Healthy Woman Research Articles

Sudden loss of consciousness due to artery of Percheron infarction

Acute cerebral infarction due to occlusion of the artery of Percheron (AOP) is rare and poses a diagnostic challenge due to unspecific clinical symptoms. A prompt diagnosis and treatment is vital due to a potentially very serious outcome. Here we represent a healthy young woman who developed sudden headache and loss of consciousness. At admission she was unconscious with GCS of 4, pupils were unevenly dilated and poorly reactive and the plantar reflex was upward bilaterally. She had seizure like movements in all limbs. CT of brain and CT angiography were normal but acute MRI showed bilateral paramedian thalamic diffusion restriction. The patient was treated with i.v. thrombolysis (tPA) 70 minutes after hospital arrival and recovered fully.

April 2021 Critical Care Case of the Month: Abnormal Acid-Base Balance in a Post-Partum Woman

No abstract available. Article truncated after first page. History of Present Illness: A 29-year-old healthy woman, who is 8 weeks postpartum, presented to the emergency department with severe shortness of breath, fast shallow breathing, nausea, several episodes of nonbloody nonbilious emesis, abdominal pain and malaise for 1 week. The patient delivered a healthy boy at full-term by spontaneous vaginal delivery. Her pregnancy was uneventful. She denied smoking or use of alcohol. Physical Exam: On presentation to the emergency department her blood pressure was found to be 121/71, temperature 36.8°C, pulse 110 beats per minute, respiratory rate 20 breaths per minute and SpO2 saturation of 99% while breathing ambient air. Physical exam was remarkable except for dry mucous membranes, sinus tachycardia, and tachypnea with mild epigastric tenderness with light palpation. Which of the following should be done? 1. Complete blood count (CBC) 2. Metabolic panel 3. Chest x-ray 4. Arterial blood gases (ABGs) 5. All of the above …

Nocardia keratitis following corneal cross linking for keratoconus

We report a case of Nocardia keratitis following corneal cross-linking for progressive keratoconus. A 26-year-old otherwise healthy woman underwent crosslinking for keratoconus in her left eye. She presented with corneal infiltrates with a wreath-like pattern, on the seventh postoperative day. Gram's and acid-fast staining revealed Nocardia. She was managed with topical fortified amikacin 2.5% eye drops. The keratitis resolved to leave dense vascularization which was managed with topical prednisolone 1% eye drops.

Heart Rate Variability Analysis and The Influence of Exercise Intensity Over Time in Young-healthy Women

Our heart is a vital organ that pumps blood and through the vessels of the circulatory system. In medical applications, we can observe the heart rate using Electrocardiograph (ECG). Currently, people tend to have high working activity without a proper exercise intensity. This study was conducted to observe the heart rate variability (HRV) on the healthy young woman who was not doing any exercise. We evaluated the HRV characteristics while exercising with a regular period and different intensity (light to hard) and how the difference before and after of evaluation period. Seven young-healthy women (19 - 21 years old) women were observed during three observation stages: pre-exercise, main exercise-period, and post-exercise for 2 months. We analyzed MeanRR, SDRR, CVRR, rMSSD, VLF, LF, HF, and the Poincaré plot parameters (SD1 and SD2) as the HRV properties. We found that SDRR was decreased from the first week (0.08 s) to the last week of the evaluation period (0.03 s) followed by the HF component (0.15 – 0.2 Hz). The Poincaré plot properties also reduced from the first week to the last week of the exercise period (0.07 s to 0.03 s). We indicated the characteristics of a woman's HRV during regular exercise periods with different intensity have made the heart more effective in pumping blood. We concluded that the heart condition would be improved during regular exercise with the increment of intensity even in a short of a period. Finally, the heart rate performance may be decreased during absent from regular exercise for a month.

Meghan Markle's healthy lifestyle in the media: Multiracial exceptionalism and the cult of slimness

This paper examines how media representations of Meghan Markle's healthy lifestyle perpetuate concepts of good femininity rooted in racialized norms. Simone de Beauvoir's concept of ‘cultural myths of femininity’ and Patricia Hill Collins's theory of ‘controlling images’ offer a framework for analyzing how mainstream health and lifestyle media promote and normalize white, bourgeois ideals of femininity. A study of 20 articles published in American and British magazines or on their websites reveals how lifestyle and health media extoll Markle as an example of a healthy and prosperous woman, thereby presenting her as what Ralina Joseph calls an ‘exceptional multiracial’. These articles promote a cult of slimness entrenched in a racist opposition between slender white women and fat Black women. ‘Multiracial exceptionalism’ further exacerbates the implicit racism in these texts.

