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delayed diagnosis of abdominal Henoch-Schonlein purpura in children:A case report

世界临床病例杂志 2023年第26期11卷 6311-6317页

作者： Hui Guo Zhi-Ling Wang Zhu Tao Department of Pediatrics West China Second University HospitalChengdu 610041Sichuan ProvinceChina Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan UniversityChengdu 610000Sichuan ProvinceChina

BACKGROUND For children with abdominal Henoch-Schonlein purpura presenting abdominal pain as an initial symptom and severe clinical manifestations,but without purpura appearance on the skin,the diagnosis and treatment are relatively *** study summarized the characteristics of this group of patients by literature review and provided additional references for further refinement of glucocorticoid therapy in this *** SUMMARY A 6-year-old girl presented mainly with repeated abdominal pain and had received short-term out-of-hospital treatment with *** day 7 after onset,gastroscopy revealed chronic non-atrophic gastritis and erosive duodenitis without purpuric rash,and no obvious resolution of the abdominal pain was found after treatment against infection and for protection of gastric *** day 14 the inflammatory indices continued to rise and the pain was relieved after enhanced anti-infective therapy,but without complete *** day 19,the patient presented with aggravated abdominal pain with purplish-red dots on the lower limbs,by which Henoch-Schonlein purpura was *** 5 d of sequential treatment with methylprednisolone and prednisone,abdominal pain disappeared and she was *** Henoch-Schonlein purpura-related rash may appear after long-term abdominal pain,and should be distinguished from acute and chronic gastrointestinal diseases at the early stage without typical *** bacterial infection-induced Henoch-Schonlein purpura,glucocorticoid therapy alone without clearing the infection may not relieve symptoms.

关键词： Henoch-Schonlein purpura delayed diagnosis Rash Abdominal pain Gastrointestinal disease Case report

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delayed diagnosis and comprehensive treatment of cutaneous tuberculosis:A case report

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World Journal of Clinical Cases 2021年第16期9卷 4007-4015页

作者： Lu-Jue Gao Zi-Hui Huang Quan-Yong Jin Guo-Ying Zhang Min-Xing Gao Jia-Yan Qian Si-Xun Zhu Yang Yu Department of Extrapulmonary Tuberculosis Nanjing Integrated Traditional Chinese and Western Medicine HospitalNanjing 210014Jiangsu ProvinceChina Department of Laboratory Nanjing Integrated Traditional Chinese and Western Medicine HospitalNanjing 210014Jiangsu ProvinceChina

BACKGROUND Tuberculosis(TB)is a widespread infectious disease,with an incidence that is increasing *** TB(CTB)occurs rarely,accounting for less than 1%of all TB *** to the clinical presentation and diagnostic difficulties,CTB is often clinically neglected and *** SUMMARY A 32-year-old man underwent several debridement surgeries and skin flap transplantation after *** wound remained unhealed,accompanied by sinus *** to empirical judgment,T-cell spot of TB test,and bacterial culture of pyogenic fluids,he was diagnosed with CTB due to infection with exogenous Mycobacterium tuberculosis.A comprehensive anti-TB regimen that included isoniazid,rifampicin,ethambutol,and pyrazinamide was *** sinus was filled with a hydrophilic fiber-containing silver dressing,and woundprotecting sponges were applied to part of the *** wound healed after 40 *** ulceration was found within 2 mo after discharge;further follow-up will be *** A non-healing wound may be caused by TB *** treatment of CTB is effective.

关键词： Cutaneous tuberculosis delayed diagnosis Dressing change Antituberculosis Case report

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delayed diagnosis of ascending colon mucinous adenocarcinoma with local abscess as primary manifestation: Report of three cases

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World Journal of Clinical Cases 2021年第26期9卷 7901-7908页

作者： Shang-Zhi Han Rong Wang Kun-Ming Wen Department of Gastrointestinal Surgery Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina

