Uncommon Condition (uncommon + condition)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Effects of Botulinum Toxin Type A on Contouring of the Lower Face

Seong Wook Choe MD
background. Masseteric muscle hypertrophy is an uncommon condition represented as a swelling of the masseter muscle. Recent reports have demonstrated the successful use of botulinum in the treatment of masseteric hypertrophy. objective. This study was a prospective trial to evaluate the effectiveness of botulinum toxin type A (Botox) in the treatment of masseteric muscle hypertrophy according to doses of 10, 20, and 30 U. materials and methods. Twenty-two patients were referred to the dermatologic clinic for the management of masseteric muscle hypertrophy. Ultrasonographic measurements of the thickness of the masseter muscle were performed, and clinical photographs were taken before treatment and 1, 2, 3, 4, 6, and 9 months after the treatment. results. The median values of percentage reduction of muscle mass were 10.3%, 16.5%, 23.7%, 24.7%, 21.6%, 16.5% in the 10 U group; 11.9%, 18.8%, 24.8%, 27.7%, 26.7%, and 21.8% in the 20 U group; and 12.0%, 19.4%, 25.0%, 27.8%, 37.8%, and 24.1% in the 30 U group. conclusion. The adequate dose of botulinum toxin type A for treatment of masseteric muscle hypertrophy should be above 20 U. The effect of botulinum toxin type A is maintained for at least 9 months as the treatment of masseteric muscle hypertrophy. [source]

A Case of Foul Genital Odor Treated with Botulinum Toxin A

Jae-Bong Lee MD
Background. Genital odor is an uncommon condition characterized by an offensive and malodorous smell in the genital area. Although the etiology of foul genital odor is multifactorial, an important cause is sweat secretion and decomposition of sweat components by bacteria. Different methods are effective in reducing body odor secondary to bromhidrosis. Conservative methods only act for a short period of time, and more invasive surgical methods carry risk of complications or are inapplicable for the genital region. Methods. A patient with localized foul odor in the genital hair bearing area was treated with botulinum toxin A. Results. Botulinum toxin A was effective in creating an odorless and anhydrous response in the genital region, and no major adverse effects were noted during a follow-up of 9 months after injection. Conclusion. Local injection of botulinum toxin A appears to be a useful treatment for foul genital odor related to sweat glands activity. [source]

Chronic prostatitis and chronic pelvic pain in men: aetiology, diagnosis and management,

GA Luzzi
ABSTRACT Patients with chronic prostatitis/pelvic pain syndrome typically report genital or pelvic pain (in or around the penis, perineum, scrotum) lasting >3 months. Whereas true chronic bacterial prostatitis is an uncommon condition characterised by recurrent prostatic and urinary infection, chronic pelvic pain syndrome (CPPS) is a common condition in which no infection is found. Recent surveys suggest a prevalence of 2.5,3% for CPPS. The four-glass test, traditionally used to distinguish inflammatory and inflammatory forms of CPPS, has not been adequately validated; whether the distinction is clinically meaningful is increasingly questioned. The aetiology of CPPS is not known; urodynamic studies imply a neuromuscular origin. More recent work supports a role for proinflammatory cytokines in the pathogenesis. In the management of chronic bacterial prostatitis, trials support the use of quinolone antibiotics as first-line treatment. In contrast, the management of CPPS is generally unsatisfactory, as no reliable treatment has been identified. Treatments commonly tried include antibiotics (notably tetracyclines, quinolones and macrolides), anti-inflammatory agents, and alpha blockers. Newer approaches include trials of finasteride, quercetin and rofecoxib. A recent systematic review demonstrated that none of the current diagnostic and treatment methods for CPPS is supported by a robust evidence base. [source]

Anaesthesia, perioperative management and outcome of correction of extrahepatic biliary atresia in the infant: a review of 50 cases in the King's College Hospital series

