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
A hygroma, or a false bursa, is a discrete, fluid-filled sac that can form on the joints of dogs in response to repeated pressure, such as that from sitting on a hard surface. It is treated by draining the fluid and may be prevented by providing padded bedding.
An untreated hygroma can develop into in a large enough swelling that stress the surrounding skin and becomes an open wound with the possibility of infection that is much more difficult to treat. In most cases a hygroma is a once in a lifetime occurrence for an animal, but other individuals will have repeated problems with hygromas.
A saddle sore in humans is a skin ailment on the buttocks due to, or exacerbated by, horse riding or cycling on a bicycle saddle. It often develops in three stages: skin abrasion, folliculitis (which looks like a small, reddish acne), and finally abscess.
Because it most commonly starts with skin abrasion, it is desirable to reduce the factors which lead to skin abrasion. Some of these factors include:
- Reducing the friction. In equestrian activities, friction is reduced with a proper riding position and using properly fitting clothing and equipment. In cycling, friction from bobbing or swinging motion while pedaling is reduced by setting the appropriate saddle height. Angle and fore/aft position can also play a role, and different cyclists have different needs and preferences in relation to this.
- Selecting an appropriate size and design of horse riding saddle or bicycle saddle.
- Wearing proper clothing. In bicycling, this includes cycling shorts, with chamois padding. For equestrian activity, long, closely fitted pants such as equestrian breeches or jodhpurs minimize chafing. For western riding, closely fitted jeans with no heavy inner seam, sometimes combined with chaps, are preferred. Padded cycling shorts worn under riding pants helps some equestrians, and extra padding, particularly sheepskin, on the seat of the saddle may help in more difficult situations such as long-distance endurance riding.
- Using petroleum jelly, chamois cream or lubricating gel to further reduce friction.
If left untreated over an extended period of time, saddle sores may need to be drained by a physician.
In animals such as horses and other working animals, saddle sores often form on either side of the withers, which is the area where the front of a saddle rests, and also in the girth area behind the animal's elbow, where they are known as a girth gall. Saddle sores can occur over the loin, and occasionally in other locations. These sores are usually caused by ill-fitting gear, dirty gear, lack of proper padding, or unbalanced loads. Reducing friction is also of great help in preventing equine saddle sores. Where there is swelling but not yet open sores, the incidence of sore backs may be reduced by loosening the girth, but not immediately removing the saddle after a long ride, thus allowing normal circulation to return slowly.
Different types of discharges from ulcer are:
- Serous, usually seen in healing ulcer
- Purulent, seen in infected ulcer. Yellow creamy discharge is observed in staphylococcal infection; bloody opalescent discharge in streptococcal infection, while greenish discharge is seen in pseudomonas ulcer
- Bloody (sanguineous), usually seen in malignant ulcers and in healing ulcers with healthy granulation tissue
- Seropurulent
- Serosanguinous
- Serous with sulphur granules, seen in actinomycosis
- Yellowish, as seen in tuberculous ulcer
Skin ulcers appear as open craters, often round, with layers of skin that have eroded. The skin around the ulcer may be red, swollen, and tender. Patients may feel pain on the skin around the ulcer, and fluid may ooze from the ulcer. In some cases, ulcers can bleed and, rarely, patients experience fever. Ulcers sometimes seem not to heal; healing, if it does occur, tends to be slow. Ulcers that heal within 12 weeks are usually classified as acute, and longer-lasting ones as chronic.
Ulcers develop in stages. In stage 1 the skin is red with soft underlying tissue. In the second stage the redness of the skin becomes more pronounced, swelling appears, and there may be some blisters and loss of outer skin layers. During the next stage, the skin may become necrotic down through the deep layers of skin, and the fat beneath the skin may become exposed and visible. In stage 4, deeper necrosis usually occurs, the fat underneath the skin is completely exposed, and the muscle may also become exposed. In the last two stages the sore may cause a deeper loss of fat and necrosis of the muscle; in severe cases it can extend down to bone level, destruction of the bone may begin, and there may be sepsis of joints.