Delayed diagnosis of dilated thyrotoxic cardiomyopathy with coexistent multifocal atrial tachycardia: a case report

BackgroundThyroid storm (TS) is a rare but potentially life-threatening sequelae of untreated or undertreated hyperthyroidism. While TS frequently causes high-output heart failure, low-output heart failure related to dilated cardiomyopathy (DCM) is extremely rare. Tachycardia is a common clinical presentation of TS, and β1-selective blockers are the first-line agents for treating TS-associated tachycardia. However, given that β-blockers have negative chronotropic and negative inotropic effects, amiodarone may be safe and effective for the treatment of TS-induced tachyarrhythmia in patients with moderate to severe heart failure. While long-term amiodarone administration causes hypothyroidism, or less frequently, hyperthyroidism, little is known about the effects of short-term amiodarone administration on thyroid function.Case presentationA 31-year-old healthy woman presented with worsening dyspnoea. She was tachycardic with multifocal atrial tachycardia (MAT) of 184 beats/min, confirmed by electrocardiogram. Echocardiographic findings were consistent with DCM, with an ejection fraction of 20%. Thus, she was initially diagnosed with acute heart failure due to DCM with coexistent MAT. Tachycardia persisted despite cardioversion attempts and treatment with multiple anti-arrhythmic drugs. Consequently, she rapidly progressed to cardiogenic shock and respiratory decompensation, which required intubation and an intra-aortic balloon pump support. Moreover, the undiagnosed Graves' disease, lack of suspicion, and postponed analysis of thyroid function tests led to a delayed diagnosis of TS. Amiodarone, which was initiated for MAT, unexpectedly ameliorated thyrotoxicosis, resulting in a euthyroid state and the patient’s significantly improved condition and cardiac function. She was discharged on day 40. Finally, she underwent total thyroidectomy; thyroid pathology was consisting with Graves' disease. Her postoperative course was uneventful.ConclusionsHerein, we describe a case of delayed diagnosis of dilated thyrotoxic cardiomyopathy with coexistent MAT. The patient required intensive care due to the catastrophic sequelae and was successfully treated with amiodarone. This is the first case report of TS-associated MAT and highlights the clinical importance of high suspicion of TS in de novo heart failure with any tachyarrhythmia or DCM of unknown etiology and the potential effects of short-term amiodarone administration in the treatment of TS.

Sinusoidal pattern: a key to a rare case of fetal anaemia

A 35-year-old healthy pregnant woman, A+ blood type, with a history of one vaginal childbirth appeared at the emergency department for reduced fetal movements (RFM). She was 37-week pregnant and...

Atrioventricular block after COVID-19: What is the mechanism, site of block, and treatment?

A 49-year-old healthy woman presented with exertional shortness of breath and palpitations of 3 months’ duration. Baseline electrocardiogram (ECG) was normal. Figure 1 shows selected tracings recorded during treadmill stress testing. Transthoracic echocardiogram showed no structural abnormalities. Cardiac positron emission tomogram showed normal myocardial perfusion and no abnormal fluorodeoxyglucose uptake. Antibody titers for Lyme disease were undetectable. Figure 2 shows selected tracings from an invasive electrophysiological (EP) study.

COVID-19 survivor experiencing long-term symptoms

COVID-19 survivor experiencing long-term symptoms

Pregnancy Anxiety and Associated Factors in Pregnant Women

Background: Pregnancy anxiety that threatens maternal mental health has a negative impact on pregnancy outcomes and can develop even in a healthy pregnant woman with no depression or anxiety problems. Objectives: The purpose of the present study was to investigate pregnancy anxiety and its related factors in pregnant women. Methods: This cross-sectional descriptive-analytical study was performed on 322 pregnant women who were registered at health centers from November 2018 to March 2018. A random sampling method was applied to select eight health centers in the city. Using the SIB system, 40 pregnant women were randomly selected in each center. Selected women who came to health centers to receive prenatal care filled out the revised version of the Farsi anxiety scale for pregnancy (F-ASP-R). Inclusion criteria were, having the ability to read and lack of psychological disorders requiring treatment. Data were analyzed by SPSS software version 18 and student t-test, analysis of variance, and multiple regression analyses. Results: The mean score of the F-ASP-R was 32.63 ± 8.9 out of 56, and 49.7% of the study participants scored below the average. Cronbach’s alpha coefficient for the F-ASP-R was 0.867. Multiple regression analyses showed that unwanted pregnancy (P = 0.008), a history of hospitalization in pregnancy (P = 0.044), lack of knowledge about analgesia during labor (P = 0.019), a history of dysmenorrhea (P < 0.001), poor spousal emotional support (P = 0.001), and perceived poor health (P < 0.001) were independent risk factors of pregnancy anxiety. Conclusions: Intervention is necessary to reduce pregnancy anxiety in women with an unwanted pregnancy, a history of dysmenorrhea or hospitalization in pregnancy, poor spousal emotional support, and perceived poor health.

