Differential Warmth Research Articles

Mature midline teratoma arising within a posterior thoracic myelomeningocele in an infant: A case report

Myelomeningocele can occur throughout the spinal axis but the area with the least common localization is the thoracic region which is uncommon. Rarely, these abnormalities coexist with a teratoma and only few reports of a teratoma arising from a myelomeningocele have been reported. Teratoma can also undergo malignant transformation to a non-germ cell malignancy. Here, we report an interesting case of a teratoma arising within thoracic myelomeningocele in an infant. A three month old girl born via vaginal delivery to two related Fulani parents presenting with upper back swelling noticed since birth. Pregnancy was claimed to be uneventful, mother never attended any antenatal clinic and delivery was at home. On examination patient was mildly dehydrated and malnourished. Status localis revealed an intact cystic midline upper back swelling measuring about 6x4cm, non-tender with no differential warmth. Radiographic evaluation was not done due to financial constraint. Grossly, three irregularly shaped firm to cystic to flabby tissues aggregating to 5x4x1.5cm, weighing 6g were received and microscopy revealed histologic features of a myelomeningocele with a teratoma having endodermal (respiratory epithelium, seromucinous glands) , ectodermal( skin) and mesodermal (cartilage) components.Teratoma is a germ cell neoplasm that contains differentiated elements derived from all three germ layers. The occurrence of a mature midline teratoma within a myelomeningocele is rare and what makes it even rarer is occurrence in the thoracic region. This can be confirmed by meticulous histopathologic evaluation.Myelomeningocele has variable prognosis based on localization and other accompanying abnormalities. Due to the risk of malignant transformation to non-germ cell tumours in teratoma, prompt histologic diagnosis and complete resection is important regardless of size of lesion and age of patient.

Parental differential warmth, hostility, and sibling differences in internalizing and externalizing behavior problems: A meta-analysis.

Parental differential treatment (PDT) of siblings is associated with differences in children's behavioral adjustment. The current meta-analysis examined the extent to which associations between relative PDT and sibling differences in behavior problems differ by type of parenting behavior (i.e., differential hostility vs. differential warmth) and type of behavior problems (i.e., differential externalizing vs. internalizing behavior problems). In September 2021, we systematically searched APA PsycInfo and Web of Science, yielding 2,259 unique hits with 19 eligible publications reporting on 215 effect sizes from 13 unique samples. The overall association between relative PDT (i.e., receiving less warmth and more hostility than one's sibling) and sibling differences in behavior problems was small but significant. Associations were stronger for differential hostility compared to differential warmth and for differential externalizing compared to differential internalizing behavior problems. Particularly marked was the finding that siblings who received more hostility from their parents showed higher levels of externalizing behavior problems. Future research investing in further dismantling the association between within-family PDT and sibling differences in adjustment is warranted to better understand why parents treat siblings differentially and to guide family support initiatives. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Parental Differential Warmth, Hostility, and Sibling Differences in Internalizing and Externalizing Behavior Problems: A Meta-Analysis

Supplemental Material for Parental Differential Warmth, Hostility, and Sibling Differences in Internalizing and Externalizing Behavior Problems: A Meta-Analysis

Acute Presentation of Upper Limb Ischemia Requiring Amputation: A Case Report

Peripheral Artery Disease (PAD) of the upper extremities is common. It is most often asymptomatic but may cause exertional pains, ischemic pains, gangrene or ulceration. The risk factors for PAD are smoking, obesity, hypertension, diabetes, hypercholesterolemia and end stage renal disease. Here the authors reported a case of 45-year-old male patient, presenting with severe aching type of pain associated with paraesthesia and numbness and blue, cold and gangrenous right forearm which was amputated below the elbow. After amputation, the condition advanced and led to weakness of the right upper arm with bone necrosis and surrounding skin was hyperaemic and oedematous with differential warmth, therefore the patient undergone amputation of the right upper arm and was managed postoperatively with antibiotics and the wound was closed with non absorbable sutures and was on oral anticoagulant therapy and after complete recovery, patient was discharged. On follow-up, removal of sutures was done and patient was referred for physiotherapy for muscle strengthening and prosthesis fitment.

Maternal differential treatment and child socioemotional competencies: A multi-informant longitudinal study of Chinese families

Research based on Western communities indicates that parents’ differential treatment may be linked to their children’s psychological and behavioral problems. Very little is known, however, about the potential implications of parental differential treatment for child socioemotional competencies or in non-Western communities. Focusing on families from Hong Kong, China, this multi-informant study tested the longitudinal associations of mothers’ differential warmth and conflict with their children’s socioemotional competencies and examined whether sibling dyad gender composition and age spacing moderated these associations. On two occasions about 12 months apart, data were collected from two children in each of 189 families and the mothers and class teachers of these children. At Time 1, older and younger children averaged 10.06 ( SD = 1.07) and 7.82 ( SD = 0.95) years of age, respectively, and 31% of older and 48% of younger children were boys. At Time 1, mothers provided demographic information and rated their warmth and conflict with each of their two children. At Times 1 and 2, teachers rated children on their emotion regulation, peer exclusion, and prosocial behaviors, and children rated their own empathy. Multilevel models revealed that, controlling for demographic factors, average mother-child relationships, and prior levels of competencies of children and their siblings, children who received less favorable treatment relative to their siblings exhibited decreases in socioemotional competencies over time. Sibling dyad gender composition and age spacing did not emerge as significant moderators, however.