Extrahepatic biliary atresia (EHBA) is an uncommon condition presenting in the first few weeks of life. It has an incidence of 0.5,1 per 10 000 live births and is the end result of a destructive inflammatory process involving the extrahepatic biliary system of unknown aetiology occurring in utero. The net result is neonatal jaundice due to bile stasis, with subsequent hepatocellular damage and cirrhosis. In the untreated, patient death is inevitable within 2 years. Precise diagnosis (or exclusion) of EHBA in the persistently jaundiced infant must be made urgently and major surgery (hepatic portoenterostomy: Kasai procedure) carried out as soon as possible, preferably before 6,8 weeks of age. This review is concerned with anaesthesia for correction of EHBA in 50 consecutive patients and also outlines the experience gained in the largest European centre for correction of EHBA where the number of cases now approaches 500. [source]

Lipoatrophic Connective Tissue Panniculitis

Myriam Marque M.D.
Among them, an autoimmune process involving the subcutaneous fat without criteria for another defined disorder coined "connective tissue panniculitis" by Winckelman et al in 1980 has been described. We describe this disease in a 4-year-old boy who presented with multiple subcutaneous inflammatory nodules that extended in an annular fashion, resolved leaving lipoatrophy, with recurrence 8 years later. The histologic findings were consistent with a granulomatous lipophagic panniculitis. We review previous reports and emphasize the limited therapeutic options, chronic evolution, severe esthetic sequelae and possible association with other autoimmune disorders of this uncommon condition. [source]

Achilles tendon rupture and its association with fluoroquinolone antibiotics and other potential risk factors in a managed care population

DrPH, John D. Seeger Pharm D
Abstract Background Case reports and observational studies have implicated fluoroquinolone antibiotic exposure as a risk factor for Achilles tendon rupture (ATR), an uncommon condition for which there are few formal studies. We sought to quantify the strength of association between exposure to fluoroquinolone antibiotics and the occurrence of ATR, accounting for other risk factors. Methods This was a case-control study nested within a health insurer cohort. Cases of ATR were identified and confirmed using patterns of health insurance claims that were validated through sampled medical record review. Information on risk factors, including fluoroquinolone exposure, came from health insurance claims. Results There were 947 cases of ATR and 18,940 controls. A dispensing of a fluoroquinolone antibiotic in the past 6 months was more common among ATR cases than controls, although not significantly so (odds ratio (OR),=,1.2; 95% confidence interval (CI),=,0.9,1.7), and exposure to a higher cumulative fluoroquinolone dose was more strongly associated (OR,=,1.5, 95%CI,=,1.0,2.3). Other risk factors for ATR were trauma (OR,=,17.2, 95%CI,=,14.0,20.2), male sex (OR,=,3.0, 95%CI,=,2.6,3.5), injected corticosteroid administration (OR,=,2.2, 95%CI,=,1.6,2.9), obesity (OR,=,2.0, 95%CI,=,1.2,3.1), rheumatoid arthritis (OR,=,1.9, 95%CI,=,1.0,3.7), skin or soft tissue infections (OR,=,1.5, 95%CI,=,0.9,2.3), oral corticosteroids (OR,=,1.4, 95%CI,=,1.0,1.8), and non-fluoroquinolone antibiotics (OR,=,1.2, 95%CI,=,1.1,1.5). Conclusions The elevation in ATR risk associated with fluoroquinolones was similar in magnitude to that associated with oral corticosteroids or non-fluoroquinolone antibiotics. Trauma and male sex were more strongly associated with ATR, as were obesity and injected corticosteroids. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Invasive oral aspergillosis in a patient with acute myeloid leukaemia

H Cho
Abstract Aspergillosis (a fungal infection by an organism of the Aspergillus species) of the oral cavity is an uncommon condition which most frequently occurs in immunocompromised patients, such as those with haematological malignancies. In such patients, prolonged neutropenia secondary to chemotherapeutic agents enables the spread of invasive aspergillosis, which is unaffected by anatomical barriers. Early detection and treatment of the condition is essential to avoid more serious complications, such as disseminated infection, which results in increased morbidity and mortality. This case report describes a patient with acute myeloid leukaemia who developed localized invasive Aspergillus flavus of the palate. High-dose antifungal therapy was instituted along with surgical removal of the involved tissues. Aspergillosis of the palate was successfully eradicated with no long-term ill effects from the treatment. Management of invasive aspergillosis includes early aggressive antifungal medication combined with surgical removal of the involved tissues. [source]

