Note: This page contains sample records for the topic previously reported due from Science.gov.
While these samples are representative of the content of Science.gov,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of Science.gov
to obtain the most current and comprehensive results.
Last update: August 15, 2014.
1

Intestinal adhesion due to previous uterine surgery as a risk factor for delayed diagnosis of uterine rupture: a case report  

PubMed Central

Introduction Uterine rupture is a life-threatening condition both to mothers and fetuses. Its early diagnosis and treatment may save their lives. Previous myomectomy is a high risk factor for uterine rupture. Intestinal adhesion due to previous myomectomy may also prevent early diagnosis of uterine rupture. Case presentation A 38-year-old primiparous non-laboring Japanese woman with a history of myomectomy was admitted in her 34th week due to lower abdominal pain. Although the pain was slight and her vital signs were stable, computed tomography revealed massive fluid collection in her abdominal cavity, which led us to perform a laparotomy. Uterine rupture had occurred at the site of the previous myomectomy; however, the small intestine was adhered tightly to the rupture, thus masking it. The baby was delivered through a low uterine segment transverse incision. The ruptured uterine wall was reconstructed. Conclusion Intestinal adhesion due to a prior myomectomy occluded a uterine rupture, possibly masking its symptoms and signs, which may have prevented early diagnosis.

2011-01-01

2

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

PubMed

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

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

2012-01-01

3

Pleuritis due to Brevundimonas diminuta in a previously healthy man.  

PubMed

Brevundimonas diminuta is rarely associated with invasive infections. We report the case of a previously healthy young man with pleural effusion, in which B. diminuta was recovered but incorrectly identified as Kingella kingae when it was freshly isolated. Consequently, the misidentification resulted in initial treatment failure. The correct identification was achieved through further incubation, sequencing of the 16S rRNA gene and MS. PMID:23180480

Lu, Binghuai; Shi, Yanli; Zhu, Fengxia; Xu, Xiaolin

2013-03-01

4

Implantable Cardiac Defibrillator Pocket Infection Due to a Previously Undescribed Cupriavidus Species?  

PubMed Central

The genus Cupriavidus consists of Gram-negative, nonfermenting bacteria most of which are environmental organisms, though some species have been associated with human disease. We report the recovery and identification of an isolate that represents a previously undescribed species of Cupriavidus from an implantable cardiac defibrillator pocket infection.

Christensen, Joshua B.; Vitko, Nicholas P.; Voskuil, Martin I.; Castillo-Mancilla, Jose R.

2010-01-01

5

Implantable cardiac defibrillator pocket infection due to a previously undescribed Cupriavidus species.  

PubMed

The genus Cupriavidus consists of Gram-negative, nonfermenting bacteria most of which are environmental organisms, though some species have been associated with human disease. We report the recovery and identification of an isolate that represents a previously undescribed species of Cupriavidus from an implantable cardiac defibrillator pocket infection. PMID:20427695

Christensen, Joshua B; Vitko, Nicholas P; Voskuil, Martin I; Castillo-Mancilla, Jose R

2010-07-01

6

Mild recessive bullous congenital ichthyosiform erythroderma due to a previously unidentified homozygous keratin 10 nonsense mutation.  

PubMed

We have identified a previously unreported homozygous nonsense mutation p.Cys427X in the keratin 10 (K10) gene (KRT10) in a Turkish girl with recessive bullous congenital ichthyosiform erythroderma (BCIE) showing superficial blistering. p.Cys427X is located upstream of the previously reported homozygous truncation mutation within the same exon 6 causing mRNA decay. Immunohistochemical examination showed a complete absence of K10 protein in the patient's epidermis. The findings of this study suggest that K10 knockout patients show unique clinicopathological features of clinically mild BCIE with blisters occurring within the granular layer. In addition, the unaffected, heterozygous carriers of the mutation indicate that the K10 peptide from one normal allele alone is sufficient for keratin network formation. PMID:18219278

Tsubota, Akiko; Akiyama, Masashi; Kanitakis, Jean; Sakai, Kaori; Nomura, Toshifumi; Claudy, Alain; Shimizu, Hiroshi

2008-07-01

7

Appearance of uterine scar due to previous cesarean section on hysterosalpingography: various shapes, locations and sizes.  

PubMed

Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes that is used predominantly in the assessment of infertility and evaluation of abnormalities of the uterus and fallopian tubes. Some of the abnormalities that can be detected by HSG include congenital anomalies, polyps, leiomyomas, synechiae and adenomyosis. HSG is also used to evaluate any scarring on the uterus and fallopian tubes. Cesarean section is the most commonly performed surgical procedure involving the uterus in fertile women. Cesarean section involves an incision made in the lower uterine segment or isthmus. Various changes in the site of the cesarean incision may be seen due to wall weakness and fibrosis. The scar may have various shapes; unilateral or bilateral, single or multiple, wedge-shaped or linear. Awareness of the appearance and locations of uterine defects due to previous cesarean section is necessary in order to differentiate them from normal variations and other pathologies mimicking it. In this study, we demonstrate the appearance of anatomic defects of the uterine cavity on HSG after cesarian section. We define different shapes such as thin linear defect, focal saccular outpouching, unilateral or bilateral diverticula (dog-ear like) and fistula and different locations such as the uterine body, lower uterine segment, uterine isthmus and the upper endocervical canal. PMID:24046789

Ahmadi, Firoozeh; Torbati, Leila; Akhbari, Farnaz; Shahrzad, Gholam

2013-06-01

8

Appearance of Uterine Scar Due to Previous Cesarean Section on Hysterosalpingography: Various Shapes, Locations and Sizes  

PubMed Central

Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes that is used predominantly in the assessment of infertility and evaluation of abnormalities of the uterus and fallopian tubes. Some of the abnormalities that can be detected by HSG include congenital anomalies, polyps, leiomyomas, synechiae and adenomyosis. HSG is also used to evaluate any scarring on the uterus and fallopian tubes. Cesarean section is the most commonly performed surgical procedure involving the uterus in fertile women. Cesarean section involves an incision made in the lower uterine segment or isthmus. Various changes in the site of the cesarean incision may be seen due to wall weakness and fibrosis. The scar may have various shapes; unilateral or bilateral, single or multiple, wedge-shaped or linear. Awareness of the appearance and locations of uterine defects due to previous cesarean section is necessary in order to differentiate them from normal variations and other pathologies mimicking it. In this study, we demonstrate the appearance of anatomic defects of the uterine cavity on HSG after cesarian section. We define different shapes such as thin linear defect, focal saccular outpouching, unilateral or bilateral diverticula (dog-ear like) and fistula and different locations such as the uterine body, lower uterine segment, uterine isthmus and the upper endocervical canal.

Ahmadi, Firoozeh; Torbati, Leila; Akhbari, Farnaz; Shahrzad, Gholam

2013-01-01

9

Medial patellar subluxation without previous lateral release: a case report.  

PubMed

Medial patellar subluxation (MPS) is normally described following a lateral release. We report on a 14-year-old girl with MPS without previous lateral release. Arthroscopic examination demonstrated MPS at 0 and 30° of flexion, and the patella was tight in flexion on the lateral side. A low lateral release with a tibial tubercle transfer was performed, followed by repair of the lateral release with an iliotibial band flap, and lateral patellofemoral ligament reconstruction. Excellent functional outcome was achieved. This type of patellar instability is often overlooked and a high index of suspicion is needed for appropriate diagnosis and treatment. PMID:24755851

Saper, Michael G; Shneider, David A

2014-07-01

10

Spontaneous Rupture of Uterus in Midtrimester Pregnancy Due to Increased Uterine Pressure with Previous Laparoscopic Myomectomy  

PubMed Central

Uterine rupture is a life threatening condition for both the mother and her fetus. It may be seen in the second trimester usually after induction for pregnancy termination in a scarred uterus. Spontaneous rupture in the second trimester before labor is a very rare condition. Here, we report a case of uterine rupture at 23-week pregnancy due to elevated uterine pressure with a history of laparoscopic myomectomy one year before admission. She was symptomatic for diffuse abdominal pain and the ultrasonographic image was interpreted as amniotic band. Four days later, because of deterioration of the patient and fetal bradycardia urgent laparotomy was performed. Fundal rupture with fibrotic borders suggested that a chronic event was seen. Laparoscopic myomectomy has advantages over laparatomy but the possibility of uterine rupture in following pregnancies should not be underestimated. Therefore, repair of the myometrium should be carefully assessed.

Kiseli, Mine; Artas, Hakan; Armagan, Figen; Dogan, Zeynep

2013-01-01

11

Intracranial meningioma at the site of a previous cranial penetrating trauma due to shrapnel.  

PubMed

Meningiomas are common and mostly benign intracranial tumors, which originate from arachnoid cells of the meninges, and account for approximately 25% of all primary intracranial tumors. Many external etiological factors have been described as etiology of meningioma in the literature, one of which is head trauma. However, trauma as a cause of meningioma remains a controversial subject. Here, a case of a patient with posttraumatic meningioma, who was wounded 25 years before, is presented. The assessment of the clinical characteristics of the patient and those reported in the literature seem to confirm that, in some cases, head trauma may be a factor contributing to the development of meningioma. PMID:24621752

Dehghani, Siavash; Azadi, Ali; Dehghani, Nima; Mansouri, Niloufar; Pourdanesh, Fereydoun

2014-03-01

12

Prolonged asthma after smoke inhalation: a report of three cases and a review of previous reports.  

PubMed

The development of prolonged obstructive airways disease after smoke inhalation is of concern to fire victims and fire fighters. Three cases of asthma that developed following the inhalation of pyrolysis products are presented along with a review of previous reports of airway injury from smoke inhalation. Polyvinyl chloride pyrolysis products seem to pose a high risk, but other toxic inhalants are also implicated. There is substantial evidence that prolonged airway hyper-responsiveness and asthma may follow numerous inflammatory insults including smoke inhalation. Studies to identify specific individual risk factors and asthmagenic pyrolysis products are needed. Early, postexposure anti-inflammatory treatment may modify the outcome. PMID:2037900

Moisan, T C

1991-04-01

13

Clinical study reports of randomised controlled trials: an exploratory review of previously confidential industry reports  

PubMed Central

Objective To explore the structure and content of a non-random sample of clinical study reports (CSRs) to guide clinicians and systematic reviewers. Search strategy We searched public sources and lodged Freedom of Information requests for previously confidential CSRs primarily written by the industry for regulators. Selection criteria CSRs reporting sufficient information for extraction (‘adequate’). Primary outcome measures Presence and length of essential elements of trial design and reporting and compression factor (ratio of page length for CSRs compared to its published counterpart in a scientific journal). Data extraction Data were extracted on standard forms and crosschecked for accuracy. Results We assembled a population of 78 CSRs (covering 90 randomised controlled trials; 144?610 pages total) dated 1991–2011 of 14 pharmaceuticals. Report synopses had a median length of 5 pages, efficacy evaluation 13.5 pages, safety evaluation 17 pages, attached tables 337 pages, trial protocol 62 pages, statistical analysis plan 15 pages and individual efficacy and safety listings had a median length of 447 and 109.5 pages, respectively. While 16 (21%) of CSRs contained completed case report forms, these were accessible to us in only one case (765 pages representing 16 individuals). Compression factors ranged between 1 and 8805. Conclusions Clinical study reports represent a hitherto mostly hidden and untapped source of detailed and exhaustive data on each trial. They should be consulted by independent parties interested in a detailed record of a clinical trial, and should form the basic unit for evidence synthesis as their use is likely to minimise the problem of reporting bias. We cannot say whether our sample is representative and whether our conclusions are generalisable to an undefined and undefinable population of CSRs.

Doshi, Peter; Jefferson, Tom

2013-01-01

14

[Conjunctivitis due to Achromobacter xylosoxidans: case report].  

PubMed

We report here a case of conjunctivitis in an immunocompetent patient due to Achromobacter xylosoxidans, which was associated with the use of rigid contact lenses. The bacteria were isolated from the scraped conjunctival swab as well as from the lens cleaning fluid. A. xylosoxidans is an opportunistic pathogen, especially in immunocompromised patients; however, in isolates of ocular infections, from immunocompetent patients, it may be confused with other gram-negative organisms, particularly Pseudomonas aeruginosa. Due to an increased resistance against different antimicrobial agents, A. xylosoxidans must be fully identified and differentiated from other gram-negative isolates from ocular infections. PMID:19466343

Lucatelli, Juliana Faggion; Cantarelli, Vlademir Vicente; Picoli, Simone Ulrich

2009-01-01

15

Compartment syndrome, disseminated intravascular coagulation, pneumonia, and acute renal failure due to varicella in a previously healthy child.  