Chronic ulcers may be painful. Most patients complain of constant pain at night and during the day. Chronic ulcer symptoms usually include increasing pain, friable granulation tissue, foul odour, and wound breakdown instead of healing. Symptoms tend to worsen once the wound has become infected.
Venous skin ulcers that may appear on the lower leg, above the calf or on the lower ankle usually cause achy and swollen legs. If these ulcers become infected they may develop an unpleasant odour, increased tenderness and redness. Before the ulcer establishes definitively, there may be a dark red or purple skin over the affected area as well as a thickening, drying, and itchy skin.
Although skin ulcers do not seem of great concern at a first glance, they are worrying conditions especially in people suffering from diabetes, as they are at risk of developing diabetic neuropathy.
Ulcers may also appear on the cheeks, soft palate, the tongue, and on the inside of the lower lip. These ulcers usually last from 7 to 14 days and can be painful.
Symptoms include sudden fever with sore throat, headache, loss of appetite, and often neck pain. Within two days of onset an average of four or five (but sometimes up to twenty) 1 to 2 mm diameter grayish lumps form and develop into vesicles with red surrounds, and over 24 hours these become shallow ulcers, rarely larger than 5 mm diameter, that heal in one to seven days. These lesions most often appear on the tonsillar pillars (adjacent to the tonsils), but also on the soft palate, tonsils, uvula, or tongue.
A small number of lesions (usually 2 - 6) form in the back area of the mouth, particularly the soft palate or tonsillar pillars. The lesions progress initially from red macules to vesicles and lastly to ulcerations which can be 2 – 4 mm in size.
Cracked nipple (or "nipple trauma") is a condition that can occur in breastfeeding women as a result of a number of possible causes. Developing a cracked nipple can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding. The mother with a cracked nipple can have severe nipple pain when the baby is nursing. This severe pain is a disincentive for continued breastfeeding. The crack can appear as a cut across the tip of the nipple and may extend to its the base. Cracked nipples develop after the birth of the infant and is managed with pharmacological and nonpharmacological treatment.
Cracked nipples are classified as a breast disorder. The nipple is not only the structure to delivery milk to the infant, it also contains small, sebaceous glands or Montgomery glands to lubricate the skin of the areola. Cracked nipples are most often associated with breastfeeding and appear as cracks or small lacerations or breaks in the skin of the nipple. In some instances an ulcer will form. The nipple in a nursing mother is in regular contact with a nursing infant. Cracked nipples are trauma to the nipple and can be quite painful. Cracked nipples typically appear three to seven days after the birth.
If the nipples appears to be wedge-shaped, white and flattened, this may indicate that the latch is not good and there is a potential of developing cracked nipples.
Saddle nose is a condition associated with nasal trauma, congenital syphilis, relapsing polychondritis, granulomatosis with polyangiitis, cocaine abuse, and leprosy, among other conditions. The most common cause is nasal trauma. It is characterized by a loss of height of the nose, because of the collapse of the bridge. The depressed nasal dorsum may involve bony, cartilaginous or both bony and cartilaginous components of the nasal dorsum.
Herpangina, also called mouth blisters, is a painful mouth infection caused by coxsackieviruses. Usually, herpangina is produced by one particular strain of coxsackie virus A (and the term "herpangina virus" refers to coxsackievirus A) but it can also be caused by coxsackievirus B or echoviruses. Most cases of herpangina occur in the summer, affecting mostly children. However, it occasionally occurs in adolescents and adults. It was first characterized in 1920.
This most common form of impetigo, also called nonbullous impetigo, most often begins as a red sore near the nose or mouth which soon breaks, leaking pus or fluid, and forms a honey-colored scab, followed by a red mark which heals without leaving a scar. Sores are not painful, but they may be itchy. Lymph nodes in the affected area may be swollen, but fever is rare. Touching or scratching the sores may easily spread the infection to other parts of the body.
Skin ulcers with redness and scarring also may result from scratching or abrading the skin.
