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The intermediate autosomal recessive form usually becomes clinically significant during the first decade of life. These patients will often suffer pathologic fractures and progressive cranial nerve compression neuropathies but typically live into adulthood. There are two subclassifications of autosomal dominant osteopetrosis, and these patients are often asymptomatic into adulthood. Type I typically does not have increased fracture risk and presents with isolated osteosclerotic thickening of the cranial vault. Patients with type II often present in adulthood with anemia, pathologic fracture, or early arthritis.Trauma to the cervical spine encompasses a wide spectrum of injury, ranging from muscular strain, capsular or ligament sprain/tear, to facet subluxations or dislocations with or without fracture. Cervical dislocations have classically been associated with traumatic spinal cord injuries. These injuries can cause spinal cord compression and dramatic neurological deficits, and the severity of the injury is dependent upon multiple factors. These can include the force applied to cause the injury, the extent of damage to the stabilizing osseous and soft tissue structures of the cervical spine, patient age, syndromic issues, bone quality, and underlying patient comorbidities.Traumatic injuries can range from minor wounds to major, complex injuries causing shock and multi-system organ dysfunction. Trauma is the leading cause of death in patients between the ages of 15 and 24. It accounts for approximately 30% of all ICU admissions annually. The lower urogenital (GU) tract is composed of the bladder, urethra, vagina, uterus, ovaries, penis, scrotum, and testes. The lower GU tract is typically protected by the bony pelvis. The pelvis is a ring structure composed of the sacrum, coccyx, and the innominate bones the pubis, ischium, and ilium. The innominate bones join anteriorly at the pubic symphysis. Bladder Anatomy The urinary bladder functions as a reservoir. The size, shape, and spatial relation to surrounding organs differs depending on the volume within the bladder. An empty bladder lies within the protection of the bony pelvis. However, as the bladder fills, it extends superiorly into the abdominal cavity and is more prone to traumatic forces. The base of the bladder is closely the testis. The remaining one-third comes from a combination of small arteries, including the vasal artery and the cremasteric arteries. The testicular artery arises from the aorta. The vasal artery arises from the superior vesicle artery, and the cremasteric artery is a branch of the inferior epigastric artery. The testis drains into the pampiniform plexus, which ultimately form a single vein that drains into the inferior vena cava on the right and the left renal vein on the left. The lymphatic vessels drain predominantly into the inter-aortocaval and para-caval nodes. Sympathetic innervation is by T10 nerve; sensory innervation is via T10 and the genitofemoral nerve (L1 and L2).Freud developmental theories on psychosexual development were among the first attempts to bring psychology under the same scientific structure and methodology of medicine and biology. Part of this structure was in setting an objective course of "normal" human sexual development. Once establishing this baseline of development, Freud was able to identify various stages, and their associated consequences should a child experience trauma during that developmental period. The theory was based on a child being born "polymorphously perverse." This essentially means that a child is born a tabula rasa regarding which part of the body they can derive sexual pleasure from. Freud developmental theory focused on two pivotal elements of human nature, "sex" and "aggression." Socialization during the child's upbringing was what drove the development of the child's libido. The child's resultant libido would determine if they had developed anxiety or neuroses. These feelings of anxiety and neuroses came as a result of the child experiencing sexual frustration or repression during any one of the five stages of development. If the child's needs were met in full or at least adequately by healthy nurturing, they could advance into adulthood with a healthy personality.The Minnesota Multiphasic Personality Inventory (MMPI) is the most common psychometric test devised to assess personality traits and psychopathology. This data can be used to draw conclusions about the test taker’s psychopathy or to interpret psychological characteristics compared to the norm. The most common treatment application of the test by providers functions in establishing or reevaluating care for an ambiguous clinical picture. For psychiatric management, this aids in creating generalizable data relevant to a plethora of possible conditions.Tropical pulmonary eosinophilia (TPE) is a hyperresponsive pulmonary syndrome in response to trapped microfilariae within the lung tissue. TPE is a clinical manifestation of lymphatic filariasis caused by filarial nematodes. Weingarten first described the term tropical pulmonary eosinophilia (TPE) in 1943. It was previously described as “pseudotuberculosis with eosinophilia.” The onset of tropical pulmonary eosinophilia is slow, and the major symptoms are fever, nocturnal cough, dyspnea, and wheezing. TPE is common in the filarial endemic region, but recently an increase in the prevalence of this disease is seen in developed countries due to migration and globalization. Lymphatic filariasis is a neglected tropical disease, and the most common clinical manifestation of this disease is elephantiasis. read more According to the World Health Organization (WHO), an estimated 120 million people are infected with lymphatic filariasis in tropical and subtropical regions. Study shows that less than 1% of individuals with filariasis will develop TPE. Pulmonary eosinophilic syndromes can be classified as extrinsic or intrinsic on the basis of causative factors. The extrinsic causes include medications (sulfonamides, phenytoin, phenobarbital, and carbamazepine) and infectious agents (parasites, fungi, mycobacteria). The intrinsic causes include Churg-Strauss syndrome, eosinophilic granuloma, chronic eosinophilic pneumonia, and idiopathic hypereosinophilic syndrome. Tropical pulmonary eosinophilia comes under extrinsic causes.

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