Teenage Patient Research Articles

What is causing this patient's urticaria?

This article describes a teenage patient who was referred to a pediatric endocrinologist after her workup for recurring urticaria revealed a suppressed thyroid-stimulating hormone level and positive microsomal thyroid peroxidase antibodies. The patient's laboratory results revealed an autoimmune cause for the urticaria as a result of new-onset autoimmune thyroid disease.

Solitary rectal ulcer syndrome in a teenage patient, an unrecognized cause of rectal bleeding: A case report

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De-escalation of the Agitated Pediatric Patient: A Standardized Patient Case for Pediatric Residents.

Over the past 5 years, pediatric mental health emergencies requiring emergency safety evaluations and inpatient boarding of pediatric patients requiring psychiatric admission have increased. Pediatric trainees must learn to effectively and safely de-escalate a patient with agitated or aggressive behavior, as mental health patients take up a larger proportion of their patient population. This standardized patient case addresses gaps in knowledge and skills to ameliorate the care of children and adolescents with behavioral crises in the hospital. Resident learners were presented with a teenage patient admitted to the hospital and awaiting inpatient psychiatric placement for suicidal ideation who became acutely agitated with aggressive behaviors. Learners were expected to attempt to verbally de-escalate the patient and select an appropriate pharmacologic agent for decreasing agitation in the patient. A standardized debrief was conducted with the assistance of child and adolescent mental health experts. Twenty-two learners participated in this activity. Residents' confidence in their management skills of the acutely agitated pediatric patient significantly increased after completion of the activity. Seventy-three percent of learners felt confident or very confident in their de-escalation skills at the end of the case, and 86% agreed that the case improved their confidence in managing acute agitation scenarios on the inpatient wards. This case led to overall increased self-efficacy in caring for the acutely agitated pediatric patient. Future iterations may include multidisciplinary learners of various skill levels and evaluating changes in patient-centered outcomes, such as restraint use, after implementation of the case.

Ranula Plunging Cervical Approach a Case Report

Background: Ranulas are pseudocystic lesions resulting from an obstruction or disruption of the sublingual gland duct. They may be of congenital origin or occur secondary to immunological disorders, sialolithiasis, trauma or tumor lesions. The symptoms they cause may be pain or difficulty when speaking or swallowing. Treatment is removal or sclerosis of the pseudocyst. In the present work we present the case of a teenage patient with a ranula that extends to the right submandibular region. A cervicotomy was indicated that allowed the total resection of the ranula simultaneously with the sublingual and submandibular glands without affecting the hypoglossal and marginal nerves mandibular or lingual.

Treatment of AICA ribosiduria by suppression of de novo purine synthesis

AICA ribosiduria is an ultra-rare disorder of de novo purine biosynthesis associated with developmental delay of varying severity, seizures, and varying degrees of visual impairment due to chorioretinal atrophy. Caused by biallelic pathogenic variants in ATIC, accumulation of AICA-riboside is the biochemical hallmark and presumed pathomechanism of the condition. In this study, we report the case of a teenage patient compound-heterozygous for the variants c.1277 A > G (p.K426R) and c.642G > C (p.Q214H) in ATIC, with the latter not previously reported. Excessive secretion of AICA-riboside and succinyladenosine was significantly reduced following the introduction of a purine-enriched diet. By suppressing de novo purine biosynthesis in favour of purine salvage, exogenous purine substitution represents a promising treatment approach for AICA ribosiduria. SynopsisSuppression of de novo purine biosynthesis by increased exogeneous purine supply leads to decreased accumulation of AICA-riboside and succinyl-adenosine and thus is a promising treatment approach for AICA ribosiduria.

Constitutional mismatch repair deficiency syndrome as a cause of numerous malignancies in a teenage patient - a case report

Constitutional mismatch repair deficiency syndrome as a cause of numerous malignancies in a teenage patient - a case report

Implantation of a large self-expanding pulmonary valve using the jugular vein approach in a teenage patient.

Implantation of a large self-expanding pulmonary valve using the jugular vein approach in a teenage patient.

