Science.gov

Sample records for previously reported due

  1. Hallux saltans due to flexor hallucis longus entrapment at a previously unreported site in an unskilled manual laborer: a case report.

    PubMed

    Purushothaman, Rajesh; Karuppal, Raju; Inassi, Jojo; Valsalan, Rejith

    2012-01-01

    Triggering of the big toe, or hallux saltans, is commonly due to stenosing tenosynovitis of the flexor hallucis longus at the fibro-osseous tunnel below the sustentaculum tali. It is a rare condition described mainly in female ballet dancers. This is hypothesized to be due to the en pointe position used in ballet, which puts enormous supraphysiologic loads on the flexor hallucis longus, predisposing it to injury. Trigger hallux is extremely uncommon in the general population. We are reporting a case of hallux saltans in an unskilled manual laborer, with the site of tendon entrapment just proximal to the medial malleolus in the distal leg, a hitherto unreported location of stenosis. PMID:22459424

  2. CAMS confirmation of previously reported meteor showers

    NASA Astrophysics Data System (ADS)

    Jenniskens, P.; Nénon, Q.; Gural, P. S.; Albers, J.; Haberman, B.; Johnson, B.; Holman, D.; Morales, R.; Grigsby, B. J.; Samuels, D.; Johannink, C.

    2016-03-01

    Leading up to the 2015 IAU General Assembly, the International Astronomical Union's Working List of Meteor Showers included 486 unconfirmed showers, showers that are not certain to exist. If confirmed, each shower would provide a record of past comet or asteroid activity. Now, we report that 41 of these are detected in the Cameras for Allsky Meteor Surveillance (CAMS) video-based meteor shower survey. They manifest as meteoroids arriving at Earth from a similar direction and orbit, after removing the daily radiant drift due to Earth's motion around the Sun. These showers do exist and, therefore, can be moved to the IAU List of Established Meteor Showers. This adds to 31 previously confirmed showers from CAMS data. For each shower, finding charts are presented based on 230,000 meteors observed up to March of 2015, calculated by re-projecting the drift-corrected Sun-centered ecliptic coordinates into more familiar equatorial coordinates. Showers that are not detected, but should have, and duplicate showers that project to the same Sun-centered ecliptic coordinates, are recommended for removal from the Working List.

  3. [Electronic cigarettes - effects on health. Previous reports].

    PubMed

    Napierała, Marta; Kulza, Maksymilian; Wachowiak, Anna; Jabłecka, Katarzyna; Florek, Ewa

    2014-01-01

    Currently very popular in the market of tobacco products have gained electronic cigarettes (ang. E-cigarettes). These products are considered to be potentially less harmful in compared to traditional tobacco products. However, current reports indicate that the statements of the producers regarding to the composition of the e- liquids not always are sufficient, and consumers often do not have reliable information on the quality of the product used by them. This paper contain a review of previous reports on the composition of e-cigarettes and their impact on health. Most of the observed health effects was related to symptoms of the respiratory tract, mouth, throat, neurological complications and sensory organs. Particularly hazardous effects of the e-cigarettes were: pneumonia, congestive heart failure, confusion, convulsions, hypotension, aspiration pneumonia, face second-degree burns, blindness, chest pain and rapid heartbeat. In the literature there is no information relating to passive exposure by the aerosols released during e-cigarette smoking. Furthermore, the information regarding to the use of these products in the long term are not also available. PMID:25799862

  4. Echinocandin failure case due to a previously unreported FKS1 mutation in Candida krusei.

    PubMed

    Jensen, Rasmus Hare; Justesen, Ulrik Stenz; Rewes, Annika; Perlin, David S; Arendrup, Maiken Cavling

    2014-06-01

    Echinocandins are the preferred therapy for invasive infections due to Candida krusei. We present here a case of clinical failure involving C. krusei with a characteristic FKS1 hot spot mutation not previously reported in C. krusei that was isolated after 14 days of treatment. Anidulafungin MICs were elevated by ≥ 5 dilution steps above the clinical breakpoint but by only 1 step for a Candida albicans isolate harboring the corresponding mutation, suggesting a notable species-specific difference in the MIC increase conferred by this mutation. PMID:24687511

  5. Splenic abscess due to Salmonella schwarzengrund in a previously healthy individual returning from Bali.

    PubMed

    Hoff, Erik; Nayeri, Fariba

    2015-01-01

    After an episode of diarrhoea, a previously healthy young man developed a splenic abscess due to invasive non-typhoidal Salmonella. The patient was presented with >1 month of fever, diffuse abdominal pain, raised C reactive protein and increased white cell count. Ultrasonography revealed a 5 × 5 cm abscess in the spleen. After an unsuccessful treatment attempt with percutaneous drainage and antibiotics, the patient was successfully treated with splenectomy and antibiotics. This case highlights the difficulties inherent in making a correct diagnosis of splenic abscess in patients without risk factors. Splenic abscess is rare in previously healthy individuals. Antibiotics are inadequate as a sole treatment, and percutaneous drainage is usually only a temporary solution. Splenectomy is still the standard treatment in most cases. PMID:26670898

  6. Splenic abscess due to chronic melioidosis in a patient previously misdiagnosed as tuberculosis

    PubMed Central

    Kunnathuparambil, Sojan George; Sathar, Shanid Abdul; Tank, Devang Chandrakanth; Sreesh, Srijaya; Mukunda, Madhav; Narayanan, Premaletha; Vinayakumar, Kattoor Ramakrishnan

    2013-01-01

    Melioidosis is endemic in Southeast Asia and Northern Australia. Sporadic cases have been reported from many parts of the world where it has an epidemic potential with high-rate fatality cases. In non-endemic areas, melioidosis may be misdiagnosed with common diseases and this may prove fatal. Sporadic cases of melioidosis are mistaken for tuberculosis in India. We report a case of splenic abscess due to chronic melioidosis who was earlier misdiagnosed as tuberculosis and underwent anti-tuberculosis therapy. Following treatment of melioidosis his symptoms subsided. This case is reported because of the rarity of the disease and to highlight the importance of looking for melioidosis in patients with splenic abscess even in non-endemic areas. PMID:24714690

  7. Phase effects due to previous pulses in time-resolved Faraday rotation measurements

    SciTech Connect

    Trowbridge, Christopher J.; Sih, Vanessa

    2015-02-14

    Time-resolved Faraday rotation measurements have proved transformative in the investigation of spin dynamics in semiconductors. In materials with spin lifetimes which are on the order of, or greater than, the laser repetition time, the collective effect of spin polarization due to the whole pump pulse train becomes important. Here, we discuss a relative phase shift which results from these spins. We derive and experimentally validate a closed-form expression which describes this phase shift and characterize it throughout parameter space. A spin lifetime measurement based on this phase shift is described, and we discuss situations in which the model used must be augmented to be applicable.

  8. Subcutaneous Emphysema Induced by Cryotherapy: A Complication due to Previous Punctures

    PubMed Central

    Martínez-Coronado, Jared; Torres-Álvarez, Bertha; Castanedo-Cázares, Juan Pablo

    2015-01-01

    Cryosurgery is a common therapeutic modality used in dermatology; therefore we must be aware of its possible adverse effects. We report a case of a patient with subcutaneous emphysema which occurred following the application of cryotherapy after multiple punctures of local anesthetic and intralesional steroids in a chest keloid scar. Despite the fact that this condition was gradually resolved after expectant observation, we warn about this complication when sprayed cryotherapy is preceded by multiple punctures on cutaneous lesions above bony surfaces. In similar settings, cryotherapy must be first administered or a cotton-tip applicator should be used. PMID:26171258

  9. Older adults who have previously fallen due to a trip walk differently than those who have fallen due to a slip.

    PubMed

    Wright, Rachel L; Peters, Derek M; Robinson, Paul D; Watt, Thomas N; Hollands, Mark A

    2015-01-01

    Studying the relationships between centre of mass (COM) and centre of pressure (COP) during walking has been shown to be useful in determining movement stability. The aim of the current study was to compare COM-COP separation measures during walking between groups of older adults with no history of falling, and a history of falling due to tripping or slipping. Any differences between individuals who have fallen due to a slip and those who have fallen due to a trip in measures of dynamic balance could potentially indicate differences in the mechanisms responsible for falls. Forty older adults were allocated into groups based on their self-reported fall history during walking. The non-faller group had not experienced a fall in at least the previous year. Participants who had experienced a fall were split into two groups based on whether a trip or slip resulted in the fall(s). A Vicon system was used to collect full body kinematic trajectories. Two force platforms were used to measure ground reaction forces. The COM was significantly further ahead of the COP at heel strike for the trip (14.3 ± 2.7 cm) and slip (15.3 ± 1.1 cm) groups compared to the non-fallers (12.0 ± 2.7 cm). COM was significantly further behind the COP at foot flat for the slip group (-14.9 ± 3.6 cm) compared to the non-fallers (-10.3 ± 3.9 cm). At mid-swing, the COM of the trip group was ahead of the COP (0.9 ± 1.6 cm), whereas for the slip group the COM was behind the COP (-1.2 ± 2.2 cm). These results show identifiable differences in dynamic balance control of walking between older adults with a history of tripping or slipping and non-fallers. PMID:25455700

  10. Due Process Hearings: An Update. Final Report.

    ERIC Educational Resources Information Center

    Ahearn, Eileen M.

    This report presents data from all 50 states on due process hearings concerning the education of students with disabilities for the years 1992, 1993, and 1994. Data were gathered from a 1996 survey conducted by the National Association of State Directors of Special Education. This survey updates due process statistics from a 1994 survey that…

  11. Ruptured noncommunicating rudimentary horn pregnancy at 19 weeks with previous cesarean delivery: a case report.

    PubMed

    Thakur, Sita; Sood, Ajay; Sharma, Chanderdeep

    2012-01-01

    Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during nonpregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done. PMID:23119197

  12. Ruptured Noncommunicating Rudimentary Horn Pregnancy at 19 Weeks with Previous Cesarean Delivery: A Case Report

    PubMed Central

    Thakur, Sita; Sood, Ajay; Sharma, Chanderdeep

    2012-01-01

    Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during nonpregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done. PMID:23119197

  13. Hepatic actinomycosis: Report of one case and analysis of 32 previously reported cases

    PubMed Central

    Yang, Xing-Xiang; Lin, Jian-Mei; Xu, Kai-Ju; Wang, Shu-Qiang; Luo, Ting-Ting; Geng, Xiao-Xia; Huang, Ren-Gang; Jiang, Nan

    2014-01-01

    Hepatic actinomycosis is rare, with few published cases. There are no characteristic clinical manifestations, and computed tomography (CT) shows mainly low-density images, making clinical diagnosis difficult, and leading to frequent misdiagnosis as primary liver cancer, metastatic liver cancer or liver abscess. Diagnosis normally requires examination of both the aetiology and pathology. This article reports one male patient aged 55 who was hospitalized because of repeated upper abdominal pain for more than 2 mo. He exhibited no chills, fever or yellow staining of the skin and sclera, and examination revealed no positive signs. The routine blood results were: haemoglobin 110 g/L, normal numbers of leukocytes and neutral leukocytes, serum albumin 32 g/L, negative serum hepatitis B markers and hepatitis C antibodies, normal tumour markers (alpha-fetoprotein and carcinoembryonic antigen). An abdominal CT scan revealed an 11.2 cm × 5.8 cm × 7.4 cm mass with an unclear edge in the left liver lobe. The patient was diagnosed as having primary liver cancer, and left lobe resection was performed. The postoperative pathological examination found multifocal actinomycetes in the hepatic parenchyma, which was accompanied by chronic suppurative inflammation. A focal abscess had formed, and large doses of sodium penicillin were administered postoperatively as anti-infective therapy. This article also reviews 32 cases reported in the English literature, with the aim of determining the clinical features and treatment characteristics of this disease, and providing a reference for its diagnosis and treatment. PMID:25473199

  14. 20 CFR 408.714 - When are reports due?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false When are reports due? 408.714 Section 408.714 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.714 When are reports due? (a) A reportable event happens. You should report...

  15. 20 CFR 408.714 - When are reports due?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When are reports due? 408.714 Section 408.714 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.714 When are reports due? (a) A reportable event happens. You should report...

  16. 20 CFR 408.714 - When are reports due?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false When are reports due? 408.714 Section 408.714 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.714 When are reports due? (a) A reportable event happens. You should report...

  17. 20 CFR 408.714 - When are reports due?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false When are reports due? 408.714 Section 408.714 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.714 When are reports due? (a) A reportable event happens. You should report...

  18. 20 CFR 408.714 - When are reports due?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false When are reports due? 408.714 Section 408.714 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Reporting Requirements § 408.714 When are reports due? (a) A reportable event happens. You should report...

  19. Cardiac Reoperation in a patient who previously underwent omentoplasty for postoperative mediastinitis: a case report

    PubMed Central

    2011-01-01

    Sternal infection has become a rare but challenging problem with significant mortality and morbidity rates since the introduction of sternotomy. Reported rates of mediastinal and sternal infection range from 0.4% to 5%. The ideal reconstruction after sternal debridement is still controversial. Different methods, such as debridement and open packing with continuous antibiotic irrigation, or sternectomy with omental or muscle transposition have been proposed. In this study, we present the cardiac reoperation of a 52 year old man with corrected transposition of great arteries (c-TGA) who had undergone a previous omentoplasty for postoperative mediastinitis. PMID:21435257

  20. Adenylosuccinate lyase (ADSL) and infantile autism: Absence of previously reported point mutation

    SciTech Connect

    Fon, E.A.; Sarrazin, J.; Rouleau, G.A.

    1995-12-18

    Autism is a heterogeneous neuropsychiatric syndrome of unknown etiology. There is evidence that a deficiency in the enzyme adenylosuccinate lyase (ADSL), essential for de novo purine biosynthesis, could be involved in the pathogenesis of certain cases. A point mutation in the ADSL gene, resulting in a predicted serine-to-proline substitution and conferring structural instability to the mutant enzyme, has been reported previously in 3 affected siblings. In order to determine the prevalence of the mutation, we PCR-amplified the exon spanning the site of this mutation from the genomic DNA of patients fulfilling DSM-III-R criteria for autistic disorder. None of the 119 patients tested were found to have this mutation. Furthermore, on preliminary screening using single-strand conformation polymorphism (SSCP), no novel mutations were detected in the coding sequence of four ADSL exons, spanning approximately 50% of the cDNA. In light of these findings, it appears that mutations in the ADSL gene represent a distinctly uncommon cause of autism. 12 refs., 2 figs.

  1. Infantile onset spinocerebellar ataxia 2 (SCA2): a clinical report with review of previous cases.

    PubMed

    Singh, Ankur; Faruq, Mohammed; Mukerji, Mitali; Dwivedi, Manish Kumar; Pruthi, Sumit; Kapoor, Seema

    2014-01-01

    Autosomal dominant cerebellar ataxia type I is a heterogeneous group of spinocerebellar ataxias with variable neurologic presentations, with age of onset varying from infancy to adulthood. Autosomal dominant cerebellar ataxia type I is composed mainly of 3 prevalent spinocerebellar ataxia types with different pathogenic loci, specifically spinocerebellar ataxia 1 (6p24-p23), spinocerebellar ataxia 2 (12q24.1), and spinocerebellar ataxia 3 (14q32.1). The shared pathogenic mutational event is the expansion of the CAG repeat that results in polyglutamine extended stretches in the encoded proteins. CAG repeat disorders generally show the phenomenon of anticipation, which is more often associated with paternal transmission. In this report, we describe a patient with infantile-onset spinocerebellar ataxia type 2 (~320 CAG repeat) who inherited the disease from his father (47 CAG repeats). We have summarized the clinical, neuroimaging, electroencephalographic (EEG), and molecular data of previous cases and attempt to highlight the most consistent findings. Our intent is to help treating clinicians to suspect this disorder and to offer timely genetic counseling for a currently potentially untreatable disorder. PMID:24300164

  2. Ruptured rudimentary horn pregnancy at 25 weeks with previous vaginal delivery: a case report.

    PubMed

    Kanagal, Deepa V; Hanumanalu, Lokeshchandra C

    2012-01-01

    Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. Timely laparotomy, excision of the horn, and blood transfusion saved the patient. PMID:22720180

  3. Ruptured Rudimentary Horn Pregnancy at 25 Weeks with Previous Vaginal Delivery: A Case Report

    PubMed Central

    Kanagal, Deepa V.; Hanumanalu, Lokeshchandra C.

    2012-01-01

    Unicornuate uterus with rudimentary horn occurs due to failure of complete development of one of the Mullerian ducts and incomplete fusion with the contralateral side. Pregnancy in a noncommunicating rudimentary horn is extremely rare and usually terminates in rupture during first or second trimester of pregnancy. Diagnosis of rudimentary horn pregnancy and its rupture in a woman with prior vaginal delivery is difficult. It can be missed in routine ultrasound scan and in majority of cases it is detected after rupture. It requires a high index of suspicion. We report a case of G2PlL1 with rupture rudimentary horn pregnancy at 25 weeks of gestation which was misdiagnosed as intrauterine pregnancy with fetal demise by ultrasound, and termination was attempted and the case was later referred to our hospital after the patient developed hemoperitoneum and shock with a diagnosis of rupture uterus. Laparotomy revealed rupture of right rudimentary horn pregnancy with massive hemoperitoneum. Timely laparotomy, excision of the horn, and blood transfusion saved the patient. PMID:22720180

  4. Case report: Recurrent glossopharyngeal neuralgia after previous glossopharyngeal rhizotomy: Microvascular decompression with intra-operative neurophysiology.

    PubMed

    Price, Sally-Ann S; Davies, Owain; Walsh, Peter; Patel, Nikunj

    2015-12-01

    We present a case of recurrent vago-glossopharyngeal neuralgia after previous surgery, treated successfully with microvascular decompression using intra-operative neurophysiology monitoring. PMID:25958960

  5. Colonic perforation resulting from ingested chicken bone revealing previously undiagnosed colonic adenocarcinoma: report of a case and review of literature.

    PubMed

    McGregor, Douglas H; Liu, Xiaoying; Ulusarac, Ozlem; Ponnuru, Kimberly D; Schnepp, Stephanie L

    2011-01-01

    An 86 year old male with a four-day history of nonspecific gastrointestinal symptoms was found on colonoscopy to have evidence of sigmoid colon obstruction and possible perforation. Emergent operative exploration revealed diffuse peritonitis, sigmoid perforation, adjacent dense adhesions, and a foreign body protruding through the perforated area. Pathologic examination showed the foreign body to be a sliver of bone consistent with chicken bone and the sigmoid subacute perforation to be associated distally with a circumferential ulcerated obstructing mass, microscopically seen to be transmurally infiltrating adenocarcinoma, signet-ring cell type. There was extensive acute and organizing peritonitis, 100% Escherichia coli was cultured from peritoneal fluid, and the patient died two days postoperatively with sepsis and hypotension. This appears to be the fifth reported case of colonic perforation resulting from foreign body perforation due to previously undiagnosed adenocarcinoma. The four previously reported cases were all deeply invasive adenocarcinoma of sigmoid colon, and the foreign bodies included three chicken/poultry bones and a metallic staple. These five cases are highly unusual examples of a potentially lethal malignant neoplasm being clinically revealed by a usually (but not always) innocuous event, the ingestion of a small foreign body. PMID:21333012

  6. Colonic perforation resulting from ingested chicken bone revealing previously undiagnosed colonic adenocarcinoma: report of a case and review of literature

    PubMed Central

    2011-01-01

    An 86 year old male with a four-day history of nonspecific gastrointestinal symptoms was found on colonoscopy to have evidence of sigmoid colon obstruction and possible perforation. Emergent operative exploration revealed diffuse peritonitis, sigmoid perforation, adjacent dense adhesions, and a foreign body protruding through the perforated area. Pathologic examination showed the foreign body to be a sliver of bone consistent with chicken bone and the sigmoid subacute perforation to be associated distally with a circumferential ulcerated obstructing mass, microscopically seen to be transmurally infiltrating adenocarcinoma, signet-ring cell type. There was extensive acute and organizing peritonitis, 100% Escherichia coli was cultured from peritoneal fluid, and the patient died two days postoperatively with sepsis and hypotension. This appears to be the fifth reported case of colonic perforation resulting from foreign body perforation due to previously undiagnosed adenocarcinoma. The four previously reported cases were all deeply invasive adenocarcinoma of sigmoid colon, and the foreign bodies included three chicken/poultry bones and a metallic staple. These five cases are highly unusual examples of a potentially lethal malignant neoplasm being clinically revealed by a usually (but not always) innocuous event, the ingestion of a small foreign body. PMID:21333012

  7. 50 CFR 86.81 - When are the reports due?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false When are the reports due? 86.81 Section 86.81 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for the States...

  8. 50 CFR 86.81 - When are the reports due?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false When are the reports due? 86.81 Section 86.81 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for the States...

  9. 50 CFR 86.81 - When are the reports due?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false When are the reports due? 86.81 Section 86.81 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE AND SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for...

  10. 50 CFR 86.81 - When are the reports due?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false When are the reports due? 86.81 Section 86.81 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE AND SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for...

  11. 50 CFR 86.81 - When are the reports due?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false When are the reports due? 86.81 Section 86.81 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for the States...

  12. 24 CFR 1710.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...-notice of revocation rights on property report cover page. 1710.558 Section 1710.558 Housing and Urban....558 Previously accepted state filingsnotice of revocation rights on property report cover page. (a)(1) The cover page on Property Reports for filings made with the Secretary pursuant to 1710.552 shall...

  13. 24 CFR 1710.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...-notice of revocation rights on property report cover page. 1710.558 Section 1710.558 Housing and Urban....558 Previously accepted state filingsnotice of revocation rights on property report cover page. (a)(1) The cover page on Property Reports for filings made with the Secretary pursuant to 1710.552 shall...

  14. A case report about the reconstruction procedures of the previously failed cylinderical implants site using distraction osteogenesis.

    PubMed

    Lee, Jung-Tae; Park, Shin-Young; Yi, Yang-Jin; Kim, Young-Kyun; Lee, Hyo-Jung

    2015-04-01

    We report the eventually successful treatment of a huge bone defect and peri-implantitis following reconstruction of a previously failed intra-mobile cylinder implant system (IMZ) implant site using distraction osteogenesis (DO). In the anterior mandible, two IMZ implants failed and surgical debridement was performed in accordance to the patient's needs. Thereafter, mobility and suppuration were decreased and the patient visited the dental clinic on a regular basis for oral health maintenance. However, the inflammation did not resolve, and the bone destruction around the implants progressed for 4 years. Finally, the implants failed and a severe bone defect remained after implant removal. To reconstruct the bone defects, we attempted bone graft procedures. Titanium mesh was unsuccessfully used to obtain bone volume regeneration. However, DO subsequently was used to obtain sufficient bone volume for implant placement. The new implants were then installed, followed by prosthetic procedures. In conclusion, progression of peri-implantitis could not be arrested despite surgical intervention and repeated maintenance care for 3 years. Reconstruction of the peri-implantitis site was complicated due to its horizontal and vertical bone defects. Lesions caused by implant failure require an aggressive regenerative strategy, such as DO. DO was successful in reconstruction of a peri-implantitis site that was complicated due to horizontal and vertical bone defects. PMID:25922820

  15. A case report about the reconstruction procedures of the previously failed cylinderical implants site using distraction osteogenesis

    PubMed Central

    2015-01-01

    We report the eventually successful treatment of a huge bone defect and peri-implantitis following reconstruction of a previously failed intra-mobile cylinder implant system (IMZ) implant site using distraction osteogenesis (DO). In the anterior mandible, two IMZ implants failed and surgical debridement was performed in accordance to the patient's needs. Thereafter, mobility and suppuration were decreased and the patient visited the dental clinic on a regular basis for oral health maintenance. However, the inflammation did not resolve, and the bone destruction around the implants progressed for 4 years. Finally, the implants failed and a severe bone defect remained after implant removal. To reconstruct the bone defects, we attempted bone graft procedures. Titanium mesh was unsuccessfully used to obtain bone volume regeneration. However, DO subsequently was used to obtain sufficient bone volume for implant placement. The new implants were then installed, followed by prosthetic procedures. In conclusion, progression of peri-implantitis could not be arrested despite surgical intervention and repeated maintenance care for 3 years. Reconstruction of the peri-implantitis site was complicated due to its horizontal and vertical bone defects. Lesions caused by implant failure require an aggressive regenerative strategy, such as DO. DO was successful in reconstruction of a peri-implantitis site that was complicated due to horizontal and vertical bone defects. PMID:25922820

  16. Salivary gland tumors and previous radiotherapy to the head or neck. Report of a clinical series

    SciTech Connect

    Katz, A.D.; Preston-Martin, S.

    1984-03-01

    To estimate what proportion of patients with newly diagnosed salivary gland tumors may have radiation-related disease, we interviewed all 275 patients in a surgical practice who had salivary gland resections during an 8 year period. Patients were asked about previous radiation treatment to the head and neck. Thirty-one patients (11 percent) had both an incident salivary gland tumor and a history of significant exposure. Four of these patients (13 percent) had multiple primary tumors of the salivary glands. The implications and generalizability of these findings have been discussed herein.

  17. NON-DETECTION OF PREVIOUSLY REPORTED TRANSITS OF HD 97658b WITH MOST PHOTOMETRY

    SciTech Connect

    Dragomir, Diana; Matthews, Jaymie M.; Antoci, Victoria; Howard, Andrew W.; Marcy, Geoffrey W.; Henry, Gregory W.; Guenther, David B.; Johnson, John A.; Kuschnig, Rainer; Weiss, Werner W.; Moffat, Anthony F. J.; Rowe, Jason F.; Rucinski, Slavek M.; Sasselov, Dimitar

    2012-11-10

    The radial velocity-discovered exoplanet HD 97658b was recently announced to transit, with a derived planetary radius of 2.93 {+-} 0.28 R{sub Circled-Plus }. As a transiting super-Earth orbiting a bright star, this planet would make an attractive candidate for additional observations, including studies of its atmospheric properties. We present and analyze follow-up photometric observations of the HD 97658 system acquired with the Microvariability and Oscillations of STars space telescope. Our results show no transit with the depth and ephemeris reported in the announcement paper. For the same ephemeris, we rule out transits for a planet with radius larger than 2.09 R{sub Circled-Plus }, corresponding to the reported 3{sigma} lower limit. We also report new radial velocity measurements which continue to support the existence of an exoplanet with a period of 9.5 days, and obtain improved orbital parameters.

  18. Life History Reports of Young Adults Previously Referred for Mental Health Services.

    ERIC Educational Resources Information Center

    McConaughy, Stephanie H.; Wadsworth, Martha E.

    2000-01-01

    This article reports factors associated with good versus poor outcomes for 173 young adults referred for mental health services. Participants with good outcomes differed in quality and stability of their living situations, full-time versus part-time employment, peer relationships, goal orientation, successful experiences, stressful experiences,…

  19. Melatonin Suppression by Light in Humans Is More Sensitive Than Previously Reported.

    PubMed

    Vartanian, Garen V; Li, Benjamin Y; Chervenak, Andrew P; Walch, Olivia J; Pack, Weston; Ala-Laurila, Petri; Wong, Kwoon Y

    2015-08-01

    The retina drives various non-image-forming photoresponses, including circadian photoentrainment and pupil constriction. Previous investigators showed that in humans, photic suppression of the clock-controlled hormone melatonin is most sensitive to 460-nm blue light, with a threshold of ~12 log photons cm(-2) s(-1). This threshold is surprising because non-image-forming vision is mediated by intrinsically photosensitive retinal ganglion cells, which receive rod-driven synaptic input and can respond to light levels as low as ~7 log photons cm(-2) s(-1). Using a protocol that enhances data precision, we have found the threshold for human melatonin suppression to be ~10 log photons cm(-2) s(-1) at 460 nm. This finding has far-reaching implications since there is mounting evidence that nocturnal activation of the circadian system can be harmful. PMID:26017927

  20. Non-detection of Previously Reported Transits of HD 97658b with MOST Photometry

    NASA Astrophysics Data System (ADS)

    Dragomir, Diana; Matthews, Jaymie M.; Howard, Andrew W.; Antoci, Victoria; Henry, Gregory W.; Guenther, David B.; Johnson, John A.; Kuschnig, Rainer; Marcy, Geoffrey W.; Moffat, Anthony F. J.; Rowe, Jason F.; Rucinski, Slavek M.; Sasselov, Dimitar; Weiss, Werner W.

    2012-11-01

    The radial velocity-discovered exoplanet HD 97658b was recently announced to transit, with a derived planetary radius of 2.93 ± 0.28 R ⊕. As a transiting super-Earth orbiting a bright star, this planet would make an attractive candidate for additional observations, including studies of its atmospheric properties. We present and analyze follow-up photometric observations of the HD 97658 system acquired with the Microvariability and Oscillations of STars space telescope. Our results show no transit with the depth and ephemeris reported in the announcement paper. For the same ephemeris, we rule out transits for a planet with radius larger than 2.09 R ⊕, corresponding to the reported 3σ lower limit. We also report new radial velocity measurements which continue to support the existence of an exoplanet with a period of 9.5 days, and obtain improved orbital parameters. Based on data from the MOST satellite, a Canadian Space Agency mission operated by Microsatellite Systems Canada Inc. (MSCI; former Dynacon Inc.) and the Universities of Toronto and British Columbia, with the assistance of the University of Vienna.

  1. [Lessons from abroad. Current and previous crisis in other countries. SESPAS report 2014].

    PubMed

    Rivadeneyra-Sicilia, Ana; Minué Lorenzo, Sergio; Artundo Purroy, Carlos; Márquez Calderón, Soledad

    2014-06-01

    The evidence available on the impact of previous crises on health reveals different patterns attributable to study designs, the characteristics of each crisis, and other factors related to the socioeconomic and political context. There is greater consensus on the mediating role of government policy responses to financial crises. These responses may magnify or mitigate the adverse effects of crises on population health. Some studies have shown a significant deterioration in some health indicators in the context of the current crisis, mainly in relation to mental health and communicable diseases. Alcohol and tobacco use have also declined in some European countries. In addition, this crisis is being used by some governments to push reforms aimed at privatizing health services, thereby restricting the right to health and healthcare. Specifically, action is being taken on the three axes that determine health system financing: the population covered, the scope of services, and the share of the costs covered. These measures are often arbitrarily implemented based on ideological decisions rather than on the available evidence and therefore adverse consequences are to be expected in terms of financial protection, efficiency, and equity. PMID:24863989

  2. Phylogenetics of HIV-1 subtype G env: Greater complexity and older origins than previously reported.

    PubMed

    Tongo, Marcel; Essomba, René G; Nindo, Frederick; Abrahams, Fatima; Nanfack, Aubin Joseph; Fokam, Joseph; Takou, Desire; Torimiro, Judith N; Mpoudi-Ngole, Eitel; Burgers, Wendy A; Martin, Darren P; Dorfman, Jeffrey R

    2015-10-01

    HIV-1 subtype G has played an early and central role in the emergent complexity of the HIV-1 group M (HIV-1M) epidemic in central/west Africa. Here, we analysed new subtype G env sequences sampled from 8 individuals in Yaoundé, Cameroon during 2007-2010, together with all publically available subtype G-attributed full-length env sequences with known sampling dates and locations. We inferred that the most recent common ancestor (MRCA) of the analysed subtype G env sequences most likely occurred in ∼1953 (95% Highest Posterior Density interval [HPD] 1939-1963): about 15 years earlier than previous estimates. We found that the subtype G env phylogeny has a complex structure including seven distinct lineages, each likely dating back to the late 1960s or early 1970s. Sequences from Angola, Gabon and the Democratic Republic of Congo failed to group consistently in these lineages, possibly because they are related to more ancient sequences that are poorly sampled. The circulating recombinant form (CRF), CRF06_cpx env sequences but not CRF25_cpx env sequences are phylogenetically nested within the subtype G clade. This confirms that the CRF06_cpx env plausibly was derived through recombination from a subtype G parent, and suggests that the CRF25_cpx env was likely derived from an HIV-1M lineage related to the MRCA of subtype G that has remained undiscovered and may be extinct. Overall, this fills important gaps in our knowledge of the early events in the spread of HIV-1M. PMID:26190450

  3. Vapor pressures of substituted polycarboxylic acids are much lower than previously reported

    NASA Astrophysics Data System (ADS)

    Huisman, A. J.; Krieger, U. K.; Zuend, A.; Marcolli, C.; Peter, T.

    2013-07-01

    The partitioning of compounds between the aerosol and gas phase is a primary focus in the study of the formation and fate of secondary organic aerosol. We present measurements of the vapor pressure of 2-methylmalonic (isosuccinic) acid, 2-hydroxymalonic (tartronic) acid, 2-methylglutaric acid, 3-hydroxy-3-carboxy-glutaric (citric) acid and DL-2,3-dihydroxysuccinic (DL-tartaric) acid, which were obtained from the evaporation rate of supersaturated liquid particles levitated in an electrodynamic balance. Our measurements indicate that the pure component liquid vapor pressures at 298.15 K for tartronic, citric and tartaric acids are much lower than the same quantity that was derived from solid state measurements in the only other room temperature measurement of these materials (made by Booth et al., 2010). This strongly suggests that empirical correction terms in a recent vapor pressure estimation model to account for the inexplicably high vapor pressures of these and similar compounds should be revisited, and that due caution should be used when the estimated vapor pressures of these and similar compounds are used as inputs for other studies.

  4. Vapor pressures of substituted polycarboxylic acids are much lower than previously reported

    NASA Astrophysics Data System (ADS)

    Huisman, A. J.; Krieger, U. K.; Zuend, A.; Marcolli, C.; Peter, T.

    2013-01-01

    The partitioning of compounds between the aerosol and gas phase is a primary focus in the study of the formation and fate of secondary organic aerosol. We present measurements of the vapor pressure of 2-Methylmalonic (isosuccinic) acid, 2-Hydroxymalonic (tartronic) acid, 2-Methylglutaric acid, 3-Hydroxy-3-carboxy-glutaric (citric) acid and 2,3-Dihydroxysuccinic (tartaric) acid which were obtained from the evaporation rate of supersaturated liquid particles levitated in an electrodynamic balance. Our measurements indicate that the pure component liquid vapor pressures at 298.15 K for tartronic, citric and tartaric acids are much lower than the same quantity which was derived from solid state measurements in the only other room temperature measurement of these materials (made by Booth et al., 2010). This strongly suggests that empirical correction terms in vapor pressure estimation models to account for the inexplicably high vapor pressures of these and similar compounds should be revisited, and that due caution should be used when the estimated vapor pressures of these and similar compounds are used as inputs for other studies.

  5. Leiomyosarcoma of the Prostate: Case Report and Review of 54 Previously Published Cases

    PubMed Central

    Vandoros, Gerasimos P.; Manolidis, Theodoros; Karamouzis, Michalis V.; Gkermpesi, Maria; Lambropoulou, Maria; Papatsoris, Athanasios G.; Zachos, Ioannis; Konstantinopoulos, Panagiotis A.

    2008-01-01

    Prostate leiomyosarcoma is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% of primary prostate malignancies. We present a patient with primary leiomyosarcoma of the prostate and review 54 cases reported in the literature to discuss the clinical, diagnostic and therapeutic aspects of this uncommon tumor. Median survival was estimated at 17 months (95% C.I. 20.7–43.7 months) and the 1-, 3-, and 5-year actuarial survival rates were 68%, 34%, and 26%, respectively. The only factors predictive of long-term survival were negative surgical margins and absence of metastatic disease at presentation. A multidisciplinary approach is necessary for appropriate management of this dire entity. PMID:19043598

  6. Spleen rupture due to primary angiosarcoma: a case report.

    PubMed

    Koutelidakis, Ioannis M; Tsiaousis, Panagiotis Z; Papaziogas, Basilios Th; Patsas, Aristeides G; Atmatzidis, Stefanos K; Atmatzidis, Konstantinos S

    2007-01-01

    A case of a 79-year-old female with rupture of the spleen due to primary angiosarcoma is presented. Symptoms were non-specific. Diagnosis was based on histology postoperatively. Primary angiosarcoma of the spleen is a very rare and aggressive neoplasm with a high metastatic rate and almost uniformly fatal. Due to small number of reported cases, there are no guidelines concerning adjuvant or palliative treatment or any beneficial protocols of chemotherapy or radiotherapy up to date. Splenectomy prior to rupture seems to have a positive impact on long-term survival. PMID:19016352

  7. FOLFIRINOX-induced reversible dysarthria: A case report and review of previous cases

    PubMed Central

    MATSUOKA, AYUMU; MAEDA, OSAMU; INADA-INOUE, MEGUMI; OHNO, EIZABURO; HIROOKA, YOSHIKI; YOKOYAMA, YUKIHIRO; FUJII, TSUTOMU; NAGINO, MASATO; GOTO, HIDEMI; ANDO, YUICHI

    2015-01-01

    FOLFIRINOX is a standard chemotherapeutic regimen for patients with advanced pancreatic cancer who have a good performance status. In this study, we present the case of a 64-year-old male who developed dysarthria following FOLFIRINOX treatment, and review all four cases of dysarthria encountered among the nine patients who received this treatment in our hospital. In all cases, dysarthria occurred during the infusion of irinotecan in the first course of treatment, persisted for several hours, and then resolved rapidly without any sequelae. Physical and neurological examinations at the onset of dysarthria revealed no other abnormalities. Imaging studies revealed no abnormal findings. Atropine was prophylactically administered in the second and subsequent courses of treatment and effectively prevented or alleviated dysarthria. This acute neurological symptom is surprising and uncommon in traditional cancer chemotherapy, and medical oncologists may initially suspect the onset of stroke or cerebrovascular disease. However, consistent with our experience, all reported cases resolved completely, with no need for dose reduction or treatment interruption. PMID:26622908

  8. Dysenteric syndrome due to Balantidium coli: a case report.

    PubMed

    Bellanger, Anne-Pauline; Scherer, Emeline; Cazorla, Arnault; Grenouillet, Frederic

    2013-04-01

    A 28-year-old man was hospitalized for a dysenteric syndrome that had developed during the previous days. Physical examination revealed abdominal pains, fever, vomiting and more than ten liquid stools per day. Fresh stool examination showed numerous mobile ciliated trophozoites of Balantidium coli. The patient reported having been on a hike the previous weekend during which he had drunk water through a hydration pouch bladder. Complete resolution was observed after intravenous rehydration and ten days of oral treatment with metronidazole (Flagyl®). Balantidium coli is the largest ciliate protozoan able to infect humans. This parasite is common in pigs and has a worldwide distribution. Human infections, a rare event in industrialised countries, are usually acquired by ingestion of food or water contaminated by mammal faeces. Human B. coli infections are easily treated but may be severe and even fatal if neglected. PMID:23686128

  9. Pyonephrosis due to Chryseobacterium gleum: a first case report.

    PubMed

    Garg, S; Appannanavar, S B; Mohan, B; Taneja, N

    2015-01-01

    Chryseobacterium spp are widely distributed in nature but data of their isolation from clinical samples is scanty. Here, we report the first case of AmpC producing C. gleum causing pyonephrosis in a patient having bilateral nephrolithiasis on double J (DJ) stent. The present isolate was resistant to vancomycin, erythromycin, clindamycin, carbapenems and ciprofloxacin and susceptible to tetracycline and minocycline. The patient was treated with tetracycline and recovered without the need for removal of the DJ stent. The environmental surveillance carried out to trace the nosocomial origin of the isolate was negative. Since antimicrobial susceptibility of this isolate is different from previous reports, we emphasise that in vitro susceptibility testing should be sought to choose optimal antimicrobial agents for these Nonfermentative Gram-Negative Bacilli (NFGNBs) with different susceptibility patterns. PMID:25865994

  10. 24 CFR 1710.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Previously accepted state filings-notice of revocation rights on property report cover page. 1710.558 Section 1710.558 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT...

  11. 12 CFR 1010.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Previously accepted state filings-notice of revocation rights on property report cover page. 1010.558 Section 1010.558 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) Certification of Substantially...

  12. Spontaneous Pneumothorax due to Ectopic Deciduosis: A Case Report.

    PubMed

    Dudek, Wojciech; Schreiner, Waldemar; Strehl, Johanna; Sirbu, Horia

    2014-12-01

    This report presents a 20-week pregnant 38-year-old woman with right-sided pneumothorax due to pulmonary deciduosis. Initial pleural drainage was ineffective. Video-assisted thoracoscopy revealed areas of consolidation within the lung parenchyma. A wedge resection with partial pleurectomy was performed. Histopathological examination showed subpleural decidual implants. The patient made a full recovery and was discharged on day 5. Videoscopic inspection of the lung parenchyma and pleura with resection of decidual foci is the recommended treatment for pneumothorax in pregnant women with pleuropulmonary deciduosis in whom classical pleural drainage is ineffective. PMID:25798365

  13. Spontaneous Pneumothorax due to Ectopic Deciduosis: A Case Report

    PubMed Central

    Dudek, Wojciech; Schreiner, Waldemar; Strehl, Johanna; Sirbu, Horia

    2014-01-01

    This report presents a 20-week pregnant 38-year-old woman with right-sided pneumothorax due to pulmonary deciduosis. Initial pleural drainage was ineffective. Video-assisted thoracoscopy revealed areas of consolidation within the lung parenchyma. A wedge resection with partial pleurectomy was performed. Histopathological examination showed subpleural decidual implants. The patient made a full recovery and was discharged on day 5. Videoscopic inspection of the lung parenchyma and pleura with resection of decidual foci is the recommended treatment for pneumothorax in pregnant women with pleuropulmonary deciduosis in whom classical pleural drainage is ineffective. PMID:25798365

  14. Intercuneiform and Lisfranc Fracture-Dislocation Due to Seizure: A Case Report.

    PubMed

    Hung, Joshua L P; Chan, Samson C F

    2016-01-01

    Cuneiform dislocation associated with Lisfranc injury is a very rare injury. Dislocation over the midfoot due to a seizure has not been previously reported in published studies. A 35-year-old female presented with an intercuneiform dislocation and Lisfranc fracture-dislocation after a generalized seizure. Immediate close reduction of the dorsally dislocated cuneiforms was performed, followed by definitive treatment to restore the foot arches. A proposed underlying pathophysiology of dislocation due to seizure in terms of the biomechanics is discussed. The purpose of our report was to present the unusual etiology of this form of cuneiform dislocation and Lisfranc joint complex injury. PMID:25451204

  15. On a Boat: A Case in Australia of Endophthalmitis and Pyogenic Liver, Prostatic, and Lung Abscesses in a Previously Well Patient due to Klebsiella pneumoniae

    PubMed Central

    2014-01-01

    This is a case report about a patient who arrived in our emergency department in Western Australia to the care of the urologists having just gotten off a ship with a bacterial infection that would result in a 44-day stay in hospital and have quite devastating lasting effects for the young male. His story was in fact reflective of an emerging global phenomenon. Once thought to generally be a bacterium of threat only to the elderly and alcoholics, causing pneumonia and urinary tract infections, this case report describes the potentially devastating consequences of what is now becoming recognized as a hypervirulent form of Klebsiella pneumoniae with the potential to spread throughout the system rapidly seeding abscesses and causing significant morbidity in nonimmunocompromised patients. Initially noticed in Asia increasingly case reports are emerging in Western countries suggesting a global spread. PMID:25309763

  16. On a Boat: A Case in Australia of Endophthalmitis and Pyogenic Liver, Prostatic, and Lung Abscesses in a Previously Well Patient due to Klebsiella pneumoniae.

    PubMed

    Vandevelde, Alecia; Stepanovic, Bojana

    2014-01-01

    This is a case report about a patient who arrived in our emergency department in Western Australia to the care of the urologists having just gotten off a ship with a bacterial infection that would result in a 44-day stay in hospital and have quite devastating lasting effects for the young male. His story was in fact reflective of an emerging global phenomenon. Once thought to generally be a bacterium of threat only to the elderly and alcoholics, causing pneumonia and urinary tract infections, this case report describes the potentially devastating consequences of what is now becoming recognized as a hypervirulent form of Klebsiella pneumoniae with the potential to spread throughout the system rapidly seeding abscesses and causing significant morbidity in nonimmunocompromised patients. Initially noticed in Asia increasingly case reports are emerging in Western countries suggesting a global spread. PMID:25309763

  17. Evidence Report: Risk of Performance Errors Due to Training Deficiencies

    NASA Technical Reports Server (NTRS)

    Barshi, Immanuel

    2012-01-01

    The Risk of Performance Errors Due to Training Deficiencies is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. Given that training content, timing, intervals, and delivery methods must support crew task performance, and given that training paradigms will be different for long-duration missions with increased crew autonomy, there is a risk that operators will lack the skills or knowledge necessary to complete critical tasks, resulting in flight and ground crew errors and inefficiencies, failed mission and program objectives, and an increase in crew injuries.

  18. Sacroiliitis due to Salmonella Typhi: A case report

    PubMed Central

    Avcu, Serhat; Menteş, Osman; Bulut, Mehmet Deniz; Sünnetçioğlu, Mahmut; Karahocagil, Mustafa Kasım

    2010-01-01

    Context: Pyogenic infections of the sacroiliac joint are observed quite rarely. The most frequent causative microorganisms are Staphylococcus aureus, Streptococcus species, and Pseudomonas aeruginosa that are commonly found in patients under intravenous medication. In this paper, a rare sacroiliitis case that developed due to Salmonella Typhi is discussed. Case Report: A woman at the age of twenty applied to our clinic with complaints of fever, headache and diarrhea with which she had been suffering for five days. On physical examination, she had a slight fever, with a body temperature of 38.6°C. She was hospitalized, and Salmonella Typhi was isolated from her blood culture. Later on, the patient described pain during left hip movement. Diffusion-weighted magnetic resonance imaging and scintigraphic examinations revealed left sacroiliitis. Conclusion: Although sacroiliitis arising from Salmonella Typhi infection is a rare entity, it should not be ignored in patients who have a clinical history for sacroiliitis. PMID:22624143

  19. Case Report: Bilateral diaphragmatic dysfunction due to Borrelia Burgdorferi

    PubMed Central

    Basunaid, Suhail; van der Grinten, Chris; Cobben, Nicole; Otte, Astrid; Sprooten, Roy; Gernot, Rohde

    2014-01-01

    Summary: In this case report we describe a rare case of bilateral diaphragmatic dysfunction due to Lyme disease. Case report: A 62-years-old male presented to the hospital because of flu-like symptoms. During initial evaluation a bilateral diaphragmatic weakness with orthopnea and nocturnal hypoventilation was observed, without a known aetiology. Bilateral diaphragmatic paralysis was confirmed by fluoroscopy with a positive sniff test. The patient was referred to our centre for chronic non-invasive nocturnal ventilation (cNPPV). Subsequent investigations revealed evidence of anti- Borrelia seroactivity in EIA-IgG and IgG-blot, suggesting a recent infection with Lyme disease, and resulted in a 4-week treatment with oral doxycycline. The symptoms of nocturnal hypoventilation were successfully improved with cNPPV. However, our patient still shows impaired diaphragmatic function but he is no longer fully dependent on nocturnal ventilatory support.     Conclusion: Lyme disease should be considered in the differential diagnosis of diaphragmatic dysfunction. It is a tick-borne illness caused by one of the three pathogenic species of the spirochete Borrelia burgdorferi, present in Europe. A delay in recognizing the symptoms can negatively affect the success of treatment. Non-invasive mechanical ventilation (NIV) is considered a treatment option for patients with diaphragmatic paralysis. PMID:25671085

  20. The association of previously reported polymorphisms for microvascular complications in a meta-analysis of diabetic retinopathy.

    PubMed

    Hosseini, S Mohsen; Boright, Andrew P; Sun, Lei; Canty, Angelo J; Bull, Shelley B; Klein, Barbara E K; Klein, Ronald; Paterson, Andrew D

    2015-02-01

    We investigated the association of signals from previous GWAS and candidate gene meta-analyses for diabetic retinopathy (DR) or nephropathy (DN), as well as an EPO variant in meta-analyses of severe (SDR) and mild diabetic retinopathy (MDR). Meta-analyses of SDR (≥severe non-proliferative diabetic retinopathy (NPDR) or history of panretinal photocoagulation) and MDR (≥mild NPDR), defined based on seven-field stereoscopic fundus photographs, were performed in two well-characterized type 1 diabetes (T1D) cohorts: the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC, n = 1,304) and Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR, n = 603). Among 34 previous signals for DR, after controlling for multiple testing, no association was replicated in our meta-analyses. rs1571942 and rs12219125 at PLXDC2 locus showed nominally significant (<0.05) association with SDR in the same direction as previous report, as did rs1801282 in PPARG gene with MDR. Among 55 loci previously associated with DN, three showed suggestive associations with SDR in our study without maintaining significance after correction for multiple testing. Of particular interest, rs1617640 (EPO) was not significantly associated with DR status, combined SDR-DN phenotype, time to SDR or time to DN (all P > 0.05). Lack of replication of previous DR hits and EPO despite reasonable statistical power implies that many of these may be false positives. Consistent with pleiotropy, we provide suggestive collective evidence for association between DR and variants previously associated with DN without reaching statistical significance at any single locus. PMID:25487307

  1. Aortic Dissection Caused by Percutaneous Coronary Intervention: 2 New Case Reports and Detailed Analysis of 86 Previous Cases

    PubMed Central

    Bajaj, Sharad; Shamoon, Fayez

    2016-01-01

    Aortic dissection, a rare sequela of percutaneous coronary intervention, can be fatal when it is not recognized and treated promptly. Treatment varies from conservative management to invasive aortic repair and revascularization. We report the cases of 2 patients whose aortic dissection was caused by percutaneous coronary intervention. In addition, we present detailed analyses of 86 previously reported cases. Aortic dissection was most often seen during intervention to the right coronary artery (in 76.7% of instances). The 2 most frequently reported causes were catheter trauma (in 54% of cases) and balloon inflation (in 23.8%). The overall mortality rate was 7.1%. We conclude that most patients can be treated conservatively or by means of stenting alone, with no need for surgical intervention.

  2. Myocerebrohepatopathy spectrum disorder due to POLG mutations: A clinicopathological report.

    PubMed

    Montassir, Hesham; Maegaki, Yoshihiro; Murayama, Kei; Yamazaki, Taro; Kohda, Masakazu; Ohtake, Akira; Iwasa, Hiroyasu; Yatsuka, Yukiko; Okazaki, Yasushi; Sugiura, Chitose; Nagata, Ikuo; Toyoshima, Mitsuo; Saito, Yoshiaki; Itoh, Masayuki; Nishino, Ichizo; Ohno, Kousaku

    2015-08-01

    We report on the clinical, neuropathological, and genetic findings of a Japanese case with myocerebrohepatopathy spectrum (MCHS) disorder due to polymerase gamma (POLG) mutations. A girl manifested poor sucking and failure to thrive since 4 months of age and had frequent vomiting and developmental regression at 5 months of age. She showed significant hypotonia and hepatomegaly. Laboratory tests showed hepatocellular dysfunction and elevated protein and lactate levels in the cerebrospinal fluid. Her liver function and neurologic condition exacerbated, and she died at 8 months of age. At autopsy, fatty degeneration and fibrosis were observed in the liver. Neuropathological examination revealed white matter-predominant spongy changes with Alzheimer type II glia and loss of myelin. Enzyme activities of the respiratory chain complex I, III, and IV relative to citrate synthase in the muscle were normal in the biopsied muscle tissue, but they were reduced in the liver to 0%, 10%, and 14% of normal values, respectively. In the liver, the copy number of mitochondrial DNA compared to nuclear DNA was reduced to 3.3% of normal values as evaluated by quantitative polymerase chain reaction. Genetic analysis revealed compound heterozygous mutations for POLG (I1185T/A957V). This case represents the differential involvement of multiple organs and phenotype-specific distribution of brain lesions in mitochondrial DNA depletion disorders. PMID:25466440

  3. Cardioinhibitory reflex due to a karate kick: a case report.

    PubMed

    de Froidmont, Sébastien; Lobrinus, Johannes Alexander; Michaud, Katarzyna; Palmiere, Cristian; Augsburger, Marc-Pierre; Mangin, Patrice; Grabherr, Silke

    2015-06-01

    This article describes the case of a 17-year-old adolescent boy who received a foot kick in the trunk area from an expert in karate. He presented with immediate cardiocirculatory arrest. After a prolonged resuscitation, he was transferred to a hospital where he died 5 days later without ever regaining consciousness. Postmortem investigations including autopsy, radiology, histology, toxicology, and postmortem chemistry were performed that showed signs of multiple organ failure, an acute hemorrhage in the region of the celiac plexus, and signs of medical resuscitation. No preexisting disease, particularly those concerning the heart, was objectified. The cause of death was attributed to multiple organ failure after a prolonged cardiocirculatory arrest. Concerning the origin of the cardiac arrest, 2 hypotheses were considered-a cardioinhibitory reflex and a cardiac contusion (commotio cordis). Because of the presence of traumatic lesions in the celiac plexus, the first hypothesis was finally submitted. This case is reported because rare cases of sudden death from celiac reflex are described in the literature where it is almost impossible to find references with accurate documentation. The presented case confirms the importance of detailed documentation of the circumstances and postmortem investigations to establish a diagnosis of death due to cardioinhibitory reflex. PMID:25881816

  4. Anton's syndrome due to cerebrovascular disease: a case report

    PubMed Central

    2009-01-01

    Introduction Anton's syndrome describes the condition in which patients deny their blindness despite objective evidence of visual loss, and moreover confabulate to support their stance. It is a rare extension of cortical blindness in which, in addition to the injury to the occipital cortex, other cortical centres are also affected, with patients typically behaving as if they were sighted. Case presentation We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. Despite her obvious blindness, illustrated by her walking into objects, the patient expressed denial of visual loss and demonstrated confabulation in her accounts of her surroundings, consistent with a diagnosis of Anton's syndrome. Conclusions A suspicion of cortical blindness and Anton's syndrome should be considered in patients with atypical visual loss and evidence of occipital lobe injury. Cerebrovascular disease is the most common cause of Anton's syndrome, as in our patient. However, any condition that may result in cortical blindness can potentially lead to Anton's syndrome. Recovery of visual function will depend on the underlying aetiology, with cases due to occipital lobe infarction after cerebrovascular events being less likely to result in complete recovery. Management in these circumstances should accordingly focus on secondary prevention and rehabilitation. PMID:20226004

  5. Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly

    PubMed Central

    van der Mee-Marquet, Nathalie L.; Blanc, Dominique S.; Gbaguidi-Haore, Houssein; Dos Santos Borges, Sandra; Viboud, Quentin; Bertrand, Xavier; Quentin, Roland

    2015-01-01

    We conducted a survey including 3334 bloodstream infections (BSIs) due to E. coli diagnosed in 2005–2014 at a stable cohort of hospitals. Marked increases in incidence were observed for community-acquired (CA) BSIs in patients aged >75 years, CA-BSIs of digestive origin in patients aged 60–74 years, healthcare-associated BSIs, and BSIs associated with ESBL (extended-spectrum B-lactamase)-producing E. coli (ESBLEc). Using MLST, we studied the genetic diversity of 412 BSI isolates recovered during the 2014 survey: 7 major sequence type complexes (STCs) were revealed in phylogenetic group B2, 3 in group A/B1 and 2 in group D. Among the 31 ESBLEc isolates, 1/3 belonged to STC 131. We searched for possible associations between clonal groups, clinical determinants and characteristics of BSIs: isolates from groups B2 (except STC 131) and D were susceptible to antibiotics and associated with BSIs of urinary origin in patients <60 years. STC 131 and group A/B1 isolates were multi-drug resistant and associated with CA-BSIs of digestive origin in patients aged 60–74 with a recent history of antibiotic treatment. STC 131 isolates were associated with HCA-BSIs in patients with recent/present hospitalization in a long-stay unit. We provide a unique population-based picture of the epidemiology of E. coli BSI. The aging nature of the population led to an increase in the number of cases caused by the B2 and D isolates generally implicated in BSIs. In addition, the association of a trend toward increasing rates of gut colonization with multi drug-resistant isolates revealed by the rise in the incidence of BSIs of digestive origin caused by STC 131 and A/B1 (STCs 10, 23, and 155) isolates, and a significant increase in the frequency of BSIs in elderly patients with recent antibiotic treatment suggested that antibiotic use may have contributed to the growing incidence of BSI. PMID:26175721

  6. Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports

    PubMed Central

    Devine, Owen; Friedman, Jan M; Louik, Carol; Honein, Margaret A

    2015-01-01

    Objective To follow up on previously reported associations between periconceptional use of selective serotonin reuptake inhibitors (SSRIs) and specific birth defects using an expanded dataset from the National Birth Defects Prevention Study. Design Bayesian analysis combining results from independent published analyses with data from a multicenter population based case-control study of birth defects. Setting 10 centers in the United States. Participants 17 952 mothers of infants with birth defects and 9857 mothers of infants without birth defects, identified through birth certificates or birth hospitals, with estimated dates of delivery between 1997 and 2009. Exposures Citalopram, escitalopram, fluoxetine, paroxetine, or sertraline use in the month before through the third month of pregnancy. Posterior odds ratio estimates were adjusted to account for maternal race/ethnicity, education, smoking, and prepregnancy obesity. Main outcome measure 14 birth defects categories that had associations with SSRIs reported in the literature. Results Sertraline was the most commonly reported SSRI, but none of the five previously reported birth defects associations with sertraline was confirmed. For nine previously reported associations between maternal SSRI use and birth defect in infants, findings were consistent with no association. High posterior odds ratios excluding the null value were observed for five birth defects with paroxetine (anencephaly 3.2, 95% credible interval 1.6 to 6.2; atrial septal defects 1.8, 1.1 to 3.0; right ventricular outflow tract obstruction defects 2.4, 1.4 to 3.9; gastroschisis 2.5, 1.2 to 4.8; and omphalocele 3.5, 1.3 to 8.0) and for two defects with fluoxetine (right ventricular outflow tract obstruction defects 2.0, 1.4 to 3.1 and craniosynostosis 1.9, 1.1 to 3.0). Conclusions These data provide reassuring evidence for some SSRIs but suggest that some birth defects occur 2-3.5 times more frequently among the infants of women treated with paroxetine or fluoxetine early in pregnancy. PMID:26156519

  7. First Case Report of Fatal Sepsis Due to Campylobacter upsaliensis

    PubMed Central

    Nakamura, Itaru; Omori, Nami; Umeda, Ayaka; Matsumoto, Tetsuya

    2014-01-01

    We encountered a rare case of severe fatal infection in a 70-year-old woman due to Campylobacter upsaliensis, identified by PCR amplification and sequencing analysis of the 16S rRNA gene using DNA extracted from the isolates. To our knowledge, fatal sepsis due to this organism has never been described to date. PMID:25411172

  8. The beet virus Q coat protein readthrough domain is longer than previously reported, with two transmembrane domains.

    PubMed

    Crutzen, François; Kreit, Marguerite; Bragard, Claude

    2009-03-01

    Ten beet virus Q (BVQ) strains from six different countries were sequenced to characterize the readthrough (RT) domain of the coat protein (CP). The GenBank/EMBL/DDBJ accession numbers for the sequences reported in this paper are FM244643-FM244652. With three nucleotide additions of 5, 285 and 1 nt, the common RT of 76 kDa was found to be longer than the single reference available to date (35 kDa). It is hypothesized that multiple inoculation cycles on Chenopodium quinoa were responsible for these three deletions in the C-terminal part of the BVQ RNA-2 previously described. Two putative transmembrane domains, TM1 and TM2, were predicted in the consensus amino acid sequence of the ten BVQ strains, and the putative BVQ TM2 was aligned with that of potato mop-top virus. PMID:19218222

  9. Identification of a new locus and validation of previously reported loci showing differential methylation associated with smoking. The REGICOR study.

    PubMed

    Sayols-Baixeras, Sergi; Lluís-Ganella, Carla; Subirana, Isaac; Salas, Lucas A; Vilahur, Nadia; Corella, Dolores; Muñoz, Dani; Segura, Antonio; Jimenez-Conde, Jordi; Moran, Sebastián; Soriano-Tárraga, Carolina; Roquer, Jaume; Lopez-Farré, Antonio; Marrugat, Jaume; Fitó, Montse; Elosua, Roberto

    2015-12-01

    Smoking increases the risk of many diseases and could act through changes in DNA methylation patterns. The aims of this study were to determine the association between smoking and DNA methylation throughout the genome at cytosine-phosphate-guanine (CpG) site level and genomic regions. A discovery cross-sectional epigenome-wide association study nested in the follow-up of the REGICOR cohort was designed and included 645 individuals. Blood DNA methylation was assessed using the Illumina HumanMethylation450 BeadChip. Smoking status was self-reported using a standardized questionnaire. We identified 66 differentially methylated CpG sites associated with smoking, located in 38 genes. In most of these CpG sites, we observed a trend among those quitting smoking to recover methylation levels typical of never smokers. A CpG site located in a novel smoking-associated gene (cg06394460 in LNX2) was hypomethylated in current smokers. Moreover, we validated two previously reported CpG sites (cg05886626 in THBS1, and cg24838345 in MTSS1) for their potential relation to atherosclerosis and cancer diseases, using several different approaches: CpG site methylation, gene expression, and plasma protein level determinations. Smoking was also associated with higher THBS1 gene expression but with lower levels of thrombospondin-1 in plasma. Finally, we identified differential methylation regions in 13 genes and in four non-coding RNAs. In summary, this study replicated previous findings and identified and validated a new CpG site located in LNX2 associated with smoking. PMID:26829059

  10. Dysphagia due to anterior cervical osteophytes--a case report.

    PubMed

    Kareem, B A; Sofiyan, M; Subramanian, S

    2000-09-01

    Dysphagia due to osteophytes in a young person is uncommon. We present a rare case of Forestier's disease causing dysphagia in a young lady without other bony involvement. The osteophytes were surgically removed and her symptoms resolved completely. PMID:11200721

  11. A Case Report of Allergic Contact Dermatitis due to Mandragora Radix

    PubMed Central

    Baysak, Sevim; Gönül, Müzeyyen; Atacan, Damla; Ergin, Can

    2015-01-01

    An 82-year-old male presented with rash, burning, and itching on his knees that had started 4 days after the local application of Mandragora Radix sap for 3 consecutive days. A dermatological examination revealed erythematous, edematous, and scaly plaque lesions on the patient's knees. An open application test with M. Radix was performed, and the patient was diagnosed with allergic contact dermatitis due to M. Radix. Mandragora species, which belong to the Solanaceae family, have sedative, aphrodisiac, emetic, analgesic, and anesthetic properties. To the best of our knowledge, only one case of M. Radix-induced allergic contact dermatitis has been previously reported. PMID:26347280

  12. Multiorgan failure due to hemophagocytic syndrome: A case report

    PubMed Central

    Mayordomo-Colunga, Juan; Rey, Corsino; Gonzlez, Soledad; Concha, Andrs

    2008-01-01

    Introduction Hemophagocytic syndrome (HFS) is a potentially lethal disorder due to an uncontrolled immune response to a triggering agent. Our objective is to raise the importance of HFS early diagnosis by presenting a representative case. Case presentation A sixteen-year-old girl with Still disease diagnosis developed a progressive multiorgan failure including acute respiratory distress (ARDS), anemia and thrombopenia, elevated liver enzymes, renal failure, coagulopathy with hypofibrinogenemia, and acute phase reactants elevation despite broad-spectrum antibiotics. A bone marrow puncture-biopsy was performed, and hemophagocytosis was found. Prolonged fever, splenomegaly, bicytopenia, hypofibrinogenemia, hyperferritinemia and hypertriglyceridemia confirmed HFS diagnosis. She received intensive care support therapy including mechanical ventilation and specific therapy according to HLH 2004 protocol, with a very good response. Conclusion Our case shows complexity of HFS diagnosis, due to septic shock-like manifestations. Early diagnosis is essential to start appropriate treatment achieving a better outcome. PMID:18834507

  13. Non Traumatic Keratitis Due to Colletotrichum Coccodes: A Case Report

    PubMed Central

    Kotwal, Aarti; Kakati, Barnali; Bahadur, Harsh; Gupta, Neeti

    2015-01-01

    Colletotrichum species, a rare and emerging fungus is a well- known plant pathogen and an uncommon cause of human infection. It has been implicated as the etiological agent of cutaneous phaeohyphomycosis and keratitis, particularly following colonization of traumatized tissues or in immunocompromised patients. However, it has hardly ever been reported in the absence of such predisposing risk factors. Here, we report a case of keratitis with Colletotrichum coccodes occurring in a middle- aged, immunocompetent person without any history of trauma or co-morbidity. The isolate was sensitive to Amphotericin B and Voriconazole, and accordingly the patient was treated successfully with ocular administration of Amphotericin B. PMID:25859457

  14. 20 CFR 416.714 - When reports are due.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... eligibility or the correct amount of your SSI benefit payments. If you do not report within 30 days of our written request, we may determine that you are ineligible to receive SSI benefits. We will suspend your... receive SSI benefits because of your failure to give us necessary information. Penalty Deductions...