PubMed

Varicella infections are usually considered to be benign. Although very rare, infection of an immunocompetent patient by this virus may result in a severe illness. We describe a case of varicella infection in a previously healthy, immunocompetent 5-y-old boy, complicated with compartment syndrome, disseminated intravascular coagulation (DIC), pneumonia, and acute renal failure. He was treated successfully with aciclovir and intravenous immunoglobulins for the varicella infection, a fasciotomy for compartment syndrome, and fresh frozen plasma for DIC. PMID:24738756

Arslansoyu Çamlar, Seçil; Çakir, Murat; Bahat Özdo?an, Elif; Kaya, Ahmet; Kerimo?lu, Servet; Ökten, Ay?enur

2014-06-01

16

[Septic polyarthritis due to an infected nail bed around an ingrown toenail in a previously healthy boy].  

PubMed

A 17-year-old, previously healthy boy was admitted with complaints of fever, malaise and pain in the pubic region and groin. His left elbow was also warm and swollen and could not be extended fully. Cultures of fluid drained from both hips and the elbow, blood and inflamed tissue from the nail bed of the right big toe yielded Staphylococcus aureus. The patient was treated with intravenous antibiotics for septic arthritis of both hips, the left elbow and possibly the pubic symphysis. The infected nail bed, which was the most likely port of entry, was also treated. One year later, the original painful symptoms had disappeared but the right hip was almost immobile. In a patient with indications of septic arthritis, timely diagnosis and adequate therapy reduce the risk of permanent damage to the joint. PMID:17225739

Veneman, N G P; Waalkens, H J; van Raaij, J J A M; Brouwer, R W

2006-04-29

17

Lobular Breast Cancer in a Male Patient with a Previous History of Irradiation Due to Hodgkin's Disease  

PubMed Central

Background Male breast cancer is rare and represents less than 1% of all breast cancers. Considering the fact that the male breast most often does not consist of lobules and acini, lobular carcinoma of the male breast is exceptionally rare. Case Report In this paper we present a unique case of alveolar variant of lobular male breast cancer in a 56-year-old patient. Conclusion According to our knowledge this is the first presentation of an alveolar variant of lobular male breast cancer that appeared 14 years after chemo- and radiotherapy for the treatment of Hodgkin's disease.

Ninkovic, Srdjan; Azanjac, Goran; Knezevic, Milan; Radovanovic, Dragce; Canovic, Dragan; Nedovic, Jasmina; Mitrovic, Slobodanka

2012-01-01

18

Intraosseous myelolipoma within proximal femoral metaphysis in a patient with previous prostate cancer: a case report.  

PubMed

We report on a case of an osteolytic lesion of the femur in a patient with previous prostate cancer, affected by hip osteoarthritis. Computed tomography of the femur demonstrated the presence of fat in the lesion. Computed tomography-guided fine needle aspiration biopsy revealed mature adipose tissue along with hematopoietic precursor cells. Surgical management consisted of curettage and packing with allograft, followed later by total hip arthroplasty. This is the third case of intraosseous myelolipoma reported in the literature. PMID:19876886

Papapietro, Nicola; Martinelli, Nicolò; Ippolito, Massimiliano; Amato, Cirino; Denaro, Vincenzo

2009-01-01

19

[Case report: prolonged croup due to herpes simplex infection].  

PubMed

In recent years only a few cases of croup due to herpes simplex infection among healthy children have been reported. This case report concerns a 15 month old, healthy boy who was admitted to the Children's Hospital with croup and failed to recover within the week. The boy had a positive throat culture for herpes simplex type 1 and was diagnosed with croup due to herpes simplex on the basis of serology. The boy was treated with corticosteroids; a recognised practice in severe cases of croup. The harmful effects of corticosteroids in herpes simplex croup, if indeed any, are not known. We surmise that in this case the use of corticosteroids was not a decisive factor, but it has been previously noted that prolonged corticosteroid treatment can play a role in herpes simplex infection. Furthermore it has been debated whether other viral pathogens proceed the infection, but in this case serology indicates otherwise. PMID:17206016

Sturludóttir, Margrét; Skúladóttir, Helga Margrét; Gudnason, Thornórólfur; Ardal, Bjoern

2006-12-01

20

Case report. Paraphimosis due to erotic dancing.  

PubMed

Paraphimosis usually develops when a tight foreskin is retracted over the glans penis for a prolonged period. Many esoteric aetiologies have been implicated in the development of paraphimosis including piercing the foreskin, Plasmodium falciparum infection, application of celadine juice to the foreskin, chancroid, pessaries and the implantation of pearls. We report the first two cases of paraphimosis developing during wining, an erotic dance native to Trinidad & Tobago. PMID:11169281

Ramdass, M J; Naraynsingh, V; Kuruvilla, T; Maharaj, D

2000-12-01

21

Protothecosis in hematopoietic stem cell transplantation: case report and review of previous cases.  

PubMed

Prototheca species are achlorophyllus algae. Prototheca wickerhamii and Prototheca zopfii cause human disease. In immunocompetent individuals, they cause soft tissue infections and olecranon bursitis, but in transplant recipients, these organisms can cause disseminated disease. We report a fatal case of disseminated P. zopfii infection in an hematopoietic stem cell transplant (HSCT) recipient with bloodstream infection and involvement of multiple soft tissue sites. We review all previous cases of protothecosis in HSCT reported in the literature. Protothecosis is uncommon after HSCT, but has a disseminated presentation that is frequently fatal. It is commonly misidentified as a yeast. Tumor necrosis factor-alpha inhibitors and contamination of central venous catheters may contribute to development of protothecosis. Optimal treatment approaches are yet to be defined. New agents such as miltefosine may be possible future therapies. PMID:24797402

Macesic, N; Fleming, S; Kidd, S; Madigan, V; Chean, R; Ritchie, D; Slavin, M

2014-06-01

22

Perivasculitic panencephalitis with relapsing polychondritis: an autopsy case report and review of previous cases.  

PubMed

We herein report an autopsy case of relapsing polychondritis encephalitis coexisting with a Lewy body pathology and also review previous autopsy cases. A 59-year-old man exhibited a tremor of the right hand, small-steppage gait and bradykinesia. Five years later, he presented with relapsing auricular chondritis and scleritis and subsequently showed exacerbation of extrapyramidal symptoms. A histological examination revealed perivascular lymphocytic cuffing and infiltration in the small vessels, as well as loss of nerve cells and gliosis in the basal ganglia, insular gyrus and medial temporal lobe. The present case was characterized by perivasculitic panencephalitis and the coexistence of a Lewy body pathology, which may have augmented the patient's parkinsonism. PMID:24881747

Niwa, Atsushi; Okamoto, Yoko; Kondo, Takayuki; Nabatame, Hidehiko; Takahashi, Ryosuke; Tomimoto, Hidekazu

2014-01-01

23

Subdural Empyema Due to Lactococcus lactis cremoris: Case Report.  

PubMed

Lactococcus lactis cremoris (L. lactis cremoris) infections are very rare in humans. Only three case reports of brain abscess have been reported and the infectious routes and pathological features are still unknown. We experienced a subdural empyema due to L. lactis cremoris in an immunocompetent adult. A 33-year-old man was admitted with fever, right facial pain, left hemiparesis, and left hemianopsia. Computed tomography demonstrated low density fluid collection in the right falcotentorial subdural space. Magnetic resonance (MR) images revealed a high signal lesion on a diffusion-weighted image (DWI) and fluid attenuated inversion recovery (FLAIR) images in the right paratentorial and parafalcine subdural space, right maxillary sinus, and bilateral ethmoidal sinus. He underwent two sequential open surgeries for removal and drainage of empyema and was treated with antibiotics including meropenem and ampicillin. To our knowledge, this is the first report of subdural empyema caused by L. lactis cremoris infection. We report the case and discuss the pathological features with the previous literature. PMID:24257498

Inoue, Mizuho; Saito, Atsushi; Kon, Hiroyuki; Uchida, Hiroki; Koyama, Shinya; Haryu, Shinya; Sasaki, Tatsuya; Nishijima, Michiharu

2014-04-15

24

Novel Endogenous Retrovirus in Rabbits Previously Reported as Human Retrovirus 5  

PubMed Central

Human retrovirus 5 (HRV-5) represented a fragment of a novel retrovirus sequence identified in human RNA and DNA preparations. In this study, the genome of HRV-5 was cloned and sequenced and integration sites were analyzed. Using PCR and Southern hybridization, we showed that HRV-5 is not integrated into human DNA. A survey of other species revealed that HRV-5 is present in the genomic DNA of the European rabbit (Oryctolagus cuniculus) and belongs to an endogenous retrovirus family found in rabbits. The presence of rabbit sequences flanking HRV-5 proviruses in human DNA extracts suggested that rabbit DNA was present in our human extracts, and this was confirmed by PCR analysis that revealed the presence of rabbit mitochondrial DNA sequences in four of five human DNA preparations tested. The origin of the rabbit DNA and HRV-5 in human DNA preparations remains unclear, but laboratory contamination cannot explain the preferential detection of HRV-5 in inflammatory diseases and lymphomas reported previously. This is the first description of a retrovirus genome in rabbits, and sequence analysis shows that it is related to but distinct from A-type retroelements of mice and other rodents. The species distribution of HRV-5 is restricted to rabbits; other species, including other members of the order Lagomorpha, do not contain this sequence. Analysis of HRV-5 expression by Northern hybridization and reverse transcriptase PCR indicates that the virus is transcribed at a low level in many rabbit tissues. In light of these findings we propose that the sequence previously designated HRV-5 should now be denoted RERV-H (for rabbit endogenous retrovirus H).

Griffiths, David J.; Voisset, Cecile; Venables, Patrick J. W.; Weiss, Robin A.

2002-01-01

25

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

SciTech Connect

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.

Fon, E.A.; Sarrazin, J.; Rouleau, G.A. [Montreal General Hospital (Canada)] [and others

1995-12-18

26

Placenta percreta invading broad ligament and parametrium in a woman with two previous cesarean sections: a case report.  

PubMed

Introduction. The incidence of placenta accreta has dramatically increased due to increasing caesarean section rate all over the world. Placenta percreta is the most severe form of placenta accretes. It frequently results in maternal morbidity and mortality mainly caused by massive obstetric hemorrhage or emergency hysterectomy. Percreta invading into the broad ligament has rarely been previously reported. Case presenting. We presented a case of placenta percreta invading left broad ligament and parametrium in a woman with two previous cesarean sections, which led to massive intraoperative hemorrhage during hysterectomy and transient ischemic encephalopathy. Conclusion. In cases of parametrial involvement, it would be more difficult to decide whether to remove placenta or leave it in site. In surgical removal neither local excision of placental bed and uterine repair nor traditional hysterectomy is adequate if parametrium invaded by placenta. We suggest delayed elective hysterectomy in such cases. So, pregnancy-induced pelvic congestion would be decreased, we can gather an expert team of gynecologists, urologists, and vascular surgeons, we could get plenty of blood products, and we may have the chance to administer methotrexate. PMID:23097727

Vahdat, Mansoureh; Mehdizadeh, Abolfazl; Sariri, Elaheh; Chaichian, Shahla; Najmi, Zahra; Kadivar, Maryam

2012-01-01

27

Placenta Percreta Invading Broad Ligament and Parametrium in a Woman with Two Previous Cesarean Sections: A Case Report  

PubMed Central

Introduction. The incidence of placenta accreta has dramatically increased due to increasing caesarean section rate all over the world. Placenta percreta is the most severe form of placenta accretes. It frequently results in maternal morbidity and mortality mainly caused by massive obstetric hemorrhage or emergency hysterectomy. Percreta invading into the broad ligament has rarely been previously reported. Case presenting. We presented a case of placenta percreta invading left broad ligament and parametrium in a woman with two previous cesarean sections, which led to massive intraoperative hemorrhage during hysterectomy and transient ischemic encephalopathy. Conclusion. In cases of parametrial involvement, it would be more difficult to decide whether to remove placenta or leave it in site. In surgical removal neither local excision of placental bed and uterine repair nor traditional hysterectomy is adequate if parametrium invaded by placenta. We suggest delayed elective hysterectomy in such cases. So, pregnancy-induced pelvic congestion would be decreased, we can gather an expert team of gynecologists, urologists, and vascular surgeons, we could get plenty of blood products, and we may have the chance to administer methotrexate.