Catheter-directed therapy for treatment of acute pulmonary embolism in a teenage patient: The role of close cooperation between the Pulmonary Embolism Response Team and pediatric physicians.

Catheter-directed therapy for treatment of acute pulmonary embolism in a teenage patient: The role of close cooperation between the Pulmonary Embolism Response Team and pediatric physicians.

A case of manifestation of acute myeloid leukemia in a teenager on the background of coronavirus infection COVID-19

This clinical case describes the manifestation of acute myeloid leukemia (AML) against the backdrop of severe COVID-19 infection in a teenage patient. The patient’s examination data, medical history, and available scientific literature on the relationship between COVID-19 and leukemia manifestation were studied and analyzed. COVID-19 infection in the context of AML was severe, with respiratory failure and involvement of more than 90% of the lungs according to computed tomography data. Changes observed in peripheral blood did not have specific alterations and only indirectly indicated an unfavorable premorbid background. This clinical case reflects the likelihood of the simultaneous presence of COVID-19 and other acute severe illnesses.

Interdisciplinary Oral Rehabilitation of a Teenage Patient with Down Syndrome: A Case Report

Abstract This case report aimed to share the dental rehabilitation of a teenage patient with Down Syndrome who applied to our clinic with aesthetic complaints and to provide a guide to dentists on the treatment options of young syndromic patients with various dental problems.The clinical and radiographic examination of a 17-year-old male patient with Down Syndrome, who applied to the University of Health Sciences, Gülhane Department of Prosthodontics, with aesthetic complaints, revealed the necessity of occlusion regulation and the restoration of the existing teeth. Aesthetic need was taken into consideration and a treatment plan was made with the Department of Pediatric Dentistry. After the extraction of the patient's hopeless teeth, the missing teeth were corrected with a fixed partial denture, taking into account the patient's wishes. Onlay restorations made of 3D printed resins are planned for teeth that remain in infraocclusion. It was planned to restore anterior maxillary teethwith strip crowns in order to achieve aesthetics, and after the root canal treatment Finally, premolar forms were created for the maxillary permanent canine teeth with strip crowns to support the occlusion.The treatment of our patient was completed, and his function and phonation were maintained, as well as achieving the aesthetic he dreamed of.

Severe KIDAR syndrome caused by deletion in the AP1B1 gene: Report of a teenage patient and systematic review of the literature

Autosomal recessive keratitis-ichthyosis-deafness syndrome (KIDAR MIM #242150) is a very rare disorder caused by pathogenic loss-of-function variants in the AP1B1 gene. So far, nine patients have been reported in the literature and more clinical descriptions are essential to further delineate the phenotype of KIDAR. Here we report a new patient with KIDAR and compare the clinical findings with those from the other published cases with molecular confirmation.We describe a 14-year-old male born to non-consanguineous parents with unremarkable family history. The patient had fetal ascites, neonatal pancreatic insufficiency with consequent failure to thrive, feeding difficulties, recurrent infections and sepsis. The skin examination was remarkable for an ichthyosis with conspicuous palmoplantar keratoderma, sparse and brittle hair with alopecia on the vertex and slight bilateral ectropion. He had short stature, thin build, frontal bossing, small teeth and prominent abdomen. Additional features were congenital profound bilateral sensorineural deafness, photosensitivity and photophobia. Mild global developmental delay was noted. Persistent mild anemia, neutropenia, thrombocytopenia, and low serum copper, ceruloplasmin and growth hormone were also present. Brain magnetic resonance imaging (MRI) showed cerebral atrophy and thin corpus callosum. Genetic testing revealed a homozygous deletion in the AP1B1 gene, possibly including the same exons as a previously reported deletion.Comparing the phenotypes of all reported individuals, they are highly concordant and major features are enteropathy with feeding difficulties, failure to thrive, ichthyosis, palmoplantar keratoderma, sensorineural deafness and sparse and brittle hair. Here we report other features present in more than one patient that could be part of the phenotypic spectrum and suggest copy number variation analysis to be performed alongside sequencing of the AP1B1 gene in case of suspicion.

Catatonia.