  15. Vitamin B12 Deficiency due to Chlorofluorocarbon: A Case Report

    PubMed Central

    Bhaskar, Hemlata; Chaudhary, Rekha

    2010-01-01

    Background. Vitamin B12 is vital for optimal functioning of various organ systems but more importantly the central nervous system and the hematological system. Deficiency of vitamin B12 clinically manifests as excessive daytime fatigue, memory difficulties, encephalopathy, myelopathy, peripheral neuropathy, and optic neuropathy. In occupational medicine, vitamin B12 deficiency has been reported with exposure to nitrous oxide in health care workers. However, not much is known about exposure to Freons in other industries and vitamin B12 deficiency. Aim. We are reporting a case of vitamin B12 deficiency in the setting of exposure to chlorofluorocarbon (CFC) gases. Case Report. A 55-year-old male refrigerator mechanic experienced recurrent visual symptoms, which included diplopia and blurring. A complete workup was done and was significant of vitamin B12 deficiency. However, his B12 levels were refractory to supplementation. Appropriate precautions at workplace improved patient's symptoms and were associated with significant improvement in B12 levels. Conclusion. To the best of our knowledge, this is the first reported case of vitamin B12 deficiency (that remains refractory to supplementation) in the setting of exposure to Freon gases. PMID:21461374

  16. Case report of bacteremia due to Neisseria mucosa.

    PubMed

    Mechergui, Arij; Achour, Wafa; Baaboura, Rekaya; Ouertani, Hela; Lakhal, Amal; Torjemane, Lamia; Othman, Tarek Ben; Hassen, Assia Ben

    2014-04-01

    Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report a case of bacteremia caused by N. mucosa in a 50-year-old neutropenic patient suffering from non-secretory multiple myeloma stage IIIA. This case underscores that mostly nonpathogenic N. mucosa can cause bacteremia in neutropenic patients who developed mucositis after hematopoietic stem cell transplantation. PMID:23905778

  17. Episodic ventriculomegaly due to hypernatremia mimicking shunt malfunction: case report.

    PubMed

    Jernigan, Sarah C; Stone, Scellig S D; Aronson, Joshua P; Putman, Melissa; Proctor, Mark R

    2015-10-01

    Patients with shunted hydrocephalus presenting with altered mental status and ventriculomegaly are generally considered to be in shunt failure requiring surgical treatment. The authors describe a case of shunted hydrocephalus secondary to a disseminated neuroectodermal tumor in a pediatric patient in whom rapid fluctuations in sodium levels due to diabetes insipidus repeatedly led to significant changes in ventricle size, with invasively confirmed normal shunt function and low intracranial pressure. This clinical picture exactly mimics shunt malfunction, requires urgent nonsurgical therapy, and underscores the importance of considering serum osmolar abnormalities in the differential diagnosis for ventriculomegaly. PMID:26186358

  18. Brain abscess due to Listeria monocytogenes: case report and literature review.

    PubMed

    Dee, R R; Lorber, B

    1986-01-01

    Listeria monocytogenes is an uncommon cause of brain abscess. Of a total of 14 cases of L. monocytogenes brain abscess (one described for the first time and 13 reported previously in the English-language literature), seven (50%) occurred in patients with leukemia and recipients of renal transplants; four (29%) of the cases occurred in previously healthy individuals. Common clinical findings were similar to those in brain abscess due to other causes and included fever (57%), headache (57%), and focal neurologic signs (64%). Distinctive, however, was the unusually high frequency of associated meningitis and bacteremia; blood cultures were positive in all eight cases in which they were performed. Eight (57%) of the 14 patients died. L. monocytogenes should be included in the differential diagnosis of brain abscess in patients with leukemia and in renal transplant recipients. Listerial brain abscess is highly unlikely when blood culture results are negative. PMID:3099364

  19. Factitious Biochemical Reports which are Caused Due to Paraproteinaemia in Multiple Myeloma - A Case Report.

    PubMed

    Nanda, Sunil Kumar; Sarangi, Rajlaxmi; Ray, Lopamudra; Kumar, Anil; Padhi, Somanath

    2013-02-01

    Factitious biochemical reports result in the misguiding of clinicians, unnecessary retesting, wrong diagnoses and incorrect treatments. A vigilant biochemist identifies these factitious biochemical reports and alerts the clinician regarding the proper interpretation of the biochemical reports, thus preventing a misdiagnosis and an incorrect treatment. We are presenting a case report of a multiple myeloma patient who presented with factitious biochemical reports which were caused due to paraproteinaemia. In the present case, the patient presented with an underestimation of urea and creatinine, an underestimation of sodium, low albumin levels and high phosphate levels. On repeating the same tests after dilutions and deproteinizing, the effects of the paraproteins on the above mentioned tests were reduced. Thus, from the observations of our study, we suggest that the interference by paraproteinaemia can be reduced by analyzing the biochemical parameters after dilution and deproteinization. PMID:23542790

  20. Scuba diver deaths due to air embolism: two case reports.

    PubMed

    Türkmen, Nursel; Akan, Okan; Cetin, Selçuk; Eren, Bülent; Gürses, Murat Serdar; Gündoğmuş, Umit Naci

    2013-04-01

    Barotraumas and decompression sickness are the two most well-known complications of diving. First presented case was 32 year-old male with recreational diver, who was found floating prone position on the bottom of sea in a depth of 33 m. He had been carried to the surface in a controlled ascent. Second case was a 39 year-old male experienced dive instructor in a diving school, after following an uneventful duration of dive was found unconscious with a floating supine position in a depth of 30 m and there were no signs of life when they were transported to the hospital. Extensive subcutaneous emphysema of the extremities was detected by palpation of the skin. In the autopsy diffuse gas bubbles like beads were seen in the coronary arteries and in ventricles, basilar artery and all of the cerebral arteries. The cause of death was attributed due to gas embolism and drowning. PMID:23641724

  1. First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii

    PubMed Central

    Baghdadi, Jonathan; Hemarajata, Peera; Humphries, Romney; Kelesidis, Theodoros

    2015-01-01

    Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt. Spontaneous translocation with yeast that is not part of the normal gastrointestinal flora in the setting of ingestion of multiple servings of a fermentation product was the likely source from which Cyberlindnera fabianii gained entrance into the VP shunt system, causing meningitis in this patient. The authors conclude that, in view of the high morbidity associated with yeast infection of the CNS, long-term antifungal therapy should be strongly considered in cases where the VP shunt cannot be completely removed. Transient fungemia may lead to invasive disease in an immunocompetent host with VP shunt, even in the absence of any other risk factors for fungemia and even after remote placement of the VP shunt. PMID:26618013

  2. [Anxiety disorder due to epilepsy: a case report].

    PubMed

    Özyurt, Gonca; Öztura, İbrahim; Alkın, Tunç; Özerdem, Ayşegül

    2015-01-01

    Epileptic patients present with psychiatric disorders more frequently than the general population and patients with other chronic medical conditions. Psychiatric disorders can co-occur with epilepsy and can be caused by epilepsy. Personality changes, as well as psychosis, and mood or anxiety disorders can occur in association with epilepsy. Anxiety disorders due to epilepsy can manifest as generalized anxiety disorder, panic disorder, phobias, or obsessive-compulsive disorder. The risk of an anxiety disorder is higher in patients with focal epilepsy, especially those with temporal lobe epilepsy, but an anxiety disorder can also occur in patients with frontal lobe epilepsy or generalized tonic-clonic epilepsy. Herein we present a 41-year-old female patient with comorbid anxiety disorder and epilepsy that improved following initiation of antiepileptic medication. The patient's EEG showed abnormalities, particularly in the frontal lobe. Epileptic activation-associated anxiety disorder presented as phobia of swallowing and the patient exhibited features of generalized anxiety disorder. Following initiation of antiepileptic medication, the seizures stopped and the symptoms of anxiety disappeared in two weeks. The patient was receiving psychotherapy once every 2 weeks. The patient remained asymptomatic during 2-years of follow-up. This case highlights the importance of differential diagnosis of underlying epilepsy in patients with acute severe anxiety and the efficacy of proper medical treatment, which was given in the presented case for the underling pathology of anxiety. PMID:25742040

  3. Eosinophilic pleuritis due to sparganum: a case report.

    PubMed

    Oh, Youngmin; Kim, Jeong-Tae; Kim, Mi-Kyeong; Chang, You-Jin; Eom, Keeseon; Park, Jung-Gi; Lee, Ki-Man; Choe, Kang-Hyeon; An, Jin-Young

    2014-10-01

    Sparganosis is a rare parasitic disease caused by migrating plerocercoid tapeworm larva of the genus Spirometra. Infection in humans is mainly caused by the ingestion of raw or inadequately cooked flesh of infected frogs, snakes, and chickens. Here, we report a rare case of a 45-year-old man who was admitted to our hospital with left lower chest pain. The chest radiograph and computed tomography (CT) scan revealed localized pleural effusion in the left lower lobe; further, peripheral blood eosinophilia and eosinophilic pleural effusion were present. Percutaneous catheter drainage was performed, which revealed long worm-shaped material that was identified as a sparganum by DNA sequencing. The patient showed clinical improvement after drainage of the sparganum. This study demonstrates the importance of considering parasitic diseases in the differential diagnosis of eosinophilic pleural effusion. PMID:25352705

  4. A death due to ecstasy - a case report.

    PubMed

    Chandra, Yp Girish; Shetty, Akshith R; Jayanth, S H; Hugar, Basappa S; Praveen, S; Harish, S

    2016-03-01

    Drug addicts face the dangers of accidental overdose, fatal intoxication, reduced tolerance and carelessness in consuming drugs. There is an increasing use of designer drugs in many cities. The body of a 29 year-old male, an event manager by profession with an alleged history of consumption of ecstasy tablets, was subjected to autopsy. The cause of death was found to be disseminated intravascular coagulation consequent upon consumption of methylenedioxymethamphetamine. This was based on the brief history, autopsy features and a chemical analysis report. This case is discussed with the background of the existing literature about the interplay of the actions of methylenedioxymethamphetamine, the hyperthermia that would result from physical exertion as in dancing in rave parties leading to hyponatremia and the causes of disseminated intravascular coagulation. PMID:26733334

  5. Allergic bronchopulmonary mycosis due to Alternaria: Case report and review.

    PubMed

    Singh, Bhagteshwar; Denning, David W

    2012-01-01

    While allergic bronchopulmonary aspergillosis and mycosis are well recognised, no cases have been described related to Alternaria spp. Alternaria is a common sensitising fungus in asthmatics and related to thunderstorm asthma. We report a case of an asthmatic who presented with worsening asthma control, mild eosinophilia on high dose inhaled corticosteroids (800 μg/day), a total IgE of 3800 KIU/L, an Alternaria-specific IgE of 21.3 KUa/L and positive skin prick test, negative specific IgE and skin prick test to Aspergillus fumigatus, Penicillium spp., Cladosporium spp., Trichophyton spp. and a normal CT scan of the thorax. He responded well to a short course of oral prednisolone and then oral itraconazole, given over 17 months but relapsed 1 month after stopping it. PMID:24371728

  6. A Case of Anterior Chamber Cholesterolosis Due to Coats' Disease and a Review of Reported Cases

    PubMed Central

    Stacey, Andrew W.; Borri, Melissa; Francesco, Sonia De; Antenore, Angela S.; Menicacci, Felice; Hadjistilianou, Theodora

    2016-01-01

    Purpose: To present the case of an 18 month old boy with Coats' disease who was found to have anterior chamber cholesterolosis. Methods: Case presentation and review of reported cases. Results: An 18 month old boy presented with unilateral stage 3B Coats' disease without other clinical findings. Two weeks after presentation he returned with xanthocoria due to anterior chamber cholesterolosis. He subsequently developed hyphema, neovascular glaucoma, and was enucleated. His case is compared to all previously reported cases of Coats' disease leading to anterior chamber cholesterolosis. Conclusion: The presentation of anterior chamber cholesterolosis in Coats' disease can range from the incidental finding in an asymptomatic patient to acute angle closure glaucoma with pain and acutely decreased vision. Clinicians should be aware of this potential complication of Coats' disease as it denotes a poor visual prognosis. PMID:27014384

  7. First report of death due to Hemiscorpius acanthocercus envenomation in Iran: Case report

    PubMed Central

    Shahi, Mehran; Rafinejad, Javad; Az-Khosravi, Leyla; Moosavy, Seyed Hamid

    2015-01-01

    Scorpion stings are significant causes of death in the western and southern regions of Iran. To date, reports have indicated that the H. lepturus species is the main cause of mortality due to scorpion stings. One of the species that belongs to this genus is Hemiscorpius acanthocercus (H. acanthocercus). This scorpion’s venom is cytotoxic, and it causes pathological changes in the blood and can cause severe damage to the kidneys. The pain of Hemiscorpius’ sting is mild and asymptomatic in the early hours. Delays in the treatment of these victims can cause hemolysis, hematuria, kidney failure, and even death. In this paper, we report the first known death due to an H. acanthocercus’ sting in Iran. PMID:26435822

  8. Case report and review of septicemia due to Serratia ficaria.

    PubMed Central

    Darbas, H; Jean-Pierre, H; Paillisson, J

    1994-01-01

    Serratia ficaria was first described in 1979 as part of the fig tree ecosystem (P.A.D. Grimont, F. Grimont, and M. P. Starr, Curr. Microbiol. 2:277-282, 1979). Since then, it has been isolated from clinical specimens from a few human patients (C. Bollet, J. Freney, P. de Micco, F. Grimont, and P.A.D. Grimont, Md. Mal. Infect. 20:97-100, 1990; J.A. Brouillard, W. Hansen, and A. Compere, J. Clin. Microbiol. 19:902-904, 1984; H. Darbas, H. Jean-Pierre, G. Boyer, and M. Riviere, Md. Mal. Infect. 23:269-270, 1993; V.J. Gill, J.J. Farmer, III, P.A.D. Grimont, M.A. Asbury, and C.L. McIntosh, J. Clin. Microbiol. 14:234-236, 1981; F.D. Pien and J.J. Farmer III, South. Med. J. 76:1591-1592, 1983; C. Richard, J. de Coquet, and C. Suc, Md. Mal. Infect. 19:45-47, 1989), but the pathogenicity of S. ficaria was always questionable. We are reporting the case of an aged cancer patient who developed S. ficaria septicemia. The habitat of this organism and its potential role as a pathogen are discussed. PMID:7814560

  9. Evidence Report: Risk of Performance Errors Due to Training Deficiencies

    NASA Technical Reports Server (NTRS)

    Barshi, Immanuel; Dempsey, Donna L.

    2016-01-01

    Substantial evidence supports the claim that inadequate training leads to performance errors. Barshi and Loukopoulos (2012) demonstrate that even a task as carefully developed and refined over many years as operating an aircraft can be significantly improved by a systematic analysis, followed by improved procedures and improved training (see also Loukopoulos, Dismukes, & Barshi, 2009a). Unfortunately, such a systematic analysis of training needs rarely occurs during the preliminary design phase, when modifications are most feasible. Training is often seen as a way to compensate for deficiencies in task and system design, which in turn increases the training load. As a result, task performance often suffers, and with it, the operators suffer and so does the mission. On the other hand, effective training can indeed compensate for such design deficiencies, and can even go beyond to compensate for failures of our imagination to anticipate all that might be needed when we send our crew members to go where no one else has gone before. Much of the research literature on training is motivated by current training practices aimed at current training needs. Although there is some experience with operations in extreme environments on Earth, there is no experience with long-duration space missions where crews must practice semi-autonomous operations, where ground support must accommodate significant communication delays, and where so little is known about the environment. Thus, we must develop robust methodologies and tools to prepare our crews for the unknown. The research necessary to support such an endeavor does not currently exist, but existing research does reveal general challenges that are relevant to long-duration, high-autonomy missions. The evidence presented here describes issues related to the risk of performance errors due to training deficiencies. Contributing factors regarding training deficiencies may pertain to organizational process and training programs for spaceflight, such as when training programs are inadequate or unavailable. Furthermore, failure to match between tasks on the one hand, and learning and memory abilities on the other hand is a contributing factor, especially when individuals' relative efficiency with which new information is acquired, and adjustments made in behavior or thinking, are inconsistent with mission demands. Thus, if training deficiencies are present, the likelihood of errors or of the inability to successfully complete a task increases. What's more, the overall risk to the crew, the vehicle, and the mission increases.

  10. 12 CFR 1010.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... revocation rights on property report cover page. 1010.558 Section 1010.558 Banks and Banking BUREAU OF... cover page. (a)(1) The cover page on Property Reports for filings made with the Director pursuant to... section XXX of the appendix to this part: Language to be Included on Property Report Cover Page. (2)...

  11. 12 CFR 1010.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... revocation rights on property report cover page. 1010.558 Section 1010.558 Banks and Banking BUREAU OF... cover page. (a)(1) The cover page on Property Reports for filings made with the Director pursuant to... section XXX of the appendix to this part: Language to be Included on Property Report Cover Page. (2)...

  12. 30 CFR 210.103 - When are my production reports due?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When are my production reports due? 210.103 Section 210.103 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT FORMS AND REPORTS Production Reports-Oil and Gas 210.103 When are my production reports due?...

  13. 30 CFR 1210.103 - When are my production reports due?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INTERIOR Natural Resources Revenue FORMS AND REPORTS Production Reports-Oil and Gas 1210.103 When are my production reports due? (a) The ONRR must receive your completed Forms MMS-4054 and MMS-4058 by the 15th day... 30 Mineral Resources 3 2011-07-01 2011-07-01 false When are my production reports due?...

  14. The Natural History of Juvenile or Subacute GM2 Gangliosidosis: 21 New Cases and Literature Review of 134 Previously Reported

    PubMed Central

    Maegawa, Gustavo H. B.; Stockley, Tracy; Tropak, Michael; Banwell, Brenda; Blaser, Susan; Kok, Fernando; Giugliani, Roberto; Mahuran, Don; Clarke, Joe T. R.

    2010-01-01

    OBJECTIVE Juvenile GM2 gangliosidosis is a group of inherited neurodegenerative diseases caused by deficiency of lysosomal β-hexosaminidase resulting in GM2 ganglioside accumulation in brain. The purpose of this study was to delineate the natural history of the condition and identify genotype-phenotype correlations that might be helpful in predicting the course of the disease in individual patients. METHODS A cohort of 21 patients with juvenile GM2 gangliosidosis, 15 with the Tay-Sachs variant and 6 with the Sandhoff variant, was studied prospectively in 2 centers. Our experience was compared with previously published reports on 134 patients. Information about clinical features, β-hexosaminidase enzyme activity, and mutation analysis was collected. RESULTS In our cohort of patients, the mean (±SD) age of onset of symptoms was 5.3 ± 4.1 years, with a mean follow-up time of 8.4 years. The most common symptoms at onset were gait disturbances (66.7%), incoordination (52.4%), speech problems (28.6%), and developmental delay (28.6%). The age of onset of gait disturbances was 7.1 ± 5.6 years. The mean time for progression to becoming wheelchair-bound was 6.2 ± 5.5 years. The mean age of onset of speech problems was 7.0 ± 5.6 years, with a mean time of progression to anarthria of 5.6 ± 5.3 years. Muscle wasting (10.6 ± 7.4 years), proximal weakness (11.1 ± 7.7 years), and incontinence of sphincters (14.6 ± 9.7 years) appeared later in the course of the disease. Psychiatric disturbances and neuropathy were more prevalent in patients with the Sandhoff variant than in those with the Tay-Sachs variant. However, dysphagia, sphincter incontinence, and sleep problems occurred earlier in those with the Tay-Sachs variant. Cerebellar atrophy was the most common finding on brain MRI (52.9%). The median survival time among the studied and reviewed patients was 14.5 years. The genotype-phenotype correlation revealed that in patients with the Tay-Sachs variant, the presence of R178H and R499H mutations was predictive of an early onset and rapidly progressive course. The presence of either G269S or W474C mutations was associated with a later onset of symptoms along with a more slowly progressive disease course. CONCLUSIONS Juvenile GM2 gangliosidosis is clinically heterogeneous, not only in terms of age of onset and clinical features but also with regard to the course of the disease. In general, the earlier the onset of symptoms, the more rapidly the disease progresses. The Tay-Sachs and Sandhoff variants differed somewhat in the frequency of specific clinical characteristics. Speech deterioration progressed more rapidly than gait abnormalities in both the Tay-Sachs variant and Sandhoff variant groups. Among patients with the Tay-Sachs variant, the HEXA genotype showed a significant correlation with the clinical course. PMID:17015493

  15. 24 CFR 1710.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Previously accepted state filings... Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (INTERSTATE...

  16. 24 CFR 1710.558 - Previously accepted state filings-notice of revocation rights on property report cover page.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Previously accepted state filings... Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (INTERSTATE...

  17. Gastrointestinal Mucormycosis following a Streptococcus pyogenes Toxic Shock Syndrome in a Previously Healthy Patient: A Case Report

    PubMed Central

    Roussy, Jean-François; Allard, Catherine; St-Germain, Guy; Pépin, Jacques

    2012-01-01

    Mucormycosis is an uncommon opportunistic infection and the gastrointestinal form is the rarest. Rhizopus sp. is the most frequent pathogen and infection occurs almost exclusively in immunocompromised patients. We describe the first case of intestinal mucormycosis occurring after a Streptococcus pyogenes toxic shock syndrome in a previously healthy patient caused by Rhizopus microsporus var. azygosporus. PMID:22900216

  18. Probable Levofloxacin-Induced Thrombocytopenia in a Patient Previously on Ciprofloxacin: A Case Report and Literature Review.

    PubMed

    Landi, A Justine; Burkes, Robert

    2016-01-01

    Drug-induced thrombocytopenia is a poorly understood, yet common phenomenon widely encountered in clinical practice. We present a case of suspected levofloxacin-induced thrombocytopenia, a rare side effect of a ubiquitous antibiotic, in a patient without similar effect to ciprofloxacin. This report builds upon other isolated case reports of fluoroquinolone-induced thrombocytopenia and demonstrates our algorithmic approach to the issue as well as a literature review pertaining to fluoroquinolone-induced thrombocytopenia. PMID:26884767

  19. Probable Levofloxacin-Induced Thrombocytopenia in a Patient Previously on Ciprofloxacin: A Case Report and Literature Review

    PubMed Central

    Landi, A. Justine; Burkes, Robert

    2016-01-01

    Drug-induced thrombocytopenia is a poorly understood, yet common phenomenon widely encountered in clinical practice. We present a case of suspected levofloxacin-induced thrombocytopenia, a rare side effect of a ubiquitous antibiotic, in a patient without similar effect to ciprofloxacin. This report builds upon other isolated case reports of fluoroquinolone-induced thrombocytopenia and demonstrates our algorithmic approach to the issue as well as a literature review pertaining to fluoroquinolone-induced thrombocytopenia. PMID:26884767

  20. Osmotic shock tolerance and membrane fluidity of cold-adapted Cryptococcus flavescens OH 182.9, previously reported as Cr. nodaensis, a biocontrol agent of Fusarium head blight

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cryptococcus nodaensis (previously reported as Cr. nodaensis), a biological control agent of Fusarium head blight, has been previously shown to have improved desiccation tolerance after cold adaptation. The goal of the current study was to determine the effect of cold adaptation on the physicochemi...

  1. Otomycosis due to Aspergillus spp. in a dog: case report and literature review.

    PubMed

    Coyner, Kimberly

    2010-12-01

    This report describes the clinical findings, clinicopathology and treatment of otomycosis caused by Aspergillus spp. in an atopic dog affected by chronic unilateral purulent otitis externa unresponsive to topical and oral antibiotics and antifungal treatments. Cytology of otic exudate revealed neutrophils and septate fungal hyphae, and otic culture grew Aspergillus spp. and no bacteria. Treatments included allergen-specific immunotherapy, topical and oral antifungal therapy and anti-inflammatory steroid therapy. Final resolution occurred after treatment of the underlying hypersensitivity disorder, administration of topical ketoconazole and debridement of infectious ear exudate. Otomycosis due to filamentous fungi may, as in humans, occur in dogs with ear canals compromised by pre-existing allergic or bacterial otitis, and possibly previous antibiotic therapy. Antifungal medications provided clinical improvement, but the key to successful treatment was the restoration of the normal physiology of the external auditory canal. PMID:20492628

  2. Analysis of Over 10,000 Cases Finds No Association between Previously-Reported Candidate Polymorphisms and Ovarian Cancer Outcome

    PubMed Central

    White, Kristin L.; Vierkant, Robert A.; Fogarty, Zachary C.; Charbonneau, Bridget; Block, Matthew S.; Pharoah, Paul D.P.; Chenevix-Trench, Georgia; Rossing, Mary Anne; Cramer, Daniel W.; Pearce, C. Leigh; Schildkraut, Joellen M.; Menon, Usha; Kjaer, Susanne Kruger; Levine, Douglas A.; Gronwald, Jacek; Culver, Hoda Anton; Whittemore, Alice S.; Karlan, Beth Y.; Lambrechts, Diether; Wentzensen, Nicolas; Kupryjanczyk, Jolanta; Chang-Claude, Jenny; Bandera, Elisa V.; Hogdall, Estrid; Heitz, Florian; Kaye, Stanley B.; Fasching, Peter A.; Campbell, Ian; Goodman, Marc T.; Pejovic, Tanja; Bean, Yukie; Lurie, Galina; Eccles, Diana; Hein, Alexander; Beckmann, Matthias W.; Ekici, Arif B.; Paul, James; Brown, Robert; Flanagan, James; Harter, Philipp; du Bois, Andreas; Schwaab, Ira; Hogdall, Claus K.; Lundvall, Lene; Olson, Sara H.; Orlow, Irene; Paddock, Lisa E.; Rudolph, Anja; Eilber, Ursula; Dansonka-Mieszkowska, Agnieszka; Rzepecka, Iwona K.; Ziolkowska-Seta, Izabela; Brinton, Louise; Yang, Hannah; Garcia-Closas, Montserrat; Despierre, Evelyn; Lambrechts, Sandrina; Vergote, Ignace; Walsh, Christine; Lester, Jenny; Sieh, Weiva; McGuire, Valerie; Rothstein, Joseph H.; Ziogas, Argyrios; Lubiński, Jan; Cybulski, Cezary; Menkiszak, Janusz; Jensen, Allan; Gayther, Simon A.; Ramus, Susan J.; Gentry-Maharaj, Aleksandra; Berchuck, Andrew; Wu, Anna H.; Pike, Malcolm C.; Van Den Berg, David; Terry, Kathryn L.; Vitonis, Allison F.; Doherty, Jennifer A.; Johnatty, Sharon; deFazio, Anna; Song, Honglin; Tyrer, Jonathan; Sellers, Thomas A.; Phelan, Catherine M.; Kalli, Kimberly R.; Cunningham, Julie M.; Fridley, Brooke L.; Goode, Ellen L.

    2013-01-01

    Background Ovarian cancer is a leading cause of cancer-related death among women. In an effort to understand contributors to disease outcome, we evaluated single-nucleotide polymorphisms (SNPs) previously associated with ovarian cancer recurrence or survival, specifically in angiogenesis, inflammation, mitosis, and drug disposition genes. Methods Twenty-seven SNPs in VHL, HGF, IL18, PRKACB, ABCB1, CYP2C8, ERCC2, and ERCC1 previously associated with ovarian cancer outcome were genotyped in 10,084 invasive cases from 28 studies from the Ovarian Cancer Association Consortium with over 37,000 observed person-years and 4,478 deaths. Cox proportional hazards models were used to examine the association between candidate SNPs and ovarian cancer recurrence or survival with and without adjustment for key covariates. Results We observed no association between genotype and ovarian cancer recurrence or survival for any of the SNPs examined. Conclusions These results refute prior associations between these SNPs and ovarian cancer outcome and underscore the importance of maximally powered genetic association studies. Impact These variants should not be used in prognostic models. Alternate approaches to uncovering inherited prognostic factors, if they exist, are needed. PMID:23513043

  3. Gradenigo’s syndrome secondary to chronic otitis media on a background of previous radical mastoidectomy: a case report

    PubMed Central

    2014-01-01

    Introduction Gradenigo’s syndrome is nowadays a rare condition characterized by a triad of otorrhea, facial pain with trigeminal nerve involvement and abducens nerve palsy. Most cases are caused by medial extension of acute otitis media into a pneumatized petrous apex and surgical drainage is usually the treatment of choice. We present a case highlighting the pathological mechanism of this disease, demonstrate rare radiological findings associated with this patient, and showcase successful medical treatment without surgical intervention. Case presentation A 63-year-old Thai man presented with complete Gradenigo triad as a complication of chronic otomastoiditis in spite of clinical history of previous radical mastoidectomy and a nonpneumatization of the petrous apex. Magnetic resonance imaging showed abnormal prominent enhancement at the roof of his right temporal bone, and the dura overlying the floor of right middle cranial fossa and right cavernous sinus. Magnetic resonance imaging also detected right petrous apicitis. With the use of intravenous antibiotics and topical antibiotic eardrops, recovery was observed within 5 days with complete resolution within 2 months. Conclusions Although there is little evidence to support the use of medical therapy in the treatment of Gradenigo’s syndrome resulting from chronic ear disease, we here demonstrate successful conservative treatment of Gradenigo’s syndrome following chronic otitis media in a patient who underwent previous radical mastoidectomy. PMID:24957520

  4. Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases.

    PubMed

    Caram, L B; Linefsky, J P; Read, K M; Murdoch, D R; Lalani, T; Woods, C W; Reller, L B; Kanj, S S; Premru, M M; Ryan, S; Al-Hegelan, M; Donnio, P Y; Orezzi, C; Paiva, M G; Tribouilloy, C; Watkin, R; Harris, O; Eisen, D P; Corey, G R; Cabell, C H; Petti, C A

    2008-02-01

    Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of Leptotrichia sp. endocarditis. PMID:17960435

  5. Supplementary Services for Previously Nonpublic School Institutionalized Students, 1984-85. P.L. 89-313. Final Report.

    ERIC Educational Resources Information Center

    Miller, Ronald C.; And Others

    The report describes accomplishments of a program serving approximately 2500 handicapped students fomerly educated in New York state operated or supported schools. The program offered supplemental services to eligible students either through teacher training or through provision of materials and equipment. Curriculum areas in component 1 included…

  6. The efficacy and safety of mirabegron compared with solifenacin in overactive bladder patients dissatisfied with previous antimuscarinic treatment due to lack of efficacy: results of a noninferiority, randomized, phase IIIb trial

    PubMed Central

    Kölbl, Heinz; Herschorn, Sender; Rechberger, Tomasz; Cambronero, Javier; Halaska, Michael; Coppell, Alex; Kaper, Mathilde; Huang, Moses; Siddiqui, Emad

    2015-01-01

    Objective: To compare the efficacy and safety of mirabegron 50 mg and solifenacin 5 mg in overactive bladder (OAB) patients dissatisfied with previous antimuscarinic treatment due to lack of efficacy. Patients and methods: This randomized, double-blind, phase IIIb, noninferiority study, enrolled male and female patients aged ⩾18 years old, with symptoms of OAB for ⩾3 months, who were dissatisfied with their previous antimuscarinic drug due to lack of efficacy. A total of 1887 patients were randomized to receive mirabegron 50 mg (n = 943) or solifenacin 5 mg (n = 944) daily for 12 weeks. The primary efficacy endpoint was change from baseline to end of treatment in mean number of micturitions/24 h. Noninferiority was confirmed if the lower limit of the two-sided 95% confidence interval (CI) for the treatment difference between solifenacin and mirabegron was > −0.20. Secondary efficacy endpoints, which included change from baseline in mean number of incontinence episodes/24 h, urgency incontinence episodes/24 h, urgency episodes (grade 3 or 4)/24 h and nocturia episodes/24 h, were analyzed using analysis of covariance. Results: For the primary endpoint, adjusted mean treatment difference (95% CI) in mean number of micturitions/24 h was −0.18 (−0.42, 0.06) and therefore noninferiority of mirabegron to solifenacin was not demonstrated. Both treatments demonstrated clinically meaningful reductions in efficacy variables and were well tolerated, with a lower incidence of dry mouth with mirabegron. Conclusions: Noninferiority of mirabegron compared with solifenacin for reduction in micturition frequency could not be demonstrated in this population of OAB patients who were dissatisfied with previous antimuscarinic therapy due to lack of efficacy. Both mirabegron and solifenacin improved key OAB symptoms with no statistically significant differences observed between the two treatments. Both drugs were well tolerated. PMID:26445596

  7. Relapsed Brucellosis Presenting as Neurobrucellosis with Cerebral Vasculitis in a Patient Previously Diagnosed with Brucellar Spondylitis: A Case Report.

    PubMed

    Kim, Eun Jung; Lee, Su Jin; Ahn, Eun Young; Ryu, Dae Gon; Choi, Yu Hee; Kim, Tae Hyun

    2015-12-01

    Brucellosis is a multisystem disease with various clinical symptoms. Neurobrucellosis is a rare but serious manifestation of brucellosis. A 60-year-old man with a previous diagnosis of brucellar spondylitis presented with sudden onset of aphasia and numbness of the right upper extremity. Cerebral angiography showed diffuse narrowing and dilatation on the distal branches of both the anterior cerebral artery (ACA) and the left middle cerebral artery (MCA) which indicated cerebral vasculitis, and the patient's Brucella agglutinin titer was 1:1280. After combined antimicrobial and steroid therapy was started, the patient's condition improved significantly, and he was discharged after 1 month. Antimicrobial therapy was continued for 16 months on an outpatient basis, and the last Brucella agglutinin titer was 1:40. To our knowledge, this is the first case of relapsed neurobrucellosis with vasculitis in Korea to have been treated successfully. PMID:26788412

  8. Relapsed Brucellosis Presenting as Neurobrucellosis with Cerebral Vasculitis in a Patient Previously Diagnosed with Brucellar Spondylitis: A Case Report

    PubMed Central

    Ahn, Eun Young; Ryu, Dae Gon; Choi, Yu Hee; Kim, Tae Hyun

    2015-01-01

    Brucellosis is a multisystem disease with various clinical symptoms. Neurobrucellosis is a rare but serious manifestation of brucellosis. A 60-year-old man with a previous diagnosis of brucellar spondylitis presented with sudden onset of aphasia and numbness of the right upper extremity. Cerebral angiography showed diffuse narrowing and dilatation on the distal branches of both the anterior cerebral artery (ACA) and the left middle cerebral artery (MCA) which indicated cerebral vasculitis, and the patient's Brucella agglutinin titer was 1:1280. After combined antimicrobial and steroid therapy was started, the patient's condition improved significantly, and he was discharged after 1 month. Antimicrobial therapy was continued for 16 months on an outpatient basis, and the last Brucella agglutinin titer was 1:40. To our knowledge, this is the first case of relapsed neurobrucellosis with vasculitis in Korea to have been treated successfully. PMID:26788412

  9. Transcatheter Aortic Valve Replacement in a Patient With a Previous Bioprosthetic Mitral Valve Replacement: Report of a Delayed Fatal Interaction.

    PubMed

    Poulin, Frédéric; Lamarche, Yoan; Le, Van Hoai Viet; Doucet, Michel; Roméo, Philippe; Généreux, Philippe

    2016-02-01

    We report on a man with bioprosthetic mitral valve perforation who presented late after transcatheter aortic valve replacement with a balloon-expandable transcatheter heart valve (THV). The protrusion of the commissural strut of the bioprosthetic mitral valve coupled with the low implanted THV resulted in repetitive trauma leading to rupture of a mitral leaflet. Potential preventive strategies are discussed. This case illustrates the importance of preprocedural imaging screening and cautious THV deployment in patients with a bioprosthetic mitral valve. PMID:26319966

  10. Dysphagia due to oesophageal obstruction: A case report of unusual occupational aetiology

    PubMed Central

    Makaram, Navnit; Gohil, Rohit; Majumdar, Samit

    2015-01-01

    Introduction We report the rare case of a patient presenting with dysphagia secondary to a large vertebral osteophyte, which formed from his previous occupation. Presentation of case A 76-year-old gentleman presented with a year-long history of dysphagia to solids, at the laryngeal level. He was otherwise well, with no red-flag symptoms. Nasoendoscopy showed a left-sided bulge obstructing the piriform fossa. Barium swallow demonstrated a large C4/C5 vertebral osteophyte. Excluding other abnormalities the patient's dysphagia was determined to be due to the osteophyte. The patient mentioned carrying large (50 kg) bags of coal for his previous occupation. This chronic trauma was concluded to be the cause for the osteophyte. Discussion We use this case as an opportunity to outline mechanism of swallowing, and the causes and classification of dysphagia are additionally described. We also review the literature regarding vertebral osteophytes to contextualise the rarity of this case, especially in regard to the strong occupational association. Conclusion A structured and thorough history and examination in dysphagia is emphasized. It is important to enquire about ‘red-flag’ symptoms, suggestive of head and neck or upper gastrointestinal malignancy. Barium swallow is a critical investigation in dysphagia-it can also demonstrate large bony abnormalities, which is a rare causative factor. PMID:26693007

  11. Small mammals and high elevation vegetation in Yosemite National Park could be responding to smaller temperature increases than previously reported

    NASA Astrophysics Data System (ADS)

    Conklin, D. R.; Daly, C.

    2009-12-01

    Recent research related the dynamics of Sierra Nevada subalpine conifers to 20th century warming, and used temperature records from Yosemite National Park headquarters and two other locations outside the Park to estimate a 3.7°C rise in average minimum temperature. More recently, observed elevational shifts of small mammals in Yosemite National Park were linked to the same upward trend in minimum monthly temperatures. However, our analysis of spatially explicit, monthly time series of temperatures, derived using the PRISM model, suggests that the large increase in minimum monthly temperatures may be limited to Yosemite Valley, where the Park headquarters itself is located. PRISM bases its interpolations on observations from 195 temperature recording stations within and near Yosemite National Park. Minimum monthly temperatures over most of the Park do not show a centennial-scale trend, but for the final quarter of the century they do trend upwards by 1°C. Our new estimate of the spatial and temporal pattern of 20th century changes in minimum temperatures in the Park could affect conclusions about the relative importance for subalpine conifers of the centennial trend compared to interdecadal variability of temperature. It also raises a question of whether the elevational shifts of the mammals took place only in the latter part of the century, and in response to smaller temperature increases. It challenges us to accept that these plants and animals are responding to smaller changes in minimum temperatures than previously estimated or else to find reasons other than an increase in minimum temperatures for the changes that have been documented, by these and other studies, over the last century in Yosemite.

  12. An Experience with Managing Cancer Patients Reportedly Previously Informed of the Absence of Additional Available Antineoplastic Therapeutic Options

    PubMed Central

    River, George; Moore, Stephanie; Tucker, Jennifer; Markman, Maurie

    2014-01-01

    Over the past 5 years, a small group of cancer patients who stated their physicians had determined there were no additional available antineoplastic therapeutic options (including potential investigational strategies) were seen for a second opinion in a cancer hospital-based oncology program and subsequently experienced what can reasonably be characterized as having achieved meaningful clinical benefit (functioning at a fairly high level for a minimum 1 year in the work, home, and/or family environments) following the further delivery of a variety of treatment approaches. While recognized to be limited (or even simply anecdotal), this experience emphasizes several clinically relevant conclusions, including the overall utility of a second-opinion strategy and the potential that the reported statement of an individual practitioner or cancer program that all rational options have been attempted may be inaccurate. PMID:25408656

  13. Cleidocranial Dysplasia with Normal Clavicles: A Report of a Novel Genotype and a Review of Seven Previous Cases.

    PubMed

    Singh, Ankur; Goswami, Mridula; Pradhan, Gaurav; Han, Min-Su; Choi, Je-Yong; Kapoor, Seema

    2015-07-01

    We report an unusual combination of features comprising delayed tooth eruption and closure of the anterior fontanel as the sole presenting features in a child with cleidocranial dysplasia (CCD). Radiological survey revealed the presence of wormian bones in the skull, pseudoepiphysis at the base of the bilateral second metacarpal, and midline ossification defects at pubic symphysis in the presence of essentially normal clavicles. DNA sequencing of the RUNX2 gene detected a novel nonsense mutation in exon1 (c.166C>T; p.Q56X) in its glutamine-alanine (Q/A) repeat domain. The genotypes of all published cases of CCD with normal clavicles were reviewed. Additional dental and otolaryngological features were enlisted. Three cases with a milder dental phenotype and normal clavicles were associated with a mutation in the Q/A domain. Collectively, we found a novel CCD-causing nonsense mutation p.Q56X in the Q/A domain of the RUNX2 gene. PMID:26279653

  14. Cleidocranial Dysplasia with Normal Clavicles: A Report of a Novel Genotype and a Review of Seven Previous Cases

    PubMed Central

    Singh, Ankur; Goswami, Mridula; Pradhan, Gaurav; Han, Min-Su; Choi, Je-Yong; Kapoor, Seema

    2015-01-01

    We report an unusual combination of features comprising delayed tooth eruption and closure of the anterior fontanel as the sole presenting features in a child with cleidocranial dysplasia (CCD). Radiological survey revealed the presence of wormian bones in the skull, pseudoepiphysis at the base of the bilateral second metacarpal, and midline ossification defects at pubic symphysis in the presence of essentially normal clavicles. DNA sequencing of the RUNX2 gene detected a novel nonsense mutation in exon1 (c.166C>T; p.Q56X) in its glutamine-alanine (Q/A) repeat domain. The genotypes of all published cases of CCD with normal clavicles were reviewed. Additional dental and otolaryngological features were enlisted. Three cases with a milder dental phenotype and normal clavicles were associated with a mutation in the Q/A domain. Collectively, we found a novel CCD-causing nonsense mutation p.Q56X in the Q/A domain of the RUNX2 gene. PMID:26279653

  15. Bacterial Interactomes: Interacting Protein Partners Share Similar Function and Are Validated in Independent Assays More Frequently Than Previously Reported.

    PubMed

    Shatsky, Maxim; Allen, Simon; Gold, Barbara L; Liu, Nancy L; Juba, Thomas R; Reveco, Sonia A; Elias, Dwayne A; Prathapam, Ramadevi; He, Jennifer; Yang, Wenhong; Szakal, Evelin D; Liu, Haichuan; Singer, Mary E; Geller, Jil T; Lam, Bonita R; Saini, Avneesh; Trotter, Valentine V; Hall, Steven C; Fisher, Susan J; Brenner, Steven E; Chhabra, Swapnil R; Hazen, Terry C; Wall, Judy D; Witkowska, H Ewa; Biggin, Mark D; Chandonia, John-Marc; Butland, Gareth

    2016-05-01

    Numerous affinity purification-mass spectrometry (AP-MS) and yeast two-hybrid screens have each defined thousands of pairwise protein-protein interactions (PPIs), most of which are between functionally unrelated proteins. The accuracy of these networks, however, is under debate. Here, we present an AP-MS survey of the bacterium Desulfovibrio vulgaris together with a critical reanalysis of nine published bacterial yeast two-hybrid and AP-MS screens. We have identified 459 high confidence PPIs from D. vulgaris and 391 from Escherichia coli Compared with the nine published interactomes, our two networks are smaller, are much less highly connected, and have significantly lower false discovery rates. In addition, our interactomes are much more enriched in protein pairs that are encoded in the same operon, have similar functions, and are reproducibly detected in other physical interaction assays than the pairs reported in prior studies. Our work establishes more stringent benchmarks for the properties of protein interactomes and suggests that bona fide PPIs much more frequently involve protein partners that are annotated with similar functions or that can be validated in independent assays than earlier studies suggested. PMID:26873250

  16. Human lymphadenitis due to Corynebacterium pseudotuberculosis: report of ten cases from Australia and review.

    PubMed

    Peel, M M; Palmer, G G; Stacpoole, A M; Kerr, T G

    1997-02-01

    Corynebacterium pseudotuberculosis commonly causes caseous lymphadenitis in Australian sheep. We describe 10 cases of human lymphadenitis due to C. pseudotuberculosis; in all cases, isolates were submitted to a reference laboratory in Victoria, Australia. Most of the patients were occupationally exposed to sheep. We also review the 12 previously published cases of this infection, most of which were reported from Australia. No patient had any underlying disease or predisposing condition. Surgical excision of the affected lymph glands is the mainstay of management, and antibiotic therapy is supplementary treatment. Diagnosis was delayed for some patients, and some patients had a protracted or recurrent clinical course and/or a slow recovery. These 10 additional cases from one Australian state indicate that human lymphadenitis caused by C. pseudotuberculosis has not been as rare as the number of published reports indicates, at least in Australia. However, the increasing use of a vaccine against caseous lymphadenitis in sheep in Australia should result in the decreasing human incidence of this zoonosis. PMID:9114145

  17. MTHFR C677T Polymorphism is Associated with Tumor Response to Preoperative Chemoradiotherapy: A Result Based on Previous Reports

    PubMed Central

    Zhao, Yue; Li, Xingde; Kong, Xiangjun

    2015-01-01

    Background Preoperative chemoradiotherapy (pRCT) followed by surgery has been widely practiced in locally advanced rectal cancer, esophageal cancer, gastric cancer and other cancers. However, the therapy also exerts some severe adverse effects and some of the patients show poor or no response. It is very important to develop biomarkers (e.g., gene polymorphisms) to identify patients who have a higher likelihood of responding to pRCT. Recently, a series of reports have investigated the association of the genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR) and epidermal growth factor receptor (EGFR) genes with the tumor response to pRCT; however, the results were inconsistent and inconclusive. Material/Methods A systematic review and meta-analysis was performed by searching relevant studies about the association of MTHFR and EGFR polymorphisms with the tumor regression grade (TRG) in response to pRCT in databases of PubMed, EMBAS, Web of science, Chinese National Knowledge Infrastructure, and Wanfang database up to March 30, 2015. The pooled odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were calculated to assess the strength of the association under 5 genetic models. Results A total of 11 eligible articles were included in the present meta-analysis, of which 8 studies were performed in rectal cancer and 3 studies were performed in esophageal cancer. We finally included 8 included studies containing 839 cases for MTHFR C677T, 5 studies involving 634 cases for MTHFR A1298C, 3 studies containing 340 cases for EGFR G497A, and 4 studies containing 396 cases for EGFR CA repeat. The pooled analysis results indicated that MTHFR C677T might be correlated with the tumor response to pRCT under the recessive model (CC vs. CTTT) in overall analysis (OR=1.426(1.074–1.894), P=0.014), rectal cancer (OR=1.483(1.102–1.996), P=0.009), and TRG 1–2 vs. 3–5 group (OR=1.423(1.046–1.936), P=0.025), while other polymorphism including MTHFR A1298C, EGFR G497A, and EGFR CA repeat polymorphisms exerted significant association under all genetic models in overall analysis or subgroup analysis. Conclusions MTHFR C677T might be correlated with the tumor response to pRCT. Further well-designed, larger-scale epidemiological studies are needed to validate our results. PMID:26456456

  18. "Preliminary data suggest rates of male military sexual trauma may be higher than previously reported": Retraction of Sheppard et al. (2015).

    PubMed

    2016-02-01

    Reports the retraction of "Preliminary data suggest rates of male military sexual trauma may be higher than previously reported" by Sean C. Sheppard, Edward J. Hickling, Mitch Earleywine, Tim Hoyt, Amanda R. Russo, Matthew R. Donati and Kevin E. Kip (Psychological Services, 2015[Nov], Vol 12[4], 344-347). The following article from the November 2015 issue is being retracted. The retraction is at the request of the authors. The data analysis was flawed due to the method used to test for statistical significance which was not consistent with modern methods. This compromised the study findings. Thus, the conclusions about statistical significance drawn in the paper were not consistent with the data. The statistical testing error that occurred was unintentional and acknowledged by the authors when pointed out by external scholars. All authors of the article joined in the request for the retraction. (The following abstract of the original article appeared in record 2015-49326-002.) Stigma associated with disclosing military sexual trauma (MST) makes estimating an accurate base rate difficult. Anonymous assessment may help alleviate stigma. Although anonymous research has found higher rates of male MST, no study has evaluated whether providing anonymity sufficiently mitigates the impact of stigma on accurate reporting. This study used the unmatched count technique (UCT), a form of randomized response techniques, to gain information about the accuracy of base rate estimates of male MST derived via anonymous assessment of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) combat veterans. A cross-sectional convenience sample of 180 OEF/OIF male combat veterans, recruited via online websites for military populations, provided data about history of MST via traditional anonymous self-report and the UCT. The UCT revealed a rate of male MST more than 15 times higher than the rate derived via traditional anonymous assessment (1.1% vs. 17.2%). These data suggest that anonymity does not adequately mitigate the impact of stigma on disclosure of male MST. Results, though preliminary, suggest that published rates of male MST may substantially underestimate the true rate of this problem. The UCT has significant potential to improve base rate estimation of sensitive behaviors in the military. (PsycINFO Database Record PMID:26641738

  19. 30 CFR 210.53 - When are my royalty reports and payments due?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When are my royalty reports and payments due? 210.53 Section 210.53 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT FORMS AND REPORTS Royalty Reports-Oil, Gas, and Geothermal Resources §...

  20. 30 CFR 1210.53 - When are my royalty reports and payments due?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false When are my royalty reports and payments due? 1210.53 Section 1210.53 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR Natural Resources Revenue FORMS AND REPORTS Royalty Reports-Oil, Gas,...

  1. 30 CFR 1210.53 - When are my royalty reports and payments due?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 false When are my royalty reports and payments due? 1210.53 Section 1210.53 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE FORMS AND REPORTS Royalty Reports-Oil, Gas, and Geothermal...

  2. 30 CFR 1210.53 - When are my royalty reports and payments due?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false When are my royalty reports and payments due? 1210.53 Section 1210.53 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE FORMS AND REPORTS Royalty Reports-Oil, Gas, and Geothermal...

  3. 30 CFR 1210.53 - When are my royalty reports and payments due?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false When are my royalty reports and payments due? 1210.53 Section 1210.53 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE FORMS AND REPORTS Royalty Reports-Oil, Gas, and Geothermal...

  4. Providing Internet access to Los Alamos National Laboratory technical reports: A case history in providing public access to previously restricted documents

    SciTech Connect

    Collins, K.A.

    1996-12-31

    The Los Alamos National Laboratory (LANL) Research Library recently fulfilled a strategic goal of providing worldwide desktop access via the Internet to full-image files of the complete unclassified holdings of Los Alamos technical reports in its Report Collection. This effort began in late 1994 with the scanning of paper and microfiche format reports. Concurrently, the Research Library helped to initiate shifting the model for publishing new technical reports from paper to electronic; the files could then be directly mounted on the Research Library`s Web server. Providing desktop access to these reports was instrumental in expediting the development of internal policies that would better define what documents, previously restricted to the general public, could be publicly released. Undoubtedly, the most significant category of such reports were previously classified reports that had been declassified, but had not gone through a further review for public release. Collaboration with LANL`s Classification Group led to approval for public release of 97% of these reports. The LANL Research Library`s Web site now offers unique and unprecedented access to the world of a huge body of technical reports never available before anywhere in any form. This paper discusses the issues and steps involved in this achievement.

  5. First report of prosthetic mitral valve endocarditis due to Corynebacterium striatum: Successful medical treatment. Case report and literature review.

    PubMed

    Mashavi, Margarita; Soifer, Elena; Harpaz, David; Beigel, Yitzhak

    2006-05-01

    A rare case of prosthetic mitral valve endocarditis due to Corynebacterium striatum, treated medically, is reported. While this organism has been described in a few cases of native valve endocarditis, only two cases of prosthetic aortic valve endocarditis have been reported. We herewith report the first case of successful medical treatment of prosthetic mitral valve endocarditis due to C. striatum, emphasizing the complicated clinical course and reviewing the literature regarding diagnosis and therapeutical approach. PMID:16236359

  6. Vaccine risk assessment in children with a referred reaction to a previous vaccine dose: 2009–2011 retrospective report at the Bambino Gesu’ children hospital, Rome, Italy

    PubMed Central

    2014-01-01

    Background During the last century, mass vaccination programs have achieved considerable success across the world in immunizing against several serious infectious diseases. However, vaccinations are threatened by their own success after results have been obtained: the more the incidence of potentially devastating diseases decreases, thanks to the success of vaccination programs, the more public attention shifts towards real or alleged “side effects” of vaccines. Methods We analyze the experience of 153 children with “reaction to a previous vaccine dose” continuing the vaccination protocol in the safe environment of the Center for risk vaccination at the Bambino Gesù Children’s Hospital IRCCS in Rome, from 2009 to 2011. Results To assess the suitability for vaccination, a specialized pre-vaccination advice and a skin prick test (SPT) was undergone, according to Wood’s guideline; 151 children were SPT negative and full vaccine was administered. Of the 153 children examined just 13 had symptoms suggestive of IgE-mediated reaction-type reactions with angioedema manifestations. Among them, 2 had positive STP, which required alternative measures of administration of the vaccine. No cases of post vaccination reaction was reported and no vaccination program was stopped due to a severe reaction. Conclusions Inadequate levels of immunization against infectious diseases remain a significant problem for public health. However, the reasons for incomplete vaccination and non-adoption of vaccination services are manifold. To maintain public confidence in vaccines, advanced immunization programs must include activities for monitoring the safety of the vaccine at the individual level and pursuing specialized counseling pre-and post-vaccination for those at risk. Our results underlined a gap between true and referred adverse reactions and are consistent with vaccine safety. Anyway, a continuous assessment of the risks and benefits of vaccination is required and the results must be disclosed in order to strengthen confidence in the existing and in the new immunization programs. PMID:24684865

  7. Invasive Candidiasis due to Candida Norvegensis in a Liver Transplant Patient: Case Report and Literature Review

    PubMed Central

    Musso, Maria; Giannella, Maddalena; Antonini, Mario; Bordi, Eugenio; Ettorre, Giuseppe Maria; Tessitore, Loretta; Mariano, Andrea; Capone, Alessandro

    2014-01-01

    Candida norvegensis is an emerging fluconazole-resistant pathogen isolated in most cases from skin and mucous membranes of immunocompromized patients. Documented invasive candidiasis (IC) due to C. norvegensis has been rarely reported, thus the clinical features of patients at risk for this pathogen are poorly defined. We report a liver transplant patient who developed IC due to C. norvegensis and review other cases of C. norvegensis IC published in the literature. PMID:25002960

  8. First Report of an Infant Botulism Case Due to Clostridium botulinum Type Af

    PubMed Central

    de Jong, Laura I. T.; Fernández, Rafael A.; Pareja, Virtudes; Giaroli, Gabriel; Guidarelli, Sergio R.; Dykes, Janet K.

    2014-01-01

    Most infant botulism cases worldwide are due to botulinum toxin types A and B. Rarely, Clostridium botulinum strains that produce two serotypes (Ab, Ba, and Bf) have also been isolated from infant botulism cases. This is the first reported case of infant botulism due to C. botulinum type Af worldwide. PMID:25502535

  9. First report of an infant botulism case due to Clostridium botulinum type Af.

    PubMed

    de Jong, Laura I T; Fernández, Rafael A; Pareja, Virtudes; Giaroli, Gabriel; Guidarelli, Sergio R; Dykes, Janet K; Lúquez, Carolina

    2015-02-01

    Most infant botulism cases worldwide are due to botulinum toxin types A and B. Rarely, Clostridium botulinum strains that produce two serotypes (Ab, Ba, and Bf) have also been isolated from infant botulism cases. This is the first reported case of infant botulism due to C. botulinum type Af worldwide. PMID:25502535

  10. A diagnostic dilemma: Left-sided appendicitis in a 10 year old boy with previously undiagnosed intestinal malrotation. A case report

    PubMed Central

    Shekhar, Ashvini; Hendahewa, Rasika; Premaratne, Gamini

    2015-01-01

    Introduction Intestinal malrotation is a congenital rotational anomaly that occurs as a result of an arrest of normal rotation of the embryonic gut, said to occur in 1 in 6000 live births. Due to the abnormal caecal and appendix position, diagnosis of acute appendicitis becomes more challenging, thus leading to diagnostic and operative intervention delays. Our aim is to highlight the diagnostic challenges in this clinical scenario. Presentation of case We present a case of a 10 year old boy with previously undiagnosed intestinal malrotation with a left sided acute appendicitis. Initial symptoms lead to a treatment for gastroenteritis, however, due to ongoing pain a CT abdomen was done which showed the malrotation and appendicitis. He required a laparoscopy converted to open appendicectomy due to an appendicecal mass. Discussion Historically, intestinal malrotation was thought to be a disease of infancy with infrequent occurrence after the age of one year. However, recent analysis has shown an increase in presentations after one year of life into adulthood. Thus, the prevalence of malrotation in children and adults over the age of one year appear to be higher than initially presumed. Conclusion Left sided acute appendicitis is a diagnostic dilemma, thus often leading to management delays. It is pertinent to remember that malrotation of the gut is more common than previously thought, and not just a disease of infancy. It is advisable to consider imaging studies while balancing the risk-benefit-ratio of radiation exposure, especially in paediatric cases to cinch the diagnosis. PMID:26204440

  11. Fatal Case of Pericardial Effusion Due to Myroides Odoratus: A Rare Case Report

    PubMed Central

    Gupta, Priyanka; Mittal, Garima; Singh, Amit K.

    2015-01-01

    Myroides spp., previously known as Flavobacterium odoratum, are rare clinical isolates and are often considered non-pathogenic. Natural habitat includes soil, fresh and marine waters, in foods and in sewage treatment plants. We present an unusual case of fatal pericardial effusion due to Myroides odoratus in a patient suffering from chronic kidney disease and undergoing maintenance haemodialysis. This case is presented to show the increasing incidence of rare isolates causing localized and systemic infections and due to their high intrinsic resistance to many antibiotics they can be fatal. Thus isolation of these pathogens is of great clinical importance. PMID:26672889

  12. Emergency surgery due to go-kart injuries: report of two consecutive cases.

    PubMed

    Y?lmaz, Kerim Bora; Ak?nc?, Melih; Kaya, Oskay; Kulao?lu, Hakan

    2012-09-01

    Injury due to go-karting accidents is a new kind of surgical emergency in Turkey and may show variations between patients. There are special details as relate to the design of the vehicles and patient characteristics. We report two seriously injured patients as a result of two different go-kart accidents. Severe intraabdominal hemorrhage due to liver laceration was seen in one patient and mesenteric intestinal avulsion in the other. Both patients were treated surgically and discharged uneventfully. PMID:23188612

  13. Tinea corporis due to Trichophyton violaceum: A report of two cases.

    PubMed

    Smriti, C; Anuradha, S; Kamlesh, T; Isampreet, K; Nitin, K

    2015-01-01

    Dermatophytes are Fungi which infect keratinized tissues, that is, skin epidermis, hair and nails. Trichophyton violaceum is an anthropophilic, cosmopolitan dermatophyte. It primarily causes tinea capitis and less commonly tinea corporis and tinea unguium. We present a report of two cases of tinea corporis due to T. violaceum in children. Infections due to T. violaceum are important because of its transmissibility within families and community and its potential to spread and establish in new geographical areas. PMID:26470976

  14. Hyperchloremic Metabolic Acidosis due to Cholestyramine: A Case Report and Literature Review

    PubMed Central

    Kamar, Fareed B.; McQuillan, Rory F.

    2015-01-01

    Cholestyramine is a bile acid sequestrant that has been used in the treatment of hypercholesterolemia, pruritus due to elevated bile acid levels, and diarrhea due to bile acid malabsorption. This medication can rarely cause hyperchloremic nonanion gap metabolic acidosis, a complication featured in this report of an adult male with concomitant acute kidney injury. This case emphasizes the caution that must be taken in prescribing cholestyramine to patients who may also be volume depleted, in renal failure, or taking spironolactone. PMID:26425378

  15. Hyperchloremic Metabolic Acidosis due to Cholestyramine: A Case Report and Literature Review.

    PubMed

    Kamar, Fareed B; McQuillan, Rory F

    2015-01-01

    Cholestyramine is a bile acid sequestrant that has been used in the treatment of hypercholesterolemia, pruritus due to elevated bile acid levels, and diarrhea due to bile acid malabsorption. This medication can rarely cause hyperchloremic nonanion gap metabolic acidosis, a complication featured in this report of an adult male with concomitant acute kidney injury. This case emphasizes the caution that must be taken in prescribing cholestyramine to patients who may also be volume depleted, in renal failure, or taking spironolactone. PMID:26425378

  16. Automatic implantable cardioverter defibrillator pocket infection due to Providencia rettgeri: a case report

    PubMed Central

    De Benedetti, Maria Elena

    2009-01-01

    Coagulase-negative staphylococci and Staphylococcus aureus are the commonest pathogens involved in infections of pacemaker-defibrillator systems. Among causative Gram-negative bacteria, infections due to Klebsiella, Serratia, Pseudomonas, Acinetobacter and other species have been reported. We report herein a unique case of an automatic implantable cardioverter defibrillator infection due to Providencia rettgeri in a 65-year-old male who was admitted to our service with bacteremia and infection of the generator and subcutaneous array in a recently implanted device. PMID:19918391

  17. Operation Sun Beam, Shot Small Boy. Project Officer's report - Project 6. 9. Correlation of present and previous electric-field measurements

    SciTech Connect

    Reno; Fowles, H.M.