Invasive cribriform carcinoma of the male breast

Male breast cancer is rare and it accounts for about 1 % of all breast cancers. Men of African and Jewish descent have higher risk of developing breast cancer. Invasive cribriform carcinoma of the breast, which has a good prognosis, is rarer particularly in male patients and only few cases have been reported in the literature. A young adult male presented with a painless, left breast mass of one-year duration at the surgical out-patient department of the Lagos University Teaching Hospital. On examination, a 24x16x6 cm mass, involving all four quadrants, attached to the overlying skin and underlying structure, was palpated in the left breast. It was non-tender and there was no differential warmth. Imaging studies revealed a Breast Imaging Reporting and Data System (BIRADS) IV lesion. On histopathology examination, an infiltrating carcinoma which was disposed in a cribriform pattern was seen. The neoplasm comprised of fairly monomorphic cells that exhibited increased nucleocytoplasmic ratio, moderate eosinophilic cytoplasm, vesicular nuclei and prominent nucleoli. Immunohistochemistry for estrogen receptor, progesterone receptor and HER-2 revealed a luminal A tumour. A diagnosis of invasive cribriform carcinoma of the breast was made. We report the first known case of invasive cribriform carcinoma of the breast in a male patient from Nigeria.

Deep neck infection and descending mediastinitis as lethal complications of dentoalveolar infection: two rare case reports

BackgroundWe report two cases of innocuous dentoalveolar infections which rapidly progressed to deep neck abscesses complicated by descending mediastinitis in a resource-constrained rural mission hospital in the Cameroon.Case presentationThe clinical presentations of a 35-year-old man and a 32-year-old woman both of Fulani origin in the Northern region of Cameroon were similar with submandibular fluctuant and tender swelling and differential warmth to palpation. The patients had tachycardia, high grade pyrexia, and normal blood pressure. Further physical and neurological examinations were unremarkable. An ultrasound scan of the neck swellings showed submandibular turbid collections. Plain chest radiographs confirmed empyema thoraces. Our patients had serial drainage of the neck abscesses as well as closed thoracostomy tube drainage which were connected to pleurovac and suctioning machines, with significant amount of pus drainage. Both patients were admitted to our intensive care unit for close monitoring. The first patient continued to make satisfactory clinical progress and was discharged by the fourth week of admission. The patient who had human immunodeficiency viral infection died on the fifth postoperative day.ConclusionsThe possibility of lethal complications and the associated morbidity and mortality portray this clinical entity as an important public health concern. Clinicians taking care of patients with dentoalveolar and oropharyngeal infections need to be sensitized to these potentially fatal complications. Alternatively, strategies to improve oral health and reduce the incidence of dental caries, the main cause of dental abscess, would maximize use of resources; especially in resources-constrained centers like ours in Banso Baptist Hospital.

Longitudinal Course and Correlates of Parents' Differential Treatment of Siblings in Mexican-Origin Families.

Parents' differential treatment (PDT) is a common family dynamic that has been linked to youth development and well-being, including adjustment problems and poor sibling relationships. Much less is known, however, about the developmental course of PDT and the conditions under which parents treat their children differently in adolescence and young adulthood. This study examined longitudinal changes in mothers' and fathers' differential warmth and conflict with their two offspring from early adolescence through young adulthood and examined parents' experiences of individual stress (depressive symptoms and role overload) and marital difficulties as time-varying correlates of (changes in) PDT. We also tested crossover effects to determine whether mothers' experiences of individual stress and marital difficulties were linked to fathers' differential treatment, and vice versa. Participants were mothers, fathers, and two siblings from 246 Mexican-origin families who were interviewed in their homes on three occasions over 8years. Multilevel models revealed that mothers' and fathers' differential conflict with their two children increased until middle adolescence and then declined into young adulthood, but there were no changes over time for parents' differential warmth. In general, both mothers' and fathers' levels of differential treatment were exacerbated by their own experiences of individual stress and marital difficulties and also by the experiences of their spouses. However, in some cases, greater stress than usual was linked to less differential treatment than usual.

