Adolescent Male Patient Research Articles

Moustache restoration after cleft lip repair

Background: We strive to achieve a functional and aesthetic repair in cleft lip patients bestowing them with all natural landmarks and making the evidence of the repair undetectable for better quality of life and complete social acceptance. The last to offer is a moustache for an adolescent male cleft lip patient. Aim: The current study is a review of moustache restoration carried out for patients after cleft lip repair. It includes 18 cases with a follow-up of 6 months to 2 years. Materials and Methods: Follicular unit extraction using 0.9 mm motorized punches is the preferred technique. Alternative method is follicular unit transplant strip technique, where individual hair follicles are dissected for a 0.5-0.6 cm × 5-6 cm strip of scalp. Each follicle serves as a micro graft. Grafts are implanted in premade needle tracks flush to the skin. Spacing is 2-3 mm in the first sitting. Second sitting may be planned 6-8 months later to add density. Results: Hair growth along the scar is delayed, it begins 4-5 months after the transplant, and complete growth is seen by 6 months. There can be 7-10% loss of grafts. Conclusion: Follicular unit micro grafting can be used for restoration of moustache after a complete cleft lip repair. Moustache provides animation of the face, restoration of aesthetic landmark, taking away the typical cleft lip look and building up confidence of the patient.

Subscapularis tears and lesser tuberosity avulsion fractures in the pediatric patient.

Background:Pediatric subscapularis tears are known to be rare injuries. They are often associated with an avulsion fragment of the lesser tuberosity leading to dual description in the literature of either subscapularis tear or lesser tuberosity avulsion. Historically, they were managed nonoperatively; however, outcomes have improved with operative management. Nonoperative management often led to bony overgrowth at the lesser tuberosity that limited motion. The literature is limited to case reports and a few small case series, often not restricted to pediatric patients.Study Design:Case series.Level of Evidence:Level 5.Methods:Radiographic and operative databases were retrospectively reviewed to identify pediatric patients with subscapularis tears or lesser tuberosity avulsions in the past 10 years.Results:Five cases of pediatric subscapularis tears were identified that underwent operative management. Of the 5 cases, 4 had delayed presentation. In 1 case, the lesser tuberosity fragment was initially missed on radiographic imaging. All patients underwent operative management.Conclusion:These cases add to the body of knowledge of a rare pediatric injury that is commonly missed or diagnosis delayed. The importance of suspicion in the adolescent male patient without instability and unrelenting shoulder pain is stressed. Additionally, the importance of early magnetic resonance imaging with suspicion as well as an axillary view of the shoulder is demonstrated. As with all rare entities, it is important to disseminate information on natural history and interventions for this injury.

Acute ST segment elevation secondary to acute gastric distention

An adolescent male trauma patient developed new asymptomatic ST segment elevations that mimicked a myocardial infarction on infero-lateral telemetry leads on hospital day #8, following burn excision and skin grafting. This was confirmed on 12 lead electrocardiogram. Laboratory test results indicated normal potassium. Troponins ×3 were negative. X-rays indicated marked gaseous gastric distention. A nasogastric tube was placed with evacuation of 400mL of fluid and resolution of gastric distention. After gastric decompression, the ST segment elevations resolved. This case illustrates the need to consider acute gastric distention in the differential of acute ST segment elevation.<Learning objective: Electrocardiographic ST segment elevation generally indicates myocardial infarction. However, in the asymptomatic patient with normal troponins, alternative explanations, such as gastric distention should be considered.>

Identification and Treatment of a Pineal Region Tumor in an Adolescent With Prodromal Psychotic Symptoms

An adolescent male patient originally presented to a prodromal clinical research program with severe obsessive-compulsive behaviors and subthreshold symptoms of psychosis, which eventually developed into first-rank psychotic symptoms. The patient was followed over a 2-year period. His symptoms did not respond to psychotherapy or pharmacotherapy. However, when a pineal region tumor was discovered and treated with chemotherapy and autologous stem cell rescue, both psychotic symptoms and psychosocial functioning reverted toward baseline. Although subcortical brain structures have been implicated in the pathophysiology of idiopathic psychosis, reports of psychiatric sequelae of treatment of subcortical tumors are rare. Etiological pathways that may have played a role in symptom development are of particular interest, as understanding these mechanisms may shed light on the pathophysiology of psychotic disorders more generally.