    1985-09-01

    On most previous nuclear detonations, signatures and quantitative measurements of the electric-field signals associated with the detonations was obtained at distances such that normal radiation field characteristics apply. On Small Boy, measurements were made from stations located much closer in, such as to be inside, on the boundary of and just outside the limits of the ionized sphere created by the nuclear burst. The electric-field characteristics in these regions were unknown. In the hope of providing continuity from the region of the unknown into the reasonably well-understood region of the radiation field, this project was requested to make the typical radiation-field type of measurement that had been made on previous detonations. This report covers the signature characteristics and quantitative measurements of the electric-field signal from Small Boy as seen from outside the immediate region of theoretical generating mechanism.

  18. Cavernosal Abscess due to Streptococcus Anginosus: A Case Report and Comprehensive Review of the Literature

    PubMed Central

    Dugdale, Caitlin M.; Tompkins, Andrew J.; Reece, Rebecca M.; Gardner, Adrian F.

    2013-01-01

    Corpus cavernosum abscesses are uncommon with only 23 prior reports in the literature. Several precipitating factors for cavernosal infections have been described including injection therapy for erectile dysfunction, trauma, and priapism. Common causal organisms include Staphylococcus aureus, Streptococci, and Bacteroides. We report a unique case of a corpus cavernosum abscess due to proctitis with hematological seeding and review the literature on cavernosal abscesses. PMID:24917758

  19. Neurovascular compromise due to true brachial artery aneurysm at the site of a previously ligated arteriovenous fistula: Case report and review of literature.

    PubMed

    Cleveland, Emily C; Sinno, Sammy; Sheth, Sharvil; Sharma, Sheel; Mussa, Firas F

    2015-12-01

    True arterial aneurysms of the upper extremity are rare. The case described is that of a 48-year-old man presenting with median neuropathy and distal vascular compromise 4 years after ligation of a brachiocephalic arteriovenous fistula. We describe our approach and present a review of the relevant literature. PMID:25612878

  20. Imaging findings of gallbladder duplication due to two cases: case report and review of literature.

    PubMed

    Gocmen, Rahsan; Yesilkaya, Yakup

    2012-12-01

    Duplication of the gallbladder, a rare congenital anomaly, is important in clinical practice as it may cause some clinical, surgical, and diagnostic problems. This anomaly is also important for surgeons due to the increased risk of complications especially after laparoscopic cholecystectomy. We report ultrasonography, computed tomography, and magnetic resonance cholangiopancreatography findings in two cases of a symptomatic duplicated gallbladder. PMID:23243652

  1. Post-Kidney Transplantation Iliac Artery Stenosis due toIatrogenic Injury: Case Report

    SciTech Connect

    Khankan, Azzam Anwar Maeda, Munehiro; Osuga, Keigo; Murakami, Takamichi; Nakamura, Hironobu

    2003-04-15

    We report a case of left external iliac artery lesions as a complication of post-kidney transplantation due to vascular clamp application injury. The lesions were proximal stenosis and distal occlusion just near the graft anastomosis site and they were diagnosed incidentally during the embolization for arteriovenous fistula. Angiography confirmed the diagnosis and it was managed successfully by percutaneous interventional techniques.

  2. 12 CFR 1410.3 - Calculation and reporting of premiums due.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Calculation and reporting of premiums due. 1410.3 Section 1410.3 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION PREMIUMS § 1410.3... financing institution that is receiving (or has received) funds provided through the insured bank; that...

  3. 12 CFR 1410.3 - Calculation and reporting of premiums due.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Calculation and reporting of premiums due. 1410.3 Section 1410.3 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION PREMIUMS § 1410.3... financing institution that is receiving (or has received) funds provided through the insured bank; that...

  4. Unique fatality due to claw injuries in a tiger attack: a case report.

    PubMed

    Pathak, Hrishikesh; Dixit, Pradeep; Dhawane, Shailendra; Meshram, Satin; Shrigiriwar, Manish; Dingre, Niraj

    2014-11-01

    This paper describes a unique case of a fatal tiger attack in the wild. In the present case, a tiger fatally mauled a 34-year-old female with its claws, instead of the usual mechanism of killing by the bite injury to the neck. The autopsy revealed multiple fatal and non-fatal injuries caused by the tiger claws. The characteristic injuries due to the tooth impacts were absent as the teeth of the offending tiger were either fallen or non-functional. To the best of our knowledge, probably this rare case would be the first reported human fatality due to the tiger claw injuries in the world. The purpose of the present article is to highlight the fatal injuries due to the tiger claws, as the claw-induced fatal injuries in a tiger attack are not reported in the medico-legal literature. Moreover, this report would be an illustrative one for differentiation between the fatal injuries due to the claws and tooth impacts in a tiger attack. Furthermore, the present report establishes the importance of the tiger claws as a source of fatal injuries in a tiger attack. PMID:25082732

  5. 12 CFR 1410.3 - Calculation and reporting of premiums due.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Calculation and reporting of premiums due. 1410... payment for periods in calendar year 2009 and subsequent years shall be equal to the amount computed by... aggregate of the premiums payable by all of the Farm Credit banks for the following calendar year...

  6. Respiratory tract infection due to Arcanobacterium haemolyticum--a case report.

    PubMed

    Katkar, V J; Shrikhande, S N; Deshpande, Abha; Tankhiwale, N S

    2005-04-01

    A case of respiratory tract infection due to Arcanobacterium haemolyticum is reported. A female of 26 years presented with cough with expectoration and fever off and on for a duration of six weeks. Mycobacterium tuberculosis and Arcanobacterium haemolyticum were isolated. Arcanobacterium haemolyticum was isolated on three separate occasions. PMID:16758672

  7. Obstructive jaundice due to hepatocarcinoma with intraductal growth. Report of a successful resection.

    PubMed

    Jiménez, L C; Teruel, A; Mezquita, S; Martínez, J; Colina, F

    1990-03-01

    We present a patient with hepatocellular carcinoma causing obstructive jaundice due to intraductal growth, diagnosed intraoperatively by cholangiography and histological examination, and radically treated by left lobectomy, extrahepatic biliary tract resection and Roux-en-Y hepaticojejunostomy. Survival after operation was 13 months. Other similar cases reported in the literature are reviewed. PMID:2178000

  8. Obstructive Jaundice Due to Hepatocarcinoma With Intraductal Growth. Report of a Successful Resection

    PubMed Central

    Teruel, Ana; Mezquita, Susana; Martínez, J.; Colina, F.

    1990-01-01

    We present a patient with hepatocellular carcinoma causing obstructive jaundice due to intraductal growth, diagnosed intraoperatively by cholangiography and histological examination, and radically treated by left lobectomy, extrahepatic biliary tract resection and Roux-en-Y hepaticojejunostomy. Survival after operation was 13 months. Other similar cases reported in the literature are reviewed. PMID:2178000

  9. A rare chemical burn due to Ranunculus arvensis: three case reports.

    PubMed

    Kocak, Abdullah O; Saritemur, Murat; Atac, Kenan; Guclu, Sibel; Ozlu, Ibrahim

    2016-01-01

    Ranunculus arvensis, a plant that is a member of Ranunculaceae family, generally used for local treatment of joint pain, muscle pain, burns, lacerations, edema, abscess drainage, hemorrhoids, and warts among the population. In this case report, we presented three patients who developed chemical skin burns after using R arvensis plant locally for knee pain. The destructive effect of the plant has been reported previously to be more in fresh plants and less in dried plants. Although protoanemonin, which is considered as the main toxic substance, was reported to be absent in dried or boiled plants, the plant was boiled, cooled, and wrapped over the region with pain in our cases. Therefore, we thought that protoanemonin may be considered to be heat resistant. Also, the burn management proceeded up to surgery by using the flap technique in one of our patients in contrast to the cases found in published reports who were treated by antibiotics and dressings. PMID:26922695

  10. Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement

    PubMed Central

    Garcia, Patrícia A.; Dias, João M. D.; Silva, Silvia L. A.; Dias, Rosângela C.

    2015-01-01

    Background: The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. Objectives: (i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. Method: A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. Results: There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa=0.595) and recurrent fallers (Kappa=0.589). The limits of agreement were 0.35±1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Conclusion: Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning. PMID:26083603

  11. Osteomyelitis of the spine due to Salmonella infection — conservative treatment with quinolone: a case report

    PubMed Central

    Tsui, Hon-For; Chiu, Kwok-Hing; Leung, Kwok-Sui

    1997-01-01

    Although osteomyelitis due to Salmonella infection is known to be associated with sickle cell anemia, various hemoglobinopathies and immune suppressive states, it may also occur in normal hosts. A 16-year-old Chinese boy without sickle cell disease or any other condition that would compromise the immune system had osteomyelitis of the lumbar spine caused by Salmonella enteritidis. The condition was treated conservatively with ciprofloxacin (quinolone group). This may be the first reported case in which a patient with spinal osteomyelitis due to Salmonella infection, who was otherwise healthy, was successfully treated nonoperatively with quinolone. PMID:9030084

  12. [Right Atrial Rupture due to Blunt Trauma;Report of a Case].

    PubMed

    Nishi, Toshihiko; Tamenishi, Akinori; Niimi, Takao; Okamoto, Hiroshi

    2015-07-01

    The survival rate of cardiac rupture due to blunt trauma is generally low. We report a case of surgical treatment of blunt cardiac trauma. A 55-year-old man was admitted to our hospital for blunt trauma due to a car accident. His hemodynamics was compromised due to cardiac tamponade. The patient underwent pericardial drainage by small subxiphoid incision. Although about 400 ml of blood was evacuated, hemorrhage was still continuing. After full sternotomy, we found a 3 mm tear in the right atrial appendage and sutured it easily without cardiopulmonary bypass. The patient recovered uneventfully and was discharged on the 10th postoperative day. He is now leading a normal life. PMID:26197827

  13. Human infections due to Salmonella Blockley, a rare serotype in South Africa: a case report

    PubMed Central

    2012-01-01

    Background Infections due to nontyphoidal Salmonella have increased worldwide over the last couple of decades. Salmonella enterica serotype Blockley (Salmonella Blockley) infections is associated with chickens and is a rarely isolated serotype in human infections in most countries. Case presentation We report a case of human infections due to Salmonella Blockley in KwaZulu-Natal, South Africa in 2011. Three African males (aged 4, 14 and 16) presented to a clinic with diarrhoea, stomach cramps and headache. They started experiencing signs of illness a day after they consumed a common meal, consisting of meat, rice and potatoes. Stool specimens from the patients cultured Salmonella Blockley. The strains showed an indistinguishable pulsed-field gel electrophoresis pattern. Conclusion This is the first recorded case of human infections due to Salmonella Blockley in South Africa. PMID:23050633

  14. Laparoscopic surgery for sigmoidocutaneous fistula due to diverticulitis: A case report.

    PubMed

    Hidaka, Eiji; Nakahara, Kenta; Maeda, Chiyo; Takehara, Yusuke; Ishida, Fumio; Kudo, Shin-ei

    2015-08-01

    Sigmoidocutaneous fistulas due to sigmoid colon diverticulitis are very rare. Here we report a case in which laparoscopic sigmoidectomy was used to successfully treat a sigmoidocutaneous fistula due to diverticulitis. A 41-year-old man was admitted to our hospital because of redness and swelling of the left inguinal skin. Enhanced abdominal CT revealed a subcutaneous abscess in the left lower abdomen. Percutaneous drainage was performed, and fistulography revealed a fistula between the sigmoid colon and left inguinal skin. Therefore, a sigmoidocutaneous fistula was diagnosed, and laparoscopic sigmoidectomy and fistulectomy were performed. The sigmoid colon had several diverticula, and a pathological examination revealed that the sigmoidocutaneous fistula was due to diverticulitis. The postoperative course was uneventful, and the patient was discharged on postoperative day 8. In cases of sigmoidocutaneous fistula, laparoscopic treatment can be safely performed. PMID:26303733

  15. Hepatocellular Carcinoma Metastasis to the Orbit in a Coinfected HIV+ HBV+ Patient Previously Treated with Orthotopic Liver Transplantation: A Case Report

    PubMed Central

    Guerriero, S.; Infante, G.; Giancipoli, E.; Cocchi, S.; Fiore, M. G.; Piscitelli, D.; Cardascia, N.

    2011-01-01

    Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease) with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient. PMID:22606466

  16. Association of the virus-like infectious agent originally reported in patients with AIDS with acute fatal disease in previously healthy non-AIDS patients.

    PubMed

    Lo, S C; Dawson, M S; Newton, P B; Sonoda, M A; Shih, J W; Engler, W F; Wang, R Y; Wear, D J

    1989-09-01

    We studied 6 patients from 6 different geographic areas who presented with acute flu-like illnesses. The patients developed persistent fevers, lymphadenopathy or diarrhea, pneumonia, and/or heart, liver, or adrenal failure. They died in 1-7 weeks. These patients had no serological evidence of HIV infection and could not be classified as AIDS patients according to CDC criteria. The clinical signs as well as laboratory and pathological studies of these patients suggested an active infectious process, although no etiological agent was found despite extensive infectious disease work-ups during their hospitalization. Post-mortem examinations showed histopathological lesions of fulminant necrosis involving the lymph nodes, spleen, lungs, liver, adrenal glands, heart, and/or brain. No viral inclusion cells, bacteria, fungi, or parasites could be identified in these tissues using special tissue stains. We report that immunohistochemistry using rabbit antiserum raised against VLIA, the virus-like infectious agent previously identified in patients with AIDS and shown to cause fatal systemic infection in primates, revealed VLIA antigens in these necrotizing lesions. In situ hybridization using an 35S labeled VLIA-specific DNA probe also detected VLIA genetic material in the areas of necrosis. Furthermore, virus-like particles closely resembling VLIA were identified ultrastructurally in these histopathological lesions. VLIA was associated with the systemic necrotizing lesions in these previously healthy non-AIDS patients with an acute fatal disease. PMID:2802022

  17. [Cystitis and haematuria due to Corynebacterium striatum. A case report and review].

    PubMed

    Beteta López, Alicia; Gil Ruiz, María Teresa; Vega Prado, Lorena; Fajardo Olivares, Miguel

    2009-09-01

    We herewith report the first case of uncomplicated urinary tract infection due to Corynebacterium striatum in an ambulatory patient without any other predisponent risk factors. C. striatum is a ubiquitous saprophyte of human skin and mucous membranes, which has been occasionally associated with infection in patients hospitalized or immunocompromised patients with underlying diseases. We conclude that C. striatum should be considered an emerging pathogen in both immunocompetent and immunocompromised hosts. PMID:19900386

  18. Spontaneous Retroperitoneal Haematoma due to Polyarteritis Nodosa: Report of a Case and Literature Review

    PubMed Central

    Simsek, Emrah; Yilmaz, Hasan; Teke, Kerem; Uslubas, Ali Kemal; Yuksekkaya, Mustafa

    2016-01-01

    Retroperitoneal haematoma is a rare clinical entity with variable etiology. It can happen spontaneously, without any obvious precipitating factors, the so-called spontaneous retroperitoneal haematoma. There is no general consensus as to the best management plan for patients with retroperitoneal haematoma. Polyarteritis nodosa (PAN) is a rare cause of retroperitoneal haematoma. Here we report relationship between PAN and retroperitoneal haematoma and treatment approaches. However, an accepted and clearly defined treatment has not been established due to its rarity. PMID:26885433

  19. Anesthetic management of a repeat cesarean section in a parturient with severe peripartum cardiomyopathy requiring ECMO in a previous pregnancy: a case report.

    PubMed

    Chen, Hsiu-Pin; Sung, Wei-Che; Hui, Yu-Ling; Hui, Chung-Kun

    2011-01-01

    The number of pregnant women with cardiac disease is increasing with improvements in technology. In addition, more people are part of the national health insurance plan. However, there are few reports concerning the best method for anesthesia and mode of delivery in these high-risk patients. We report a 29-year-old woman scheduled for a planned caesarean section, who had a history of severe peripartum cardiomyopathy requiring extracorporeal membrane oxygenation in a previous pregnancy. The patient had regular prenatal care in our obstetric clinic. At 29 weeks' gestation, she developed severe dyspnea. A chest radiograph revealed bilateral pulmonary edema and 2-dimensional echocardiography showed a global hypokinesis and severe valve regurgitation with left ventricular ejection fraction of 41.2%. She had an emergency caesarean section and a cardiovascular surgeon was consulted to stand-by. Anesthesia was induced by ketamine 25 mg, midazolam 2.5 mg and rocuronium 50 mg for rapid intubation. The patient tolerated the procedure well and was extubated on postoperative day 1. She was discharged one week after surgery. Postoperatively, the patient was followed in the obstetric and cardiovascular surgery outpatient departments and at 5 months after surgery she was in good condition without any complaints. PMID:22490455

  20. Mis-reporting, previous health status and health status of family may seriously bias the association between food patterns and disease

    PubMed Central

    2010-01-01

    Background Food pattern analyses are popular tools in the study of associations between diet and health. However, there is a need for further evaluation of this methodology. The aim of the present cross-sectional study was to evaluate the relationship between food pattern groups (FPG) and existing health, and to identify factors influencing this relationship. Methods The inhabitants of Västerbotten County in northern Sweden are invited to health check-ups when they turn 30, 40, 50, and 60 years of age. The present study includes data collected from almost 60,000 individuals between 1992 and 2005. Associations between FPG (established using K-means cluster analyses) and health were analyzed separately in men and women. Results The health status of the participants and their close family and reporting accuracy differed significantly between men and women and among FPG. Crude regression analyses, with the high fat FPG as reference, showed increased risks for several health outcomes for all other FPGs in both sexes. However, when limiting analysis to individuals without previous ill-health and with adequate energy intake reports, most of the risks instead showed a trend towards protective effects. Conclusions Food pattern classifications reflect both eating habits and other own and family health related factors, a finding important to remember and to adjust for before singling out the diet as a primary cause for present and future health problems. Appropriate exclusions are suggested to avoid biases and attenuated associations in nutrition epidemiology. PMID:21034501

  1. Allergic contact dermatitis mimicking angioedema due to paraphenylendiamine hypersensitivity: a case report.

    PubMed

    Tukenmez Demirci, Gulsen; Kivanc Altunay, Ilknur; Atis, Guldehan; Kucukunal, Asli

    2012-09-01

    Active sensitization to paraphenylendiamine (PPD) and related compounds from temporary black henna tattoos has become an epidemic in the recent years. Hair dyes also include PPD like black henna tatoos which cause allergic contact dermatitis. Skin lesions of allergic contact dermatitis from PPD are mostly seen as an exudative erythema, an erythema multiforme-like eruption or a bullous contact dermatitis. We, herein, report a 27 year-old woman with an angioedema-like reaction occurring after the first exposure to hair dye who was unaware of being previously sensitized to PPD from black henna tattoo. PMID:22181557

  2. Bacteremia due to Rhodococcus equi: a case report and review of the literature*

    PubMed Central

    Chen, Xi-yuan; Xu, Feng; Xia, Jing-yan; Cheng, Yu-sheng; Yang, Yan

    2009-01-01

    Rhodococcus equi, previously known as Corynebacterium equi, is one of the most important causes of zoonotic infections in grazing animals. Increased cases of human infection with R. equi have been reported, especially in immunocompromised patients, within recent years. We present a case of R. equi bacteremia in a 51-year-old man with diabetes and liver cirrhosis, on long-term corticosteroid therapy after skin-grafting surgery. The patient recovered soon after he was treated with vancomycin. This review focuses on the microbiological characteristics of this organism, and the diagnosis and treatment of this infection. PMID:19946958

  3. Traumatic epidermal inclusion cysts due to shoe impingement: a report of two cases.

    PubMed

    Craigen, M A; Anderson, E G

    1991-02-01

    Two cases are presented of bilateral traumatic inclusion cysts occurring on the dorsum of the first metatarsophalangeal joint. Both cases were women who wore high-heeled fashion shoes and the cysts occurred where the edge of the shoe impinged on a particularly prominent extensor hallucis longus tendon. Inclusion cysts have not previously been reported on the dorsum of the foot and their occurrence where impingement exists confirms a traumatic etiology. The importance of identifying the causative factor in such cases is emphasized. PMID:1677343

  4. Clinicoradiological Correlation of Macropsia due to Acute Stroke: A Case Report and Review of the Literature

    PubMed Central

    Montalvo, Mayra Johana; Khan, Muhib Alam

    2014-01-01

    Dysmetropsia (macropsia, micropsia, teleopsia, or pelopsia) most commonly results from retinal pathologies, epileptic seizure, neoplastic lesions, viral infection, or psychoactive drugs. Vascular lesions are an uncommon cause of dysmetropsia. Vascular hemimicropsia, although rare, has been more frequently described in the literature, whereas hemimacropsia from acute ischemic injury is exceedingly rare. We describe a patient presenting in the emergency room (ER) with visual perception disturbances characterized by a distorted perception of the size of objects, compatible with left hemimacropsia. Magnetic resonance imaging (MRI) of the brain showed an acute occipitotemporal ischemic injury corresponding to the posterior cerebral artery (PCA) territory. The location of the lesion is consistent with previous case reports that suggest that hemimacropsia is associated with the occipitotemporal projection, which plays a decisive role in the visual identification of objects by interconnecting the striate, prestriate, and inferior temporal areas. The difference of our case as compared to previous case reports is that the lesion in our patient spared Brodmann area 17 (calcarine cortex) and therefore did not present symptoms of quadrantanopsia. Instead, the patient presented isolated hemimacropsia, therefore suggesting that the anatomical lesion causing hemimacropsia is located in the ventral portion of the occipitotemporal projection, more specifically Brodmann areas 18 (parastriate) and 19 (peristriate). PMID:25574407

  5. Gastric wall ischemia following massive gastric distension due to peptic pyloric stenosis: a case report.

    PubMed

    Santos, Tatiana; Freitas, Carla; Pinto-de-Sousa, João

    2016-01-01

    Gastric necrosis is a rare entity mainly due to the rich collateral blood flow the stomach is supplied by. Acute gastric dilation is one of the described underlying causes, and although not fully understood, many potential alterations, such as vascular compression, herniation, volvulus, acute necrotizing gastritis, complications after abdominal surgery, anorexia, bulimia nervosa, trauma, exposure to caustic materials, diabetes, medications, infections, debilitating chronic illness, gastric outlet obstruction, aerophagia and acute pancreatitis have been described. In this report, we present a case of partial gastric ischemia with necrosis and consequent perforation of the lesser curvature of the stomach, as a result of gastric outlet obstruction due to pyloric stenosis. The patient underwent an emergency laparotomy. An atypical gastrectomy and a Heineke-Mikulicz pyloroplasty were performed. We emphasize the need for the quick recognition of this condition and for the urgent management because of the high mortality rate associated with undiagnosed gastric necrosis. PMID:26851051

  6. Gastric wall ischemia following massive gastric distension due to peptic pyloric stenosis: a case report

    PubMed Central

    Santos, Tatiana; Freitas, Carla; Pinto-de-Sousa, João

    2016-01-01

    Gastric necrosis is a rare entity mainly due to the rich collateral blood flow the stomach is supplied by. Acute gastric dilation is one of the described underlying causes, and although not fully understood, many potential alterations, such as vascular compression, herniation, volvulus, acute necrotizing gastritis, complications after abdominal surgery, anorexia, bulimia nervosa, trauma, exposure to caustic materials, diabetes, medications, infections, debilitating chronic illness, gastric outlet obstruction, aerophagia and acute pancreatitis have been described. In this report, we present a case of partial gastric ischemia with necrosis and consequent perforation of the lesser curvature of the stomach, as a result of gastric outlet obstruction due to pyloric stenosis. The patient underwent an emergency laparotomy. An atypical gastrectomy and a Heineke–Mikulicz pyloroplasty were performed. We emphasize the need for the quick recognition of this condition and for the urgent management because of the high mortality rate associated with undiagnosed gastric necrosis. PMID:26851051

  7. Pulmonary Pressure Necrosis due to Chronic Pleural Effusion after Heart Transplantation: A Case Report

    PubMed Central

    Jung, Jae Seung; Lee, Sung Ho; Lee, Jeong Hyeon; Sun, Kyung

    2014-01-01

    A 51-year-old woman had severe restrictive cardiomyopathy with heart failure. The first symptoms had started 12 years ago, and her symptoms gradually worsened. She was treated with diuretics, intermittent but repetitive thoracentesis, and paracentesis due to recurrent pleural effusion and ascites. Consequently, a collapse of the right lower lobe (RLL) was noted. We stopped thoracentesis and paracentesis and added continuous intravenous diuretics for 3 months before heart transplantation (HT). Finally, she underwent HT. However, her RLL remained collapsed and chest tube drainage persisted. We performed a RLL lobectomy with video-assisted thoracic surgery. No specific pathologic findings were noted except pulmonary necrotic lesions. We report a rare case of pulmonary necrosis caused by mechanical compression due to chronic pleural effusion after HT. PMID:25798361

  8. An unusual penetrating craniocerebral injury due to landmine explosion: a case report.

    PubMed

    Atabey, Cem; Ersoy, Turgay

    2012-03-01

    Penetrating landmine injuries are the unavoidable consequences of military conflicts. They are potentially life-threatening. The mortality rates in the literature range from 23% to 92% and are considerably higher in patients admitted with poor neurologic state. Penetrating craniocerebral injuries require early surgical management designated to prevent infection and remove foreign objects, necrotic tissue and complicating blood clots, as well as to minimalize post-traumatic sequelae. We report herein an interesting case of penetrating intracerebral injury with giant shrapnel due to landmine in a 20-year-old young man. PMID:22792828

  9. Hemolytic Disease of the Newborn Due to Anti-c Isoimmunization: A Case Report.

    PubMed

    Sheeladevi, C S; Suchitha, S; Manjunath, G V; Murthy, Srinivas

    2013-09-01

    The Rhesus (Rh) blood group is one of the most complex blood groups known in humans. It has remained of primary importance in obstetrics, being the main cause of hemolytic disease of the newborn (HDN). Anti-D causes the most severe form of HDN. Other Rh allo antibodies that are capable of causing severe HDN include anti-c, which clinically is the most important Rh antigen after the D antigen. We report a case of hemolytic disease of the newborn due to Rh anti-c in an infant of an Rh positive mother. PMID:24426362

  10. Superior vena cava syndrome due to metastasis from urothelial cancer: A case report and literature review

    PubMed Central

    Wakeda, Hironobu; Hamasuna, Ryoichi; Asada, Yujiro; Kamoto, Toshiyuki

    2013-01-01

    Superior vena cava (SVC) syndrome is caused by compression or obstruction of the SVC. We report here in a case of SVC syndrome due to lymph node metastasis from urothelial cancer to the mediastinum and lung. The origin of metastasis was determined by computed tomography (CT)-guided biopsy of metastases. After radiotherapy to the mediastinum with glucocorticoid failed, anticancer pharmacotherapy including paclitaxel, gemicitabine, and cisplatin proved effective and SVC syndrome resolved. But patient died from cerebral bleeding from newer brain metastases 10 months later. PMID:24311914

  11. Cloning and nucleotide sequence analysis of psaA, the Streptococcus pneumoniae gene encoding a 37-kilodalton protein homologous to previously reported Streptococcus sp. adhesins.

    PubMed Central

    Sampson, J S; O'Connor, S P; Stinson, A R; Tharpe, J A; Russell, H

    1994-01-01

    Gene psaA, which encodes the Streptococcus pneumoniae 37-kDa protein, was cloned in Escherichia coli, and its complete nucleotide sequence was determined. Analysis of the sequence of the 2.4-kb cloned fragment revealed three open reading frames (ORFs). ORF2, which is 933 bp long, was identified as psaA. The two other ORFs identified flank psaA. ORF1, located upstream of psaA, is 836 nucleotides long and encodes a protein with a calculated molecular mass of 29,843 Da. The sequence for ORF3, located downstream of psaA, was only partially determined. Northern (RNA) blot analysis of pneumococcal RNA suggests that psaA is transcribed as part of a polycistronic message. Analysis of the primary structure of the protein encoded by this gene indicated significant similarity to two previously reported streptococcal proteins, SsaB (80% similarity) and FimA (92.3% similarity), from S. sanguis and S. parasanguis, respectively. These two homologous proteins have been shown to be associated with bacterial adhesion, and the possibility of a similar role for PsaA is hypothesized. Images PMID:7505262

  12. Case report of right hamate hook fracture in a patient with previous fracture history of left hamate hook: is it hamate bipartite?

    PubMed Central

    Evans, Marion W; Gilbert, Micheal L; Norton, Sandra

    2006-01-01

    Background Hamate hook fracture is a common fracture in golfers and others who play sports that involve rackets or sticks such as tennis or hockey. This patient had a previous hamate fracture in the opposing wrist along with potential features of hamate bipartite. Case presentation A 19 year old male presented with a complaint of right wrist pain on the ulnar side of the wrist with no apparent mechanism of injury. The pain came on gradually one week before being seen in the office and he reported no prior care for the complaint. His history includes traumatic left hamate hook fracture with surgical excision. Conclusion The patient was found to have marked tenderness over the hamate and with a prior fracture to the other wrist, computed tomography of the wrist was ordered revealing a fracture to the hamate hook in the right wrist. He was referred for surgical evaluation and the hook of the hamate was excised. Post-surgically, the patient was able to return to normal activity within eight weeks. This case is indicative of fracture rather than hamate bipartite. This fracture should be considered in a case of ulnar sided wrist pain where marked tenderness is noted over the hamate, especially after participation in club or racket sports. PMID:17038179

  13. Evidence Report: Risk of Crew Adverse Health Event Due to Altered Immune Response

    NASA Technical Reports Server (NTRS)

    Crucian, Brian; Sams, Clarence F.

    2013-01-01

    The Risk of Crew Adverse Health Event Due to Altered Immune Response is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. It is known that human immune function is altered in- and post-flight, but it is unclear at present if such alterations lead to increased susceptibility to disease. Reactivation of latent viruses has been documented in crewmembers, although this reactivation has not been directly correlated with immune changes or with observed diseases. As described in this report, further research is required to better characterize the relationships between altered immune response and susceptibility to disease during and after spaceflight. This is particularly important for future deep-space exploration missions.

  14. Death Due to Combined Intake of Ethanol and Toluene: a Case Report

    PubMed Central

    GÜRSES, Murat Seradar; TÜRKMEN, Nursel; EREN, Bulent; ÇETİN, Selcuk; GÜNDOĞMUŞ, Umit Naci

    2014-01-01

    Toluene is a commonly used volatile organic chemical in industry and is the most often chosen illicit substance among volatile substance abusers. Studies involving healthy volunteers suggest that ethanol consumption inhibits toluene metabolism, thus increasing its blood levels. In this study, a lethal case of combined ethanol consumption and toluene inhalation has been reported. Our case was a 30-year-old male who had used volatile substance for 15 years. The autopsy revealed no abnormal findings. Toxicological analysis revealed alcohol and toluene in the blood and the cause of death was considered as toxicity due to acute combined intake of alcohol and toluene. Lethal combined ethanol and toluene intake is rarely reported in the literature. Experimental studies indicate that toluene increases the risk of ethanol dependence and each substance increases the toxic effects of the other. PMID:25705313

  15. Small bowel perforation due to indistinguishable metastasis of angiosarcoma: case report and brief literature review.

    PubMed

    Uchihara, Tomoyuki; Imamura, Yu; Iwagami, Shiro; Kajihara, Ikko; Kanemaru, Hisashi; Karashima, Ryuichi; Ida, Satoshi; Ishimoto, Takatsugu; Baba, Yoshifumi; Sakamoto, Yasuo; Miyamoto, Yuji; Yoshida, Naoya; Watanabe, Masayuki; Iyama, Ken-Ichi; Ihn, Hironobu; Baba, Hideo

    2016-12-01

    Intestinal metastasis of angiosarcoma is extremely rare. We herein report a case of intestinal perforation due to intestinal metastasis of angiosarcoma. The patient was a 72-year-old Japanese man with multiple recurrent angiosarcomas of the scalp. He developed acute abdominal pain with guarding, and we performed an emergency exploratory laparotomy. An intestinal perforation was found 80 cm from the ligament of Treitz, and partial jejunectomy was successfully performed. Macroscopic inspection revealed no obvious injury, ulcer, or tumor at or around the perforation site. Pathological examination revealed angiosarcoma cells penetrating through all layers of the jejunum at the site of intestinal perforation. This is the first reported case of intestinal perforation caused by indistinguishable intestinal metastasis of angiosarcoma. This case emphasizes intestinal metastasis of angiosarcoma as a possible cause of small bowel perforation in patients with advanced angiosarcoma, even when no visible tumor is present during surgery. PMID:27156097

  16. Lower lip numbness due to the mandibular canal narrowing after dental reimplantation: A case report

    PubMed Central

    Shamloo, Nafiseh; Safi, Yaser; Fathpour, Kamyar; Yaghmaei, Masood; Bahemmat, Nika

    2015-01-01

    Mandibular canal is the most important anatomical landmark in the body of mandible which always must be considered for implant surgery in posterior mandibular region. Damage to vessels and inferior alveolar nerve that passes through the mandibular canal can cause problems such as hemorrhage and neurosensory disturbances. Damage to the mandibular canal can occur during implant surgery. Depending on the severity of injuries, it would result in temporary or permanent neurosensory disturbances. We have reported a case that mandibular canal narrowing occurred following implant surgery and resulted in anesthetic and hypoesthetic areas in the lower lip. Patient had a history of implant surgery in the region of teeth numbered 30 and numbered 31. The inserted implant failed after 6 years, and reimplantation was done in this area, but due to lower lip numbness in the right side, the second implant was removed, and another implant was inserted in the region of the tooth numbered 32. After 2 years, right lower lip numbness was reported again by the patient. Cone beam computed tomography images showed canal narrowing in the region of the tooth numbered 31 where the second implant was inserted. It seems that the main cause for anesthesia and hypoesthesia in this patient is canal narrowing due to damage during implant replacement and removal. PMID:26288630

  17. Bulbar Paralysis and Facial Paralysis due to Metastatic Hepatocellular Carcinoma: A Case Report and Literature Review.

    PubMed

    Liu, Min; Liu, Shixin; Liu, Bailong; Liu, Bin; Guo, Liang; Wang, Xu; Wang, Qiang; Yang, Shuo; Dong, Lihua

    2016-01-01

    Skull-base metastasis (SBM) from hepatocellular carcinoma (HCC) is extremely rare, and multiple cranial nerve paralysis due to SBM from HCC is also rare. We report a case of bulbar and facial paralysis due to SBM from HCC.A 46-year-old Chinese man presented with a hepatic right lobe lesion that was detected during a routine physical examination. After several failed attempts to treat the primary tumor and bone metastases, neurological examination revealed left VII, IX, X, and XI cranial nerve paralysis. Computed tomography of the skull base subsequently revealed a large mass that had destroyed the left occipital and temporal bones and invaded the adjacent structure. After radiotherapy (27 Gy, 9 fractions), the patient experienced relief from his pain, and the cranial nerve dysfunction regressed. However, the patient ultimately died, due to the tumor's progression.Radiotherapy is usually the best option to relieve pain and achieve regression of cranial nerve dysfunction in cases of SBM from HCC, although early treatment is needed to achieve optimal outcomes. The present case helps expand our understanding regarding this rare metastatic pathway and indicates that improved awareness of SBM in clinical practice can help facilitate timely and appropriate treatment. PMID:26825921

  18. First case report of bacteremia due to 'Campylobacter-like organism 3'.

    PubMed

    Nakamura, Itaru; Ohkusu, Kiyofumi; Nakagami, Yoshihiro; Tachibana, Masaaki; Matsumoto, Tetsuya

    2016-01-01

    A case of bacteremia caused by a rare Helicobacter species, Campylobacter-like organism 3 (CLO-3), in a 75-year-old man with prostate cancer and an indwelling urethral catheter for urinary retention, is reported. Oral levofloxacin (500mg per day) was effective, although the results of antimicrobial susceptibility testing were unknown. Non-film-like, small, clear colonies were isolated on blood agar after 72h of microaerobic incubation at 37°C. Biochemical testing indicated that the isolates were catalase-positive, negative for nitrate reduction and urease activity, and positive for indoxyl acetate hydrolysis. The isolate was identified as CLO-3 by sequence analysis of the 16S rRNA and hsp60 genes. Although CLO-3 is known to cause enterocolitis, bacteremia due to CLO-3 has not been described. There have been an increasing number of reports of bacteremia caused by Helicobacter cinaedi and Helicobacter fennelliae, which were first reported as CLO-1 and CLO-2, and CLO-3 may represent another emerging cause of Helicobacter-induced bacteremia. PMID:26639044

  19. Massive lower gastrointestinal bleeding due to 'Dieulafoy's vascular malformation' of the jejunum: case report.

    PubMed Central

    Goins, W. A.; Chatman, D. M.; Kaviani, M. J.

    1995-01-01

    Dieulafoy reported three cases of massive gastric hemorrhage due to a dilated submucosal artery in 1898, and since then, more than 100 cases of this gastric vascular malformation have been reported in the literature. These same pathologic lesions are even a rarer occurrence in the small bowel. This article reports a 38-year-old hypotensive male who presented to the hospital after an acute onset of massive lower gastrointestinal hemorrhage; superior mesenteric angiography demonstrated an actively bleeding lesion in a proximal jejunal branch. Intraoperative small bowel endoscopy via an enterotomy demonstrated a 4 mm bleeding submucosal lesion 30 cm distal to the ligament of Treitz. A literature review revealed six other cases of Dieulafoy's vascular malformation that occurred in the small bowel, with the lesions located in the proximal jejunum between 15 cm and 45 cm distal to the ligament of Treitz. The cause of these lesions is unknown. This case demonstrates the importance of preoperative angiography and intraoperative endoscopy when massive lower gastrointestinal hemorrhage is suspected to be from a small bowel source. Images Figure 1 Figure 2 Figure 3 PMID:7473854

  20. Acute appendicitis due to Cytomegalovirus in an apparently immunocompetent patient: a case report

    PubMed Central

    2014-01-01

    Introduction In healthy subjects, Cytomegalovirus infection can be asymptomatic or manifest as mononucleosis syndrome, but organ disease has also been reported. However, in immunocompromised patients this infection can lead to its most significant and severe disease and even mortality. When Cytomegalovirus causes a gastrointestinal tract infection, it more commonly manifests with luminal tract disease and is usually characterized by ulcerative lesions. Appendicitis is a rare manifestation, and has been reported mainly in human immunodeficiency virus-infected patients or patients with other causes of immunocompromise. Case presentation The authors report on a case of acute primary Cytomegalovirus infection complicated with acute appendicitis due to Cytomegalovirus in an apparently immunocompetent 24-year-old Caucasian man also suffering from primary sclerosing cholangitis and ulcerative colitis. Diagnosis was based on clinical manifestations, serology results, as well as microbiological and histological findings. Treatment consisted of surgery and anti-Cytomegalovirus therapy. Conclusions Cytomegalovirus should be included among the etiologic agents of acute appendicitis in patients with primary sclerosing cholangitis and ulcerative colitis. Currently, there are no definitive data regarding the frequency of Cytomegalovirus appendicitis and the role of anti-Cytomegalovirus treatment in human immunodeficiency virus-negative and apparently immunocompetent subjects. PMID:24612821

  1. Sepsis due to Erysipelothrix rhusiopathiae in a patient with chronic lymphocytic leukemia associated with bronchopneumonia due to Pseudomonas aeruginosa and Escherichia coli: A case report

    PubMed Central

    Bîrlutiu, Victoria

    2015-01-01

    INTRODUCTION: The present report describes a case of sepsis due to Erysipelothrix rhusiopathiae in a patient with B-cell chronic lymphocytic leukemia with no animal exposure, associated with concomitant bronchopneumonia due to Pseudomonas aeruginosa and Escherichia coli. CASE PRESENTATION: A 54-year-old Caucasian man presented to an emergency room with a three-day history of chest pain, fever, cough with purulent sputum, chills and dyspnea. The patient had associated erythematous papules on the chest and enlarged axillary, submandibular, pectoral and supraclavicular lymph nodes, which regressed under treatment with penicillin. The patient was found to have sepsis without endocarditis caused by E rhusiopathiae, associated with bronchopneumonia that was induced by a double Gram-negative infection. CONCLUSIONS: The underlying-B cell chronic lymphocytic leukemia may have favoured the development of bacteremia due to E rhusiopathiae, which occurred subsequent to glossitis in an immunocompromised host being treated with methylprednisolone and cladribine. PMID:26015797

  2. Laparoscopic treatment of acute small bowel obstruction due to left paraduodenal hernia: A case report and literature review

    PubMed Central

    Zizzo, Maurizio; Smerieri, Nazareno; Barbieri, Italo; Lanaia, Andrea; Bonilauri, Stefano

    2016-01-01

    Introduction Internal hernia is a pathological condition resulting from abnormal protrusion of abdominal viscera through an opening in the intraperitoneal recesses of the abdominal cavity. Small bowel obstruction due to internal hernia is not common (0.25–0.9% of cases). The most common group is that of paraduodenal hernias (53%), of which the left-sided one is the most common type (75%). Presentation of case We report a case of a 43 year-old man with a history of recurrent abdominal pain, who was hospitalized because of an episode of acute small bowel obstruction. He had no previous surgery. Computed tomography revealed an encapsulated circumscribed cluster of jejunal loops in the left upper quadrant, near the ligament of Treitz, and the hernia orifice was adjacent to the left side of the inferior mesenteric vessels. Emergency laparoscopic surgery was performed: the small bowel was found completely herniated under the inferior mesenteric vessels. It was gradually reduced and the hernia space was closed with a running suture. The patient was discharged on the fourth day without complications. Conclusion Left paraduodenal hernia is a rare cause of small bowel obstruction that should be taken into account in a patient with a history of recurrent abdominal pain or intestinal obstruction, and no previous surgery. Computed tomography is the standard for a correct diagnosis. Surgery is treatment of choice, because it reduces the risk of emergency and complications associated to hernia. Laparoscopic approach is feasible and effective, also in emergency situation. PMID:26826933

  3. Unexpected intraoperative hypercapnia due to undetected expiratory valve dysfunction--a case report.

    PubMed

    Han, Sin-Ru; Ho, Chee-Sang; Jin, Chen-Hui; Liu, Chien-Chiang

    2003-12-01

    The normally functioning of anesthetic circle system depends mainly on the integrity of both inspiratory and expiratory unidirectional valves which keep the inspiratory gas will not be contaminated by the expired CO2. In case there is a leakage defect in one or both of these valves, i.e. inability to keep tightly closed during the cycle, retrograde gas flow may happen and the exhaled CO2 may get into the inspiratory limb, resulting in rebreathing and hypercapnia with disastrous aftermath. Here we report a rather rare incident of unrecognized expiratory valve insufficiency that was not detected before anesthesia in a 40-year-old female patient who developed intraoperative hypercapnea during general anesthesia with mechanical ventilation. Discussions on the causes, management, and prevention of hypercapnia due to respiratory valve dysfunction are presented. PMID:14768521

  4. Hearing loss due to metastasis of gastric cancer to temporal bone: A case report

    PubMed Central

    CAO, XIANGMING; CUI, FANGBO; WEI, JIA; WANG, QING; DENG, LI CHUN; LIU, BAO RUI; SHEN, WEI SHENG

    2016-01-01

    Metastatic temporal bone tumors are rare, and tend to be asymptomatic. The clinical symptoms consist of aural discharge, bleeding, hearing loss and facial nerve paresis. The most common origin of the metastasis is breast cancer, and other sites of the primary tumor include the thyroid gland, brain, lungs, prostate and blood. Clinical reports of hearing loss due to gastric cancer metastatic to temporal bone are rare. In the present study, a case of gastric cancer metastasis to temporal bone without other organ involvement is described. The patient presented with the symptom of hearing loss, and the metastatic tumor was diagnosed by radiological imaging, including magnetic resonance imaging, computed tomography and bone scan. PMID:26893735

  5. Bromovinyldeoxyurdine treatment of outer retinal necrosis due to varicella-zoster virus: a case-report.

    PubMed

    Dullaert, H; Maudgal, P C; Leys, A; Dralands, L; Clercq, E

    1996-01-01

    In December 1995, a 70-years old male was referred to us because of rapid visual loss in the right eye, one month after a central retinal artery occlusion in the left eye. This renal transplant patient, with limited renal function, was on immunosuppressive therapy. The diagnosis of bilateral progressive outer retinal necrosis (PORN) due to varicella-zoster virus (VZV) was confirmed by polymerase chain reaction (PCR) detection of VZV DNA in the aqueous fluid. As retinitis progressed despite of intravenous acyclovir administration, the antiviral therapy was switched to oral bromovinyldeoxyuridine (BVDU). This case-report demonstrates that oral BVDU can be a good alternative to acyclovir for the treatment of VZV retinal infections. PMID:9339038

  6. Acute massive pulmonary thromboembolism due to acute intoxication by duloxetine: a case report.

    PubMed

    Mari, Francesco; Gualco, Barbara; Rensi, Regina; Bertol, Elisabetta

    2012-09-01

    Duloxetine (Cymbalta) is a potent serotonin norepinephrine reuptake inhibitor used for the management of major depression and pain associated with diabetic peripheral neuropathy. Cymbalta delayed-release capsules contain Duloxetine HCl equivalent to 20, 30, 60 mg of Duloxetine. The ingestion of high quantities of Duloxetine may have serious outcomes such as venous thrombosis, causing cardiac respiratory arrest. The Authors outline a case report of an elderly woman, suffering from depression, found dead in her apartment. The cause of death was attributed to acute massive pulmonary thromboembolism due to acute intoxication of Duloxetine bought the day before. The thesis supported by the authors and confirmed by the data from other studies is that a massive intake of Duloxetine drug increases considerably the medication's side effects such as somnolence, dry mouth, fatigue, insomnia, dizziness, constipation, considerable increases in recumbent systolic and diastolic blood pressure, and a small decrease in heart rate. PMID:22351288

  7. [Laparoscopic Surgery for Adult Intussusception Due to Rectal Cancer--A Case Report].

    PubMed

    Ishikawa, Akira; Higuchi, Ichiro; Akiyama, Yosuke; Tanigawa, Takahiko; Hasuike, Yasunori

    2015-11-01

    An 87-year-old woman with the chief complaint of bloody stool was referred to our hospital from an institution for the aged. The abdomen was soft and flat, and a tumor was not palpable on digital rectal examination. Tumor markers were within normal ranges. Abdominal enhanced CT scan showed a multiple concentric ring sign at the rectum. Colonoscopic and barium examination led to a diagnosis of rectal intussusception due to rectal cancer. We first tried to reposition it preoperatively, but it was impossible. She fortunately had no symptoms of ileus; therefore, we chose to perform laparoscopic surgery. We achieved the reposition intraoperatively and performed Hartmann's operation with D2 lymph node dissection because she was a very elderly patient with high-risk comorbidities. The pathological diagnosis was as follows: RS, 40×40 mm, type 2, tub2, pT3 (SS), pN0, ly0, v0, pStageⅡ, R0, Cur A. Adult intussusception due to rectal cancer is extremely rare. We report that in this case that laparoscopic surgery was possible, along with a review of the relevant literature. PMID:26805342

  8. Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report

    PubMed Central

    Sohn, Min Kyun

    2014-01-01

    Central pontine myelinolysis (CPM) classically occurs in alcoholics, malnourished individuals, chronic liver diseases, and rapid correction of hyponatremia. This report presents locked-in syndrome due to CPM following rapid correction of hyponatremia. A 44-year-old male came to the hospital due to a short period of loss of consciousness. He was alert and had no focal neurological abnormalities at admission. The serum sodium concentration was 118 mEq/L and was corrected to 134 mEq/L in the first 18 hours. One week later, progressive weakness in limbs developed and he progressed to a complete quadriplegic state and bulbar palsy, with only eye blinking preserved. Brain magnetic resonance imaging revealed a characteristic hyperintense signal abnormality in both pons, so he was diagnosed to locked-in syndrome caused by CPM. The patient gradually improved following continuous intensive rehabilitation for more than 2 years. He was able to move all joint muscles against gravity in generally and he could gait under supervision. PMID:25379502

  9. [Aorto-oesophageal fistula due to an aortic endovascular prosthesis: case report and state of the art].

    PubMed

    Gentilli, Sergio; Pizzorno, Chiara; Pessione, Silvia; Bellora, Paolo; Garavaglia, Marcello

    2008-01-01

    Aorto-oesophageal fistula is a rare and often fatal condition due to pathologies of the aorta and oesophagus. Recently, a new aetiology for aorto-oesophageal fistulas has been detected, namely, decubitus of an aortic endovascular prosthesis positioned in the presence of aneurysms. The symptoms are those of Chiari's triad: (1) chest pain and/or dysphagia (2) haematemesis (3) massive haematemesis. If the patient is haemodynamically stable the gold standard diagnostic examination is a CT scan with contrast medium. Aorto-oesophageal fistulas are characterised by a rapidly worsening acute clinical presentation and high postoperative morbidity and mortality. The treatment of aorto-oesophageal fistula is divided into three progressive steps: (1) control of bleeding; (2) prevention of mediastinitis; (3) oesophageal repair. We report a case of a 59-year-old male patient with an aorto-oesophageal fistula due to the decubitus of an endovascular aortic prosthesis previously positioned for a traumatic aneurysm of the descending aorta. We controlled the bleeding in emergency with a Sengstaken-Blakemore tube. Since the cardiovascular surgeons excluded any intervention, we executed a bipolar oesophageal exclusion in our department of general surgery and subsequently positioned a self-expanding oesophageal prosthesis by a retrograde route. The patient survived for 7 months, the cause of death being septic shock. PMID:18389760

  10. Knee Locking in Osteoarthritis due to Synovial Lipoma: A Case Report

    PubMed Central

    S. Amarjit, Kataria; Budhiraja, Shivali; Chandramouleeswari, K.; Anita, S.

    2013-01-01

    Intra–articular synovial lipomas are very rare and only few cases have been reported till now. We are reporting a rare case of a unilateral intra–articular lipoma of osteoarthritic knee joint in a 62 years old male. Patient had two episodes of sudden locking of knee joint, which resolved spontaneously. A plain X-ray showed changes which were suggestive of osteoarthritis. Clinically, patient was diagnosed as a case of loose bodies in left knee joint. An arthrotomy was performed. After a Histopathological Examination (HPE) of loose bodies, a diagnosis of an intra–articular synovial lipoma was made. Due to wide differentials and varied clinical behaviour of loose bodies, lipoma should be included in differential diagnosis of osteroarthritic patients who complain of episodic locking of knees. Intraarticular lipomas, on arthroscopic guided excision, get cured permanently, with no recurrence. The differentiation of an intra-articular lipoma from a relatively more common entity, Lipoma arborescens, has also been discussed. PMID:24086885

  11. Secondary Involvement of the Mandible due to Basal Cell Carcinoma: A Case Report

    PubMed Central

    Mosannen Mozaffary, Pegah; Delavarian, Zahra; Amirchaghmaghi, Maryam; Dalirsani, Zohreh; Vazifeh Mostaan, Leila; Saghafi Khadem, Shadi; Ghalavani, Hanieh

    2015-01-01

    Basal cell carcinoma (BCC) is the most common cutaneous malignancy among Caucasians. Rare examples of aggressive and neglected BCC have been reported. Here we report a unique case of a neglected BCC with significant jaw involvement. A 50-year-old female, referred by an otorhinologist, presented with a large ulcer on her chin, which was extended to her mandibular vestibule. The ulcer was 9×5.5 cm in size, and tissue destruction, necrosis was observed in the central portion, and the mandibular bone was exposed. On intraoral examination, tooth mobility and severe bone loss were evident. Due to the primary cutaneous origin of the lesion, BCC was considered as preliminary diagnosis. Biopsy was performed and diagnosis of BCC was confirmed. The diseased mandibular bone was resected and reconstructed with a surgical plate. The soft tissue defect was reconstructed with deltopectoral flap. The patient refused secondary stage plastic surgery. Although BCC is not a lethal malignancy, if left untreated and neglected, it can result in severe destruction, disfigurement, and even mortality. PMID:25999630

  12. Chiropractic management of a patient with lumbar spine pain due to synovial cyst: a case report

    PubMed Central

    Cox, James M.

    2012-01-01

    Introduction The purpose of this study is to report the findings resulting from chiropractic care using flexion distraction spinal manipulation for a patient with low back and radicular pain due to spinal stenosis caused by a synovial cyst. Case Report A 75-year-old man presented with low back pain radiating to the right anterior thigh and down the left posterior leg of 3 years' duration. Physical and imaging examinations showed a synovial cyst–induced spinal stenosis at the right L3-L4 level and bilateral L4-L5 spinal stenosis. Intervention and Outcomes Flexion distraction spinal manipulation and physiological therapeutics were applied at the levels of stenosis. After 4 visits, the patient noted total absence of the right and left lower extremity pain and no adverse reaction to treatment. After 3 months of treatment and 16 visits, his low back and buttock pain were minimal; and he had no leg pain. Conclusion Lumbar synovial cyst and stenosis–generated low back and radicular pain was 80% relieved in a 75-year-old man following Cox flexion distraction spinal manipulation. PMID:22942836

  13. Knee Locking in Osteoarthritis due to Synovial Lipoma: A Case Report.

    PubMed

    S Amarjit, Kataria; Budhiraja, Shivali; Chandramouleeswari, K; Anita, S

    2013-08-01

    Intra-articular synovial lipomas are very rare and only few cases have been reported till now. We are reporting a rare case of a unilateral intra-articular lipoma of osteoarthritic knee joint in a 62 years old male. Patient had two episodes of sudden locking of knee joint, which resolved spontaneously. A plain X-ray showed changes which were suggestive of osteoarthritis. Clinically, patient was diagnosed as a case of loose bodies in left knee joint. An arthrotomy was performed. After a Histopathological Examination (HPE) of loose bodies, a diagnosis of an intra-articular synovial lipoma was made. Due to wide differentials and varied clinical behaviour of loose bodies, lipoma should be included in differential diagnosis of osteroarthritic patients who complain of episodic locking of knees. Intraarticular lipomas, on arthroscopic guided excision, get cured permanently, with no recurrence. The differentiation of an intra-articular lipoma from a relatively more common entity, Lipoma arborescens, has also been discussed. PMID:24086885

  14. ADVANCED INTRAMOLECULAR DIELS-ALDER STUDY TOWARD THE SYNTHESIS OF (-)-MORPHINE: STRUCTURE CORRECTION OF A PREVIOUSLY REPORTED DIELS-ALDER PRODUCT. (R826113)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  15. Calcaneal Osteomyelitis due to Non-tuberculous Mycobacteria: A Case Report.

    PubMed

    Yi, Tae-Im; Ha, Seung-A; Choe, Yeo-Reum; Kim, Joo-Sup; Kwon, Kye-Won

    2016-02-01

    Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort. PMID:26949685

  16. Calcaneal Osteomyelitis due to Non-tuberculous Mycobacteria: A Case Report

    PubMed Central

    Yi, Tae-Im; Choe, Yeo-Reum; Kim, Joo-Sup; Kwon, Kye-Won

    2016-01-01

    Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort. PMID:26949685

  17. Precocious pseudopuberty due to an autonomous ovarian follicular cyst: case report with a review of literatures

    PubMed Central

    2013-01-01

    Background Small follicular cysts are commonly found in the ovaries of prepubertal girls, and in most cases, they are of no clinical importance. These cysts are usually self-limiting and resolve spontaneously. However, occasionally, these cysts may enlarge and continue to produce estrogen, resulting in signs of sexual precocity. Here, we report a case of precocious pseudopuberty associated with an autonomous ovarian follicular cyst. Case presentation A 5.9-year-old girl initially presented to a local clinic with vaginal bleeding and a large unilateral ovarian cyst. At 6 months after the initial acute episode, the patient visited our hospital as the ovarian cyst had persisted and increased in size. Endocrinological examination showed elevated estrogen levels and suppressed gonadotropin levels on GnRH stimulation test. Also, no skin pigmentation or bone anomaly was noted. Based on these observations, laparoscopic cystectomy was performed, and histologic analysis confirmed the diagnosis of a follicular cyst. After the laparoscopic cystectomy, the patient’s hormone levels returned to normal and no ovarian cyst was detected by ultrasound. Conclusions As autonomous ovarian cysts are usually self-limiting disorder, no treatment is necessary. Therefore, surgical management should be deferred as long as possible to avoid the risk of repeat surgery, as pseudoprecocious puberty due to autonomous ovarian cysts can resolve spontaneoulsy and frequently recurs. Precocious pseudopuberty with an ovarian cyst may be due to granulosa cell tumor or may be one symptom of the McCune-Albright Syndrome (MAS). A careful longer-term follow up of patients with autonomous ovarian cysts and/or molecular studies may be necessary in such cases. PMID:23937919

  18. [Non-fatal hyperkalemia in lactic acidosis due to metformin overdose. Report of one case].

    PubMed

    Díaz, Rienzi; Vega, Jorge; Goecke, Helmuth

    2015-03-01

    We report a 74-year-old man with diabetes mellitus type 2 and hypertension, who recently underwent coronary bypass surgery due to severe triple vessel disease receiving cardiological and combined antidiabetic therapy, including metformin 4 g/day. He was admitted with abdominal pain, nausea, vomiting, diarrhea and loss of consciousness. At admission, he was disoriented and agitated with signs of poor perfusion. His blood pressure was 80/70 mmHg, pulse rate 40 beats/min, respiratory rate 20-breaths/min, and axillary temperature 35 °C. Biochemical profile revealed an extreme hyperkalemia of 15.4 mEq/L (double checked), elevated creatinine, uremia and brain natriuretic peptide; hypoglycemia (blood glucose 68 mg/dl) and normal C Reactive Protein. Arterial blood gases revealed severe lactic acidemia. The electrocardiogram showed sinus bradycardia, simple AV block, widened QRS with prominent T wave and prolonged QT. He was admitted to the Intensive Care Unit (ICU) with the suspicion of lactic acidosis associated with metformin, receiving fluid management, intravenous hypertonic glucose plus insulin and sodium bicarbonate, mechanical ventilation, vasopressor therapy, a temporary pacemaker lead, in addition to continuous venovenous hemodiafiltration. Two days later, the patient experienced a significant clinical improvement with normalization of the acid-base status, plasma lactate and potassium levels. On day 9, diuresis was recovered, creatinine and uremia returned to normal levels and the patient was discharged from the ICU. PMID:26005828

  19. Inaccurate pulse CO-oximetry of carboxyhemoglobin due to digital clubbing: case report.

    PubMed

    Harlan, Nicole; Weaver, Lindell K; Deru, Kayla

    2016-01-01

    Newer pulse CO-oximeters provide a non-invasive and quick means of measuring oxyhemoglobin, carboxyhemoglobin and methemoglobin. Clubbing has been reported to cause inaccuracy in pulse oximeters. We present a case of inaccurate carboxy-hemoglobin measurement by pulse CO-oximetry due to digital clubbing. An 18-year-old man with a history of cystic fibrosis presented after a suicide attempt by inhalation of exhaust. At the initial emergency department evaluation, his blood carboxyhemoglobin was 33%. He was intubated, placed on 100% oxygen and transferred to our facility. Upon arrival, we placed three different pulse CO-oximeters on different fingers and toes. Carboxyhemoglobin levels measured by these meters ranged from 9%-11%. A venous blood gas drawn on arrival showed a carboxyhemoglobin level of 2.3% after four hours on 100% oxygen by endotracheal tube. Thirty minutes later, we checked arterial blood gas, which revealed a COHb level of 0.9%. Again, non-invasive carboxyhemoglobin measurements read 10%. The patient was treated with hyperbaric oxygen for carbon monoxide poisoning. This case suggests that non-invasive measurements of carboxyhemoglobin should be correlated with the clinic history and with an arterial or venous blood gas oximetry analysis. PMID:27000014

  20. Acute Kidney Injury and Quadriparesis Due to Rosuvastatin Induced Rhabdomyolysis- A Case Report.

    PubMed

    Suthar, Kamlesh S; Vanikar, Aruna V; Trivedi, Hargovind L

    2015-05-01

    Statins as lipid lowering drugs, are safe and effective in reducing cardiovascular disease risk, but rarely produce myopathy like myalgia, myositis or rhabdomyolysis. We report the case of Rosuvastatin induced rhabdomyolytic acute renal failure and quadriparesis in a 67-year old male, a known case of type-2 diabetes mellitus and with a history of coronary angioplasty four months back. He was on antihypertensive, oral hypoglycemic and antiplatelet medications with Rosuvastatin 40mg/day. He was admitted with altered sensorium, breathlessness, vomiting, muscle weakness and decreased urine output and had raised serum creatinine, creatinine phosphokinase and myoglobin. After ruling out all other causation for rhabdomyolysis, we stopped Rosuvastatin and started supportive management and hemodialysis. Patient showed gradual recovery in renal function and quadriparesis. Patient was discharged with good urine output and on antihypertensive, hypoglycemic drug and diet restrictions for lipid control. He recovered completely and had normal renal function with well controlled lipid level on follow up of 6 months after discharge. Thus, prompt diagnosis of Rhabdomyolysis due to Rosuvastatin in absence of other aetiology and the multidisciplinary management can prevent further complication with favorable outcome. PMID:26155510

  1. The Hemoptysis and the Subclavian Artery Pseudoaneurysm due to a Fishbone Injury: A Case Report.

    PubMed

    Lee, Yong Jik; Park, Chang-Ryul; Kim, Jeong Won; Kim, Yun Seok; Hwang, Jae Cheol; Seo, Kwang Won; Jung, Jong-Pil

    2015-10-01

    Ingestion of a foreign body is a common cause of esophageal injury, but hemoptysis is a rare manifestation of the esophageal penetration by a swallowed foreign body. The swallowing of a fishbone is hard to diagnose and the definite diagnosis is usually made during surgery. We describe the case of a 50-year-old man with direct injury to the lung parenchyma, the azygos vein, and the subclavian artery pseudoaneurysm due to a fishbone penetration from the upper esophagus into the lung. To our knowledge, this is the first case report that we know of in which a swallowed foreign body that penetrated from the upper esophagus into the lung caused vascular injuries and lung damage and it was solved by minimally invasive surgery and an endovascular stent.We successfully diagnosed and treated a case with the migration of the fishbone from the upper esophagus into the lung. A contrast-enhanced computed tomography (CT) scan is recommended to clarify the fact of vascular injury before surgery. Thoracoscopic operation (VATS) combined with endovascular treatment could be a safer and a more feasible treatment option in this rare condition. PMID:26496319

  2. Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review

    PubMed Central

    Zou, Hai; Pan, Ke-Hua; Pan, Hong-Ying; Huang, Dong-Sheng; Zheng, Ming-Hua

    2015-01-01

    Tuberculosis (TB) is a common disease to threaten human health. TB of the central nervous system (CNS) is rare but the most serious type of systemic TB because of its high mortality rate, serious neurological complications and sequelae. In this case report, we describe a woman who presented with walking instability, intracerebral hemorrhage and leptomeningeal enhancement due to tuberculosis meningitis. The patient had no significant medical history and the initial clinical symptoms were walking instability. On analysis, the cerebrospinal fluid was colorless and transparent, the pressure was more than 400 mm H2O, there was lymphocytic pleocytosis, increased protein, and decreased glucose levels present. No tuberculosis or other bacteria were detected. The patient's brain computed tomography image showed intra-cerebral hemorrhage (ICH) and contrast magnetic resonance imaging showed ICH in the right frontal lob, and leptomeningeal enhancement. CNS TB is rare but has a high mortality rate. As this disease has no unique characteristics at first presentation such as epidemiology and obvious clinical manifestation, a diagnosis of CNS TB remains difficult. PMID:26675758

  3. A preliminary report of successful cleavage after calcium ionophore activation at ICSI in cases with previous arrest at the pronuclear stage.