In this poem, the author/doctor describes a female teenage patient with catatonia. The author asks her what she is thinking of. Her mother delays among the sleepers in the waiting room, touches the author's sleeve, blessing the faint music, fleet as hope. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Policies Affecting Pregnant Women with Substance Use Disorder

Policies Affecting Pregnant Women with Substance Use Disorder

Sub-mandibular soft tissue myxoma in a teenager patient

Sub-mandibular soft tissue myxoma in a teenager patient

59. An unusual finding of an ameloblastoma associated with an ectopic canine in a teenage patient: A case report

Ameloblastomas are the most common odontogenic neoplasms of the jaws, unicystic subtypes forming the minority. Despite their benign nature and slow growth, ameloblastomas in the maxilla have the potential to invade the cranial base, becoming locally aggressive and fatal. The single well-defined cavity resembles a dentigerous cyst in many cases, posing a considerable diagnostic challenge.

Successful desensitization in a patient with adalimumab hypersensitivity

Adalimumab is a fully-humanized monoclonal antibody against tumor necrosis factor alpha (TNF-α) that is used to suppress the immune response. Though rare, hypersensitivity reactions to adalimumab can occur. Desensitization protocols have been developed to safely administer many medications in patients with Type I and Type IV hypersensitivity reactions. This case describes a teenage patient with Crohn's Disease who developed a delayed pruritic urticarial rash hypersensitivity reaction to adalimumab. A novel desensitization protocol was developed based on available literature. Our protocol consisted of four weekly doses, with the first dose in seven steps, second dose in two steps, and two full doses at weekly intervals, before spacing to biweekly injections. This multipart protocol was necessary due to the long half-life of adalimumab, which also allows for maintenance of the desensitized state in between injections. This protocol successfully treated our patient's hypersensitivity to adalimumab, with no further hypersensitivity occurring over a two-year follow-up period.

EOSINOPHILIC CYSTITIS IN A PEDIATRIC PATIENT WITH X-LINKED CHRONIC GRANULOMATOUS DISEASE

<h3>Introduction</h3> Pediatric Eosinophilic Cystitis is an uncommon inflammatory disease associated with X-linked Chronic Granulomatous Disease (X-CGD)¹. We present a rare case of a teenage patient with refractory eosinophilic cystitis. <h3>Case Description</h3> Patient is a 14-year-old male with X-CGD, colitis, and complications from chronic steroid use, including bilateral cataracts, osteoporosis, and adrenal insufficiency. His colitis was well-controlled with vedolizumab when he presented for evaluation of new onset dysuria and intermittent scrotal pain that improved with voiding. Infectious workup was unrevealing. CT of abdomen and pelvis demonstrated asymmetric, irregular thickening, nodularity and enhancement of the left bladder wall and bladder base. Pathology from cystoscopy was significant for scattered eosinophils, suspicious for eosinophilic cystitis. He demonstrated mild peripheral eosinophilia (0.63 K/µL). He was started on intravesical dexamethasone 10mg, to minimize complications from systemic steroid use, and oral loratadine 5mg on intravesical treatment days. However, his symptoms did not resolve and intravesical dexamethasone was increased to 25mg then to 50mg. Loratadine was increased to 10mg daily. His bladder ultrasound normalized after 12 doses of intravesical dexamethasone and daily 10mg loratadine. Three weeks after loratadine was weaned to every other day, his urinary symptoms returned. Loratadine was increased to 10mg daily and he remained asymptomatic off steroids. <h3>Discussion</h3> Reported cases of pediatric eosinophilic cystitis are mostly in young children, only requiring a short course of intravesical steroids and oral antihistamine, unlike our patient^2,3. More research is needed to elucidate the history, optimal diagnosis and guide appropriate management of eosinophilic cystitis in pediatric X-CGD patients.

