases of ASPS occurring in the tongues of children younger than 5 years of age were indexed by MEDLINE between 1952 and 2006. Here, we describe the 1st case consistent with typical ASPS of the tongue in 15 years at our hospital. The patient is a 2-year-old girl who has been disease-free for 32 months.

Rhodococcus equi pulmonary–central nervous system syndrome: brain abscess in a patient on high-dose steroids—a case report and review of the literature

Rhodococcus equi has emerged as an opportunistic pathogen usually causing necrotizing pneumonia in immunosuppressed patients but has been found increasingly in extrapulmonary sites. We report the 1st case of R. equi brain abscess in a patient receiving corticosteroid monotherapy and review the literature for risk factors and sites of infection.

Meningococcal serotype Y myopericarditis

Involvement of the pericardium in meningococcal disease is a well-recognized but rare complication. Isolated meningococcal pericarditis is defined as purulent pericarditis without clinical evidence of meningococcemia. Neisseria meningitidis serotypes C, B, and W135 have been previously described to cause pericarditis. This is the 1st case report of isolated meningococcal myopericarditis due to N. meningitidis serotype Y.

Pneumorachis caused by metastatic gas gangrene

Pneumorachis has previously been described only after spread from a contiguous site or after a traumatic event. Our patient experienced sepsis due to multiple enteric organisms, and gas was identified within the spinal canal on computed tomographic imaging. We present the 1st case of pneumorachis caused by disseminated infection.

First report of methicillin-resistant Staphylococcus aureus septic arthritis complicating acupuncture: simple procedure resulting in most devastating outcome

We report the 1st case of methicillin-resistant Staphylococcus aureus (MRSA) septic arthritis after acupuncture, with articular cartilage destruction and chronic osteomyelitis. The patient responded to arthrotomy, synovectomy, and 6 months of antibiotics. The emergence of community-associated MRSA infections would further aggravate the problem. Strict adherence to proper infection control guidelines is mandatory.

Abstract B145: Association between physical activity, sleep duration, and cancer risk among women in Washington County, MD: A prospective cohort study

Abstract B145 Background Physical activity is known to be protective for multiple cancers including breast. Modulation of hormonal factors such as leptin, ghrelin, and hyperinsulinemia as well as energy balance and BMI are thought to play a protective role. Short duration of sleep appears to have an opposite effect on many of these factors. Methods In a population based prospective cohort (CLUE II), we assessed the association between physical activity energy expenditure (PAEE), sleep duration, and incidence of first cancer (all-site) in women. 5968 adult females who answered questions on sleep and physical activity on a 1998 follow up questionnaire were included in the study population. Incident cases were identified through linkage of cohort participants with the Washington County Cancer Registry and Maryland State Cancer Registry. Adjusted hazard ratios (HR) and 95% confidence intervals were estimated from Cox proportional hazards models. All statistical tests were two sided. Results During 9.6 years of follow up, 604 1st incident cancer cases including 186 breast cancers were diagnosed. Overall cancer risk (HR=0.80, 95% CI 0.68, 0.95) and breast cancer risk (HR=0.75, 95% CI 0.55, 1.01) were significantly reduced among women in the upper 50% of PAEE compared to the lower. Sleep duration was not significantly associated with overall or breast cancer risk in adjusted HR models, but with an increase in colon cancer risk (HR = 1.72, 95% CI 0.99, 2.78) though the sample size was small. Excluding elderly women (> 65 yrs in 1998) who may have different sleep patterns, sleep duration [≥ 7hrs/day vs. < 7hrs/day] significantly modified the association between PAEE [upper vs. lower 50%] and overall cancer risk (p interaction=0.014). A 1.5 fold increase in cancer risk (HR=1.47, 95% CI 1.05, 2.06) was observed among women ≤ 65 years in the upper 50% of PAEE who did not have sufficient sleep (< 7 hrs/day). Conclusions Increased PAEE was protective for cancer risk irrespective of age. In addition insufficient sleep may modify the observed protective effect of increased PAEE on cancer incidence among young and middle aged women. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B145.

First case report of sepsis caused by Mycobacterium wolinskyi in chronic myelogenous leukemia

Infections caused by Mycobacterium wolinskyi have rarely been reported, and essentially all were cellulitis and/or osteomyelitis related with traumatic event or surgical wound. Here, we present the 1st case of septic complication due to this organism in a patient with chronic myelogenous leukemia of the 1st but late chronic phase.