Vahdat, Mansoureh; Mehdizadeh, Abolfazl; Sariri, Elaheh; Chaichian, Shahla; Najmi, Zahra; Kadivar, Maryam

2012-01-01

28

Malignant fibrous histiocytoma: a report of two cases arising in sites of previous irradiation.  

PubMed

This report illustrates two cases of malignant fibrous histiocytoma of the maxilla arising in sites which had been irradiated. The prognosis for such tumours in the jaws appears to be very poor. PMID:2840113

Ireland, A J; Eveson, J W; Leopard, P J

1988-06-01

29

Large Vaginal and Bladder Calculi in a Woman With Previous Operation of Bladder Exstrophy: A Case Report  

PubMed Central

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones.

Tavakkoli, Mahmoud; Ghoreifi, Alireza

2013-01-01

30

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

SciTech Connect

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.

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

1984-03-01

31

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

SciTech Connect

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.

Dragomir, Diana; Matthews, Jaymie M.; Antoci, Victoria [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T1Z1 (Canada); Howard, Andrew W.; Marcy, Geoffrey W. [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Henry, Gregory W. [Center of Excellence in Information Systems, Tennessee State University, 3500 John A. Merritt Blvd., Box 9501, Nashville, TN 37209 (United States); Guenther, David B. [Department of Astronomy and Physics, St. Marys University Halifax, NS B3H 3C3 (Canada); Johnson, John A. [Department of Astronomy, California Institute of Technology, 1200 East California Boulevard, MC 249-17, Pasadena, CA 91125 (United States); Kuschnig, Rainer; Weiss, Werner W. [Universitaet Wien, Institut fuer Astronomie, Tuerkenschanzstrasse 17, A1180 Wien (Austria); Moffat, Anthony F. J. [Dept de physique, Univ de Montreal C.P. 6128, Succ. Centre-Ville, Montreal, QC H3C 3J7, and Obs. du mont Megantic (Canada); Rowe, Jason F. [NASA Ames Research Center, Moffett Field, CA 94035 (United States); Rucinski, Slavek M. [Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H4 (Canada); Sasselov, Dimitar, E-mail: diana@phas.ubc.ca [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)

2012-11-10

32

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

Microsoft Academic Search

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

Edward A. Fon; Julie Sarrazin; G. A. Rouleau; Julio Alarcia; Michael I. Shevell; Anne Philippe; Marion Leboyer

1995-01-01

33

Sudden onset methaemoglobinaemia in a previously well Ugandan child: a case report and literature review  

PubMed Central

Methaemoglobinaemia is a rare condition of unknown prevalence. Diagnostic tests in resource limited settings are very rare but clinical signs can be a good guide. We set out to describe a case of Methaemoglobinaemia, raise awareness among practitioners in resource limited settings and to share experiences in its diagnosis and management. A previously well three and a half year old girl was admitted with central cyanosis of sudden onset. She underwent clinical, laboratory and radiological evaluation. Having been in a resource limited setting, the process of making a diagnosis was slow and difficult. After the diagnosis, the treatment was not available in the country but we managed to get it all the way from Nairobi, Kenya. A diagnosis of Methaemoglobinaemia was made using Spectrophotometry and she was successfully treated using 2 doses of intravenous Methylene blue. The cause of Methaemoglobinaemia was established to have been nitrites from food preservatives.

Nabukeera-Barungi, Nicolette; Mworozi, Edison

2012-01-01

34

Central mucoepidermoid carcinoma in a previously enucleated radiolucent lesion in the mandible. A case report.  

PubMed

Central muco epidermoid carcinomas (CMC) are rare tumours, representing about 2 to 3% of all mucoepidermoid carcinomas. Usually affecting the mandible, they appear as uni- or multilocular radiolucent lesions. We report a case of CMC in a 52-year-old Middle Eastern woman who presented with pain, limitation of jaw movement and tingling sensation of the tongue, related to a radiolucent lesion in the angle of the mandible. The lesion was first detected but not diagnosed in another hospital three years earlier. We describe the progression of the lesion over the past three years and describe the clinical, radiographic, histopathological, and surgical aspects of the case. PMID:22715640

Abu-Karaky, A; Al, Hadidi A; Al, Shafii A; Dibs, D; Al, Basha S; Sawair, F A; Khraisat, A

2012-03-01

35

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

PubMed

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

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

2014-06-01

36

Reduced dose maintenance eculizumab in atypical hemolytic uremic syndrome (aHUS): an update on a previous case report  

PubMed Central

Objective To describe how maintenance eculizumab sustains improved renal function in severe atypical hemolytic uremic syndrome (aHUS). Case report A previously described 50-year-old woman with aHUS had a remarkable recovery with eculizumab, which safely reversed profound neurologic damage and eliminated the need for dialysis. Her recovery has been sustained on long-term eculizumab treatment. She initially received eculizumab 900 mg weekly for four doses. On week 5 she commenced maintenance therapy starting at 1200 mg every 2 weeks. Due to nausea and vomiting at that dose, the maintenance dosing was reduced to 600 mg weekly, beginning on dose seven. After receiving 600 mg weekly for nine doses, eculizumab was then reduced to 600 mg every 2 weeks, with continued improvement in renal function. This dosing is lower than the usual 1200 mg every 2 weeks described in the adult literature and used in current clinical trials of aHUS. Conclusion Six months after the initial diagnosis, our patient continues to have improved renal function on maintenance doses of eculizumab as low as 600 mg every 2 weeks.

Ohanian, Maro; Cable, Christian; Halka, Kathleen

2011-01-01

37

Cutaneous infection due to Bacillus pumilus: report of 3 cases.  

PubMed

Human infection due to Bacillus pumilus is exceptional. We report 3 cases of cutaneous infection caused by B. pumilus that occurred in 3 shepherds, 2 of whom were members of the same family. The lesions appeared to have a morphology similar to that of cutaneous anthrax lesions. Two patients were cured after treatment with amoxicillin-clavulanate, and the third patient was cured after prolonged treatment with ciprofloxacin. To our knowledge, primary cutaneous infection due to B. pumilus has not been reported. B. pumilus should be considered in patients who develop lesions suggestive of cutaneous anthrax. PMID:17243047

Tena, Daniel; Martinez-Torres, Juan Angel; Perez-Pomata, María Teresa; Sáez-Nieto, Juan Antonio; Rubio, Virginia; Bisquert, Julia

2007-02-15

38

Case reports. Six cases of infection due to Trichophyton verrucosum.  

PubMed

Dermatophyte infections due to Trichopkyton verrucosum are not frequent in Europe. Six cases observed in Italy in the period 1995-99 are reported. Two were cases of tinea barbae, two of tinea corporis and two of tinea capitis, one of which had been preceded by tinea faciei. In three cases the source of contagion was horses, in two it was cattle and in one case it was another person. The two cases of tinea barbae were initially interpreted and treated as bacterial infections, a diagnostic error reported with increasing frequency in the literature regarding dermatophytosis due to T. verrucosum. PMID:11714072

Roman, C; Massai, L; Gianni, C; Crosti, C

2001-01-01

39

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

NASA Astrophysics Data System (ADS)

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.

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

2013-01-01

40

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

NASA Astrophysics Data System (ADS)

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.

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

2013-07-01

41

Large vaginal and bladder calculi in a woman with previous operation of bladder exstrophy: a case report.  

PubMed

This is to report the case of a huge vaginal stone, and bladder calculi in a 26-year-old woman with previous operation of bladder exstrophy. It seems that the vaginal stone was secondary to the remaining wire used in her previous reconstructive surgery for pelvic closure 20 years ago and now surgery is performed to remove the vaginal and bladder stones. PMID:24719809

Tavakkoli, Mahmoud; Ghoreifi, Alireza

2014-01-01

42

Spinal tumour due to primary hyperparathyroidism causing sciatica: case report  

Microsoft Academic Search

We report a unilateral intraspinal cyst-like lesion adjacent to the lamina and facet joint at the L4-L5 level producing sciatica. Histological examination revealed multinucleate giant cells suggesting a brown tumour. Further studies disclosed primary hyperparathyroidism, whose first manifestation was the lumbar nerve root compression. Previous cases of compression of neural structures by spinal brown tumours are reviewed and a radiological

M. Motateanu; J. P. Déruaz; H. Fankhauser

1994-01-01

43

Wenckebach Block due to Hyperkalemia: A Case Report  

PubMed Central

Hyperkalemia is a commonly encountered electrolyte abnormality that can significantly alter normal cardiac conduction. Potentially lethal dysrhythmias associated with hyperkalemia include complete heart block and Mobitz Type II second-degree AV block. We report a unique case of Mobitz Type 1 second-degree atrioventricular (AV) block, known commonly as Wenckebach, due to hyperkalemia. The patient's symptoms and electrocardiogram (ECG) evidence of Wenckebach block resolved with lowering of serum potassium levels, with subsequent ECG showing first-degree AV block. This paper highlights an infrequently reported dysrhythmia associated with hyperkalemia that emergency physicians should be familiar with.

Sohoni, Aparajita; Perez, Berenice; Singh, Amandeep

2010-01-01

44

Dissociative disorder due to Graves' hyperthyroidism: a case report.  

PubMed

We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility. PMID:24713328

Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

2014-01-01

45

Predominantly Cystic Central Mucoepidermoid Carcinoma Developing from a Previously Diagnosed Dentigerous Cyst: Case Report and Review of the Literature  

PubMed Central

Primary intraosseous mucoepidermoid carcinoma of the jawbones is an extremely rare malignant salivary gland tumour constituting 2-4.3% of all the reported mucoepidermoid carcinomas. We report a case of intraosseous mucoepidermoid carcinoma of the mandible in an 80-year old female patient developing from a previously diagnosed dentigerous cyst. An excisional biopsy was performed and the histopathological features confirmed low grade-cystic intraosseous mucoepidermoid carcinoma. The origin of central mucoepidermoid carcinoma could be suggested to be from the epithelial lining of previously diagnosed dentigerous cyst. Thus, emphasizing the need for careful examination of the entire excision specimen to rule out such neoplastic transformation of epithelial lining of odontogenic cyst and provide appropriate and effective treatment.

Spoorthi, Banavar Ravi; Rao, Roopa S.; Rajashekaraiah, Premalatha Bidadi; Patil, Shankargouda; Venktesaiah, Sowmya Samudrala; Purushothama, Preethi

2013-01-01

46

Association Testing of Previously Reported Variants in a Large Case-Control Meta-analysis of Diabetic Nephropathy  

PubMed Central

We formed the GEnetics of Nephropathy–an International Effort (GENIE) consortium to examine previously reported genetic associations with diabetic nephropathy (DN) in type 1 diabetes. GENIE consists of 6,366 similarly ascertained participants of European ancestry with type 1 diabetes, with and without DN, from the All Ireland-Warren 3-Genetics of Kidneys in Diabetes U.K. and Republic of Ireland (U.K.-R.O.I.) collection and the Finnish Diabetic Nephropathy Study (FinnDiane), combined with reanalyzed data from the Genetics of Kidneys in Diabetes U.S. Study (U.S. GoKinD). We found little evidence for the association of the EPO promoter polymorphism, rs161740, with the combined phenotype of proliferative retinopathy and end-stage renal disease in U.K.-R.O.I. (odds ratio [OR] 1.14, P = 0.19) or FinnDiane (OR 1.06, P = 0.60). However, a fixed-effects meta-analysis that included the previously reported cohorts retained a genome-wide significant association with that phenotype (OR 1.31, P = 2 × 10?9). An expanded investigation of the ELMO1 locus and genetic regions reported to be associated with DN in the U.S. GoKinD yielded only nominal statistical significance for these loci. Finally, top candidates identified in a recent meta-analysis failed to reach genome-wide significance. In conclusion, we were unable to replicate most of the previously reported genetic associations for DN, and significance for the EPO promoter association was attenuated.

