Optic Neuritis in a 15-Year-Old Female Patient: A Case Report and Literature Review.

Optic neuritis represents a rare clinical entity leading to vision loss within the pediatric population. While not an urgent or life-threatening condition, optic neuritis may serve as a manifestation of various systemic diseases. When pediatric patients present with complaints of vision loss, it is imperative to consider optic neuritis as a potential differential diagnosis. This prompts further investigation to exclude systemic diseases capable of causing substantial morbidity. This article details a case report involving optic neuritis in a 15-year-old Hispanic female, outlining the investigation and management approach. Additionally, a review of the literature identifies six recent case reports documenting pediatric optic neuritis within the last year.

Liver Abscess as an Uncommon Complication of Laparoscopic Appendectomy: A Case Report.

Pyogenic liver abscess (PLA) is an infrequently seen complication of appendicitis that once was common, but now is so rare many textbooks omit the condition entirely. In this report, we document a recent case of post-appendicitis PLA in an eight-year-old Hispanic female treated with a combination of medical and surgical management. We have detailed the course of treatment, both to raise awareness of this uncommon complication of appendicitis and to help provide a guide for other clinicians treating similar cases. While cases of pediatric PLA post-appendicitis are rare in the modern world, timely diagnosis and treatment of the lesions are paramount to patient recovery and prevention of long-term sequelae. Study of prior literature and research is likely to be of vital importance to the treatment of the condition. Multiple treatment modalities may be considered, and there is no true standard of care for pediatric populations presenting with PLA.

Bezoars: Culprits of gastrointestinal obstruction that may lead to surgical intervention and potentially surgical complications.

Key Clinical Message: Bezoars can cause gastrointestinal obstruction and may require surgery. Surgery carries the risk of complications. Medical professionals should perform detailed history in diet and behaviors for patients presenting with abdominal pain to identify risk factors for bezoars, then educate these patients and their families about risks and complications of bezoars. Abstract: Bezoars are solid masses of undigested material that can cause obstruction of the gastrointestinal tract. There are different types of bezoars; phytobezoar, trichobezoar, pharmacobezoar, lactobezoar, and bezoars containing tissue paper or polystyrene foam. This case report is of a 13-year-old Hispanic male who suffered a postsurgical complication after removal of bezoar. He had a past surgical history of appendectomy and presented to the hospital with a 1-day history of right lower quadrant abdominal pain associated with fever and diarrhea. X-radiation images and computed tomography scans aided in the diagnosis of pelvic abscess as a complication of postsurgical enterotomy and closure of the enterotomy to remove bezoar from the small bowel. The initial bezoar removal and the postsurgical complication of pelvic abscess resulted in the patient staying for 19 days in the hospital. At discharge, the patient and his guardian were advised to follow up with the patient's primary care physician and surgical team. The patient made an uneventful recovery. He did not experience any long-term complications and fully recovered. This report demonstrates that although bezoars are rare, they can cause significant obstruction of the gastrointestinal tract leading to the need for management, such as surgery, which carries its own risks. It is important to note that the postsurgical complication of pelvic abscess can occur due to surgery itself and not because of bezoar specifically. Abdominal surgery in general poses the risk of pelvic abscess. The consideration is to expectantly decrease the occurrence of bezoars so that consequently there will not be a need for surgery in removal of bezoars due to obstruction. The effects of bezoars can be prevented through educating the community and addressing underlying psychiatric disorders.

Immunoglobulin A Nephropathy Presenting After Streptococcal Pharyngitis: A Case Report.

Immunoglobulin A (IgA) nephropathy (IgAN) is a condition characterized by IgA glomerular deposits with local cellular proliferation on renal biopsy. IgAN is the most common glomerular disease and the most common cause of renal failure worldwide. IgAN's pathogenesis is hypothesized as a four-hit process causing improper IgA production. Four-hit processes result in an increased level of circulating galactose deficient IgA1 (Gd-IgA1). In response, Gd-IgA1 is perceived as an autoantigen by other antibodies leading to renal tissue injury. This report outlines a case of a 15-year-old Hispanic male who presented to the Emergency Department with complaints of fever and hematuria, a week after testing positive for streptococcal pharyngitis. This case summarizes the presentation and management of IgAN.

