ABSTRACT
BACKGROUND AND PURPOSE: Epilepsy is most common in lower-income settings where access to electroencephalography (EEG) is generally poor. A low-cost tablet-based EEG device may be valuable, but the quality and reproducibility of the EEG output are not established. METHODS: Tablet-based EEG was deployed in a heterogeneous epilepsy cohort in the Republic of Guinea (2018-2019), consisting of a tablet wirelessly connected to a 14-electrode cap. Participants underwent EEG twice (EEG1 and EEG2), separated by a variable time interval. Recordings were scored remotely by experts in clinical neurophysiology as to data quality and clinical utility. RESULTS: There were 149 participants (41% female; median age 17.9 years; 66.6% ≤21 years of age; mean seizures per month 5.7 ± SD 15.5). The mean duration of EEG1 was 53 ± 12.3 min and that of EEG2 was 29.6 ± 12.8 min. The mean quality scores of EEG1 and EEG2 were 6.4 [range, 1 (low) to 10 (high); both medians 7.0]. A total of 44 (29.5%) participants had epileptiform discharges (EDs) at EEG1 and 25 (16.8%) had EDs at EEG2. EDs were focal/multifocal (rather than generalized) in 70.1% of EEG1 and 72.5% of EEG2 interpretations. A total of 39 (26.2%) were recommended for neuroimaging after EEG1 and 22 (14.8%) after EEG2. Of participants without EDs at EEG1 (n = 53, 55.8%), seven (13.2%) had EDs at EEG2. Of participants with detectable EDs on EEG1 (n = 23, 24.2%), 12 (52.1%) did not have EDs at EEG2. CONCLUSIONS: Tablet-based EEG had a reproducible quality level on repeat testing and was useful for the detection of EDs. The incremental yield of a second EEG in this setting was ~13%. The need for neuroimaging access was evident.
Subject(s)
Epilepsy , Adolescent , Electroencephalography , Epilepsy/diagnosis , Female , Guinea , Humans , Male , Reproducibility of Results , Seizures/diagnosisABSTRACT
The authors present a case of intravesical ureterocele in a female which prolapsed out of the external urethral meatus causing urinary obstruction, and was managed by reduction into the bladder followed by endoincision.
Subject(s)
Ureteral Diseases/surgery , Urinary Bladder Diseases/surgery , Adult , Female , Humans , Postoperative Complications/diagnosis , Prolapse , Ureteral Diseases/diagnosis , Urinary Bladder Diseases/diagnosis , Urodynamics/physiology , Urography , Vesico-Ureteral Reflux/diagnosisABSTRACT
We report a case of giant segmental hydronephrosis of the right moiety of a horseshoe kidney. The diagnosis was not established until exploration, despite thorough evaluation by all the available imaging techniques.
Subject(s)
Hydronephrosis/diagnostic imaging , Kidney/abnormalities , Adult , Congenital Abnormalities/diagnostic imaging , Humans , Hydronephrosis/complications , Hydronephrosis/surgery , Male , Tomography, X-Ray ComputedABSTRACT
We report a case of urethral lymphangioma presenting with frank, painless hemaluria as the only symptom. Such a case has not been described in the literature to our knowledge.
Subject(s)
Lymphangioma/diagnosis , Urethral Neoplasms/diagnosis , Adolescent , Humans , MaleABSTRACT
Carcinoma of the prostate is rare in young patients and has an aggressive biological behavior and rapidly fatal outcome, irrespective of the treatment modality. Presentation and clinical course of the carcinoma in 2 patients 28 and 31 years of age are described with a brief review of the relevant literature.
Subject(s)
Adenocarcinoma, Mucinous/epidemiology , Adenocarcinoma/epidemiology , Prostatic Neoplasms/epidemiology , Adenocarcinoma/diagnosis , Adenocarcinoma, Mucinous/diagnosis , Adult , Age Factors , Humans , Incidence , Male , Prostate/pathology , Prostatic Neoplasms/diagnosisABSTRACT
We report a case of urosepsis and multiple ureteric strictures following extracorporeal shock wave lithotripsy for recurrent renal stones. The multiple ureteric strictures required ileal ureteral replacement.
Subject(s)
Lithotripsy/adverse effects , Pyelonephritis/etiology , Ureteral Obstruction/etiology , Humans , Kidney Calculi/therapy , Male , Middle Aged , Ureteral Obstruction/pathology , Ureteral Obstruction/surgeryABSTRACT
The neurodevelopmental outcome of premature infants with persistent apnea of prematurity (AOP) is reported. Sixty premature infants (birthweight [BW], 1469 +/- 533 gm; gestational age [GA , 31 +/- 3 weeks) with AOP were compared to 47 control infants (BW, 1586 +/- 581 gm; GA, 31 +/- 3 weeks) matched for gestational age and degree of neonatal illness. The infants were enrolled in a multidisciplinary follow-up program, and outcome data between 12 and 24 months are reported. Assessments included the Bayley Scores of Infant Development, neurologic examinations, speech and hearing examinations. There were no significant differences in the cognitive outcome between the premature infants with AOP and the premature control group. In 50 of 60 infants the Bayley Mental Developmental Index was in the normal range (112 +/- 18) as was 39 of 47 of the control group (112 +/- 13). Delays in motor development were seen in both premature groups, although a greater percentage of premature infants with persistent apnea had mild motor delays than did control infants. There was a comparable incidence of cerebral palsy (8% vs 11%), speech delays (20% vs 23%), retinopathy (8% vs 13%), and esotropia (7% vs 4%) between the infants with AOP and the premature control infants. The presence of persistent neonatal apnea without additional adverse perinatal events did not appear to be associated with a higher incidence of significant developmental problems.
Subject(s)
Apnea/epidemiology , Cerebral Palsy/epidemiology , Developmental Disabilities/epidemiology , Infant, Premature, Diseases/epidemiology , Infant, Premature/growth & development , Apnea/complications , Cerebral Palsy/diagnosis , Child, Preschool , Developmental Disabilities/diagnosis , Female , Follow-Up Studies , Humans , Incidence , Infant , Infant, Newborn , MaleABSTRACT
Fourteen neonates with posterior mediastinal air collections (retrocardiac pneumomediastinum) are described. In the majority of the infants (13 of 14), the mediastinal air developed as a complication of assisted ventilation. It is suggested that the retrocardiac pneumomediastinum represents air trapped in a potential space in the mediastinum posterior to the heart and not within the pulmonary ligament. The collections have a variable shape and size and rarely may produce a tension phenomenon elevating the posterior, inferior portion of the heart off of the diaphragm. There was a strong association of retrocardiac pneumomediastinum with other manifestations of extraalveolar air, including pulmonary interstitial emphysema (13 of 14 infants), pneumothorax (10 of 14 infants), dissection of air into the soft tissues of the neck (10 of 14 infants), and pneumoperitoneum (5 of 14 infants).