Williams, Winfred W.; Salem, Rany M.; McKnight, Amy Jayne; Sandholm, Niina; Forsblom, Carol; Taylor, Andrew; Guiducci, Candace; McAteer, Jarred B.; McKay, Gareth J.; Isakova, Tamara; Brennan, Eoin P.; Sadlier, Denise M.; Palmer, Cameron; Soderlund, Jenny; Fagerholm, Emma; Harjutsalo, Valma; Lithovius, Raija; Gordin, Daniel; Hietala, Kustaa; Kyto, Janne; Parkkonen, Maija; Rosengard-Barlund, Milla; Thorn, Lena; Syreeni, Anna; Tolonen, Nina; Saraheimo, Markku; Waden, Johan; Pitkaniemi, Janne; Sarti, Cinzia; Tuomilehto, Jaakko; Tryggvason, Karl; Osterholm, Anne-May; He, Bing; Bain, Steve; Martin, Finian; Godson, Catherine; Hirschhorn, Joel N.; Maxwell, Alexander P.; Groop, Per-Henrik; Florez, Jose C.

2012-01-01

47

Rosette-forming glioneuronal tumour of the fourth ventricle with previous intratumoural haemorrhage: case report and review of the literature.  

PubMed

The case is reported of a rosette-forming glioneuronal tumour of the fourth ventricle (RGTFV) in a 27-year-old male. Symptoms included headache, severe vomiting and clumsy walking that had progressively worsened over 14 days. Computed tomography and magnetic resonance imaging indicated a 3.0 x 2.5 x 2.0 cm solid-cystic mass in the fourth ventricle and obstructive hydrocephalus. The tumour showed evidence of previous intra-tumour haemorrhage, with heterogeneous enhancement after contrast administration. Complete excision of the lesion was performed. Signs of previous intra-tumoural haemorrhage were seen intra-operatively. The detailed clinical, radiological and pathological features in this patient are described and compared with existing literature on this type of tumour. Despite benign histological features and a reported favourable post-operative course, there is still limited clinical experience with this type of tumour, however intratumoural haemorrhage may result in morbidity and mortality. This report will help provide better characterization of this entity, improving the diagnosis and potentially reducing mortality in RGTFV. PMID:19589282

Li, Y M; Li, W Q; Pan, Y; Lu, Y C; Long, N Y; Tao, X F; Yu, H Y

2009-01-01

48

Brain abscess due to odontogenic infection: a case report.  

PubMed

In this report, we describe a case of brain abscess due to odontogenic infection. A 53-year-old female who had been suffering from headache and trismus for two weeks visited the Department of Oral and Maxillofacial Surgery at the Sun Dental Hospital (Daejeon, Korea). Even after several routine tests, we still could not make a diagnosis. However, after the combined multidisciplinary efforts of oral surgeons and neurosurgeons, the patient was treated for odontogenic infection and made an uneventful recovery. Therefore, patients with infections in the head and neck region showing symptoms such as headache, changes in mental state, nausea, vomiting, seizures, hemiplegia, speech disturbance, and visual disturbance, a brain abscess should be included in the list of differential diagnoses. PMID:25045643

Park, Sung Yong; Suh, Dong Won; Park, Chul Min; Oh, Min Seok; Lee, Dong-Kun

2014-06-01

49

[Isolated hyoid bone fracture due to blunt trauma: case report].  

PubMed

Fractures of the hyoid bone are very rare. Diagnosis of hyoid fracture is difficult and can be made only with a strong degree of suspicion. We report a case of isolated hyoid bone fracture due to blunt trauma to the neck. A 26-year-old woman was admitted to emergency department for motor vehicle accident. She complained of dysphagia and anterior neck discomfort. Physical examination showed hyperemia and tenderness of neck. A tomographic scan of neck was performed. The findings demonstrated hyoid fracture. Patient was observed with medical therapy for 24 hours and discharged with recommendation of outpatient control.Emergency physician has to be aware of the possibility of hyoid fractures in blunt traumas. Patients with hyoid fracture should be observed for 24 hours. Generally, medical treatment is satisfactory in isolated hyoid fractures. PMID:23720121

Erdo?an, Mehmet Ozgür; Ko?argelir, Mehmet; Yorulmaz, Rasim; Meriç, Kaan; Erdo?an, Bar??

2013-05-01

50

Neonatal meningoventriculitis due to proteus mirabilis - a case report.  

PubMed

A five day old full term born baby was admitted to our Neonatal Intensive Care Unit with seizures, opisthotonous posture and was icteric upto thigh. Baby had a three day history of poor feeding, lethargy and abnormal body movements. Mother was a 29 years old primigravida and had a normal vaginal delivery at home. Sepsis profile of the patient was requested, lumbar puncture and ventricular tap was performed. Patient was put on third generation cephalosporins, aminoglycosides and phenobarbitone. Culture and sensitivity report of blood, Cerebro spinal fluid and ventricular fluid showed Proteus mirabilis. Computerized Tomography scan showed a large parenchymal lesion in the right frontal lobe and diffuse ependymal enhancement along both the lateral ventricles suggestive of meningoventriculitis. We hereby present a fatal case of neonatal meningoventriculitis due to Proteus mirabilis. PMID:23543669

Juyal, Deepak; Rathaur, Vyas Kumar; Sharma, Neelam

2013-02-01

51

Brain abscess due to odontogenic infection: a case report  

PubMed Central

In this report, we describe a case of brain abscess due to odontogenic infection. A 53-year-old female who had been suffering from headache and trismus for two weeks visited the Department of Oral and Maxillofacial Surgery at the Sun Dental Hospital (Daejeon, Korea). Even after several routine tests, we still could not make a diagnosis. However, after the combined multidisciplinary efforts of oral surgeons and neurosurgeons, the patient was treated for odontogenic infection and made an uneventful recovery. Therefore, patients with infections in the head and neck region showing symptoms such as headache, changes in mental state, nausea, vomiting, seizures, hemiplegia, speech disturbance, and visual disturbance, a brain abscess should be included in the list of differential diagnoses.

Park, Sung Yong; Suh, Dong Won; Park, Chul Min; Oh, Min Seok

2014-01-01

52

Cerebral venous thrombosis due to high-altitude polycythemia. Case report.  

PubMed

A case of cerebral venous thrombosis due to polycythemia secondary to adaptation to a high altitude is reported. A 27-year-old previously healthy man developed severe neurological symptoms after climbing 8511 m. Computerized tomography and cerebral angiography suggested hemorrhagic infarction or intratumoral hemorrhage, and a craniotomy was performed. Pathological examination confirmed the diagnosis of hemorrhagic infarction secondary to cortical venous thrombosis. The etiology and incidence of cerebral venous thrombosis secondary to polycythemia are discussed. PMID:3941339

Fujimaki, T; Matsutani, M; Asai, A; Kohno, T; Koike, M

1986-01-01

53

[Photocontacs dermatitis due to dexketoprofen. Report of 2 cases].  

PubMed

Dexketoprofen is the active isomer of ketoprofen and likewise belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs) derived from propionic acid. We have recently studied, using patch and photopatch tests, two women with a characteristic clinical picture of contact photodermatitis who had used topical dexketoprofen (Enangel) in the days before onset of the rash. In both cases we used the standard series of GEIDC, a series for NSAIDs, the product itself (Enalgel) and its excipients. On examination of the photopatches of both patients at 96 hours we found positive reactions to dexketoprofen and Enalgel. Furthermore, in one of the women we observed simultaneous photosensitivity to other NSAIDs and to several excipients of Enangel. Reviewing the literature we have found only three references on contact photodermatitis due to dexketoprofen. We describe two new cases, with multiple photosensitivities in one of them. We consider that such patients should be patch tested with dexketoprofen at 0.1-1 % petrolatum, concentrations that are notably inferior to those used in previous publications. PMID:16978545

González-Pérez, R; Trébol, I; García-Ríos, I; Arregui, M A; Soloeta-Arechavala, R

2006-09-01

54

A different sequence of events than previously reported leads to arsenic-induced damage in Ceratophyllum demersum L.  

PubMed

Arsenic (As) is a common pollutant, and still many questions remain concerning As toxicity mechanisms under environmentally relevant conditions in plants. Here we investigated thresholds and interactions of various proposed As toxicity mechanisms. Experiments were done under environmentally pertinent conditions in the rootless aquatic macrophyte Ceratophyllum demersum L., a model for plant shoots. Arsenic (provided as As(v)) inhibited plant metabolism at much lower concentrations and with a different sequence of events than previously reported. The first observed effect of toxicity was a decrease in pigment concentration, it started even at 0.5 ?M As. In contrast to toxic metals, no inhibition of the photosystem II reaction centre (PSIIRC; measured as Fv/Fm) was found at sublethal As concentrations. Instead, the decrease in light harvesting pigments caused a less efficient exciton transfer towards the PSIIRC. At higher As concentrations this led to increased non-photochemical quenching (NPQ) by light harvesting complex II (LHCII). Afterwards, photosynthetic electron transport decreased, but the increase in starch content indicated stronger inhibition of starch consumption than production. At lethal As concentration, photosynthesis was completely inhibited, its malfunction caused oxidative stress and not the other way round as reported previously. Photosynthesis was inhibited before any sign of oxidative stress was observed. Elevated phosphate drastically shifted thresholds of lethal As effects, not only by the known uptake competition but also by modifying uptake regulation and intracellular processes. PMID:24382492

Mishra, Seema; Stärk, Hans-Joachim; Küpper, Hendrik

2014-03-01

55

Mucocele of the appendix due to endometriosis: A rare case report  

PubMed Central

Mucocele of the appendix due to endometriosis is extremely rare, and there are only 10 previously reported cases in the English literature. We report a case of mucocele of the appendix due to endometriosis and provide the first review of the literature. A 43-year-old woman was admitted to the hospital because of recurrent right lower abdominal pain during her menstrual periods. Colonoscopy revealed submucosal tumor-like elevations of the appendiceal orifice. Computed tomography and magnetic resonance imaging of the abdomen suggested cystic lesions near the appendix. Consequently, mucocele of the appendix was suspected preoperatively. An open ileocecal resection was performed. Multiple cystic lesions were observed around the appendix. The cystic lesions contained mucus. Histopathological examination was consistent with a mucocele of the appendix due to endometriosis. The postoperative course was uneventful. We present the first review of the literature to clarify the clinical features.

Tsuda, Motoyuki; Yamashita, Yukitaka; Azuma, Shunjiro; Akamatsu, Takuji; Seta, Takeshi; Urai, Shunji; Uenoyama, Yoshito; Deguchi, Yasunori; Ono, Kazuo; Chiba, Tsutomu

2013-01-01

56

Fungemia due to Lachancea fermentati: a case report  

PubMed Central

Background Lachancea fermentati is an environmental yeast that is also used in the fermentation of alcoholic drinks. It has not previously been described as a human pathogen although the closely related yeast, Saccharomyces boulardii, can cause fungemia. Here we report a case of L. fermentati acting as a pathogen in a septic patient with cultures positive from blood, peritoneal fluid, bile, and sputum. Case presentation A 36 year-old Caucasian man was hospitalized with acute alcoholic hepatitis complicated by Escherichia coli spontaneous bacterial peritonitis. Three days after admission, he developed new fevers with sepsis requiring mechanical ventilation and vasopressor support. He was found to have a bowel perforation. Cultures from blood, peritoneal fluid, and sputum grew a difficult-to-identify yeast. Micafungin was started empirically. On hospital day 43 the yeast was identified as L. fermentati with low minimum inhibitory concentrations (by Epsilometer test) to all antifungals tested. Micafungin was changed to fluconazole to complete a 3-month course of therapy. Serial peritoneal fluid cultures remained positive for 31 days. One year after his initial hospitalization the patient had ongoing cirrhosis but had recovered from fungemia. Conclusion This case demonstrates the need for clinicians to consider host factors when interpreting culture results with normally non-pathogenic organisms. In this immunocompromised host L. fermentati caused disseminated disease. We believe his hobby of brewing alcohol led to colonization with L. fermentati, which then resulted in invasive disease when the opportunity arose.

