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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
In young children, the only symptom of a urinary tract infection (UTI) may be a fever. Because of the lack of more obvious symptoms, when females under the age of two or uncircumcised males less than a year exhibit a fever, a culture of the urine is recommended by many medical associations. Infants may feed poorly, vomit, sleep more, or show signs of jaundice. In older children, new onset urinary incontinence (loss of bladder control) may occur.
Lower urinary tract infection is also referred to as a bladder infection. The most common symptoms are burning with urination and having to urinate frequently (or an urge to urinate) in the absence of vaginal discharge and significant pain. These symptoms may vary from mild to severe and in healthy women last an average of six days. Some pain above the pubic bone or in the lower back may be present. People experiencing an upper urinary tract infection, or pyelonephritis, may experience flank pain, fever, or nausea and vomiting in addition to the classic symptoms of a lower urinary tract infection. Rarely the urine may appear bloody or contain visible pus in the urine.
Bacterial skin infections include:
- Folliculitis is an infection of the hair follicle that can resemble pimples.
- Impetigo is a highly contagious bacterial skin infection most common among pre-school children. It is primarily caused by "Staphylococcus aureus", and sometimes by "Streptococcus pyogenes".
- Erysipelas is an acute streptococcus bacterial infection of the deep epidermis with lymphatic spread.
- Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken: cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, intravenous drug injection or sites of intravenous catheter insertion. Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of the body.
Congenital cytomegalovirus infection refers to a condition where cytomegalovirus is transmitted in the prenatal period.
Human cytomegalovirus is one of the vertically transmitted infections that lead to congenital abnormalities. (Others are: toxoplasmosis, rubella, and herpes simplex. )
Fungal skin infections may present as either a superficial or deep infection of the skin, hair, and/or nails. As of 2010, they affect about one billion people globally.
The signs and symptoms of a vertically transmitted infection depend on the individual pathogen. It may cause subtle signs such as a influenza-like illness and may not even be noticed by the mother during the pregnancy. In such cases, the effects may be seen first at birth.
Symptoms of a vertically transmitted infection may include fever and flu like symptoms. The newborn is often small for gestational age. A petechial rash on the skin may be present, with small reddish or purplish spots due to bleeding from capillaries under the skin. An enlarged liver and spleen (hepatosplenomegaly) is common, as is jaundice. However, jaundice is less common in hepatitis B because a newborn's immune system is not developed well enough to mount a response against liver cells, as would normally be the cause of jaundice in an older child or adult. Hearing impairment, eye problems, mental retardation, autism, and death can be caused by vertically transmitted infections. The mother often has a mild infection with few or no symptoms.
The genetic conditions of Aicardi-Goutieres syndrome are possibly present in a similar manner.
For infants who are infected by their mothers before birth, two potential adverse scenarios exist:
- Generalized infection may occur in the infant, and can cause complications such as low birth weight, microcephaly, seizures, petechial rash similar to the "blueberry muffin" rash of congenital rubella syndrome, and moderate hepatosplenomegaly (with jaundice). Though severe cases can be fatal, with supportive treatment most infants with CMV disease will survive. However, from 80% to 90% will have complications within the first few years of life that may include hearing loss, vision impairment, and varying degrees of learning disability.
- Another 5% to 10% of infants who are infected but without symptoms at birth will subsequently have varying degrees of hearing and mental or coordination problems. The onset of hearing loss can occur at any point during childhood, although commonly within the first decade. It is progressive and can affect both ears.
These risks appear to be almost exclusively associated with women who previously have not been infected with CMV and who are having their first infection with the virus during pregnancy. There appears to be little risk of CMV-related complications for women who have been infected at least 6 months prior to conception. For this group, which makes up 50% to 80% of the women of child-bearing age, the rate of newborn CMV infection is 1%, and these infants appear to have no significant illness or abnormalities.
The virus can also be transmitted to the infant at delivery from contact with genital secretions or later in infancy through breast milk. However, these infections usually result in little or no clinical illness in the infant.
To summarise, during a pregnancy when a woman who has never had CMV infection becomes infected with CMV, there is a risk that after birth the infant may have CMV-related complications, the most common of which are associated with hearing loss, visual impairment, or diminished mental and motor capabilities. On the other hand, healthy infants and children who acquire CMV after birth have few, if any, symptoms or complications. However, preterm born infants infected with CMV after birth (especially via breastmilk). This can lead to cognitive and motor impairments later in life.