Changing patterns in the management of gastric volvulus over 14 years

W. J. Teague
Background: Gastric volvulus is an uncommon condition, which can be difficult to diagnose and treat. This study represents a large series of patients with the condition. Methods: All patients presenting with gastric volvulus over a 14-year period were reviewed. Results: Some 36 patients (median age 75 years) were identified. Volvulus, usually secondary to a hiatus hernia, presented acutely in 29 patients. The major symptoms were abdominal pain, vomiting and upper gastrointestinal haemorrhage. The most useful investigations were barium contrast studies and upper gastrointestinal endoscopy, which were helpful in 21 of 25 and 11 of 18 patients respectively. Treatment was conservative in five patients, by open surgery in 13 and laparoscopic repair in 18 (three converted to open operation). There were no major complications and no deaths. Median hospital stay was shorter in patients treated by laparoscopic rather than open surgery (6 (range 4,36) versus 14 (7,50) days; P < 0·05). Conclusion: Acute and chronic gastric volvulus can be treated successfully by either open or laparoscopic surgery. However, laparoscopic surgery now represents a safe and acceptable approach, with minimal morbidity and a significantly shorter hospital stay. This is likely to be of considerable benefit for the treatment of a predominantly elderly population, often with significant co-morbidity. © 2000 British Journal of Surgery Society Ltd [source]

Actinomycotic canaliculitis: resolution following surgery and short topical antibiotic treatment

Eyrún Baldursdóttir
Abstract. Purpose:, This study aimed to study the incidence and clinical characteristics of patients diagnosed with actinomycotic canaliculitis in Iceland. Methods:, We present a nationwide, retrospective case series for which cases were identified by searches of hospital diagnostic registries and pathology databases. Case histories were reviewed and histopathological analysis repeated to confirm the diagnosis. Results:, Nine cases of actinomycotic canaliculitis were diagnosed in Iceland during 1988,2007. Subjects included six women and three men and represented 16% of all patients diagnosed with actinomycosis in the country. The incidence was 0.16 cases/100 000 inhabitants/year. Age-specific incidence rates were 0.59 cases/100 000 inhabitants/year for the 40,59-year-old age group and 1.37 cases/100 000 inhabitants/year for individuals aged 60,79 years. All patients underwent a three-way snip procedure and 1 week of topical antibacterial therapy. Conclusions:, Actinomycotic canaliculitis is an uncommon condition which frequently eludes diagnosis. Topical antibiotics for 1 week may be sufficient following surgery, a finding which contrasts with previous reports. [source]

Vincristine, an efficacious alternative for diffuse neonatal haemangiomatosis

S Pérez-Valle
Abstract Diffuse neonatal haemangiomatosis (DNH) is an uncommon condition characterized by multiple cutaneous and visceral haemangiomas frequently causing severe complications. Corticosteroids constitute the first therapeutic line; however, when they fail, other alternatives are available, provided possible side effects are closely monitored during and after treatment. We present a case of life-threatening DNH, non-responsive to corticosteroids, successfully treated with Vincristine with minor side effects. We conclude that Vincristine is a valid alternative in corticosteroid-resistant DNH. [source]

Impacts of national surveillance for uncommon conditions in childhood

Yvonne A Zurynski
Abstract: The Australian Paediatric Surveillance Unit (APSU) facilitates the conduct of national collaborative research that is consistent with national health priorities, has potential to impact on public health, and addresses gaps in knowledge. Since 1993 paediatricians and other child health specialists have contributed monthly data on rare childhood conditions to the APSU. Over 40 conditions, including infectious diseases, injuries, vaccine-preventable diseases and genetic disorders have been studied. Information on epidemiology, frequency, diagnosis, management and short-term outcomes of these conditions is collected and provides evidence to support changes to clinical practice, prevention policy and allocation of health resources. In this review we give examples of the value of information gathered through the APSU surveillance system in the last 14 years. [source]