2014-01-01

57

Power line frequency electromagnetic fields do not increase the rate of protein synthesis in human skin fibroblasts as previously reported.  

PubMed

Rodemann et al. [Rodemann et al. (1987): Biochem Biophys Res Commun 145:1-9] reported that human skin fibroblasts increase their rate of protein synthesis by as much as over ninefold in response to long term exposure to 20 Hz, 8.4 mT (84 G) magnetic fields. Here we report studies of protein synthesis using an identical cell type, exposure conditions, and the same means of measuring protein synthetic rates. Our initial goal was to determine if the earlier results could be replicated, but we found an inconsistency in the earlier protocol. It exposed cells to [(3)H]leucine for 6 h prior to measuring incorporation into protein. We found, however, that 24 h is required for [(3)H]leucine to reach a steady state distribution across the cells' plasma membranes. In addition, we typically measured 100-200 cpm/thousand cells. This is four- to eightfold higher than the 19-28 cpm/1000 cells previously reported. Using these conditions, we could find no significant difference in protein synthesis rates between control cells and cells exposed for up to three weeks in an identical electromagnetic field. In addition, we investigated the effects of a 60 Hz field since that is the frequency used for electric power distribution in the United States. Again, we could find no significant effect of this field on rates of protein synthesis, even after 21 days of exposure. PMID:12955751

Shi, Biao; Isseroff, R Rivkah; Nuccitelli, Richard

2003-10-01

58

Cholestasis and Seizure Due to Lead Toxicity: A Case Report  

PubMed Central

Introduction Lead poisoning is a major public health risk which may involve major organs. Recently, there have been reports of opioid adulteration with lead in Iran. The following case report is the first of its kind in that intrahepatic cholestasis due to lead toxicity has been described. Case Presentation A 65-year-old man presented to the emergency department with abdominal pain, abnormal liver function tests (cholestatic pattern), and normocytic anemia. He had been an opium user for 20 years. Clinical and preclinical findings including the bluish discoloration of periodontal tissues, or Burton’s sign, and generalized ileus on abdominal x-ray led us to the possibility of lead poisoning. Lead levels were higher than normal (150 ?g/dL). Magnetic resonance cholangiopancreatography (MRCP) and abdominal ultrasound were performed to rule out extra hepatic causes of cholestasis. To evaluate the possibility of lead-induced hepatotoxicity, a liver biopsy was performed. Histological features of lead-induced hepatotoxity have rarely been described in humans. In this patient, focal canalicular cholestasis and mild portal inflammation were confirmed. Thus, treatment with ethylenediaminetetraacetic acid (EDTA) and British anti-lewisite (BAL) were initiated and continued for five days. The patient’s liver function tests returned to their normal values, clinical findings including nausea, vomiting, and abdominal pain subsided, and the patient was discharged from the hospital in good condition. Conclusions Lead toxicity should always be taken into account in cases of intrahepatic cholestasis with an unknown etiology, especially in a setting where opium abuse is common.

Mokhtarifar, Ali; Mozaffari, Hooman; Afshari, Reza; Goshayeshi, Ladan; Akavan Rezayat, Kambiz; Ghaffarzadegan, Kamran; Sheikhian, Mohammadreza; Rajabzadeh, Farnood

2013-01-01

59

Fetal adrenal suppression due to maternal corticosteroid use: case report.  

PubMed

During pregnancy, steroids are usually used in maternal diseases such as adrenal failure or other autoimmune diseases, e.g. idiopathic thrombocytopenic purpura (ITP), Crohn's disease, systemic lupus erythematosus, dermatomyositis, scleroderma, Addison's disease and hyperemesis gravidarum, HELLP syndrome. Endogenous or exogenousmaternal steroids are metabolized by the placental enzyme 11 beta-hydroxy steroid dehydrogenase type 2. Prednisolone and methylprednisolone are highly sensitive to this enzyme, while dexamethasone and betamethasone are less well metabolized. Steroids which can cross the placental barrier are administered in cases like fetal lupus, congenital adrenal hyperplasia and for enhancement of fetal lung maturation, whereas steroids used in maternal diseases are usually the ones with low affinity to the placenta; however, in case of long-term use or in high doses, placental enzyme saturation occurs and thus, resulting in fetal adrenal suppression. Antenatal steroids can lead to low birth weight, as observed in our patient. Here, we report a case with fetal adrenal suppression due to maternal methylprednisolone use presenting with early hypoglycaemia and late hyponatremia in neonatal period and requiring three-month replacement therapy. PMID:21911331

Kurto?lu, Selim; Sar?c?, Dilek; Ak?n, Mustafa Ali; Daar, Ghaniya; Korkmaz, Levent; Memur, ?eyma

2011-01-01

60

Hypercalcemia due to giant cell myocarditis: a case report.  

PubMed

Granulomatous diseases are a rare cause of hypercalcemia. The pathogenesis is presumed to be from endogenous production of 1,25-dihydroxyvitamin D by activated macrophages in granulomatous lesions, which harbor the 1?-hydroxylase enzyme. Herein the first case of hypercalcemia associated with giant cell myocarditis, an unusual type of granulomatous process, is reported. In this case, a patient with giant cell myocarditis had development of progressive heart failure and cardiorenal syndrome that required biventricular support. One year later, hypercalcemia associated with a relatively high 1,25-vitamin D level and a concomitantly suppressed parathyroid hormone level developed in the presence of stage 4 chronic kidney disease. Her other workup of hypercalcemia was unrevealing for vitamin D intoxication and multiple myeloma. Computed tomography of her chest showed no signs of hilar lymphadenopathy. Her calcium levels returned to normal with low-dose steroid therapy and have remained normal following a successful heart transplant. This case illustrates an unusual cause of hypercalcemia thought to be due to extrarenal calcitriol production associated with giant cell myocarditis. PMID:24311400

Patel, Ami M; Jessup, Mariell; Tomaszewski, John; Doyle, Alden

2013-12-01

61

[Intestinal perforation due to multiple magnet ingestion: a case report].  

PubMed

Multiple magnet ingestion during childhood may result in emergency situations. A single magnet may be discharged with intestinal peristalsis, but multiple magnets may stick together and cause significant intestinal complications. Here we present a case with intestinal perforation due to ingestion of multiple magnets and metal pieces. An eight-year-old girl presented with abdominal pain and vomiting. She had abdominal tenderness and defense on the physical examination. Abdominal X-ray showed air and fluid levels. Metallic images were not considered at first as important in the diagnosis. Abdominal ultrasonography was reported as acute appendicitis. During the abdominal exploration, the appendix was normal, but there were dense adherences around the ileum and cecum. After adhesiolysis, intestinal perforations were seen in the cecum and 15 and 45 cm proximal to the cecum. Magnet and metal pieces were present in the perforated segments. Wedge resection and primary repair was performed. There were no postoperative complications, and she was discharged on the postoperative fifth day. Pediatric surgeons should be aware of the complications of multiple magnet ingestion. If the patient has a history of multiple magnet ingestion, follow-up with daily abdominal X-rays should be done, and in cases where magnets seem to cluster together or if acute abdominal signs develop, surgical exploration should be considered. PMID:22792831

Cevizci, Mehmet Nuri; Karada?, Cetin Ali; Demir, Mesut; Dokucu, Ali Ihsan

2012-03-01

62

The magnetic properties of transition metals on triangular lattices and the crystallography of new and previously reported sulfates  

NASA Astrophysics Data System (ADS)

The study of magnetism on a triangular lattice has intrigued physicists for some years, as this special arrangement allows the probing of new electronic phenomena by frustrating the dominant nearest-neighbor couplings. Every project presented here bears importance to geometric frustration. Three chapters present research on compounds in previously known crystal structure families that exhibit signs of geometric frustration: pyrochlores (ch. 2), anhydrous alums (ch. 3) and yavapaiites (ch. 4). The last two chapters (5 and 6) present the discovery of two previously unknown crystal structures, both possessing triangles within their structures, and which may lead to future discoveries within the field of geometric frustration. In addition to the magnetic properties of triangular lattice materials, each project presents important progress in the crystallography of these materials. It was shown that the pyrochlores could soak up oxygen into the normally vacant 8a site forming a metastable material with excess oxygen. The anhydrous alums were shown to exhibit an inherent disorder along one crystallographic axis. The discovery of this feature led to the reassignment of the crystal structure of anhydrous alum itself, KAl(SO4)2. A comparison of the known anhydrous alums and the related yavapaiite structures has shown a non-systematic correlation of cation radius and electron count to specific crystallographic features such as unit cell size and bond angles. The discovery of two crystal structures in the Pb-Mn-SO4 phase diagram revealed novel crystallographic features. The first, PbMn5(SO4) 6, has unique Mn2+2O9 dimers of face sharing octahedra and two complementary triangular layers of magnetic cations that resemble regular polygon tilings. The second material, PbMn(SO 4)2, forms a rare chiral structure in which the Pb and Mn atoms spiral around each other along one axis to form a double helix. Overall, the work provides insight into the interplay of magnetism, magnetic interactions and crystal structure by probing materials that were previously reported, and by expanding horizons through the discovery of novel crystal structures. It is of particular importance that the new crystal structures are made with readily available materials under relatively simple conditions. This implies that many chemically simple systems may remain to be found. In addition, it highlights the wonderful complexity of solid state chemistry that prevents the researcher from knowing a priori what crystal structures will form with a particular stoichiometry.

West, D. Vincent

63

Clinical Characteristics, Patient-Reported Outcomes, and Previous Therapeutic Management of Patients with Uncontrolled Neuropathic Pain Referred to Pain Clinics  

PubMed Central

Background. The aim of this report was to evaluate the clinical profile and previous management of patients with uncontrolled neuropathic pain who were referred to pain clinics. Methods. We included adult patients with uncontrolled pain who had a score of ?4 in the DN4 questionnaire. In addition to sociodemographic and clinical data, we evaluated pain levels using a visual analog scale as well as anxiety, depression, sleep, disability, and treatment satisfaction employing validated tools. Results. A total of 755 patients were included in the study. The patients were predominantly referred to pain clinics by traumatologists (34.3%) and primary care physicians (16.7%). The most common diagnoses were radiculopathy (43%) and pain of oncological origin (14.3%). The major cause for uncontrolled pain was suboptimal treatment (88%). Fifty-three percent of the patients were depressed, 43% had clinical anxiety, 50% rated their overall health as bad or very bad, and 45% noted that their disease was severely or extremely interfering with their daily activities. Conclusions. Our results showed that uncontrolled neuropathic pain is a common phenomenon among the specialties that address these clinical entities and, regardless of its etiology, uncontrolled pain is associated with a dramatic impact on patient well-being.

de Andres, Jose; de la Calle, Jose-Luis; Perez, Maria; Lopez, Vanessa

2014-01-01

64

Bilateral Diaphragmatic Hernia Due to Blunt Trauma; a Case Report.  

National Technical Information Service (NTIS)

A case of bilateral diaphragmatic hernia due to blunt trauma with clinical manifestations similar to those of cardiac tamponade was treated successfully by bilateral thoracotomy and laparotomy. Two types can be distinguished: (1) True bilateral diaphragma...

W. Enyu

1980-01-01

65

Ileocolic intussusception due to Burkitt lymphoma: a case report  

PubMed Central

Burkitt lymphoma has many forms of clinical presentations and, in children, it is usually discovered due to the presence of an abdominal mass. This rapidly growing tumor is highly malignant, aggressive, and may cause either indirect symptoms, due to pressure phenomena or direct involvement of the bowel lumen, leading to either intestinal obstruction or intussusception. We describe the case of a 4-year-old girl who exhibited an unusual presentation of ileocolic intussusception on a Burkitt lymphoma lesion of the ileum.

