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Biomedical subjects

S Elangovan

Publications and source records attributed to S Elangovan.

8 recordsLinked to original sources

Case report: calcification within aneurysmal bone cyst.

Aneurysmal bone cyst (ABC) usually affects older children or young adults. The radiological appearance is of a purely osteolytic expansile metaphyseal lesion with thinned out cortex and internal septations. We present a case of ABC in a 5-year-old girl which showed internal calcification and was initially diagnosed as enchondroma. However, pathological examination revealed typical appearance of ABC with large area of dystrophic calcification.

Bone Cysts, Aneurysmal

Intralobar sequestration of the lung presenting as a continuous murmur--a case report.

An eighteen-year-old asymptomatic woman with a continuous murmur, normal two-dimensional echocardiogram, and mild haziness of the left lower segment of the lung on chest x-ray was diagnosed to have sequestration based on the presence of a large anomalous systemic artery arising from the descending thoracic aorta supplying the lower lobe of the left lung. Normal bronchial connections with the rest of the lung on bronchoscopy and delayed dye clearance from the left lower lobe bronchioles on bronchogram indicated its intralobar nature. The cause of the continuous murmur was thought to be the large flow through the anomalous systemic artery.

Adolescent

Aortic dissection with a fistulous communication into the right atrium: a case report.

A case of aortic dissection (type 1, De Bakey) with a rent into the right atrium (RA), diagnosed by echocardiography (echo) and confirmed by aortography, is reported. The patient presented with cardiac failure and a continuous murmur in the right second and third intercostal spaces. The patient has survived for two years with medial treatment.

Adult

Clinical and laboratory findings in acute appendicitis in the elderly.

BACKGROUND: Early diagnosis and surgery are important factors by which the morbidity and mortality of acute appendicitis in elderly patients can be lowered. This study was conducted to determine clinical and laboratory results that are commonly associated with acute appendicitis in elderly patients. METHODS: A retrospective chart review was conducted of patients aged 60 years or older who underwent appendectomy or laparotomy for suspected acute appendicitis during a 5-year period in a metropolitan county. Acute appendicitis was confirmed by the pathology report. RESULTS: Elevated band cells and right lower quadrant pain were predictors of acute appendicitis in clinically suspected cases. Band cells greater than 6 percent had an excellent positive predictive value, as all patients with elevated band cells had acute appendicitis. With increasing white cell count and temperature, specificity increased, sensitivity decreased, and the positive predictive value remained high. CONCLUSIONS: It is essential to have a high degree of suspicion to recognize acute appendicitis in an afebrile elderly patient who has abdominal pain, a mildly elevated white cell count, and band cells in the upper limits of normal.

Acute Disease

Improving pneumococcal vaccination rates in an elderly population by patient education in an outpatient clinic.

BACKGROUND: Invasive pneumococcal disease is a major cause of morbidity and mortality in elderly patients. This study investigated the impact of a patient education intervention on the pneumococcal vaccination rate in elders. METHODS: Charts of all patients aged 65 years or older who visited a university ambulatory care clinic during a 3-month period were reviewed for pneumococcal vaccination status before the patients' arrival for an office visit. Those who did not have the vaccination were provided patient education in the waiting room. Data were collected on age, sex, race, and immunization status. The reasons for refusing the vaccination before or during this intervention also were obtained. The charts of patients who consented were flagged for the attending physician to order the vaccination if appropriate. RESULTS: Charts of 535 patients were reviewed for pneumococcal vaccination status. Of these patients, 291 had had a pneumococcal vaccination before the study. The cumulative vaccination rate increased significantly from 54 percent to 79 percent after the study intervention. The rate of pneumococcal vaccination was significantly lower among African-Americans than whites both before and after the patient education intervention. CONCLUSION: This study reports a substantial impact of patient education on improving pneumococcal vaccination rates in an elderly population. Most elders accept vaccination, and it can be delivered effectively without an additional visit.

Black or African American

Incidence of acute appendicitis confirmed by histopathologic diagnosis.

The annual incidence of acute appendicitis by gender, age, and race in Sedgwick County, Kansas was lower than values reported in most other communities. However, the trends of peak incidence during the second decade, male predominance among all races, and the highest incidence in Caucasians also were noted in the current study. The rates of perforation and gangrenous appendicitis were significantly higher in the elderly. No association was noted between the presence of fecalith and acute appendicitis or perforation. A better understanding of the etiology of acute appendicitis may explain the trends and differences in the incidence of acute appendicitis observed.

Acute Disease