Hereditary multiple exostoses in a 15-year-old boy: A case report and review of literature

Background: Hereditary Multiple Exostoses (HME) is a rare bone disease, usually associated with deformity and pressure symptoms. It is an autosomal dominant disorder characterized by the development of benign tumours growing outward from the metaphyses of long bones and can lead to considerable psychosocial problems. This paper aims at reporting a case of HME with some peculiar features. Methods: A case report of a 15- year-old Nigerian male with Hereditary Multiple Exostoses is presented to highlight the clinical, radiological features and management challenges of the condition. Results: The patient presented with multiple hard, bony and ridge-like growth along the spine, scapula and para-vertebral region which gradually increased in size. These swellings were non-tender, not attached to the overlying skin and immobile, had no differential warmth and appeared to be continuous with the underlying bony structures. A striking feature was exostoses that extended from the lumbar spine towards the left scapula. He also had brachymetatarsia of the first ray of both feet. Skeletal survey confirmed the diagnosis. Conclusion: Though rare, HME do occur in our environment. The treatment is individualized, with small asymptomatic or minimally symptomatic lesions followed up and only supportive care provided. Larger symptomatic lesions may cause major physical handicap and may be resected. Keywords: Hereditary, Multiple, Exostoses, Deformity

Post Circumcision Penile Epidermal Inclusion Cyst: A Case Report

Post circumcision penile epidermal inclusion cysts are rare and few cases have been reported worldwide. A five year old boy presented with a complaint of a mass located at the dorsal aspect of the penis along the circumcision scar. The mass was noticed few weeks after circumcision. On examination the mass was located at the dorsal aspect of the penis proximal to the coronal sulcus along the circumcision scar and measured about 1cm × 1.5cm. It was oval in shape with no differential warmth and non tender. The mass was smooth, firm, mobile and with well defined edges. The overlying skin was normal with no punctum. The mass was excised under general anaesthesia. Histologic sections show an attenuated cystic structure, lined by stratified squamous epithelium containing keratin debris and amorphous material. Histologic diagnosis was epidermal inclusion cyst. Post circumcision epidermal inclusion cyst is usually easy to diagnose from history and physical examination. Complete total excision is usually curative and prevents recurrence.

Non-Hodgkin′s lymphoma "masquerading" as Pott′s disease in a 13-year old boy

Lymphomas are malignant neoplasms of the lymphoid lineage. They are broadly classified as either Hodgkin disease or as non-Hodgkin lymphoma (NHL). Burkitt's lymphoma, a variety of NHL, is significantly most common in sub-Saharan Africa, where it accounts for approximately one half of childhood cancers. Lymphoblastic lymphoma is less common. A case of paravertebral high grade non-Hodgkin's lymphoma (lymphoblastic lymphoma) “masquerading” as Pott's disease in a 13-year-old child is reported. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief appraisal is provided of the clinical parameters, management strategies and challenges. AT was a 13-year boy that presented on account of a slowly evolving and progressively increasing hunch on the back and inability to walk over 4 and 8 months duration, respectively. There was subsequent inability to control defecation and urination. There was no history of cough. He and his twin brother lived with their paternal grandfather who had chronic cough with associated weight loss. The grandfather died shortly before the child's admission. The child had no BCG immunization. The essential findings on examination were in keeping with lower motor neurons (LMN) paralysis of the lower limbs. The upper limbs appeared normal. There was loss of cutaneous sensation from the umbilicus (T10) downward. There was a firm, (rather tense), non-tender non-pulsatile, smooth swelling over the mid-third of the back (T6-L1) the mass had no differential warmth. It measures about 20×12 cm. Chest radiograph showed no active focal lung lesion, but the thoraco-lumbar spine showed a vertebral planner at L1 and a wedged collapse of T11-T12 vertebrae. There was sclerosis of the end plates of all the vertebral bodies with associated reduction in the bone density. He had an excision biopsy on the 90th day on admission, following which his clinical state rapidly deteriorated. He died within 48 h post surgery. This report aims at raising the local index of clinical suspicion by highlighting the reality of rarities, even in the presence of inadequate diagnostic facilities!

Warmth with mothers and fathers from middle childhood to late adolescence: Within- and between-families comparisons.

The authors examined siblings' dyadic and differential experiences of parental warmth from 7 to 19 years of age. Participants were first- and second-borns from 201 families who reported on their warmth with each parent in 4 home interviews spaced over 5 years. Supporting an individual development hypothesis, multilevel model analyses revealed declines in parental warmth from early through midadolescence but no changes or increases in warmth in middle childhood and later adolescence. Consistent with a learning-from-experience hypothesis, declines in paternal warmth were less pronounced for second-borns than for firstborns. The results also suggest gender intensification in differential warmth for parents of mixed-gender sibling dyads. Within-family comparisons of youth provide unique insights about family relationship development.

Editorial

Editorial

Congruence between mothers' and fathers' differential treatment of siblings: links with family relations and children's well-being.

We studied patterns of mothers' and fathers' differential treatment of firstborn (average age 10.5 years) and secondborn (average age 8 years) school-age siblings, and we examined the links between parents' differential treatment and children's well-being and dyadic family relationships. Mothers, fathers, and both siblings in 110 families were interviewed in their homes. For each dimension of parental behavior that we assessed (i.e., differential affection and discipline) we created groups of families that reflected mothers' and fathers' levels of differential treatment (e.g., discipline the firstborn more, equal treatment, discipline the secondborn more). Although we detected substantial correspondence between the 2 parents' differential treatment, we found a sizable group of families in which parents' reports were incongruent (i.e., 1 parent reported equal and the other differential treatment). Parental patterns were linked to differences between the siblings' well-being and both sibling and parent-child relationships, with younger siblings exhibiting greater vulnerability to differential treatment. Incongruence in differential warmth was associated with marital distress.