Balanescu, NR; Topor, L; Malureanu, D; Stoica, I

2013-01-01

66

Aspiration of parenteral nutrition - a previously unreported complication of central venous access in an infant: a case report  

PubMed Central

Introduction The insertion of percutaneous central venous catheters is a common procedure in neonatal intensive care nurseries. Placement of the catheter tip in a large central vein is most desirable. Occasionally, due to difficult venous access, catheter tips are left in places that are less than ideal. Case presentation A female infant with a complicated gastroschisis developed signs of short bowel syndrome post surgery. She was treated with a combination of parenteral nutrition and enteral feeds. A central venous line was inserted through a scalp vein. The tip was noted to be in a vessel at the level of the mandible. She subsequently became unwell with large milky pharyngeal aspirates and episodes of bradycardia. Chest radiography revealed aspiration. The central venous line was removed because of presumed extravasation. This is the first reported case of parenteral nutrition extravasation into the pharynx causing aspiration in an infant. Conclusion This complication may have been prevented by recognising that the tip of the catheter was not correctly placed. When catheters are in unusual positions it may be useful to obtain a second radiograph from a different angle or an ultrasound scan to confirm the positioning of the catheter tip.

Jardine, Luke A; Inglis, Garry DT; Davies, Mark W

2008-01-01

67

A robust, sensitive assay for genomic uracil determination by LC/MS/MS reveals lower levels than previously reported.  

PubMed

Considerable progress has been made in understanding the origins of genomic uracil and its role in genome stability and host defense; however, the main question concerning the basal level of uracil in DNA remains disputed. Results from assays designed to quantify genomic uracil vary by almost three orders of magnitude. To address the issues leading to this inconsistency, we explored possible shortcomings with existing methods and developed a sensitive LC/MS/MS-based method for the absolute quantification of genomic 2'-deoxyuridine (dUrd). To this end, DNA was enzymatically hydrolyzed to 2'-deoxyribonucleosides and dUrd was purified in a preparative HPLC step and analyzed by LC/MS/MS. The standard curve was linear over four orders of magnitude with a quantification limit of 5 fmol dUrd. Control samples demonstrated high inter-experimental accuracy (94.3%) and precision (CV 9.7%). An alternative method that employed UNG2 to excise uracil from DNA for LC/MS/MS analysis gave similar results, but the intra-assay variability was significantly greater. We quantified genomic dUrd in Ung(+/+) and Ung(-/-) mouse embryonic fibroblasts and human lymphoblastoid cell lines carrying UNG mutations. DNA-dUrd is 5-fold higher in Ung(-/-) than in Ung(+/+) fibroblasts and 11-fold higher in UNG2 dysfunctional than in UNG2 functional lymphoblastoid cells. We report approximately 400-600 dUrd per human or murine genome in repair-proficient cells, which is lower than results using other methods and suggests that genomic uracil levels may have previously been overestimated. PMID:23742752

Galashevskaya, Anastasia; Sarno, Antonio; Vågbø, Cathrine B; Aas, Per A; Hagen, Lars; Slupphaug, Geir; Krokan, Hans E

2013-09-01

68

Ileocolic intussusception due to Burkitt lymphoma: a case report.  

PubMed

Burkitt lymphoma has many forms of clinical presentations and, in children, it is usually discovered due to the presence of an abdominal mass. This rapidly growing tumor is highly malignant, aggressive, and may cause either indirect symptoms, due to pressure phenomena or direct involvement of the bowel lumen, leading to either intestinal obstruction or intussusception. We describe the case of a 4-year-old girl who exhibited an unusual presentation of ileocolic intussusception on a Burkitt lymphoma lesion of the ileum. PMID:23599821

B?l?nescu, N R; Topor, L; Malureanu, D; Stoica, I

2013-03-15

69

Hydronephrosis in the Goat Due to Neoplasia. A Case Report.  

National Technical Information Service (NTIS)

The clinical history, gross and microscopic necropsy findings are presented in a case of hydronephrosis in a goat due to a primary neoplasm of the urinary tract. The neoplasm, a transitional cell adenocarcinoma, had interfered with urine flow to a degree ...

D. K. Hysell A. J. Neves

1970-01-01

70

Multiorgan failure due to hemophagocytic syndrome: A case report  

PubMed Central

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.

Mayordomo-Colunga, Juan; Rey, Corsino; Gonzalez, Soledad; Concha, Andres

2008-01-01

71

FBI Reports Drop in Crime Due to Gun Control  

NSDL National Science Digital Library

In a report released Sunday, the FBI found that a seven percent drop in homicides was entirely attributable to a decrease in killings committed with guns. The report also linked a drop in the rate of robbery involving guns to a ten percent drop in overall robberies nationwide. The decline in crime remained consistent in other categories as well, including property crimes, homicide against women, and random violent crimes. Surprisingly, in the wake of certain highly publicized acts of youth violence, the rate of violent juvenile crime has also dropped. This marks the seventh straight year that crime has declined in America. While both the report and many experts see a direct link between declining crime and tougher gun control, there continue to be dissenters -- one might ask if there isn't a certain circularity to the FBI's conclusions, and it remains to be seen if the current Congress will be swayed to retake up the gun legislation defeated this past summer.

Charbonneau, David D.

72

Optic neuritis due to immunobiologics: first Brazilian case report*  

PubMed Central

The change in immunological response obtained by immunobiologics has brought a new paradigm to the treatment of immune-mediated disorders. As a result of their efficacy, there is a positive impact on the quality of life of patients. However, severe side effects, such as demyelination of cerebral or peripheral nerves, have been reported. After review of literature using PubMed and MEDLINE data from 2000 to 2012, we identified the cases correlating the biological uniterms and optic neuritis. This article reports the first Brazilian optic neuritis case associated with the use of immunobiologics. This publication is justified by the rarity of the disease and atypical therapeutical evolution.

da Silva, Luiz Gustavo Martins; Sasso, Leticia Soares; Nelli, Carlos Jose; Bernardes Filho, Fred; de Abreu, Marilda Aparecida Milanez Morgado

2013-01-01

73

Chronic breast abscess due to Mycobacterium fortuitum : a case report  

Microsoft Academic Search

Introduction  \\u000a Mycobacterium fortuitum is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune\\u000a deficiency. There have been few published reports of Mycobacterium fortuitum associated with breast infections mainly associated with breast implant and reconstructive surgery.\\u000a \\u000a \\u000a \\u000a \\u000a Case presentation  We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast

Dibendu Betal; Fiona A MacNeill

2011-01-01

74

A farmworker death due to pesticide toxicity: A case report  

Microsoft Academic Search

In the state of California, the use of pesticides is closely regulated. Physicians are required to report all occupational illness attributable to pesticide use. The case of a death involving the handling of aldicarb, a potent methylcarbamate insecticide, is presented. Although the autopsy indicated trauma as the cause of death, subsequent analysis of tissue residues of aldicarb and its metabolites

Marshall H. Lee; James F. Ransdell

1984-01-01

75

Vitamin B12 Deficiency due to Chlorofluorocarbon: A Case Report  

PubMed Central

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.

Bhaskar, Hemlata; Chaudhary, Rekha

2010-01-01

76

Acute hyperparathyroidism due to cervicomediastinal adenoma. A case report.  

PubMed

A case of primary hyperparathyroidism presenting with an acute clinical onset is reported. The diagnostic and therapeutic approach to this rare clinical entity are emphasized. Ultrasonography and CT allow a thorough morphologic and topographic preoperative definition of the lesion. Surgery should not be delayed beyond 96 hours from diagnosis and should be preceded by an intensive metabolic resuscitation for a successful result. PMID:3068195

De Bernardinis, G; Agnifili, A; Gola, P; Masci, C; Lombardi, L; Gianfelice, F; Flati, G

1988-01-01

77

Case report of bacteremia due to Neisseria mucosa.  

PubMed

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

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

2014-04-01

78

Acute urinary retention due to HSV-1: a case report.  

PubMed

Complications in urinary tract nervous routes due to herpes viruses as VZV and HSV-2 are well known. Acute urinary retention and chronic neuropathic pain are not rare when sacral dermatomes are involved by these viruses. However, an analogous condition has not yet been clearly ascribed to HSV-1 infection. We present a 32-year-old immunocompetent patient with fever, lumbar pain and acute urinary retention who had never had herpetic clinical manifestations. Urodynamic studies diagnosed a neurologic bladder with an absent filling sensation. Cystoscopic assessment revealed the presence of reddened and isolated small mucosal areas in the bladder walls. The search for herpes viruses in plasma and CSF by PCR assay were positive for HSV-1. After treatment with antiviral therapy the disease resolved. Intermittent catheterization was necessary and voiding dysfunction resolved after three weeks by its appearance. Neurological damage to the central nervous system (CNS) and/or PNS due to HSV-1 seems to be the most likely reason. The course of disease was benign and self-remitting. PMID:19359825

Mancino, P; Dalessandro, M; Falasca, K; Ucciferri, C; Pizzigallo, E; Vecchiet, J

2009-03-01

79

Chronic breast abscess due to Mycobacterium fortuitum: a case report  

PubMed Central

Introduction Mycobacterium fortuitum is a rapidly growing group of nontuberculous mycobacteria more common in patients with genetic or acquired causes of immune deficiency. There have been few published reports of Mycobacterium fortuitum associated with breast infections mainly associated with breast implant and reconstructive surgery. Case presentation We report a case of a 51-year-old Caucasian woman who presented to our one-stop breast clinic with a two-week history of left breast swelling and tenderness. Following triple assessment and subsequent incision and drainage of a breast abscess, the patient was diagnosed with Mycobacterium fortuitum and treated with antibiotic therapy and surgical debridement. Conclusion This is a rare case of a spontaneous breast abscess secondary to Mycobacterium fortuitum infection. Recommended treatment is long-term antibacterial therapy and surgical debridement for extensive infection or when implants are involved.

2011-01-01

80

Tissue Necrosis due to Chloroform: A Case Report  

PubMed Central

For many years, gutta-percha has been the root canal filling material of choice. Chloroform is one of the most efficient solvents widely used for gutta-percha removal in retreatment cases, despite being toxic and carcinogenic. The present case report discusses a chloroform extrusion through an existing perforation to the surrounding periodontal ligament space and subsequent necrosis in supporting bone and tissues, during an endodontic retreatment visit for an addicted patient. Subsequently, the management and preventive options are reviewed.

Mohammadzadeh Akhlaghi, Nahid; Baradaran Mohajeri, Ladan; Fazlyab, Mahta

2013-01-01

81

Conjunctivitis due to Neisseria sicca: A case report  

PubMed Central

We report the first case, in Medline-based literature, of conjunctivitis caused by gram negative diplococcus, Neisseria sicca. Although it is not widely accepted as such, isolation from cultures of repeated eye swab samples suggests that N. sicca may be a pathogen in conjunctival infections. Positive culture for this organism should not be readily dismissed. Such conjunctivitis responded favorably to treatment with netilmicin eye drops.

Eser, Ilker; Akcali, Alper; Tatman-Otkun, Muserref; Taskiran-Comez, Arzu

2014-01-01

82

Acute urinary retention due to cystic echinococcosis: A case report  

PubMed Central

Urinary hydatidosis is very rare and represents 2% to 4% of all cases of cystic echinococcosis. We present a case of a 21-year-old man with symptoms of frequency, urinary retention and reduced force in urinary stream due to cystic echinococcosis. Anti-Echinococcus granulosus antibodies were determined by echinococcosis western blotting, and pelvic computed tomography revealed a 11 × 14 × 10-cm retrovesical homogeneous cystic mass. The patient underwent surgical intervention; the cystic mass and retrovesical cavity were removed. After a 3-year follow-up period, there was no episode of lower urinary tract symptoms. This case illustrates that cystic echinococcosis should be considered in every case of cystic mass, especially in endemic countries, such as Turkey.

Izol, Volkan; Eken, Alper; Aridogan, I. Atilla; Koltas, Soner; Tansug, Zuhtu

2012-01-01

83

Adult Intussusception due to Cecal Lymphangioma: A Case Report.  

PubMed

We present a rare case of adult intussusception due to cecal lymphangioma. A 30-year-old female was admitted to our hospital with abdominal pain and a palpatable mass on the right lower quadrant. Preoperative radiologic studies by ultrasound and computed tomography showed ileocolic intussusception with a multiseptated cystic tumor as a leading point on the cecum. An ileocecectomy was performed, and the postoperative course was uneventful. Histopathology showed a cecal lymphangioma. Although endoscopic polypectomy or endoscopic mucosal resection is recommended for pedunculated or semi-pedunculated colonic lymphangiomas less than 2 cm in size, it is proper to treat large or symptomatic colonic lymphangiomas with limited a bowel resection or a tumor resection. PMID:21602970

Kim, Dong Il; Seo, Hyung Il; Kim, Jae Hun; Kim, Hyun Sung; Jo, Hong Jae

2011-04-01

84

Infections due to Phialemonium species: case report and review.  