Bullous impetigo, mainly seen in children younger than 2 years, involves painless, fluid-filled blisters, mostly on the arms, legs, and trunk, surrounded by red and itchy (but not sore) skin. The blisters may be large or small. After they break, they form yellow scabs.
Fever, sore throat, odynophagia (painful swallowing), swelling in neck.
Beau's lines are deep grooved lines that run from side to side on the fingernail or the toenail. They may look like indentations or ridges in the nail plate. This condition of the nail was named by a French physician, Joseph Honoré Simon Beau (1806–1865), who first described it in 1846.
Beau's lines are horizontal, going across the nail, and should not be confused with vertical ridges going from the bottom (cuticle) of the nail out to the fingertip. These vertical lines are usually a natural consequence of aging and are harmless. Beau's lines should also be distinguished from Muehrcke's lines of the fingernails. While Beau's lines are actual ridges and indentations in the nail plate, Muehrcke lines are areas of hypopigmentation without palpable ridges; they affect the underlying nail bed, and not the nail itself. Beau's lines should also be distinguished from Mees' lines of the fingernails, which are areas of discoloration in the nail plate.
There are several causes of Beau's lines. It is believed that there is a temporary cessation of cell division in the nail matrix. This may be caused by an infection or problem in the nail fold, where the nail begins to form, or it may be caused by an injury to that area. Some other reasons for these lines include trauma, coronary occlusion, hypocalcaemia, and skin disease. They may be a sign of systemic disease, or may also be caused by an illness of the body, as well as drugs used in chemotherapy or malnutrition. Beau's lines can also be seen one to two months after the onset of fever in children with Kawasaki disease.
Human nails grow at a rate which varies with many factors: age, and the finger or toe in question as well as nutrition. However, typically in healthy populations fingernails grow at about 0.1mm/day and toenails at about 0.05mm/day. With this in mind the date of the stress causing Beau's lines and other identifiable marks on nails can be estimated. As the nail grows out, the ridge visibly moves upwards toward the nail edge. When the ridge reaches the nail edge, the fingertips can become quite sore due to the mis-shapen nail pressing into the flesh deeper than usual, exposing the sensitive nail bed (the quick) at the nail edge.
A researcher found Beau's lines in the fingernails of two of six divers following a deep saturation dive to a pressure equal to 305 meters of sea water, and in six of six divers following a similar dive to 335 meters. They have also been seen in Ötzi the Iceman.
The symptoms can be mild or severe and may include:
- Not able to chew or swallow
- Sores on the inside of the cheeks or gums
- Fever
- General discomfort, uneasiness, or ill feeling
- Very sore mouth with no desire to eat
- Halitosis (bad breath)
Anterior space abscess can cause trismus (spasm of jaw muscle) and hard mass formation along the angle of the mandible, with medial bulging of the tonsil and lateral pharyngeal wall. Posterior space abscess causes swelling in posterior pharyngeal wall. Trismus (spasm of jaw muscle) is minimal. Posterior abscess may involve structures within the carotid sheath, causing rigors, high fever, bacteremia, neurologic deficit, massive haemorrhage caused by carotid artery rupture.
Bezold's Abscess is an abscess deep to sternocleidomastoid muscle where pus from mastoiditis erodes through the cortex of Mastoid part of the temporal bone, medial to the attachment of sternocleidomastoid, extends into the infratemporal fossa, and deep to the investing layer of the deep cervical fascia . It is a rare complication of acute otitis media.
It can usually be corrected with augmentation rhinoplasty by filling the dorsum of nose with cartilage, bone or synthetic implant. If the depression is only cartilaginous, cartilage is taken from the nasal septum or auricle and laid in single or multiple layers. If deformity involves both cartilage and bone, cancellous bone from iliac crest is the best replacement. Autografts are preferred over allografts. Saddle deformity can also be corrected by synthetic implants of teflon or silicon, but they are likely to be extruded.
Symptoms include pain during sports movements, particularly hip extension, and twisting and turning. This pain usually radiates to the adductor muscle region and even the testicles, although it is often difficult for the patient to pin-point the exact location.