BACKGROUND Colorectal mucinous adenocarcinoma is a distinct subtype of colorectal adenocarcinoma that is not sensitive to chemotherapy and radiotherapy,and its prognosis is worse than that of nonmucinous *** diagnosis and aggressive surgical treatment may be the key to improving the prognosis of *** colon mucinous adenocarcinoma with the primary manifestation of a local abscess caused by non-intestinal perforation has never been ***,since the lumen of the ascending colon is large,and early stage ascending colon cancer lacks typical clinical manifestations,the diagnosis may be delayed *** herein report three cases of delayed diagnosis of colorectal mucinous *** SUMMARY We present three patients(two females and one male)with mucinous ascending colon mucinous adenocarcinoma with the primary manifestation of a local abscess(the right area of the lumbar spine,right groin,and lower right abdomen)caused by non-intestinal *** the initial clinical visit,the common causes of those abscesses,including spinal tuberculosis and urinary tract infection,were *** treatment of the abscess was through an incision and ***,the source of the abscess was not made clear,which led to an abscess recurrence and a delayed diagnosis of colorectal mucinous *** the patients were referred to our hospital,a definitive diagnosis of ascending colon mucinous adenocarcinoma was made with the help of tumor markers and colonoscopic *** of the delayed diagnosis of the disease,two patients(case 1 and case 2)missed the chance of surgery due to disease progression and died in a short follow-up *** case 3 underwent radical surgery for the tumor in the right colon and partial abdominal wall resection and achieved a better *** Abscesses in the right area of the lumbar spine,right groin,or right lower quadrant caused by non-intestinal perforation as the prima

关键词： delayed diagnosis Colorectal mucinous adenocarcinoma Local abscess Case report

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delayed diagnosis for tricuspid regurgitation after blunt chest trauma

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Chinese Medical Journal 2014年第9期127卷 1794-1795页

作者： Zhao Haige Robert A. McCready Fan Jingya Hu Peng Ni Yiming Dominige Calcaterra Ma Liang Department of Cardiothoracic Surgery First Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang 310003 China Department of Cardiovascular Surgery Indiana University Health Physicians Methodist Hospital Indianapolis Indiana USA

Tricuspid valve regurgitation is a rare complication of blunt chest *** 150 cases have been reported since first being described by Todd et al in 1848.1 During the past few decades traumatic tricuspid regurgitation has been reported with increasing frequency,which may in part be attributed to more patients surviving blunt chest trauma as well as improved diagnostic imaging studies,such as *** incidence of traumatic tricuspid regurgitation is likely underestimated since chronic,isolated tricuspid insufficiency may be well tolerated in some patients who experience few or no symptoms after the traumatic event.2 Furthermore,some patients may not recall antecedent chest trauma unless specifically *** cases of traumatic tricuspid regurgitation are secondary to blunt chest trauma.1

关键词： tricuspid valve regurgitation blunt chest trauma delayed diagnosis

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Determinants of delayed diagnosis and treatment of tuberculosis in Cambodia:a mixed-methods study

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Infectious Diseases of Poverty 2020年第3期9卷 129-129页

作者： Alvin Kuo Jing Teo Chetra Ork Sothearith Eng Ngovlyly Sok Sovannary Tuot Li Yang Hsu Siyan Yi Saw Swee Hock School of Public Health National University of SingaporeNational University Health SystemSingaporeSingapore 不详

Background:Cambodia is among the 30 countries in the world with the highest burden of tuberculosis(TB),and it is estimated that 40%of people with TB remain *** this study,we aimed to investigate the determinants of delayed diagnosis and treatment of TB in ***:This mixed-method explanatory sequential study was conducted between February and September 2019 in 12 operational districts in *** comprised of a retrospective cohort study of 721 people with TB,followed by a series of in-depth *** assessed factors associated with time to TB diagnosis and treatment initiation using Cox proportional hazards ***,we conducted in-depth interviews with 31 people with TB purposively selected based on the time taken to reach TB diagnosis,sex,and *** were coded,and thematic analyses were ***:The median time from the onset of symptoms to TB diagnosis was 49 days(Interquartile range[IQR]:21–112).We found that longer time to diagnosis was significantly associated with living in rural area(Adjusted hazards ratio[aHR]=1.25;95%confidence interval[CI]:1.06–1.48);TB symptoms-cough(aHR:1.52;95%CI:1.18–1.94),hemoptysis(aHR 1.32;95%CI:1.07–1.63),and night sweats(aHR:1.24;95%CI:1.05–1.46);seeking private health care/self-medication(aHR:1.23;95%CI:1.04–1.45);and higher self-stigma(aHR:1.02;95%CI:1.01–1.03).Participants who received education level above the primary level were inversely associated with longer time to diagnosis(aHR:0.78;95%CI:0.62–0.97).The median time from TB diagnosis to the initiation of treatment was two days(IQR:1–3).The use of smear microscopy for TB diagnosis(aHR:1.50;95%CI:1.16–1.95)was associated with longer time to treatment *** private health care and self-medication before TB diagnosis,lack of perceived risk,threat,susceptibility,and stigma derived qualitatively further explained the quantitative ***:TB diagnostic delay was *** publi