Evaluation of a Neck Mass in a Six-Month-Old Infant: A Case Report.

Pediatric neck masses are one of the commonly encountered problems in clinical practice. They comprise a wide spectrum of congenital to acquired lesions manifesting in early or late childhood. They often pose a diagnostic challenge to the physician. We hereby present a case report of a six-month-old boy with a left-sided neck mass. Findings of a detailed workup were consistent with acute bacterial cervical lymphadenitis, ruling out neoplasia. The child showed significant improvement after including extended coverage of antibiotic therapy for methicillin-resistant Staphylococcus aureus (MRSA) and was put under follow-up.

Recurrent Intussusception in the Setting of Meckel's Diverticulum in an Infant.

Intussusception is a condition consisting of a proximal portion of the bowel contracting into a more distal bowel portion. The recurring act of intussusception is typically caused by a pathological lead point persisting within the bowel. The most common lead point for intussusception is a Meckel's diverticulum, which arises due to the incomplete obliteration of the omphalomesenteric canal causing a true diverticulum in the small bowel. This report outlines a case of a 10-month-old male infant who experienced three intussusception episodes, eventually requiring surgical intervention. A clinician's awareness of this phenomenon aids in implementing adequate treatment.

An evaluation of iterative reconstruction strategies based on mediastinal lesion detection using hybrid Ga-67 SPECT images.

Using psychophysical studies, the authors have evaluated the effectiveness of various strategies for compensating for physical degradations in SPECT imaging. The particular application was Ga-67-citrate imaging of mediastinal tumors, which was chosen because Ga-67 is a particularly challenging radionuclide for imaging. The test strategies included compensations for nonuniform attenuation, distance-dependent spatial resolution, and scatter applied in various combinations as part of iterative reconstructions with the rescaled block iterative-expectation maximization (RBI-EM) algorithm. The authors also evaluated filtered backprojection reconstructions. Strategies were compared on the basis of human-observer studies of lesion localization and detection accuracy using the localization receiver operating characteristics (LROC) paradigm. These studies involved hybrid images which were obtained by adding the projections of Monte Carlo-simulated lesions to disease-free clinical projection data. The background variability in these images can provide a more realistic assessment of the relative utility of reconstruction strategies than images from anthropomorphic digital phantoms. The clinical datasets were obtained using a GE-VG dual-detector SPECT system with CT-estimated attenuation maps. After determining a target lesion contrast, they conducted pilot LROC studies to obtain a near-optimal set of reconstruction parameters for each strategy, and then conducted the strategy comparison study. The results indicate improved detection accuracy with RBI-EM as more compensations are applied within the reconstruction. The relative rankings of the test strategies agreed in most cases with those of previous studies that employed simulated projections of digital anthropomorphic phantoms, thus confirming the findings of those studies.

Long pathlength, three-dimensional absorbance microchip.

A long pathlength, three-dimensional U-type flow cell was microfabricated and evaluated for improved absorbance detection on a glass microdevice. A small diameter hole (75mum) was laser etched in a thin glass substrate whose thickness (100mum) defined much of the pathlength of the cell. This substrate was thermally bonded and sandwiched between two different glass substrates. The top substrate contained a typical injection cross and separation microchannel. Projecting out of the plane of the separation device was a 126mum pathlength flow cell as defined by the laser etched hole and the attached microchannels. The flow cell was connected to a microchannel on the bottom substrate that led to a waste reservoir. The planar, flat windows on the top and bottom of this device made light introduction and collection a simple matter using a light emitting diode (LED) and microscope objective. The experimentally obtained detection limit for rhodamine B was determined to be 0.95muM, which is nearly identical to the theoretical limit calculated by Beer's Law. A separation of three fluorescent dyes was performed, and direct comparisons were made between the transmittance changes through the narrow pathlength separation microchannel and the adjacent long pathlength, three-dimensional U-type flow cell.