Imagination and theI

Abstract: Thought experiments about the self seem to lead to deeply conflicting intuitions about the self. Cases imagined from the 3rd person perspective seem to provoke different responses than cases imagined from the 1st person perspective. This paper argues that recent cognitive theories of the imagination, coupled with standard views about indexical concepts, help explain our reactions in the 1st person cases. The explanation helps identify intuitions that should not be trusted as a guide to the metaphysics of the self.

Primary peritonitis due to Streptococcus pyogenes with reduced susceptibility to fluoroquinolones

We report the 1st case of primary peritonitis caused by Streptococcus pyogenes with a reduced susceptibility to fluoroquinolones in a healthy woman, leading to a clinical and microbiological treatment failure. DNA sequencing of parC and gyrA revealed the association of the following 3 substitutions in ParC: Ser80Pro, Asp91Asn, and Ser140Pro.

Some Aspects Cognition of Paragraphs Connection－Highschool 1st and 2st graders' cases in their reading and writing－

Some Aspects Cognition of Paragraphs Connection－Highschool 1st and 2st graders' cases in their reading and writing－

Congenital Intracranial Mesenchymal Chondrosarcoma: Case Report and Review of the Literature in Pediatric Patients

In this paper we report the 1st case of a congenital intracranial mesenchymal chondrosarcoma in a 2-month-old infant, apparently present at birth. A magnetic resonance image showed a large left parietal solid mass, while microscopy revealed a mixture of undifferentiated small cells and mature hyaline cartilage islands, positive for vimentin, S-100, and CD99. A surgical excision was performed but the patient died after a few weeks as a result of a rapid relapse of the tumor. We also review the pediatric cases (in patients less than 20 years old) of extraskeletal (intracranial) mesenchymal chondrosarcomas of the literature, with a focus on the most recent cytogenetic and immunohistochemical studies.

Duplication œsophagienne à révélation néonatale. À propos de 2 cas

Oesophageal duplication is a rare form of digestive duplication. This congenital malformation can be asymptomatic or manifest itself through respiratory signs due to airway compression. We report 2 cases of oesophageal duplication discovered in the neonatal period.In both cases, symptoms were dominated by respiratory distress and vomiting. Diagnosis was confirmed by oesophageal contrast X-rays, which revealed a total tubular form in the 1st case and a cystic form in the 2nd case.Oesophageal duplication is a rare abnormality of benign nature, which can be revealed in neonatal period by a noisy compression picture. Diagnosis of this anomaly should trigger a search for other digestive duplications, as well as associated malformations, in particular vertebral.

Bordetella hinzii septicemia in association with Epstein–Barr virus viremia and an Epstein–Barr virus-associated diffuse large B-cell lymphoma

We report the 1st case of Bordetella hinzii septicemia associated with Epstein–Barr virus viremia and lymphoma. B. hinzii identification necessitated cellular fatty acid analysis by gas–liquid chromatography and 16S rRNA gene sequencing. Isolates were resistant to many antimicrobials. Resistance and diagnostic challenges complicated management and contributed to mortality.

Aberrant Expression of β-HCG in Anaplastic Large Cell Lymphoma

We report a case of anaplastic large cell lymphoma (ALCL) showing aberrant expression of beta subunit of human chorionic gonadotrophin (beta-HCG). The patient was a 14-year-old boy who presented with a right inguinal mass and a raised serum beta-HCG level. Biopsy of the mass revealed a malignant neoplasm composed of large, pleomorphic cells with prominent nucleoli. These malignant cells showed positive staining with CD30, ALK, epithelial membrane antigen, and beta-HCG. Chromosomal analysis showed t(2;5)(p23;q35) translocation, and polymerase chain reaction demonstrated T-cell receptor gene rearrangement. The patient did not respond well to chemotherapy, and he died 8 months after the diagnosis. To the best of our knowledge, this is the 1st case of ALCL showing aberrant expression of beta-HCG and associated with a raised serum level of beta-HCG. We report this case to bring awareness of this presumably rare occurrence to avoid the risk of misdiagnosis.

Avaler des aimants : un jeu dangereux. À propos d’une observation

Complications related to the ingestion of magnetic foreign bodies by children represents an affirmed health hazard in the United States. In France, an alert has been announced. We report the 1st case in France. Our aim is to alert pediatricians and emergency physicians and to draw attention to the particularities of this type of foreign body. Responsible for complications is the ingestion of at least 2 magnets, or 1 magnet and a metallic foreign body, with a time interval between ingestions. In these cases, it is strongly recommended to extract the foreign bodies with endoscopy if they have not yet passed the pylorus. For those further advanced in the intestinal tract, continuous observation is warranted and surgical extraction is indicated on apparition of 1st clinical symptoms.