Healthy Young Man Research Articles

Spontaneous Pathologic Splenic Rupture in a Patient with Plasmodium falciparum Infection, First Case Reported in Israel.

Travelers exposed to malaria may develop severe disease and complications. A less well-known complication is spontaneous pathologic splenic rupture, which is still under-reported and has never been reported in Israel. In this paper, we report a 23 years old healthy young man presenting in the emergency department, two weeks after coming back from Sierra Leone, with intermittent fever, mild tachycardia and mild left upper quadrant abdominal pain. The patient was diagnosed with Plasmodium falciparum infection and developed rapidly after hospital admission spleen rupture. He was managed conservatively at first but ultimately underwent splenectomy after being hemodynamically unstable. In the recovery period, the patient developed acute respiratory distress syndrome and was reintubated. A high level of suspicion is recommended in every malaria patient presenting with left upper quadrant abdominal pain, even if minimal. Ultrasonography availability in the internal medicine department may be a critical diagnostic tool, especially in non-endemic areas.

Transformations: What I Learned Along My Patient's Gender Journey.

It took me almost a decade after I met Rex to really know him; or perhaps more accurately, I might say I knew Rex for almost a decade before I ever met him. The first ten years I was his endocrinologist, he was not Rex, the confident, outgoing, hard-working, healthy young man successfully juggling college, managing his diabetes, and working several jobs to pay for college; he was Rose, the withdrawn, isolated, depressed teen-aged girl struggling with, among many other things, her diabetes. When Rose came to the diabetes clinic, she would politely and reluctantly indulge me as I instructed her on the importance of taking her insulin, counting her carbohydrates, and checking her blood sugar levels. I would sometimes make it all the way through the lesson before her eyes glazed over, but more often not. I worried about her long-term health and felt that I was failing her as her doctor. I attributed our failure to connect to our vast differences in age, ethnic background, and socioeconomic situation. She connected better, I think, with one of our nurse practitioners, although she continued to struggle with depression, with a lack of motivation, and, of course, with her diabetes … Address correspondence to Stuart A. Weinzimer, MD, Department of Pediatrics, School of Medicine, Yale University, PO Box 208064, New Haven, CT 06520-8064. E-mail: stuart.weinzimer{at}yale.edu

The Woes of a Stuffy Nose: A Case Report of Allergic Fungal Sinusitis.

IntroductionAllergic fungal sinusitis (AFS) is a relatively uncommon cause of sinus pain and congestion. Extreme cases may require specialty evaluation and surgical treatment.Case ReportIn this case, an otherwise healthy young man presented to the emergency department with sinus pain and congestion for two weeks and was admitted to surgery for resection of his AFS.ConclusionThis case demonstrates how a thorough history and physical exam can help catch potentially serious diseases, such as allergic fungal sinusitis, from the frequently benign chief complaint of sinus pain.

EP11 A case of COVID-19 induced myocarditis in a healthcare-worker

EP11 A case of COVID-19 induced myocarditis in a healthcare-worker

HEALTH VALUES IN STRUCTURE OF YOUTH’S SOCIAL POTENTIAL IN RUSSIAN REGIONS

The article discusses health values in views of modern youth, based on author's research among youth of Russian regions; an analysis of health value, attitude to health of young people in large and medium cities is carried out. The study of values and value orientations of Russians and modern youth is traditionally and constantly in field of scientists’ attention. The author's interest is focused on study of youth values in framework of physical and psychological health. This problem seems to be very significant, since the prospects of Russian society development will depend on value potential of young Russians: its progress is largely associated with well-being of young people and is due to their basic life values. Youth health is inalienable potential of Russian society development - its reproductive, intellectual and socio-economic resources. The state of physical and mental health of youth acts as foundation of its social potential, contributing to solution of perspective tasks of socio-economic development. For young people, prevailing system of life values determines the choice of life path, and health is an important resource that can ensure high-quality self-realization. Healthy young man can afford to create normal family, reproduce healthy children, has the ability to physically and mentally work, and then build a career and show active life position.