    PubMed

    Darwish, Ehab; Magdi, Yasmin

    2015-12-01

    Artificial oocyte activation (AOA) has been previously suggested as a means to overcome the problem of total fertilization failure, which affects about 1-3% of the intracytoplasmic sperm injection (ICSI) cycles. A preliminary study on the application of chemical AOA was conducted using A23187 Ca(2+) ionophore to improve embryonic development in four women with a history of complete fertilization arrest and inability to transit to cleavage stage during previous ICSI trials. Data indicated that activated oocytes resulted in better fertilization, embryonic development and clinical pregnancy in one of the four couples. Therefore, ICSI combined with AOA using Ca(2+) ionophore may be useful in selected patients with cleavage failure, and may help the zygotes to reach more advanced developmental stages. PMID:26507280

  4. Omalizumab in pregnant women treated due to severe asthma: two case reports of good outcomes of pregnancies.

    PubMed

    Kupryś-Lipińska, Izabela; Tworek, Damian; Kuna, Piotr

    2014-05-01

    The article presents case reports of 2 women who became pregnant during therapy with omalizumab. Both subjects suffered from very severe asthma and were treated chronically with all available medications including systemic steroids (first - 20 mg prednisolone/day, second - 40 mg prednisolone/day). Both were enrolled into treatment with omalizumab and started regular therapy in 2007. The course of asthma significantly improved in both cases (withdrawal of oral steroids or significant reduction of their dose, better asthma control). The first woman, 32-year-old, became pregnant in 2010 and gave birth in Oct 2010 - it was her 3(rd) pregnancy, and 3(rd) labor. The second woman, 31-year-old, also became pregnant in 2010 and gave birth in Jan 2011 - it was her 5(th) pregnancy and 2(nd) labor. Both had severe asthma exacerbations during previous pregnancies and labors, and decided to continue therapy with omalizumab. The first woman, besides omalizumab, was treated with high doses of inhaled corticosteroids (ICS) and long-acting β agonists (LABA) while the second one was treated with high doses of ICS, LABA and 2.5 mg to 5 mg prednisone/day. The pregnancies proceeded without asthma exacerbations. The first woman delivered a healthy girl (Apgar 9, weight 3200 g, length 56 cm) in the 40(th) week of pregnancy by caesarean section due to the narrow pelvis. The second one delivered a healthy boy (Apgar 9, weight 3800 g, length 56 cm) in week 40 by caesarean section due to the aggravating obstetrical history. In both cases, treatment with omalizumab did not affect pregnancies and newborns. PMID:25097476

  5. Bing-Neel Syndrome Case Report: A Previously Undocumented IgG Variant with MRI, PET/CT, and PET/MRI Imaging.

    PubMed

    Halperin, Daniel; Hallam, Simon; Haroon, Athar; Butler, Tom; Agrawal, Samir

    2016-01-01

    Waldenstrom's macroglobulinaemia is the most commonly reported subtype of lymphoplasmacytic lymphoma (LPL); it is characterised by IgM secretion. Neurological complications are common usually as a result of hyperviscosity. In rare cases, cells can infiltrate the central nervous system; this is known as Bing-Neel syndrome. We report the case of a 57-year-old male with lymphoplasmacytic lymphoma of the IgG-subtype with neurological symptoms and the consequent finding of lymphoplasmacytoid cells in his cerebrospinal fluid as well as deposits on MRI and PET-CT imaging. This is the first report of Bing-Neel syndrome in IgG-subtype LPL. We discuss the biological and radiological markers of his disease, including PET imaging, which has been minimal in this area to date. PMID:27144041

  6. Bing-Neel Syndrome Case Report: A Previously Undocumented IgG Variant with MRI, PET/CT, and PET/MRI Imaging

    PubMed Central

    Halperin, Daniel; Hallam, Simon; Haroon, Athar; Butler, Tom; Agrawal, Samir

    2016-01-01

    Waldenstrom's macroglobulinaemia is the most commonly reported subtype of lymphoplasmacytic lymphoma (LPL); it is characterised by IgM secretion. Neurological complications are common usually as a result of hyperviscosity. In rare cases, cells can infiltrate the central nervous system; this is known as Bing-Neel syndrome. We report the case of a 57-year-old male with lymphoplasmacytic lymphoma of the IgG-subtype with neurological symptoms and the consequent finding of lymphoplasmacytoid cells in his cerebrospinal fluid as well as deposits on MRI and PET-CT imaging. This is the first report of Bing-Neel syndrome in IgG-subtype LPL. We discuss the biological and radiological markers of his disease, including PET imaging, which has been minimal in this area to date. PMID:27144041

  7. Autosomal recessive hydrocephalus due to aqueduct stenosis: report of a further family and implications for genetic counselling.

    PubMed

    Lapunzina, P; Delicado, A; de Torres, M L; Mor, M A; Pérez-Pacheco, R F; Lópes, Pajares I

    2002-07-01

    We report on two abortuses with hydrocephalus due to congenital stenosis of the aqueduct of Silvius. The occurrence of this disorder in two siblings (a male and a female) with normal parents supports the autosomal recessive pattern of inheritance. Such a mechanism of inheritance should be taken into account when counselling families with congenital hydrocephaly due to aqueduct stenosis. PMID:12422912

  8. Application of the electromagnetic borehole flowmeter and evaluation of previous pumping tests at Paducah Gaseous Diffusion Plant. Final report, June 15, 1992--August 31, 1992

    SciTech Connect

    Young, S.C.; Julian, S.C.; Neton, M.J.

    1993-01-01

    Multi-well pumping tests have been concluded at wells MW79, MW108, and PW1 at the Paducah Gaseous Diffusion Plant (PGDP) to determine the hydraulic properties of the Regional Gravel Aquifer (RGA). Soil cores suggest that the RGA consists of a thin sandy facies (2 to 6 feet) at the top of a thicker (> 10 feet) gravelly facies. Previous analyses have not considered any permeability contrast between the two facies. To assess the accuracy of this assumption, TVA personnel conducted borehole flowmeter tests at wells MW108 and PW1. Well MW79 could not be tested. The high K sand unit is probably 10 times more permeable than comparable zone in the gravelly portion of the RGA. Previous analyses of the three multi-well aquifer tests do not use the same conceptual aquifer model. Data analysis for one pumping test assumed that leakance was significant. Data analysis for another pumping test assumed that a geologic boundary was significant. By collectively analyzing all three tests with the borehole flowmeter results, the inconsistency among the three pumping tests can be explained. Disparity exists because each pumping test had a different placement of observation wells relative to the high K zone delineating by flowmeter testing.

  9. The Extent to Which Four-Year College Presidents Who Previously Served as Senior Student Affairs Officers Report Having the Characteristics of Effective Presidents

    ERIC Educational Resources Information Center

    Risacher, Joanne

    2004-01-01

    Results of a research study to determine the extent to which presidents of 4-year institutions with Senior Student Affairs Officer (SSAO) experience share the leadership characteristics of effective presidents as defined by earlier research are reported. Based on analysis of the data using t test and ANOVA statistical procedures, it is concluded…

  10. Case report: Colonic bezoar due to Box Myrtle seeds: A very rare occurrence.

    PubMed

    Chauhan, Narvir Singh; Sood, Dinesh

    2011-01-01

    Large bowel seed bezoars are rare and are mostly due to seeds of sunflower, prickly pear cactus, sesame and cucumber. We present a rare case of sigmoid colon seed bezoar due to Box Myrtle seeds because of an underlying benign stricture. PMID:21431028

  11. 49 CFR 579.28 - Due date of reports and other miscellaneous provisions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... VIN, or a tire manufacturer is not aware of the TIN, at the time the incident is initially reported... period in which the VIN or TIN is identified. A manufacturer need not submit an updated report if the...

  12. 49 CFR 579.28 - Due date of reports and other miscellaneous provisions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... VIN, or a tire manufacturer is not aware of the TIN, at the time the incident is initially reported... period in which the VIN or TIN is identified. A manufacturer need not submit an updated report if the...

  13. 49 CFR 579.28 - Due date of reports and other miscellaneous provisions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... VIN, or a tire manufacturer is not aware of the TIN, at the time the incident is initially reported... period in which the VIN or TIN is identified. A manufacturer need not submit an updated report if the...

  14. 49 CFR 579.28 - Due date of reports and other miscellaneous provisions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... VIN, or a tire manufacturer is not aware of the TIN, at the time the incident is initially reported... period in which the VIN or TIN is identified. A manufacturer need not submit an updated report if the...

  15. 49 CFR 579.28 - Due date of reports and other miscellaneous provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... VIN, or a tire manufacturer is not aware of the TIN, at the time the incident is initially reported... period in which the VIN or TIN is identified. A manufacturer need not submit an updated report if the...

  16. [Onset of a fulminant malignant hyperthermia crisis. Case report of a 74-year-old patient with previously subclinical central core disease].

    PubMed

    Wejbora, M; Bornemann-Cimenti, H; Lessel, D; Mandl, C; Voit-Augustin, H; Schwarz, G

    2013-01-01

    Malignant hyperthermia (MH) is a latent, autosomal dominant inherited syndrome of skeletal musculature which results in excessive hypermetabolism induced by halogenated anesthetic agents and depolarizing muscle relaxants and is caused by an uncontrolled intramuscular calcium release. This case report focuses on the description of symptoms of a fulminant MH crisis. A possible link between central core disease (CCD) and the clinical severity of MH crisis is postulated in this paper. PMID:23247425

  17. Facet joint septic arthritis due to community acquired methicillin resistant Staphylococcus aureus (MRSA) - A case report.

    PubMed

    Purushothaman, Rajesh; Inassi, Jojo; Marthya, Anwar

    2015-10-01

    Septic arthritis of facet joint (SAFJ) is extremely rare. Only about sixty cases have been reported so far. A single case of SAFJ in a series of 491 cases of spinal infections was first reported by David-Chaussé in 1981. A case report of SAFJ was published by Halpin in 1987. With the growing availability and use of MRI, more and more cases are being reported. The most common organism that causes SAFJ is Staphylococcus aureus. We are reporting a case of SAFJ caused by community acquired, methicillin resistant S aureus (MRSA) successfully treated by Linezolid. PMID:26719620

  18. Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review

    PubMed Central

    Orme, Joseph; Rivera-Bonilla, Tomas; Loli, Akil; Blattman, Negin N.

    2015-01-01

    Ralstonia pickettii is a rare pathogen and even more rare in healthy individuals. Here we report a case of R. pickettii bacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report of Ralstonia species causing infective endocarditis with perivalvular abscess. PMID:25648998

  19. Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review.

    PubMed

    Orme, Joseph; Rivera-Bonilla, Tomas; Loli, Akil; Blattman, Negin N

    2015-01-01

    Ralstonia pickettii is a rare pathogen and even more rare in healthy individuals. Here we report a case of R. pickettii bacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report of Ralstonia species causing infective endocarditis with perivalvular abscess. PMID:25648998

  20. A Case Report of Acute Acalculous Cholecystitis and Acute Hemorrhagic Cystitis due to Salmonella Typhi

    PubMed Central

    Beyazal Polat, Hatice; Beyazal Çeliker, Fatma

    2014-01-01

    Acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi are a rare condition. A 24-year-old female patient was admitted to our clinic with abdominal pain, nausea, fever, headache, urinary burning, and bloody urine. Based on clinical, laboratory, and radiological evaluations, the patient was diagnosed with acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi. The patient was treated with intravenous ceftriaxone for two weeks. After the treatment, the patient's clinical and laboratory findings improved. Acute acalculous cholecystitis due to Salmonella Typhi concomitant with acute hemorrhagic cystitis is very rare and might be difficult to diagnose. Infectious agents such as Salmonella Typhi should be considered when acute acalculous cholecystitis and acute hemorrhagic cystitis are detected in adult patients with no underlying diseases. PMID:25161668

  1. Anorectal Injuries due to Foreign Bodies: Case Reports and Review of the Management Options

    PubMed Central

    Karateke, Faruk; Das, Koray; Ozyazici, Sefa; Menekse, Ebru; Koseoglu, Zikret; Karcioglu, Ozgur

    2013-01-01

    Anorectal injuries due to autoerotic activity with rectal foreign bodies were identified in four male patients. The objects were bottle in one patient, glasses in two patients, and showerhead in one patient. Foreign bodies were extracted within lithotomy position after anal dilatation, under general anesthesia in 3 patients. One patient presented with peritoneal irritation and had a diagnosis of rectal perforation. He underwent transanal rectal repair with proximal fecal diversion. In this paper we described 4 patients who had anorectal injuries due to autoerotic activity with foreign bodies and reviewed the management options in literature. PMID:23533918

  2. [Uterine lipoma: A case report probably due to a surgical traumatism].

    PubMed

    Favre, N; Rabischong, B; Kaemmerlen, A-G; Charpy, C; Déchelotte, P; Da Ines, D; Mage, G

    2011-01-01

    Uterine lipomas are uncommon. Several histology hypotheses are described. Ultrasound is firstly performed but diagnosis is sometimes difficult. Magnetic resonance imaging is more specific and helpful to make a differential diagnosis with a dermoid ovarian cyst. Despite those imaging exams we detail a case of a patient where a laparoscopic hysterectomy with bilateral salpingo-oophorectomy and preliminary adhesiolysis has been necessary to establish diagnosis. Among her medical history some previous abdominal surgeries could be the cause of this lesion. PMID:21190886

  3. Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - case report.

    PubMed

    Atanasijević, Tatjana; Jovanović, Aleksandar A; Nikolić, Slobodan; Popović, Vesna; Jasović-Gasić, Miroslava

    2009-06-01

    A case is reported of a 36-year-old male, found dead in his locked room, lying on a bed, dressed in his mother's clothes, with a plastic bag over his head, hands tied and with a barrel wooden cork in his rectum. Two pornographic magazines were found on a chair near the bed, so that the deceased could see them well. Asphyxia was controlled with a complex apparatus which consisted of two elastic luggage rack straps, the first surrounding his waist, perineum, and buttocks, and the second the back of his body, and neck. According to the psychological autopsy based on a structured interview (SCID-I, SCID-II) with his father, the deceased was single, unemployed and with a part college education. He had grown up in a poor family with a reserved father and dominant mother, and was indicative of fulfilling DSM-IV diagnostic criteria for alcohol dependence, paraphilia involving hypoxyphilia with transvestic fetishism and anal masturbation and a borderline personality disorder. There was no evidence of previous psychiatric treatment. The Circumstances subscale of Beck's Suicidal Intent Scale (SIS-CS) pointed at the lack of final acts (thoughts or plans) in anticipation of death, and absence of a suicide note or overt communication of suicidal intent before death. Integration of the crime scene data with those of the forensic medicine and psychological autopsy enabled identification of the event as an accidental death, caused by neck strangulation, suffocation by a plastic bag, and vagal stimulation due to a foreign body in the rectum. PMID:19556957

  4. Sudden hearing loss due to internal auditory canal metastasis of Her2-positive gastric cancer: A case report

    PubMed Central

    KIM, CHANG-HEE; SHIN, JUNG EUN; ROH, HONG GEE; LEE, JONG SIK; YOON, SO YOUNG

    2014-01-01

    Internal auditory canal (IAC) metastasis due to leptomeningeal carcinomatosis (LMC) from gastric cancer (GC) has rarely been reported. Early manifestation of symptoms, such as hearing loss, vertigo and facial paralysis, in cases of IAC metastasis due to LMC may facilitate the early detection of brain metastasis. To the best of our knowledge, the present study is the first to report IAC metastasis due to LMC in human epidermal growth factor receptor 2 (Her2)-positive GC. This study reports a case of an Her2-positive GC patient with LMC including IAC metastasis, who presented with acute sensorineural hearing loss, ipsilateral facial paralysis and vertigo during trastuzumab containing chemotherapy. The current study also discusses the early diagnosis and management of this complicated condition, demonstrating that clinical suspicion is key for a prompt diagnosis and proper management of LMC including IAC metastasis in Her2-positive GC. PMID:24959283

  5. The Cost of Special Education Due Process Fair Hearings and Appeals in California. Final Project Report.

    ERIC Educational Resources Information Center

    Peterson, Gerald P.; Ayer, Sue F.

    The California State Board of Education authorized the study to document the overall costs of special education due process fair hearings to all parties--the parents, local education agencies, and the state. The study also analyzed the factors that enter into the costs of hearings, and some conclusions were drawn and recommendations made for…

  6. Surgical management of colonic perforation due to ulcerative colitis during pregnancy: Report of a case

    PubMed Central

    Overbey, Douglas; Govekar, Henry; Gajdos, Csaba

    2014-01-01

    This report describes a young female in her second trimester of pregnancy with known ulcerative colitis on maintenance medical therapy. She was admitted for abdominal pain, and workup revealed a colonic stricture and ulceration with contained perforation. After multidisciplinary discussion she was managed with colectomy and end ileostomy. She delivered a healthy newborn 18 wk after surgery. Only a few prior reports described surgical management of inflammatory bowel disease during pregnancy, with recent results indicating low risk of adverse outcomes. PMID:25346802

  7. Claudication Due to Sciatic Nerve Palsy Following Nicolau Syndrome: A Case Report

    PubMed Central

    Hatefi, Masoud; Pirabadi, Nabi Ramezani; Khajavikhan, Javaher

    2015-01-01

    Nicolau syndrome is a rare drug reaction due to intramuscular injection administration that can lead to limb loss or even death. A 3.8-year-old Iranian boy received an intramuscular injection of Benzathine Penicillin. Immediately after injection the child developed lower limb pain and livedoid discolouration and was referred to our department. The patient was diagnosed to develop Nicolau syndrome and fasciotomy carried out due to compartment syndrome. Pharmacologic therapy with Heparin, Cefazolin and Methylprednisolone was initiated. On 18th day, he was discharged, although he was not able to move. Finally, after 6 months of care at home, physiotherapy and Electromyography (EMG) at regular intervals, the child was gradually able to move and his claudication improved. PMID:26557581

  8. Claudication Due to Sciatic Nerve Palsy Following Nicolau Syndrome: A Case Report.

    PubMed

    Hatefi, Masoud; Pirabadi, Nabi Ramezani; Khajavikhan, Javaher; Jaafarpour, Molouk

    2015-10-01

    Nicolau syndrome is a rare drug reaction due to intramuscular injection administration that can lead to limb loss or even death. A 3.8-year-old Iranian boy received an intramuscular injection of Benzathine Penicillin. Immediately after injection the child developed lower limb pain and livedoid discolouration and was referred to our department. The patient was diagnosed to develop Nicolau syndrome and fasciotomy carried out due to compartment syndrome. Pharmacologic therapy with Heparin, Cefazolin and Methylprednisolone was initiated. On 18(th) day, he was discharged, although he was not able to move. Finally, after 6 months of care at home, physiotherapy and Electromyography (EMG) at regular intervals, the child was gradually able to move and his claudication improved. PMID:26557581

  9. Green Urine Due to Propofol: A Case Report with Review of Literature

    PubMed Central

    Yadav, Sankalp

    2015-01-01

    The change in the colour of urine is a known occurrence in an intensive care setting and is always a cause of concern to the clinicians who have to differentiate between benign and pathological causes. Herein, we present a case of 62-year-old postoperative lady, noticed to be passing green coloured urine believed to be due to intravenous Propofol administration for induction of general anaesthesia. The green colour of urine due to Propofol occurs when clearance of Propofol exceeds hepatic elimination, and extrahepatic elimination of Propofol occurs. This discolouration of urine is a rare (less than 1% cases) but a benign side effect of Propofol, which is non-nephrotoxic and gets reversed after discontinuation of the drug. PMID:26673613

  10. Single sternal metastasis due to malignant melanoma with unexpected long-term survival: a case report

    PubMed Central

    Gogakos, Apostolos S; Paliouras, Dimitrios; Asteriou, Christos; Rallis, Thomas; Lazopoulos, Achilleas; Chatzinikolaou, Fotios; Zissimopoulos, Athanassios; Tsavlis, Drosos; Tsirgogianni, Katerina; Zarogoulidis, Konstantinos; Porpodis, Konstantinos; Tsakiridis, Kosmas; Pitsiou, Georgia; Kioumis, Ioannis; Karapantzos, Ilias; Karapantzou, Chrysanthi; Sachpekidis, Nikos; Zarogoulidis, Paul; Barbetakis, Nikolaos

    2016-01-01

    Metastases from melanoma have a very poor prognosis for the patient. Single metastatic lesions in the sternum due to melanoma are extremely rare. A rare case of a presternal mass in a 56-year-old patient who had undergone excision for malignant melanoma is presented. Review of the patient’s history and surgical resection of a single metastatic soft tissue lesion offer the best chance of long-term survival. PMID:26848270

  11. Toxic encephalopathy due to paradichlorobenzene toxicity: a case report and review of imaging characteristics.

    PubMed

    Weidman, Elizabeth K; Tsiouris, A John; Heier, Linda A

    2015-01-01

    Neurotoxicity following paradichlorobenzene (PDCB) exposure is rare and can occur in patients with pica and mothball or toilet cake ingestion. We present a rare case of toxic encephalopathy due to PDCB mothball inhalation and ingestion and describe the rapidly progressive leukoencephalopathy seen on computed tomography, magnetic resonance, and magnetic resonance spectroscopy. Given the nonspecificity of clinical and imaging findings, it is important for radiologists to maintain a high index of suspicion for toxic encephalopathy. PMID:26388394

  12. Localized hypertrichosis due to temporary henna tattoos: report of three cases.

    PubMed

    Durmazlar, Selda Pelin Kartal; Tatlican, Semih; Eskioglu, Fatma

    2009-01-01

    Temporary henna tattoos have become increasingly widespread. Although reactions to henna tattoo are becoming progressively more common, only one case of a henna pseudotattoo resulting in temporary hypertrichosis has been reported so far. We report three patients who received paint-on henna tattoos on their right upper arm. Approximately 1 week later, localized hypertrichosis was observed over the same area as the tattoo, which resolved spontaneously within 3-4 months. Clinicians should be aware of this complication and it should be noted that treatment is not necessary as hypertrichosis resolves spontaneously. PMID:19954396

  13. [Infections due to Kocuria kristinae: case reports of two patients and review of the literature].

    PubMed

    Chávez Valencia, Venice; Orizaga de la Cruz, Citlalli; Aguilar Bixano, Omar; Huerta Ruíz, Marilyn Karla; Sánchez Estrada, Erik Emilio

    2014-12-01

    Kocuria kristinae is a gram-positive coccus of the family of Micrococcaceae. It inhabits the skin and mucous and human oropharynx and some mammals. Clinical cases of proven infections are scarce, affecting patients with indwelling devices and severe underlying diseases. We report two unusual case of a K. kristinae infection in a hemodialysis. First is a case of bacteremia associated with permanent hemodialysis catheter in a 20-year-old female; and second is a case of acute peritonitis in a 68-year-old male patient on continuous ambulatory peritoneal dialysis. A review of other reported K. kristinae infections is provided. PMID:25643779

  14. Statistical analysis of reportable events due to maintenance and testing activities in nuclear power facilities

    SciTech Connect

    Wong, S. M.; Koehler, K.; Husseiny, A. A.; Sabri, Z. A.; Sprung, J. L.

    1980-01-01

    Operating experience of US commercial nuclear power plants has shown that routine maintenance, testing, and inspection activities play a significant role in their operational safety, reliability, and availability. Licensee Event Reports (LER's) for all nuclear power plants in commercial operation from 1972 to 1978 were reviewed for the base-line data. Out of 3600 reported events, 385 were traceable to maintenance and testing activities. Categories of actions which are most highly associated with particular component failures were identified through an analysis of cross-classified frequency tables. Inconsistencies in the pattern of association across the various systems and reactor types were investigated.

  15. Massive Hemoptysis due to Endotracheal Hemangioma: A Case Report and Literature Review

    PubMed Central

    Yu, Yeonsil; Lee, Suhyeon; An, Jinyoung; Lee, Jeongmin; Kim, Jihoon; Lee, Youngkyung; Jung, Eunah; Song, Sookhee; Kim, Hyeok

    2015-01-01

    Tracheal hemangioma is a rare benign vascular tumor in adults. We reported a case of massive hemoptysis caused by a cavernous hemangioma in a 75-year-old man. This is the first report, to our knowledge, of a tracheal cavernous hemangioma that presented with massive hemoptysis. The lesion was removed with a CO2 laser under rigid laryngoscopy. Endovascular tumors, such as tracheobronchial hemangiomas, should be considered a diagnostic option in cases of massive hemoptysis without a significant underlying lung lesion. PMID:25861344

  16. Tenosynovitis of a digit due to Erysipelothrix rhusiopathiae: case report and review of the literature

    PubMed Central

    Tolis, K.; Spyridonos, S.; Tsiplakou, S.; Fandridis, E.

    2015-01-01

    Erysipelothrix rhusiopathiae is a Gram-positive bacterium that in humans causes skin infections, such as erysipeloid, as a result of direct contact with contaminated animals or their waste or products. We present the first reported case of tenosynovitis of a finger in a 30-year-old woman. PMID:26693283

  17. Native Pulmonic Valve Endocarditis due to Mycobacterium fortuitum: A Case Report and Literature Review

    PubMed Central

    Mulhall, Aaron M.; Hebbeler-Clark, Renee S.

    2015-01-01

    Endocarditis secondary to Mycobacterium fortuitum is a rare entity often involving prosthetic valves and rarely native valves. Pulmonic valve endocarditis secondary to any organism is rare. We report the first case of native pulmonic valve endocarditis secondary to M. fortuitum and a literature review of native valve M. fortuitum endocarditis. PMID:26167313

  18. The Shoulder Pain due to Metastatic Breast Cancer -A Case Report-

    PubMed Central

    Jung, Min Woo; Kim, Jin Mo

    2011-01-01

    A rotator cuff tear causes shoulder pain and limits movement of the shoulder joint. A chronic degenerative change or impingement is the reason for a rotator cuff tear. Diagnosis is made based on medical history and, physical and radiological examinations. Other causes of shoulder pain include calcific tendinitis, degenerative arthropathy, joint dislocation, fracture, and primary or metastatic neoplasm. However, metastatic cancer in the shoulder joint is difficult to diagnosis. We experienced a case in which a 46-year-old female patient complained of left shoulder pain and limited joint mobility, and these symptoms were due to metastatic breast cancer in the shoulder. PMID:21716612

  19. Alteration of liver function due to H1N1 infection: a case report

    PubMed Central

    Alhammadi, Ahmed H; Hendaus, Mohamed A; Kayoum, Anas A

    2013-01-01

    H1N1 virus is known to affect the respiratory tract. The majority of healthcare providers focus on the respiratory complications attributed to H1N1 infection, overlooking possible multi-organ involvement. We present a rare case of abnormal liver function in a child who was admitted for respiratory illness due to the H1N1 virus. There was a marked elevation in liver function tests concurrent with the respiratory disease. Our patient was treated with oseltamavir for the H1N1 infection, and the liver function levels decreased dramatically in 72 hours. PMID:24068870

  20. Evidence Report: Risk of Acute Radiation Syndromes Due to Solar Particle Events

    NASA Technical Reports Server (NTRS)

    Carnell, Lisa; Blattnig, Steve; Hu, Shaowen; Huff, Janice; Kim, Myung-Hee; Norman, Ryan; Patel, Zarana; Simonsen, Lisa; Wu, Honglu

    2016-01-01

    Crew health and performance may be impacted by a major solar particle event (SPE), multiple SPEs, or the cumulative effect of galactic cosmic rays (GCR) and SPEs. Beyond low-Earth orbit, the protection of the Earth's magnetosphere is no longer available, such that increased shielding and protective mechanisms are necessary in order to prevent acute radiation sickness and impacts to mission success or crew survival. While operational monitoring and shielding are expected to minimize radiation exposures, there are EVA scenarios outside of low-Earth orbit where the risk of prodromal effects, including nausea, vomiting, anorexia, and fatigue, as well as skin injury and depletion of the blood-forming organs (BFO), may occur. There is a reasonable concern that a compromised immune system due to high skin doses from a SPE or due to synergistic space flight factors (e.g., microgravity) may lead to increased risk to the BFO. The primary data available at present are derived from analyses of medical patients and persons accidentally exposed to acute, high doses of low-linear energy transfer (LET) (or terrestrial) radiation. Data more specific to the space flight environment must be compiled to quantify the magnitude of increase of this risk and to develop appropriate protection strategies. In particular, information addressing the distinct differences between solar proton exposures and terrestrial exposure scenarios, including radiation quality, dose-rate effects, and non-uniform dose distributions, is required for accurate risk estimation.

  1. Multiple cerebral artery occlusion due to non-bacterial thrombotic endocarditis: an autopsy case report.

    PubMed

    Nagakane, Yoshinari; Takezawa, Hidesato; Katsura, Kanade; Yamamoto, Yasumasa

    2016-03-30

    A 60-year-old man was admitted to our hospital because of vertigo and repeated vomiting, which suddenly occurred 25 hours before admission. Neurologic examination revealed Wallenberg syndrome on the left side, and brain MRI showed acute infarcts in the left lateral medulla as well as in the left internal carotid artery (ICA) territory. MR angiography did not depict the left vertebral artery (VA) and the left ICA. Despite antithrombotic treatment, he developed bulbar palsy, and then, brain herniation due to infarct growth in the left middle cerebral artery territory. He died on day 9. Histopathlogical examination found verruca involving the mitral leaflet, which was consistent with non-bacterial thrombotic endocarditis (NBTE). Atherosclerosis was also found in the systemic arteries, and there was sclerotic stenosis with calcification at the portion of piercing dulla matter in the left VA and at the cavernous segment of the left ICA. Because the cerebral emboli in the narrowed lumen presented a histologic appearance similar to that of the verruca, the diagnosis of brain embolism due to NBTE was confirmed. PMID:26960272

  2. Unusual presentation of death due to carbon monoxide poisoning. A report of two cases.

    PubMed

    Ruszkiewicz, A; de Boer, B; Robertson, S

    1997-06-01

    Two cases are reported representing opposite ends of the spectrum of death as a result of carbon monoxide poisoning from car exhaust fumes. In one case, a women was reported to be found dead in bed early in the morning by her husband. The cause of her death, established by autopsy, was carbon monoxide poisoning. Toxicology examination indicated a car engine as the possible source of carbon monoxide. The mode of administration was never established. In the second case, a women was found in a car located in her garage with a hose leading from the exhaust pipe to the interior of the sealed vehicle. Autopsy revealed negligible carboxyhemoglobin saturation of the blood, bilateral infarction of the globus pallidus, and extensive bronchopneumonia. It was concluded that inhalation of carbon monoxide resulted in sublethal hypoxia with subsequent exhalation of carbon monoxide and a delayed death. PMID:9185938

  3. First report of major vascular injury due to lateral transpsoas approach leading to fatality.

    PubMed

    Assina, Rachid; Majmundar, Neil J; Herschman, Yehuda; Heary, Robert F

    2014-11-01

    Extreme lateral interbody fusion (XLIF) has gained popularity among spine surgeons for treating multiple conditions of the lumbar spine. In contrast to the anterior lumbar interbody fusion (ALIF) approach, the minimally invasive XLIF approach affords wide access to the lumbar disc space without an access surgeon and causes minimal tissue disruption. The XLIF approach offers many advantages over other lumbar spine approaches, with a reportedly low complication profile. The authors describe the first fatality reported in the literature following an XLIF approach. They describe the case of a 50-year-old woman who suffered a fatal intraoperative injury to the great vessels during a lateral transpsoas approach to the L4-5 disc space. PMID:25192374

  4. Paralysis due to a glomangioma in a Macaca mulatta. Final report

    SciTech Connect

    Hubbard, G.B.; Fanton, J.W.; Harvey, R.C.; Wood, D.H.

    1984-01-01

    Glomangioma have many synonyms including: glomus tumors, tumors of neuromyoarterial glomi, angioneuromas, angioneuromyomas, neuromyoarterial glomi, painful subcutaneous tubercles, Popoff tumors or subcotaneous glomal tumors. They are common in humans, rare in nonhuman primates and to the best of our knowledge, have only been reported in irradiated rhesus. The neoplasms originate in arterial-venous shunts known as neuromyoarterial glomi which are commonly found beneath fingernails and fingertips, but have been reported in many locations both superficial and deep. The neoplasm can be confused with hemangiopericytomas, hemangiomas, paragangliomas, and leiomyomas, and must be definitely diagnosed ultrastructurally. A glomangioma at the 6-7 thoracic intervertebral space caused compression of the spinal cord with posterior paralysis in an irradiated 20-year-old female rhesus monkey (Macaca mulatta).

  5. Nosocomial bacteremia due to Kluyvera cryocrescens: Case report and literature review

    PubMed Central

    Yoshino, Yusuke; Nakazawa, Susumu; Otani, Sumire; Sekizuka, Eiichi; Ota, Yasuo

    2016-01-01

    Kluyvera cryocrescens infection has been considered rare; clinical features of K. cryocrescens bacteremia remain unclear because few reports have been published. We report a case of K. cryocrescens bacteremia in an adult male patient and review the literature. Our case was one with nosocomial bacteremia in a patient with interstitial lung disease. The primary infection site was undetermined, although he had an indwelling peripheral intravenous catheter and a urinary catheter. Piperacilin/tazobactam was administered for 2 weeks and the bacteremia resolved. Unfortunately, there was acute exacerbation of the interstitial lung disease, which was fatal. According to our review, including our case, K. cryocrescens bacteremia tends to occur in immunocompromised hosts, and indwelling catheters might be risk factors. Extended spectrum cephalosporins, carbapenems, fluoroquinolones and tetracyclines are generally adequate agents for empiric therapy based on susceptibilities of K. cryocrescens clinical isolates.

  6. Paralytic ileus due to a novel anticancer drug, nab-paclitaxel: A case report

    PubMed Central

    JIAO, XIAO-DONG; LUO, XIU; QIN, WEN-XING; YUAN, LING-YAN; ZANG, YUAN-SHENG

    2016-01-01

    Nab-paclitaxel is a recently emerged chemotherapy drug, which is widely used for the treatment of multiple types of cancer. The prospects of this novel drug are very bright as a result of its higher efficacy and lower toxicity compared with paclitaxel. Hence, the side effect, even if rare, require attention in clinical practice. The present study described an unusual case of nab-paclitaxel-associated paralytic ileus. To the best of our knowledge, this is the first report to demonstrate that nab-paclitaxel may lead to acute intestinal obstruction. Since nab-paclitaxel will be used more frequently, this unusual side effect might be encountered by a clinical oncologist and must be treated correctly. This is the first reported case, to the best of our knowledge, of paralytic ileus caused by nab-paclitaxel, which will be widely used as a novel anticancer drug. PMID:27123288

  7. Left main bronchus compression due to main pulmonary artery dilatation in pulmonary hypertension: two case reports

    PubMed Central

    Jaijee, Shareen K.; Ariff, Ben; Howard, Luke; O’Regan, Declan P.; Gin-Sing, Wendy; Davies, Rachel

    2015-01-01

    Abstract Pulmonary arterial dilatation associated with pulmonary hypertension may result in significant compression of local structures. Left main coronary artery and left recurrent laryngeal nerve compression have been described. Tracheobronchial compression from pulmonary arterial dilatation is rare in adults, and there are no reports in the literature of its occurrence in idiopathic pulmonary arterial hypertension. Compression in infants with congenital heart disease has been well described. We report 2 cases of tracheobronchial compression: first, an adult patient with idiopathic pulmonary arterial hypertension who presents with symptomatic left main bronchus compression, and second, an adult patient with Eisenmenger ventricular septal defect and right-sided aortic arch, with progressive intermedius and right middle lobe bronchi compression in association with enlarged pulmonary arteries. PMID:26697180

  8. Meningitis due to Campylobacter fetus intestinalis in a kidney transplant recipient. A case report.

    PubMed

    Rao, K V; Ralston, R A

    1987-01-01

    A 47-year-old man developed Campylobacter fetus intestinalis meningitis 3 years after cadaver renal transplantation. The infection was successfully controlled with chloramphenicol followed by erythromycin. There were no relapses during the past 5 years and the allograft function remains normal. The available evidence suggests that the campylobacter sepsis was associated with nutritional therapy, the patient received in a Mexican clinic. The present case is reported because of its clinical importance and epidemiological implications. PMID:3324765

  9. [Haemospermia due to seminal vesicle amyloidosis. Treatment by laparoscopic vesiculectomy. A case report].

    PubMed

    Vandwalle, Jérôme; Dugardin, Fabrice; Petit, Thomas; Surga, Nicolas; Paul, Alexandre; Petit, Jacques

    2007-11-01

    Amyloidosis of the seminal vesicles is a rare cause of haemospermia. The authors report the case of a 42-year-old patient with recurrent haemospermia over a period of 2 years and abnormalities of one seminal vesicle on ultrasonography and MRI, justifying laparoscopic resection. Histological examination demonstrated localized amyloidosis, secondary to inflammation. No recurrence was observed with a follow-up of one. PMID:18271428

  10. [Amputation of the hand due to necrotising fasciitis: a case report].

    PubMed

    Hohendorff, Bernd; Seyler, S; Naik, M; Biber, F; Franke, J

    2015-02-01

    We report the case of an 81-year-old woman who fell at home on her left hand and suffered a laceration of her forehead. Within days a fulminant necrotizing fasciitis of the hand from group A ?-haemolytic streptococcus developed. Lacking an apparent local germ entry point at the hand, the infection was initially misinterpreted as compartment syndrome. The patient's life was saved by amputation of the hand. PMID:24696384

  11. Infective endocarditis due to Bacillus cereus in a pregnant female: A case report and literature review

    PubMed Central

    Shah, Mahek; Patnaik, Soumya; Wongrakpanich, Supakanya; Alhamshari, Yaser; Alnabelsi, Talal

    2015-01-01

    Incidence of infective endocarditis during pregnancy is around 0.006% with high maternal and fetal mortality. Bacillus cereus is an extremely rare cause for endocarditis in intravenous drug abusers (IVDA) or those with valvular disease or devices such as pacemakers. We report a case of B. cereus endocarditis, which, to the best of our knowledge, has never been reported in pregnancy. A 30-year-old, 25-week pregnant female presented with right shoulder pain, swelling and erythema on the lateral aspect of deltoid muscle from large abscess over her deltoid muscle. She was found to have a vegetation on the native tricuspid valve. Cultures from abscess fluid and blood cultures grew B. cereus, she was appropriately treated with antimicrobials and had favorable outcomes. There are <20 cases of B. cereus endocarditis reported but none during pregnancy. When cultures grow unusual organisms the case must be thoroughly investigated. This case illustrates a rare situation (endocarditis in pregnancy) with an unusual outcome (B. cereus) on an uncommon valve (tricuspid valve). PMID:26793477

  12. Reduction of erosion in elbows due to flow modifications: Final report, Phase 1. [Elbows

    SciTech Connect

    Johnson, E.K.; Means, K.H.; Eyler, R.L.; Holtzworth, J.D.

    1987-11-01

    The objective of this project is to investigate the concept of flow-field modification as a method for reducing erosion in bends (elbows) used in pneumatic transport systems. Flow field modifications were primarily accomplished by injecting air at selected locations within the bends. Part I of this project shows the feasibility of the concept. Part II of this project will include further experiments and analysis, leading to a design methodology for incorporating this concept into piping systems. This report represents the final report for Part I of this project. This report contains a survey of the literature dealing with the erosion in bends (elbows) and the fundamental subjects of erosion and two-phase, gas-solids, flow. Based on this literature survey, a pneumatic transport test loop was constructed. Several bend designs were tested, using sand, under a variety of operating conditions. The results of this exploratory effort indicate that modifying the flow field in a bend with jets may: (1) decrease erosion; (2) change the erosion pattern with the same amount of erosion; or (3) significantly increase the erosion process. Data indicate that the erosion rate may be reduced by low-velocity jets for high phase-density flow. Apparently the interaction of jets with dilute phase-density flow tends to accelerate the erosion process. It is recommended that the project be continued in order to more fully understand the process and its capabilities to solve the difficult technical problem of erosion in bends (elbows).

  13. Use of a dual lumen cannula for venovenous extra corporeal membrane oxygenation in a patient with acute respiratory distress syndrome and a previously inserted inferior vena cava filter: a case report

    PubMed Central

    Palizas Jr., Fernando; García, Christian Casabella; Norese, Mariano

    2016-01-01

    Extracorporeal membrane oxygenation is used in refractory hypoxemia in many clinical settings. Thoracic trauma patients usually develop acute respiratory distress syndrome. Due to high risk of bleeding, thrombotic complications present in this context are particularly difficult to manage and usually require insertion of an inferior vena cava filter to prevent embolism from the distal veins to the pulmonary circulation. Here, we present a case of a thoracic trauma patient with severe acute respiratory distress syndrome requiring venovenous extracorporeal membrane oxygenation via a right internal jugular double lumen cannula due to a previously inserted inferior vena cava filter caused by distal bilateral calf muscle vein deep vein thrombosis. PMID:27096680

  14. Autopsy diagnosis of a death due to scorpion stinging--a case report.

    PubMed

    Kumar, Lavlesh; Naik, Shrabana Kumar; Agarwal, Swapnil S; Bastia, Binaya Kumar

    2012-11-01

    Post-mortem diagnosis of envenomation by a scorpion with or without a reliable history is a herculean task for any forensic pathologist. The challenge is compounded when stinging occurs at night, with the history remaining unreliable. The autopsy diagnosis is further complicated when the inflicted wound is small, and the mark is obliterated by healing within few days. As the venom of a scorpion is a mixture of enzymes, most of the forensic science laboratories in India fail to diagnose the poisoning. We present a case in which there was no external evidence of stinging, but the internal post-mortem findings along with histology of the organ systems pointed towards the diagnosis and were corroborated by the history. We reemphasise the importance of pathological sampling of organ systems, whenever there is death due to a suspicious, unknown insect bite. PMID:23084316

  15. Occupational death due to bilateral carotid artery occlusion - a medico-legal case report.

    PubMed

    Das, Siddhartha; Patra, Ambika Prasad; Shaha, Kusa Kumar; Sukumar, Sanjay; Chaudhari, Vinod Ashok; Rahman, Nisreen Abdul

    2015-05-01

    Occupational deaths are work-related deaths and usually occur in the work place of an individual. A case of occupational death in a female factory worker has been described, where the saree she was wearing accidentally got entangled in the moving belt and caused ligature strangulation. She was unconscious throughout indicating bilateral occlusion of the carotids and died a day after the incident. The authors have described the correlation between the distribution of the injuries on the body and the manner a saree is worn. Investigation of the workplace revealed that the place where she was standing was located between two machines, and the space was inadequate for normal movement. Some suggestions have been offered which may decrease the incidences of occupational ligature strangulation due to entanglement of dress materials in the moving machineries. PMID:25882146

  16. Myelopathy due to multilevel cervical canal stenosis with Forestier disease: case report.

    PubMed

    Koizumi, Shinichiro; Yamaguchi-Okada, Mitsuo; Namba, Hiroki

    2010-01-01

    A 56-year-old woman presented with multilevel myelopathy associated with Forestier disease (FD). The patient was hospitalized for dysphagia, bilateral shoulder pain, and progressive gait disturbance. The diagnosis was confirmed by radiography and magnetic resonance imaging which demonstrated coalescent anterior osteophyte formation extending from C2 to C7 with atlanto-axial dislocation and persistence of mobility at C3-4, and a hyperintense area in the spinal cord at the C1 and C3-4 levels on T(2)-weighted images. Dynamic radiography showed no instability at the C1 and C3-4 levels. Decompressive laminectomy of the atlas, dome-like laminectomy, and facet fusion at C3-4 were performed, resulting in symptomatic improvement. Myelopathy is very rare in patients with FD and is due to mechanical stress at the level where mobility persists. Strategic intervention should be considered based on evaluation of mobile levels and stenotic lesions. PMID:21030813

  17. Contact dermatitis due to ultrasound gel: A case report and published work review.

    PubMed

    Chasset, François; Soria, Angèle; Moguelet, Philippe; Mathian, Alexis; Auger, Yvain; Francès, Camille; Barete, Stéphane

    2016-03-01

    Adverse skin reactions with ultrasound gel are rare and related mostly to allergic contact dermatitis or contact urticaria. We report an allergic contact dermatitis with Doppler ultrasound gel applied in a 67-year-old man. The patient developed atypical purpuric cutaneous presentation located on vascular axes. Semi-open test with ultrasound gel and patch test with phenoxyethanol were followed by the same clinical purpuric eruption which strongly suggested the accountability of this later component as allergen. Based on this observation, we present a review of published work with a focus on clinical features and allergens involved in ultrasound gel cutaneous reaction. PMID:26346708

  18. A rare case of subcutaneous mucormycosis due to Syncephalastrum racemosum: case report and review of literature.

    PubMed

    Mangaraj, S; Sethy, G; Patro, M K; Padhi, S

    2014-01-01

    Zygomycosis represent a group of uncommon but potentially fatal fungal infections. The incidence of zygomycosis has increased manifold in recent years. Despite aggressive treatment, it can lead to a highly invasive disease state with fatal outcomes, especially among immuno-compromised. Syncephalastrum racemosum is a fungus belonging to Zygomycetes. Very few cases of human disease caused by this particular fungus have been documented. However, it has been clearly implicated in causing highly invasive disease in recent reported cases. Knowledge about the pathogenicity and clinical presentation of this rare fungal infection will alert the clinicians for instituting an early appropriate therapy leading to better outcomes. PMID:25297037

  19. Lead induced anaemia due to traditional Indian medicine: a case report

    PubMed Central

    Spriewald, B. M.; Rascu, A.; Schaller, K. H.; Angerer, J.; Kalden, J. R.; Harrer, T.

    1999-01-01

    Lead intoxication in adults without occupational exposure is a rare and unexpected event. The case of a western European is reported who had severe anaemia after ingestion of several ayurvedic drugs, obtained during a trip to India. Laboratory findings showed high blood lead concentrations, an increased urinary lead concentration, and an increased urinary excretion of delta-aminolaevulinic acid. Also, slightly increased urinary concentrations of arsenic and silver were found. Physicians should be aware that with growing international travel and rising self medication with drugs from uncontrolled sources the risk of drug induced poisoning could increase in the future.   PMID:10450247

  20. Mechanical Removal of Migrated Onyx Due to Microcatheter Rupture During AVM Embolization: A Technical Case Report.

    PubMed

    Senturk, Cagin

    2015-12-01

    We report a case where migrated Onyx could be removed safely with a mechanical thrombectomy device after withdrawal of the damaged microcatheter. A microcatheter was retained in the superior cerebellar artery with attached Onyx fragments on its tip during embolization of a bled cerebellar AVM. During retrieval maneuvers microcatheter shaft was ruptured and Onyx fragments were released into the vertebrobasilar system causing occlusion. Finally, Onyx fragment on tip of the microcatheter could be detached with dimethyl sulfoxide injection and the microcatheter could be withdrawn. A Merci retriever device (Concentric Medical, Mountain View, CA, USA) was successfully used to retrieve most of the dislodged Onyx material and recanalize the vertebrobasilar circulation. PMID:25910968

  1. Valvuloplasty for anterior mitral leaflet prolapse due to infective endocarditis: report of 2 cases.

    PubMed

    Hata, Hiroki; Miyamoto, Yuji; Matsumiya, Goro; Sawa, Yoshiki; Fukushima, Norihide; Takano, Hiroshi; Monta, Osamu; Matsuda, Hikaru

    2004-01-01

    We report 2 clinical cases of successful repair of an infected mitral valve with a broad-range prolapse of the anterior mitral leaflet (AML) with large vegetation. The chordal transfer technique was used in both cases, and autologous pericardium was transplanted in one case. There was neither residual mitral regurgitation nor recurrence of mitral valve infection. Chordal transfer is a useful technique for AML lesions of infective endocarditis if the corresponding area of the posterior ML remains normal, and even in the case of a broadly destroyed lesion of the AML, it is valuable to try to apply this technique with an autologous pericardial patch. PMID:15799924

  2. Acute liver failure due to Varicella zoster virus infection after lung transplantation: a case report.

    PubMed

    Verleden, G M; Vos, R; Van Raemdonck, D E; Laleman, W; Vanaudenaerde, B M

    2012-06-01

    Most adults are Varicella zoster virus (VZV)-positive at the age of 20 years. Some, however, remain antibody-negative and may develop primary chicken pox during adulthood. We report a patient with Williams-Campbell syndrome who underwent double-lung transplantation while being VZV-negative. One year after the successful procedure, he was admitted with fulminant hepatic failure and some cutaneous vesicles in his face. Despite a rapid diagnosis of VZV infection and treatment with acyclovir, his situation deteriorated within 24 hours and while awaiting an urgent liver transplantation, he developed multiple organ failure and died. PMID:22664036

  3. Case Report: Severe acute respiratory distress by tracheal obstruction due to a congenital thyroid teratoma.

    PubMed Central

    Colleti Junior, Jose; Tannuri, Uenis; Monti Lora, Felipe; Armelin Benites, Eliana Carla; Koga, Walter; Honda Imamura, Janete; Rute Moutinho, Patricia; Brunow de Carvalho, Werther

    2015-01-01

    Congenital teratoma is a rare condition and is a germ cell tumor composed of elements from one or more of the embryonic germ layers and contain tissues usually foreign to the anatomic site of origin. We report a case of a neck tumor diagnosed during pregnancy, initially thought to be a goiter. After birth the neck mass kept growing until it compressed the trachea and produced respiratory failure. The infant had a difficult tracheal intubation because of the compressing mass. The staff decided to surgically remove the neck mass. After that, the infant became eupneic. The histological analysis showed a mature teratoma with no atypias. PMID:26664704

  4. Case report: Unilateral conduction hearing loss due to central venous occlusion.

    PubMed

    Ribeiro, Phillip; Patel, Swetal; Qazi, Rizwan A

    2016-01-01

    Central venous stenosis is a well-known complication in patients with vascular access for hemodialysis. We report two cases involving patients on hemodialysis with arteriovenous fistulas who developed reversible unilateral conductive hearing loss secondary to critical stenosis of central veins draining the arteriovenous dialysis access. A proposed mechanism for the patients' reversible unilateral hearing loss is pterygoid venous plexus congestion leading to decreased Eustachian tube patency. Endovascular therapy was conducted to treat the stenosis and the hearing loss of both patients was returned to near normal after successful central venous angioplasty. PMID:27079669

  5. Paradoxical air embolism during percutaneous nephrolithotomy due to patent foramen ovale: Case report

    PubMed Central

    Chahal, Daljeet; Ruzhynsky, Vladimir; McAuley, Iain; Sweeney, Desmond; Sobkin, Paul; Kinahan, Michael; Gardiner, Rich; Kinahan, John

    2015-01-01

    Paradoxical air embolism is a very rare complication associated with percutaneous nephrolithotomy (PCNL). Incidence may be higher if patients also suffer from a septal heart defect. We report the case of a 76-year old male who presented for PCNL treatment of a right kidney lower calyceal calculus. During the procedure, the patient developed signs and symptoms consistent with that of air embolism. Intraoperative echocardiography confirmed the diagnosis. Subsequent intraoperative and postoperative medical management was carried out and the patient was discharged after recovery three days later. This case highlights the importance of a rare but potentially fatal complication of PCNL. PMID:26425235

  6. Anaerobic Spondylodiscitis due to Fusobacterium Species: A Case Report Review of the Literature

    PubMed Central

    Latta, Tiffany N.; Mandapat, Aimee L.; Myers, Joseph P.

    2015-01-01

    Spondylodiscitis caused by Fusobacterium species is rare. Most cases of spontaneous spondylodiscitis are caused by Staphylococcus aureus and most postoperative cases are caused by Staphylococcus aureus or coagulase-negative staphylococci. Escherichia coli is the most common Gram-negative organism causing spondylodiscitis. Fusobacterium species are unusual causes for anaerobic spondylodiscitis. We report the case of a patient with spontaneous L2-L3 spondylodiscitis, vertebral osteomyelitis, and epidural abscess caused by Fusobacterium species and review the literature for patients with Fusobacterium spondylodiscitis. PMID:26000181

  7. Bilateral macular hemorrhage due to megaloblastic anemia: A rare case report

    PubMed Central

    Vaggu, Sree Kumar; Bhogadi, Preethi

    2016-01-01

    We report a case of a 17-year-old female patient who presented with sudden, painless, nonprogressive diminished vision in both eyes (best corrected visual acuity in right eye - 6/60 and left eye - 6/36). An ophthalmological evaluation revealed bilateral pale tarsal conjunctiva and bilateral macular hemorrhage. Hematological evaluation revealed the presence of megalocytic anemia (with hemoglobin - 4.9 g%). General examination showed severe pallor. On systemic examination, no abnormality was detected, confirmed by ultrasonography abdomen. Other causes. This case documents the rare occurrence of bilateral subinternal limiting membrane macular hemorrhage with megaloblastic anemia without thrombocytopenia and other retinal features of anemic retinopathy. PMID:27050355

  8. Pancytopenia due to iron deficiency worsened by iron infusion: a case report

    PubMed Central

    Ganti, Apar Kishor; Shonka, Nicole A; Haire, William D

    2007-01-01

    Introduction Iron deficiency anemia is commonly associated with thrombocytosis, although thrombocytopenia has been reported in occasional patients with iron-deficiency anemia. Much less common is the development of thrombocytopenia following replenishment of iron stores. Case Presentation We present the unusual case of a 39 year old African American female Jehovah's Witness who presented with a 10 month history of menorrhagia and pancytopenia. Laboratory investigations confirmed a severe iron deficiency. Since blood transfusion was unacceptable to her, she was started on intravenous iron replacement therapy. This precipitated a sudden drop in both her platelet and white blood cell counts. Histopathological examination of the bone marrow revealed a hypercellular marrow with orderly trilineage hematopoiesis, iron deficiency anemia, granulocytic hyperplasia, and mild megakaryocytic hypoplasia. Both her white blood cell and platelet counts recovered uneventfully with continuing iron supplementation. The possible mechanism for this phenomenon is discussed in this report. Conclusion This case illustrates two rather uncommon associations of a very common problem. Severe iron deficiency anemia may be associated with pancytopenia and iron replacement may cause a transient decline in megakaryopoiesis and leukopoiesis. Severe iron deficiency should be added to the list of conditions leading to thrombocytopenia. PMID:18067664

  9. Phytocontact dermatitis due to Ranunculus arvensis mimicking burn injury: report of three cases and literature review.

    PubMed

    Akbulut, Sami; Semur, Heybet; Kose, Ozkan; Ozhasenekler, Ayhan; Celiktas, Mustafa; Basbug, Murat; Yagmur, Yusuf

    2011-01-01

    Ranunculus arvensis (corn buttercup) is a plant species of the genus Ranunculus that is frequently used in the Far East to treat rheumatic diseases and several dermatological disorders. In Turkey, the plant is seen in the eastern and southeastern Anatolian highlands, which are underdeveloped areas of the country. Herein, we report three patients who used Ranunculus arvensis for the treatment of arthralgia and osteoarthritis. A distinctive phytodermatitis developed on the right thumb in one patient (48-year-old male), on the anterior aspect of both knees in another patient (70-year-old female) and all around both knees in a third (59-year-old female). The patients were treated with topical antibiotics and daily wound dressing, and none of them experienced any complications. Ranunculus arvensis was confirmed as the cause of the phytodermatitis in the three cases. Poultices of plants applied to the skin demonstrate beneficial effects on many dermatological and rheumatic diseases; however, they have several adverse effects that should not be ignored. In this study, we also present a review of 25 cases reported in the literature. PMID:21408003

  10. Spinal cord compression due to extramedullary hematopoiesis associated with polycythemia vera--case report.

    PubMed

    Ohta, Yuzuru; Shichinohe, Hideo; Nagashima, Kazuo

    2002-01-01

    A 69-year-old woman with a 14-year history of polycythemia vera suffered progressive paraparesis due to epidural involvement of hematopoietic tissue. Magnetic resonance (MR) imaging demonstrated extensive epidural masses. Decompressive surgery and radiotherapy were performed and she made an almost complete clinical recovery. Serial MR imaging showed no regrowth of the other epidural masses. Extramedullary hematopoiesis occurs in patients with various hematologic disorders involving a chronic increase in the production of red blood cells, and is often associated with thalassemia, but is less common with polycythemia vera. The most frequent sites are the spleen, liver, and kidney. Extramedullary hematopoietic tissue occurring within the spinal canal and causing cord compression is very rare. Total surgical excision is not usually feasible because of the diffuse nature of extramedullary hematopoietic tissue and the possibility of recurrence, but acute neurological deterioration does require emergency surgery. Extramedullary hematopoiesis is radiosensitive and displays a rapid response to low dosages, so radiation therapy is recommended for residual tumors. Considering the possibility of central nervous system extramedullary hematopoiesis in patients with polycythemia vera, an early diagnosis is necessary for a favorable prognosis. PMID:11902077

  11. [Wernicke's encephalopathy due to excessive intake of isotonic drink; report of 2 cases].

    PubMed

    Hiraki, Akiyoshi; Kikuchi, Masahiro

    2014-01-01

    Wernicke's encephalopathy (WE) is an acute neurological disease resulting from thiamine (vitamin B1) deficiency. WE is often caused by an unbalanced diet or excessively strict diet therapy in pediatric cases. We experienced 2 cases of WE due to excessive intake of isotonic drink. Patient 1 was a 15-month-old boy. After frequent vomiting, he presented with mental status changes, ocular abnormalities, and truncal ataxia (the classic triad). Patient 2 was a 7-month-old boy. He was hospitalized because of status epilepticus. In both cases, the clinical symptoms improved immediately after the administration of vitamin B1. However, mental retardation was observed as a neurological sequel in patient 2. Because many patients with WE present with vomiting at an early stage, we should take care not to confuse WE with gastroenterocolitis. In addition, it should be noted that some patients with WE present with seizure. Because these 2 cases resulted from an unbalanced diet, it is important to evaluate the patients' eating and drinking habits and advise their parents on proper nutrition. Since many people believe that isotonic drinks are very beneficial and consume them frequently, we should promote awareness that they can be harmful when consumed in excess. PMID:24620429

  12. [Progressive Intracranial Hypertension due to Superior Sagittal Sinus Thrombosis Following Mild Head Trauma: A Case Report].

    PubMed

    Suto, Yuta; Maruya, Jun; Watanabe, Jun; Nishimaki, Keiichi

    2015-07-01

    Cerebral venous sinus thrombosis after mild head trauma without skull fracture or intracranial hematoma is exceptionally rare. We describe an unusual case of progressive intracranial hypertension due to superior sagittal sinus thrombosis following mild head trauma. A 17-year-old boy presented with nape pain a day after a head blow during a gymnastics competition (backward double somersault). On admission, he showed no neurological deficit. CT scans revealed no skull fractures, and there were no abnormalities in the brain parenchyma. However, his headache worsened day-by-day and he had begun to vomit. Lumbar puncture was performed on Day 6, and the opening pressure was 40 cm of water. After tapping 20 mL, he felt better and the headache diminished for a few hours. MR venography performed on Day 8 revealed severe flow disturbance in the posterior third of the superior sagittal sinus with multiple venous collaterals. Because of the beneficial effects of lumbar puncture, we decided to manage his symptoms of intracranial hypertension conservatively with repeated lumbar puncture and administration of glycerol. After 7 days of conservative treatment, his symptoms resolved completely, and he was discharged from the hospital. Follow-up MR venography performed on Day 55 showed complete recanalization of the superior sagittal sinus. The exact mechanism of sinus thrombosis in this case is not clear, but we speculate that endothelial damage caused by shearing stress because of strong rotational acceleration or direct impact to the superior sagittal sinus wall may have initiated thrombus formation. PMID:26136327

  13. Diagnostic dilemmas due to fish bone ingestion: Case report & literature review

    PubMed Central

    Beecher, Suzanne M.; O’Leary, Donal Peter; McLaughlin, Ray

    2015-01-01

    Introduction The diagnosis of abdominal complications due to fish bone ingestion is particularly difficult as the presentation may mimic common abdominal pathologies. Presentation of case 65 year-old male presented with a two day history of right iliac fossa pain. He denied any nausea and vomiting. He had no systemic systems including fever, change in bowel habit. He had tenderness and guarding localized to the right iliac fossa. He had raised inflammatory markers. A CT scan of the abdomen was performed which showed fat standing in proximity to the terminal ileum, with the appearance of Crohn’s disease. The clinical picture did not match the imaging and so the patient underwent a diagnostic laparoscopy. Findings included an acutely inflamed terminal ileum. A foreign body was identified piercing through at the small bowel wall at the terminal ileum. The foreign body was removed and revealed a fish bone. Intracorporeal sutures were inserted at the site of the microperforation. The patient was discharged well two days post operatively. Discussion Fish bone perforation is not a common cause of gastrointestinal perforation. Unfortunately the history is often non-specific and these people can be misdiagnosed with acute appendicitis & other pathologies. CT scans can be useful to aid diagnostics. It is not however fully sensitive in detecting complications arising from fishbone ingestion. Conclusion Management therefore, should be based taking into account primarily the clinical picture & may necessitate diagnostic laparoscopy. PMID:26188981

  14. Idiopathic systemic granulomatous pathology causing sudden death due to myocarditis: a rare case report.

    PubMed

    Singh, Harpal; Kundal, Ramesh

    2015-01-01

    Idiopathic granulomatous myocarditis is extremely rare, particularly since the introduction of drugs effective against tuberculosis (TB), viruses, fungi and the effective treatment of sarcoidosis. Here is a case of a 65-year-old female prisoner having history of sudden collapse and ultimately death. Autopsy findings of various viscera on histopathological examination show granulomatous pathology, that is, in spleen, liver and in the left ventricular wall of heart. Ziehl-Neelsen staining of the sections show the absence of acid fast bacilli, negative for fungal staining as most of the granulomas are noncaseating type with presence of giant cells having no asteroid body and Schuamann body, real-time polymerase chain reaction for TB is negative. Idiopathic giant cell myocarditis is a disease of relatively young adults, that is, between 3 rd and 4 th decade of life. So, this case is strongly considered to be a case of sudden death due to myocarditis as a result of idiopathic systemic granulomatous pathology, a rare case in in literature. PMID:25673606

  15. [Case Report of Cerebellar Vermis Arteriovenous Malformation Presenting with Hydrocephalus due to Aqueductal Stenosis].