Synovial sarcoma of the lung presenting late with compression of mediastinal structures and its successful resection: A case report

Synovial sarcoma accounts for 5-14% of all soft tissue tumours. We present a case of 35 year-old male who presented with five months history of progressively increasing shortness of breath and cough. On evaluation, there was no air entry on the left side. CAT scan chest showed a large necrotic mass involving the entire left hemi-thorax. The tru-cut biopsy of this mass was done and it showed synovial sarcoma. The entire tumour along with the lung and the pericardium was removed completely. The patient had an uneventful recovery and was discharged home in 10 days with follow-up for adjuvant chemotherapy. Due to the rarity of this disease, no guidelines for the treatment are available. Main existing treatment includes surgery followed by either radiation, chemotherapy or both. Synovial sarcoma should be considered in the differentials of an adolescent or adult male patient presenting with a mass in the thorax.

Metatarsal Osteosarcoma in Rothmund-Thomson Syndrome

Padhy, Debabrata MS1; Madhuri, Vrisha MS, MCh1; Pulimood, Susanne A. MD1; Danda, Sumita MD, DM1; Walter, Noel M. FRCPath1; Wang, Lisa L. MD2 Author Information

Utility of SPECT/CT with Meckel’s scintigraphy

Meckel's diverticulum is a relatively common source of gastrointestinal tract morbidity in children. Individuals may present with symptoms of lower gastrointestinal tract bleeding, bowel obstruction or diverticulitis. Technetium-99 m pertechnetate scintigraphy is used to demonstrate those Meckel's diverticula that contain heterotopic gastric mucosa. We present a case of an adolescent male patient with rectal bleeding and suspected Meckel's diverticulum where the use of SPECT/CT fusion imaging provided valuable diagnostic information and prevented a false-negative study.

Abdominal cocoon in an adolescent male patient

Abdominal cocoon is a rare cause of bowel obstruction. The condition was first described three decades ago and is found mainly among adolescent females in tropical and sub-tropical countries. It is characterized by a thick fibrous membrane encapsulating the small intestines partially or completely. Patients present with features of intestinal obstruction and diagnosis is usually made intraoperatively. Surgical excision of the membrane and adhesiolysis result in complete recovery. We report on an adolescent male patient who had acute intestinal obstruction due to abdominal cocoon detected at surgery.

Magical Moments of Change: How Psychotherapy Turns Kids Around

Magical Moments of Change: How Psychotherapy Turns Kids Around

Nurse Practice Issues Regarding Sperm Banking in Adolescent Male Cancer Patients

The impressive increase in the survival rate of childhood cancer patients has produced increased interest in quality of life issues. This research addresses nurse practice issues in determining whether the newly diagnosed adolescent male patient is offered the option of sperm banking before undergoing chemotherapy treatment. Questionnaires were distributed to nurses and nurse practitioners on 3 inpatient and outpatient units who care for adolescent male cancer patients at the time of diagnosis, during chemotherapy, and during follow-up care. Findings indicate that 96.3% of respondents agreed that all male patients undergoing cancer treatment with infertility as a potential side effect should be offered sperm banking. Respondents viewed oncologists and nurse practitioners as appropriate professionals to discuss the option. Lack of knowledge regarding sperm banking could be limiting nurses' willingness to introduce the topic, and education regarding cryopreservation may improve their knowledge and practice.

Arcanobacterium haemolyticum associated with pyothorax: case report

Arcanobacterium haemolyticum has an established role in the etiology of human pharyngitis. There are increasing reports of systemic infections caused by this organism. From India, we report the first case of Arcanobacterium haemolyticum causing pyothorax in an immunocompetent adolescent male patient. The probable mode of infection is also discussed. The role of A. hemolyticum as an animal pathogen needs further study.

Osteoid Osteoma of the Lumbar Spine

O steoid osteomas are rare, benign tumors. They are differentiated from osteoblastomas by their size. McLeod et al. defined lesions with a diameter of ≤1.5 cm as osteoid osteomas and those with a diameter of >1.5 cm as osteoblastomas1. Approximately 20% of osteoid osteomas occur in the spine, and most involve the posterior elements2,3. Ten percent of those in the spine occur in the vertebral body4. The lumbar spine is the most commonly involved segment3,4. The rate of associated compensatory scoliosis has been reported to be as high as 74%; Heiman et al. reported that seventeen (74%) of twenty-three patients with osteoid osteomas or osteoblastomas had a spinal deformity4. The tumor typically is located at or near the concave apex of the curve5,6. If the fourth or fifth lumbar vertebra is involved, the apex is typically cephalad to the lesion and pelvic obliquity is present5. Asymmetric pain-provoked muscle spasm on the side of the lesion is thought to be the cause of the scoliosis6. Ransford et al. postulated that the concave-side muscle spasms, if present for long enough, eventually will cause asymmetric growth inhibition of the vertebral epiphysis, leading to a rotational deformity and making the curve more structural7. Osteoid osteoma typically presents with an insidious onset of back pain, with or without radicular symptoms and usually with no neurological findings on physical examination, in an adolescent male patient who is between ten and twenty years old8. The pain can be worse at night and usually can be relieved with salicylates. Kirwan et al. emphasized that these lesions also are associated with “marked spinal stiffness.”5 Although the natural course of osteoid osteoma is …

Non-syndrome multiple supplemental supernumerary teeth

Multiple supernumerary teeth without any associated systemic conditions or syndromes are not common. We document a case of non-syndrome multiple supplemental supernumerary teeth in mandibular premolar region of an adolescent male patient, an incidental findings during routine radiographic examination. Periodic examination is recommended to monitor the clinical behavior.

