Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
The first symptoms of neuroblastoma are often vague making diagnosis difficult. Fatigue, loss of appetite, fever, and joint pain are common. Symptoms depend on primary tumor locations and metastases if present:
- In the abdomen, a tumor may cause a swollen belly and constipation.
- A tumor in the chest may cause breathing problems.
- A tumor pressing on the spinal cord may cause weakness and thus an inability to stand, crawl, or walk.
- Bone lesions in the legs and hips may cause pain and limping.
- A tumor in the bones around the eyes or orbits may cause distinct bruising and swelling.
- Infiltration of the bone marrow may cause pallor from anemia.
Neuroblastoma often spreads to other parts of the body before any symptoms are apparent and 50 to 60% of all neuroblastoma cases present with metastases.
The most common location for neuroblastoma to originate (i.e., the primary tumor) is in the adrenal glands. This occurs in 40% of localized tumors and in 60% of cases of widespread disease. Neuroblastoma can also develop anywhere along the sympathetic nervous system chain from the neck to the pelvis. Frequencies in different locations include: neck (1%), chest (19%), abdomen (30% non-adrenal), or pelvis (1%). In rare cases, no primary tumor can be discerned.
Rare but characteristic presentations include transverse myelopathy (tumor spinal cord compression, 5% of cases), treatment-resistant diarrhea (tumor vasoactive intestinal peptide secretion, 4% of cases), Horner's syndrome (cervical tumor, 2.4% of cases), opsoclonus myoclonus syndrome and ataxia (suspected paraneoplastic cause, 1.3% of cases), and hypertension (catecholamine secretion or renal artery compression, 1.3% of cases).
Neuroblastoma (NB) is a type of cancer that forms in certain types of nerve tissue. It most frequently starts from one of the adrenal glands, but can also develop in the neck, chest, abdomen, or spine. Symptoms may include bone pain, a lump in the abdomen, neck, or chest, or a painless bluish lump under the skin.
Occasionally neuroblastoma may be due to a mutation inherited from a person's parents. Environmental factors have not been found to be involved. Diagnosis is based on a tissue biopsy. Occasionally it may be found in a baby by ultrasound during pregnancy. At diagnosis the cancer has usually already spread. The cancer is divided into low, intermediate, and high risk groups based on a child's age, cancer stage, and what the cancer looks like.
Treatment and outcomes depends on the risk group a person is in. Treatments may include observation, surgery, radiation, chemotherapy, or stem cell transplantation. Low-risk disease in babies typically has a good outcome with surgery or simply observation. In high-risk disease chances of long term survival, however, are less than 40% despite aggressive treatment.
Neuroblastoma is the most common cancer in babies and the third most common cancer in children after leukemia and brain cancer. About 1 in every 7,000 children is affected at some point in time. About 90% of cases occur in children less than 5 years old and it is rare in adults. Of cancer deaths in children about 15% are due to neuroblastoma. The disease was first described in the 1800s.
Typical visible symptoms include rash-like patches, tumors, or lesions. Itching (pruritus) is common, perhaps in 20 percent of patients, but is not universal. The symptoms displayed are progressive, with early stages consisting of lesions presented as scaly patches. These lesions prefer the buttock region. The later stages involve the patches evolving into plaques distributed over the entire body. The advanced stage of mycosis fungoides is characterized by generalized erythroderma, with severe pruritus and scaling.
Mycosis fungoides, also known as Alibert-Bazin syndrome or granuloma fungoides, is the most common form of cutaneous T-cell lymphoma. It generally affects the skin, but may progress internally over time. Symptoms include rash, tumors, skin lesions, and itchy skin.
While the cause remains unclear, most cases are not hereditary. Most cases are in people over 20 years of age, and it is more common in men than women. Treatment options include sunlight exposure, ultraviolet light, topical corticosteroids, chemotherapy, and radiotherapy.
A limbal nodule is any nodular lesion at the limbus (junction of the cornea and sclera) of the eye.
The differential diagnosis for a limbal nodule can include:
- Pinguecula
- Early Pterygium
- Foreign body / foreign body granuloma
- Phlycten, an inflamed nodule of lymphoid tissue
- Episcleritis
- Scleritis
- Granuloma
- Limbal dermoid, a kind of choristoma (NB: in other organs "dermoid" can refer to a teratoma)
- malignant melanoma
Phlegmon is a spreading diffuse inflammatory process with formation of purulent exudate (the suppuration of pus). This is the result of acute purulent inflammation which may be related to bacterial infection; however, the term 'phlegmon' (from Greek 'phlegmone', inflammation) mostly refers to a walled-off inflammatory mass without bacterial infection, one that may be palpable on physical examination.
An example would be phlegmon of diverticulitis. In this case a patient would present to the emergency department with left lower-quadrant abdominal tenderness, and the diagnosis of sigmoid diverticulitis would be high on the differential diagnosis, yet the best test to confirm it would be CT scan.
Another example, phlegmon affecting the spine, is known as spondylodiscitis and is associated with endplate destruction and loss of disc height. In adults, the bone marrow is affected first, while in children, the disease starts in the disc itself and spreads rapidly to the adjacent vertebral bodies. Phlegmon in the spine can be a diffuse enhancement, or localized abscess, (peripheral enhancement) in the epidural, subligamentous or paraspinous spaces. Under MRI examination, phlegmon will show dark with T1, and high signal (bright) with T2.
Systemic features of infection such as increased body temperature (up to 38-40 °C), general fatigue, chills, sweatings, headache, loss of appetite).
Inflammatory signs – dolor (localized pain), calor (increase local tissue temperature), rubor (skin redness/hyperemia), tumor (either clear or non-clear bordered tissue swelling), functio laesa (diminish affected function).
NB: severity of patient condition with phlegmons is directly proportional to the degree of intoxication level i.e. the more severe the condition, the higher the degree of intoxication level.
A noninfectious occurrence of phlegmon can be found in the acute pancreatitis of Systemic Lupus Erythematosus. The immunosuppressive aspects of this disease and the immunosuppressive medications used to treat it blunt each of the signs of infection.
Flystrike in sheep is a myiasis condition, in which domestic sheep are infected by one of several species of flies which are external parasites of sheep.
Fly strike in sheep is a condition where parasitic flies lay eggs on soiled wool or open wounds. After hatching, the maggots, bury themselves in the sheep’s wool and eventually under the sheep’s skin, feeding off their flesh. Once the larvae develop, flies continue to deposit eggs on to new or already infected sheep, starting the infection process over again. Sheep display symptoms such as agitation, odour and matted wool, all which further encourage the attraction of flies. Fly strike can be lethal for sheep due to ammonia poisoning.
Fly strike is problematic, not only causing loss or degradation of stock, but also requiring expenditure of both money and time for effective management. In Australia, "Lucilia cuprina" causes about 90% of infestations, and "Chrysomya rufifacies" is the most common secondary pest the targets wounds caused by "L. cuprina".