Effects Of Cold Water Intake During A Short Exercise In Heat On Cognitive Function

PURPOSE: This study evaluated the effect of cold water intakes before and during exercise in the heat on the cognitive function in healthy young man. METHODS: Ten men (26.3±4.4 yrs, 176.2±5.8 cm, 77.2±14.6 kg) who participated in vigorous exercises at least twice in a week and maximal oxygen capacity estimated by Rockport’s 1-mile test was over 32.7 ml/kg/min were recruited. They underwent three testing sessions with different conditions in separate days; cold water (CW, 4 °C), neutral temperature water (AW, 36 °C), and no water conditions (NW). Testing order was randomly assigned and balanced. In each session, they were asked to ingest a prescribed amount of tap water (10 ml/body weight) at rest (1/3 of the total amount) and during exercise (2/3 of the total amount). After resting, they ran on a treadmill for 20 min in a hot environment (39.2±2.1 °C, 41.7±9.4 % relative humidity) at their predicted 75% of maximal heart rate. At 6, 12, and 18 min of exercise of CW and AW, they drank water. Cognitive test was performed 3 times; at rest, immediately after exercise, and after 20 min of recovery, by using Stroop color-word test (SCWT). During resting and exercise, their temperature, heart rate (HR), ratings of perceived exertion (RPE), naked body weight changes, and water intakes were measured. RESULTS: The average ear temperature during exercise was 37.2±0.6, 37.5±0.6, and 37.2±0.5 °C, and mean skin temperature was 34.8±2.3, 35.3±1.6, and 34.9±1.2 °C at CW, AW, and NW, respectively (p>0.05), Average HR and RPE was 148.3±14.1, 150.8±15.6, and 149.9±12.7 bpm and 13.3±0.7, 13.0±0.9, and 12.7±1.4 at CW, AW, and NW, respectively (p>0.05). They drank a total of 813±133 ml at CW and 812±130 ml at AW. They lost weight by sweating 493±145, 507±257, and 390±139 ml at CW, AW, and NW, respectively. The reliability of cognitive test was 0.909. The cognition score was 23.5±16.2, 24.3±15.5, and 22.0±11.8 in CW, 24.2±13.5, 28.1±10.4, and 25.1±9.7 in AW, and 17.5±8.3, 22.3±10.6, and 21.1±7.9 in NW, at resting, immediately after exercise, and after recovery, respectively (p>0.05). CONCLUSIONS: No advantage of cold water drinking before and during a short bout of exercise in the heat was evident for the cognitive function. The mode, intensity, and duration of exercise may be responsible for the outcomes.

Spontaneous Intra-Cerebral Haemorrhage Presenting with Chest Pain in a Healthy Young Man.

Spontaneous intra-cerebral haemorrhage is a challenge in daily practice due to the wide range of clinical symptoms on presentation.Chest pain mimicking acute myocardial infarction is an atypical presentation of intra-cerebral haemorrhage.In the primary care setting, misdiagnosis of a patient with spontaneous cerebral haemorrhage with chest discomfort suggesting cardiac aetiology and prompting antiplatelet/aspirin therapy could result in disaster.Taking a detailed history and conducting a thorough neurological examination is important in every clinical encounter and may trigger diagnostic suspicion.

Seizure with CSF lymphocytosis as a presenting feature of COVID-19 in an otherwise healthy young man