PubMed

Abstract Infections caused by rarely encountered fungal pathogens have increased in recent decades. The present study describes a disseminated infection caused by Phialemonium curvatum, and reviews the literature in an effort to summarize prior experiences with this unusual pathogen. The clinical and microbiological characteristics of a new case due to Phialemonium are presented. The case is analysed with 19 other which have appeared in the literature since 1986. Ten cases were sporadic infections, while the others were associated with three small outbreaks. In all but our patient the skin's natural barrier was compromised (15/20 [75%]) and immunosuppression was a factor in the majority of cases (14/20 [70%]). Dissemination was noted in 83% (5/6) of the immunocompetent patients and in 57% (8/14) of immunocompromised patients. Endocarditis was the most frequent form of infection (8/20 [40%]). Blood cultures were positive in 92% (12/13) of those with disseminated disease. The mortality rate was 54% (7/13) among those with disseminated infections, but fatal outcomes were not observed in patients receiving treatment with itraconazole, voriconazole or posaconazole. The in vitro susceptibility of Phialemonium indicated a more consistent level of activity for voriconazole and posaconazole. Although infections usually occur when there is a breakdown in the skin the skin barrier or host defences are weakened, our case points out that infections due to Phialemonium species may occur in patients without these risk factors. The most frequent form of Phialemonium infections is endovascular, often with endocarditis and positive blood cultures, associated with high mortality rates. Treatment with the new triazoles is associated with improved survival. PMID:19888810

Rivero, María; Hidalgo, Angel; Alastruey-Izquierdo, Ana; Cía, Maite; Torroba, Luis; Rodríguez-Tudela, Juan Luis

2009-11-01

85

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

PubMed Central

OBJECTIVE Juvenile GM2 gangliosidosis is a group of inherited neurodegenerative diseases caused by deficiency of lysosomal ?-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, ?-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.

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

86

Sudden death due to black esophagus: a case report.  

PubMed

Black esophagus, also known as acute esophageal necrosis syndrome, is a rare but often fatal pathology. It can be identified during autopsy examination and should be diagnosed by the forensic examiner via simple macroscopic examination. We report the case of an elderly man who was found dead, presenting with this pathology. A microscopic examination was carried out that confirmed the diagnosis. We consider that all forensic examiners should be made aware of this pathology to make the diagnosis quickly, in turn allowing the deceased to be returned promptly to their loved ones. PMID:23099544

Venara, Aurélien; Pavageau, Aude Helene; Maillart, Clotilde Rouge; Jousset, Nathalie

2013-03-01

87

Study by University of Maryland finds that US cervical cancer rates are higher than previously reported, especially among older women  

Cancer.gov

Cervical cancer rates in the United States are higher than previously believed, particularly among 65- to 69-year-old women and African-American women, according to a study led by a researcher at the University of Maryland School of Medicine.

88

Occupational allergy due to seafood delivery: Case report  

PubMed Central

Background Sensitization to fish or crustaceans requires intensive skin contact and/or airway exposition and therefore especially workers in the seafood processing industry may develop an occupational seafood allergy. However, even in jobs with limited direct exposure, individuals with atopic disposition not using appropriate skin protection are at risk for developing occupational seafood allergy which requires termination of employment. Case presentation Due to increasing workload and pressure of time a truck driver in charge of seafood deliveries for 10 years neglected preventive measures such as wearing protective cloths and gloves which resulted in increasing direct skin contact to seafood or mucosal contact to splashing storage ice. Despite his sensitization to fish and crustaceans he tried to remain in his job but with ongoing incidental allergen exposure his symptoms progressed from initial contact urticaria to generalized urticaria, anaphylaxis and finally occupational asthma. Conclusion Faulty knowledge and increased work load may impede time-consuming usage of preventive measures for occupational health and safety. In predisposed atopic individuals even minor allergen exposure during seafood distribution may lead to occupational seafood allergy. With ongoing allergen exposure progression to potentially life-threatening allergy symptoms may occur.

Seitz, Cornelia S; Brocker, Eva B; Trautmann, Axel

2008-01-01

89

Allergic bronchopulmonary mycosis due to Alternaria: Case report and review  

PubMed Central

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 ?g/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.

Singh, Bhagteshwar; Denning, David W.

2012-01-01

90

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

PubMed

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 ?g/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

Singh, Bhagteshwar; Denning, David W

2012-01-01

91

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

PubMed Central

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.

2014-01-01

92

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

PubMed Central

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.

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; Lubinski, 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

93

[Radiotherapy induced glioblastoma in a child previously treated for cerebellar medulloblastoma (case report and review of the literature)].  

PubMed

Malignant gliomas represent the most frequent radiotherapy induced ("secondary") solid tumor. Their prognosis remains extremely poor despite of aggressive multimodal treatment. We present a case report of a 16 years old boy who developed cerebellar glioblastoma six years following the combined treatment for medulloblastoma. Clinical history, pathological and cytogenetic findings of the case are discussed along with treatment possibilities. PMID:19097413

Pavelka, Z; Brichtová, E; Kren, L; Skotáková, J; Oltová, A; Slampa, P; Zitterbart, K; St?rba, J

2008-01-01

94

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

PubMed

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

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

95

Bulimia nervosa patient diagnosed with previously unsuspected ADHD in adulthood: clinical case report, literature review, and diagnostic challenges.  

PubMed

There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account. PMID:24311027

Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich

2014-05-01

96

Effect of calcium lactate supplementation on cholesterol concentration in patients with hyperlipidaemia and previous viral hepatitis: a preliminary report  

PubMed Central

Summary Summary The aim of the study was to estimate the effect of calcium supplementation on cholesterol concentrations in patients with hyperlipidaemia and previous viral hepatitis. The study comprised 43 patients, aged 28 to 82 years (21 with type 2 hyperlipidaemia). The control group included 22 healthy subjects. After four weeks of a hypolipaemic diet (wash-out period), the patients with type 2 hyperlipidaemia were recruited to a group administered a complex preparation containing 170 mg of calcium lactate and 60 mg of vitamin C (Calcium C, Polfa-Lodz SA, Poland) at a dose of one tablet three times a day. After four weeks of active therapy, the concentration of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) decreased by 4, 6 and 8%, respectively. Statistical significance was obtained for only TC (p = 0.03) when comparing the group of patients with hypercholesterolaemia before and after the therapy with the calcium preparation. A statistically insignificant increase of high-density lipoprotein cholesterol (HDL-C) of 1% was observed. Within the four-week period of calcium supplementation at a dose of 510 mg/24 h, the total concentration of calcium decreased by 3%, whereas the concentration of ionised calcium increased by 7%. None of the obtained values was of statistical significance. In patients with type 2 hyperlipidaemia and previous viral hepatitis, a four-week supplementation of calcium in a calcium lactate preparation beneficially modified the lipid profile. It statistically significantly decreased the total cholesterol concentration by 4% (p = 0.03), did not cause any significant changes in serum calcium concentration, was well tolerated and did not induce any side effects.

Andryskowski, G; Chojnowska-Jezierska, J; Broncel, M; Barylski, M; Banach, M

2008-01-01

97

Outcome of unicompartmental knee arthroplasty in octogenarians with tricompartmental osteoarthritis: A longer followup of previously published report  

PubMed Central

Background: Unicompartmental knee arthroplasty (UKA) has specific indications, producing excellent results. It, however, has a limited lifespan and needs eventual conversion to total knee arthroplasty (TKA). It is, therefore, a temporizing procedure in select active young patients with advanced unicompartmental osteoarthritis (UCOA). Being a less morbid procedure it is suggested as an alternative in the very elderly patients with tricompartmental osteoarthritis (TCOA). We performed UKA in a series of 45 octogenarians with TCOA predominant medial compartment osteoarthritis (MCOA) and analyzed the results. Materials and Methods: Forty five octogenarian patients with TCOA predominant MCOA underwent UKA (19 bilateral) from January 2002 to January 2012. All had similar preoperative work-up, surgical approach, procedure, implants and postoperative protocol. Clinicoradiological assessment was done at 3-monthly intervals for the first year, then yearly till the last followup (average 72 months, range 8-128 months). Results were evaluated using the knee society scores (KSS), satisfaction index [using the visual analogue scale (VAS)] and orthogonal radiographs (for loosening, subsidence, lysis or implant wear). Resurgery for any cause was considered failure. Results: Four patients (six knees) died due to medical conditions, two patients (three knees) were lost to followup, and these were excluded from the final analysis. Barring two failures, all the remaining patients were pain-free and performing well at the final followup. Indications for resurgery were: medial femoral condyle fracture needing fixation subsequent conversion to TKA at 2 years (n=1) and progression of arthritis and pain leading to revision TKA at 6 years (n=1). Conclusion: UKA has shown successful outcomes with regards to pain relief and function with 96.4% implant survival and 94.9% good or excellent outcomes. Due to lower demands, early rehabilitation, less morbidity, and relative short life expectancy, UKA can successfully manage TCOA in the octogenarians.

Marya, Sanjiv KS; Thukral, Rajiv

2013-01-01

98

Episodic biliary obstruction due to an intrahepatic biliary cystadenoma: a case report  

PubMed Central

Introduction Biliary cystadenoma is a rare, benign neoplasm of the bile ducts with malignant potential. Symptoms, predominantly right hypochondrial pain and the feeling of a lump or fullness are usually due to the mass effect. Jaundice is rare. This is the fifth reported patient with an intrahepatic biliary cystadenoma giving rise to episodic biliary obstruction, which is usually caused by choledocholithiasis or periampullary carcinoma. Considering the mean age of previous similar patients (53.5, standard deviation 14.6 years), the early age of presentation is very unusual in our patient. Case presentation A 25-year-old Asian woman presented with right hypochondrial pain and episodic biliary obstruction. Contrast enhanced computed tomography revealed a cystic mass in segment 4B and protruding into and along the left hepatic duct. Laparotomy confirmed the contrast enhanced computed tomography findings and histology revealed an intrahepatic mucinous biliary cystadenoma. Conclusion Biliary cystadenoma should be considered as a differential diagnosis in patients with cystic liver lesions who present with episodic biliary obstruction. Due to the reported malignant potential, radical surgery such as wide local excision of the lesion or hepatic resection is needed to minimize the risk of local recurrence.

2009-01-01

99

Lichen planus-like drug eruptions due to ?-blockers: a case report and literature review.  

PubMed

Lichen planus-like drug eruptions (LDE) can appear similar or identical to idiopathic lichen planus. We present a 45-year-old man with a widespread, violaceous, papular, generalized exanthema with histologic features of a lichenoid reaction, which subsequently resolved with the cessation of labetatol. We found 29 cases of previously reported ?-adrenoceptor antagonist (?-blocker)-associated LDE. This is a relatively rare complication that may present as classic lichenoid papules indistinguishable from lichen planus and has a predilection for the limbs, chest, back, and oral mucosa. Histologically, there is a lichenoid infiltrate often with eosinophils. LDE may be due to drug cross-reactivity or as a result of a suppressed skin adrenergic system. Multiple potential medications in case studies and the inability to differentiate LDE from idiopathic lichen planus in cross-sectional association studies make any conclusive analysis difficult. PMID:22809321

Fessa, Chris; Lim, Penny; Kossard, Steve; Richards, Shawn; Peñas, Pablo Fernandez

2012-12-01

100

41 CFR 102-84.55 - When are the Annual Real Property Inventory reports due?  

Code of Federal Regulations, 2013 CFR

...Annual Real Property Inventory reports due? ...Contracts and Property Management Federal Property Management Regulations System...Continued) FEDERAL MANAGEMENT REGULATION REAL...84-ANNUAL REAL PROPERTY INVENTORIES §...

2013-07-01

101

[Hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS): its clinical concept and the review of the previously reported cases].  

