Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment.

Appendicitis is a common occurrence in both the adult and pediatric populations. The condition most commonly occurs between the ages of 10 and 20 years with a lifetime risk of 8.6% and 6.7% for males and females respectively. Its diagnosis focuses on clinical presentation and imaging modalities classified according to scoring systems such as the Alvarado scoring system. A number of imaging modalities can be used, with CT being the most common one. For acute appendicitis, surgical intervention is considered to be the gold standard of treatment. However, recent research has focused on other modalities of treatment including antibiotics and endoscopic retrograde appendicitis therapy (ERAT) to avoid surgical complications

Mesalamine Associated Bradycardia.

A 38-year-old female presented with an acute flare of ulcerative colitis. She was started on prednisone and mesalamine. Within 24 hours of initiating mesalamine, she developed sinus bradycardia. After holding mesalamine, the heart rate returned to normal within five days. Our case illustrates the third described case, to our knowledge, of severe sinus bradycardia secondary to mesalamine

Adult Onset Morgagni Hernia: Medical vs. Surgical Management.

Morgagni hernia is a type of diaphragmatic hernia where bowel content herniates through an irregular opening into the thoracic cavity. Herein, we present the case of an 84-year-old female patient with multiple hospital admissions for abdominal symptoms. Radiological studies confirmed Morgagni hernia. She underwent a laparoscopic intervention with mesh placement. She was discharged in stable condition and was doing well on follow-up

Streptococcus Intermedius Brain and Diverticular Abscesses After Dental Manipulation: A Case Report.

A brain abscess is defined as a focal intracerebral infection consisting of an encapsulated collection of pus, which can be a life-threatening complication of infections, trauma, or surgery. While immunocompromised patients can have a wide array of causative organisms, bacterial species represent the most common etiology in immunocompetent individuals. The incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000, with a high predisposition among immunocompromised patients and in those with disruption of the blood-brain barrier. The most common causative organisms found were Streptococcus species, particularly S. viridians and S. pneumonia, Enterococcus, and Staphylococcus species, mainly S. aurieus and S. epidermidis. Microorganism can invade the brain through different mechanisms, either directly by contiguous spread and odontogenic infections, which usually cause a single brain abscess, or indirectly through hematogenous spread which can cause multiple brain abscesses. Both surgical and conservative dental procedures contribute to hematogenous spreading of oral microorganisms. Although most of those organisms are eliminated shortly after they gain access to the bloodstream, some can persist and contribute to the pathogenesis of abscesses in the appropriate environment. Odontogenic origins are rarely implicated in the formation of brain abscesses, and oral foci comprise approximately 5% of identified cases. We report a case of brain and diverticular abscesses due to S. intermidius occurring two months after dental extraction. This case highlights the fact that even usual dental workup can result in the development of bacteremia and disseminated abscesses including but not restricted to the brain. Consequently, in addition to identifying the possible source of bacteremia with an extensive history and physical exam, the diagnosis of Streptococcus milleri organisms should prompt the physicians to screen for sites of possible metastatic infection spread

Anticholinergic Toxicity Secondary to Overuse of Topricin Cream, a Homeopathic Medication.

Adverse reactions from over-the-counter medications present a challenge to physicians. Homeopathic medicine is an alternative practice, originating in Germany and gaining popularity in the United States. It utilizes dilute preparations of substances in order to treat and cure disease. Patients may potentially suffer serious effects from the use of these products as the contents and concentrations are often unclear. Here, we describe a case of suspected atropine toxicity due to the overuse of a topical homeopathic cream, Topricin, which contains belladonna, a plant containing atropine

How autochthonous microorganisms influence physiological status of Zea mays L. cultivated on heavy metal contaminated soils?

Funding information This work was supported by the Polish Ministry of Science and Higher Education (Institute for Ecology of Industrial Areas statutory funds).Peer reviewedPublisher PD

A Case of Plasmodium falciparum Malaria with a Prolonged Incubation Period of Four Years

With increased global travel, unique diseases from different parts of the world pose a new category of differential diagnosis, and an incubation period of different infectious diseases helps narrow differential diagnosis to point to one specific etiology. The normal incubation period of Plasmodium falciparum malaria is 7-40 days. We report a case of symptomatic P. falciparum malaria that manifested four years after a visit to a malaria-endemic area in a 51- year-old female patient. Our case illustrates the importance of a broad differential with regard to infectious disease including remote travel history and raises questions of the survival of P. falciparum for four years despite the administration of traditional chemoprophylactic agents

Diverticulitis: A review of diagnosis, treatment, and prevention

© 2019 Cliggott Publishing Co. All Rights Reserved. Diverticulitis is a common occurrence in the hospital setting. Occurring in up to 25% of patients with diverticulosis, it presents with fever, pain, and a palpable mass in the left lower quadrant. In the early 20th century, intervention focused on surgery. Currently, a conservative medical route utilizing antibiotics selectively is recommended in cases of uncomplicated diverticulitis. Several studies question the need for antibiotics. Recurrence is a relative indication for surgical intervention, and percutaneous drainage is offered for cases with an abscess greater than 3 cm