    PubMed

    Ono, Kenichiro; Oishi, Hidenori; Suga, Yasuo; Yamamoto, Munetaka; Nonaka, Senshu; Nakajima, Madoka; Miyajima, Masakazu; Arai, Hajime

    2015-09-01

    A 56-year-old man complained of gait disturbance and confused thinking. Magnetic resonance imaging(MRI)revealed an arteriovenous malformation(AVM)of the cerebellar vermis(Spetzler-Martin grade IV)causing hydrocephalus. One dilated precentral cerebellar vein was compressing the aqueduct. After feeder embolization over 3 sessions using N-butyl cyanoacrylate(NBCA), the nidus was reduced to one-third in size. However, symptoms remained unimproved, and endoscopic third ventriculostomy(ETV)was performed. The third ventricle showed thinning of the floor, with a fenestration in part of the floor. Radiological findings and clinical symptoms improved, and the patient returned home after rehabilitation. The condition of the patient remained stable as of six months later. On angiography, the draining vein showed a pressure of 20 mmHg with no change in the residual AVM. Embolization alone achieved a reduction in nidus volume, but could not reduce venous pressure, and combination therapy including ETV proved necessary. Cases with hydrocephalus due to aqueductal stenosis by AVM are extremely rare. This pathology is discussed with reference to the literature. PMID:26321699

  16. Burn due to misuse of an acetylene gas burner: a case report.

    PubMed

    Shimada, K; Aoki, Y; Ide, Y; Ishikura, N; Kawakami, S

    1999-11-01

    A rare case of deep penetrating burn injury caused by misuse of a high-pressure acetylene burner is reported. A 35 year old man was admitted with second and third degree burns involving the right arm cubital area and a subcutaneous burn on his right arm caused by a high-pressure acetylene gas flame. Early surgical debridement and secondary skin grafting using a preserved subcutaneous vascular network skin graft (PSVNSG) proved effective in this patient. Skin contracture was prevented and function was recovered. The basis of PSVNSG is that the vascular system existing in the graft is used as a permanent vascular system without degeneration. This case shows that, in this kind of burn injury, subcutaneous tissue damage should be suspected and that it is important to perform surgical debridement early after admission. PMID:10563697

  17. Steady hydrodynamic loads due to vortex shedding from the OTEC cold water pipe. Final report

    SciTech Connect

    Griffin, O.M.

    1982-01-13

    This report is limited in scope to consideration of the problems caused by vortex shedding from flexible, bluff cylinders in steady current flows, as these problems apply to the OTEC cold water pipe. In particular, the steady deflections caused by the amplified drag forces that accompany vortex-excited oscillations are considered. Emphasis placed upon the discussion of design methods, applications of these methods to practical problems, and comparison with available experimental data. A discussion is given of laboratory and field studies that have been conducted with model OTEC cold water pipes. Various devices that have been developed for the suppression of vortex-excited oscillations also are discussed. A comparison is made of the effectiveness of various suppresion devices and procedures, and practical approaches to implementing their application are presented. The implications of vortex-induced hydrodynamic drag and the suppression of vortex-excited oscillations in OTEC cold water pipe design are discussed briefly.

  18. The occurrence of a strangulated ileus due to a traumatic transmesenteric hernia: report of a case.

    PubMed

    Kuga, T; Taniguchi, S; Inoue, T; Zempo, N; Esato, K

    2000-01-01

    We report herein the case of a 6-year-old boy in whom a strangulated ileus was caused by a traumatic transmesenteric hernia. The boy had fallen from his bicycle and suffered a severe blow to the abdomen. Abdominal pain and vomiting developed 10 h after the accident and he was admitted to our hospital. Abdominal ultrasonogram and computed tomogram demonstrated ascites, intestinal wall thickening with fluid, and an engorged radiating mesenteric vasculature. Thus, an emergency laparotomy was performed which revealed bloody ascites, a strangulated ileus, and torsion with a transmesenteric hernia. The necrotic intestine was resected and an anastomosis was performed. Macroscopic and microscopic findings revealed a traumatic mesenteric rent. The unusual presentation of this case is discussed. PMID:10883470

  19. Thoracolumbar Scoliosis Due to Cryptococcal Osteomyelitis: A Case Report and Review of the Literature.

    PubMed

    Li, Zheng; Liang, Jinqian; Shen, Jianxiong; Qiu, Guixing; Weng, Xisheng

    2016-02-01

    Cryptococcus neoformans causes opportunistic infections in immunocompromised patients, with vertebral osteomyelitis being a very rare involvement.This study is to present a case of thoracolumbar scoliosis occurring in the setting of cryptococcal osteomyelitis.Pharmacological intervention with anticryptococcal medicine and medical management of immune hemolytic anemia were administered. After initial acute stabilization, she underwent spinal debridement and fusion on October 29, 2008. She eventually recovered fully from this episode with no subsequent mechanical instability or neurological deficits on subsequent clinic follow-ups.To the best of our knowledge, there have been no reports describing the onset of spinal cryptococcal osteomyelitis along with immune hemolytic anemia. We suggest a comprehensive algorithm for the diagnosis of vertebral cryptococcal osteomyelitis. PMID:26844472

  20. Case Report: Pulmonary Alveolar Calcification as a Result of Severe Hypercalcemia due to Acute Lymphoblatic Leukemia.

    PubMed Central

    Colleti Junior, Jose; Carla Armelin Benites, Eliana; Spadaccia dos Santos Fernandes, Gustavo; Antonio Freddi, Norberto; Koga, Walter; Brunow de Carvalho, Werther

    2015-01-01

    Severe hypercalcemia is a rare metabolic disorder in pediatric medicine. This report describes a rare case of severe hypercalcemia and its clinical manifestations in a 2-year-old toddler. The radiological findings caused by hypercalcemia and osteolysis were emblematic of the osteolytic lesions. Hypercalcemia led to massive pulmonary alveolar calcification. The hypercalcemia was successfully treated with pamidronate, a bisphosphonate drug class. Further investigation resulted in a diagnosis of acute lymphoblastic leukemia (ALL). The patient is currently on chemotherapy and has a favorable prognosis. Although severe hypercalcemia alone is an unusual finding as the first sign for ALL, this should be considered, not to mention the radiological images resulted from calcium deposits. PMID:26213611

  1. Transient bacteraemia due to Chryseobacterium indologenes in an immunocompetent patient: a case report and literature review.

    PubMed

    Esposito, Silvano; Russo, E; De Simone, G; Gioia, R; Noviello, S; Vitolo, M; Rega, M R; Massari, A; Posteraro, L

    2015-12-01

    A 51-year-old woman was admitted to the emergency unit with diffuse headache, visus reduction, and paraesthesias of the trigeminal area and the left hand. Three days after admission she showed shaking chills, vomiting, and sudden onset of fever (39·4°C). Blood cultures were performed soon after fever onset. Fever persisted for the whole day, decreasing slowly after 12 hours. No empirical antibiotic treatment was started in order to better define the diagnosis. Fever completely disappeared the day after. Two blood cultures for aerobes were positive for Chryseobacterium indologenes. The patient was discharged with the diagnosis of transient bacteraemia and transferred to the neurology unit for further investigations. C. indologenes infections are described in 31 studies with a total of 171 cases (pneumonia and bacteraemia being the most frequent). Our case is the first report of transient bacteraemia caused by C. indologenes in an immunocompetent, non-elderly patient without needing medical devices. PMID:25096711

  2. Bilateral Femoral Neck Fatigue Fracture due to Osteomalacia Secondary to Celiac Disease: Report of Three Cases.

    PubMed

    Selek, Ozgur; Memisoglu, Kaya; Selek, Alev

    2015-08-01

    Bilateral non traumatic femoral neck fatigue fracture is a rare condition usually occurring secondary to medical conditions such as pregnancy, pelvic irradiation, corticosteroid exposure, chronic renal failure and osteomalacia. In this report, we present three young female patients with bilateral femoral neck fracture secondary to osteomalacia. The underlying cause of osteomalacia was Celiac disease in all patients. The patients were treated with closed reduction and internal fixation with cannulated lag screws. They were free of pain and full weight bearing was achieved at three months. There were no complications, avascular necrosis and nonunion during the follow up period. In patients with bone pain, non traumatic fractures and muscle weakness, osteomalacia should be kept in mind and proper diagnostic work-up should be performed to identify the underlying cause of osteomalacia such as celiac disease. PMID:26265523

  3. Infection due to Rhizomucor pusillus: report of four cases in patients with leukemia and review.

    PubMed

    St-Germain, G; Robert, A; Ishak, M; Tremblay, C; Claveau, S

    1993-05-01

    Rhizomucor pusillus, a thermophilic fungus of the order Mucorales, is a rare cause of human infection. A search of the literature has produced only seven reports describing nine cases of infection caused by this organism. Recently, over a period of 17 months, four cases of R. pusillus infection in patients with leukemia were diagnosed: a cluster of three cases in a Montreal hospital and one isolated case from Quebec City. All four cases were proven both by histopathologic examination and by culture of tissues. In three cases, pulmonary involvement was confirmed following lung surgery, and in one case, disseminated infection was observed at autopsy. All patients received amphotericin B, and two underwent surgical debridement; however, none of the patients survived. PMID:8507755

  4. Acute Presentation of Lumbar Spinal Schwannoma Due to Torsion: A Case Report

    PubMed Central

    Khanna, Ryan; Ortmeier, Thomas C; Tapia-Zegarra, Gino G; Lindley, Timothy E; Smith, Zachary A; Dahdaleh, Nader S

    2016-01-01

    Although schwannomas are common spinal tumors with insidious presentations, acute neurological deterioration is an extremely rare manifestation that can occur in the setting of tumor torsion and infarction. The present case reports an unusual presentation of a spinal schwannoma that underwent torsion and infarction. A 65-year-old male presented initially with acute radicular pain progressing to cauda equina syndrome and confusion. MRI of the lumbar spine revealed an intradural extramedullary lesion at the level of L1/L2 measuring 1.1x0.9 cm. Intraoperatively, a reddish mass was seen caudally twisted around itself. Gross total resection was achieved with a final diagnosis of schwannoma with areas of infarction. At his six week follow up clinical visit, the patient was asymptomatic and his neurological exam was normal. The neurosurgeon should be aware of such atypical radiographic and clinical presentation amongst the spectrum of clinical manifestation of these nerve sheath tumors. 

  5. Sudden Death in Sauna Due to Fatal Burns: A Case Report.

    PubMed

    Lindroos, Katarina; Keltanen, Terhi

    2016-03-01

    Sudden death during or after sauna bathing is a rare event. When occurring accidentally, it is often caused or contributed by consumption of ethanol. To accidentally burn to death because of hot air is highly uncommon without some contributing factor that lowers the person's consciousness. Hot air burns have been reported to develop in 20 to 60 minutes. We present a case of sudden death of a healthy man with rare and extensive hot air burns that developed in less than 10 minutes in the sauna. Ethanol was not a contributing factor. Substantial injuries were found at the autopsy, both external and internal, for instance, small hemorrhages in the stomach mucosa, indicating a heavy antemortem stress reaction. The most probable reason for the extensive scalds was concluded to be, apart from the high temperature, the high degree of relative humidity in the sauna. PMID:26566054

  6. Retroperitoneal fibrosis and obstructive uropathy due to actinomycosis: case report of a treatment approach.

    PubMed

    Yagmurdur, Mahmut Can; Akbulut, Sami; Colak, Aysel; Aygun, Cem; Haberal, Mehmet

    2009-01-01

    An actinomycotic retroperitoneal infection usually occurs in the presence of an intrauterine device (IUD). It can result in pelvic inflammatory disease and diffuse retroperitoneal fibrosis. A 39-year-old patient was admitted to the emergency unit with left flank pain. A computed tomography scan of the abdomen showed bilateral hydroureteronephrosis and a retroperitoneal malignant mass. Other tumors were excluded with a colonoscopy and an upper gastrointestinal endoscopy. Results of a fine needle aspiration biopsy showed fibrosis compatible with retroperitoneal mesenteritis. Double-J stents were placed in both ureters, and immunosuppressive therapy was started. The patient had clinical and radiologic responses to the therapy. A bilateral ureterolysis and sigmoid colon resection were done. The pathology report showed fibrosis and Actinomyces israelii infection. Parenteral and oral penicillins were administered. The probability of an Actinomyces infection in patients with retroperitoneal fibrosis should be kept in mind, especially in cases in which the patient has an intrauterine device. PMID:20302022

  7. [Hypokalemia, hypovolemia and electrocardiographic changes due to furosemide abuse. Report of one case].

    PubMed

    Aravena, César; Salas, Ignacio; Tagle, Rodrigo; Jara, Aquiles; Miranda, Rodrigo; McNab, Paul; Rodríguez, José A; Valdés, Gloria; Valdivieso, Andrés

    2007-11-01

    Hypokalemia (serum K+ < 3.5 mEq/1) is a potentially serious adverse effect of diuretic ingestion. We report a 27 year-old woman admitted with muscle weakness, a serum potassium of 2.0 mEq/1, metabolic alkalosis and EKG abnormalities simulating cardiac ischemia, that reverted with potassium chloride administration. She admitted high dose furosemide self-medication for edema. Glomerular filtration rate, tubular sodium reabsorption, potassium secretion, the renin-aldosterone system, total body water distribution and capillary permeability, were studied sequentially until 90 days after her admission. There was hyperactivity of the renin-aldosterone axis, reduction in extracellular and intracellular volumes, normal capillary permeability and high sodium tubular reabsorption, probably explained by a "rebound" salt retention associated with her decreased extracellular volume. PMID:18259658

  8. Cerebral salt wasting syndrome due to tuberculous meningitis; a case report

    PubMed Central

    Ahmad, Syed; Majid, Zain; Mehdi, Mehwish; Mubarak, Muhammed

    2016-01-01

    A 58-year-old male presented with fever, nausea, and vomiting since 15 days along with irritability and confusion since 5 days. His laboratory reports showed low serum sodium, serum osmolality and uric acid. Computerized tomography (CT) scan of brain revealed age-related changes. While on lumbar puncture (LP) and cerebrospinal fluid (CSF) examination, CSF protein, lactate dehydrogenase (LDH) and total leukocyte count (predominant lymphocytes) were all increased. On his 14th day of admission, his serum sodium was 116 mEq/l and he had a high urine output. Fluid restriction was tried in order to rule out syndrome of inappropriate antidiuretic hormone secretion (SIADH) but the patient did not respond to it. Keeping in view the above findings, a final diagnosis of tuberculous meningitis leading to cerebral salt wasting syndrome was made. The patient was started on 3% hypertonic saline, mineralocorticoids and anti-tuberculous therapy (ATT), to which he responded favorably and was later discharged.

  9. Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature

    PubMed Central

    Thongpooswan, Supat; Chyn, Eric; Alfishawy, Mostafa; Restrepo, Erfidia; Berman, Charles; Ahmed, Kawser; Muralidharan, Sethu

    2015-01-01

    Patient: Female, 46 Final Diagnosis: CMV gastroparesis and radiculopathy Symptoms: Nausea • paraplegia • urinary retention • vomiting Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases Objective: Unusual clinical course Background: Cytomegalovirus (CMV) infection has been well described as an opportunistic infection of patients with human immunodeficiency virus (HIV). To the best of our knowledge, this is the first case report of a patient with AIDS and lumbosacral polyradiculopathy, associated with gastroparesis resulting from CMV infection. Case Report: A 46-year-old Hispanic woman with a history of HIV for 10 years was admitted to our hospital for nausea, vomiting, urinary retention, and generalized weakness. Bilateral lower extremity examination revealed flaccid paraplegia, decreased sensations from the groin downwards, bilateral lower extremity areflexia, and absent plantar reflexes, with enlarged urinary bladder. CMV was detected in CSF by PCR, and cervical and lumbar magnetic resonance imaging (MRI) revealed intense nodular leptomeningeal enhancement from the lower thoracic cord and extending along the conus medullaris/filum terminalis and nerve roots. Gastric emptying scintigraphy revealed severe delayed gastric emptying time. Ganciclovir was initiated and her neurological symptoms and gastrological symptoms gradually improved. Over 8 weeks, nausea and vomiting resolved and the patient was able to walk before being discharged from the hospital. Conclusions: Polyradiculopathy and gastroparesis can result from CMV infection in AIDS patients. Whether the mechanism is secondary to viral infection or immune systems remains unclear. It is important for physicians to be aware of this uncommon presentation in the antiretroviral therapy (ART) era. CMV treatment should be initiated immediately once diagnosis is confirmed. PMID:26552851

  10. "Syndrome in syndrome": Wernicke syndrome due to afferent loop syndrome. Case report and review of the literature.

    PubMed

    D'Abbicco, D; Praino, S; Amoruso, M; Notarnicola, A; Margari, A

    2011-01-01

    Wernicke syndrome is a rare neurological pathology due to a deficit in vitamin B1. The syndrome is common among alcohol abusers, patients with malignant tumor or gastrointestinal diseases, those who undergo hemodialysis or long-term peritoneal dialysis, pregnant women with hyperemesis, women who breast-feed, patients with hyperthyroidism or anorexia nervosa or gastric or jejunal-ileal bypass surgery for obesity, patients submitted to gastric surgery or prolonged total parenteral nutrition or prolonged intravenous therapy. We report a case of Wernicke syndrome due to afferent loop syndrome characterized by incoercible vomiting. PMID:22217376

  11. Three-component hydraulic penile prosthesis malfunction due to penile fibrolipoma secondary to augmentative phalloplasty: A case report.

    PubMed

    Antonini, Gabriele; Vicini, Patrizio; De Berardinis, Ettore; Pacchiarotti, Arianna; Gentile, Vincenzo; Perito, Paul

    2015-12-01

    Fibrolipomas are an infrequent type of lipomas. We describe a case of a man suffering from subcutaneous penile fibrolipoma, who twelve months earlier has been submitted to augmentative phalloplasty due to aesthetic dysmorphophobia. The same patient three years earlier has been submitted to three-component hydraulic penile prostheses implantation due to erectile dysfunction. After six months from removing of the mass, the penile elongation and penile enlargement were stable, the prostheses were correctly functioning and the patient was satisfied with his sexual intercourse and life. The diagnostics and surgical characteristics of this case are reported. PMID:26766813

  12. An Italian kindred with FALS due to c.149T>C mutation in the SOD1 gene: case report of an affected family member.

    PubMed

    Trojsi, Francesca; Piccirillo, Giovanni; Femiano, Cinzia; Damiano, Raffaele; Rosaria Monsurrò, Maria

    2013-05-01

    We report the first Italian kindred with Familial Amyotrophic Lateral Sclerosis (FALS) due to c.149T>C mutation in the exon 5 of superoxide dismutase-1 (SOD1) gene. The proband was a 49-year-old woman who came to our observation because of an history of progressive limbs weakness and gait impairment. She belonged to a family of 24 affected members. The prevalent phenotype of the affected members was characterized by slowly progressive spinal impairment with proximal distribution of weakness, and bulbar involvement in advanced stages. We briefly reviewed the few previous reports about the same SOD1 mutation and discussed the hypothesis that structural instability of the mutant codon 149 protein may underlie some toxic effects significantly involved in FALS pathogenesis. PMID:23853506

  13. Vertebral artery dissection due to an esophageal foreign body migration: a case report.

    PubMed

    Benmansour, Najib; Ouattassi, Naouar; Benmlih, Amine; Elalami, Mohamed Noureddine

    2014-01-01

    Unintentional foreign bodies' swallowing is a fairly common occurrence in ENT consultation especially among children. They usually pass through the gastrointestinal tract without complications. Migration of a foreign body through the esophageal wall is rare. It represents about 1% to 4% of all cases of foreign bodies' ingestion. A 16 year's old female patient has presented to ENT emergency with a painful dysphagia following an accidental ingestion of a metallic pin. Cervical X ray confirmed the presence of the pin while endoscopic investigations have shown no foreign body. Cervical CT scan revealed the migration of the foreign body through the esophageal wall with left vertebral artery dissection. Endoscopic management has been sufficient with an uneventful post operative follow up. Esophageal foreign bodies are very diverse mainly dominated by fish bones (60%) and chicken bones (16%). Metallic pins are rare. The major risks of migration of those foreign bodies are cervical abscess, mediastinitis and oeso-vascular fistulae. Cases of self extrusion through the skin have been reported. Migration of a foreign body through the esophageal wall is rare. Endoscopic management has been sufficient. PMID:25018833

  14. Vertebral artery dissection due to an esophageal foreign body migration: a case report

    PubMed Central

    Benmansour, Najib; Ouattassi, Naouar; Benmlih, Amine; Elalami, Mohamed Noureddine

    2014-01-01

    Unintentional foreign bodies‘ swallowing is a fairly common occurrence in ENT consultation especially among children. They usually pass through the gastrointestinal tract without complications. Migration of a foreign body through the esophageal wall is rare. It represents about 1% to 4% of all cases of foreign bodies‘ ingestion. A 16 year's old female patient has presented to ENT emergency with a painful dysphagia following an accidental ingestion of a metallic pin. Cervical X ray confirmed the presence of the pin while endoscopic investigations have shown no foreign body. Cervical CT scan revealed the migration of the foreign body through the esophageal wall with left vertebral artery dissection. Endoscopic management has been sufficient with an uneventful post operative follow up. Esophageal foreign bodies are very diverse mainly dominated by fish bones (60%) and chicken bones (16%). Metallic pins are rare. The major risks of migration of those foreign bodies are cervical abscess, mediastinitis and oeso-vascular fistulae. Cases of self extrusion through the skin have been reported. Migration of a foreign body through the esophageal wall is rare. Endoscopic management has been sufficient. PMID:25018833

  15. Pneumatosis intestinalis due to gastrointestinal amyloidosis: A case report & review of literature

    PubMed Central

    Khalid, Filza; Kaiyasah, Hadiel; Binfadil, Wafa; Majid, Maiyasa; Hazim, Wessam; ElTayeb, Yousif

    2016-01-01

    Introduction Pneumatosis intestinalis (PI) is not a disease but a radiological finding with a poorly understood pathogenesis. It can be divided into primary/idiopathic (15%) or secondary (85%) Kim et al. 2007, based on the factors thought to play a role in its development. Amongst the rare causes of secondary PI is gastrointestinal (GI) amyloidosis. Presentation of the case We report a case of a 46-year-old gentleman who presented with a one month history of acute on chronic abdominal pain, associated with one episode of melena. Upon further investigation, he was found to have pneumoperitoneum. He was taken to the operating theatre, where he was noted to have features of pneumatosis intestinalis of the small bowel with no evidence of bowel perforation. Postoperatively, he underwent an upper GI endoscopy with biopsies that revealed GI amyloidosis. Discussion One of the rare causes that can lead to secondary PI is GI amyloidosis as proven in our case. Patients with symptomatic gastrointestinal amyloidosis usually present with one of four syndromes: gastrointestinal bleeding, malabsorption, protein-losing gastroenteropathy, and, less often, gastrointestinal dysmotility. Conclusion GI amyloidosis is a rare cause of secondary pneumatosis intestinalis. The presentation of the disease varies from patient to patient, therefore, the management should be tailored accordingly. PMID:27085104

  16. [Total A-V block due to tuberous sclerosis. A case report].

    PubMed

    Valente, N; Guidugli Neto, J; De Paola, A A; Pimenta, J

    1989-10-01

    Tuberous sclerosis is a neurologic disease affecting various organs with a triade: sebaceum adenoma, mental retardation and seizures. This report presents a case of a patient with tuberous sclerosis and third degree A-V block with complete invasive and non-invasive evaluation. The patient had sincope and complete A-V block with QRS complexes showing right bundle branch block morphology. The echocardiogram showed dilated cardiomyopathy with diffuse left ventricular dysfunction and had normal coronary arteriography. The eletrophysiologic evaluation showed complete infra-hisian A-V block and QRS with left bundle branch block pattern with normal sinus nodal and A-V nodal function. It was not possible to induce ventricular tachtyarrhythmias up to two extrastimuli. Histologic study showed normal myocardium under light and electronic microscopy. After permanent VVI pacemaker implant, the patient in follow-up for 16 years. This case seems to be the first in the international medical literature of tuberous sclerosis with complete heart block. PMID:2629681

  17. Medical neglect death due to acute lymphoblastic leukaemia: an autopsy case report.

    PubMed

    Usumoto, Yosuke; Sameshima, Naomi; Tsuji, Akiko; Kudo, Keiko; Nishida, Naoki; Ikeda, Noriaki

    2014-12-01

    We report the case of 2-year-old girl who died of precursor B-cell acute lymphoblastic leukaemia (ALL), the most common cancer in children. She had no remarkable medical history. She was transferred to a hospital because of respiratory distress and died 4 hours after arrival. Two weeks before death, she had a fever of 39 degrees C, which subsided after the administration of a naturopathic herbal remedy. She developed jaundice 1 week before death, and her condition worsened on the day of death. Laboratory test results on admission showed a markedly elevated white blood cell count. Accordingly, the cause of death was suspected to be acute leukaemia. Forensic autopsy revealed the cause of death to be precursor B-cell ALL. With advancements in medical technology, the 5-year survival rate of children with ALL is nearly 90%. However, in this case, the deceased's parents preferred complementary and alternative medicine (i.e., naturopathy) to evidence-based medicine and had not taken her to a hospital for a medical check-up or immunisation since she was an infant. Thus, if she had received routine medical care, she would have a more than 60% chance of being alive 5 years after diagnosis. Therefore, we conclude that the parents should be accused of medical neglect regardless of their motives. PMID:25895240

  18. Death due to ingestion of nicotine-containing solution: case report and review of the literature.

    PubMed

    Solarino, Biagio; Rosenbaum, Frank; Riesselmann, Benno; Buschmann, Claas T; Tsokos, Michael

    2010-02-25

    Nicotine, a lipid-soluble alkaloid obtained from the dried leaves of Nicotiana, is most frequently encountered in tobacco products for smoking, chewing or sniffing as well as in a limited number of pesticides. Though nicotine is one of the most toxic drugs of abuse, it has rarely led to fatalities. Sudden death can be caused by cardiovascular arrest, respiratory muscle paralysis and/or central respiratory failure. A 42-year-old man was found dead by his wife. He was lying on the floor, next to a box containing many empty bottles of beer and vodka. Some labeled chemical bottles found at the scene contained various substances, including nicotine and brucine. Gross examination of the organs at autopsy revealed no specific findings. The toxicological examination failed to disclose any lethal toxic agents other than a high concentration of nicotine and its primary metabolite cotinine in femoral venous blood (2.2 microg/mL). Blood alcohol was determined to be 2.1 g/L in femoral venous blood. Only a paucity of fatal cases of nicotine poisoning has been reported in the literature so far. PMID:19954906

  19. AB076. Congenital hyperinsulinism due to mutation of HNF4A: a case report

    PubMed Central

    Duong, Dang Anh; Dung, Vu Chi; Dat, Nguyen Phu; Ngoc, Can Thi Bich; Thao, Bui Phuong; Khanh, Nguyen Ngoc; Dien, Tran Minh

    2015-01-01

    Background Hyperinsulinemic hypoglycemia (HH) is the commonest cause of persistent hypoglycemia in the neonatal and infancy periods. HNF4A mutations are the third most common cause of diazoxide responsive congenital hyperinsulinism. Individuals carrying HNF4A mutations that result in familial monogenic diabetes later in life can present in early infancy with hyperinsulinism. The study was to describe a child associated with HH due to mutations in the HNF4A gene. Methods Clinical data were obtained from chart review. Gene sequencing of HNF4A was performed. Results At the National Hospital of Pediatric from January 2007 to April 2015. We have 68 cases with congenital hyperinsulinism diagnosed and molecular analysis. Mutation HNF4A gene found 1/68 cases (1.47%). A boy born large for gestational age (birth weight 4,700 g with 40 gestation weeks) after an uneventful pregnancy, presented 24 h after birth with lethargy, poor feeding, cyanosis, no seizure caused by severe hypoglycaemia (serum glucose 0.5 mmol/L). Hypoglycaemia was treated with 2 mL/kg 10% glucose i.v. followed by a continuous i.v. glucose infusion (9.57 mg/kg/min) to maintain serum glucose above 3 mmol/L. Laboratory investigations at the time of hypoglycaemia showed inadequate suppression insulinemia (57.9 pmol/L) and C-peptide (0.38 nmol/L), negative ketone bodies, absent urine ketone bodies, hyperammonemia (365.1 µg/dL), hypofattyacidaemic. His mother had three pregnancies [the first boy born with 35 gestational weeks (birth weight 2,800 g), died 2 days after birth with cyanosis unknown causes, the second 28 gestational weeks boy, died some hours after birth with cyanosis unknown causes]. A diagnosis of ‘hyperinsulinism’ was made. Molecular analysis showed he is heterozygous for a novel HNF4A missense mutation on location Exon 6, protein description p.Leu220Pro (p.L220P) from his mother. The leucine residue at codon 220 is highly conserved across species and it is therefore likely, although not certain, that the p.L220P mutation is pathogenic. Treatment was started with diazoxide (10 mg/kg per day in three doses) and had good response and stopped diazoxide after 2 weeks with normal glucose level and normal. Up to now, he is 5 years old with normal growth and development, normal glucose level. Conclusions Babies who inherit the HNF4A gene often have a high birth weight (over 4 kg) and may have low blood sugars early in life (neonatal hypoglycaemia) needing treatment immediately after birth. HNF4A mutations responses well to diazoxide.

  20. AB130. Pseudoaldosteronism due to mutation of SCNN1A gene: a case report

    PubMed Central

    Can, Ngoc Thi Bich; Vu, Dung Chi; Bui, Thao Phuong; Nguyen, Khanh Ngoc; Zennaro, Maria-Christina; Wudy, Stefan A.

    2015-01-01

    Background Pseudohypoaldosteronism type 1 (PHA1) is a rare inherited disease characterized by resistance to the actions of aldosterone. It was first described in 1958 by Cheek and Perry, and common clinical manifestations include salt wasting, hyperkalaemia, metabolic acidosis and elevated plasma aldosterone levels in the neonatal period. Objective To describe clinical characteristics, laboratory features and management of one Vietnamese patient with pseudohypoaldosteron. Methods Clinical features, biochemical finding, mutation analysis and management in a 1 month-old-boy was studied. Based on analysis of this patient’s clinical symptoms associated with biochemical examination, the urinary steroid metabolomics analysis was performed using gas chromatography spectrometry and mutation analysis of SCNN1A was performed using PCR & direct sequencing. Results Patient is the first child normal delivery with the gestation age of 41 weeks, birth weight of 3,200 g, and onset of the disease at 7 days of age. He presented with lost weight, dehydration without vomit, diarrhea or hyperpigmentation. He was admitted with the features of cyanosis, allorhythmic, electrolyte imbalance with sodium of 119 mmoL/L, potassium of 7.4 mmoL/L. Investigation show pH 7.26, PCO2 34 mmHg, PO2 110 mmHg, HCO3- 18 mmoL/L, BE -10, plasma 17OHP level: 2.4 ng/mL, testosterone level: 1.94 nmoL/L, Cortisol 8am: 2,662.8 pmoL/L, Ure 7.4 mmoL/L, Creatinine 44.2 µmoL/L, Glucose 4.8 mmoL/L. The urine steroid metabolomics analysis showed extensive excretion of aldosterone ID-ISTD1 of 1,157.41 µg/L. Novel homozygous mutation (c.1668C > A; p.S556R) of SCNN1A gene was identified in the proband. He was treated with florinef of 0.1 mg/kg/day for electrolyte balance. He had complication of intestinal perforation and died due to infection. In conclusions, PHA1 causes severe hyponatremia, metabolic acidosis, and life-threatening hyperkalemia, with normal 17-a-hydroxyprogesterone levels and high excretion of aldosterone levels.

  1. Celiac trunk and branches dissection due to energy drink consumption and heavy resistance exercise: case report and review of literature.

    PubMed

    González, Wilma; Altieri, Pablo I; Alvarado, Enrique; Banchs, Héctor L; Colón, Edgar; Escobales, Nelson; Crespo, María

    2015-01-01

    Higher doses and consumption of energy drinks leads to cardiovascular effects and potential consequences. Principal components found in energy drinks such as caffeine, guarana and taurine has been related to dilatation, aneurysm formation, dissection and ruptures. There is no evidence showing an integration of these components and its effects in endothelium and aortic walls due to higher levels of pressure during exercises. We report a case of a 44 years male with celiac trunk and branches dissection due to long-term consumption of energy drinks and intense exercise routine. Our proposition relates cell and vessel walls alterations including elasticity in endothelial wall due to higher blood pressure, resistance by intense exercise routine and long-term consumption of energy drinks. PMID:26035983

  2. Erythema Ab Igne due to Heating Pad Use: A Case Report and Review of Clinical Presentation, Prevention, and Complications

    PubMed Central

    Milchak, Marissa; Smucker, Joanne; Chung, Catherine G.; Seiverling, Elizabeth V.

    2016-01-01

    Erythema ab igne is an asymptomatic cutaneous condition caused by exposure to heat. Cases of erythema ab igne may prove to be diagnostically challenging due to lack of familiarity with the condition. While this dermatosis carries a favorable prognosis, nonmelanoma skin cancers have been reported to arise within lesions of erythema ab igne. Erythema ab igne is preventable, and, thus, clinicians should provide education regarding safe use of heating devices to patients using these products in both outpatient and inpatient settings. PMID:26880929

  3. Evaluation of the electromagnetic effects due to direct lighting to nuclear explosive areas at Pantex. Final report

    SciTech Connect

    Merewether, K.O.; Chen, K.C.

    1993-11-01

    This report summarizes the effort to quantify the electromagnetic environments in the nuclear explosive areas at Pantex due to direct lightning. The fundamental measure of the threat to nuclear safety is assumed to be the maximum voltage between any two points in an assembly area, which is then available for producing arcing or for driving current into critical subsystems of a nuclear weapon. This maximum voltage has been computed with simple analytical models and with three-dimensional finite-difference computer codes.

  4. Intrathecal Trastuzumab Treatment of the Neoplastic Meningitis due to Breast Cancer: A Case Report and Review of the Literature.

    PubMed

    Dumitrescu, Cristina; Lossignol, Dominique

    2013-01-01

    We report the case of a 65-year-old woman, diagnosed with a breast cancer human epidermal growth factor receptor (HER2) previously negative, who developed leptomeningeal carcinomatosis and was treated with intrathecal (IT) trastuzumab (TST). After five doses of IT trastuzumab, at escalading doses, once weekly, the patient's neurological status stabilised, and that result was maintained for two months. There is evidence in the literature that breast cancer receptor status may change over time, and when it occurs, it may modify the therapeutical approach. We reviewed the pertinent literature and concluded that IT trastuzumab might be a promising treatment for patients with HER2-positive breast cancer leptomeningeal carcinomatosis. PMID:23424693

  5. Intrathecal Trastuzumab Treatment of the Neoplastic Meningitis due to Breast Cancer: A Case Report and Review of the Literature

    PubMed Central

    Lossignol, Dominique

    2013-01-01

    We report the case of a 65-year-old woman, diagnosed with a breast cancer human epidermal growth factor receptor (HER2) previously negative, who developed leptomeningeal carcinomatosis and was treated with intrathecal (IT) trastuzumab (TST). After five doses of IT trastuzumab, at escalading doses, once weekly, the patient's neurological status stabilised, and that result was maintained for two months. There is evidence in the literature that breast cancer receptor status may change over time, and when it occurs, it may modify the therapeutical approach. We reviewed the pertinent literature and concluded that IT trastuzumab might be a promising treatment for patients with HER2-positive breast cancer leptomeningeal carcinomatosis. PMID:23424693

  6. Traumatic rupture of a Meckel’s diverticulum due to blunt abdominal trauma in a soccer game: A case report

    PubMed Central

    Tummers, W.S.; van der Vorst, J.R.; Swank, D.J.

    2015-01-01

    Introduction a Meckel’s diverticulum is one of the most common congenital anomalies of the digestive tract. The reported lifetime complication rate is 4%, mostly due to hemorrhage, obstruction, perforation or inflammation. A symptomatic Meckel’s diverticulum due to rupture after blunt abdominal trauma is very rare. We believe this case report is the first reporting a rupture of a Meckel’s diverticulum after a low velocity blunt abdominal trauma and outlining the importance of a thorough and complete examination of the patient after blunt abdominal trauma. Presentation of case a 17-year-old male presented with abdominal pain after blunt abdominal trauma during a soccer game. Physical examination showed signs of peritonitis in all quadrants of the abdomen. During admission the patient deteriorated with decreasing blood pressure and raising pulse rate. A CT-scan showed free abdominal fluid. Our patient was scheduled for an emergent laparotomy where a perforated Meckel’s diverticulum with fecal spill was found. A segmental ileal resection was performed. Post-operative, patient developed a pneumonia and also intra-abdominal abscesses treated with percutaneous drainage. After an admission period of 17-days the patient was discharged. Conclusion perforation of a Meckel’s diverticulum is rarely suspected as a cause of acute deterioration following blunt abdominal trauma. This case shows the importance of awareness of this kind of injury especially in male patients. PMID:26701844

  7. Recurrent aborted sudden cardiac death with seizures and rhabdomyolysis due to bulimia-induced hypokalemia: report of one case.

    PubMed

    Finsterer, Josef; Stöllberger, Claudia

    2014-06-01

    Recurrent vomiting due to bulimia associated with abuse of furosemide and laxatives causing severe hypokalemia may result in recurrent aborted sudden cardiac death (SCD) and seizures. We report a 25-year-old female with a history of bulimia associated with abuse of furosemide and laxatives since the age of 15 years, migraine since puberty, renal abscesses at age 20 y, and rhabdomyolysis of unknown cause at age 24 y. She experienced aborted SCD due to severe hypokalemia with symptomatic seizures at 21 and 25 years of age. Bulimia patients additionally taking laxatives or furosemide are at particular risk of SCD and rhabdomyolysis and require periodic determination of electrolytes, potassium substitution, and adequate psychiatric therapy and surveillance. PMID:25327327

  8. Spontaneous common bile duct perforation due to chronic pancreatitis, presenting as a huge cystic retroperitoneal mass: a case report

    PubMed Central

    Ya?ar, Bekir; Kebap?, Mahmut

    2009-01-01

    Spontaneous perforation of the bile duct, is a disease in which spontaneous perforation occurs in the wall of the extrahepatic or intrahepatic duct without any traumatic or iatrogenic injury and more often described in neonates. In this report, we present a 38-year-old female patient who underwent surgery due to an intraabdominal cystic mass. The diagnosis of spontaneous rupture of the common bile duct and huge retroperitoneal biloma was made by intraoperative abdominal exploration. The biloma was drained, ruptured portion of the common bile duct was primarily repaired over a T-tube. PMID:19918569

  9. Radiculopathy in the setting of lumbar nerve root compression due to an extradural intraforaminal lipoma: a report of 3 cases.

    PubMed

    Loriaux, Daniel B; Adogwa, Owoicho; Gottfried, Oren N

    2015-07-01

    A true adult spinal lipoma is an exceedingly rare cause of lumbar compression neuropathy. Only 5 cases of true extradural intraforaminal lipomas have been documented in the medical literature. The diagnostic criteria and treatment guidelines for this specific lipoma have yet to be established. This report features 3 histologically confirmed cases of extradural intraforaminal spinal lipomas that recently presented to the authors' practice. In addition, the literature was surveyed to include the 5 previously reported cases of true adult extradural intraforaminal spinal lipomas. The consistency in presentation, response to surgical intervention, and postoperative recovery in these 8 cases supports surgical intervention at the time of diagnosis. The authors' findings support elevated clinical suspicion, efficient diagnosis based on MRI, and early surgical intervention for this rare pathological entity. All cases presented in this report were symptomatic and occurred in the absence of other significant pathologies such as general spinal epidural lipomatosis, intradural lesions, tethering, or severe degenerative stenosis or herniated discs. The clinical, neuroradiological, and histological findings characteristic of a true adult extradural intraforaminal lipoma are emphasized to differentiate this lesion from the more common etiologies for lumbar compression neuropathy. Heightened awareness and clinical suspicion for the focal, foraminal spinal lipoma as a cause of radiculopathy symptoms will enable more efficient diagnosis and treatment. PMID:25840038

  10. A unique cause of a rare disorder, unilateral macromastia due to lymphangiomatosis of the breast: a case report.

    PubMed

    Hynes, Sean O; McLaughlin, Ray; Kerin, Michael; Rowaiye, Babatunde; Connolly, Charles E

    2012-01-01

    Macromastia and in particular unilateral macromastia is a rare clinical entity. It relates to massive enlargement of the breast in non-obese women. This case report describes an initially mild unilateral asymmetry occurring nine months postpartum in a 33-year-old female. However, following her second pregnancy within 12 months, her left breast became severely enlarged. This did not improve on delivery. No discrete lesion was seen on imaging and no significant abnormalities were seen in her blood chemistry. Surgical treatment was a mammoplasty and 580 g of mammary tissue was removed. Grossly, there was spongiform subcutaneous tissue with diffuse extension. On histology, this consisted of a highly complex and diffuse pattern of infiltration and of cavernous empty channels lined by a delicate attenuated endothelium which was CD34 and D2-40 positive. The appearances were consistent with lymphangiomatosis, more commonly encountered in the limbs, heretofore. Lymphangiomatosis has not been previously described in breast tissue and only a single case report exists for such a lesion in axillary tissue. Treatment of such lesions in the periphery by surgical excision is very difficult and excision without being radical can be impossible. Follow up of our patient, shows no evidence of recurrence in this patient. Our case report describes the clinicopathological features, differential diagnosis to be considered and treatment, in addition to reviewing the relevant literature. PMID:22730958

  11. Spontaneous acute epidural hematoma developed due to skull metastasis of hepatocelluar carcinoma: A case report and review of the literature

    PubMed Central

    KIM, YOU-SUB; MOON, KYUNG-SUB; LEE, KYUNG-HWA; JUNG, TAE-YOUNG; JANG, WOO-YOUL; KIM, IN-YOUNG; JUNG, SHIN

    2016-01-01

    Acute epidural hematoma (AEDH) is one of the most common pathological types of head trauma, and may develop without an accidental event, although this is uncommon. The present study reports the case of a 41-year-old male patient that developed spontaneous AEDH due to skull metastasis of hepatocellular carcinoma (HCC). The man was admitted to Chonnam National University Hwasun Hospital and Medical School due to drowsiness and right-sided hemiparesis. A computed tomography scan of the head revealed the presence of a large AEDH and a lytic bone lesion in the left posterior fossa and parieto-occipital region, which exhibited heterogeneous enhancement. The perioperative findings revealed a large amount of mixed-stage epidural hematoma and a soft hemorrhagic mass that exhibited lytic change on the occipital bone. No evidence of head trauma, such as skull fracture or scalp contusion, was detected. The pathological diagnosis was hematoma with metastatic HCC. The current study reports the rare case of a patient with a metastatic tumor located in the skull that resulted in the development of spontaneous AEDH. Once a sudden and unpredicted neurological deficit occurs in a patient with HCC that is also diagnosed with skull metastasis, the possibility of spontaneous AEDH developing from the metastasis should be considered. PMID:26870277

  12. Spontaneous intracranial hemorrhage in children: report of a hemophilia patient who survived due to a brain cyst

    PubMed Central

    Colleti Junior, José; Koga, Walter; de Carvalho, Werther Brunow

    2015-01-01

    We report the case of a 2-year-old child who survived an acute episode of severe spontaneous intracranial hemorrhage with clinical and radiological signs of intracranial hypertension and transtentorial herniation. The patient underwent emergency surgery to drain the hematoma, and a catheter was inserted to monitor intracranial pressure. In the initial computed tomography analysis performed prior to hematoma drainage, a brain cyst was evident contralateral to the hematoma, which, based on the analysis by the care team, possibly helped to avoid a worse outcome because the cyst accommodated the brain after the massive hemorrhage. After the investigation, the patient was determined to have previously undiagnosed hemophilia A. The patient underwent treatment in intensive care, which included the control of intracranial pressure, factor VIII replacement and discharge without signs of neurological impairment. PMID:26761482

  13. Molecular characterization of twelve patients affected by homocystinuria due to cystathionine beta-synthase deficiency: Report of two novel mutations

    SciTech Connect

    Sebastio, G.; Sperandeo, M.P.; Panico, M.

    1994-09-01

    Cystathionine beta-synthase (CBS) deficiency, an autosomal recessive disorder of sulfur amino acid metabolism (MIM 236200), causes homocystinuria and a clinical presentation involving eye, skeleton, central nervous and vascular systems. Less that 20 mutations of CBS gene have been characterized so far, G919A and T833C being the most commonly reported (36 and 9 out of 62 identified alleles, respectively). We have investigated 12 patients (10 Italians, 1 Jewish-French, 1 Italian-Spanish) and one allele of each patient has been characterized at least. T833C has been found in 7 independent alleles (6 in heterozygosity and 1 in homozygosity); G9191A, the most common mutation in Irish and North-European patients, has never been detected in the present survey. C341T (previously reported in 1 Irish-German patient only) has been found in 3 patients in heterozygosity. Besides the two new mutations previously described, i.e. G374A and C770T, we have identified two additional new missense mutations: C869T, a transition in exon 8, causing a P290L amino acid substitution, and C262T, a transition in exon 2, causing a P88S amino acid change. In 4 additional Italian patients, none of the known mutations have been detected; in one of them, a 50 bp deletion has been found in intron 11. The deletion involves the entire sequence of the second element of a tandem repeat. Conclusions: T833C is the most common panethnic mutation; C341T is relatively widespread, while G919A appears to be restricted to North-European patients. Exons 3 and 8 of the CBS gene are the hot-spots of mutational events leading to CBS deficiency.

  14. Annoyance and self-reported sleep disturbance due to night-time railway noise examined in the field.

    PubMed

    Pennig, Sibylle; Quehl, Julia; Mueller, Uwe; Rolny, Vinzent; Maass, Hartmut; Basner, Mathias; Elmenhorst, Eva-Maria

    2012-11-01

    Railway noise interferes with daytime activities and disturbs sleep leading to annoyance of exposed residents. The main objective of this paper was to establish exposure-response relationships between nocturnal railway noise exposure and annoyance and to examine self-reported sleep disturbances as short-term reactions to noise. In a field study 33 residents living close to railway tracks in the Cologne/Bonn area (Germany) were investigated. Railway noise was measured indoors during nine consecutive nights at each site. Questionnaires referring to annoyance and non-acoustical factors were performed. Annoyance ratings increased significantly with the total number of trains and freight trains per night, and non-significantly with rising number of passenger trains and energy equivalent sound pressure level (L(Aeq)), when adjusting the model for non-acoustical variables. The total number of trains and the number of freight trains also significantly affected self-reported awakening frequency, but no other aspects of subjective sleep disturbances. The responses of this subject sample referring to railway noise in the previous night point to rather low impairments of exposed residents. PMID:23145596

  15. [First report of a human case of trichinellosis due to Trichinella britovi after jackal (Canis aureus) meat consumption in Algeria].

    PubMed

    Nezri, M; Ruer, J; De Bruyne, A; Cohen-Valensi, R; Pozio, E; Dupouy-Camet, J

    2006-05-01

    We report a single case of trichinellosis contracted in Algeria (Batna region), in a practising Moslim. Shortly after returning to France in November 2004, the patient developed the typical clinical and biological signs of the disease. Although the patient claimed having only eaten mutton, an unusual host for Trichinella, a meticulous investigation revealed that he also had eaten a grilled leg of jackal (Canis aureus). One of the four Trichinella larvae detected in a muscular biopsy enabled us to identify the parasite as Trichinella britovi by a multiplex PCR analysis. This is the first identification of the etiological agent of sylvatic trichinellosis occurring in North Africa and the first case of symptomatic trichinellosis due to jackal meat consumption in Africa. PMID:16821437

  16. Four limb amputations due to peripheral gangrene from inotrope use – Case report and review of the literature

    PubMed Central

    Ang, Chuan Han; Koo, Oon Thien; Howe, Tet Sen

    2015-01-01

    INTRODUCTION We present a rare case of 4 limb amputations due to peripheral gangrene which resulted from the use of inotropes for septic shock. PRESENTATION OF CASE A 72-year-old woman with no past medical history presented with fever and pain in bilateral big toes. She was diagnosed with Streptococcal pneumoniae septicaemia and was started on broad spectrum antibiotics, dopamine and noradrenaline in the medical intensive care unit. She developed peripheral gangrene of all 4 extremities due to microvascular spasm from inotrope use and 4 limb amputations were performed electively in a single stage. DISCUSSION The gangrene was contributed by the presence of disseminated intravascular coagulation and septic shock. There was no evidence of an autoimmune disorder or vasculitis on laboratory investigations and tissue histology. CONCLUSION Microvascular spasm is a rare complication of inotrope use which may lead to extensive peripheral gangrene. Anecdotal reports of reversal agents have been discussed. Four limb amputations are a reasonable option especially if done in an elective setting after the gangrene has demarcated itself. Rehabilitation with prosthesis after 4 limb amputations can result in good functional outcome. PMID:26232740

  17. Large hemorrhage due to venipuncture in the elbow of a patient with severe hemophilia: A case report and literature review

    PubMed Central

    LYU, JINGTONG; WU, WENJIE; XIANG, ZHOU; HUANG, FUGUO

    2016-01-01

    Hemophilia A, which is the most common form of hemophilia, is caused by a deficiency of clotting factor VIII. The incidence of hemophilia A is 1:10,000 people worldwide. The most common complication associated with hemophilia A is bleeding into joints, predominantly the knees, ankles, and elbows, which may lead to destruction or osteoarthritis of the specific joint. Various degrees of disability may follow these initial or recurrent hemorrhages. Subsequent to improvements in medical management, patients with hemophilia A currently have a life expectancy similar to that of the normal population. However, the management of patients with hemophilia A remains a clinical challenge for various reasons, including the lack of reliable and cost-effective treatment, and the high risk of intra- or post-operative hemorrhages. Large hemorrhages due to the phlebotomizing of young patients are very rare. To the best of our knowledge, the present case is the first report regarding the occurrence of a large hemorrhage due to venipuncture in the elbow of a patient with hemophilia A, and discusses the pathogenesis, clinical manifestation, and the medico-chirurgical treatment of this patient. PMID:26998031

  18. Irreducible dislocation of the thumb interphalangeal joint due to displaced flexor pollicis longus tendon: case report and new reduction technique.

    PubMed

    Naito, Kiyohito; Sugiyama, Yoichi; Igeta, Yuka; Kaneko, Kazuo; Obayashi, Osamu

    2014-08-01

    Dislocation of the thumb interphalangeal (IP) joint is uncommon because of the inherent stability of the joint. Cases in which reduction was blocked by the volar plate, the flexor pollicis longus (FPL) tendon, the sesamoid bone, and an osteochondral fragment have been described in the literature. This article reports a case of closed thumb IP joint dislocation caused by the displacement of the FPL tendon. A new percutaneous reduction technique for this injury will also be presented. A 63-year-old woman presented to the emergency room with an obvious thumb deformity. Radiographs confirmed dorsal dislocation of the thumb IP joint without associated fracture. Closed reduction was not successful. Percutaneous reduction was performed under locoregional anesthesia, because the dislocation was due to an FPL tendon that had displaced dorsally and radially to the proximal phalanx. After reduction, Kirschner wire fixation was not needed, but IP joint immobilization with a splint was required for 3 weeks. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. This technique enables a mini-invasive reduction by operating percutaneously on the FPL. In addition, unlike with a volar zigzag approach, it is possible to suppress the occurrence of postoperative adhesion of the flexor tendon. This new minimally invasive reduction technique is useful for irreducible dislocation of the thumb IP joint due to a displaced FPL tendon. PMID:24902518

  19. Community-acquired necrotizing pneumonia due to methicillin-sensitive Staphylococcus aureus secreting Panton-Valentine leukocidin: a review of case reports

    PubMed Central

    2011-01-01

    Background Community-acquired necrotizing pneumonia caused by Panton-Valentine leukocidin (PVL)-secreting Staphylococcus aureus is a highly lethal infection that mainly affects healthy children and young adults. Both methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) may carry the PVL-phage, but the majority of publications relate to community-associated methicillin-resistant S. aureus (CA-MRSA) or mixed patient groups. This study focuses on necrotizing pneumonia due to methicillin-sensitive S. aureus strains, with the purpose to determine factors associated with outcome. Methods We report a patient with PVL secreting MSSA necrotizing pneumonia and performed a systematic review of similar case in the literature. We analyzed factors associated with outcome. Results A total of 32 patient descriptions were retained for analysis. Septic shock (p = 0.007), influenza-like prodrome (p = 0.02), and the absence of a previous skin and soft-tissue infection (p = 0.024) were associated with fatal outcome. In multivariate analysis, influenza-like prodrome (odds ratio (OR), 7.44; 95% confidence interval (CI), 1.24-44.76; p = 0.028) and absence of previous skin and soft-tissue infection (OR, 0.09; 95% CI, 0.01-0.86; p = 0.036) remained significant predictors of death. Conclusions Influenza-like prodrome may be predictive of adverse outcome in PVL-secreting MSSA necrotizing pneumonia. In contrast, previous skin and soft-tissue infection may be associated with improved prognosis. PMID:22192614

  20. Successful management of infertility due to retrograde ejaculation using assisted reproductive technologies: a report of two cases.

    PubMed

    Zhao, Y; Garcia, J; Jarow, J P; Wallach, E E

    2004-01-01

    Although retrograde ejaculation is a relatively uncommon cause of infertility, it is nonetheless the most common cause of ejaculatory dysfunction. Retrograde ejaculation is characterized by either all or part of the seminal fluid going into the bladder. The initial management of patients with ejaculatory dysfunction is medical therapy. In couples who have failed medical therapy, assisted reproductive techniques using sperm harvested from either the urine or the male reproductive tract would be the ultimate option. We report successful management of two couples, both men with advanced age and complete retrograde ejaculation, by intrauterine insemination in one and in vitro fertilization (IVF) using intracytoplasmic sperm injection (ICSI) in the other using sperm harvested from urine. The cases reported herein suggest that male infertility due to retrograde ejaculation may be successfully treated in men significantly older than the usual reproductive age and that traditional methods of hydration and urine alkalinization allow for the successful recovery of fertile sperm for ART. The selection of the method of ART must be individualized to the needs of each couple based upon both male and female factors. PMID:15669603

  1. Ecthyma gangrenosum in a previously healthy patient

    PubMed Central

    Bozkurt, Ilkay; Yuksel, Esra Pancar; Sunbul, Mustafa

    2015-01-01

    Ecthyma gangrenosum is a rare skin infection caused by Pseudomonas aeruginosa. It is usually seen in immunocompromised and critically ill patients. We report one such case in a previously healthy 20-year old male. Ecthyma gangrenosum can occur in healthy patients without bacteremia. PMID:26500865

  2. [Complete remission of consciousness disturbances and spasticity due to a severe subarachnoid hemorrhage after intrathecal baclofen therapy: a case report].

    PubMed

    Asahi, Takashi; Kashiwazaki, Daina; Koh, Masaki; Matsumura, Nobuhisa; Kuroda, Satoshi

    2015-03-01

    Typically, intrathecal baclofen therapy(ITB)for spasticity is continuously required because the spasticity can recur if the ITB is stopped. Thus, an infusion pump for the ITB is permanently implanted. Some sporadic cases exhibiting remarkable improvements in their spasticity and consciousness disturbances have been reported after implanting the ITB pump. We experienced a rare case involving removal of the ITB pump after the spasticity resolved and the consciousness disturbances markedly improved. A 15-year-old girl developed a subarachnoid hemorrhage due to rupture of an aneurysm in the right anterior cerebral artery. Her initial Glasgow Coma Scale score was 4(E1V1M2). Trapping of the aneurysm and decompression craniotomy were performed. Subsequently, she underwent a tracheotomy, and a percutaneous gastrostomy(PEG)tube was implanted because of persistent consciousness disturbances. Cranioplasty and lumbar-peritoneal shunt for normal pressure hydrocephalus were performed after 1 month. An ITB pump was implanted to improve the spasticity observed mainly in the lower extremities 61 days after hemorrhage onset. Right hemiparesis remained due to Kernohan's notch. After transfer to the rehabilitation hospital, her consciousness disturbances and spasticity remarkably improved(1.9 to 1.0 and 3.5 to 1.0 on the Ashworth scale for the upper and lower extremities, respectively). The tracheostomy and PEG tubes were removed, and the baclofen dose was gradually reduced. She was completely off baclofen after 7 months, and she was discharged with a short leg brace and a cane for walking. The baclofen pump was then removed. In this case, temporary ITB improved the spasticity and consciousness disturbances. PMID:25748812

  3. Parametric study of the potential for BWR ECCS strainer blockage due to LOCA generated debris. Final report

    SciTech Connect

    Zigler, G.; Brideau, J.; Rao, D.V.; Shaffer, C.; Souto, F.; Thomas, W.

    1995-10-01

    This report documents a plant-specific study for a BWR/4 with a Mark I containment that evaluated the potential for LOCA generated debris and the probability of losing long term recirculation capability due ECCS pump suction strainer blockage. The major elements of this study were: (1) acquisition of detailed piping layouts and installed insulation details for a reference BWR; (2) analysis of plant specific piping weld failure probabilities to estimate the LOCA frequency; (3) development of an insulation and other debris generation and drywell transport models for the reference BWR; (4) modeling of debris transport in the suppression pool; (5) development of strainer blockage head loss models for estimating loss of NPSH margin; (6) estimation of core damage frequency attributable to loss of ECCS recirculation capability following a LOCA. Elements 2 through 5 were combined into a computer code, BLOCKAGE 2.3. A point estimate of overall DEGB pipe break frequency (per Rx-year) of 1.59E-04 was calculated for the reference plant, with a corresponding overall ECCS loss of NPSH frequency (per Rx-year) of 1.58E-04. The calculated point estimate of core damage frequency (per Rx-year) due to blockage related accident sequences for the reference BWR ranged from 4.2E-06 to 2.5E-05. The results of this study show that unacceptable strainer blockage and loss of NPSH margin can occur within the first few minutes after ECCS pumps achieve maximum flows when the ECCS strainers are exposed to LOCA generated fibrous debris in the presence of particulates (sludge, paint chips, concrete dust). Generic or unconditional extrapolation of these reference plant calculated results should not be undertaken.

  4. Hemolytic disease of the newborn due to anti-jkb: case report and review of the literature.

    PubMed

    Velasco Rodríguez, Diego; Pérez-Segura, G; Jiménez-Ubieto, A; Rodríguez, M A; Montejano, L

    2014-06-01

    Although anti-Jkb is a well-defined cause of severe acute or delayed hemolytic transfusion reactions, it is rarely associated with severe Hemolytic Disease of the Newborn (HDN), even with high antibody titer. To date, only 13 cases have been reported, so the possible reasons for that still remain unclear. Most of HDN due to anti-Jkb are mild-to-moderate, and usually have a good prognosis. A 41-years-old woman, who had a positive antibody screening test in her 13th week of pregnancy, was sent to the blood bank for study before an amniocentesis. Antibody identification and red blood cell (RBC) phenotyping of the patient and his husband were performed, plus arrays study in the amniotic fluid. An anti-Jkb was identified in the patient's serum with a titer of 1:1, and her RBC phenotype was O Rh(D) positive, C(+), c(+), E(-), e(+), K(-), Jka(+), Jkb(-). The RBC genotype of the fetus was B Rh(D) positive, Jka(+), Jkb(+). Antibody titer remained stable and the pregnancy was uneventful. At birth, there was no need of phototherapy or exchange transfusion for the newborn and her Jk(b+) typing result was confirmed in a cord blood sample. Although most of HDN cases due to anti-Jkb have a good outcome, monitoring antibody titer should be done to prevent fatal complications. Furthermore, antenatal antibody screening should be performed in every pregnant woman irrespective of her Rh(D) antigen status in order to detect red cell alloimmunization to other clinically significant blood group antigens. PMID:24839369

  5. Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report.

    PubMed

    Tufan, Ali Evren; Bilici, Rabia; Usta, Genco; Erdoğan, Ayten

    2012-01-01

    Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were "irritability, regressive behavior, apathy, crying and truancy" which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg's sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg's sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal symptoms lacking a clear etiology may be rare manifestation of vitamin B12 and/or folate deficiency in children and adolescents and be potentially amenable to treatment. PMID:22726236

  6. Fatal Mycobacterium colombiense/cytomegalovirus coinfection associated with acquired immunodeficiency due to autoantibodies against interferon gamma: a case report

    PubMed Central

    2013-01-01

    Background Reports of acquired immunodeficiency due to autoantibodies against interferon gamma in the adult population are increasing. The interleukin-12-dependent interferon-gamma axis is a major regulatory pathway of cell-mediated immunity and is critical for protection against a few intracellular organisms, including non-tuberculous mycobacteria and Salmonella spp. We report the first case of a fatal disseminated Mycobacterium colombiense/cytomegalovirus coinfection in an adult woman associated with the acquisition of autoantibodies against interferon-gamma. Case presentation A 49-year-old woman, born to nonconsanguineous parents in Laos, but who had lived in Canada for the past 30 years, presented with a 1-month history of weight loss, fatigue, cough, and intermittent low-grade fever. A thoracic computed tomography scan revealed an 8 × 7 cm irregular mass impacting the right superior lobar bronchus along with multiple mediastinal and hilar adenopathies. On the fourth day of admission, the patient developed fever with purulent expectorations. Treatment for a post-obstructive bacterial pneumonia was initiated while other investigations were being pursued. Almost every culture performed during the patient’s hospitalization was positive for M. colombiense. Given the late presentation of symptoms - at the age of 49 years - and the absence of significant family or personal medical history, we suspected an acquired immunodeficiency due to the presence of anti-interferon-gamma autoantibodies. This was confirmed by their detection at high levels in the plasma and a STAT1 phosphorylation assay on human monocytes. The final diagnosis was immunodeficiency secondary to the production of autoantibodies against interferon-gamma, which resulted in a post-obstructive pneumonia and disseminated infection of M. colombiense. The clinical course was complicated by the presence of a multiresistant Pseudomonas aeruginosa post-endobronchial ultrasound mediastinitis, cytomegalovirus pneumonitis with dissemination, and finally, susceptible P. aeruginosa ventilator-associated pneumonia with septic shock and multiple organ failure, leading to death despite appropriate antibacterial and anti-mycobacterial treatment. Conclusions Although rare, acquired immunodeficiency syndromes should be considered in the differential diagnosis of patients with severe, persistent, or recurrent infections. Specifically, severe non-tuberculous mycobacteria or Salmonella infections in adults without any other known risk factors may warrant examination of autoantibodies against interferon-gamma because of their increasing recognition in the literature. PMID:23336346

  7. Peritoneal tuberculosis due to Mycobacterium caprae

    PubMed Central

    Nebreda, T.; Álvarez-Prida, E.; Blanco, B.; Remacha, M.A.; Samper, S.; Jiménez, M.S.