Following sporting activity the person with athletic pubalgia will be stiff and sore. The day after a match, getting out of bed or a car will be difficult. Any exertion that increases intra-abdominal pressure, such as coughing, sneezing, or sporting activity can cause pain. In the early stages, the person may be able to continue playing their sport, but the problem usually gets progressively worse.
As pain in the groin and pelvis can be referred from a number of problems, including injuries to the lumbar spine, the hip joint, the sacro-iliac joint, the abdomen, and the genito-urinary system, diagnosis of athletic pubalgia requires skillful differentiation and pubic examination in certain cases where there is intense groin pain.
The diagnosis is based on the patient's history, clinical signs, and, increasingly, an MRI exam. Symptoms can often be reproduced by maneuvers such as performing sit-ups or crunches. Pain can also be elicited with the patient in a "frog position," in which the patient is supine with knees bent and heels together.
The exact lesion may differ, but common pathologic findings at operation are:
- torn external oblique aponeurosis
- tear in the conjoint tendon
- conjoint tendon torn from pubic tubercle
- dehiscence between conjoined tendon and inguinal ligament
- tear in the fascia transversalis
- abnormal insertion of the rectus abdominis muscle
- tear of the abdominal internal oblique muscle from the pubic tubercle
- entrapment of the ilioinguinal nerve or genitofemoral nerve
Several of these lesions may occur simultaneously. Also, many athletes have concomitant weakness or tearing of the adductor muscles or labral tears of the hip.
When the adductor muscles are tight post injury, that can be enough to trigger symptoms. The first conservative treatment option should be to restore normal motion after the adductor has begun to heal (usually 6–8 weeks post injury). Sleeping in a prone position with the hip on the affected side flexed and externally rotated can be a cure in some individuals.
The exact incidence of these entities is unknown: some believe it is the most common cause of chronic groin pain in athletes, while others argue that it is only rare. Conservative therapies (gentle stretching and a short period of rest) may temporarily alleviate the pain, but definitive treatment consists of surgical repair followed by a structured rehabilitation.
Gingivostomatitis symptoms in infants may wrongly be dismissed as teething. "Coincidentally, primary tooth eruption begins at about the time that infants are losing maternal antibody protection against the herpes virus. Also, reports on teething difficulties have recorded symptoms which are remarkably consistent with primary oral herpetic infection such as fever, irritability, sleeplessness, and difficulty with eating." "Younger infants with higher residual levels of antibodies would experience milder infections and these would be more likely to go unrecognized or be dismissed as teething difficulty."
Gingivostomatitis must also be differentiated from herpangina, another disease that also commonly causes ulcers in the oral cavity of children, but is caused by the Coxsackie A virus rather than a herpes virus. In herpangina, ulcers are usually isolated to the soft palate and anterior pillar of the mouth. In herpetic gingivostomatitis, lesions can be found in these locations, but they are almost always accompanied by ulcerations on the gums, lips, tongue or buccal mucosa and/or by hyperemia, hypertrophy or hemorrhage of the gums.
Athletic pubalgia, also called sports hernia, hockey hernia, hockey groin, Gilmore's Groin, or groin disruption is a medical condition of the pubic joint affecting athletes.
It is a syndrome characterized by chronic groin pain in athletes and a dilated superficial ring of the inguinal canal. Football and ice hockey players are affected most frequently, and both recreational and professional athletes may be affected.
Severe pain in perimastoid region, difficulty of swallowing, sore throat, difficulty in breathing, nuchal rigidity, and fever.
A perforated septum can vary in size and location, and is usually found deep inside the nose. It may be asymptomatic, or cause a variety of signs and symptoms. Small perforations can cause a whistling noise when breathing. Larger perforations usually have more severe symptoms. These can be a combination of crusting, blood discharge, difficulty breathing, nasal pressure and discomfort. The closer the perforation is to the nostrils, the more likely it is to cause symptoms.
Herpes infections usually show no symptoms; when symptoms do appear they typically resolve within two weeks. The main symptom of oral infection is inflammation of the mucosa of the cheek and gums—known as acute herpetic gingivostomatitis—which occurs within 5–10 days of infection. Other symptoms may also develop, including headache, nausea, dizziness and painful ulcers—sometimes confused with canker sores—fever, and sore throat.