Congenital cytomegalovirus infection can be an important cause of intraventricular hemorrhage and neonatal encephalopathy.
Tubo-ovarian abscesses (TOA) are one of the late complications of pelvic inflammatory disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis. It consists of an encapsulated or confined 'pocket of pus' with defined boundaries that forms during an infection of a fallopian tube and ovary. These abscesses are found most commonly in reproductive age women and typically result from upper genital tract infection. It is an inflammatory mass involving the fallopian tube, ovary and, occasionally, other adjacent pelvic organs. A TOA can also develop as a complication of a hysterectomy.
Patients typically present with fever, elevated white blood cell count, lower abdominal-pelvic pain, and/or vaginal discharge. Fever and leukocytosis may be absent. TOAs are often polymicrobial with a high percentage of anaerobic bacteria. The cost of treatment is approximately $2,000 per patient, which equals about $1.5 billion annually. Though rare, TOA can occur without a preceding episode of PID or sexual activity.
A vertically transmitted infection is an infection caused by pathogens (such as bacteria and viruses) that uses mother-to-child transmission, that is, transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It can occur when the mother gets an infection as an intercurrent disease in pregnancy. Nutritional deficiencies may exacerbate the risks of perinatal infection.
The signs and symptoms of tubo-ovarian abscess (TOA) are the same as with pelvic inflammatory disease (PID) with the exception that the abscess can be found with magnetic resonance imaging (MRI), sonography and x-ray. It also differs from PID in that it can create symptoms of acute-onset pelvic pain. Typically this disease is found in sexually active women but sexually inexperienced, virginal girls have rarely been found with this infection.
AIDS-related complex, or ARC, was introduced after discovery of the HIV (Human Immunodeficiency Virus) when the medical community became aware of the inherent difficulties associated with treating patients suffering from an advanced case of HIV which gave rise to the term Acquired Immune Deficiency Syndrome (AIDS). The necessity for doctors to quickly and accurately understand the special needs of unknown patients suffering from AIDS in an emergency room situation was addressed with the creation of the term ARC.
ARC is "A prodromal phase of infection with the human immunodeficiency virus (HIV). Laboratory criteria separating AIDS-related complex ( ARC) from AIDS include elevated or hyperactive B-cell humoral immune responses, compared to depressed or normal antibody reactivity in AIDS; follicular or mixed hyperplasia in ARC lymph nodes, leading to lymphocyte degeneration and depletion more typical of AIDS; evolving succession of histopathological lesions such as localization of Kaposi's sarcoma, signaling the transition to the full-blown AIDS."
Clinical use of this term was widely discontinued by the year 2000 in the United States after having been replaced by modern laboratory criteria.
Other symptoms of the syndrome include:
- retroorbital pain due to pain in the area supplied by the ophthalmic branch of the trigeminal nerve (fifth cranial nerve),
- abducens nerve palsy (sixth cranial nerve), and
- otitis media.
Other symptoms can include photophobia, excessive lacrimation, fever, and reduced corneal sensitivity.
The syndrome is usually caused by the spread of an infection into the petrous apex of the temporal bone.
Condensing osteitis is a periapical inflammatory disease that results from a reaction to a dental related infection. This causes more bone production rather than bone destruction in the area (most common site is near the root apices of premolars and molars). The lesion appears as a radiopacity in the periapical area hence the sclerotic reaction. The sclerotic reaction results from good patient immunity and a low degree of virulence of the offending bacteria. The associated tooth may be carious or contains a large restoration, and is usually associated with a non-vital tooth.
Despite the alternative name for this condition, "denture sore mouth", it is usually painless and asymptomatic. The appearance of the involved mucosa is erythematous (red) and edematous (swollen), sometimes
with petechial hemorrhage (pin-points of bleeding). This usually occurs beneath an upper denture. Sometimes angular cheilitis can coexist, which is inflammation of the corners of the mouth, also often associated with "Candida albicans". Stomatitis rarely develops under a lower denture. The affected mucosa is often sharply defined, in the shape of the covering denture.
The Newton classification divides denture-related stomatitis into three types based on severity. Type one may represent an early stage of the condition, whilst type two is the most common and type three is uncommon.
- Type 1 - Localized inflammation or pinpoint hyperemia
- Type 2 - More diffuse erythema (redness) involving part or all of the mucosa which is covered by the denture
- Type 3 - Inflammatory nodular/papillary hyperplasia usually on the central hard palate and the alveolar ridge
Infection of periapical tissues of a high immunity host by organisms of low virulence which leads to a localized bony reaction to a low grade inflammatory stimulus.
