Strongyloides stercoralis infection in a patient with rheumatoid arthritis and type 2 diabetes mellitus: a case-based review

AbstractStrongyloides stercoralis (S. stercoralis), a human intestinal nematode, can lead to hyper/disseminated (HD) infection in patients treated with corticosteroids. Here, we report a case of strongyloidiasis in a 58-year-old female with a history of rheumatoid arthritis (RA) and type 2 diabetes mellitus (T2DM). The patient presented with abdominal pain and gastrointestinal (GI) bleeding. Stool was negative for parasitic agents in the first direct smear examination, and the patient with the probable diagnosis ofHelicobacter pylori (H. pylori) infection or Crohn ’s disease received antibiotics and corticosteroids. Parasitic agents were not detected in further direct stool examinations, and the patient with the diagnosis of pneumonia, chronic kidney disease (CKD), ulcerative colitis, sepsis, and candidiasis received fungal, antibiotic, and corticosteroids medications. Low sensitivity of direct smear and the lack of using two methods in diagnosing intestinal parasitic infections led to delayed detection. In the fourth direct stool examination, rhabditiform larva ofS. stercoralis was reported. The treatment of corticosteroids was discontinued and albendazole was started. A literature review was conducted by searching Medline, Embase, Scopus, and Web of Science with the keywordsS. stercoralis, strongyloidiasis, RA, and T2DM. Our case indicates that screeningS. stercoralis infection in high-risk groups, especially those who are candidates for corticosteroids medications, m...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research

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Authors: Kleinaki Z, Kapnisi S, Theodorelou-Charitou SA, Nikas IP, Paschou SA Abstract Diabetes mellitus (DM) is a chronic multisystem disease. Diabetic nephropathy (DN) is one of its significant microvascular complications, associated with increased morbidity and mortality. The aim of this article is to review the literature regarding the latest advances in the management of type 2 DM (T2DM) in patients with chronic kidney disease (CKD). We initially refer to the screening guidelines, the diagnostic tests used, the need for novel biomarkers in DN, the recent advances in high-risk patient identification, the recomm...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Background: Brachial plexus birth injury (BPBI) is a condition in which the brachial plexus is thought to be damaged during the birth process. Studies have cited a varying incidence rate ranging from 0.5 to 4.0 per 1000 live births. The purpose of this study is to evaluate birth claims data over a 15-year period to identify risk and protective factors for BPBI in the state of Colorado. Methods: A data request was made to the state hospital association for birth claims data. We requested all birth claims from the years 2000 to 2014. ICD9 codes for variables of interest included: BPBI, shoulder dystocia, heavy-for-dates...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Upper Extremity Source Type: research
Conclusions: The data suggest that there is not a meaningful association between crouch gait and knee pain. Having patella alta was associated with pain. Further studies that use validated pain questionnaires are needed to understand the multifactorial etiology of knee pain within ambulatory individuals with CP. Level of Evidence: Level III—case-control study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Cerebral Palsy Source Type: research
Conclusions: When considering a child with an irritable knee, a heterogeneity of potential underlying pathologies and combinations of pathologies are possible. Importantly, the age of the patient and CRP can guide a clinician when considering further workup. Older patients with a higher admission CRP value warrant an immediate magnetic resonance imaging, as they are likely to have osteomyelitis, which was associated with worse outcomes when compared with patients with isolated septic arthritis. Level of Evidence: Level III—retrospective research study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
Conclusions: Short-term results indicate that MCGR may be a good option in SMA-associated collapsing spine deformity to reduce the burden of repetitive lengthening procedures. The authors recommend apical deformity control in the convex side in case of curve rigidity. In addition, including the pelvis in the instrumentation at index surgery is critical to prevent distal adding-on. Level of Evidence: Level IV—retrospective case series.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Early Onset Scoliosis Source Type: research
Conclusion: There are several risk factors for subsequent contralateral SCFE. On the basis of the available data, younger patients with a high PSA of the unaffected hip would most likely benefit from prophylactic fixation of the unaffected hip. Level of Evidence: Level II.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Hip Source Type: research
The objective of this study was to identify depression using the Mental Component Score (MCS-12) of the Short Form-12 (SF-12) survey and to correlate with patient outcomes. Summary of Background Data. The impact of preexisting depressive symptoms on health-care related quality of life (HRQOL) outcomes following lumbar spine fusion is not well understood. Methods. Patients undergoing lumbar fusion between one to three levels at a single center, academic hospital were retrospectively identified. Patients under the age of 18 years and those undergoing surgery for infection, trauma, tumor, or revision, and less than 1-ye...
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Conclusion. The spontaneous incidence rate of vertebral body infection among OVF patients was 0.7%; however, the occurrence of this complication led to serious events. Clinicians should pay attention to the possibility of bacillemia in elderly or immunocompromised OVF patients. Level of Evidence: 4
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Conclusion. Although intent-to-treat analysis failed to show significant differences in patients treated surgically, results of the as-treated analysis determined statically greater improvements in those patients with spondylolisthesis who were treated surgically as compared to those treated nonoperatively. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
Conclusion. Ten years after its inception, SPORT has made strides in standardization and optimization of treatment for spinal pathologies. SPORT has provided clinicians with insight about outcomes of surgical and nonoperative treatment of IDH. Results showed significantly greater improvements in patients treated surgically. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
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