A simple management option for chronically impacted sharp tracheobronchial foreign bodies in children

Distally impacted chronic tracheobronchial sharp foreign bodies in children are a management challenge that presents with clinical subtlety and extreme variability. The use of image guided techniques, imaginat...

https://ift.tt/2IEzuHm

Hemorrhagic stroke after Epley maneuver: a case report

This is the first case to our knowledge of a serious adverse event following the Epley maneuver, which is the treatment of choice for benign paroxysmal positional vertigo (BPPV), the most common vestibular dis...

https://ift.tt/2Hfmz1z

An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen

Cats are the major source of indoor inhalant allergens after house dust mites. The global incidence of cat allergies is rising sharply, posing a major public health problem. Ten cat allergens have been identif...

https://ift.tt/2Ho9UXF

Antenatal Spontaneous Renal Forniceal Rupture Presenting as an Acute Abdomen

Background. Renal forniceal rupture is a lesser-known cause of acute abdomen in pregnancy. The ureteral compression by the gravid uterus places pregnant women at a higher risk. Sequelae in pregnancy could include intractable pain, acute kidney injury, and preterm birth. Case. A 22-year-old primigravida with no prior medical history presented with an acute abdomen in her second trimester. The diagnosis of renal forniceal rupture was made by a radiologist using MRI. A percutaneous nephrostomy catheter was placed, and the patient's pain was relieved. She subsequently delivered at term. Conclusion. Upon presentation of an acute abdomen in pregnancy, providers may not include renal forniceal rupture in their differential as readily as obstetric or gynecologic causes, resulting in delayed diagnosis, unnecessary invasive interventions, and potentially adverse maternal and neonatal outcomes. Increasing provider awareness could result in improved outcomes.

https://ift.tt/2GR44Ri

Impact of cognitive function on oral perception in independently living older people

Abstract

Objectives

Oral tactile perception is important for better mastication, appetite, and enjoyment of food. However, previous investigations have not utilized comprehensible variables thought to have negative effect on oral perception, including aging, denture wearing, and cognitive function. The aim of this study was to elucidate the impact of cognitive function on oral perception in independently living older individuals.

Materials and methods

The study sample was comprised of 987 participants (466 males, 521 females; age 69–71 years). Oral examinations, assessments of cognitive function in preclinical level by Montreal Cognitive Assessment (MoCA)-J, and determination of oral stereognostic ability as an indicator of oral perception were performed. Related variables were selected by univariate analyses; then, multivariate logistic regression model analysis was conducted.

Results

Univariate analyses revealed that number of teeth, removable dentures usage, and cognitive function respectively had a significant relationship with stereognostic score. Next, the subjects were classified into good and poor perception groups (lowest 17.4%) according to oral stereognostic ability. Logistic regression analysis revealed that lower cognitive function was significantly associated with poor oral perception (OR = 0.934, p = 0.017) after controlling for other variables.

Conclusions

Cognitive decline even in preclinical stage was associated with reduced oral perception after controlling for gender, tooth number and denture use in independent living older people.

Clinical relevance

This study suggested that preclinical level of change in cognitive function affected oral perception. Dental practitioners and caregivers may need to pay attention to reduced oral perception among older people even if they do not have trouble in daily life.

https://ift.tt/2Hosf6O

Evaluation of the Preventive Effect of Chlorhexidine Acetate Gargle for Upper Gastrointestinal Tract Infection After ESD

Conditions:   Esophageal Cancer;   Gastric Cancer
Intervention:   Drug: chlorhexidine acetate gargle
Sponsor:   Peking University Third Hospital
Recruiting

https://ift.tt/2H79HdJ

Ichthyosis: A Harbinger of Lymphoma

Description

A 60-year-old, previously healthy woman presented with patchy skin colour change and dryness for 3 months duration. She also gave a history of recurrent boils requiring local and oral antibiotics. On examination, patchy hyperpigmented skin with scaly appearance was apparent along with features of healed and active infection (figure 1). She also had multiple, firm, lymph nodes (largest 2 cm) in the bilateral axillae. On evaluation, haemoglobin was 115 g/L, white blood cells 7.8x10⁹/L, platelets 248x10⁹/L; peripheral blood smear was normal. Representative skin biopsy showed loss of granular layer characteristic of ichthyosis (figure 2). Right axillary lymph node excision biopsy and immunohistochemistry confirmed the diagnosis of T-cell non-Hodgkin's lymphoma (not otherwise specified). HIV ELISA, thyroid function tests and coeliac serology were inconclusive. She was treated with cyclophosphamide, doxorubicin, vincristine  and prednisolone chemotherapy along with moisturisers (urea-based), regular skin cleansing and salty water bath. After six cycles...

https://ift.tt/2qmMutD