PEDIATRICS???WEIGHT TRAINING AND RHABDOMYOLYSIS

HISTORY: A 14-year-old male junior high school football player presented to the emergency department with a history of bilateral thigh pain for three days. The pain began four hours after a vigorous unsupervised lower extremity weight training session and progressively worsened. The training session consisted of: leg extension (two sets of 5 repetitions with 100 lbs), leg press (two sets of 5 repetitions with 310 lbs), and squats (three sets of 5 repetitions with 140 lbs). Three days later he had difficulty standing from a sitting position without assistance. He did not report numbness or paresthesias on his legs. There was no history of blunt trauma or crush injuries. There was a history of a pruritic rash on his thighs for the past month. The patient denied taking any medications, illicit drugs or performance enhancing substances. Other than a history of eczema, past medical history was unremarkable. Family history was positive for several autoimmune diseases but was negative for neuromuscular diseases. The patient reported an intense desire to increase his muscle bulk to improve his performance in school football. PHYSICAL EXAMINATION: Exam in the emergency department revealed an alert adolescent male patient in moderate distress from pain. Weight was 86.3 Kg (> 95th%) and height was 174.5 cm (95th-97th%) with a blood pressure of 124/88 mmHg, a pulse of 70 beats/min, a respiratory rate of 16 breaths/min, and a temperature of 98.6°F. General examination and cranial nerve examination were normal. The lower extremities revealed soft compartments with significant muscular tenderness localized to the anterior, medial and lateral aspects of thighs bilaterally; distal perfusion was intact based on both normal pulses and capillary refill time. Neurologic examination was normal with the exception of bilateral symmetric quadriceps muscle strength of 4/5. There was no muscle atrophy. A mild erythematous maculo-papular rash was seen on the anterior aspect of both thighs. Gait was antalgic and waddling. Coordination was normal. Sensation was intact to light touch and pinprick. DIFFERENTIAL DIAGNOSIS: Exertional Rhabdomyolysis Dermatomyositis Muscular Dystrophy TEST AND RESULTS: On the day of admission, urine obtained for analysis was dip positive for the presence of blood and was negative therafter. Laboratory studies revealed normal complete blood count (including platelets), normal serum electrolytes, normal blood urea nitrogen (BUN) and creatinine (Cr), and normal antinuclear antibody (ANA) and dsDNA. Erythrocyte sedimentation rate (ESR) was 18 mm/hr. The levels of creatine kinase (CK) post exercise were: 35,596 U/L at 72 hrs; 41,050 U/L at 6 days; 10,583 U/L at 8 days; and 136 U/L at 18 days. FINAL/WORKING DIAGNOSIS: Exertional Rhabdomyolysis Mild Eczema TREATMENT AND OUTCOMES: IV hyperhydration and alkalinization with sodium bicarbonate Improvement of eczema with 1% hydrocortisone cream Discharged home with follow up labs after 3 days of inpatient treatment Physical therapy referral for a program of gradual reintroduction to strength training after normalization of muscle enzymes Guidance regarding judicious use of weight training was emphasized Discussed supervision of weight training sessions with school coach

Melanoma in situ of the oral mucosa in an adolescent with dysplastic nevus syndrome

We describe a case of melanoma in situ occurring on the oral mucosa in an adolescent male patient who has dysplastic nevus syndrome. This association has not been previously reported and is of interest both because of the rarity of melanoma involving the oral mucosa, particularly in childhood, and because of the lack of any previous reports of oral mucosal melanoma in association with the dysplastic nevus syndrome. (J Am Acad Dermatol 2000;42:844-6.)

Malrotated Gut Mimcking Gastric Out Let Obstruction in an Adolescent- A Case Report

Most of the patients with mal-rotated gut present in neonate and infancy either with acute strangulating obstruction or with recurrent episodes of sub-acute obstruction. Here an adolescent male patient of 17 years with mal-rotated gut presented with upper abdominal pain, vomiting after meal and loss of weight mimicking gastric out let obstruction. Because of rarity of the condition at this age, we are inspired to report this case. doi: 10.3329/taj.v18i1.3307 TAJ 2005; 18(1): 53-54