    2016-01-01

    The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made. PMID:27134824

  8. Effective Use of Sertraline for Pathological Laughing after Severe Vasospasm Due to Aneurysmal Subarachnoid Hemorrhage: Case Report

    PubMed Central

    TAKEUCHI, Hayato; IWAMOTO, Kazuhide; MUKAI, Mao; FUJITA, Tomoaki; TSUJINO, Hitoshi; IWAMOTO, Yoshihiro

    2014-01-01

    Pathological laughing, one subgroup of psuedobulbar affect, is known as laughter inappropriate to the patient's external circumstances and unrelated to the patient's internal emotional state. The authors present the case of a 76-year-old woman with no significant medical history who experienced pathological laughing after subarachnoid hemorrhage (SAH) due to rupture of an aneurysm, which was successfully treated with craniotomy for aneurysm clipping. In the acute stage after the operation she suffered from severe vasospasm and resulting middle cerebral artery territory infarction and conscious disturbance. As she regained consciousness she was afflicted by pathological laughing 6 months after the onset of SAH. Her involuntary laughter was inappropriate to the situation and was incongruent with the emotional state, and she could not control by herself. Finally the diagnosis of pathological laughing was made and treatment with sertraline, a selective serotonin reuptake inhibitor (SSRI), effectively cured the symptoms. Her pathological laughing was estimated to be consequence of infarction in the right prefrontal cortex and/or corona radiata, resulting from vasospasm. To the authors' knowledge, this is the first report of pathological laughing after aneurysmal SAH. The authors offer insight into the pathophysiology of this rare phenomenon. Effectiveness of sertraline would widen the treatment modality against pathological laughing. PMID:24201096

  9. Reported foodborne outbreaks due to fresh produce in the United States and European Union: trends and causes.

    PubMed

    Callejón, Raquel M; Rodríguez-Naranjo, M Isabel; Ubeda, Cristina; Hornedo-Ortega, Ruth; Garcia-Parrilla, M Carmen; Troncoso, Ana M

    2015-01-01

    The consumption of fruit and vegetables continues to rise in the United States and European Union due to healthy lifestyle recommendations. Meanwhile, the rate of foodborne illness caused by the consumption of these products remains high in both regions, representing a significant public health and financial issue. This study addresses the occurrence of reported foodborne outbreaks associated with fresh fruits and vegetables consumption in the United States and European Union during the period 2004-2012, where data are available. Special attention is paid to those pathogens responsible for these outbreaks, the mechanisms of contamination, and the fresh produce vehicles involved. Norovirus is shown to be responsible for most of the produce-related outbreaks, followed by Salmonella. Norovirus is mainly linked with the consumption of salad in the United States and of berries in the European Union, as demonstrated by the Multiple Correspondence Analysis (MCA). Salmonella was the leading cause of multistate produce outbreaks in the United States and was the pathogen involved in the majority of sprouts-associated outbreaks. As is reflected in the MCA, the pattern of fresh produce outbreaks differed in the United States and European Union by the type of microorganism and the food vehicle involved. PMID:25587926

  10. Reported foodborne outbreaks due to fresh produce in the United States and European Union: trends and causes.

    TOXLINE Toxicology Bibliographic Information

    Callejón RM; Rodríguez-Naranjo MI; Ubeda C; Hornedo-Ortega R; Garcia-Parrilla MC; Troncoso AM

    2015-01-01

    The consumption of fruit and vegetables continues to rise in the United States and European Union due to healthy lifestyle recommendations. Meanwhile, the rate of foodborne illness caused by the consumption of these products remains high in both regions, representing a significant public health and financial issue. This study addresses the occurrence of reported foodborne outbreaks associated with fresh fruits and vegetables consumption in the United States and European Union during the period 2004-2012, where data are available. Special attention is paid to those pathogens responsible for these outbreaks, the mechanisms of contamination, and the fresh produce vehicles involved. Norovirus is shown to be responsible for most of the produce-related outbreaks, followed by Salmonella. Norovirus is mainly linked with the consumption of salad in the United States and of berries in the European Union, as demonstrated by the Multiple Correspondence Analysis (MCA). Salmonella was the leading cause of multistate produce outbreaks in the United States and was the pathogen involved in the majority of sprouts-associated outbreaks. As is reflected in the MCA, the pattern of fresh produce outbreaks differed in the United States and European Union by the type of microorganism and the food vehicle involved.

  11. MENINGOENCEPHALITIS DUE TO VARICELLA ZOSTER VIRUS IN AIDS PATIENTS. REPORT OF ELEVEN CASES AND REVIEW OF THE LITERATURE

    PubMed Central

    CORTI, Marcelo; VILLAFAÑE, María F.; VITTAR, Natalia; BANCO, María C.; PRIARONE, Maia; MAMMANA, Lilia; GILARDI, Leonardo

    2015-01-01

    Neurological complications of varicella-zoster virus (VZV) are infrequent and include various clinical pictures. The reactivation of VZV in patients with AIDS is generally associated with an acute and severe meningoencephalitis. We report the epidemiological, clinical and virological data from 11 consecutive patients with diagnosis of HIV/AIDS and central nervous system (CNS) involvement due to VZV. All patients were male and seropositive for HIV. The primary risk factor for HIV infection was unprotected sexual contact. The median of CD4 T cell count was 142 cells/µL. All of them presented signs and symptoms of meningoencephalitis. Six patients (54.5%) presented pleocytosis; they all showed high CSF protein concentrations with a median of 2.1 g/dL. Polymerase chain reaction of cerebrospinal fluid specimen was positive for VZV in all of them and they were treated with intravenous acyclovir at doses of 30/mg/kg/day for 21 days. Overall survival was 63% (7 of 11 patients). The four dead patients had low cellular counts in CSF, below the median of this parameter. VZV should be included among the opportunistic pathogens that can involve CNS with a diffuse and severe meningoencephalitis in patients with advanced HIV/AIDS disease. PMID:27049704

  12. MENINGOENCEPHALITIS DUE TO VARICELLA ZOSTER VIRUS IN AIDS PATIENTS. REPORT OF ELEVEN CASES AND REVIEW OF THE LITERATURE.

    PubMed

    Corti, Marcelo; Villafañe, María F; Vittar, Natalia; Banco, María C; Priarone, Maia; Mammana, Lilia; Gilardi, Leonardo

    2015-12-01

    Neurological complications of varicella-zoster virus (VZV) are infrequent and include various clinical pictures. The reactivation of VZV in patients with AIDS is generally associated with an acute and severe meningoencephalitis. We report the epidemiological, clinical and virological data from 11 consecutive patients with diagnosis of HIV/AIDS and central nervous system (CNS) involvement due to VZV. All patients were male and seropositive for HIV. The primary risk factor for HIV infection was unprotected sexual contact. The median of CD4 T cell count was 142 cells/µL. All of them presented signs and symptoms of meningoencephalitis. Six patients (54.5%) presented pleocytosis; they all showed high CSF protein concentrations with a median of 2.1 g/dL. Polymerase chain reaction of cerebrospinal fluid specimen was positive for VZV in all of them and they were treated with intravenous acyclovir at doses of 30/mg/kg/day for 21 days. Overall survival was 63% (7 of 11 patients). The four dead patients had low cellular counts in CSF, below the median of this parameter. VZV should be included among the opportunistic pathogens that can involve CNS with a diffuse and severe meningoencephalitis in patients with advanced HIV/AIDS disease. PMID:27049704

  13. Visualization of a Traumatic Pseudoaneurysm at Internal Carotid Artery Bifurcation due to Blunt Head Injury: A Case Report

    PubMed Central

    Han, Ju-Hee; Choi, Ha-Young; Park, Jung-Soo; Lee, Jong-Myong

    2014-01-01

    Traumatic intracranial pseudoaneurysms occurring after blunt head injuries are rare. We report an unusual case of subarachnoid hemorrhage (SAH) caused by rupturing of the traumatic pseudoaneurysm of the internal carotid artery (ICA) bifurcation that resulted from a non-penetrating injury. In a patient with severe headache and SAH in the right sylvian cistern, which developed within 7 days after a blunt-force head injury, a trans-femoral cerebral angiogram (TFCA) showed aneurysmal sac which was insufficient to confirm the pseudoaneurysm. We obtained a multi-slab image of three dimensional time of flight (TOF) of magnetic resonance angiography (MRA). The source image of the gadolinium-enhanced MRA revealed an intimal flap within the intracranial ICA bifurcation, providing a clue for the diagnosis of a dissecting pseudoaneurysm at the ICA bifurcation due to blunt head trauma. We performed direct aneurysmal neck clipping, without neurological deficit. A follow-up TFCA did not show either aneurysm sac or luminal narrowing. We suggest that in the patient with a history of blunt head injury with SAH following shortly, multi-slab image of 3D TOF MRA can give visualization of the presence of a pseudoaneurysm. PMID:27169047

  14. Identifying questions in the American Association of Swine Veterinarian's PRRS risk assessment survey that are important for retrospectively classifying swine herds according to whether they reported clinical PRRS outbreaks in the previous 3 years.

    PubMed

    Holtkamp, Derald J; Lin, Hui; Wang, Chong; O'Connor, Annette M

    2012-09-01

    The American Association of Swine Veterinarian's (AASV) Production Animal Disease Risk Assessment Program (PADRAP) is a web-based program that offers a set of risk assessment surveys being used by veterinarians who are members of the AASV. Members use PADRAP to help producers systematically assess risk factors that may be associated with clinical outcomes. As assessments are performed the completed surveys are added to the dataset maintained at the Iowa State University College of Veterinary Medicine. One of the surveys included in PADRAP is the porcine reproductive and respiratory syndrome (PRRS) Risk Assessment for the Breeding Herd. The aim of the study was to categorize questions in version 2 of the PRRS Risk Assessment for the Breeding Herd survey as important or unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. The results elucidate the relative importance of risk factors and areas of risk factors for clinical outcomes and removing unimportant questions may reduce the time required to complete the survey without affecting the quality of information obtained. Surveys from 896 sow herd sites in the United States and Canada completed between March 2005 and March 2009 were included in the analysis. The survey contained a large number of questions with a complex correlation structure among the questions. Responses for several questions were dependent upon responses to others. To address these issues, an approach was developed using a series of statistical methods including random forest, principle component analysis, logistic regression and receiver operating characteristic (ROC) analysis to classify the herds using the questions in the survey as explanatory variables. Questions were ranked by importance and systematically excluded from least important to most important. The questions excluded, without significantly affecting the performance of the model for classifying herds were identified as unimportant. Thirty-eight of the 127 questions analyzed were identified as unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. Sections of the survey where a large number of questions were identified as unimportant included (1) entry of semen into the breeding herd and (2) transportation of live animals. Sections with a high percentage of questions identified as unimportant included (1) characteristics of the site, (2) disposal of dead animals and waste management and (3) employee and visitors. PMID:22475927

  15. Paraneoplastic secondary hypertension due to a renin-secreting desmoplastic small round cell tumor: A case report

    PubMed Central

    LEE, HEE-JEONG; HYUN, JIN-SOO; JANG, HOE-SOO; SUL, HYOUNG; PARK, SANG-GON

    2014-01-01

    Desmoplastic small round cell tumor (DSRCT) is a rare and aggressive malignancy with a poor outcome that occurs in adolescents and young adults; <200 cases of DSRCT have been reported. Renin-producing tumors are also rare and cases of extrarenal renin-producing tumors are even rarer. The present study describes the case of a 20-year-old male that was diagnosed with DSRCT and presented with severe hypertension and hypokalemia, as well as metabolic alkalosis. The plasma renin activity (PRA) level was identified to be markedly elevated (normal range in standing and supine positions, 1.3–4.0 ng/ml/h and 0.15–2.33 ng/ml/h, respectively) and the plasma aldosterone level was also increased (normal range in standing and supine positions, 4.0–31.0 ng/dl and 1.0–1.6 ng/dl, respectively). The symptoms of the patient were consistent with the renin-secreting tumor triad, which comprises hypertension, hypokalemia and elevated PRA. Paraneoplastic syndromes must always be considered in cancer patients exhibiting unusual clinical findings, despite their rarity. The current patient was diagnosed with paraneoplastic secondary hypertension due to the presence of disseminated renin-secreting DSRCT. The patient was treated with the VAC/IE regimen (vincristine, adriamycin, cyclophosphamide, ifosfamide and etoposide) for six cycles. Following this treatment, the serum renin and aldosterone levels fell to within the normal range and the patient’s blood pressure was normalized without antihypertensive medication. Although an immunohistochemical evaluation of renin was not conducted as the sample size was inadequate, the present study demonstrated that the tumor had produced renin. The biosynthesis of renin was identified by the presence of mRNA that coded for the renin precursor, which was observed in the ascites of the patient. The current study describes, to the best of our knowledge, the first reported case of paraneoplastic secondary hypertension in a patient presenting with a renin-producing DSRCT. PMID:25289084

  16. Heroin Addicts Reporting Previous Heroin Overdoses Also Report Suicide Attempts

    ERIC Educational Resources Information Center

    Bradvik, Louise; Frank, Arne; Hulenvik, Per; Medvedeo, Alvaro; Berglund, Mats

    2007-01-01

    Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmo, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt

  17. Heroin Addicts Reporting Previous Heroin Overdoses Also Report Suicide Attempts

    ERIC Educational Resources Information Center

    Bradvik, Louise; Frank, Arne; Hulenvik, Per; Medvedeo, Alvaro; Berglund, Mats

    2007-01-01

    Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmo, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt…

  18. Heroin addicts reporting previous heroin overdoses also report suicide attempts.

    PubMed

    Brådvik, Louise; Frank, Arne; Hulenvik, Per; Medvedeo, Alvaro; Berglund, Mats

    2007-08-01

    Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmö, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt to commit suicide (but not using heroin). Suicide attempts were significantly more common among those who had taken unintentional overdoses as compared with those who had never taken any overdose (p < 0.01). The more overdoses, the greater the risk of suicide attempt. PMID:17896887

  19. TESTING AND ANALYSIS OF CAP CONCRETE STRESS AND STRAIN DUE TO SHRINKAGE, CREEP, AND EXPANSION FINAL REPORT

    SciTech Connect

    Guerrero, H.; Restivo, M.

    2011-08-01

    In-situ decommissioning of Reactors P- and R- at the Savannah River Site will require filling the reactor vessels with a special concrete based on materials such as magnesium phosphate, calcium aluminate or silica fume. Then the reactor vessels will be overlain with an 8 ft. thick layer of Ordinary Portland Cement (OPC) steel reinforced concrete, called the 'Cap Concrete'. The integrity of this protective layer must be assured to last for a sufficiently long period of time to avoid ingress of water into the reactor vessel and possible movement of radioactive contamination into the environment. During drying of this Cap Concrete however, shrinkage strains are set up in the concrete as a result of diffusion and evaporation of water from the top surface. This shrinkage varies with depth in the poured slab due to a non-uniform moisture distribution. This differential shrinkage results in restraint of the upper layers with larger shrinkage by lower layers with lesser displacements. Tensile stresses can develop at the surface from the strain gradients in the bulk slab, which can lead to surface cracking. Further, a mechanism called creep occurs during the curing period or early age produces strains under the action of restraining forces. To investigate the potential for surface cracking, an experimental and analytical program was started under TTQAP SRNL-RP-2009-01184. Slab sections made of Cap Concrete mixture were instrumented with embedded strain gages and relative humidity sensors and tested under controlled environmental conditions of 23 C and relative humidities (RH) of 40% and 80% over a period of 50 days. Calculation methods were also developed for predictions of stress development in the full-scale concrete placement over the reactor vessels. These methods were evaluated by simulating conditions for the test specimens and the calculation results compared to the experimental data. A closely similar test with strain gages was performed by Kim and Lee for a concrete mixture that did not employ humidity sensors and the admixtures used in this program. Yuan and Wan tried to predict the shrinkage strains and stresses in the Kim and Lee experiment, but did not include a creep analysis. Grasley and Lange conducted full restraint load tests on a concrete prism instrumented with humidity sensors over a 7 day curing period. The hypothetical case of full-scale placement of the Cap Concrete was also analyzed using the developed analytical methods. The calculation performed in this report is for scoping purposes only.

  20. Lessons learned from previous dengue outbreaks

    PubMed Central

    Wiwanitkit, Viroj

    2014-01-01

    Dengue is an important tropical infection caused by an arbovirus dengue. As a mosquito borne infection, this disease is widely spread in several tropical endemic countries. Millions of world populations are at risk for this arboviral infection. Each year, thousands of dengue infections are reported and there are several death cases. Each year, the outbreaks of dengue emerge in several countries and this implies the global importance of this infection. Fighting with dengue outbreak is important in public health. In this specific chapter, the author discussed lessons learned from previous dengue outbreaks.

  1. Word Frequency Effects in Naming for Experienced and Previously Experienced Adult Readers of Persian.

    ERIC Educational Resources Information Center

    Baluch, Bahman

    1996-01-01

    Reports that in a word naming experiment, experienced readers of Persian named high frequency transparent Persian words significantly faster than matched low frequency words. Finds no such effects for adults who had, for 10 years, little experience in reading Persian due to emigration to the West; overall, previously experienced adults named words…

  2. Association of a wide invasive malignant thymoma with myastenia gravis and primary hyperparathyroidism due to parathyroid adenoma: case report and review of the literature.

    PubMed

    Triggiani, Vincenzo; Guastamacchia, Edoardo; Lolli, Ivan; Troccoli, Giuseppe; Resta, Francesco; Sabbà, Carlo; Ruggieri, Nadia; Tafaro, Emilio

    2006-01-01

    There are few cases described in the world literature reporting an association of thymoma (with myasthenia gravis or not) with hyperparathyroidism. In these cases the hyperparathyroidism was due to the presence of an adenoma or hyperplasic parathyroid tissue either in the cervical region or in an ectopic intrathymic location.(12345) In other cases the syndrome of hypercalcemia was due to the secretion of parathyroid-related protein (PTHRP) (6) or parathyroid hormone (PTH) (7) by the thymoma itself. We report the first case, at the best of our knowledge, of a wide invasive malignant thymoma (type B3), associated with myasthenia gravis and hyperparathyroidism caused by parathyroid adenoma. PMID:16873103

  3. Treatment for Progressive Hearing Loss Due to Paget's Disease of Bone - A Case Report and Literature Review.

    PubMed

    Aoki, Mitsuhiro; Tanahashi, Shigeaki; Mizuta, Keisuke; Kato, Hiroki

    2015-12-01

    Paget's disease is a common bone remodeling disorder that typically begins with excessive bone resorption in the elderly. Bilateral progressive hearing loss is the most frequently encountered complication of Paget's disease. The types of hearing loss identified by audiometry are conductive, sensorineural, or both. However, the precise mechanism of hearing loss remains unclear, and the treatment has been controversial. We present a 73-year-old man who suffered from bilateral progressive hearing loss due to Paget's disease. Potent bisphosphonates, oral risedronate in daily adjusted dosages for 6 months, did not decrease or suppress the worsening of the hearing loss. The Nucleus CI24 Contour electrode array was successfully inserted on the left side without surgical and postoperative complications. The Japanese open set monosyllable word recognition test in a sound field at 65 dB had a result of 74%. This cochlear implantation can be an indication for cases of profound hearing loss due to Paget's disease. PMID:26915163

  4. Carbon dioxide pneumothorax occurring during laparoscopy-assisted gastrectomy due to a congenital diaphragmatic defect: a case report

    PubMed Central

    Park, Hye-Jin

    2016-01-01

    During laparoscopic surgery, carbon dioxide (CO2) pneumothorax can develop due to a congenital defect in the diaphragm. We present a case of a spontaneous massive left-sided pneumothorax that occurred during laparoscopy-assisted gastrectomy, because of an escape of intraperitoneal CO2 gas, under pressure, into the pleural cavity through a congenital defect in the esophageal hiatus of the left diaphragm. This was confirmed on intraoperative chest radiography and laparoscopic inspection. This CO2 pneumothorax caused tolerable hemodynamic and respiratory consequences, and was rapidly reversible after release of the pneumoperitoneum. Thus, a conservative approach was adopted, and the remainder of the surgery was completed, laparoscopically. Due to the high solubility of CO2 gas and the extra-pulmonary mechanism, CO2 pneumothorax with otherwise hemodynamically stable conditions can be managed by conservative modalities, avoiding unnecessary chest tube insertion or conversion to an open procedure. PMID:26885310

  5. Responsibility for reporting patient death due to hospital error in Japan when an error occurred at a referring institution.

    PubMed

    Maeda, Shoichi; Starkey, Jay; Kamishiraki, Etsuko; Ikeda, Noriaki

    2013-12-01

    In Japan, physicians are required to report unexpected health care-associated patient deaths to the police. Patients needing to be transferred to another institution often have complex medical problems. If a medical error occurs, it may be either at the final or the referring institution. Some fear that liability will fall on the final institution regardless of where the error occurred or that the referring facility may oppose such reporting, leading to a failure to report to police or to recommend an autopsy. Little is known about the actual opinions of physicians and risk managers in this regard. The authors sent standardised, self-administered questionnaires to all hospitals in Japan that participate in the national general residency program. Most physicians and risk managers in Japan indicated that they would report a patient's death to the police where the patient has been transferred. Of those who indicated they would not report to the police, the majority still indicated they would recommend an autopsy PMID:24597392

  6. Exsanguination due to gastric ulceration in a foal.

    PubMed

    Traub-Dagartz, J; Bayly, W; Riggs, M; Thomas, N; Pankowski, R

    1985-02-01

    An Arabian foal with a congenital heart disease died due to hemorrhage secondary to a large gastric ulcer. Previously, death of foals with gastric ulcers has been due to diffuse peritonitis resulting from gastric ulcer perforation. The foal in this case report died due to hemorrhage secondary to a large gastric ulcer. PMID:3972690

  7. Cervical myelopathy due to chronic overshunting in a pediatric patient: case report and review of the literature.

    PubMed

    Ulrich, Nils Harry-Bert; Maier, Matthias; Bernays, Rene-Ludwig; Krayenbuhl, Niklaus; Kollias, Spyros

    2013-01-01

    We present a rare cause of cervical myelopathy produced by an engorged suboccipital epidural venous plexus due to chronic cerebrospinal fluid (CSF) overdrainage. A 17-year-old boy with obstructive hydrocephalus due to a retrocerebellar cyst and secondary implantation of a ventricloperitoneal shunt (VP-shunt) presented with progressive spastic tetraparesis. MRI imaging revealed myelopathy due to significant compression of the cervical spinal cord by engorged epidural veins. Further assessment at a low-pressure setting revealed a broken shunt valve. The VP-shunt valve was changed with an additional anti-siphon device leading to a gradual increase of the intracranial pressure (ICP). After intensive physiotherapy, the patient showed slight clinical improvement. Follow-up imaging within nine days showed distinct regression of the dilated venous plexus at the cranial-cervical junction (CCJ) with the resolution of cord compression. Engorgement of the epidural venous plexus should always be considered in the differential diagnosis of myelopathy in long-term shunt patients even when classical clinical and radiological signs of overshunting are missing. PMID:23756987

  8. Pelvic Abscess Due to Ochrobactrum anthropi in an Immunocompetent Host: Case Report and Review of the Literature

    PubMed Central

    Vaidya, Sagar A.; Citron, Diane M.; Fine, Marjorie B.; Murakami, Georgette; Goldstein, Ellie J. C.

    2006-01-01

    Ochrobactrum anthropi infection is rare in humans and is generally associated with immunocompromised hosts with indwelling foreign bodies. We report a case of pelvic abscess with O. anthropi after a routine appendectomy in an immunocompetent patient and review the literature on O. anthropi infection in patients with normal immune function. PMID:16517927

  9. Cantharidin Poisoning due to Blister Beetle Ingestion in Children: Two case reports and a review of clinical presentations.

    PubMed

    Al-Binali, Ali M; Shabana, Medhat; Al-Fifi, Suliman; Dawood, Sami; Shehri, Amer A; Al-Barki, Ahmed

    2010-08-01

    Cantharidin is an intoxicant found in beetles in the Meloidae (Coleoptera) family. Ingestion may result in haematemesis, impaired level of consciousness, electrolyte disturbance, haematurea and renal impairment. Here, we report two paediatric cases of meloid beetle ingestion resulting in cantharidin poisoning and the clinical presentation of the ensuing intoxication. PMID:21509239

  10. Chylous ascites and chylothorax due to constrictive pericarditis in a patient infected with HIV: a case report

    PubMed Central

    2012-01-01

    Introduction Chylothorax and chylous ascites are uncommon and usually associated with trauma or neoplasms. To the best of our knowledge, constrictive pericarditis leading to chylothorax and chylous ascites in a person infected with HIV has never previously been described. Case presentation A 39-year-old Thai man was referred to our institute with progressive dyspnea, edema and abdominal distension. His medical history included HIV infection and pulmonary tuberculosis that was complicated by tuberculous pericarditis and cardiac tamponade. Upon further investigation, we found constrictive pericarditis, chylothorax and chylous ascites. A pericardiectomy was performed which resulted in gradual resolution of the ascites and chylous effusion. Conclusions Although constrictive pericarditis is an exceptionally rare cause of chylothorax and chylous ascites, it should nonetheless be considered in the differential diagnosis as a potentially reversible cause. PMID:22738274

  11. 26 CFR 53.6081-1 - Automatic extension of time for filing the return to report taxes due under section 4951 for self...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... return to report taxes due under section 4951 for self-dealing with a nuclear decommissioning fund. 53... 4951 for self-dealing with a nuclear decommissioning fund. (a) In general. A “disqualified person” for purposes of section 4951(e)(4) who engaged in self-dealing with a Nuclear Decommissioning Fund, and...

  12. 26 CFR 53.6081-1 - Automatic extension of time for filing the return to report taxes due under section 4951 for self...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... return to report taxes due under section 4951 for self-dealing with a nuclear decommissioning fund. 53... 4951 for self-dealing with a nuclear decommissioning fund. (a) In general. A “disqualified person” for purposes of section 4951(e)(4) who engaged in self-dealing with a Nuclear Decommissioning Fund, and...

  13. 26 CFR 53.6081-1 - Automatic extension of time for filing the return to report taxes due under section 4951 for self...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... return to report taxes due under section 4951 for self-dealing with a nuclear decommissioning fund. 53... 4951 for self-dealing with a nuclear decommissioning fund. (a) In general. A “disqualified person” for purposes of section 4951(e)(4) who engaged in self-dealing with a Nuclear Decommissioning Fund, and...

  14. 26 CFR 53.6081-1 - Automatic extension of time for filing the return to report taxes due under section 4951 for self...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... return to report taxes due under section 4951 for self-dealing with a nuclear decommissioning fund. 53... 4951 for self-dealing with a nuclear decommissioning fund. (a) In general. A “disqualified person” for purposes of section 4951(e)(4) who engaged in self-dealing with a Nuclear Decommissioning Fund, and...

  15. 26 CFR 53.6081-1 - Automatic extension of time for filing the return to report taxes due under section 4951 for self...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Automatic extension of time for filing the return to report taxes due under section 4951 for self-dealing with a nuclear decommissioning fund. 53.6081-1 Section 53.6081-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) MISCELLANEOUS EXCISE TAXES...

  16. A case report of bacteremia manifesting as an overwhelming postsplenectomy infection due to Streptococcus pneumoniae post vaccination.

    PubMed

    Hirose, Kosuke; Okabe, Hirohisa; Yoshizumi, Tomoharu; Uchiyama, Hideaki; Ikegami, Toru; Harimoto, Norifumi; Itoh, Shinji; Kimura, Koichi; Baba, Hideo; Maehara, Yoshihiko

    2016-12-01

    A 62-year-old woman was admitted for acute epigastralgia and high-grade fever of over 39 °C. The patient had undergone splenectomy for idiopathic portal hypertension 1 year ago and vaccination against Streptococcus pneumoniae immediately post operation. She developed localized peritoneal irritation and abdominal distension. Her serum creatinine had increased to 1.5 mg/dL and procalcitonin was 12.5 ng/ml. Computed tomography of the abdomen revealed edematous large intestine and increased ascites. From these results, the patient was considered to have spontaneous bacterial peritonitis (SBP). Vancomycin (VCM) and doripenem (DRPM) were administered to control the infection. Unexpectedly, S. pneumoniae was detected in the blood culture. Hence, ampicillin/sulbactam was administered after discontinuing VCM. The patient recovered without any life-threatening complications and was discharged after 10 days. In conclusion, overwhelming postsplenectomy infection (OPSI) due to S. pneumoniae could develop in patient with splenectomy even after vaccination. Although the bacteremia probably due to SBP and acute renal dysfunction was accompanied by OPSI, our patient recovered rapidly. PMID:27221131

  17. Fanconi anemia-D1 due to homozygosity for the BRCA2 gene Cypriot founder mutation: A case report

    PubMed Central

    LOIZIDOU, MARIA A.; HADJISAVVAS, ANDREAS; TANTELES, GEORGE A.; SPANOU-ARISTIDOU, ELENA; KYRIACOU, KYRIACOS; CHRISTOPHIDOU-ANASTASIADOU, VIOLETTA

    2016-01-01

    Fanconi anemia (FA) is a rare disorder characterized by multiple congenital malformations, progressive bone marrow failure and susceptibility to malignancies. Biallelic mutations in the breast cancer 2, early onset (BRCA2) gene are responsible for the FA-D1 subgroup, which accounts for ~3% of all the FA cases. Patients with biallelic BRCA2 mutations generally display a more severe phenotype, with earlier onset and increased incidence of leukaemia and other solid tumors, than other patients with FA. In the present report, the first Cypriot patient with FA-D1 is described, which is the fifth case of a homozygote for the same null allele reported thus far, and the third known case of neuroblastoma in association with FA-D1. PMID:26834852

  18. Atlantoaxial Subluxation due to an Os Odontoideum in an Achondroplastic Adult: Report of a Case and Review of the Literature

    PubMed Central

    Rahimizadeh, Abolfazl; Soufiani, Housain F.; Hassani, Valiolah; Rahimizadeh, Ava

    2015-01-01

    The authors report the first example of an adult achondroplastic dwarf with progressive quadriparesis secondary to atlantoaxial subluxation as a consequence of an os odontoideum. Actually, craniocervical region is a frequent site of compression and myelopathy in achondroplasia particularly in children as a result of small foramen magnum and hypertrophied opisthion. Moreover, very rarely in achondroplastic patients, coexistence of atlantoaxial instability as the sequel of os odontoideum can result in further compression of the already compromised cervicomedullary neural tissues, the scenario that has been reported only in five achondroplastic children. Herein, a 39-year-old achondroplastic male suffering such an extremely rare combination is presented. With C1-C2 screw rod instrumentation, atlas arch laminectomy, limited suboccipital craniectomy, and release of dural fibrous bands, reduction, decompression, and stabilization could be achieved properly resulting in steady but progressive recovery. PMID:26693369

  19. Bilateral medial malleolus stress fractures due to osteoarthritis of knee: A case report and review of literature

    PubMed Central

    Soni, Ashish; Vollans, Samuel; Haendlmayer, Kurt; Ng, Aaron

    2014-01-01

    Introduction Medial malleolar stress fracture is a relatively uncommon injury but it can occur in athletes participating in running and jumping activities. Stress fractures of pelvis, proximal tibia and metatarsals are well documented in the elderly population but medial malleolus involvement in this subgroup has never been reported. Presentation of case We report a case of bilateral medial malleolus stress fractures secondary to bilateral knee osteoarthritis. Discussion Osteoporosis and mechanical malalignment have been postulated as the possible risk factors for stress fractures in the elderly population. The pathomechanics and management of the case are discussed here. Conclusion A high index of suspicion is required to identify such fractures. Identification and treatment of the predisposing factors are a very important part of treatment. PMID:25553531

  20. Alzheimer random walk model: Two previously overlooked diffusion regimes

    NASA Astrophysics Data System (ADS)

    Cressoni, J. C.; Viswanathan, G. M.; Ferreira, A. S.; da Silva, M. A. A.

    2012-10-01

    A non-Markovian one-dimensional random walk model is studied with emphasis on the phase-diagram, showing all the diffusion regimes, along with the exactly determined critical lines. The model, known as the Alzheimer walk, is endowed with memory-controlled diffusion, responsible for the model's long-range correlations, and is characterized by a rich variety of diffusive regimes. The importance of this model is that superdiffusion arises due not to memory per se, but rather also due to loss of memory. The recently reported numerically and analytically estimated values for the Hurst exponent are hereby reviewed. We report the finding of two, previously overlooked, phases, namely, evanescent log-periodic diffusion and log-periodic diffusion with escape, both with Hurst exponent H=1/2. In the former, the log-periodicity gets damped, whereas in the latter the first moment diverges. These phases further enrich the already intricate phase diagram. The results are discussed in the context of phase transitions, aging phenomena, and symmetry breaking.

  1. Humoral hypercalcemia due to gastric carcinoma secreting parathyroid hormone-related protein during chemotherapy: a case report.

    PubMed

    Iino, Chikara; Shimoyama, Tadashi; Akemoto, Yui; Igarashi, Takasato; Aihara, Tomoyuki; Ishii, Kentaro; Sakamoto, Juichi; Tono, Hiroshi; Fukuda, Shinsaku

    2016-04-01

    Humoral hypercalcemia due to a gastric carcinoma-secreting parathyroid hormone-related protein (PTHrP) is a rare disease associated with poor prognosis. A 61-year-old male with gastric cancer who had been receiving chemotherapy showed serum hypercalcemia and an elevated level of serum PTHrP with a suppressed intact parathyroid hormone level. Computed tomography revealed stable disease 4 weeks prior, and the laboratory examination revealed no adverse effects 2 weeks prior. The biopsy at the time of diagnosis was immunohistochemically positive for PTHrP later. Despite intensive care, the patient died of multiorgan failure on the 14th day after admission. In case of undifferentiated gastric cancer, the possibility of humoral hypercalcemia of malignancy caused by gastric cancer should be considered even when the patient is receiving chemotherapy. PMID:26972102

  2. Small bowel perforation due to a migrated esophageal stent: Report of a rare case and review of the literature

    PubMed Central

    Karagul, Servet; Yagci, Mehmet Ali; Ara, Cengiz; Tardu, Ali; Ertugrul, Ismail; Kirmizi, Serdar; Sumer, Fatih

    2015-01-01

    Introduction Endoscopic esophageal stent placement is used to treat benign strictures, esophageal perforations, fistulas and for palliative therapy of esophageal cancer. Although stent placement is safe and effective method, complications are increasing the morbidity and mortality rate. We aimed to present a patient with small bowel perforation as a consequence of migrated esophageal stent. Presentation of case A 77-years-old woman was admitted with complaints of abdominal pain, abdominal distension, and vomiting for two days. Her past medical history included a pancreaticoduodenectomy for pancreatic tumor 11 years ago, a partial esophagectomy for distal esophageal cancer 6 months ago and an esophageal stent placement for esophageal anastomotic stricture 2 months ago. On abdominal examination, there was generalized tenderness with rebound. Computed tomography showed the stent had migrated. Laparotomy revealed a perforation localized in the ileum due to the migrated esophageal stent. About 5 cm perforated part of gut resected and anastomosis was done. The patient was exitus fifty-five days after operation due to sepsis. Discussion Small bowel perforation is a rare but serious complication of esophageal stent migration. Resection of the esophagogastric junction facilitates the migration of the stent. The lumen of stent is often allow to the passage in the gut, so it is troublesome to find out the dislocation in an early period to avoid undesired results. In our case, resection of the esophagogastric junction was facilitated the migration of the stent and late onset of the symptoms delayed the diagnosis. Conclusion Patients with esophageal stent have to follow up frequently to preclude delayed complications. Additional technical procedures are needed for the prevention of stent migration. PMID:25967554

  3. Recurrent burner syndrome due to presumed cervical spine osteoblastoma in a collision sport athlete – a case report

    PubMed Central

    2007-01-01

    We present a case of a 35-year-old active rugby player presenting with a history of recurrent burner syndrome thought secondary to an osteoblastoma involving the posterior arch of the atlas. Radiographically, the lesion had features typical for a large osteoid osteoma or osteoblastoma, including osseous expansion, peripheral sclerosis and bony hypertrophy, internal lucency, and even suggestion of a central nidus. The patient subsequently underwent an en bloc resection of the posterior atlas via a standard posterior approach. The surgery revealed very good clinical results. In this report, we will discuss in detail, the presentation, treatment, and return to play recommendations involving this patient. PMID:17553154

  4. Cardiovascular dysfunction due to sympathetic hypoactivity after complete cervical spinal cord injury: a case report and literature review.

    PubMed

    Oh, Young-Min; Eun, Jong-Pil

    2015-03-01

    Spinal cord injury (SCI) is one of the most devastating of all traumatic events; it may cause permanent dysfunction in several organ systems and lead to motor and sensory impairment. Cardiovascular dysfunction has been recognized to be the leading cause of morbidity and mortality in the acute and chronic stages following SCI. Although cardiovascular dysfunction causes the deaths of many SCI patients, most clinicians are unfamiliar with the phenomenon. The purpose of reporting our case is to remind clinicians to consider the possibility of cardiovascular dysfunction in patients with complete SCI. The patient signed informed consent for publication of this case report and any accompanying image. The ethical approval of this study was waived by the ethics committee of the Chonbuk National University Hospital, Jeonju, Korea, because this study was a case report and the number of patients was <3. A 63-year-old man was transferred to our emergency room after a fall. He complained of weakness and numbness of the lower extremity. Radiologic evaluation revealed C7/T1 unilateral facet dislocation with spinal cord contusion. On neurologic examination, the patient exhibited a paraplegic state below the T4 dermatome because of complete SCI. His vital signs were stable, but respiration was shallow. We performed intraoperative manual reduction and anterior interbody fusion. On the second postoperative day, the patient experienced sudden cardiac arrest after he was shifted from a supine to a semilateral position. Upon position change, heart rate was decreased <40 beats/min and blood pressure could not be checked. We immediately started cardiac massage and administered atropine 0.5 mg and epinephrine 1 mg, and the patient was successfully resuscitated. Cardiac arrest recurred when we performed endotracheal suction or changed patient's position. Echocardiographic and Holter monitoring findings demonstrated normal heart function and sinus bradycardia, and there was no evidence of pulmonary thromboembolism. We concluded that cardiac arrest was induced by sympathetic hypoactivity following complete SCI. Two months later, this phenomenon had resolved, and 4 months after presentation, he was discharged reliant on a home ventilator. Through this report, we emphasize that a thorough understanding of cardiovascular dysfunction following SCI is important for establishing a diagnosis and optimizing clinical outcomes. PMID:25816041

  5. Gassings due to methylene chloride, xylene, toluene, and styrene reported to Her Majesty's Factory Inspectorate 1961-80.

    PubMed Central

    Bakinson, M A; Jones, R D

    1985-01-01

    For the period 1961-80, 118 cases of industrial gassings caused by the solvents methylene chloride, xylene, toluene, and styrene were reported to Her Majesty's Factory Inspectorate. The data have been collated and analysed according to the predetermined criteria of age, sex, mode and circumstances of use, clinical effect, and outcome. The means of collection of the data and their objectivity is discussed. The study shows the narcotic effect of these solvents and underlines the dangers of their use in confined spaces. Symptoms were most commonly attributable to the nervous and respiratory systems. The problem of addiction and the vulnerability of the younger worker is also discussed. PMID:3970884

  6. Gassings due to methylene chloride, xylene, toluene, and styrene reported to Her Majesty's Factory Inspectorate 1961-80.

    PubMed

    Bakinson, M A; Jones, R D

    1985-03-01

    For the period 1961-80, 118 cases of industrial gassings caused by the solvents methylene chloride, xylene, toluene, and styrene were reported to Her Majesty's Factory Inspectorate. The data have been collated and analysed according to the predetermined criteria of age, sex, mode and circumstances of use, clinical effect, and outcome. The means of collection of the data and their objectivity is discussed. The study shows the narcotic effect of these solvents and underlines the dangers of their use in confined spaces. Symptoms were most commonly attributable to the nervous and respiratory systems. The problem of addiction and the vulnerability of the younger worker is also discussed. PMID:3970884

  7. Are Nectarines to Blame? A Case Report and Literature Review of Spontaneous Bacterial Peritonitis Due to Listeria monocytogenes.

    PubMed

    How, Joan; Azar, Marwan M; Meyer, Jaimie P

    2015-01-01

    Spontaneous bacterial peritonitis (SBP) is a frequent and potentially deadly complication of ascites in patients with end-stage liver disease. Unlike other pathogens more commonly implicated in SBP, Listeria monocytogenes is a nonenteric organism that maybe acquired either sporadically or in the setting of foodborne outbreaks. Listeria is an unusual cause of SBP that presents particular management challenges because of the organism's intrinsic resistance to first-line and empiric SBP treatment that would otherwise include third-generation cephalosporins. We present here a case of Listeria SBP in a 68-year-old man with previously unidentified cirrhosis. His infection occurred in the context of a nationwide fruit recall for Listeria contamination, prompting an epidemiologic investigation. After describing the case, we then review the extant literature on Listeria peritonitis. To date, no case studies on Listeria SBP have systematically described risk factors for Listeria acquisition. As incidence of Listeria SBP is increasing, however, knowledge of patient risk factors, especially foodborne exposure risks, may be important in preventing future episodes of Listeria SBP, and in accurately monitoring foodborne outbreaks. PMID:25960571

  8. Are Nectarines to Blame? A Case Report and Literature Review of Spontaneous Bacterial Peritonitis Due to Listeria monocytogenes

    PubMed Central

    How, Joan; Azar, Marwan M.; Meyer, Jaimie P.

    2015-01-01

    Spontaneous bacterial peritonitis (SBP) is a frequent and potentially deadly complication of ascites in patients with end-stage liver disease. Unlike other pathogens more commonly implicated in SBP, Listeria monocytogenes is a nonenteric organism that may be acquired either sporadically or in the setting of foodborne outbreaks. Listeria is an unusual cause of SBP that presents particular management challenges because of the organism’s intrinsic resistance to first-line and empiric SBP treatment that would otherwise include third-generation cephalosporins. We present here a case of Listeria SBP in a 68-year-old man with previously unidentified cirrhosis. His infection occurred in the context of a nationwide fruit recall for Listeria contamination, prompting an epidemiologic investigation. After describing the case, we then review the extant literature on Listeria peritonitis. To date, no case studies on Listeria SBP have systematically described risk factors for Listeria acquisition. As incidence of Listeria SBP is increasing, however, knowledge of patient risk factors, especially foodborne exposure risks, may be important in preventing future episodes of Listeria SBP, and in accurately monitoring foodborne outbreaks. PMID:25960571

  9. Invasive sinonasal disease due to dematiaceous fungi in immunocompromised individuals: case report and review of the literature.

    PubMed

    Derber, Catherine; Elam, Kara; Bearman, Gonzalo

    2010-09-01

    Invasive dematiaceous fungal sinusitis is an uncommon and aggressive disease in immunocompromised individuals. We report a unique case of invasive Exserohilum sinusitis in a pregnant, immunocompromised woman. After treating the woman with pregnancy-induced aplastic anemia and invasive Exserohilum sinusitis and pulmonary disease, we performed a Medline/PubMed review of invasive dematiaceous fungal sinonasal disease in immunocompromised individuals. Twelve cases of proven and one case of probable invasive sinonasal dematiaceous fungal disease in immunocompromised patients are reported in the English-language literature. The majority of patients had underlying hematological conditions. The crude mortality was high, with over half of the patients dying from presumed complications of the underlying immunosuppression. Successful outcomes were associated with surgical debridement, aggressive antifungal use, and a reduction of immunosuppression. The optimal treatment for immunocompromised patients with invasive dematiaceous fungal disease is not known. The role of newer triazoles, posaconazole and voriconazole, appears promising, however more clinical data are needed. Definitive diagnosis requires tissue biopsy and successful treatment is associated with reduction of immunosuppression, aggressive surgical debulking, and systemic antifungal therapy. PMID:20594890

  10. [Non-Specific Back Pain due to Superior Cluneal Nerve Entrapment Neuropathy Treated with Neurolysis: A Case Report].

    PubMed

    Morimoto, Daijiro; Isu, Toyohiko; Kim, Kyongsong; Yamazaki, Kazuyoshi; Iwamoto, Naotaka; Isobe, Masanori; Morita, Akio

    2016-02-01

    A 43-year-old man with a 10-year history of low back pain (LBP) had been conservatively treated elsewhere with medications for non-specific back pain. He presented to our institute with LBP and difficulty in standing up, sitting down, and sitting for prolonged periods. His Numerical Rating Scale score, due to LBP, was 8 out of 10. He had numbness on the lateral aspect of his left thigh. A lumbar radiography and magnetic resonance imaging studies revealed mild degenerative changes and mild canal stenosis in the lumbar spine. Palpation over the left posterior superior iliac crest, 8 cm from the midline over the iliac crest, revealed severe tenderness. A superior cluneal nerve(SCN)block performed at the trigger point in both the buttocks resulted in complete pain abatement and disappearance of the radiating pain. Therefore, we diagnosed SCN entrapment neuropathy(SCNE). However, the pain reappeared a few days later and subsequent treatments failed to relieve it; therefore, we decided to perform surgery. The SCN penetrates the thoracolumbar fascia through an orifice just before crossing over the iliac crest. We opened the orifice with microscissors in a distal to rostral direction along the SCN and released the entrapped nerve. After surgery, the symptoms were relieved and the patient experienced no recurrence in the last 4 years after the treatment. SCNE should be considered as a causative factor of LBP, and its treatment using minimally invasive surgery yields excellent clinical outcome. PMID:26856270

  11. Upper limb amputation due to a brachial arterial embolism associated with a superior mesenteric arterial embolism: a case report

    PubMed Central

    2012-01-01

    Background Acute mesenteric ischemia due to an embolism of the superior mesenteric artery is associated with a high mortality rate. Over 20 percent of acute mesenteric embolism cases consist of multiple emboli, and the long-term prognosis depends on the incidence of subsequent embolic events at other sites. The incidence of emboli in the upper extremity associated with a superior mesenteric arterial embolism has rarely been described. The signs and symptoms of ischemic change in the upper limb can be masked by other circumstances, such as postoperative conditions or complications. In these cases, a late presentation or delayed diagnosis and treatment can result in limb loss. Case presentation We present a rare case of a 67-year-old Japanese woman with atrial fibrillation who developed an embolic occlusion of the brachial artery associated with a superior mesenteric arterial embolism. She developed gangrene in her right hand, which had progressed to the point that amputation was necessary by the time the gastrointestinal surgeon had consulted the Department of Orthopedic Surgery. The brachial arterial embolism diagnosis was delayed by the severe abdominal symptoms and shock conditions that followed the emergency enterectomy, resulting in amputation of the upper limb despite anticoagulation therapy. In this case, multiple infarctions of the spleen were also observed, indicating a shower embolism. Conclusions When treating a superior mesenteric arterial embolism in a patient with atrial fibrillation, the possibility of recurrent or multiple arterial thromboembolic events should be considered, even after the procedure is completed. PMID:22828325

  12. [Brain Abscess due to Infection with Dematiaceous Fungi Cladophialophora bantiana Associated with Hypogammaglobulinemia Following Gastrectomy: A Case Report].

    PubMed

    Shimogawa, Takafumi; Sayama, Tetsuro; Haga, Sei; Akiyama, Tomoaki; Makihara, Kosuke; Morioka, Takato

    2016-01-01

    Dematiaceous fungi have melanin-like pigment in the cell wall and usually cause a variety of dermal infections in humans. Infections of the central nervous system(cerebral phaeohyphomycosis)are rare but serious, since they commonly occur in immunocompromized patients. A 76-year-old man was admitted with mild motor aphasia and underwent total excision of a mass in the left frontal lobe. With the postoperative diagnosis of brain abscess due to infection with dematiaceous fungi (C. bantiana) associated with hypogammaglobulinemia following gastrectomy, intravenous antifungal drugs including amphotericin B and fluconazole were administered. Regrowth of the abscess with intraventricular rupture was noted at about the 88th day after the initial surgery, and the patient underwent neuroendoscopic aspiration of the pus and placement of a ventricular drain. Following intraventricular administration of miconazole through ventricular drainage or an Ommaya reservoir, neuroradiological findings improved, but general and neurological conditions worsened. Further treatment was discontinued and the patient died 9 months after onset. The poor outcome in this patient is attributed to 1)intractability of dematiaceous fungi, 2)development of ventriculitis and the need for intraventricular administration of antifungal drugs, and 3)untreatable hypogammaglobulinemia following gastrectomy. PMID:26771098

  13. Skin infection due to Alternaria species in kidney allograft recipients: report of a new case and review of the literature.

    PubMed

    Gallelli, Beniamina; Viviani, Marianna; Nebuloni, Manuela; Marzano, Angelo V; Pozzi, Cristina; Messa, Piergiorgio; Fogazzi, Giovanni B

    2006-01-01

    A kidney allograft recipient developed a cutaneous infection 29 months after transplantation, due to the dematiaceous fungus Alternaria infectoria on his right forearm and left leg. Since the lesions were too large to be excised, the patient was treated only with systemic itraconazole and a reduction of the immunosuppressive therapy. After 4 months, the lesions were completely healed, and no relapses were observed at follow-up of 22 months. Twenty-seven other cases of cutaneous alternariosis have been described so far in renal transplant recipients. All types of immunosuppressive treatment can be associated with Alternaria infection, for which predisposing factors are jobs with frequent contact with earth, diabetes mellitus and skin trauma. In 70% of cases the infection occurred within the first year after transplantation. More frequently the lower limbs were involved and the lesions were multiple. Alternaria alternata was the commonest causative agent, followed by Alternaria tenuissima,Alternaria infectoria and Alternaria chartarum. The treatment is far from being standardized, but the best results are obtained with the surgical excision of the lesion(s) associated with systemic antifungal therapy. Since relapses are possible, strict control of the patients over time is essential. PMID:17136699

  14. Multiple recurrent postoperative spinal infections due to an unrecognized presacral abscess following placement of bicortical sacral screws: case report.

    PubMed

    Bloom, Laura; Burks, S Shelby; Levi, Allan D

    2016-03-01

    Postoperative wound infections in spinal surgery remain an important complication to diagnose and treat successfully. In most cases of deep infection, even with instrumentation, aggressive soft-tissue debridement followed by intravenous antibiotics is sufficient. This report presents a patient who underwent L3-S1 laminectomy and pedicle screw placement including bicortical sacral screws. This patient went on to develop multiple (7) recurrent infections at the operative site over a 5-year period. Continued investigation eventually revealed a large presacral abscess, which remained the source of recurrent bacterial seeding via the remaining bone tracts of the bicortical sacral screws placed during the original lumbar surgery. Two years after drainage of this presacral collection via a retroperitoneal approach, the patient remains symptom free. PMID:26613281

  15. Traction Induced Vertical Displacement of Odontoid due to Type III Odontoid Fracture with Unrecognized Ligamentous Injury: A Case Report

    PubMed Central

    Jung, Min-Ho; Hur, Hyuk; Jang, Jae-Won; Kim, Jae-Hyoo; Kim, Soo-Han

    2014-01-01

    Dens fractures are a common traumatic cervical spine injury. Among them, a type III fracture is the second common fracture. Although there are several treatment options, it has been accepted that type III fracture is usually healed by non-surgical method. After adequate reduction with traction, subsequent external immobilization has been associated with successful union rates. However, in the review of literatures, there are some cases with neurological deterioration after application of skull traction. So, the authors report a case of type III dens fracture with initially unrecognized ligamentous injury in which vertical dissociation and quadriplegia occurred after only five-pound Gardner-Well tongs traction. And also, the authors raise awareness of this potentially injury.

  16. Fulminant systemic capillary leak syndrome due to C1 inhibitor deficiency complicating acute dermatomyositis: a case report

    PubMed Central

    2014-01-01

    Introduction Dermatomyositis is a chronic inflammatory disorder characterized by muscular and dermatologic symptoms with variable internal organ involvement. This is the first report on a patient with acute dermatomyositis and fulminant systemic capillary leak syndrome. Case presentation A 69-year-old Caucasian woman with chronic dermatomyositis presented with clinical signs of severe hypovolemic shock and pronounced hemoconcentration (hematocrit, 69%). Her colloid osmotic pressure was 4.6mmHg. Following a bolus dose of prednisolone (500mg), fluid resuscitation was initiated. During volume loading, anasarca and acute respiratory distress rapidly developed. Echocardiography revealed an underfilled, hypokinetic, diastolic dysfunctional left ventricle with pericardial effusion but no signs of tamponade. Despite continued fluid resuscitation and high-dosed catecholamine therapy, the patient died from refractory shock 12 hours after intensive care unit admission. A laboratory analysis of her complement system suggested the presence of C1 inhibitor deficiency as the cause for systemic capillary leakage. The post-mortem examination revealed bilateral pleural, pericardial and peritoneal effusions as well as left ventricular hypertrophy with patchy myocardial fibrosis. Different patterns of endomysial/perimysial lymphocytic infiltrations adjacent to degenerated cardiomyocytes in her myocardium and necrotic muscle fibers in her right psoas major muscle were found in the histological examination. Conclusions This case report indicates that acute exacerbation of chronic dermatomyositis can result in a fulminant systemic capillary leak syndrome with intense hemoconcentration, hypovolemic shock and acute heart failure. In the presented patient, the cause for diffuse capillary leakage was most probably acquired angioedema, a condition that has been associated with both lymphoproliferative and autoimmunologic disorders. PMID:24467750

  17. Small Finger Snapping due to Retinacular Ligament Injury at the Level of Proximal Interphalangeal Joint: A Case Report.

    PubMed

    Lee, Young-Keun; Lee, Jun-Mo; Lee, Malrey

    2015-06-01

    Pathological snapping secondary to posttraumatic subluxation of the extensor tendon at proximal interphalangeal joint (PIPJ) of the finger is rare. Here, we want to describe a patient with snapping of the left small finger at PIPJ due to retinacular ligament injury. A 24-year-old man was admitted because of a 5-year history of a snapping sound in the left small finger. On examination, the radial side lateral band of the small finger was dislocated volarly at the level PIPJ with flexion of >50°, which was clearly felt over the skin. There was an obvious snapping sound at the time of dislocation. There was no specific radiographic abnormality. With the patient under regional anesthesia, exploration through a zigzag skin incision over the dorsum of the PIPJ revealed that the retinacular ligament complex was injured. We also found a partial tear in PIPJ capsule, through the incision of the injured retinacular ligament complex. We repaired the joint capsule and retinacular ligament complex with prolene 4-0. Postoperatively the small finger was immobilized in a below-elbow plaster splint with full extension of the fingers for 1 week, then dynamic splinting was advised for another 5 weeks and unrestricted full active motion was allowed at the 6th week. At the 6-month follow-up, the patient had regained full range of motion with no discomfort, and there was no sign of recurrence. We stress that when there is snapping over the dorsum of the PIPJ of the finger, the clinician should suspect rupture of the retinacular ligaments, especially in minor trauma patients. Primary repair of retinacular ligaments and dynamic splinting provided satisfactory results without recurrence in our patient. PMID:26091481

  18. Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report

    PubMed Central

    2016-01-01

    During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar. PMID:26877992

  19. A mini dental implant-supported obturator application in a patient with partial maxillectomy due to tumor: case report.

    PubMed

    Dilek, Ozkan Cem; Tezulas, Emre; Dincel, Mert

    2007-03-01

    Following a partial maxillectomy in a patient, the oral and nasal cavities remain open, providing a passageway for transmission of air and fluids between the 2 cavities. In such cases the primary aim should be the construction of an implant-supported obturator prosthesis with adequate retention, stability, and peripheral seal. In this case report, a 34-year-old female patient who underwent a class II (according to Okay et al.) partial maxillectomy 14 years before was fitted with an obturator that was supported by 5 mini dental implants. The reason for the preference of mini dental implants is the lack of adequate bone tissue for conventional implant placement in the resected area and the placement of mini dental implants with a simple surgical procedure. The treatment achieved restoration of the lost functions, which satisfied the patient, restoring her self-confidence and enhancing her quality of life. Thus, applying obturators supported by mini dental implants was successful and may be considered as an alternative to more complicated surgical techniques. Although the presented case is promising, further clinical research is needed to draw more definite conclusions. PMID:17197207

  20. Accidental injury of the inferior alveolar nerve due to the extrusion of calcium hydroxide in endodontic treatment: a case report.

    PubMed

    Shin, Yooseok; Roh, Byoung-Duck; Kim, Yemi; Kim, Taehyeon; Kim, Hyungjun

    2016-02-01

    During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar. PMID:26877992

  1. Primary cutaneous cryptococcosis in an immunocompetent patient due to Cryptococcus gattii molecular type VGI in Brazil: a case report and review of literature.

    PubMed

    Nascimento, Erika; Bonifácio da Silva, Maria Emília Nadaletto; Martinez, Roberto; von Zeska Kress, Marcia Regina

    2014-07-01

    Primary Cutaneous Cryptococcosis is an uncommon infection caused by the yeast Cryptococcus neoformans and C. gattii. Few case reports are available in the literature describing in detail primary cutaneous cryptococcosis due to C. gattii in immunocompetent patients. Herein, we present a case of a 68-year-old immunocompetent male patient with erythematous nodular lesions on the right forearm due to C. gattii mating-type α and molecular type VGI. The virulence factors test was performed for capsule diameter, melanin production and phospholipase activity. In vitro fluconazole testing showed the sensitivity profile of this clinical isolate. In addition, a review of the literature on this subject was carried out and verified that this is the first reported case of VGI in the south-east region of Brazil. PMID:24612099

  2. Case report of a near medical event in stereotactic radiotherapy due to improper units of measure from a treatment planning system

    SciTech Connect

    Gladstone, D. J.; Li, S.; Jarvis, L. A.; Hartford, A. C.

    2011-07-15

    Purpose: The authors hereby notify the Radiation Oncology community of a potentially lethal error due to improper implementation of linear units of measure in a treatment planning system. The authors report an incident in which a patient was nearly mistreated during a stereotactic radiotherapy procedure due to inappropriate reporting of stereotactic coordinates by the radiation therapy treatment planning system in units of centimeter rather than in millimeter. The authors suggest a method to detect such errors during treatment planning so they are caught and corrected prior to the patient positioning for treatment on the treatment machine. Methods: Using pretreatment imaging, the authors found that stereotactic coordinates are reported with improper linear units by a treatment planning system. The authors have implemented a redundant, independent method of stereotactic coordinate calculation. Results: Implementation of a double check of stereotactic coordinates via redundant, independent calculation is simple and accurate. Use of this technique will avoid any future error in stereotactic treatment coordinates due to improper linear units, transcription, or other similar errors. Conclusions: The authors recommend an independent double check of stereotactic treatment coordinates during the treatment planning process in order to avoid potential mistreatment of patients.

  3. SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study

    PubMed Central

    Randmaa, Maria; Mårtensson, Gunilla; Leo Swenne, Christine; Engström, Maria

    2014-01-01

    Objectives We aimed to examine staff members’ perceptions of communication within and between different professions, safety attitudes and psychological empowerment, prior to and after implementation of the communication tool Situation-Background-Assessment-Recommendation (SBAR) at an anaesthetic clinic. The aim was also to study whether there was any change in the proportion of incident reports caused by communication errors. Design A prospective intervention study with comparison group using preassessments and postassessments. Questionnaire data were collected from staff in an intervention (n=100) and a comparison group (n=69) at the anaesthetic clinic in two hospitals prior to (2011) and after (2012) implementation of SBAR. The proportion of incident reports due to communication errors was calculated during a 1-year period prior to and after implementation. Setting Anaesthetic clinics at two hospitals in Sweden. Participants All licensed practical nurses, registered nurses and physicians working in the operating theatres, intensive care units and postanaesthesia care units at anaesthetic clinics in two hospitals were invited to participate. Intervention Implementation of SBAR in an anaesthetic clinic. Primary and secondary outcomes The primary outcomes were staff members’ perception of communication within and between different professions, as well as their perceptions of safety attitudes. Secondary outcomes were psychological empowerment and incident reports due to error of communication. Results In the intervention group, there were statistically significant improvements in the factors ‘Between-group communication accuracy’ (p=0.039) and ‘Safety climate’ (p=0.011). The proportion of incident reports due to communication errors decreased significantly (p<0.0001) in the intervention group, from 31% to 11%. Conclusions Implementing the communication tool SBAR in anaesthetic clinics was associated with improvement in staff members’ perception of communication between professionals and their perception of the safety climate as well as with a decreased proportion of incident reports related to communication errors. Trial registration ISRCTN37251313. PMID:24448849

  4. A new species of Neolebouria Gibson, 1976 (Opecoelidae: Plagioporinae) from the whitecheek monocle bream, Scolopsis vosmeri (Perciformes: Nemipteridae), from the Panjim coast at Goa, with a checklist of parasites previously reported from this fish.