A 20-year old previously well man was brought to hospital following a seizure. For three days he had complained of myalgia, lethargy and fever. On attempting to get out of bed at home, he had experienced lightheadedness with blurred and double vision and felt his legs were too weak to allow him walk. He then had a generalised tonic-clonic seizure, which lasted one minute. In the wake of the seizure he was confused and aggressive, requiring intravenous midazolam in the emergency department. He was febrile (101.3 F) with heart rate 85bpm, respiratory rate 12, and sO2 97 % on room air. Respiratory examination was normal. His confusion resolved within six hours with no deficits and a normal neurological examination. He was isolated and treated with levetiracetam, aciclovir, ceftriaxone and vancomycin for possible central nervous system (CNS) infection. There was no prior history of seizures or epilepsy; psychomotor delay; head injury or CNS infection and no history of recent travel. A nasopharyngeal swab for severe acute respiratory syndrome conornavirus 2 (SARS-CoV-2) and influenza was negative and isolation precautions were discontinued. Routine blood tests were largely unremarkable (Table 1). Chest x-ray was normal. A CT brain and MRI brain were unremarkable, apart from mild mucosal thickening noted in the sphenoid sinus. CSF analysis demonstrated a lymphocytic pleocystosis (21 cells/mm3, 99 % mononuclear, 1% polymorphs) with normal protein and gluose (Table 1). CSF culture demonstrated no growth and PCR for herpes simplex virus, varicella zoster virus, and enterovirus was negative. Within two days of his admission, the patient’s wife developed respiratory symptoms and tested positive for SARS-CoV-2 at another hospital. The patient was isolated again and a repeat nasopharyngeal swab for SARS-CoV-2 was positive. CSF PCR for SARS-CoV-2 was negative. The patient remained well and was discharged home. EEG, performed on outpatient follow-up for infection control reasons, was normal.Table 1Clinical Laboratory Results.VariableReference RangeValueHaemoglobin (g/dL)13.0−18.016.2Haematocrit (%)0.400−0.5000.455White cell count (x109/LL)3.50−11.0012.02*Neutrophils (x109/L)2.00−8.007.83Lymphocytes (x109/L)1.00−4.003.07Platelets (x109/L)150−400210Sodium (mmol/liter)133−146138Potassium (mmol/liter)3.3−5.03.8Chloride (mmol/liter)95−108103Carbon dioxide (mmol/liter)22−2925Urea (mmol/liter)2.8−8.65.4Creatinine (umol/liter)65−10781C- reactive protein (mg/liter)<74Glucose (mmol/L)3.7−6.05.7D-dimer (mg/L)0.00−0.500.35Ferritin (ug/l)22−275281*The value in the patient was above the normal range.Albumin (g/L)35−5045Alanine transferase (iu/L)0−55356*The value in the patient was above the normal range.Alkaline Phosphatase (iu/L)30−13073Anion gap (mmol/L)10−1610CSFRed cells022White cells0−421Protein (mg/L)150−450404Glucose (mmol/L)3.2* The value in the patient was above the normal range. Open table in a new tab Neurological symptoms occuring in the context of COVID-19 are not uncommon, Mao et al. reported a rate of 36.4% (78/214). Neurological symptoms were more common among those who were systemically unwell (45.5 %, 40/88) and may be secondary to sepsis and organ dysfunction. [[1]Mao L. Wang M. Chen S. et al.Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study.SSRN Electron J. 2020; Crossref PubMed Google Scholar] Coronaviruses have the potential to invade the CNS. Possible routes include haematogenous or lymphatic spread or neural invasion with retrograde transport. [[2]Baig A.M. Khaleeq A. Ali U. et al.Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms.ACS Chem Neurosci. 2020; 11: 995-998Crossref PubMed Scopus (1268) Google Scholar] A case of acute necrotising encephalitis related to COVID-19 has been reported [[1]Mao L. Wang M. Chen S. et al.Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study.SSRN Electron J. 2020; Crossref PubMed Google Scholar,[3]Poyiadji N. Shahin G. Noujaim D. et al.COVID-19–associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features.Radiology. 2020; (Mar 31:201187)Crossref Scopus (927) Google Scholar]. Although CSF lymphocytosis may occur in unprovoked seizures, in this case the viral prodrome and identification of an infectious agent argues against this as a sole cause of pleocytosis [[4]Tumani H. Jobs C. Brettschneider J. Hoppner A.C. Kerling F. Fauser S. Effect of epileptic seizures on the cerebrospinal fluid--A systematic retrospective analysis.Epilepsy Res. 2015; 114: 23-31Crossref PubMed Scopus (38) Google Scholar]. Our case helps confirm that COVID-19 may involve the CNS, potentially causing a meningoencephalitis. In our patient the lack of obvious respiratory involvement, the overall mild clinical course, and the initial falsely negative nasopharyngeal swab testing were all noteworthy features. None to declare.