Negativibacillus massiliensis gen. nov., sp. nov., a New Bacterial Genus Isolated from a Human Left Colon Sample

A new genus, a member of the Ruminococcaceae family, was isolated from the left colon of a healthy woman. Strain Marseille P3213 was a non-motile, spore-forming, Gram-stain negative, rod-shaped bacterium. This strictly anaerobic species reached optimal growth after an incubation of 72 h at 37 °C. The 16S rRNA gene sequence of this strain shared a 93.52% similarity level with Harryflintia acetispora strain V20-281a, its closest phylogenetic neighbor with standing in the nomenclature. Its genome had a size of 2.87 Mb, with a 45.81% G + C content. We hereby propose the creation of Negativibacillus massiliensis strain P3213T as the 43rd genus within the Ruminococcaceae family.

Transpalpebral Superolateral Orbitotomy for Orbital Cavernous Hemangioma Extirpation: 2-Dimensional Operative Video.

Cavernous hemangiomas of the orbit are low-pressure vascular tumors. Usually benign, they become symptomatic by the local mass effect, pushing the eyeball forward, causing exophthalmia, by oculomotor muscle and nerve compression causing diplopia or by optic nerve compression, leading to visual impairment. Radiotherapy is of limited value in their treatment because of the fragility of the optic nerve and subsequent blindness risk. Surgery remains the gold standard and definitive treatment. We illustrate in this video a transpalpebral superolateral orbitotomy and extirpation of an orbital cavernous hemangioma. A 52-yr-old healthy woman was sent for neurosurgical consultation by her ophthalmologist. She described a history of progressive unilateral right exophthalmia in the last months. A cerebral magnetic resonance imaging (MRI) revealed a 2.5-cm-large orbital lesion located superiorly and laterally to the eyeball. Surgery was proposed and accepted by the patient. The frontozygomatic component of the orbital rim needed to be removed to safely extirpate the cavernous hemangioma without exerting unnecessary and risky pressure on the eyeball.1,2 We decided to go for a superolateral orbitotomy via a transpalpebral incision.3 Total removal of the lesion was achieved with no complication. Exophthalmia normalized. Written patient consent was obtained for use and publication of their image after complete information. The patient consented to the surgery.

An unusual cause of fever and jaundice

A 52 year old previously healthy woman from Mumbai presented with fever and jaundice of 10 days duration. At admission, she was jaundiced with tachycardia, tachypnea, hypoxia, hypotension, conjunctival congestion and mild erythematous flush over the skin. She had very high WBC counts and CRP's with direct hyperbilirubinemia and azotemia. Investigations for infectious causes of fever were negative. RT-PCR for SARS-CoV-2 in the nasopharynx was negative. However her SARS-CoV-2 antibodies were reactive. She also had echocardiographic and biochemical evidence of cardiac dysfunction. The diagnosis of Multisystem inflammatory syndrome–Adult (MIS-A) was thus established. She rapidly improved with intravenous immunoglobulin (2 gm/kg) and high dose steroids.

A Case Report of Cellulitis of the Mouth Floor Presenting as Necrotizing Fasciitis

Cellulitis of the mouth floor can seldom be complicated by necrotizing fasciitis. Cellulitis of the mouth floor that has been identified in association with necrotizing fasciitis tends to arise in cervicofacial region of patients who have predisposing factors. But this article describes a rare case of cellulitis of the mouth floor causing necrotizing fasciitis in a healthy woman. The clinical features, diagnosis, and treatment are discussed in detail.