关键词： Tuberculosis delayed diagnosis Health-seeking behavior Cambodia

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Surgical treatment of an old avulsion fracture of the ischial tuberosity and ischial ramus: A case report

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World Journal of Orthopedics 2024年第1期15卷 94-100页

作者： Zi-Ru Chen Shi-Jie Liao Fu-Chun Yang Department of Orthopedic Trauma and Hand Surgery The First Affiliated Hospital of Guangxi Medical UniversityNanning 530021Guangxi Zhuang Autonomous RegionChina

BACKGROUND Avulsion fracture of the ischial tuberosity is a relatively clinically rare type of trauma that is mainly incurred by adolescents during competitive sports *** to previous literature,the most commonly involved sports are soccer,sprinting,and gymnastics,in descending ***-induced avulsion fracture of the ischial tuberosity and ischial ramus is extremely clinically *** SUMMARY A case of a neglected avulsion fracture of the ischial tuberosity and ischial ramus was diagnosed in a young female dancer who complained of pain and restricted movement of her right *** stated that she had suffered the injury while performing a split leap during a dance performance 9 mo ***,she underwent surgery and obtained satisfactory treatment *** Early diagnosis of these fractures is important to ensuring early proper treatment towards a quicker *** old fractures with nonunion and chronic buttock pain,surgery is a preferred therapeutic choice with good treatment outcomes.

关键词： Ischial tuberosity Ischial ramus Avulsion fracture delayed diagnosis Splitleap injury Case report

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Profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria: a retrospective study in China, 2014–2021

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Infectious Diseases of Poverty 2022年第6期11卷 50-59页

作者： Tao Zhang Duoquan Wang Yingjun Qian Wei Ruan Ying Liu Jing Xia Hui Yan Yuan Sui Shenning Lu Xian Xu Jingjing Jiang Xiaofeng Lyu Shuqi Wang Shizhu Li Weidong Li Anhui Provincial Center for Disease Control and Prevention Hefei 230601China National Institute of Parasitic Diseases Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research)NHC Key Laboratory of Parasite and Vector BiologyWHO Collaborating Center for Tropical DiseasesNational Center for International Research on Tropical DiseasesShanghai 200025China Zhejiang Provincial Center for Disease Control and Prevention Hangzhou 310051China Henan Provincial Center for Disease Control and Prevention Zhengzhou 450016China Hubei Provincial Center for Disease Control and Prevention Wuhan 430079China Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention Nanning 530028China Brown School Washington UniversitySt.LouisMOUSA School of Global Health Chinese Center for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghai 200025China

Background: In areas where malaria has been eliminated, delayed care-seeking and diagnosis of imported malaria are constant threats. This study aimed to describe the profile and determinants of delayed care-seeking and diagnosis among patients with imported malaria in ***: This retrospective study assessed surveillance data obtained from 2014 to 2021 in the Chinese provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, and Zhejiang, and Guangxi. Epidemiological characteristics were analyzed using descriptive statistics. Furthermore, factors associated with delayed care-seeking and diagnosis among imported malaria cases were identified using multivariate logistic ***: Overall, 11.81% and 30.08% of imported malaria cases had delays in seeking care and diagnosis, respectively. During the study period, there was a decreasing trend in the proportion of imported malaria cases with delayed care-seeking (χ^(2) = 36.099,P diagnosis (χ^(2) = 11.395,P = 0.001). In multivariate analysis, independent risk factors associated with delayed care-seeking include PLADs (Guangxi as reference), consultations in high-level facilities for the first medical visit, infections with non-Plasmodium falciparum species, and older age. However, PLADs (Guangxi as reference), the purpose of traveling (labour as reference), and infections with non-P. falciparum species increased the risk of delayed diagnosis. delayed care-seeking (adjusted odds ratio: 1.79,P = 0.001) and diagnosis (adjusted odds ratio: 1.62,P = 0.004) were risk factors for severe disease ***: Based on this study’s findings, we strongly advocate for improved access to quality healthcare to reduce the rate of misdiagnosis at the first visit. Infections caused by non-P. falciparum species should be highlighted, and more sensitive and specific point-of-care detection methods for non-P. falciparum species should be developed and implemented. In addition, educati