    PubMed

    Jaiswal, Neeshma; Upadhyay, S K; Malhotra, Anshu; Blend, Charles K; Dronen, Norman O; Malhotra, Sandeep K

    2014-01-01

    Neolebouria capoori n. sp. (Opecoelidae: Plagioporinae) is described from the whitecheek monocle bream, Scolopsis vosmeri (Bloch) (Perciformes: Nemipteridae) from the Panjim coast on the central west coast of India at Goa. The new species differs from both Neolebouria cantherhini (Li, Qiu & Zhang, 1988) as originally described from Thamnaconus modestus (Günther) (syn. Cantherines modestus Günther ) and Neolebouria confusum (Overstreet, 1969) as originally described from Ocyurus chrysurus (Bloch) by having the cirrus sac surpassing the ventral sucker posteriorly in N. cantherhini and being entirely preacetabular in N. confusum compared to terminating near the midlevel of the ventral sucker in N. capoori n. sp. The new species is most similar to N. confusum, but it further differs from this species by having the vitelline fields terminating near the level of the esophageal bifurcation compared to terminating near the level of the posterior margin of the pharynx, a larger sucker ratio (1:1.7-1:2.0 compared to 1:1.4-1:1.7), a somewhat shorter cirrus sac relative to body length (160-448, representing 9-18% of the body length compared to about 367, representing 22%), and the egg of the new species has a boss at the anopercular end that is not present in N. confusum. This study represents the first report on an opecoelid from S. vosmeri. A review of the parasites reported from S. vosmeri is included. PMID:24870995

  5. Total hip arthroplasty with cement and without acetabular bone graft for severe hip dysplasia. A concise follow-up, at a minimum of twenty years, of a previous report.

    PubMed

    Klapach, A S; Callaghan, J J; Miller, K A; Goetz, D D; Sullivan, P M; Pedersen, D R; Johnston, R C

    2005-02-01

    We previously evaluated a cohort of fifty-three patients with severe hip dysplasia (Crowe Type-II, III, or IV subluxation) who underwent a total of sixty-six Charnley total hip arthroplasties. The acetabular component was placed at the anatomic hip center, the superolateral defect was filled with cement, and no bone-grafting was used to supplement the acetabular wall. All but one patient, who was lost to follow-up, were followed until death or for a minimum of twenty years. Radiographic and functional follow-up data were collected prospectively. This retrospective review included twenty-four patients (thirty-four hips) who were alive at a minimum of twenty years following the surgery. Fourteen (22%) of the sixty-five hips underwent revision of a component, with eleven of the revisions performed because of aseptic loosening. Eight of those eleven hips underwent revision because of acetabular loosening alone; two, because of femoral loosening alone; and one, because of loosening of both components. The combined prevalence of revision because of aseptic loosening of the acetabular component and radiographic evidence of failure of the acetabular component was 28% (eighteen hips). With the numbers available, the need for acetabular revision was not associated with the percentage of cement coverage (p = 0.362) or the Crowe classification (p = 0.159). At a minimum of twenty years postoperatively, the survivorship of the acetabular component was 86% +/- 8% with revision because of aseptic loosening as the end point and 82% +/- 10% with revision because of aseptic loosening or radiographic evidence of loosening as the end point. The results that we evaluated at a minimum of twenty years after use of this technique can be compared with the results of other techniques in studies with similar long-term follow-up periods. PMID:15687148

  6. Intraductal papilloma of ectopic breast tissue in axillary lymph node of a patient with a previous intraductal papilloma of ipsilateral breast: a case report and review of the literature.

    PubMed

    Dzodic, Radan; Stanojevic, Boban; Saenko, Vladimir; Nakashima, Masahiro; Markovic, Ivan; Pupic, Gordana; Buta, Marko; Inic, Momcilo; Rogounovitch, Tatiana; Yamashita, Shunichi

    2010-01-01

    The presence of ectopic breast tissue in axillary lymph nodes (ALN) is a benign condition that must be differentiated from primary or metastatic carcinoma. Here we report a patient who underwent excision of enlarged ALN 10 years after she had received surgical treatment of ipsilateral breast for an intracystic intraductal papilloma (IDP). Histological examination of the removed ALN revealed that the proliferative lesion consisted of papillary and tubular structures lined by luminal cuboidal cells and a distinct outer layer of myoepithelial cells resembling IDP of the breast. Immunostaining with a set of immunohistochemical markers including AE/AE3, alpha-smooth muscle actin and p63 in combination with estrogen and progesterone receptors confirmed the diagnosis of ectopic IDP.This case shows that even though benign proliferative change in ectopic breast tissue is an extremely rare phenomenon, this possibility should be taken into account for correct diagnosis. PMID:20222992

  7. Report of a patient with chronic intractable autoimmune hemorrhaphilia due to anti-factor XIII/13 antibodies who died of hemorrhage after sustained clinical remission for 3 years.

    PubMed

    Kotake, Takeshi; Souri, Masayoshi; Takada, Koji; Kosugi, Satoru; Nakata, Soichi; Ichinose, Akitada

    2015-06-01

    Although the incidence of autoimmune hemorrhaphilia due to anti-Factor XIII (FXIII, not FVIII or FXII to avoid confusion) antibodies (AH13) or hemorrhagic "acquired FXIII deficiency due to anti-FXIII autoantibodies" was previously considered rare, it has been on the increase in the twenty-first century, at least in Japan. An 83-year-old woman with an unexplained hemorrhage was admitted to our hospital for intramuscular hematoma and severe anemia. Her FXIII activity was reduced to 10 % of normal; since FXIII inhibitors and anti-FXIII-A subunit autoantibodies were detected, she was definitively diagnosed with AH13. Despite developing cardiac tamponade due to pericardial hemorrhage, she clinically recovered from AH13 after hemostatic therapy with FXIII-concentrates and immunosuppressive treatment with rituximab and cyclophosphamide. However, her FXIII activity remained low and she died of hemorrhage 3.5 years after admission. AH13 patients should be monitored for a prolonged period, as this disease is very likely a chronic intractable hemorrhagic disorder. PMID:25663511

  8. A Novel Botulinum Neurotoxin, Previously Reported as Serotype H, Has a Hybrid-Like Structure With Regions of Similarity to the Structures of Serotypes A and F and Is Neutralized With Serotype A Antitoxin.

    PubMed

    Maslanka, Susan E; Lúquez, Carolina; Dykes, Janet K; Tepp, William H; Pier, Christina L; Pellett, Sabine; Raphael, Brian H; Kalb, Suzanne R; Barr, John R; Rao, Agam; Johnson, Eric A

    2016-02-01

    Botulism is a potentially fatal paralytic disease caused by the action of botulinum neurotoxin (BoNT) on nerve cells. There are 7 known serotypes (A-G) of BoNT and up to 40 genetic variants. Clostridium botulinum strain IBCA10-7060 was recently reported to produce BoNT serotype B (BoNT/B) and a novel BoNT, designated as BoNT/H. The BoNT gene (bont) sequence of BoNT/H was compared to known bont sequences. Genetic analysis suggested that BoNT/H has a hybrid-like structure containing regions of similarity to the structures of BoNT/A1 and BoNT/F5. This novel BoNT was serologically characterized by the mouse neutralization assay and a neuronal cell-based assay. The toxic effects of this hybrid-like BoNT were completely eliminated by existing serotype A antitoxins, including those contained in multivalent therapeutic antitoxin products that are the mainstay of human botulism treatment. PMID:26068781

  9. Quality of life with palbociclib plus fulvestrant in previously treated hormone receptor-positive, HER2-negative metastatic breast cancer: patient-reported outcomes from the PALOMA-3 trial

    PubMed Central

    Harbeck, N.; Iyer, S.; Turner, N.; Cristofanilli, M.; Ro, J.; André, F.; Loi, S.; Verma, S.; Iwata, H.; Bhattacharyya, H.; Puyana Theall, K.; Bartlett, C. H.; Loibl, S.

    2016-01-01

    Background In the PALOMA-3 study, palbociclib plus fulvestrant demonstrated improved progression-free survival compared with fulvestrant plus placebo in hormone receptor-positive, HER2− endocrine-resistant metastatic breast cancer (MBC). This analysis compared patient-reported outcomes (PROs) between the two treatment groups. Patients and methods Patients were randomized 2 : 1 to receive palbociclib 125 mg/day orally for 3 weeks followed by 1 week off (n = 347) plus fulvestrant (500 mg i.m. per standard of care) or placebo plus fulvestrant (n = 174). PROs were assessed on day 1 of cycles 1–4 and of every other subsequent cycle starting with cycle 6 using the EORTC QLQ-C30 and its breast cancer module, QLQ-BR23. High scores (range 0–100) could indicate better functioning/quality of life (QoL) or worse symptom severity. Repeated-measures mixed-effect analyses were carried out to compare on-treatment overall scores and changes from baseline between treatment groups while controlling for baseline. Between-group comparisons of time to deterioration in global QoL and pain were made using an unstratified log-rank test and Cox proportional hazards model. Results Questionnaire completion rates were high at baseline and during treatment (from baseline to cycle 14, ≥95.8% in each group completed ≥1 question on the EORTC QLQ-C30). On treatment, estimated overall global QoL scores significantly favored the palbociclib plus fulvestrant group [66.1, 95% confidence interval (CI) 64.5–67.7 versus 63.0, 95% CI 60.6–65.3; P = 0.0313]. Significantly greater improvement from baseline in pain was also observed in this group (−3.3, 95% CI −5.1 to −1.5 versus 2.0, 95% CI −0.6 to 4.6; P = 0.0011). No significant differences were observed for other QLQ-BR23 functioning domains, breast or arm symptoms. Treatment with palbociclib plus fulvestrant significantly delayed deterioration in global QoL (P < 0.025) and pain (P < 0.001) compared with fulvestrant alone. Conclusion Palbociclib plus fulvestrant allowed patients to maintain good QoL in the endocrine resistance setting while experiencing substantially delayed disease progression. Clinical Trial Registration NCT01942135. PMID:27029704

  10. Failure of Urological Implants in Spinal Cord Injury Patients due to Infection, Malfunction, and Implants Becoming Obsolete due to Medical Progress and Age-Related Changes in Human Body Making Implant Futile: Report of Three Cases

    PubMed Central

    Vaidyanathan, Subramanian; Soni, Bakul; Singh, Gurpreet; Hughes, Peter; Selmi, Fahed

    2013-01-01

    Any new clinical data, whether positive or negative, generated about a medical device should be published because health professionals should know which devices do not work, as well as those which do. We report three spinal cord injury patients in whom urological implants failed to work. In the first, paraplegic, patient, a sacral anterior root stimulator failed to produce erection, and a drug delivery system for intracavernosal administration of vasoactive drugs was therefore implanted; however, this implant never functioned (and, furthermore, such penile drug delivery systems to produce erection had effectively become obsolete following the advent of phosphodiesterase type 5 inhibitors). Subsequently, the sacral anterior root stimulator developed a malfunction and the patient therefore learned to perform self-catheterisation. In the second patient, also paraplegic, an artificial urinary sphincter was implanted but the patient developed a postoperative sacral pressure sore. Eight months later, a suprapubic cystostomy was performed as urethral catheterisation was very difficult. The pressure sore had not healed completely even after five years. In the third case, a sacral anterior root stimulator was implanted in a tetraplegic patient in whom, after five years, a penile sheath could not be fitted because of penile retraction. This patient was therefore established on urethral catheter drainage. Later, infection with Staphylococcus aureus around the receiver block necessitated its removal. In conclusion, spinal cord injury patients are at risk of developing pressure sores, wound infections, malfunction of implants, and the inability to use implants because of age-related changes, as well as running the risk of their implants becoming obsolete due to advances in medicine. Some surgical procedures such as dorsal rhizotomy are irreversible. Alternative treatments such as intermittent catheterisations may be less damaging than bladder stimulator in the long term. PMID:23864980

  11. An Outbreak of Food-Borne Typhoid Fever Due to Salmonella enterica Serotype Typhi in Japan Reported for the First Time in 16 Years

    PubMed Central

    Kobayashi, Tetsuro; Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Ohmagari, Norio; Uryu, Hideko; Yamada, Ritsuko; Kashiwa, Naoyuki; Nei, Takahito; Ehara, Akihito; Takei, Reiko; Mori, Nobuaki; Yamada, Yasuhiro; Hayasaka, Tomomi; Kagawa, Narito; Sugawara, Momoko; Suzaki, Ai; Takahashi, Yuno; Nishiyama, Hiroyuki; Morita, Masatomo; Izumiya, Hidemasa; Ohnishi, Makoto

    2016-01-01

    For the first time in 16 years, a food-borne outbreak of typhoid fever due to Salmonella enterica serotype Typhi was reported in Japan. Seven patients consumed food in an Indian buffet at a restaurant in the center of Tokyo, while one was a Nepali chef in the restaurant, an asymptomatic carrier and the implicated source of this outbreak. The multiple-locus variable-number tandem repeat analysis showed 100% consistency in the genomic sequence for five of the eight cases. PMID:26621565

  12. An Outbreak of Food-Borne Typhoid Fever Due to Salmonella enterica Serotype Typhi in Japan Reported for the First Time in 16 Years.

    PubMed

    Kobayashi, Tetsuro; Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Ohmagari, Norio; Uryu, Hideko; Yamada, Ritsuko; Kashiwa, Naoyuki; Nei, Takahito; Ehara, Akihito; Takei, Reiko; Mori, Nobuaki; Yamada, Yasuhiro; Hayasaka, Tomomi; Kagawa, Narito; Sugawara, Momoko; Suzaki, Ai; Takahashi, Yuno; Nishiyama, Hiroyuki; Morita, Masatomo; Izumiya, Hidemasa; Ohnishi, Makoto

    2016-02-01

    For the first time in 16 years, a food-borne outbreak of typhoid fever due to Salmonella enterica serotype Typhi was reported in Japan. Seven patients consumed food in an Indian buffet at a restaurant in the center of Tokyo, while one was a Nepali chef in the restaurant, an asymptomatic carrier and the implicated source of this outbreak. The multiple-locus variable-number tandem repeat analysis showed 100% consistency in the genomic sequence for five of the eight cases. PMID:26621565

  13. An acute hemolytic transfusion reaction due to the “anti-c” rhesus antibody: A case report emphasizing the role of transfusion medicine

    PubMed Central

    Sachan, Deepti; Jayakumar, Rajeswari; Varghese, Joy; Rela, Mohamed

    2015-01-01

    Rhesus (Rh) mediated hemolytic transfusion reactions (HTR) are usually immunoglobulin G mediated and delayed onset. Rh antibodies being the cause of acute HTR (AHTR) and intravascular hemolysis are still under debate. We report here a case of a 53-year-old male who developed AHTR due to “anti-c” antibodies within 3 h of blood transfusion, precipitating fatal acute liver failure in a patient with hepatitis C related chronic liver disease. This case emphasizes the need of inclusion of antibody screening in routine pretransfusion testing as well as a critical role of transfusion medicine specialists for early diagnosis and minimizing transfusion-related morbidity and mortality. PMID:26420949

  14. Clinical Case Report of Expansive Laminoplasty for Cervical Myelopathy Due to Both Disc Herniation and Developmental Cervical Spinal Canal Stenosis in Older Adolescents.

    PubMed

    Zhou, Hua; Sun, Yu; Zhang, Fengshan; Dang, Gengting; Liu, Zhongjun

    2016-02-01

    Reports on adolescent patients with cervical myelopathy who underwent anterior cervical discectomy and fusion are scarce. However, to our knowledge, no cases of expansive laminoplasty for cervical myelopathy associated with progressive neurological deficit after a series of conservative treatment, caused by both disc herniation and developmental cervical spinal canal stenosis, have been reported.From January 2006 to July 2012, we retrospectively studied 3 patients in late adolescence presenting with cervical myelopathy who underwent expansive unilateral open-door laminoplasty at our hospital. The outcomes after the surgery were evaluated according to the Japanese Orthopedic Association scores.Symptoms presented by these patients were due to both disc herniation and developmental cervical spinal canal stenosis. No major complications occurred after the surgical procedures. The median follow-up time was 66 months (range 36-112 months). The Japanese Orthopedic Association scores after surgery showed a significant increase. Long-term outcomes after surgery were satisfactory according to the evaluation criteria for the Japanese Orthopedic Association scores. However, the ranges of motion of the cervical spine decreased, especially the ranges of motion on flexion after surgery showed a significant decrease.Expansive laminoplasty is helpful for older adolescent patients with cervical myelopathy due to both disc herniation and developmental cervical spinal canal stenosis, presenting with progressive neurological deficit after long conservative treatment. PMID:26937923

  15. Congestive Myelopathy due to Intradural Spinal AVM Supplied by Artery of Adamkiewicz: Case Report with Brief Literature Review and Analysis of the Foix-Alajouanine Syndrome Definition

    PubMed Central

    Sood, Dinesh; Mistry, Kewal A.; Khatri, Garvit D.; Chadha, Veenal; Garg, Swati; Suthar, Pokhraj P.; Patel, Dhruv G.; Patel, Ankitkumar

    2015-01-01

    Summary Background Spinal arteriovenous malformations (AVMs) can lead to development of congestive myelopathy (Foix-Alajouanine syndrome). Spinal AVMs are rare and so is this syndrome. Diagnosis is often missed due to its rarity and confusing definitions of the Foix-Alajouanine syndrome. Case Report We report a case of a 47-year-old male patient suffering from this rare syndrome with an AVM arising from the artery of Adamkiewicz, which is another rarity. Our patient was treated by embolization of the lesion with 20% glue, after which he showed mild improvement of symptoms. We also present a brief review of literature on spinal AVMs and elucidate the evolution of the term Foix-Alajouanine syndrome. Conclusions Use of the term “Foix-Alajouanine syndrome” should be restricted to patients with progressive subacute to chronic neurological symptoms due to congestive myelopathy caused by intradural spinal AVMs. CT angiography should supplement DSA as preliminary Imaging modality. Patients may be treated with surgery or endovascular procedures. PMID:26171088

  16. Clinical Case Report of Expansive Laminoplasty for Cervical Myelopathy Due to Both Disc Herniation and Developmental Cervical Spinal Canal Stenosis in Older Adolescents

    PubMed Central

    Zhou, Hua; Sun, Yu; Zhang, Fengshan; Dang, Gengting; Liu, Zhongjun

    2016-01-01

    Abstract Reports on adolescent patients with cervical myelopathy who underwent anterior cervical discectomy and fusion are scarce. However, to our knowledge, no cases of expansive laminoplasty for cervical myelopathy associated with progressive neurological deficit after a series of conservative treatment, caused by both disc herniation and developmental cervical spinal canal stenosis, have been reported. From January 2006 to July 2012, we retrospectively studied 3 patients in late adolescence presenting with cervical myelopathy who underwent expansive unilateral open-door laminoplasty at our hospital. The outcomes after the surgery were evaluated according to the Japanese Orthopedic Association scores. Symptoms presented by these patients were due to both disc herniation and developmental cervical spinal canal stenosis. No major complications occurred after the surgical procedures. The median follow-up time was 66 months (range 36–112 months). The Japanese Orthopedic Association scores after surgery showed a significant increase. Long-term outcomes after surgery were satisfactory according to the evaluation criteria for the Japanese Orthopedic Association scores. However, the ranges of motion of the cervical spine decreased, especially the ranges of motion on flexion after surgery showed a significant decrease. Expansive laminoplasty is helpful for older adolescent patients with cervical myelopathy due to both disc herniation and developmental cervical spinal canal stenosis, presenting with progressive neurological deficit after long conservative treatment. PMID:26937923

  17. Amnesia due to spontaneous haemorrhage into a colloid cyst.

    PubMed

    Sivakumaran, Ramanan; Edwards, Richard J

    2014-10-14

    Anterograde amnesia is a recognised complication of colloid cyst excision, occurring usually as a result of forniceal injury. However, spontaneous amnesia due to intra-cyst haemorrhage prior to excision has not been reported previously. We report such a case in which amnesia completely resolved following endoscopic cyst excision. PMID:25311041

  18. Previous Mental Distress May Slow Concussion Recovery

    MedlinePlus

    ... nih.gov/medlineplus/news/fullstory_158414.html Previous Mental Distress May Slow Concussion Recovery If 'psychosomatic symptoms' ... had psychosomatic symptoms -- aches and pains caused by mental distress -- before their head injury, new research suggests. ...

  19. Survey context and question wording affects self reported annoyance due to road traffic noise: a comparison between two cross-sectional studies

    PubMed Central

    2012-01-01

    Background Surveys are a common way to measure annoyance due to road traffic noise, but the method has some draw-backs. Survey context, question wording and answer alternatives could affect participation and answers and could have implications when comparing studies and/or performing pooled analyses. The aim of this study was to investigate the difference in annoyance reporting due to road traffic noise in two types of surveys of which one was introduced broadly and the other with the clearly stated aim of investigating noise and health. Methods Data was collected from two surveys carried out in the municipality of Malmö, southern Sweden in 2007 and 2008 (n = 2612 and n = 3810). The first survey stated an aim of investigating residential environmental exposure, especially noise and health. The second survey was a broad public health survey stating a broader aim. The two surveys had comparable questions regarding noise annoyance, although one used a 5-point scale and the other a 4-point scale. We used geographic information systems (GIS) to assess the average road and railway noise (LAeq,24h) at the participants' residential address. Logistic regression was used to calculate odds ratios for annoyance in relation to noise exposure. Results Annoyance at least once a week due to road traffic noise was significantly more prevalent in the survey investigating environment and health compared to the public health survey at levels > 45 dB(A), but not at lower exposure levels. However no differences in annoyance were found when comparing the extreme alternatives "never" and "every day". In the study investigating environment and health, "Noise sensitive" persons were more likely to readily respond to the survey and were more annoyed by road traffic noise compared to the other participants in that survey. Conclusions The differences in annoyance reporting between the two surveys were mainly due to different scales, suggesting that extreme alternatives are to prefer before dichotomization when comparing results between the two. Although some findings suggested that noise-sensitive individuals were more likely to respond to the survey investigating noise and health, we could not find convincing evidence that contextual differences affected either answers or participation. PMID:22404876

  20. Identification of multidrug resistance in previously treated tuberculosis patients: a mixed methods study in Cambodia

    PubMed Central

    Royce, S; Khann, S; Yadav, RP; Mao, ET; Cattamanchi, A; Sam, S; Handley, MA

    2014-01-01

    SUMMARY Setting Previously treated tuberculosis (TB) patients are a priority for drug susceptibility testing (DST) to identify cases with multidrug resistance (MDR). In Cambodia, a recent study found that only one-third of smear-positive previously treated patients had DST results. Objective To quantify the gaps in detecting MDR in previously treated TB patients in Cambodia, and describe health workers’ perspectives on barriers, facilitators and potential interventions. Design We analyzed case notifications in Cambodia (2004–2012) and conducted semi-structured interviews with key stakeholders Results The proportion of previously treated notifications varied significantly across provinces 2010–12, in the context of longer term trends of decreasing relapse and increasing “other” retreatment notifications. Correct classification of patients’ TB treatment history and ensuring specimens from previously-treated patients are collected and reach the laboratory could nearly double the number of detected MDR-TB cases. Identified barriers include patients’ reluctance to disclose and staff difficulty eliciting treatment history, partly due to availability of streptomycin only in hospitals. Facilitators include trained health workers, collection of sputum for DST even if previously treated patients are not taking streptomycin, streamlining sputum transportation and promptly reporting results. Conclusion Improved monitoring, supportive supervision, and correctly classifying previously treated patients are essential for improving detection of MDR-TB. PMID:25299861

  1. No cumulative effects for one or two previous concussions

    PubMed Central

    Iverson, G L; Brooks, B L; Lovell, M R; Collins, M W

    2006-01-01

    Background Sports medicine clinicians and the general public are interested in the possible cumulative effects of concussion. Objective To examine whether athletes with a history of one or two previous concussions differed in their preseason neuropsychological test performances or symptom reporting. Method Participants were 867 male high school and university amateur athletes who completed preseason testing with ImPACT version 2.0. They were sorted into three groups on the basis of number of previous concussions. There were 664 athletes with no previous concussions, 149 with one previous concussion, and 54 with two previous concussions. Multivariate analysis of variance was conducted using the verbal memory, visual memory, reaction time, processing speed, and postconcussion symptom composite scores as dependent variables and group membership as the independent variable. Results There was no significant multivariate effect, nor were there any significant main effects for individual scores. There was no measurable effect of one or two previous concussions on athletes' preseason neuropsychological test performance or symptom reporting. Conclusion If there is a cumulative effect of one or two previous concussions, it is very small and undetectable using this methodology. PMID:16371496

  2. 77 FR 70176 - Previous Participation Certification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... URBAN DEVELOPMENT Previous Participation Certification AGENCY: Office of the Chief Information Officer... of Housing and Urban Development, 451 Seventh Street SW., Washington, DC 20410; email Colette Pollard... notice informs the public that the Department of Housing and Urban Development has submitted to OMB...

  3. A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy.

    PubMed

    Ke, Jiang-Qiong; Yin, Bo; Fu, Fang-Wang; Shao, Sheng-Min; Lin, Yan; Dong, Qi-Qiang; Wang, Xiao-Tong; Zheng, Guo-Qing

    2016-02-01

    Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy.A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, although the patient remained conscious, he could not speak but could communicate with the surrounding by blinking or moving his eyes, and turned to complete quadriplegia, complete facial and bulbar palsy, dyspnea at 4 hours after admission. He was diagnosed with LIS. Then, the patient was received cervical and brain computed tomography angiography that showed bilateral VAD. Aortocranial digital subtraction angiography showed vertebrobasilar thrombosis, blocking left vertebral artery, and stenosis of right vertebral artery. The patient was treated by using emergency arterial embolectomy and followed by antiplatelet therapy and supportive therapy in the intensive care unit and a general ward. Twenty-seven days later, the patient's physical function gradually improved and discharged but still left neurological deficit with muscle strength grade 3/5 and hyperreflexia of limbs.Our findings suggested that CSM might have potential severe side-effect like LIS due to bilaterial VAD, and arterial embolectomy is an important treatment choice. The practitioner must be aware of this complication and should give the patients informed consent to CSM, although not all stroke cases temporally related to SCM have pre-existing craniocervical artery dissection. PMID:26844510

  4. A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy

    PubMed Central

    Ke, Jiang-Qiong; Yin, Bo; Fu, Fang-Wang; Shao, Sheng-Min; Lin, Yan; Dong, Qi-Qiang; Wang, Xiao-Tong; Zheng, Guo-Qing

    2016-01-01

    Abstract Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy. A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, although the patient remained conscious, he could not speak but could communicate with the surrounding by blinking or moving his eyes, and turned to complete quadriplegia, complete facial and bulbar palsy, dyspnea at 4 hours after admission. He was diagnosed with LIS. Then, the patient was received cervical and brain computed tomography angiography that showed bilateral VAD. Aortocranial digital subtraction angiography showed vertebrobasilar thrombosis, blocking left vertebral artery, and stenosis of right vertebral artery. The patient was treated by using emergency arterial embolectomy and followed by antiplatelet therapy and supportive therapy in the intensive care unit and a general ward. Twenty-seven days later, the patient's physical function gradually improved and discharged but still left neurological deficit with muscle strength grade 3/5 and hyperreflexia of limbs. Our findings suggested that CSM might have potential severe side-effect like LIS due to bilaterial VAD, and arterial embolectomy is an important treatment choice. The practitioner must be aware of this complication and should give the patients informed consent to CSM, although not all stroke cases temporally related to SCM have pre-existing craniocervical artery dissection. PMID:26844510

  5. The first description of metyrapone use in severe Cushing Syndrome due to ectopic ACTH secretion in an infant with immature sacrococcygeal teratoma. Case Report.

    PubMed

    Wojcik, Malgorzata; Kalicka-Kasperczyk, Anna; Luszawska-Kutrzeba, Teresa; Balwierz, Walentyna; Starzyk, Jerzy B

    2015-12-01

    Cushing syndrome due to ectopic secretion of ACTH in infants is rare. The treatment of choice is radical resection of the tumour in combination with pre-operative chemotherapy using steroidogenesis inhibitors if necessary. If radical surgery is not possible, palliative treatment of hypercortisolemia is recommended. The most frequently used drug in infants is ketoconazole. Experience with the use of metyrapone is poor. We report an 8-month-old female infant with congenital immature sacrococcygeal teratoma secreting AFP, beta hCG and ACTH who had undergone non-radical resection of the tumour mass and was receiving standard risk chemotherapy (vinblastine, bleomycin, and cisplatin). The infant initially presented at the age of 6 months with ACTH-dependent Cushing syndrome (cortisol and ACTH level 325 ng/mL, 112 pg/mL respectively). Treatment with ketoconazole was initiated with a dose of 600 mg/day. Due to its ineffectiveness metyrapne was added in increasing dosages, up to 1,500 mg/day. In addition the schema of chemotherapy was changed (adriamycin, bleomycin, carboplatin), which resulted in normalization of cortisol levels and blood pressure. There were no metyrapone side effects during the treatment period. We can conclude that treatment with metyrapone at a dose of 1500 mg/day might be effective and safe in infants with Cushing syndrome. PMID:26859587

  6. Occupational injuries due to violence.

    PubMed

    Hales, T; Seligman, P J; Newman, S C; Timbrook, C L

    1988-06-01

    Each year in the United States, an estimated 800 to 1,400 people are murdered at work, and an unknown number of nonfatal injuries due to workplace violence occur. Based on Ohio's workers' compensation claims from 1983 through 1985, police officers, gasoline service station employees, employees of the real estate industry, and hotel/motel employees were found to be at the highest risk for occupational violent crime (OVC) injury and death. Grocery store employees, specifically those working in convenience food stores, and employees of the real estate industry had the most reported rapes. Four previously unidentified industries at increased risk of employee victimization were described. Identification of industries and occupations at high risk for crime victimization provides the opportunity to focus preventive strategies to promote employee safety and security in the workplace. PMID:3392614

  7. Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: A case report and literature review

    PubMed Central

    2012-01-01

    Background Fusobacterium species are uncommon causes of osteomyelitis. These organisms are normal flora of the oral cavity. Therefore, they mostly cause osteomyelitis of the head and neck. Hematogenous osteomyelitis at distant sites other than the head and neck has rarely been reported in pediatric or immunocompromised patients. Here, we report the first case of osteomyelitis of a long bone combined with a muscle abscess due to Fusobacterium nucleatum in an otherwise healthy adult. Case presentation A 59-year-old Korean man was admitted for pain and swelling of the right lower leg, which had been persistent for two weeks. Magnetic resonance imaging showed osteomyelitis of the right fibula with a surrounding muscle abscess of the right lower leg. Incision and drainage was performed, and repetitive tissue cultures grew F. nucleatum. In this patient, it was presumed that recurrent periodontitis caused hematogenous seeding of F. nucleatum to a distant site leading to osteomyelitis with a muscle abscess. The patient was successfully treated with intravenous ampicillin-sulbactam for three weeks and oral amoxicillin-clavulanate for eight weeks. He also underwent repeated surgical drainage. He has no evidence of recurrence after seven months of follow-up. Conclusions Clinicians should be aware that F. nucleatum could be the etiologic agent of hematogenous osteomyelitis of a long bone in an immunocompetent patient. PMID:22817336

  8. C8-T1 Radiculopathy Due to an Intradural Extramedullary Metastasis of a Pancreatic Neuroendocrine Tumor: Case Report and Review of the Literature.

    PubMed

    Cabezas-Camarero, Santiago; Sastre, Javier; Polidura, María Carmen; Gómez-Ruíz, María Natividad; Subhi-Issa, Issa; Alonso Lera, Pedro; Paredes, Beatriz García; Díaz-Rubio, Eduardo

    2016-01-01

    Pancreatic neuroendocrine tumors (pNETs) are usually well-to-moderately differentiated neuroendocrine tumors (NETs) that most often metastasize to the liver and lymph nodes with other locations being uncommon. We present a case of intradural pNET metastasis and conduct a review of the literature. Forty-five cases, including the case presently reported, of spinal cord compression due to well-differentiated NETs were found: carcinoid (80%), pNET (13.3%), and NETs of unknown primary (6.7%). Seventy-eight percent of cases consisted of extradural compressions from vertebral bone metastases, whereas there were only 5 cases of intradural extramedullary spinal cord compression. Most cases were managed with surgery and/or radiotherapy with a good clinical outcome in the majority. We report the first case of a pNET intradural extramedullary metastasis and conduct the largest review to date of an infrequent complication of well-differentiated NETs such as malignant spinal cord compression. Aggressive local treatment is warranted in most cases because it usually achieves neurologic improvement and symptomatic relief in patients who may still have a long life expectancy. PMID:27077714

  9. Sudden death in custody due to pituitary apoplexy during long restriction in a sitting position: a case report and review of the literature.

    PubMed

    Sun, Tingyi; Liu, Liang; Sunnassee, Ananda; Zhuo, Luo; Zhu, Shaohua

    2013-10-01

    Pituitary apoplexy is an uncommon clinical emergency arising from hemorrhage into or infarction of a pituitary adenoma. The most common presentation is sudden headache, visual field defects and signs of hypopituitarism. It usually occurs in the age group from 20 to 50 years and affects more male than female. Sudden death due to pituitary apoplexy without common symptoms is rarely reported. Here, we described a scarcely-reported case of sudden death in custody caused by pituitary apoplexy resulting from stress-induced hemorrhage of gonadotroph adenoma, a kind of pituitary adenoma, without common clinical symptoms. In this case, a 49-year-old man was restrained in a sitting position for 4 days and died unexpectedly. At autopsy, external examination showed free of trauma. Destruction of bony structure and a circumscribed pituitary tumor were observed in sella turcica. Immunohistochemically, the tumor cells were particular positive for follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thus clarifying the presence of a pituitary gonadotroph adenoma. We provide the case description and a short review of pituitary apoplexy and pituitary adenoma as a rare cause of sudden death. PMID:24112326

  10. Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature

    PubMed Central

    Giotakis, A.; Kral, F.; Riechelmann, H.; Freund, M.

    2015-01-01

    We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA). DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS) may be used as alternatives. SRS may also be used as enhancement procedure of the DSA. Considering the prognosis of a successfully closed carotid-cavernous sinus fistula, recanalization occurs only in a minority of patients. Close follow-up is advised. PMID:26839726

  11. Progressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine: a case report and literature review

    PubMed Central

    Zhang, Chao; Ruan, Dike; He, Qing; Wen, Tianyong; Yang, Pushan

    2014-01-01

    Diffuse idiopathic skeletal hyperostosis (DISH) is considered an underdiagnosed and mostly asymptomatic nonprimary osteoarthritis. The etiology of DISH remains unknown and the validated diagnostic criteria are absent. This condition is still recognized radiologically only. Rarely, large projecting anterior osteophytes result in esophageal impingement and distortion leading to dysphagia. We report the case of progressive dysphagia and neck pain due to DISH of the cervical spine in a 70-year-old man, which was surgically removed with excellent postoperative results and complete resolution of symptoms. Imaging studies, surgical findings, and histopathological examinations were used to support the diagnosis. The patient was successfully treated with total excision of the anterior osteophytes with no evidence of recurrence 12 months after surgery. In this report, we also discuss the clinical features and perioperative considerations in combination with a literature review. Our patient illustrates that clinicians should be aware of this rare clinical manifestation as the presenting feature of DISH in cervical spine. Surgical decompression through osteophytectomy is effective for patients who fail conservative treatment. PMID:24729695

  12. Observations on water system and pipeline performance in the Limon area of Costa Rica due to the April 22, 1991 earthquake. Technical report

    SciTech Connect

    O'Rourke, M.J.; Ballantyne, D.

    1992-06-30

    The document focuses on earthquake damage to water and oil pipelines, water supply, and water treatment following the 22 April 1991 Costa Rica Earthquake. The moment magnitude 7.5 earthquake occurred approximately 40 km south-southwest of Limon, and resulted in a coseismic uplift of up to 1.5 meters along Costa Rica's east coast. The report also provides an overview of the engineering aspects of the event and recovery activities. Turbidity in the watershed which provides Limon's primary water supply increased to as high as 2.4 percent solids, making it extremely difficult to treat. In addition, the water treatment plant was damaged by the earthquake. Cast iron, ductile iron and reinforced concrete cylinder pipe water transmission lines were damaged by both wave propagation and permanent ground deformation. Water distribution piping, also including PVC and galvanized iron, was similarly impacted. Documentation and evaluation of that damage is described, and compared with empirical estimates from previous earthquakes. Twin 150 mm (6 in), 100 km long, oil transmission lines suffered only a single failure from wrinkling. A description of the pipelines and the failure is provided.

  13. "Battered Women" and Previous Victimization: Is the Question Relevant?

    ERIC Educational Resources Information Center

    Gudim, Laurie, Comp.; And Others

    This report discusses battered women and the role of their previous victimization. After a literature review on family violence in general, these topics are discussed: (1) family violence and the patriarchy; (2) the historical background of family violence; (3) intergenerational cycle of violence; and (4) psychological literature's four ways…

  14. Previous Open Rotor Research in the US

    NASA Technical Reports Server (NTRS)

    VanZante, Dale

    2011-01-01

    Previous Open Rotor noise experience in the United States, current Open Rotor noise research in the United States and current NASA prediction methods activities were presented at a European Union (EU) X-Noise seminar. The invited attendees from EU industries, research establishments and universities discussed prospects for reducing Open Rotor noise and reviewed all technology programs, past and present, dedicated to Open Rotor engine concepts. This workshop was particularly timely because the Committee on Aviation Environmental Protection (CAEP) plans to involve Independent Experts in late 2011 in assessing the noise of future low-carbon technologies including the open rotor.

  15. Potential hazard due to induced radioactivity secondary to radiotherapy: the report of task group 136 of the American Association of Physicists in Medicine.

    PubMed

    Thomadsen, Bruce; Nath, Ravinder; Bateman, Fred B; Farr, Jonathan; Glisson, Cal; Islam, Mohammad K; LaFrance, Terry; Moore, Mary E; George Xu, X; Yudelev, Mark

    2014-11-01

    External-beam radiation therapy mostly uses high-energy photons (x-rays) produced by medical accelerators, but many facilities now use proton beams, and a few use fast-neutron beams. High-energy photons offer several advantages over lower-energy photons in terms of better dose distributions for deep-seated tumors, lower skin dose, less sensitivity to tissue heterogeneities, etc. However, for beams operating at or above 10 MV, some of the materials in the accelerator room and the radiotherapy patient become radioactive due primarily to photonuclear reactions and neutron capture, exposing therapy staff and patients to unwanted radiation dose. Some recent advances in radiotherapy technology require treatments using a higher number of monitor units and monitor-unit rates for the same delivered dose, and compared to the conventional treatment techniques and fractionation schemes, the activation dose to personnel can be substantially higher. Radiotherapy treatments with proton and neutron beams all result in activated materials in the treatment room. In this report, the authors review critically the published literature on radiation exposures from induced radioactivity in radiotherapy. They conclude that the additional exposure to the patient due to induced radioactivity is negligible compared to the overall radiation exposure as a part of the treatment. The additional exposure to the staff due to induced activity from photon beams is small at an estimated level of about 1 to 2 mSv y. This is well below the allowed occupational exposure limits. Therefore, the potential hazard to staff from induced radioactivity in the use of high-energy x-rays is considered to be low, and no specific actions are considered necessary or mandatory. However, in the spirit of the "As Low as Reasonably Achievable (ALARA)" program, some reasonable steps are recommended that can be taken to reduce this small exposure to an even lower level. The dose reduction strategies suggested should be followed only if these actions are considered reasonable and practical in the individual clinics. Therapists working with proton beam and neutron beam units handle treatment devices that do become radioactive, and they should wear extremity monitors and make handling apertures and boluses their last task upon entering the room following treatment. Personnel doses from neutron-beam units can approach regulatory limits depending on the number of patients and beams, and strategies to reduce doses should be followed. PMID:25271934

  16. Ataxia telangiectasia: learning from previous mistakes

    PubMed Central

    Kumar, Naveen; Aggarwal, Puneet; Dev, Nishanth; kumar, Gunjan

    2012-01-01

    Ataxia telangiectasia is an early onset neurodegenerative disorder. We report a case of childhood onset ataxia and ocular telangiectasia, presenting with pulmonary infection. The patient was diagnosed as ataxia telangiectasia. The patient succumbed to death owing to late diagnosis and sepsis. PMID:23242084

  17. Current Psychopathology in Previously Assaulted Older Adults

    ERIC Educational Resources Information Center

    Acierno, Ron; Lawyer, Steven R.; Rheingold, Alyssa; Kilpatrick, Dean G.; Resnick, Heidi S.; Saunders, Benjamin E.

    2007-01-01

    Older adult women age 55+ years (N = 549) were interviewed as part of a population-based epidemiological research study of lifetime experiences with physical and sexual assault and current mental health problems. Although overall rates of psychopathology were low, producing very small cells for comparison, women who reported experiencing physical…

  18. Rebound Of Previously Compressed O-Ring

    NASA Technical Reports Server (NTRS)

    Moore, Carleton J.

    1988-01-01

    Report presents theoretical and experimental analysis of relaxation characteristics of O-ring of vinylidene fluoride/hexafluoropropylene copolymer of same composition used in solid rocket boosters on Space Shuttle flight 51-L. Study covers range of temperatures from 10 to 120 degree F. Presents one-dimensional mathematical model of response provided for both elastic response and creep.

  19. Patient With Severe Hyponatremia Caused by Adrenal Insufficiency Due to Ectopic Posterior Pituitary Lobe and Miscommunication Between Hypothalamus and Pituitary: A Case Report.

    PubMed

    Grammatiki, Maria; Rapti, Eleni; Mousiolis, Athanasios C; Yavropoulou, Maria; Karras, Spyridon; Tsona, Afroditi; Daniilidis, Michalis; Yovos, John; Kotsa, Kalliopi

    2016-03-01

    Hyponatremia may be one of the clinical manifestations of adrenal insufficiency (AI) and during the diagnostic workup of hyponatremic patients investigation of AI should be included.We report the case of an 82-year-old patient who was admitted to our hospital with clinical symptoms and laboratory findings of hyponatremia. Following the diagnostic algorithm of hyponatremia we reached the diagnosis of AI. Clinician's attention must focus on the underlying cause of AI which in this case was hidden in a miscommunication between hypothalamus and pituitary due to an ectopic posterior pituitary lobe and became apparent by a pituitary magnetic resonance imaging (MRI) scan. Treatment with oral hydrocortisone resulted in full clinical recovery and electrolyte balance, which was maintained after 7 months of follow-up.Secondary AI is related with hyponatremia through increased ADH secretion. Although a hyponatremic episode may be the first presentation of AI, clinical suspicion is of high importance in order to place the right diagnosis. Disruption of communication between hypothalamus and pituitary is a rare but considerable cause of AI. PMID:26962783

  20. Spinal cord compression due to primary intramedullary tuberculoma of the spinal cord presenting as paraplegia: A case report and literature review

    PubMed Central

    Mishra, Sudhansu Sekhar; Das, Deepak; Das, Srikanta; Mohanta, Itibrata; Tripathy, Soubhagya Ranjan

    2015-01-01

    Background: Spinal cord compression can be due to various causes but spinal intramedullary tuberculoma is a rare cause. We report a case that had an intramedullary spinal cord tuberculomas in which the diagnosis was made histologically, without evidence of symptoms of systemic tuberculosis. This lesion, located in the thoracic region, mimicked as an intramedullary tumor radiologically. Case Description: The patient was a 25-year-old male who presented with a history of progressive paraparesis. Initial diagnosis was made as an intramedullary tumor by magnetic resonance imaging (MRI). The treatment of the patient involved is complete surgical excision of intramedullary lesion followed by appropriate antituberculous therapy. Postoperatively, his neurological symptoms were dramatically improved. With combination of both surgical and medical treatments, excellent clinical outcome was obtained. Conclusion: This case illustrates the risk of misdiagnosis and the importance of histological confirmation of a pathological lesion as spinal cord tuberculoma prior to surgical therapy, which should be kept in mind as a differential diagnosis of the intramedullary spinal cord tumors. PMID:25883834

  1. Babesiosis due to the canine Babesia microti-like small piroplasm in dogs - first report from Portugal and possible vertical transmission

    PubMed Central

    2011-01-01

    Background Canine babesiosis (or piroplasmosis) is endemic in northern Portugal, but molecularly confirmed cases of infection with small piroplasms have not been reported in the country. Three German shepherd dogs - a bitch and its 2-month old pup and an unrelated male - clinically suspected of piroplasmosis were assessed for babesial infection. Results Parasitemia with small piroplasms was detected by microscopy in two dogs. All three dogs were positive by PCR and the Babesia microti-like small piroplasm (syn. Theileria annae) was identified by DNA sequencing. These are the first confirmed cases of babesiosis caused by the B. microti-like piroplasm both in dogs from Portugal and in dogs suspected of clinical piroplasmosis outside of Spain. Conclusions Although the bitch and the male had visited neighboring Galicia (northwestern Spain), where the disease is endemic, incursion of this piroplasm into northern Portugal is evident and infection of the non-traveled pup was due to either vertical transmission or autochthonous tick infection. PMID:21489238

  2. Can previous learning alter future plasticity mechanisms?

    PubMed

    Crestani, Ana Paula; Quillfeldt, Jorge Alberto

    2016-02-01

    The dynamic processes related to mnemonic plasticity have been extensively researched in the last decades. More recently, studies have attracted attention because they show an unusual plasticity mechanism that is independent of the receptor most usually related to first-time learning-that is, memory acquisition-the NMDA receptor. An interesting feature of this type of learning is that a previous experience may cause modifications in the plasticity mechanism of a subsequent learning, suggesting that prior experience in a very similar task triggers a memory acquisition process that does not depend on NMDARs. The intracellular molecular cascades necessary to assist the learning process seem to depend on the activation of hippocampal CP-AMPARs. Moreover, most of these studies were performed on hippocampus-dependent tasks, even though other brain areas, such as the basolateral amygdala, also display NMDAR-independent learning. (PsycINFO Database Record PMID:26795579

  3. Books Average Previous Decade of Economic Misery

    PubMed Central

    Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  4. Books average previous decade of economic misery.

    PubMed

    Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159

  5. Congruency sequence effects are driven by previous-trial congruency, not previous-trial response conflict

    PubMed Central

    Weissman, Daniel H.; Carp, Joshua

    2013-01-01

    Congruency effects in distracter interference tasks are often smaller after incongruent trials than after congruent trials. However, the sources of such congruency sequence effects (CSEs) are controversial. The conflict monitoring model of cognitive control links CSEs to the detection and resolution of response conflict. In contrast, competing theories attribute CSEs to attentional or affective processes that vary with previous-trial congruency (incongruent vs. congruent). The present study sought to distinguish between conflict monitoring and congruency-based accounts of CSEs. To this end, we determined whether CSEs are driven by previous-trial reaction time (RT)—a putative measure of response conflict—or by previous-trial congruency. In two experiments using a face-word Stroop task (n = 49), we found that current-trial congruency effects did not vary with previous-trial RT independent of previous-trial congruency. In contrast, current-trial congruency effects were influenced by previous-trial congruency independent of previous-trial RT. These findings appear more consistent with theories that attribute CSEs to non-conflict processes whose recruitment varies with previous-trial congruency than with theories that link CSEs to previous-trial response conflict. PMID:24027550

  6. Due Process and Higher Education: A Systemic Approach to Fair Decision Making. ASHE-ERIC Higher Education Report, Volume 27, Number 2.

    ERIC Educational Resources Information Center

    Stevens, Ed

    Due process has become an important principle in higher education as a result of many new legal issues, including dismissals of students from campus, firings of staff members, faculty tenure and promotion, sexual harassment, discrimination, and substance abuse. This volume defines due process; explains when due process procedures are required;…

  7. The molecular basis of homocystinuria due to cystathionine {beta}-synthase deficiency in Italian families, and report of four novel mutations

    SciTech Connect

    Sebastio, G.; Sperandeo, M.P.; Panico, M.

    1995-06-01

    Four new mutations in the cystathionine {beta}-synthase (CBS) gene have been identified in Italian patients with homocystinuria. The first mutation is a G-to-A transition at base 374 in exon 3, causing an arginine-to-glutamic acid substitution at position 125 of the protein (R125Q). This mutation has been found in homozygosity in a patient partially responsive to pyridoxine treatment. The second mutation is a C-to-T transition at base 770 in exon 7, causing a threonine-to-methionine substitution at amino acid 257 of the protein (T257M). This mutation has been observed in homozygosity in a patient non-responsive to the cofactor treatment. The third mutation, found in heterozygosity in a patient responsive to pyridoxine treatment, is an insertion of 68 bp in exon 8 at base 844, which introduces a premature termination codon. The fourth mutation is C-to-T transition in exon 2 at base 262, causing a proline-to-serine substitution at position 88 of the protein (P88S). This mutation is carried on a single allele in three affected sisters responsive to the cofactor treatment. In addition, six previously reported mutations (A114V, E131D, P145L, I278T, G307S, and A{sub 1224-2}C) have been tested in 14 independent Italian families. Mutations A114V and I278T are carried by three and by seven independent alleles, respectively. The other four mutations - including G307S and A{sub 1224-2}C, common among northern European patients - have not been detected. 21 refs., 6 figs., 5 tabs.

  8. The molecular basis of homocystinuria due to cystathionine beta-synthase deficiency in Italian families, and report of four novel mutations.

    PubMed Central

    Sebastio, G; Sperandeo, M P; Panico, M; de Franchis, R; Kraus, J P; Andria, G

    1995-01-01

    Four new mutations in the cystathionine beta-synthase (CBS) gene have been identified in Italian patients with homocystinuria. The first mutation is a G-to-A transition at base 374 in exon 3, causing an arginine-to-glutamic acid substitution at position 125 of the protein (R125Q). This mutation has been found in homozygosity in a patient partially responsive to pyridoxine treatment. The second mutation is a C-to-T transition at base 770 in exon 7, causing a threonine-to-methionine substitution at amino acid 257 of the protein (T257M). This mutation has been observed in homozygosity in a patient nonresponsive to the cofactor treatment. The third mutation, found in heterozygosity in a patient responsive to pyridoxine treatment, is an insertion of 68 bp in exon 8 at base 844, which introduces a premature termination codon. The fourth mutation is C-to-T transition in exon 2 at base 262, causing a proline-to-serine substitution at position 88 of the protein (P88S). This mutation is carried on a single allele in three affected sisters responsive to the cofactor treatment. In addition, six previously reported mutations (A114V, E131D, P145L, I278T, G307S, and A1224-2C) have been tested in 14 independent Italian families. Mutations A114V and I278T are carried by three and by seven independent alleles, respectively. The other four mutations--including G307S and A1224-2C, common among northern European patients--have not been detected. Images Figure 1 Figure 2 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:7762555

  9. Radiotherapeutic alternatives for previously irradiated recurrent gliomas

    PubMed Central

    Combs, Stephanie E; Debus, Jürgen; Schulz-Ertner, Daniela

    2007-01-01

    Re-irradiation for recurrent gliomas has been discussed controversially in the past. This was mainly due to only marginal palliation while being associated with a high risk for side effects using conventional radiotherapy. With modern high-precision radiotherapy re-irradiation has become a more wide-spread, effective and well-tolerated treatment option. Besides external beam radiotherapy, a number of invasive and/or intraoperative radiation techniques have been evaluated in patients with recurrent gliomas. The present article is a review on the available methods in radiation oncology and summarizes results with respect to outcome and side effects in comparison to clinical results after neurosurgical resection or different chemotherapeutic approaches. PMID:17760992

  10. Defendants previous history and mock sentencing.

    PubMed

    Wear, D A; Pasewark, R A

    1984-05-01

    Six hundred forty-four undergraduates served as mock judges in sentencing male or female defendants convicted of homicide, child molestation, embezzlement, fraudulent issuance of checks, heroin possession, and consensual homosexuality. Defendants had a reported history of psychiatric hospitalization, imprisonment, or neither hospitalization nor incarceration. Results indicated: (1) those defendants with a mental health history were more likely to be accorded a disposition that involved mandatory health treatment; (2) dispositions of persons with a mental health history tended to be more restrictive than those of defendants with neither a mental health nor criminal history; and (3) sex of defendant of mock judge influenced sentencing disposition only in child molestation cases. PMID:6747006

  11. Protracted Clinical Course of Postinfectious Glomerulonephritis in a Previously Healthy Child

    PubMed Central

    Grøndahl, Camilla; Rittig, Søren; Povlsen, Johan Vestergaard; Kamperis, Kostantinos

    2016-01-01

    Acute postinfectious glomerulonephritis (PIGN) affects children typically after upper respiratory tract or skin infections with streptococci but can complicate the course of other infections. In children, it is generally a self-limiting disease with excellent prognosis. This paper reports a previously healthy 4-year-old boy who experienced a protracted course of PIGN with persisting episodes of gross haematuria, proteinuria, decreased complement C3c levels but normal P-creatinine levels. Due to the protracted course and the nephrotic-range proteinuria, a renal biopsy was performed 6 months after the initial presentation and the overall pathology was consistent with acute endocapillary glomerulonephritis. PMID:27226969

  12. Forest NEP is significantly driven by previous year's weather

    NASA Astrophysics Data System (ADS)

    Zielis, S.; Etzold, S.; Zweifel, R.; Eugster, W.; Haeni, M.; Buchmann, N.

    2013-10-01

    Understanding the response of forest net ecosystem productivity (NEP) to environmental drivers under climate change is highly relevant for predictions of annual forest carbon (C) flux budgets. Modeling annual forest NEP with soil-vegetation-atmosphere transfer models (SVATs), however, remains challenging due to unknown responses of forests to weather of the previous year. In this study, we addressed the influence of previous year's weather on the inter-annual variability of NEP for a subalpine spruce forest in Switzerland. Analysis of long-term (1997-2011) eddy covariance measurements showed that the Norway spruce forest Davos Seehornwald was a consistent sink for atmospheric CO2, sequestering 210 ± 88 g C m-2 per year on average. Previous year's weather strongly affected inter-annual variability of NEP, increasing the explained variance in linear models to 53% compared to 20% without previous year's weather. Thus, our results highlight the need to consider previous year's weather in modeling annual C budgets of forests. Furthermore, soil temperature in the current year's spring played a major role controlling annual NEP, mainly by influencing gross primary productivity early in the year, with spring NEP accounting for 56% of annual NEP. Consequently, we expect an increase in net CO2 uptake with future climate warming, as long as no other resources become limiting.

  13. Cancer Incidence in Heart Transplant Recipients With Previous Neoplasia History.

    PubMed

    Delgado, J F; Alonso-Pulpón, L; Mirabet, S; Almenar, L; Villa, F P; González-Vílchez, F; Palomo, J; Blasco, T; Dolores García-Cosio, M; González-Costello, J; de la Fuente, L; Rábago, G; Lage, E; Pascual, D; Molina, B D; Arizón, J M; Muñiz, J; Crespo-Leiro, M G

    2016-05-01

    Neoplasm history increases morbidity and mortality after solid organ transplantation and has disqualified patients from transplantation. Studies are needed to identify factors to be considered when deciding on the suitability of a patient with previous tumor for heart transplantation. A retrospective epidemiological study was conducted in heart transplant (HT) recipients (Spanish Post-Heart Transplant Tumor Registry) comparing the epidemiological data, immu-nosuppressive treatments and incidence of post-HT tumors between patients with previous malignant noncardiac tumor and with no previous tumor (NPT). The impact of previous tumor (PT) on overall survival (OS) was also assessed. A total of 4561 patients, 77 PT and 4484 NPT, were evaluated. The NPT group had a higher proportion of men than the PT group (p < 0.001). The incidence of post-HT tumors was 1.8 times greater in the PT group (95% confidence interval [CI] 1.2-2.6; p < 0.001), mainly due to the increased risk in patients with a previous hematologic tumor (rate ratio 2.3, 95% CI 1.3-4.0, p < 0.004). OS during the 10-year posttransplant period was significantly lower in the PT than the NPT group (p = 0.048) but similar when the analysis was conducted after a first post-HT tumor was diagnosed. In conclusion, a history of PT increases the incidence of post-HT tumors and should be taken into account when considering a patient for HT. PMID:26613555

  14. A case report of false negative Legionella test results in a chlorinated public hot water distribution system due to the lack of sodium thiosulfate in sampling bottles.

    PubMed

    Wiedenmann, A; Langhammer, W; Botzenhart, K

    2001-12-01

    We examined samples from the showers and the central water distribution system of a public building with an indoor swimming pool. The pool was used for school and recreational activities and as a sports therapy facility for patients with coronary heart disease. The building's hot water system was contaminated with Legionella pneumophila. Due to the building's intricate piping system, several attempts to completely eliminate legionellae by thermal and chemical disinfection had failed, so an external sanitation company was charged with the installation of a continuous chlorination device in order to keep Legionella concentrations low. The laboratory which was contracted by the sanitation company to monitor bacteria levels after installation of the chlorination device used sampling bottles without sodium thiosulfate and repeatedly reported an absence of Legionella. However, up to 69,000 colony forming particles (CFP) of Legionella pneumophila (Lp) per litre and up to 171 CFP/ml of heterotrophic bacteria could be detected when parallel samples were collected in bottles containing sodium thiosulfate at standard concentrations. Laboratories, epidemiologists, public health officials and technical staff who may be in charge of delivering, preparing or using sterile sampling devices for the collection of environmental samples to be tested for legionellae should be aware that cultures can return false negative results if the sampling containers used to collect chlorinated drinking water or chlorinated pool water samples do not contain a neutralizing agent to instantly inactivate residual halogen biocides. False negative results may lead to a false sense of security regarding the safety of water systems or the success of disinfection measures, and may thus endanger public health or even hinder the epidemiological clarification of outbreaks. PMID:11833297

  15. Mycobacterium microti: More Diverse than Previously Thought▿

    PubMed Central

    Smith, N. H.; Crawshaw, T.; Parry, J.; Birtles, R. J.

    2009-01-01

    Mycobacterium microti is a member of the Mycobacterium tuberculosis complex of bacteria. This species was originally identified as a pathogen of small rodents and shrews and was associated with limited diversity and a much reduced spoligotype pattern. More recently, specific deletions of chromosomal DNA have been shown to define this group of organisms, which can be identified by the absence of chromosomal region RD1mic. We describe here the molecular characteristics of 141 strains of the Mycobacterium tuberculosis complex isolated in Great Britain over a 14-year period. All strains have characteristic loss of some spoligotype spacers and characteristic alleles at the ETR-E and ETR-F variable-number tandem-repeat (VNTR) loci, and a sample of these strains was deleted for regions RD7, RD9, and RD1mic but intact for regions RD4 and RD12. We therefore identified these strains as M. microti and show that they have much more diverse spoligotype patterns and VNTR types than previously thought. The most common source of these strains was domestic cats, and we show that the molecular types of M. microti are geographically localized in the same way that molecular types of Mycobacterium bovis are geographically localized in cattle in the United Kingdom. We describe the pathology of M. microti infection in cats and suggest that the feline disease is a spillover from a disease maintained in an unknown wild mammal, probably field voles. The location of the cats with M. microti infection suggests that they do not overlap geographically with the strains of Mycobacterium bovis in Great Britain. PMID:19535520

  16. Significance of previous year's weather for forest net ecosystem productivity

    NASA Astrophysics Data System (ADS)

    Zielis, S.; Etzold, S.; Zweifel, R.; Eugster, W.; Haeni, M.; Buchmann, N. C.

    2013-12-01

    Understanding the response of forest net ecosystem productivity (NEP) to environmental drivers under climate change is highly relevant for predictions of annual forest carbon (C) flux budgets. Modeling annual forest NEP with climate-vegetation models, however, remains challenging due to unknown responses of forests to weather of the previous year. In this study, we address the influence of previous year's weather on the inter-annual variability of NEP for six European forests, including evergreen needleleaf forests (ENF) and deciduous broadleaf forests (DBF): Davos, Switzerland (ENF); Hyytiälä, Finland (ENF); Loobos, Netherlands (ENF); Soroe, Denmark (DBF); Tharandt, Germany (ENF); and Vielsalm, Belgium (DBF). We hypothesize, that previous year's weather significantly increases explained inter-annual variability of NEP in European forests, with a stronger influence on DBF than ENF. The strongest impact of previous year's weather was found in the subalpine Norway spruce forest at Davos, Switzerland, increasing the explained variance of NEP in linear models from 20% to 53%, with previous year's spring temperature promoting current year NEP strongly. Moreover, soil temperature in the current year's spring played a major role, controlling annual NEP mainly by influencing gross primary productivity (GPP) early in the year, with spring NEP accounting for 56% of annual NEP. Results from the other forests confirmed a forest ecosystem response to previous year's weather with one exception (Hyytiälä). In four of the five forests we were able to reveal an increase of explained variance of NEP when previous year's weather was considered in the analysis, ranging between 7% and 22%. Additionally, we found no trend towards a stronger response of DBF to previous year's weather, in contrast with our hypothesis. Our results suggest that considering responses of NEP to previous year's weather in climate-vegetation models is highly promising and allows for more precise estimates of annual C budgets of forest ecosystems. Upcoming research will focus on revealing site characteristics driving the observed differences in forest NEP response to previous year's weather, and thus, allowing for general conclusions on a larger spatial scale

  17. Group B streptococcal meningitis in a previously healthy man.

    PubMed

    Li, Lucy Qian; Cheema, Sanjay; Goel, Nupur

    2016-01-01

    Group B Streptococcus (GBS) is an infrequent cause of meningitis in adults, usually affecting elderly patients and those with serious underlying disease. It is more commonly recognised as one of the leading aetiological agents of neonatal sepsis following maternally derived infection during pregnancy. We report a case of a previously healthy 26-year-old man who presented with fevers, confusion and headache. Lumbar puncture results were consistent with bacterial meningitis, and blood cultures grew GBS. To the best of our knowledge, our patient represents one of the few reported cases of GBS meningitis in a previously healthy young man. Interestingly, our patient had a significant family history of central nervous system infection including a son with herpes simplex virus encephalitis, a sister with meningococcal meningitis and a great-uncle with meningitis of unknown cause. We discuss genetic factors that may predispose certain people to develop meningitis with normally harmless microorganisms such as GBS. PMID:26759446

  18. The effect of previous traumatic injury on homicide risk.

    PubMed

    Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald

    2014-07-01

    Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case-control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09-2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24-5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs. PMID:24673555

  19. A previously unrecognized kanosamine biosynthesis pathway in Bacillus subtilis.

    PubMed

    Vetter, Natasha D; Langill, David M; Anjum, Shazia; Boisvert-Martel, Julie; Jagdhane, Rajendra C; Omene, Egiroh; Zheng, Hongyan; van Straaten, Karin E; Asiamah, Isaac; Krol, Ed S; Sanders, David A R; Palmer, David R J

    2013-04-24

    The ntd operon in Bacillus subtilis is essential for biosynthesis of 3,3'-neotrehalosadiamine (NTD), an unusual nonreducing disaccharide reported to have antibiotic properties. It has been proposed that the three enzymes encoded within this operon, NtdA, NtdB, and NtdC, constitute a complete set of enzymes required for NTD synthesis, although their functions have never been demonstrated in vitro. We now report that these enzymes catalyze the biosynthesis of kanosamine from glucose-6-phosphate: NtdC is a glucose-6-phosphate 3-dehydrogenase, NtdA is a pyridoxal phosphate-dependent 3-oxo-glucose-6-phosphate:glutamate aminotransferase, and NtdB is a kanosamine-6-phosphate phosphatase. None of these enzymatic reactions have been reported before. This pathway represents an alternate route to the previously reported pathway from Amycolatopsis mediterranei which derives kanosamine from UDP-glucose. PMID:23586652

  20. Combination of congenital left atrial appendage aneurysm in an infant with transposition of the great arteries: a previously unreported association.