A clinical pilot study on the effect of the probiotic Lacticaseibacillus rhamnosus TOM 22.8 strain in women with vaginal dysbiosis

Lactobacilli with probiotic features play an essential role in maintaining a balanced vaginal microbiota and their administration has been suggested for the treatment and prevention of vaginal dysbiosis. The present study was aimed to in vitro and in vivo investigate the probiotic potential of the Lacticaseibacillus rhamnosus TOM 22.8 strain, isolated from the vaginal ecosystem of a healthy woman. For this purpose, safety and functional properties were in depth evaluated. The strain exhibited a broad spectrum of antagonistic activity against vaginal pathogens; adhesion capacity to both the vaginal VK2/E6E7 and the intestinal Caco-2 cells; anti-inflammatory and antioxidant activities, suggesting its promising probiotic features. In addition, an in vivo pilot-study was planned. Based on both clinical and microbiological parameters, the oral or vaginal strain administration, determined a significant pathogens reduction after 10 days of administration and a maintenance of eubiosis up to 30 days after the end of the treatment. Therefore, the L. rhamnosus TOM 22.8 strain can be proposed as valuable oral and/or vaginal treatment for vaginal dysbiosis.

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth.

SummaryWe present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect.Learning pointsHVPTC is an aggressive variant of PTC, usually associated with radioactive iodine refractoriness, and a higher mortality rate compared to classic PTC. However, there is a marked individual variability in this association.HVPTC usually appears as small unifocal lesion but a multinodular goiter presentation may occur.The present case highlights that despite of the histology, our patient achieved a high ablation success rate after radioactive iodine therapy.

Takotsubo Syndrome Associated with Isolated Hyponatremia: Case Report

Background: Electrolyte disorders have been exceptionally associated with the development of takotsubo syndrome (TTS). Case Presentation: A 73-year-old healthy and active woman was admitted to the Emergency Department for acute dyspnea and chest pain. She had no medical history, except for arterial hypertension successfully controlled by lisinopril. Laboratory investigations revealed marked and isolated hyponatremia, consistent with a syndrome of inappropriate antidiuretic hormone (SIADH) secretion. The diagnosis of takotsubo syndrome (TTS) was based on the echocardiogram and coronary angiography findings. Conclusion: Lisinopril appeared to be the most likely triggering factor of SIADH and hyponatremia, possibly deepened by a recent and transient increase of water intake. The mechanism linking hyponatremia and TTS is not fully understood.

Draft genome and description of Microvirga mediterraneensis strain Marseille-Q2068T sp. nov., a new bacterium isolated from human healthy skin

In 2019, by culturing a skin swab from the forehead of a 70-year-old healthy woman via the culturomics method, we isolated the new bacterial strain Marseille-Q2068T (= CSUR-Q2068). Matrix-assisted desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) failed to identify this isolate. Analysis of the 16S ribosomal RNA gene and genome-to-genome comparison suggested that this taxon belongs to a novel bacterial species within the family Methylobacteriaceae in the phylum Proteobacteria. We describe here its main phenotypic characteristics, genome sequence and annotation of Microvirga mediterraneensis strain Marseille-Q2068T, a new member of the Microvirga genus, which we propose as the type strain.

Draft genome and description of Mixta mediterraneensis strain Marseille-Q2057T sp.nov., a new bacterium isolated from human healthy skin

In 2019, by culturing a skin swab from the hand of a 30-year-old healthy woman using the culturomic method, we isolated the new bacterial strain Marseille-Q2057T (= CSUR-Q2057). Matrix-assisted desorption–ionization time-of-flight mass spectrometry (MALDI-TOF MS) failed to identify this isolate. Analysis of the 16S rRNA gene and Genome-to-Genome comparison suggested that this taxon belongs to a novel bacterial species within the family Erwiniaceae, phylum Proteobacteria. We describe here its main phenotypic characteristics, genome sequence and annotation of Mixta mediterraneensis strain Marseille-Q2057T, a new member of the Mixta genus, that we propose as type strain.

Severe orthostatic hypotension in otherwise uncomplicated Plasmodium vivax infection

Impaired autonomic control of postural homeostasis resulting in orthostatic hypotension has been described in falciparum malaria. However, severe orthostatic intolerance in Plasmodium vivax has been rarely reported. A case of non-immune previously healthy Thai woman presenting with P. vivax infection with well-documented orthostatic hypotension is described. In addition to oral chloroquine and intravenous artesunate, the patient was treated with fluid resuscitation and norepinephrine. During hospitalization, her haemodynamic profile revealed orthostatic hypotension persisting for another three days after microscopic and polymerase chain reaction confirmed parasite clearance. Potential causes are discussed.