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An Unusual Case of Giant Polymicrobial Shoulder Abscess Developing Two Decades After an Insect Bite: The Role of Chronic Intermittent Swelling as a Predisposing Factor.
Cureus
December 2024
Department of Orthopaedics and Traumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, TUR.
Shoulder abscesses, commonly resulting from bacterial infections, can occasionally present with atypical etiologies and delayed onset. We report a rare case of a massive polymicrobial shoulder abscess developing two decades after an insect bite, emphasizing its clinical presentation, diagnostic approach, and surgical management. A 65-year-old female presented with severe, progressively worsening right shoulder pain, a 20 cm swelling, and purulent discharge persisting for 15 days.
View Article and Find Full Text PDFCase: Pediatric Morel-Lavallée lesions are infrequent and may present in atypical locations. A 3-year-old boy presented with a nontender, mobile, cystic swelling on the medial aspect of his left distal thigh, 2 weeks after a road traffic accident. The diagnosis was confirmed using 3D ultrasonography.
View Article and Find Full Text PDFChapter 5: THE ROLE OF GENETICS IN PRIMARY HYPERPARATHYROIDISM.
Ann Endocrinol (Paris)
January 2025
Univ. Lille, Inserm, CHU Lille, U1286 - Infinite, F-59045 Lille Cedex, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France. Electronic address:
Around 10% of cases of primary hyperparathyroidism are thought to be genetic in origin, some of which are part of a syndromic form such as multiple endocrine neoplasia types 1, 2A or 4 or hyperparathyroidism-jaw tumor syndrome, while the remainder are cases of isolated familial primary hyperparathyroidism. Recognition of these genetic forms is important to ensure appropriate management according to the gene and type of variant involved, but screening for a genetic cause is not justified in all patients presenting primary hyperparathyroidism. The indications for genetic analysis have made it possible to propose a decision tree that takes into account whether the presentation is familial or sporadic, syndromic or isolated, patient age, and histopathological type of parathyroid lesion.
View Article and Find Full Text PDFChapter 8: MANAGEMENT OF AGGRESSIVE FORMS OF PRIMARY HPT: PARATHYROID CARCINOMA AND ATYPICAL PARATHYROID TUMOR.
Ann Endocrinol (Paris)
January 2025
Imaging Department, Nuclear Medicine Service, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France.
Parathyroid carcinoma is extremely rare, affecting 1% of cases of primary hyperparathyroidism. For this reason, management is poorly codified and requires expertise in specialized center. PC is genetically determined in a quarter to a third of cases, notably involving the CDC73 gene coding for parafibromin.
View Article and Find Full Text PDFChapter 4: DIFFERENTIAL DIAGNOSIS of PRIMARY HYPERPARATHYROIDISM.
Ann Endocrinol (Paris)
January 2025
Service d'Endocrinologie, Diabétologie, Métabolisme, Nutrition; Hôpital Huriez, CHU Lille; Inserm U1190, Institut Génomique Européen pour le Diabète, Université de Lille, F-59000 Lille, France. Electronic address:
The differential diagnosis of primary hyperparathyroidism can be considered clinically, biologically and radiologically. Clinically, primary hyperparathyroidism should be suspected in case of diffuse pain, renal lithiasis, osteoporosis, repeated fracture, cognitive or psychiatric disorder, or disturbance of consciousness. Nevertheless, the differential diagnosis of primary hyperparathyroidism is mainly biological, particularly in atypical forms, which must be differentiated from hypercalcemia with hypocalciuria or non- elevated PTH on the one hand, and from normo-calcemia with elevated PTH, hypophosphatemia or hypercalciuria on the other.
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