Primary HSV infection in adolescents frequently manifests as severe pharyngitis with lesions developing on the cheek and gums. Some individuals develop difficulty in swallowing (dysphagia) and swollen lymph nodes (lymphadenopathy). Primary HSV infections in adults often results in pharyngitis similar to that observed in glandular fever (infectious mononucleosis), but gingivostomatitis is less likely.
Recurrent oral infection is more common with HSV-1 infections than with HSV-2. Symptoms typically progress in a series of eight stages:
1. Latent (weeks to months incident-free): The remission period; After initial infection, the viruses move to sensory nerve ganglia (trigeminal ganglion), where they reside as lifelong, latent viruses. Asymptomatic shedding of contagious virus particles can occur during this stage.
2. Prodromal (day 0–1): Symptoms often precede a recurrence. Symptoms typically begin with tingling (itching) and reddening of the skin around the infected site. This stage can last from a few days to a few hours preceding the physical manifestation of an infection and is the best time to start treatment.
3. Inflammation (day 1): Virus begins reproducing and infecting cells at the end of the nerve. The healthy cells react to the invasion with swelling and redness displayed as symptoms of infection.
4. Pre-sore (day 2–3): This stage is defined by the appearance of tiny, hard, inflamed papules and vesicles that may itch and are painfully sensitive to touch. In time, these fluid-filled blisters form a cluster on the lip (labial) tissue, the area between the lip and skin (vermilion border), and can occur on the nose, chin, and cheeks.
5. Open lesion (day 4): This is the most painful and contagious of the stages. All the tiny vesicles break open and merge to create one big, open, weeping ulcer. Fluids are slowly discharged from blood vessels and inflamed tissue. This watery discharge is teeming with active viral particles and is highly contagious. Depending on the severity, one may develop a fever and swollen lymph glands under the jaw.
6. Crusting (day 5–8): A honey/golden crust starts to form from the syrupy exudate. This yellowish or brown crust or scab is not made of active virus but from blood serum containing useful proteins such as immunoglobulins. This appears as the healing process begins. The sore is still painful at this stage, but, more painful, however, is the constant cracking of the scab as one moves or stretches their lips, as in smiling or eating. Virus-filled fluid will still ooze out of the sore through any cracks.
7. Healing (day 9–14): New skin begins to form underneath the scab as the virus retreats into latency. A series of scabs will form over the sore (called Meier Complex), each one smaller than the last. During this phase irritation, itching, and some pain are common.
8. Post-scab (12–14 days): A reddish area may linger at the site of viral infection as the destroyed cells are regenerated. Virus shedding can still occur during this stage.
The recurrent infection is thus often called "herpes simplex labialis". Rare reinfections occur inside the mouth ("intraoral HSV stomatitis") affecting the gums, alveolar ridge, hard palate, and the back of the tongue, possibly accompanied by "herpes labialis".
A lesion caused by herpes simplex can occur in the corner of the mouth and be mistaken for angular cheilitis of another cause. Sometimes termed "angular herpes simplex". A cold sore at the corner of the mouth behaves similarly to elsewhere on the lips. Rather than utilizing antifungal creams, angular herpes simplex is treated in the same way as a cold sore, with topical antiviral drugs.
Bumblefoot (ulcerative pododermatitis) is a bacterial infection and inflammatory reaction on the feet of birds, rodents, and rabbits. Ulcerative pododermatitis is referred to as "sore hocks" when it affects a rabbit and "bumblefoot" when it affects a bird. The terms "sore hocks" and "bumblefoot" are used interchangeably when describing ulcerative pododermatitis in rodents. The infection can usually be attributed to poor husbandry practices, therefore is much more likely to occur in captive animals than in those in the wild. It is caused by bacteria, namely strains of "Staphylococcus", "Pseudomonas" and "Escherichia coli" "(E. coli)", with "S. aureus" being the most common cause of the infection.