A Healthy Young Man With Headache and Trochlear Nerve Palsy – “The Great Masquerader” presenting as Tuberculous Meningitis: A Case Report (5283)

A Healthy Young Man With Headache and Trochlear Nerve Palsy – “The Great Masquerader” presenting as Tuberculous Meningitis: A Case Report (5283)

A case of paraspinal pyomyositis in a healthy young man

Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous bacterial spread. It has always been thought to be an infection of the tropics, but has been recognised in temperate climates with increasing frequency.[1][1] Pyomyositis has also been described among athletes

Active surveillance in stage 1 disease: standard of care independent of risk factors?

Approximately 30% of clinical stage 1 (CS1) nonseminomatous germ cell tumours (NSGCT) and 15-20% of CS1 seminoma relapse without adjuvant treatment. Despite this, the 5-year survival for CS1 is 99%. The purpose of this review is to assess if active surveillance should be standard for all patients with CS1 testis cancer independent of risk factors. Recent data from Princess Margaret Cancer Centre suggest a nonrisk-adapted surveillance approach avoids treatment in ∼70% of patients. Most relapse early at a median time of 7.4 months. The majority of relapses are confined to the retroperitoneum (66%) and only one modality of treatment is required: chemotherapy only in 61% and RPLND only in 73%. Surveillance is the preferred option and a safe proven strategy for the management of CS1 disease independent of risk factors. The prognosis for CS1 disease is excellent and the decision to offer surveillance or adjuvant treatment needs to highlight the treatment-related morbidity in an otherwise fit and healthy young man.

Cold beverage-induced vasovagal syncope in a healthy young adult man: a case report

BackgroundSwallowing-induced syncope is rare and there are few case reports of it in the existing medical literature. Even rarer are instances involving young and healthy individuals, with no existing pre-conditions or apparent risk factors. Hence the value of such case reports in understanding the phenomenon better and potentially inferring patterns of practical interest is significant; here we describe an unusual case of a swallowing-induced syncope in a young, healthy, and active white man.Case presentationA healthy 32-year-old white man experienced a syncopal episode following the ingestion of a cold carbonated beverage on a hot day. He rapidly recovered consciousness and save for mild lightheadedness all ill effects disappeared within minutes. On examination no concerns were detected and he was discharged, with the cause being ascribed to esophageal stimulation effected vagus nerve overactivation.ConclusionsThe suddenness and unpredictability of swallowing-induced syncope make it a potentially dangerous condition, with risks both to the patient as well as, depending on the context, others. However, it is poorly understood due to its infrequency. The present case report adds to the body of much needed evidence which should help facilitate an improved understanding of the phenomenon.

P853 Bilateral lower limb ischemia in a healthy young man what if the heart was hiding the etiology

Abstract Cardiac myxoma is the most common benign cardiac tumor with diverse nonspecific clinical manifestations; moreover, atrial myxoma embolization to the peripheral vessels is rare. A 24-year-old man presented tothe emergency departement complaining ofpain and coldness of his two lower extremities. The right femoral pulse was normally felt while the pulses of the left lower limb from the femoral down to the posterior and anterior tibial arteries were not felt. Bilateral thrombectomy was performed on emergency basisand a fatty-like mass from the left femoral artery was removed. The histological examination of this mass was suggestive of myxoma.So, transthoracic echocardiography was done and confirmed the diagnosis of myxoma that was seen in the left atrium and measuring about 10X6 cm in its maximal dimensions. Surgical removal of the myxoma was done later and the patient recovered uneventfully. Conclusion Although myxomas are rare, they should be considered in the differential diagnosis of peripheral embolic disease, especially when an embolic event occurs in a young adult without evidence of endocarditis or arrhythmia. Echocardiography is the modality of choice for diagnosis and follow-up of this type of tumors. FIGURE 1: CTA (computed tomography angiography) showing Occlusion of the left popliteal artery and occlusion of the distal part of the right popliteal artery FIGURE 2: macroscopic view of gelatinous left atrial myxoma