    PubMed

    Saygi, Murat; Ergul, Yakup; Guzeltas, Alper

    2015-10-01

    A 35-day-old boy weighing 4.5 kg was referred to our department from a general paediatric hospital due to low oxygen saturation. His transcutaneous oxygen saturation was 75%. Transthoracic echocardiography showed discordant ventriculo-arterial connections, a non-restrictive atrial septal defect, and patent ductus arteriosus, in addition to a 23 mm×10-mm left atrial appendage aneurysm. As far as we know, this association has not been reported previously in the literature. PMID:26205429

  1. Squamous cell carcinoma arising in previously burned or irradiated skin

    SciTech Connect

    Edwards, M.J.; Hirsch, R.M.; Broadwater, J.R.; Netscher, D.T.; Ames, F.C.

    1989-01-01

    Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation.

  2. Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report

    PubMed Central

    Tunc, Mehtap; Sazak, Hilal; Karlilar, Bulent; Ulus, Fatma; Tastepe, Irfan

    2015-01-01

    Introduction: Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS. Case Presentation: We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications. Conclusions: Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS. PMID:26082848

  3. Pregnancy hemoperitoneum and placenta percreta in a patient with previous pelvic irradiation and ovarian failure

    SciTech Connect

    Pridjian, G.; Rich, N.E.; Montag, A.G. )

    1990-05-01

    Placenta percreta in a patient with previous pelvic irradiation has never been described. Reported is a case of placenta percreta with hemoperitoneum associated with a second-trimester incomplete abortion in a patient with previous pelvic irradiation and ovarian failure.

  4. [Consciousness Impairment and Left Hemiparesis due to Contrast Medium in the Coil Embolization of Unruptured Large Right Middle Cerebral Artery Aneurysm:A Case Report].

    PubMed

    Nakajima, Nobuhiko; Koyanagi, Masaomi; Kobayashi, Tamaki; Enatsu, Rei; Oda, Masashi; Saiki, Masaaki

    2016-05-01

    Neurological deficits following coil embolization of anterior circulation aneurysms due to the toxicity of contrast medium are rare. Here, we describe a patient with mild consciousness impairment and left hemiparesis following coil embolization of a large right middle cerebral artery aneurysm without evidence of ischemia or hemorrhage, who recovered completely with conservative treatment. The patient's clinical course and radiological findings led us to conclude that the neurological deficits were due to the toxic effect of contrast medium used during the coil embolization. PMID:27166842

  5. Progression of neuropsychiatric and cognitive features due to exons 2 to 5 deletion in the epsilon-sarcoglycan gene: a case report.

    PubMed

    Multani, Namita; Moro, Elena; Lang, Anthony; Zurowski, Mateusz; Duff Canning, Sarah; Tartaglia, Maria Carmela

    2016-04-01

    Physical symptoms of myoclonus dystonia due to epsilon-sarcoglycan mutations are well documented; however, the progression of neuropsychiatric and cognitive symptoms remains unclear. We present a case of a 34-year-old woman with early childhood onset of myoclonic jerks, dystonic posture and developmental delay due to exons 2 to 5 deletion in the epsilon-sarcoglycan gene. Over time, she developed neuropsychiatric symptoms. She underwent bilateral deep brain stimulation of the ventral intermediate nucleus of the thalamus for her motor symptoms, which greatly improved but she exhibited slow deterioration of her neuropsychiatric and cognitive symptoms, particularly apathy, aggression and severe executive dysfunction. PMID:26652670

  6. Occupational asthma due to azodicarbonamide.

    PubMed

    Kim, Cheol-Woo; Cho, Jae-Hwa; Leem, Jong-Han; Ryu, Jeong-Seon; Lee, Hong-Lyeol; Hong, Yun-Chul

    2004-04-30

    Azodicarbonamide is a low molecular weight foaming agent for plastics and rubbers. Azodicarbonamide can elicit acute and chronic health related problems due to its potential for pulmonary and cutaneous sensitization. Some cases of occupational asthma associated with exposure to azodicarbonamide have been reported, of which only a few cases were confirmed by specific inhalation challenges. Here, the first case of occupational asthma due to azodicarbonamide in Korea, in which the diagnosis was confirmed by specific inhalation challenge, is reported. PMID:15119006

  7. Statin-induced myopathy in a patient with previous poliomyelitis.

    PubMed

    Martikainen, Mika H; Gardberg, Maria; Kohonen, Ia; Lähdesmäki, Janne

    2013-11-01

    This report describes a patient with a history of poliomyelitis who developed new, progressive symptoms of muscle fatigue and weakness, suggestive of postpoliomyelitis syndrome. However, comprehensive investigations led to the diagnosis of statin-induced myopathy as the cause of the patient's symptoms. This case highlights the possibility of statin-induced myopathy in patients with a history of poliomyelitis and the differential diagnosis between postpoliomyelitis syndrome and statin-induced myopathy in these patients. The possibility of statin-induced myopathy should be considered when patients with previous poliomyelitis who take statin medication develop symptoms suggestive of postpoliomyelitis syndrome. PMID:23370588

  8. 1979J2 - Discovery of a previously unknown Jovian satellite

    NASA Technical Reports Server (NTRS)

    Synnott, S. P.

    1980-01-01

    Detailed examination of imaging data of Jupiter taken by Voyager 1 reveals a previously unknown satellite 1979J2. Analysis of the image on the Jovian disk indicates that it is not an atmospheric feature or the shadow of any known satellite. The orbital period is calculated at 16 hours 11 minutes 21.25 seconds + or - 0.5 second and the semimajor axis is 3.1054 Jupiter radii. The observed profile is roughly circular with a diameter of 80 kilometers. An albedo of approximately 0.05 is reported, which is similar to Amalthea's. The geometry of the observational situation is illustrated.

  9. [Off-pump coronary artery bypass for old myocardial infarction associated with jejunotomy for obstructive ileus due to gall bladder stone; report of a case].

    PubMed

    Shibata, T; Fujimatsu, T; Suzuki, H; Kitanaka, Y; Osawa, H; Odagiri, N; Tauchi, K; Koike, H; Aruga, M; Sakurai, S; Yorita, K; Kumazaki, S

    2005-09-01

    In non-cardiac operative cases with inflammatory digestive organ disease, bacterial translocation (BT) often results from non-enteral nutrition postoperatively. If coronary artery bypass grafting (CABG) is performed in the case having old myocardial infarction (OMI) and inflammatory digestive organ disease at first before non-cardiac operation, he seems vulnerable to have severe complications such as multiple organ failure due to systemic inflammatory response syndrome (SIRS) and preexisting BT postoperatively. We performed a off-pump CABG (OPCAB) for OMI associated with jejunotomy for obstructive ileus due to gall bladder stone. No complication was found in the postoperative course. We conclude that combined operation, non-cardiac surgery after OPCAB is worth considering in those cases. And we think OPCAB is better than conventional CABG in such cases, because cardiopulmonary bypass is known to ponder comparable damages to immune system, coagulation system and others. PMID:16167822

  10. Investigation of diesel-fuel fire vulnerability parameters in armored personnel carriers due to ballistic penetration. Interim report, March 1984-March 1985

    SciTech Connect

    Kanakia, M.D.; Wright, B.R.

    1985-03-22

    A series of full-scale ballistics tests were conducted to evaluate the diesel fuel fire vulnerability parameters in armored personnel carriers due to penetration by 90-mm HEAT rounds. The tests considered fuel cell penetration through 1.5-inch aluminum armor with the four variables: fuel temperature, fuel antimisting additive concentration, air availability, and Halon 1301 fire-suppression system. The test results are summarized.

  11. [Invasive disease due to Streptococcus pyogenes in a patient with A H1N1 influenza infection. Report of one case].

    PubMed

    Guerrero S, Gonzalo; Marín S, Felipe

    2015-08-01

    Bacterial superinfection is a known complication among patients affected by viral respiratory tract infections. Streptococcus pyogenes, a major bacterial agent involved in acute tonsillopharyngitis, skin and soft tissue infections, was reported as a co-infecting microorganism during the 2009 A H1N1 influenza pandemic. We report a 65-year-old male patient who evolved with multifocal pneumonia and multiple organ failure with a fatal outcome. Influenza A H1N1 was detected by a polymerase chain reaction-based technique from a tracheal aspirate sample. S. pyogenes was identified by a rapid test from a nasopharyngeal sample and isolated afterwards from a positive blood culture. PMID:26436938

  12. Ground subsidence due to mining operations. October 1976-November 1989 (Citations from the COMPENDEX data base). Report for October 1976-November 1989

    SciTech Connect

    Not Available

    1990-01-01

    This bibliography contains citations concerning ground subsidence associated with mining operations. Mine subsidence is discussed with reference to mathematical modeling, forecasting extent of cavitation, and rock mechanics and mechanisms of stress relaxation. Damage to above- and below-ground structures as well as agricultural areas, and mining techniques designed to prevent or reduce subsidence are included. Monitoring of subsidence and detection of cavitation for surface, underground, and ocean-floor mining areas are discussed and examples are analyzed. Subsidence due to aquifer water removal is referenced in a related published bibliography. (Contains 213 citations fully indexed and including a title list.)

  13. Deepwater Gulf of Mexico more profitable than previously thought

    SciTech Connect

    Craig, M.J.K.; Hyde, S.T.

    1997-03-10

    Economic evaluations and recent experience show that the deepwater Gulf of Mexico (GOM) is much more profitable than previously thought. Four factors contributing to the changed viewpoint are: First, deepwater reservoirs have proved to have excellent productive capacity, distribution, and continuity when compared to correlative-age shelf deltaic sands. Second, improved technologies and lower perceived risks have lowered the cost of floating production systems (FPSs). Third, projects now get on-line quicker. Fourth, a collection of other important factors are: Reduced geologic risk and associated high success rates for deepwater GOM wells due primarily to improved seismic imaging and processing tools (3D, AVO, etc.); absence of any political risk in the deepwater GOM (common overseas, and very significant in some international areas); and positive impact of deepwater federal royalty relief. This article uses hypothetical reserve distributions and price forecasts to illustrate indicative economics of deepwater prospects. Economics of Shell Oil Co.`s three deepwater projects are also discussed.

  14. Instantaneous death due to transorbital reverse penetration of a screw in an accidental fall: unusual autopsy case report and review of the literature.

    PubMed

    Gioia, Sara; Bacci, Mauro; Lancia, Massimo; Carlini, Luigi; Suadoni, Fabio

    2014-03-01

    We present a peculiar autopsy case of a transorbital penetrating head injury, in a male worker, after an accidental fall onto a screw not completely stuck into a wooden board. A 13-cm screw entered the cranium 9.5 cm deep, penetrating with the flat end, a condition defined in literature as "reverse penetration." The death was instantaneous and caused by a neurogenic shock due to injuries to the brain stem and the right cerebellar hemisphere. These injuries, enabled by the length of the screw, are generally described in literature as due to nontransorbital penetrations, frequently associated with posterior entry and a large intracranial injury. The ocular globe has been, furthermore, perfectly preserved thanks to its mobility in the orbit. Even the dynamic of the incident is peculiar because of the stationary nature of the penetrating object, which the victim actively fell on by accident. To the best of our knowledge, the matter is therefore a very peculiar mortal case of transorbital intracranial penetration, whose verified injuries and dynamics are absolutely atypical. The case is now under discussion, and a review of pertinent literature is performed. PMID:24457588

  15. Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report.

    PubMed

    Baracaldo, Rafael M; Bao, Dashi; Iampornpipopchai, Pichet; Fogel, Joshua; Rubinstein, Sofia

    2015-10-01

    Osteitis fibrosa cystica (OFC) is the most frequent type of osseous change in renal osteodystrophy affecting the majority of dialysis patients. Brown tumors are a severe form of OFC. The involvement of the craniofacial skeleton causing facial disfigurement in patients on dialysis appears to be limited to case reports. After searching PubMed, we performed a systematic review of 127 cases with a severe form of OFC resulting in a facial disfigurement to understand possible determinants for this condition. We found that since the first published case in 1974, and after a peak in 1996, there appears to be an increase in published reported cases. Only 27.6% of these cases were published in nephrology journals. The most common region for reported cases was North America. Mean age of these patients was 31.2 years with a mean dialysis duration of 7 years. Almost 67% were women, and almost all were on hemodialysis. The disease tended to most commonly localize to the maxilla (73.2%) and mandible (57.5%). As part of the treatment, 59% of patients had a parathyroidectomy. More than one-third (35.4%) had symptomatic improvement at follow-up. Mean follow-up was 1.6 years. Clinicians should be aware of this clinical presentation of a severe form of OFC and/or brown tumors. Timely diagnosis and intervention may help to prevent or decrease destructive bone changes and reduce negative psychological consequences of facial disfigurement. PMID:25828738

  16. Total Resolution of Large Scalp Swelling due to Calvarial Tuberculosis with Medical Management Only: Case Report and Review of the Literature.

    PubMed

    Dawar, Pankaj; Satyarthee, Guru Dutta; Sharma, Bhawani S

    2015-01-01

    Calvarial tuberculosis is rare. It presents with single or multiple discharging sinus or a localized focal scalp swelling with overlying skin discoloration. Usually subgaleal collection is associated with evolution of sinus formation in different stages. However, extensive scalp swelling spreading across bifrontal area and overlying healthy scalp is not reported. Pathologically it causes significant destruction of calvarium including erosion of both the tables with concurrent significant epidural granulation tissue deposits as dura acts as barrier to trans-dural spread. Concurrent surgical management and antitubercular medication is the standard treatment modality. Authors report a unique presentation of calvarial tuberculosis in 17-year- female presented with complaint of large painless scalp swelling extensively spreading over both frontal area from supraorbital margin to coronal suture without discoloration, puckering of overlying scalp or sinus formation, and neuroimaging showed absence of extradural granulation tissue deposits with very subtle bony architecture changes of adjacent calvarium. The swelling completely subsided with medical therapy alone. To the best of knowledge of authors such case of calvarial tuberculosis having large scalp swelling in western literature has not been reported. Clinical presentation, imaging, management and pertinent literature are reviewed. PMID:26014020

  17. Congenital oesophageal stenosis due to tracheobronchial remnants

    PubMed Central

    Deiraniya, A. K.

    1974-01-01

    Deiraniya, A. K. (1974).Thorax, 29, 720-725. Congenital oesophageal stenosis due to tracheobronchial remnants. Two cases of distal oesophageal obstruction due to tracheobronchial remnant after the successful treatment of proximal oesophageal atresia with an associated tracheo-oesophageal fistula are reported. This association of congenital distal oesophageal stenosis due to tracheobronchial remnant with oesophageal atresia and tracheo-oesophageal fistula has not previously been reported in the literature. The diagnosis should be suspected in cases of distal oesophageal obstruction presenting in childhood or adult life with a history dating back to infancy or childhood. Radiologically a short stenotic non-relaxing segment is the hallmark. There is no hiatus hernia and no gastro-oesophageal reflux. Surgical excision is recommended and can be achieved easily through a thoracic approach. Dilatation is difficult, at times impossible and occasionally hazardous, and any benefit is transient. Excision of the stenotic segment with primary end-to-end anastomosis is the method of choice and almost always possible. Images PMID:4450182

  18. [Obscure gastrointestinal bleeding due to duodenal infiltration of a non-functioning pancreatic neuroendocrine tumor diagnosed by capsule endoscopy: a case report].

    PubMed

    García-Compeán, D; Jáquez-Quintana, J O; González-González, J A; Hernández-Martínez, S; Reyes-Cabello, E A; Ramírez-Monterrubio, L; Garza-Galindo, A A; Maldonado-Garza, H J

    2011-01-01

    Non-functioning pancreatic neuroendocrine tumors (PNETs) are infrequent slow-growing, clinically-silent tumors. They are incidentally detected and some of them may present in advanced stages with local involvement of surrounding structures. The diagnostic accuracy of endoscopio ultrasound (EUS) and fine needle aspiration (FNA) biopsy is significantly lower in neuroendocrine tumors (46.7%) compared with adenocarcinoma (81.4%) and other histologies (75%). Therefore, preoperative diagnosis is very difficult. Exceptionally, hey present with gastrointestinal bleeding. We present a case of a non-functioning PNET initially diagnosed as cystic serous tumor of pancreas with EUS and FNA biopsy. Two years later patient presented obscure gastrointestinal bleeding due to duodenal infiltration. Diagnosis was made by capsule endoscopy. PMID:22188965

  19. Hemorrhagic shock occurring due to a concealed hematoma after insertion of a subclavian venous catheter in a patient undergoing anticoagulation therapy: a case report

    PubMed Central

    Hwang, Boo-Young; Kim, Won-Sung; Cho, Ah-Reum; Cho, Mi-Jung; Lee, Chung-Won

    2014-01-01

    A 74-year-old man who had been receiving warfarin for atrial fibrillation, underwent emergency thrombectomy. A central venous catheter (CVC) was inserted via the left subclavian vein, and heparin was administered to prevent preoperative and postoperative thrombotic events. After an uneventful thrombectomy, the patient was transferred to the intensive care unit (ICU). On the second postoperative day, the patient developed syncope and his blood pressure and oxygen saturation decreased. A computed tomography (CT) revealed a huge hematoma under the pectoralis major muscle. The patient was then treated with continuous renal replacement therapy and mechanical ventilation for multiorgan dysfunction syndrome, which developed due to hemorrhagic shock in the ICU. These findings suggest that when a CVC is inserted in patients requiring anticoagulant therapy, the possible risk of excessive bleeding must be carefully considered. Further, choosing a proper insertion site and performing an ultrasound-guided aspiration may be helpful in preventing these complications. PMID:25473468

  20. [Fatal surgical extraction of cardiac resynchronisation therapy defibrillator leads in a context of endocarditis due to methicillin-resistant Staphylococcus epidermidis. A case report and review of literature].

    PubMed

    Verdier-Watts, F; Zouaghi, O; Berend, M; Wey, P-F; Farhat, F; Bonnefoy, E; Mioulet, D; Griffet, V

    2015-02-01

    A 82-year-old man equipped with a cardiac resynchronisation therapy defibrillator for dilated cardiomyopathy with normal coronary arteries, in complete atrioventricular block, develops six months after a change of the generator-pocket a severe endocarditis due to a methicillin-resistant Staphylococcus epidermidis with a large lead vegetation. After 4 days of adapted antimicrobial therapy, a surgical device removal is realised with unfortunately a fatal end during extraction. This observation points out the severity of cardiovascular device infections in old and weak population, as well as the difficulty of treatment choices because of both infectious and rhythmic constraints. The lead extraction is a strong recommendation but the modality and timing of extraction are not consensual, especially in cardioverter defibrillator-dependent patients. Surgical removal remains an alternative to percutaneous lead extraction but with a higher operative risk. PMID:24836938

  1. A case report of an anorexia nervosa patient with end-stage renal disease due to pseudo Bartter's syndrome and Chinese herb nephropathy requiring maintenance hemodialysis.

    PubMed

    Wada, Kentaro; Shinoda, Toshio

    2008-10-01

    The extent of end stage renal disease (ESRD) has not been well documented in anorexia nervosa (AN). We herein describe a 47-year-old female with ESRD who required maintenance hemodialysis (HD) following a 27 year history of AN, and seven years of diuretic and purgative abuse. In spite of HD treatment, her serum inorganic phosphorus level remained elevated (10.2-15.8 mg/dL). Tissue degradation due to catabolism, insufficient dialysis treatment, and use of Chinese herbal medicine, including aristolochic acid, are speculated as the cause of her hyperphosphatemia. We also speculated that the causes of her renal dysfunction are as follows: chronic interstitial nephritis caused by pseudo Bartter's syndrome resulting from chronic abuse of diuretics and purgatives, and Chinese herb nephropathy. PMID:18937729

  2. Paraplegia as the presenting manifestation of extramedullary megakaryoblastic transformation of previously undiagnosed chronic myelogenous leukemia.

    PubMed

    Bryant, Barbara J; Alperin, Jack B; Elghetany, M Tarek

    2007-02-01

    Extramedullary tumors, also known as granulocytic sarcomas (GS), occur most frequently in acute myelogenous leukemia (AML). They may signal the onset of the accelerated phase of chronic myelogenous leukemia (CML) or the blastic transformation of a myeloproliferative disorder. Occasionally, a GS may be the presenting sign of undiagnosed AML, and rarely the presenting sign of undiagnosed CML or aleukemic leukemia. Paraplegia due to a spinal cord GS is an extremely rare presentation of undiagnosed leukemia. This is the first case report of paraplegia as the presenting manifestation of extramedullary megakaryoblastic transformation of previously undiagnosed CML. A 53-year-old woman reported back pain for 6 days, rapidly progressing to paraplegia. Physical examination noted a large abdominal mass and flaccid paralysis in both lower extremities. Spinal MRI revealed a T4-T6 vertebral mass causing spinal stenosis and cord compression. Tumor debulking and laminectomy were performed emergently. The tumor consisted of noncohesive blast cells. The CBC revealed a leukocyte count of 238,300/microl and a differential consistent with CML. Reexamination of the patient found that the abdominal mass was a giant spleen. Further immunohistochemical studies of the tumor were consistent with extramedullary acute megakaryoblastic blast transformation of CML. Although extramedullary blast crises herald the accelerated phases in approximately 10% of CML cases, megakaryoblastic blast transformation of CML accounts for less than 3% of these cases. The combination of acute paraplegia and megakaryoblastic transformation in a previously undiagnosed patient with CML is extremely rare and may pose a diagnostic dilemma. PMID:17019692

  3. Ectopic acromegaly due to a GH-secreting pituitary adenoma in the sphenoid sinus: a case report and review of the literature

    PubMed Central

    2013-01-01

    Background In more than 98% of cases, acromegaly is due to a GH-secreting pituitary adenoma. The term “ectopic acromegaly” includes neuroendocrine tumors secreting GH releasing hormone (GHRH), usually located in the lungs, thymus and endocrine pancreas. Considerably less frequent are cases of ectopic acromegaly due to GH-secreting tumors located out of the pituitary fossa; except for one isolated case of a well-documented GH-secreting lymphoma, the majority of these lesions are located in the sphenoid sinus. Case presentation We present the case of a 45 year old woman with acromegaly whose MRI showed an empty sella without evidence of a pituitary adenoma but revealed a large mass within the sphenoid sinus. She underwent transsphenoidal surgery and the excised sphenoid sinus mass, proved to be a GH-secreting adenoma; the sellar floor was intact and no other lesions were found in the pituitary fossa. She required postoperative treatment with somatostatin analogs and cabergoline for clinical and biochemical control. Conclusions This case highlights the importance of carefully evaluating the structures surrounding the sellar area when a pituitary adenoma is not found with currently available imaging techniques. The finding of an intact sellar floor and duramater lead us to conclude that the patient’s tumor originated de novo from embryological pituitary remnants. Upon a careful review of the literature and a critical evaluation of our case we found neither clinical nor biochemical features that would distinguish an ectopic from the more common eutopically located somatotrophinoma. PMID:24119925

  4. Successful treatment of a case of acute myocardial infarction due to type A aortic dissection by coronary artery stenting: A case report

    PubMed Central

    WANG, ZHENG-GUI; ZHAO, WEI; SHEN, BO-TAO; ZHENG, YANG; LIU, QUAN

    2015-01-01

    Acute type A aortic dissection (AD) has been recognized as a potentially life threatening condition, which sometimes involves the ostium of the coronary artery and may lead to acute myocardial infarction (AMI). In patients with acute type A AD presenting with clinical signs of AMI, it is crucial to establish the diagnosis rapidly in order to proceed with the correct treatment. The present study reports the diagnosis of a rare case of acute type A AD with the typical presentation of acute inferior MI and cardiogenic shock, which was accidentally diagnosed during catheterization and treated by right coronary ostial occlusion stenting, allowing for further surgical interventions. PMID:26622389

  5. Total Colonic Expulsion with Part of Small Bowel per Vaginum due to Low-Flow Phenomenon and NOMI: A Case Report

    PubMed Central

    Deen, Suha; Powell, Martin

    2011-01-01

    Introduction. Intestinal ischaemia is a devastating disease process that could lead to bowel gangrene and death if either not diagnosed early or left untreated; death is usually caused by irreversible shock, intestinal necrosis, or septicaemia. It is usually seen in elderly patients with atherosclerotic disease. The course of bowel ischaemia may affect variable lengths of the intestine and it is not unusual for the condition to be followed by uneventful recovery. Case presentation. We are reporting an unusually rare case where an elderly patient passed an extraordinarily long segment of bowel, including rectum, the whole of the large bowel, and part of the small bowel, through anus following an episode of nonobstructive mesenteric ischaemia (NOMI) complicating myocardial infarction. To our knowledge, there are only eight cases reported in the literature where the condition was diagnosed upon the passage of short segments of the large bowel particularly of the rectosigmoid segment through the anus. Conclusion. Physician should keep a high level of suspicion in order to prevent it or at least recognise it early on and offer adequate management and hence reducing morbidity and mortality. PMID:21603021

  6. A previously unreported locality record for the Gila monster (Heloderma suspectum)

    USGS Publications Warehouse

    Lovich, Jeff; Haxel, Gordon

    2011-01-01

    Although the Gila Monster (Heloderma suspectum) is widely distributed throughout the Sonoran and portions of the Mojave Deserts of the southwestern United States and northwestern Mexico, details of its distribution in California are imperfectly known, due to the apparent rarity of the species in that state. In their review of Gila Monster records for California, Lovich and Beaman (2007) documented only 26 credible sightings during a period of 153 years. In May 2009 another sighting in California was documented by Ruppert (2010a, b) who photographed a specimen in the Providence Mountains, an area known for previous Gila Monster sightings (Lovich and Beaman 2007). In this paper we report the 28th credible record of a Gila Monster in California.

  7. "Spontaneous" CSF Fistula due to Transtegmental Brain Herniation in Combination with Signs of Increased Intracranial Pressure and Petrous Bone Hyperpneumatization: An Illustrative Case Report.

    PubMed

    Rivera, Diones; Fermin-Delgado, Rafael; Stoeter, Peter

    2014-12-01

    Background and Importance Transtegmental brain herniation into the petrous bone is a rare cause of rhinoliquorrhea. Our case presents a combination of several typical clinical and imaging findings illustrating the ongoing etiologic discussion of such cerebrospinal fluid (CSF) fistulas. Clinical Presentation A 53-year-old man presented with nasal discharge after a strong effort to suppress coughing. Imaging revealed a transtegmental herniation of parts of the inferior temporal gyrus into the petrous bone and in addition a combination of signs of chronically increased intracranial pressure and a hyperpneumatization of the petrous bone. The fistula was closed by a middle cranial fossa approach. Conclusion The case illustrates the two main predisposing factors for development of petrous bone CSF fistulas: increased intracranial pressure and thinning of the tegmental roof due to extensive development of air cells. Because the CSF leakage repair does not change the underlying cause, patients have to be informed about the possibility of developing increased intracranial pressure and recurrences of brain herniations at other sites. PMID:25485224

  8. “Spontaneous” CSF Fistula due to Transtegmental Brain Herniation in Combination with Signs of Increased Intracranial Pressure and Petrous Bone Hyperpneumatization: An Illustrative Case Report

    PubMed Central

    Rivera, Diones; Fermin-Delgado, Rafael; Stoeter, Peter

    2014-01-01

    Background and Importance Transtegmental brain herniation into the petrous bone is a rare cause of rhinoliquorrhea. Our case presents a combination of several typical clinical and imaging findings illustrating the ongoing etiologic discussion of such cerebrospinal fluid (CSF) fistulas. Clinical Presentation A 53-year-old man presented with nasal discharge after a strong effort to suppress coughing. Imaging revealed a transtegmental herniation of parts of the inferior temporal gyrus into the petrous bone and in addition a combination of signs of chronically increased intracranial pressure and a hyperpneumatization of the petrous bone. The fistula was closed by a middle cranial fossa approach. Conclusion The case illustrates the two main predisposing factors for development of petrous bone CSF fistulas: increased intracranial pressure and thinning of the tegmental roof due to extensive development of air cells. Because the CSF leakage repair does not change the underlying cause, patients have to be informed about the possibility of developing increased intracranial pressure and recurrences of brain herniations at other sites. PMID:25485224

  9. Analysis of reservoir heterogeneities due to shallowing-upward cycles in carbonate rocks of the Pennsylvanian Wahoo Limestone of Northeastern Alaska. Annual report, September 1989--September 1990

    SciTech Connect

    Watts, K.F.

    1992-09-01

    This report presents the preliminary results of research accomplished by a team of specialists in carbonate petrology, biostratigraphy, and diagenesis during the 1989--1990 fiscal year. It includes a summary of some of the petrographic data which has been entered into a computerized database; a discussion of biostratigraphic data, particularly conodont biofacies analyses; an overview of diagenetic studies; and a section of the regional geological framework studies. The database is allowing us to test which parameters, such as ooids, can be used to recognize and understand the carbonate petrology of the shallowing-upward cycles. The cycles have been interpreted in terms of depositional environments and sea-level fluctuations and used to develop detailed facies models.

  10. [Aortic root replacement with free-style stentless valve for aorto-left and right ventricular communication due to infective endocarditis; report of a case].

    PubMed

    Kamikubo, Y; Murashita, T; Kunishige, H; Shiiya, N; Matsui, Y; Yasuda, K

    2004-04-01

    Aortic root abscess remains a major determinant of both early and late results of surgical treatment of endocarditis. This complication rarely progresses to intracardiac shunt followed by cardiac failure. We report a surgical case of a 40-year-old man, who had been diagnosed as prosthetic valve endocarditis with aortic root abscess ruptured into left and right ventricle creating aorto-left and right ventricular communication. Because of complete debridment of infective and/or dead tissue, aortic root replacement was required. We used free-style stentless valve, xenograft, since homograft was not available at the time of operation. We believe that this prosthesis has easier handling and is more resistant to infection, therefore, it might be an option for infective endocarditis with aortic root abscess. PMID:15071869

  11. Dacryocystitis due to Sporothrix brasiliensis: a case report of a successful clinical and serological outcome with low-dose potassium iodide treatment and oculoplastic surgery.

    PubMed

    de Macedo, P Marques; Sztajnbok, D C N; Camargo, Z P; Rodrigues, A M; Lopes-Bezerra, L M; Bernardes-Engemann, A R; Orofino-Costa, R

    2015-04-01

    Sporothrix brasiliensis is the main species of the S. schenckii complex implicated in the zoonotic epidemics of sporotrichosis in Rio de Janeiro, Brazil. Epidemiological features have been already described, such as zoonotic transmission by cats and increased frequency of atypical clinical aspects. The involvement of the face by contact with cats is common in childhood; as a result, ophthalmic manifestations have increased. We report a case of acute dacryocystitis in a 9-year-old girl. A calmodulin-based molecular phylogeny was used to identify the agent as S. brasiliensis. This is a rare type of presentation, usually complicated with nasolacrimal duct occlusion. The patient was cured without sequelae after treatment with a low dose of saturated solution of potassium iodide and decompressive oculoplastic surgery. Therapeutic options and considerations of aetiological agents and serology are discussed. PMID:25155197

  12. Assessment of predictive models for the failure of titanium and ferrous alloys due to hydrogen effects. Report for the period of June 16 to September 15, 1981

    SciTech Connect

    Archbold, T.F.; Bower, R.B.; Polonis, D.H.

    1982-04-01

    The 1977 version of the Simpson-Puls-Dutton model appears to be the most amenable with respect to utilizing known or readily estimated quantities. The Pardee-Paton model requires extensive calculations involving estimated quantities. Recent observations by Koike and Suzuki on vanadium support the general assumption that crack growth in hydride forming metals is determined by the rate of hydride formation, and their hydrogen atmosphere-displacive transformation model is of potential interest in explaining hydrogen embrittlement in ferrous alloys as well as hydride formers. The discontinuous nature of cracking due to hydrogen embrittlement appears to depend very strongly on localized stress intensities, thereby pointing to the role of microstructure in influencing crack initiation, fracture mode and crack path. The initiation of hydrogen induced failures over relatively short periods of time can be characterized with fair reliability using measurements of the threshold stress intensity. The experimental conditions for determining K/sub Th/ and ..delta..K/sub Th/ are designed to ensure plane strain conditions in most cases. Plane strain test conditions may be viewed as a conservative basis for predicting delayed failure. The physical configuration of nuclear waste canisters may involve elastic/plastic conditions rather than a state of plane strain, especially with thin-walled vessels. Under these conditions, alternative predictive tests may be considered, including COD and R-curve methods. The double cantilever beam technique employed by Boyer and Spurr on titanium alloys offers advantages for examining hydrogen induced delayed failure over long periods of time. 88 references. (DLC)

  13. Oral Rehabilitation of Adult Edentulous Siblings Severely Lacking Alveolar Bone Due to Ectodermal Dysplasia: A Report of 2 Clinical Cases and a Literature Review.

    PubMed

    Wu, Yiqun; Zhang, Chenping; Squarize, Cristiane H; Zou, Duohong

    2015-09-01

    The oral conditions of adult edentulous patients with ectodermal dysplasia (ED) often lead to decreased physical and psychological health, and the negative effects can become as extreme as social and psychological isolation. However, restoring oral function of adult edentulous patients with ED using zygomatic implants (ZIs) or conventional implants (CIs) remains challenging for dentists because of the severe atrophy of these patients' alveolar ridges. This report describes 2 cases of adult edentulous siblings with ED; they exhibited severe alveolar bone atrophy and were treated with ZIs and CIs as bases to augment the bone in their anterior jaws. For these patients, bone augmentation was completed with an autogenous fibular graft. Although there was mild evidence of bone graft resorption in the maxilla, the bone augmentation procedures were successful in the 2 patients. Effective osseointegration of the implants was obtained. After placement, the functional and esthetic results of the oral rehabilitation were acceptable. More importantly, restoration of the patients' oral function enhanced their self-confidence and self-esteem. Therefore, restoring oral function in adult patients with ED and edentulous jaws using ZIs and CIs as the bases for bone augmentation is an effective approach. PMID:25957874

  14. Three Case Reports of Successful Vibration Therapy of the Plantar Fascia for Spasticity Due to Cerebral Palsy-Like Syndrome, Fetal-Type Minamata Disease.

    PubMed

    Usuki, Fusako; Tohyama, Satsuki

    2016-04-01

    Fetal-type Minamata disease is caused by the exposure to high concentrations of methylmercury in the fetal period and shows cerebral palsy-like clinical features. Relief of spasticity is a major task of rehabilitation to improve their activities of daily living.Here we report the effect of long-term vibration therapy on bilateral lower-limb spasticity in 3 patients with fetal-type Minamata disease. We used a simple, inexpensive, and noninvasive approach with hand-held vibration massagers, which were applied to the plantar fascia at 90 Hz for 15 minutes.The effect was observed soon after the first treatment and resulted in better performance of the repetitive facilitation. Vibration therapy for 1 year improved Modified Ashworth Scale for the ankle flexors in 2 cases. The labored gait improved and gait speed increased in another case. Continued vibration therapy for another 1 year further improved Modified Ashworth Scale score and range of motion of ankle dorsiflexion in 1 case. This case showed the decreased amplitude of soleus H-reflex after the 15-minute vibration therapy, suggesting that α-motor neuron excitability was suppressed.Vibration therapy using a hand-held vibration massager may offer safe and effective treatment for lower-limb spasticity in patients with chronic neurological disorders. PMID:27082608

  15. Cerebral proton magnetic resonance spectroscopy demonstrates reversibility of N-acetylaspartate/creatine in gray matter after delayed encephalopathy due to carbon monoxide intoxication: a case report

    PubMed Central

    2014-01-01

    Introduction Predictive markers for long-term outcome in carbon monoxide-intoxicated patients with late encephalopathy are desired. Here we present the first data demonstrating a full reversibility pattern of specific brain substances measured by cerebral proton magnetic resonance spectroscopy in a carbon monoxide-intoxicated victim. This may provide clinicians with important information when estimating patient outcome. Case presentation We report the case of a 40-year-old Caucasian woman with severe carbon monoxide poisoning who was treated with five repetitive sessions of hyperbaric oxygen therapy in a multiplace chamber (100 percent oxygen with a ventilator, 90 minutes exposure to 2.8 atmospheres absolute). Initially, our patient recovered completely after three days of hospitalization, but became encephalopathic after a lucid interval of four weeks. An examination of the brain with cerebral proton magnetic resonance spectroscopy showed a dramatically decrease in N-acetylaspartate to total creatine ratios and elevated lactate levels in the gray matter. Subsequently, our patient received six additional sessions of hyperbaric oxygen therapy with only minimal recovery. At six-month follow-up our patient showed significant improvement in cognition and neuromuscular coordination. Extraordinarily, the cerebral proton magnetic resonance spectroscopy measurements at relapse compared to measurements at follow-up (217 days post insult) revealed full reversal of the severe abnormalities in mid-occipital gray matter and partial reversal in white matter. Conclusions The present case indicates that cerebral proton magnetic spectroscopy provides valuable information on brain metabolism in patients presenting with delayed encephalopathy after acute carbon monoxide intoxication. The full reversal of N-acetylaspartate to total creatine ratios in gray matter has, to our knowledge, never been described before and shows that severe, initial measurements may not predict poor long-term patient outcome. PMID:24947173

  16. Evaluation of groundwater contamination due to leakage from a process waste storage pond and a plan for recovering the site. Final technical report

    SciTech Connect

    Glass, J.P.; Gidley, J.

    1983-02-01

    In 1975 an open holding pond with a nominal capacity of 1 million gallons was constructed at the Morgantown Energy Technology Center (METC) to contain liquid process wastes generated by the research in coal gasification being conducted there. This report contains the results of a study to investigate the amount of groundwater contamination that may have occurred in the area and to draft a plan for the environmentally safe recovery of the site. The project consisted of 4 tasks: (1) Installation and operation of a groundwater system in the vicinity of the pond; (2) Analysis of groundwater quality and movement in the vicinity of the holding pond; (3) Mitigating groundwater contamination; and (4) Recovery of the lagoon area. The accomplishment of the above tasks was impaired in varying degrees by the unfortunate lack of success in arranging the installation of the groundwater monitoring system specified under Task 1. Since these wells were never constructed it became necessary to rely on a variety of secondary data sources, including the following: (1) Logs of old wells and exploratory borings on and near the METC property. (2) Data from the existing but unsatisfactory monitoring wells near the waste storage pond. (3) Analyses of groundwater samples collected in seepage pits along the banks of the gully lying to the west of the pond. (4) Water balance computations based on inflow and outflow measurements at the pond. (5) Observations and samples from a series of shallow auger holes bored by hand around the periphery of the pond. Ground water was analyzed for phenol, chromium, lead, cadmium, vanadium, chlorides, and chemical oxygen demand. 41 figures, 10 tables. (DMC)

  17. Analysis of reservoir heterogeneities due to shallowing-upward cycles in carbonate rocks of the Pennsylvanian Wahoo Limestone of Northeastern Alaska. Annual report, October 1990--September 1991

    SciTech Connect

    Watts, K.

    1992-09-01

    The primary objective of this project is to develop an integrated database to characterize reservoir heterogeneities resulting from numerous small-scale shallowing-upward cycles (parasequences) comprising the carboniferous Pennsylvanian Wahoo Limestone. The Wahoo Limestone is the upper formation of an extensive carbonate platform sequence of the Carboniferous Lisburne Group which is widely exposed in the Brooks Range and is a widespread hydrocarbon reservoir unit in the subsurface of the North Slope of Alaska. A principal goal is to determine lateral and vertical variations in the complex mosaic of carbonate facies comprising the Wahoo Limestone. This report presents the preliminary results of research accomplished by a team of specialists in carbonate petrology, biostratigraphy, and diagenesis during the 1990--1991 fiscal year.It includes a summary of regional geological framework studies, a discussion conodont analyses, an overview of diagenetic studies, a brief description of progress in computerized database development, and appendices containing some of the new data on petrographic analyses, conodont analyses, and locality and sample information. Our correlation scheme, which uses cyclic stratigraphy, biostratigraphy, and cement stratigraphy, will allow interpretation of the depositional history and paleogeographic evolution of the region. We have developed predictive facies models and will make paleogeographic maps to illustrate different stages in the history of the Wahoo carbonate ramp. Our detailed analyses of the Wahoo Limestone will provide a basis for interpreting correlative rocks in the adjacent subsurface of the coastal plain of ANWR, a potential hydrocarbon lease-sale area. In a broader sense, our work will provide an excellent generic example of carbonate shallowing-upward cycles which typify carbonate sediments.

  18. Transient disappearance of Q waves of previous myocardial infarction due to exercise-induced ischemia of the contralateral noninfarcted myocardium.

    PubMed

    Madias, J E; Manyam, B; Khan, M; Singh, V; Tziros, C

    1997-04-01

    The electrocardiogram (ECG) of a 40-year-old woman with an old inferolateral myocardial infarction revealed, in the course of an exercise treadmill/thallium test, gradual disappearance of infarctional Q waves, which reappeared gradually during recovery from exercise. The patient had evidence of exercise-induced myocardial ischemia both by the ECG and by thallium-201 perfusion scintigraphy involving several myocardial regions. The temporal association of transient disappearance of Q waves with the occurrence of reversible ischemia suggested that the latter was instrumental in producing this phenomenon, through a transient failure of the ischemic anterior wall to shift the initial depolarization forces away from the infarcted inferolateral territory. Further evidence for this concept was provided by the case of another patient, a 49-year-old man who also had an old inferolateral myocardial infarction and whose ECG in the course of an exercise treadmill/thallium test did not reveal any changes in the infarctional Q waves. In this patient, thallium images showed mild, reversible inferolateral myocardial ischemia but a well perfused anterior wall, which provided for early depolarization forces (thus Q waves) directed opposite to the region of infarcted myocardium. PMID:9141603

  19. Influenceable and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique—Case Report, Systematic Literature Review, and a Technical Note

    PubMed Central

    2014-01-01

    Following the first case of a systemic air embolism due to percutaneous CT-guided lung biopsy in our clinic we analysed the literature regarding this matter in view of influenceable or avoidable risk factors. A systematic review of literature reporting cases of systemic air embolism due to CT-guided lung biopsy was performed to find out whether prone positioning might be a risk factor regarding this issue. In addition, a technical note concerning coaxial biopsy practice is presented. Prone position seems to have relevance for the development and/or clinical manifestation of air embolism due to CT-guided lung biopsy and should be considered a risk factor, at least as far as lesions in the lower parts of the lung are concerned. Biopsies of small or cavitary lesions in coaxial technique should be performed using a hemostatic valve. PMID:25431666

  20. Global Distribution of Extreme Precipitation and High-Impact Landslides in 2010 Relative to Previous Years

    NASA Technical Reports Server (NTRS)

    Kirschbaum, Dalia; Adler, Robert; Adler, David; Peters-Lidard, Christa; Huffman, George

    2012-01-01

    It is well known that extreme or prolonged rainfall is the dominant trigger of landslides worldwide. While research has evaluated the spatiotemporal distribution of extreme rainfall and landslides at local or regional scales using in situ data, few studies have mapped rainfall-triggered landslide distribution globally due to the dearth of landslide data and consistent precipitation information. This study uses a newly developed Global Landslide Catalog (GLC) and a 13-year satellite-based precipitation record from TRMM data. For the first time, these two unique products provide the foundation to quantitatively evaluate the co-occurrence of precipitation and landslides globally. Evaluation of the GLC indicates that 2010 had a large number of high-impact landslide events relative to previous years. This study considers how variations in extreme and prolonged satellite-based rainfall are related to the distribution of landslides over the same time scales for three active landslide areas: Central America, the Himalayan Arc, and central-eastern China. Several test statistics confirm that TRMM rainfall generally scales with the observed increase in landslide reports and fatal events for 2010 and previous years over each region. These findings suggest that the co-occurrence of satellite precipitation and landslide reports may serve as a valuable indicator for characterizing the spatiotemporal distribution of landslide-prone areas in order to establish a global rainfall-triggered landslide climatology. This study characterizes the variability of satellite precipitation data and reported landslide activity at the globally scale in order to improve landslide cataloging, forecasting and quantify potential triggering sources at daily, monthly and yearly time scales.

  1. Recovery from Mild Traumatic Brain Injury in Previously Healthy Adults.

    PubMed

    Losoi, Heidi; Silverberg, Noah D; Wäljas, Minna; Turunen, Senni; Rosti-Otajärvi, Eija; Helminen, Mika; Luoto, Teemu M; Julkunen, Juhani; Öhman, Juha; Iverson, Grant L

    2016-04-15

    This prospective longitudinal study reports recovery from mild traumatic brain injury (MTBI) across multiple domains in a carefully selected consecutive sample of 74 previously healthy adults. The patients with MTBI and 40 orthopedic controls (i.e., ankle injuries) completed assessments at 1, 6, and 12 months after injury. Outcome measures included cognition, post-concussion symptoms, depression, traumatic stress, quality of life, satisfaction with life, resilience, and return to work. Patients with MTBI reported more post-concussion symptoms and fatigue than the controls at the beginning of recovery, but by 6 months after injury, did not differ as a group from nonhead injury trauma controls on cognition, fatigue, or mental health, and by 12 months, their level of post-concussion symptoms and quality of life was similar to that of controls. Almost all (96%) patients with MTBI returned to work/normal activities (RTW) within the follow-up of 1 year. A subgroup of those with MTBIs and controls reported mild post-concussion-like symptoms at 1 year. A large percentage of the subgroup who had persistent symptoms had a modifiable psychological risk factor at 1 month (i.e., depression, traumatic stress, and/or low resilience), and at 6 months, they had greater post-concussion symptoms, fatigue, insomnia, traumatic stress, and depression, and worse quality of life. All of the control subjects who had mild post-concussion-like symptoms at 12 months also had a mental health problem (i.e., depression, traumatic stress, or both). This illustrates the importance of providing evidence-supported treatment and rehabilitation services early in the recovery period. PMID:26437675

  2. 5 CFR 732.301 - Due process.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Due process. 732.301 Section 732.301...) NATIONAL SECURITY POSITIONS Due Process and Reporting § 732.301 Due process. When an agency makes an... any determination. (b) Comply with all applicable administrative due process requirements, as...

  3. Road Accident due to a Pancreatic Insulinoma

    PubMed Central

    Parisi, Amilcare; Desiderio, Jacopo; Cirocchi, Roberto; Grassi, Veronica; Trastulli, Stefano; Barberini, Francesco; Corsi, Alessia; Cacurri, Alban; Renzi, Claudio; Anastasio, Fabio; Battista, Francesca; Pucci, Giacomo; Noya, Giuseppe; Schillaci, Giuseppe

    2015-01-01

    Abstract Insulinoma is a rare pancreatic endocrine tumor, typically sporadic and solitary. Although the Whipple triad, consisting of hypoglycemia, neuroglycopenic symptoms, and symptoms relief with glucose administration, is often present, the diagnosis may be challenging when symptoms are less typical. We report a case of road accident due to an episode of loss of consciousness in a patient with pancreatic insulinoma. In the previous months, the patient had occasionally reported nonspecific symptoms. During hospitalization, endocrine examinations were compatible with an insulin-producing tumor. Abdominal computerized tomography and magnetic resonance imaging allowed us to identify and localize the tumor. The patient underwent a robotic distal pancreatectomy with partial omentectomy and splenectomy. Insulin-producing tumors may go undetected for a long period due to nonspecific clinical symptoms, and may cause episodes of loss of consciousness with potentially lethal consequences. Robot-assisted procedures can be performed with the same techniques of the traditional surgery, reducing surgical trauma, intraoperative blood loss, and hospital stays. PMID:25816027

  4. Photometric Properties of Ceres and Comparisons with Previous HST Observations

    NASA Astrophysics Data System (ADS)

    Li, J.-Y.; Nathues, A.; Le Corre, L.; Reddy, V.; Sykes, M. V.; Hoffmann, M.; Mottola, S.; Schröder, S. E.; Longobardo, A.; Ciarniello, M.; McFadden, L. A.; Raymond, C. A.; Russell, C. T.

    2015-10-01

    NASA's Dawn spacecraft entered the first science orbit around its second target, dwarf planet Ceres, in April 2015. The photometric properties of Ceres not only reveal clues about the physical state of the regolith, surface composition, and geological history, but also are important for correcting the data collected under various observing and illumination geometries to a common geometry to facilitate the interpretations of all photometric and spectral data. The Dawn data collected during its approach to Ceres cover phase angles from a few degrees to ~155º, and almost cover the full range of incidence angles and emission angles from 0º to 90º, making an excellent dataset for studying the spectrophotometric properties of Ceres. We report the analysis of the photometric properties of Ceres in the visible wavelengths using the Framing Camera (FC) [1] data through all seven color filters and one clear filter, acquired during the approach and the Survey orbit of the mission. Although previous studies [2-4] suggested a remarkably uniform surface of Ceres, the images collected by Dawn during its approach to the target at a scale of a few km/pixel revealed some small but extremely bright spots and regions, with albedos up to >4 times the average albedo of Ceres, representing the highest contrast so far observed in all asteroids imaged from close distances by spacecraft missions. These bright spots should be geologically young, and might be related to the episodic water sublimation activity of Ceres [5-7]. We performed detailed comparisons of the albedos of these bright spots between previous Hubble Space Telescope (HST) observations and the Dawn observations that span about 10 years to search for any possible changes. By the time of preparing this abstract, the Dawn FChas collected images at pixel scale down to 2.1 km/pixel. By June 2015, the data with a scale of 0.4 km/pixel will have been collected during the Survey Orbit phase.

  5. Wildlife Loss Estimates and Summary of Previous Mitigation Related to Hydroelectric Projects in Montana, Volume Three, Hungry Horse Project.

    SciTech Connect

    Casey, Daniel

    1984-10-01

    This assessment addresses the impacts to the wildlife populations and wildlife habitats due to the Hungry Horse Dam project on the South Fork of the Flathead River and previous mitigation of theses losses. In order to develop and focus mitigation efforts, it was first necessary to estimate wildlife and wildlife hatitat losses attributable to the construction and operation of the project. The purpose of this report was to document the best available information concerning the degree of impacts to target wildlife species. Indirect benefits to wildlife species not listed will be identified during the development of alternative mitigation measures. Wildlife species incurring positive impacts attributable to the project were identified.

  6. Severe Bloodstream Infection due to KPC-Producer E coli in a Renal Transplant Recipient Treated With the Double-Carbapenem Regimen and Analysis of In Vitro Synergy Testing: A Case Report.

    PubMed

    Oliva, Alessandra; Cipolla, Alessia; Gizzi, Francesca; D'Abramo, Alessandra; Favaro, Marco; De Angelis, Massimiliano; Ferretti, Giancarlo; Russo, Gianluca; Iannetta, Marco; Mastroianni, Claudio M; Mascellino, Maria T; Vullo, Vincenzo

    2016-02-01

    Transplant recipients are at high risk of infections caused by multidrug resistant microorganisms. Due to the limited therapeutic options, innovative antimicrobial combinations against carbapenem-resistant Enterobacteriaceae causing severe infections are necessary.A 61-year-old woman with a history of congenital solitary kidney underwent renal transplantation. The postoperative course was complicated by nosocomial pneumonia due to Stenotrophomonas maltophilia and pan-sensitive Escherichia coli, successfully treated with antimicrobial therapy. On postoperative day 22, diagnosis of surgical site infection and nosocomial pneumonia with concomitant bacteremia due to a Klebisella pneumoniae carbapenemase-producer E coli was made. The patient was treated with the double-carbapenem regimen (high dose of meropenem plus ertapenem) and a potent synergistic and bactericidal activity of this un-conventional therapeutic strategy was observed in vitro. Despite a microbiological response with prompt negativity of blood cultures, the patient faced a worse outcome because of severe hemorrhagic shock.The double-carbapenem regimen might be considered as a rescue therapy in those subjects, including transplant recipients, in whom previous antimicrobial combinations failed or when colistin use might be discouraged. Performing in vitro synergy testing should be strongly encouraged in cases of infections caused by pan-drug resistant strains, especially in high-risk patients. PMID:26886594

  7. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a...

  8. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a...

  9. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a...

  10. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a...

  11. 22 CFR 40.91 - Certain aliens previously removed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens previously removed. 40.91... IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year bar. An alien who has been found inadmissible, whether as a...

  12. Increasing Resistance of Coagulase-Negative Staphylococci in Total Hip Arthroplasty Infections: 278 THA-Revisions due to Infection Reported to the Norwegian Arthroplasty Register from 1993 to 2007

    PubMed Central

    Langvatn, Håkon; Dale, Håvard; Schrama, Johannes Cornelis; Hallan, Geir; Sjursen, Haakon; Engesæter, Lars B.

    2014-01-01

    We investigated bacterial findings from intraoperative tissue samples taken during revision due to infection after total hip arthroplasty (THA). The aim was to investigate whether the susceptibility patterns changed during the period from 1993 through 2007. Reported revisions due to infection in the Norwegian Arthroplasty Register (NAR) were identified, and 10 representative hospitals in Norway were visited. All relevant information on patients reported to the NAR for a revision due to infection, including bacteriological findings, was collected from the medical records. A total of 278 revision surgeries with bacterial growth in more than 2 samples were identified and included. Differences between three 5-year time periods were tested by the chi-square test for linear trend. The most frequent isolates were coagulase-negative staphylococci (CoNS) (41%, 113/278) and Staphylococcus aureus (19%, 53/278). The proportion of CoNS resistant to the methicillin-group increased from 57% (16/28) in the first period, 1993–1997, to 84% (52/62) in the last period, 2003–2007 (P = 0.003). There was also significant increase in resistance for CoNS to cotrimoxazole, quinolones, clindamycin, and macrolides. All S. aureus isolates were sensitive to both the methicillin-group and the aminoglycosides. For the other bacteria identified no changes in susceptibility patterns were found. PMID:25371827

  13. Determining root correspondence between previously and newly detected objects

    SciTech Connect

    Paglieroni, David W.; Beer, N Reginald

    2014-06-17

    A system that applies attribute and topology based change detection to networks of objects that were detected on previous scans of a structure, roadway, or area of interest. The attributes capture properties or characteristics of the previously detected objects, such as location, time of detection, size, elongation, orientation, etc. The topology of the network of previously detected objects is maintained in a constellation database that stores attributes of previously detected objects and implicitly captures the geometrical structure of the network. A change detection system detects change by comparing the attributes and topology of new objects detected on the latest scan to the constellation database of previously detected objects.

  14. Evidence of previous avian influenza infection among US turkey workers.

    PubMed

    Kayali, G; Ortiz, E J; Chorazy, M L; Gray, G C

    2010-06-01

    The threat of an influenza pandemic is looming, with new cases of sporadic avian influenza infections in man frequently reported. Exposure to diseased poultry is a leading risk factor for these infections. In this study, we used logistic regression to investigate serological evidence of previous infection with avian influenza subtypes H4, H5, H6, H7, H8, H9, H10, and H11 among 95 adults occupationally exposed to turkeys in the US Midwest and 82 unexposed controls. Our results indicate that farmers practising backyard, organic or free-ranging turkey production methods are at an increased risk of infection with avian influenza. Among these farmers, the adjusted odds ratios (ORs) for elevated microneutralization assay titres against avian H4, H5, H6, H9, and H10 influenza strains ranged between 3.9 (95% CI 1.2-12.8) and 15.3 (95% CI 2.0-115.2) when compared to non-exposed controls. The measured ORs were adjusted for antibody titres against human influenza viruses and other exposure variables. These data suggest that sometime in their lives, the workers had been exposed to low pathogenicity avian influenza viruses. These findings support calls for inclusion of agricultural workers in priority groups in pandemic influenza preparedness efforts. These data further support increasing surveillance and other preparedness efforts to include not only confinement poultry facilities, but more importantly, also small scale farms. PMID:19486492

  15. Shuffler measurements of previously unverified and unconfirmed inventory items

    SciTech Connect

    Hurd, J.R.; Hsue, F.; Rinard, P.M.

    1996-09-01

    The two new shufflers at Los Alamos National Laboratory (LANL) have been used on uranium inventory items that could not be previously verified or confirmed because of the lack of a suitable assay instrument. A third shufflers at the Westinghouse Savannah River Site (SRS) is currently measuring yet another inventory. One of the LANL inventories had items with only uranium while the second inventory had many mixtures of uranium and plutonium. The only calibration standards available were uniformly shaped cans of uranium oxide with no significant impurities. The inventory items had a wide variety of compositions, impurities, and geometric forms. Three measurement plans have been used with increasing sophistication as our experience and resources have grown. They are semi-quantitative and quantitative analyses of only the active-mode shufflers data, and quantitative analyses of active- and passive-shuffler data combined with isotopics and enrichments deduced from gamma-ray measurements. Measurement results for the first two approaches for the LANL inventories are given in this paper. Results of the third approach in the SRS case will be reported at a later date after they are completed.

  16. Geological Evidence that Mercury Contracted by More than Previously Recognized

    NASA Astrophysics Data System (ADS)

    Solomon, S. C.; Byrne, P. K.; Klimczak, C.; Sengor, A. M.; Watters, T. R.; Hauck, S. A.

    2013-12-01

    Images of Mercury returned by the Mariner 10 spacecraft showed a hemisphere replete with landforms interpreted to be contractional tectonic structures. Most such structures were attributed to the horizontal shortening that accompanied planetary cooling and contraction; estimates of the amount of strain they accommodated corresponded to a decrease by 0.8-2 km in planetary radius. More recently, photogeological studies of flyby and orbital data from the MESSENGER spacecraft have suggested 1-3 km of radius decrease (for an assumed fault dip angle, θ, of 30°). In contrast, thermal history models of Mercury have consistently predicted ~5-10 km of radial contraction, substantially more than indicated by photogeology. In the most comprehensive synthesis yet of contractional tectonics on Mercury, we have used global photomosaics to make new estimates of planetary radius change due to global contraction. From the application of a scaling relationship between fault displacement and fault length derived from 216 representative structures for θ=35°-25° to all mapped contractional landforms on Mercury, we find that the planet's radius has shortened by 4.7-7.1 km (5.7 km for θ=30°). Our survey includes smooth-plains-hosted wrinkle ridges, a portion of whose strain may be due to subsidence rather than global contraction. Even if all such structures are excluded, we calculate that Mercury's radius has decreased by 4.2-6.3 km (5.1 km for θ=30°). Whatever the extent to which wrinkle ridges accommodated some global contraction, Mercury experienced far more contraction than previously recognized. Our findings resolve a four-decades-old conflict: the planet's history of heat production and loss and the accumulated global contraction inferred from the record of surface deformation are now consistent. Our result provides an important new constraint for future thermal history models that address the bulk silicate abundances of heat-producing elements, the question of whether the mantle is currently convecting, and the history of cooling and present-day structure of Mercury's large metallic core, the source of the planet's internal magnetic field.

  17. Bacteremia due to Elizabethkingia meningoseptica

    PubMed Central

    Shinha, Takashi; Ahuja, Rakesh

    2015-01-01

    Elizabethkingia meningoseptica is a nonfermentative gram-negative bacillus that is ubiquitously found in hospital environments and as such, it has been associated with various nosocomial infections. Immunocompromised individuals are particularly at increased risk for developing severe infections due to E. meningoseptica, including bacteremia. E. meningoseptica is resistant to multiple antimicrobials commonly used for gram-negative bacteria and conventional empirical antimicrobials targeting those organisms may result in unfavorable outcome. We report a case of bacteremia due to E. meningoseptica in a patient who necessitated chronic hemodialysis therapy to heighten awareness of this emerging pathogen among patients on hemodialysis. PMID:26793448

  18. Previous Mental Health Service Utilization and Change in Clients' Depressive Symptoms

    ERIC Educational Resources Information Center

    Boswell, James F.; McAleavey, Andrew A.; Castonguay, Louis G.; Hayes, Jeffrey A.; Locke, Benjamin D.

    2012-01-01

    Although a potentially important factor in case conceptualization and treatment planning, the impact of previous treatment on subsequent counseling response has received little empirical attention. Using archival data, this study aimed to (a) report the prevalence of previous treatment utilization in a counseling population, (b) examine potential…

  19. Contributions of Attentional Style and Previous Experience to 4-Month-Old Infants' Categorization

    ERIC Educational Resources Information Center

    Kovack-Lesh, Kristine A.; Oakes, Lisa M.; McMurray, Bob

    2012-01-01

    We examined how infants' categorization is jointly influenced by previous experience and how much they shift their gaze back and forth between stimuli. Extending previous findings reported by K. A. Kovack-Lesh, J. S. Horst, and L. M. Oakes (2008), we found that 4-month-old infants' (N = 122) learning of the exclusive category of "cats" was related…

  20. Emergency thyroidectomy: Due to acute respiratory failure

    PubMed Central

    Bayhan, Zulfu; Zeren, Sezgin; Ucar, Bercis Imge; Ozbay, Isa; Sonmez, Yalcin; Mestan, Metin; Balaban, Onur; Bayhan, Nilufer Araz; Ekici, Mehmet Fatih

    2014-01-01

    INTRODUCTION Giant cervical and mediastinal goiter may lead to acute respiratory failure caused by laryngotracheal compression and airway obstruction. Here, we present a case admitted to the emergency service with a giant goiter along with respiratory failure and poor general health status, which required urgent surgical intervention. PRESENTATION OF CASE A 71-year-old female admitted to the emergency room with shortness of breath and poor general health status resulting from a giant cervical swelling progressively increased during the last 7 years and constituted severe respiratory failure which has become severe in the last one month. A giant nodular goiter of the left thyroid lobe extending retrosternally, causing tracheal compression, limiting the neck movements was detected with clinical examination and bedside ultrasound. Emergency thyroidectomy was planned. Fiberoptic-assisted awake nasal intubation was performed in the operating room. Emergency total thyroidectomy was performed for the life-threatening respiratory failure. Postoperative period was uneventful. She was transferred from intensive care unit to the ward on postoperative day 3 and was discharged from the hospital on the postoperative 7th day. Benign multinodular hyperplasia was reported on the histopathological report. Patient was included in routine follow-up. DISCUSSION In the present case tracheal destruction due to compression of the giant goiter was found in agreement with previous reports. Emergency thyroidectomy was performed after awake intubation since it is a common surgical option for the treatment of giant goiter causing severe airway obstruction. CONCLUSION Respiratory failure due to giant nodular goiter is a life-threatening situation and should be treated immediately by performing awake endotracheal intubation following emergency total thyroidectomy. PMID:25437688