关键词： Malaria delayed care-seeking delayed diagnosis Imported malaria Prevention Re-establishment China Plasmodium falciparum

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Exploring the Pathways of Leprosy Patients from Their Communities to a diagnosis in the Districts of Mayuge, Yumbe and Kasese-Uganda

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Advances in Infectious Diseases 2024年第2期14卷 346-373页

作者： Rose Kengonzi Stavia Turyahabwe Samuel Orach Lisa Gerwing-Adima Ronald W. Nyote Vincent Kamara Kabugho Faith Consolata Mpambara National Tuberculosis and Leprosy Program Ministry of Health Uganda Kampala Uganda Health Department Uganda Catholic Medical Bureau Kampala Uganda German Leprosy and Tuberculosis Relief Association Kampala Uganda National Tuberculosis and Leprosy Program Kampala Uganda

Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity buildi

关键词： Leprosy Patient Pathway Skin Lesions Disability Discrimination delayed diagnosis

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delayed Management of High-Grade Renal Trauma in a Child with Bilateral Lower Polar Artery: A Case Report

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Open Journal of Urology 2022年第11期12卷 556-562页

作者： Doudou Gueye Florent Tshibwid A. Zeng Ibrahima Bocar Wellé Papa Alassane Mbaye Lissoune Cissé Christ Tsague Momo Ndeye Aby Ndoye Aloï se Sagna Gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital Centre Université Cheikh Anta Diop Dakar Senegal

High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with grade IV renal trauma complicated with infected urinoma and bilateral lower polar vessels. She was non-operatively managed with ultrasound-guided percutaneous drainage of the urinoma, which resolved, and had unremarkable six months follow-up. We discuss the role of preexistent hydronephrosis in low-velocity impact, pitfalls of diagnosis in resource-constrained settings, and management of high-grade trauma.

关键词： Renal Trauma Lower Polar Artery Urinoma delayed diagnosis Case Report

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Presentation delay in breast cancer patients and its association with sociodemographic factors in North Pakistan

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Chinese Journal of Cancer Research 2015年第3期27卷 288-293页

作者： Muhammad Aleem Khan Sheharyar Hanif Sundas Iqbal Muhammad Faheem Shahzad Sehrish Shafique Muhammad Taha Khan Department of Nuclear Medicine Nuclear MedicineOncology and Radiotherapy Institute Department of Medicine Ziauddin Medical University Armed Forces Institute of Cardiology Department of Physiology Rawal Institute of Health Sciences Nuffield Brentwood Hospital

Background： There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. The objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our ***： We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to the consultation from doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed ***： A total of 39.01%（n=123） of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2% were not having enough resources; 17.1% presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, 〈8 school years of education and low to middle socio-economic status were significantly associated with delayed presentation（P〈0.05）. Education and socioeconomic status were two independent variables related to the delayed presentation after adjustment for others [odds ratios（OR） of 2.26, 2.29 and 95% confidence intervals（CI） was 1.25-4.10, 1.06-4.94 respectively].Conclusions： Significant percentage of women with breast cancer in North Pakistan is experiencing presentation delay due to their misconceptions about the disease. Coordinated efforts with public health department are needed to educate the focused groups and mitigating the barriers identified in the study. Long term impact will be reduced overall burden of the disease in the region.

关键词： Breast cancer delayed diagnosis survival

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