Cutaneous melioidosis in a healthy young man

Cutaneous melioidosis in a healthy young man

P1493 Univentricular heart diagnosed by echocardiography in a patient with good functional capacity

Abstract A 32 years old male without a history of cardiac disease or surgery was referred to our hospital due to abnormal findings on electrocardiography (ECG). He was a healthy active young man applying for private health insurance and did not have any symptoms. On physical examination he had normal vital signs and a systolic ejection murmur was present in the pulmonic area. His Oxygen saturation was 93% and had a functional capacity of 11 METs. On electrocardiography which is shown in part A and B of the figure, he had right axis deviation and poor R progression. On chest x-ray (part C of the figure) he had top normal cardiothoracic ratio and prominent main pulmonary artery (PA). On laboratory data he had normal complete blood count and normal electrolytes. Because of the murmur found in physical examination and the right axis deviation in ECG, transthoracic echocardiography was done for the patient which revealed single ventricle with left ventricle morphology and mild systolic dysfunction (part D of the figure). Abdominal and atrial situs were solitus. There was normal inferior vena cava continuity into the right atrium. Transesophageal echocardiography was also done for the patient which revealed thickening of the pulmonary valve and presence of a subvalvular web which resulted in severe subvalvular PS (part E and F of the figure). There were dilated main PA and its branches. The left sided atrioventricular valve had mild regurgitation while the right sided one had mild to moderate regurgitation. There was dilated coronary sinus due to persistent left superior vena cava. The case describes the role of echocardiography in diagnosing rare congenital heart disease in a patient without symptoms of cardiac disease. Abstract P1493 Figure

Prediction of Daily Happiness Using Supervised Learning of Multimodal Lifelog Data

Developing an approach to predict happiness based on individual conditions and actions could enable us to select daily behaviors for enhancing well-being in life. Therefore, we propose a novel approach of applying machine learning, a branch of the field of artificial intelligence, to a variety of information concerning people’s lives (i.e., a lifelog). We asked a participant (a healthy young man) to record 55 lifelog items (e.g., positive mood, negative events, sleep time etc.) in his daily life for about eight months using smartphone apps and a smartwatch. We then constructed a predictor to estimate the degree of happiness from the multimodal lifelog data using a support vector machine, which achieved 82.6% prediction accuracy. This suggests that our approach can predict the behaviors that increase individuals’ happiness in their daily lives, thereby contributing to improvement in their happiness. Future studies examining the usability and clinical applicability of this approach would benefit from a larger and more diverse sample size.

Consecutive episodes of heart and kidney failure in an \u201cotherwise\u201d healthy young man

BackgroundAcute renal failure is a rare occurrence in a patient with an unremarkable past medical history and should always lead to an in depth clinical study. The occurrence in the same healthy young subject, of consecutive episodes of heart failure and of acute renal failure is an even rarer event and should prompt diagnostic tests and restrict the diagnostic hypotheses.Case presentationWe present the case of a 28 year-old man who, while waiting to undergo assessment for a mild chronic kidney disease, was diagnosed with decompensated dilated cardiomyopathy and placed on diuretics and β-blockers. After few weeks he developed a non oligoanuric acute renal failure with a slight elevation of serum calcium. Renal biopsy proved suggestive for renal sarcoidosis; thus the hypothesis of systemic sarcoidosis with cardiac and renal involvement was possible avoiding further delay in initiation of therapy.ConclusionsCardiac sarcoidosis is usually silent but the majority of cases are diagnosed when cardiac symptoms are present in a patient with systemic sarcoidosis. Renal involvement with granulomatous interstitial nephritis is also quite rare and can be an unexpected finding at kidney biopsy. This case highlights the need to evaluate thoroughly clinical problems that do not fit in a specific scenario and emphasizes the importance of performing a kidney biopsy in case of kidney failure of unknown etiology.