Lemierre's syndrome: A rare cause of multifocal infection in an adolescent

Lemierre's syndrome is a rare disease characterized by septic thrombophlebitis of the internal jugular vein with septic emboli causing multifocal infection. This syndrome is most commonly seen after an upper respiratory tract infection in the adolescent population. We present a case of a teenage patient diagnosed with Epstein-Barr Virus (EBV) who presented to our tertiary care facility in multisystem organ failure with initial findings concerning for necrotizing fasciitis of the retroperitoneum. The patient underwent surgical debridement with frank purulence in the retroperitoneal space and emphysematous osteomyelitis of the right ilium. F. necrophorum was isolated from surgical specimens which led to the suspicion of Lemierre's syndrome. Further work up revealed internal jugular vein thrombosis, as well as multifocal inoculation with infection in the ankle, hip, chest, and neck confirming the clinical diagnosis. Lemierre's syndrome is associated with significant morbidity and can be fatal if not promptly recognized and treated. Therefore, early identification is essential to providing appropriate medical and surgical care.

Diagnostic difficulties in the diagnosis of high acute-phase proteins levels in a teenage drug addicted female patient

BackgroundYouth drug addiction is a significant social and health problem. Symptoms of the disease include a number of neurological, gastrointestinal and cardiovascular disorders. Possible hormonal disorders and dysregulation of the immune system could also occur.Case presentationWe describe a case of a teenage patient with multiple diseases such as esophagitis, allergic disease, and numerous behavioral disorders leading to: self-injury of the body, suicide attempts by drugs overdosing, and experimentation with various psychoactive substances (morphine, amphetamine, methamphetamine, codeine). She was also diagnosed with bipolar disorder. A few hours before the admission to the ward, the patient had an intravenous injection of drugs. Toxicological tests confirmed the presence of amphetamine, ecstasy and opioids in the blood and urine. Laboratory tests revealed extremely increased inflammatory parameters, leucopenia, increased levels of IgG, IgA and IgE (total) immunoglobulins, low concentration of vitamin D. Bacteriological examinations were negative. General condition of the patient got better very quickly, antibiotic therapy was abandoned on the 4th day. It was concluded that the cause of the elevated concentration of acute-phase proteins was most likely caused by intoxication with psychoactive drugs.ConclusionsThe discussed case shows the difficulties of differential diagnosis in a teenage patient struggling with many diseases, who has been abusing drugs for several years. Increased inflammatory parameters in the form of an raised PCT, CRP, NLR, PLR values may be caused by many factors. In adolescents who frequently experiment with psychoactive substances, such cause of these disturbances should also be taken into account.

Relationship of Anti-Mullerian Hormone in Polycystic Ovary Syndrome Patients with Different Subgroups

Objective: To determine the association between hyperandrogenism (HA) and polycystic ovarian morphology in a Chinese cohort of patients with polycystic ovary syndrome and the usefulness of anti-Mullerian hormone Methods: Patients who visited the Department of Obstetrics and Gynecology at Indus Medical College Tando Muhammad Khan between May 2020 and October 2020 were the subjects of a prospective case-control study. According to Rotterdam criteria, 50 females with Polycystic ovary syndrome (PCOS) and 50 females without the condition participated in the study. Results: An teenage patient clinic at our hospital enrolled 100 consecutive patients (50 by PCOS, 50 by healthy controls aged equal to the adolescent patients). Menstrual anomaly and hirsutism were most common in the study group, while vaginal discharge was most common in the control group. Analyses of anthropometric measures between the two groups showed a significant difference (p&lt;0.05). In the PCOS group, both plasma fasting insulin (p-value = 0.001) and HOMA index (p value =0.003) had statistically greater values. PCOS patients also had significantly higher means of fT and 17-OH-P, as well as LH and LH/FSH ratios. Serum AMH levels were found to be negatively correlated with FSH levels in all patients (r=-0.238, p=0.031). The AUC value indicated by ROC analysis for distinguishing PCOS was 0.678. However, the sensitivity and specificity scores according to the highest Youden index were 47.8% and 76.1%, respectively. Conclusion: The Anti-Mullerian hormone level is also linked to the existence of polycystic ovary morphology, which suggests that the AMH level might have a role in the diagnosis and treatment of PCOS. Keywords: Anti-Mullerian Hormone, Polycystic Ovary Syndrome, Polycystic Ovary Morphology