The condition most commonly is located at the junction of the hard and soft palate. However, the condition may arise anywhere minor salivary glands are located. It has also been occasionally reported to involve the major salivary glands. It may be present only on one side, or both sides. The lesion typically is 1–4 cm in diameter.
Initially, the lesion is a tender, erythematous (red) swelling. Later, in the ulcerated stage, the overlying mucosa breaks down to leave a deep, well-circumscribed ulcer which is yellow-gray in color and has a lobular base.
There is usually only minor pain, and the condition is often entirely painless. There may be prodromal symptoms similar to flu before the appearance of the lesion.
Gradenigo's syndrome, also called Gradenigo-Lannois syndrome and petrous apicitis, is a complication of otitis media and mastoiditis involving the apex of the petrous temporal bone. It was first described by Giuseppe Gradenigo in 1904 when he reported a triad of symptoms consisting of: (1)"unilateral periorbital pain" related to trigeminal nerve involvement, (2)"diplopia" due to sixth nerve palsy and (3)persistent "otorrhea", associated with bacterial otitis media with apex involvement of the petrous part of the temporal bone (petrositis). The classical syndrome related to otitis media has become very rare after the antibiotic era.
Symptoms of orchitis are similar to those of testicular torsion. These can include:
- hematospermia (blood in the semen)
- hematuria (blood in the urine)
- severe pain
- visible swelling of a testicle or testicles and often the inguinal lymph nodes on the affected side.
Transient erythroblastopenia of childhood (TEC) is a slowly developing anemia of early childhood characterized by gradual onset of pallor.
Necrotizing sialometaplasia (NS) is a benign, ulcerative lesion, usually located towards the back of the hard palate. It is thought to be caused by ischemic necrosis (death of tissue due to lack of blood supply) of minor salivary glands in response to trauma. Often painless, the condition is self-limiting and should heal in 6–10 weeks.
Although entirely benign and requiring no treatment, due to its similar appearance to oral cancer, it is sometimes misdiagnosed as malignant. Therefore, it is considered an important condition, despite its rarity.
Foals appear normal immediately after birth. JEB affects tissues including mucous membranes, so one of the first signs is blistering of the gingiva and tongue after the first attempt at nursing. Within the next few days, the foal develops lesions all over the body, especially over pressure points. The proteins affected by the gene mutations are also present in the hooves, causing hooves to slough.
Other symptoms that occur in JEB:
- Corneal lesions
- Dental dysplasia
- Depression
- Oral ulcers
- Suppressed appetite
- Incisors present at birth
As the grinding components cause metal flakes to shed from the system, the implant wears down. Metallosis results in numerous additional side effects:
- Confusion;
- Feelings of malaise;
- Gastrointestinal problems;
- Emotional disturbance;
- Recurring infections;
- Dizziness;
- Headaches;
- Problems in the nervous system (feelings of burning, tingling, or numbness of the extremities); and
- Cobalt poisoning (skin rashes, cardiomyopathy, problems with hearing, sight or cognition, tremors, and hypothyroidism).
The cause is chronic parafunctional activity of the masticatory system, which produces frictional, crushing and incisive damage to the mucosal surface and over time the characteristic lesions develop. Most people are aware of a cheek chewing habit, although it may be performed subconsciously. Sometimes poorly constructed prosthetic teeth may be the cause if the original bite is altered. Usually the teeth are placed too far facially (i.e. buccally and/or labially), outside the "neutral zone", which is the term for the area where the dental arch is usually situated, where lateral forces between the tongue and cheek musculature are in balance. Glassblowing involves chronic suction and may produce similar irritation of the buccal mucosa. Identical, or more severe damage may be caused by self-mutilation in people with psychiatric disorders, learning disabilities or rare syndromes (e.g. Lesch-Nyhan syndrome and familial dysautonomia).
The lesions are located on the mucosa, usually bilaterally in the central part of the anterior buccal mucosa and along the level of the occlusal plane (the level at which the upper and lower teeth meet). Sometimes the tongue or the labial mucosa (the inside lining of the lips) is affected by a similarly produced lesion, termed morsicatio linguarum and morsicatio labiorum respectively. There may be a coexistent linea alba, which corresponds to the occlusal plane, or crenated tongue. The lesions are white with thickening and shredding of mucosa commonly combined with intervening zones of erythema (redness) or ulceration. The surface is irregular, and people may occasionally have loose sections of mucosa that comes away.