Classification of pulse waves based on cluster analysis of time parameters

The paper shows the results of the investigation of the classification of pulse waves based on the cluster analysis of the time parameters of a pulse signal. On the example of the record of the pulse signal of a healthy young man, it was shown a method for classifying pulse waves using the proposed method. It was performed two-cluster, three-cluster and four-cluster classification. After clustering, the data were evaluated in terms of the difference between the separated groups using the nonparametric Kruskel-Wallis. After the classification, it was analyzed the largest group that contains the form of the pulse wave that occurs in the recording most often. The paper shows that the first group of the four-cluster classification contained the most frequently observed type of pulse wave in the recording (46%), and the first group statistically significantly differed from the other two large groups of pulse waves (the second and the third groups, 41%). This classification made it possible to statistically significantly differentiated the largest first group from the following groups by size – the second and the third groups – according to all the attributes, except Er. Pulse waves in the first group will allow estimating correctly the time parameters of the cardiocycle. This classification will make it possible to choose pulse waves with the most accurate parameters in the cardiovascular system for time analysis of the cardiocycle. This investigation will promote creating a decision support system in the sofware for recording and analyzing cardiosignals.

Advanced Coronary Atherosclerosis and Fatal Myocardial Infarction in Mild Dyslipidemic, Low Risk Young Man: A Case Report With Literature Reviewed

Acute Myocardial infarction (AMI) at a young age (below 45 years) is rare and difficult to predict. We reported a fatal myocardial infarction from advanced atherosclerosis in a healthy young man who had no other major coronary risk factors except mild hypercholesterolemia. Thus, all available systemic risk scores identified him as a low risk candidate for developing a cardiovascular event. Autopsy revealed advanced atherosclerosis in all three major coronary arteries causing acute and old myocardial infarction. Thick epicardial adipose tissue and myocardial bridging of the mid left anterior descending artery were also noted. He frequently used etoricoxib to treat knee and back pain for consecutive five years. Potential mechanisms of sudden death from atherosclerosis, myo- cardial bridging, epicardial adipose tissue and selective COXIB are discussed in more detail below.

A compact pulsatile simulator based on cam-follower mechanism for generating radial pulse waveforms

BackgroundThere exists a growing need for a cost-effective, reliable, and portable pulsation simulator that can generate a wide variety of pulses depending on age and cardiovascular disease. For constructing compact pulsation simulator, this study proposes to use a pneumatic actuator based on cam-follower mechanism controlled by a DC motor. The simulator is intended to generate pulse waveforms for a range of pulse pressures and heart beats that are realistic to human blood pulsations.MethodsThis study first performed in vivo testing of a healthy young man to collect his pulse waveforms using a robotic tonometry system (RTS). Based on the collected data a representative human radial pulse waveform is obtained by conducting a mathematical analysis. This standard pulse waveform is then used to design the cam profile. Upon fabrication of the cam, the pulsatile simulator, consisting of the pulse pressure generating component, pressure and heart rate adjusting units, and the real-time pulse display, is constructed. Using the RTS, a series of testing was performed on the prototype to collect its pulse waveforms by varying the pressure levels and heart rates. Followed by the testing, the pulse waveforms generated by the prototype are compared with the representative, in vivo, pulse waveform.ResultsThe radial Augmentation Index analysis results show that the percent error between the simulator data and human pulse profiles is sufficiently small, indicating that the first two peak pressures agree well. Moreover, the phase analysis results show that the phase delay errors between the pulse waveforms of the prototype and the representative waveform are adequately small, confirming that the prototype simulator is capable of simulating realistic human pulse waveforms.ConclusionsThis study demonstrated that a very accurate radial pressure waveform can be reproduced using the cam-based simulator. It can be concluded that the same testing and design methods can be used to generate pulse waveforms for other age groups or any target pulse waveforms. Such a simulator can make a contribution to the research efforts, such as development of wearable pressure sensors, standardization of pulse diagnosis in oriental medicine, and training medical professionals for pulse diagnosis techniques.