PubMed

Leukoencephalopathy or leukodystrophy is characterized pathologically by extensive degenerative and/or demyelinating lesions in cerebral white matter and produces various clinical manifestations such as behavioral and/or mood changes, dementia, motor impairment and epilepsy. The hereditary form of this disease is rare, but recent advances in diagnostic techniques have made it possible to make a correct pre-mortem diagnosis for some diseases including CADASIL and CARASIL. Recently, another unique form of the disease, hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) has been noted. The clinical picture of HDLS is as follows: age of onset ranging from 8 to 78 years (average: 39 years), autosomal dominant inheritance, and dementia. The presence of numerous neuroaxonal spheroid in cerebral white matter is one of the pathologic hallmarks of HDLS. Another term "familial pigmentary orthochromatic leukodystrophy (POLD)" has been also used for the patients showing similar clinical pictures and pathologic findings of the patients. Both disorders are now regarded as a single disease entity. Rademakers et al have just reported that HDLS is caused by mutation in the colony stimulating factor 1 receptor gene (CSF1R) and HDLS should be included in the differential diagnosis of familial occurrence of pre-senile dementia. PMID:23196627

Ikeda, Shu-Ichi

2012-01-01

102

Cutaneous cryptococccosis due to Cryptococcus gattii in immunocompetent hosts: case report and review.  

PubMed

Cutaneous cryptococcosis caused by C. gattii, in immunocompent patients is a rare manifestation of disease, and may be one of the first manifestations of disseminated cryptococcosis. We report a case of disseminated cryptococcosis caused by Cryptococcus gattii presenting as cutaneous lesions in an immunocompetent patient. Previously to our report, only five cases of cutaneous involvement by Cryptococcus gattii in immunocompetent patients have been reported in the literature. Risk factors for C. gattii infection included exposure to the eucalypt reservoirs in tropical and subtropical areas. Skin involvement corresponded to the disseminated form of cryptococcosis in the majority of patients, and commonly affected the face and neck with different morphologies including papules, pustules, plaques, ulcers, subcutaneous masses, cellulitis or acneiform lesions. Due to the severity of this infection and the life threatening condition that it represents, clinicians must be aware that cutaneous involvement may be one of the first manifestations of disseminated cryptococcosis caused by C. gattii especially in patients living and coming from endemic areas. PMID:16552487

Dora, José Miguel; Kelbert, Silvia; Deutschendorf, Caroline; Cunha, Vanessa S; Aquino, Valério R; Santos, Rodrigo Pires Dos; Goldani, Luciano Zubaran

2006-04-01

103

Liver Transplantation during Pregnancy for Acute Liver Failure due to HBV Infection: A Case Report.  

PubMed

Acute hepatic failure during pregnancy is a life-threatening situation for the mother and fetus and might need a super-urgent liver transplantation. Many pregnancies with positive outcomes are reported after a previous liver transplantation before the pregnancy, but only a few of them are mentioned with transplantation during pregnancy. In these few cases, fetal outcome is mostly adverse. Experience with liver failure during pregnancy and its management is still deficient and needs to be approved. For sure, patients need to be treated in highly qualified centers in a multidisciplinary approach. We present a case of successful super-urgent liver transplantation during the second trimester of pregnancy after acute hepatic failure due to an acute hepatitis B infection with positive maternal and fetal outcome. Liver transplantation during pregnancy due to an acute liver failure can be a life-saving procedure for the mother and fetus. An early initiated maternal therapy with antiviral drugs and immunoglobulins seems to be safe and able to prevent fetal infection and immunosuppressive therapy after transplantation seems to be well tolerated. Nevertheless, fetal outcome differs widely and long-term outcome is deficiently known. PMID:24383021

Kimmich, Nina; Dutkowski, Philipp; Krähenmann, Franziska; Müllhaupt, Beat; Zimmermann, Roland; Ochsenbein-Kölble, Nicole

2013-01-01

104

Phaeohyphomycosis and onychomycosis due to Chaetomium spp., including the first report of Chaetomium brasiliense infection.  

PubMed

Chaetomium species have been rarely described as aetiological agents of invasive and dermatomycotic infections in humans. The majority of cases have been reported within the last two decades. Treatment failed in most of these cases. In this paper we present two cases in which Chaetomium spp. can be clearly identified as an aetiological agent in pathological conditions. In the first report, we describe a new aetiological agent, Chaetomium brasiliense, which was implicated in a case of otitis externa in a patient with spinocellular carcinoma basis cranii. The patient had been repeatedly treated for relapsing otitis externa and had previously undergone surgery several times for otitis media. The fungal aetiology was confirmed by repeated positive culture and histologic studies. The second case involved onychomycosis with strikingly brown nail discoloration due to Chaetomium globosum in an otherwise healthy patient. The nail lesion was successfully cured by oral terbinafine. The determination of both species was supported by sequencing of rDNA regions. The morphological aspect of Chaetomium spp. identification is also discussed. In vitro antifungal susceptibility tests demonstrated that both isolates were susceptible to terbinafine and azole derivates except fluconazole. Amphotericin B was effective only against the C. brasiliense strain. We review the literature to summarize clinical presentations, histologic findings, and treatment strategies. PMID:21466265

Hubka, Vit; Mencl, Karel; Skorepova, Magdalena; Lyskova, Pavlina; Zalabska, Eva

2011-10-01

105

Thermomyces lanuginosus infective endocarditis: Case report and a review of endocarditis due to uncommon moulds?  

PubMed Central

We describe a case of Thermomyces lanuginosus endocarditis, the first reported in a living patient, and review the literature to delineate the clinical characteristics, investigations and management of endocarditis due to such rare but emerging mould pathogens.

Sivagnanam, Shobini; Chen, Sharon C.-A.; Halliday, Catriona; Packham, Donald

2013-01-01

106

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

PubMed

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

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

2014-05-13

107

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

PubMed Central

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.

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

2014-01-01

108

Prosthetic hip infection due to Brucella melitensis: case report and literature review  

Microsoft Academic Search

Prosthetic joint infection (PJI) due to Brucella spp. is extremely rare. We report the case of a prosthetic hip infection due to Brucella melitensis in a 51-year-old male patient. The initial presentation was a gluteal abscess. There was radiographic evidence of implant loosening. The patient was cured after prolonged treatment with streptomycin, rifampicin, and doxycycline, followed by 2-stage exchange of

Daniel Tena; Oscar Romanillos; Manuel Rodríguez-Zapata; Basilio de la Torre; María Teresa Pérez-Pomata; Ramón Viana; José María Chaves; Julia Bisquert

2007-01-01

109

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

PubMed Central

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.

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

2013-01-01

110

Bacteremia Due to Clostridium Difficile: Case Report and Review of the Literature  

PubMed Central

Objective The purpose of this study is to report a case of C. difficile bacteremia in a Crohn’s disease patient and to review the literature on previously reported cases. Methods Searches of MEDLINE and PubMed databases were made. Results We report the first case of C. difficile bacteremia in a Crohn’s disease patient. There are 15 other reported cases of C. difficile bacteremia reported in the literature. We found that the majority of patients (10 of 15 patients) had polymicrobial bacteremia and that the overall mortality rate is significant, with 6 of 15 reported patients dying. Conclusion In conclusion, we find that C. difficile bacteremia is associated with a significant mortality rate and it would seem prudent to consider aggressive antibiotic therapy.

Daruwala, Cherag; Mercogliano, Giancarlo; Newman, Gary; Ingerman, Mark J.

2009-01-01

111

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

PubMed

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

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

2013-08-01

112

Native valve endocarditis due to Micrococcus luteus: a case report and review of the literature  

Microsoft Academic Search

Introduction  \\u000a Micrococcus luteus endocarditis is a rare case of infective endocarditis. A total of 17 cases of infective endocarditis due to M luteus have been reported in the literature to date, all involving prosthetic valves. To the best of our knowledge, we describe\\u000a the first case of native aortic valve M luteus endocarditis in an immunosuppressed patient in this report.

George Miltiadous; Moses Elisaf

2011-01-01

113

Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma: A case report  

Microsoft Academic Search

Cavernous hemangioma consists mainly of congenital vascular malformations present before birth and gradually increasing in\\u000a size with skeletal growth. A small number of patients with cavernous hemangioma develop scoliosis, and surgical treatment\\u000a for the scoliosis in such cases has not been reported to date. Here we report a 12-year-old male patient with severe progressive\\u000a scoliosis due to a huge subcutaneous

Yoji Ogura; Kota Watanabe; Naobumi Hosogane; Takashi Tsuji; Ken Ishii; Masaya Nakamura; Yoshiaki Toyama; Kazuhiro Chiba; Morio Matsumoto

2011-01-01

114

Vertebral collapse with quadraparesis due to metastatic gliobla multiforme: case report and review of the literature  

Microsoft Academic Search

A case is reported of a patient rendered quadraparetic following collapse of a cervical vertebra due to neoplastic invasion by metastatic glioblastoma multiforme. The case is discussed in light of a review of the world literature regarding the clinical incidence and significance of metastasis of glial tumors. It is recommended that all patients with high grade glial tumors who complain

Randall M. Chesnut; Jean Jacques Abitbol; Marc Chamberlain; Lawrence F. Marshall

1993-01-01

115

Severe Mitral Regurgitation due to Traumatic Anterolateral Papillary Muscle Rupture: A Case Report  

PubMed Central

A 29-year-old man was admitted for abrupt dyspnea and hemoptysis. An echocardiogram revealed severe mitral regurgitation due to papillary muscle rupture for which an emergency mitral valve replacement operation was performed 4 days after admission. Herein, we report our experience with this case along with a review of the literature.

Lee, Chul Ho; Lee, Sub; Jang, Jae Seok

2012-01-01

116

Sinus pericranii with severe symptom due to transient disorder of venous return--case report.  

PubMed

The authors report a case of sinus pericranii in a 22-year-old female presenting with severe headache, vomiting, bradycardia, and bradypnea following excessive distention of the tumor. After tumor removal, the symptoms were completely relieved. The symptoms were thought to be due to transient impairment of blood flow in the superior sagittal sinus. PMID:1717865

Anegawa, S; Hayashi, T; Torigoe, R; Nakagawa, S; Ogasawara, T

1991-05-01

117

12 CFR 1410.3 - Calculation and reporting of premiums due.  

Code of Federal Regulations, 2012 CFR

12 Banks and Banking 9 2012-01-01 2012-01-01...premiums due. 1410.3 Section 1410.3 Banks and Banking FARM CREDIT SYSTEM INSURANCE...purposes of computing premiums, each insured bank shall, without limitation, report...

2012-01-01

118

Case report of fatal complication in prostatic cryotherapy. First reported death due to argon gas emboli.  

PubMed

We present the first reported fatality from argon gas emboli during prostate cryosurgery. The decedent underwent cryotherapy for prostate carcinoma using cryoablation probes which were cooled with argon and nitrous oxide and warmed with helium. Minutes into the procedure he experienced sudden cardiovascular collapse and could not be resuscitated. Postmortem examination was performed at the request of family and healthcare providers. Collection of tissues and blood samples had to be conducted carefully to capture suspected noble gases,argon, and helium. Specimens were submitted to Saint Louis University Forensic Toxicology Laboratory for toxicological examination and for evaluation of the composition of the gas retrieved from the vascular system.Gas chromatography mass spectrometric analyses confirmed argon in blood, brain, liver, and gas retrieved from the aorta. These samples had significant argon compared with room air also sent for comparison. The manner of death was accident. To date, there have been no intraoperative surgical fatalities reported from prostatic cryotherapy. We report such an unfortunate death to raise awareness in the medical community. We also describe how to collect and handle blood and tissue samples to submit for toxicological analysis in cases of volatile gas emboli. PMID:22442836

Sandomirsky, Marianna; Crifasi, Joseph A; Long, Christopher; Mitchell, Erik K

2012-03-01

119

Two Case Reports of Resensitization to Previous Chemotherapy with the Novel Hypoxia-Activated Hypomethylating Anticancer Agent RRx-001 in Metastatic Colorectal Cancer Patients.  

PubMed

The development of chemoresistance is a persistent problem during the treatment of cancer. Although reversion or modification of acquired chemoresistance has been previously observed, no systematic exploration has been undertaken. Here, we report a case study of 2 male patients, 62 and 66 years old, both with histologically proven, radiologically progressing, extensively pretreated, metastatic and refractory (?2 conventional regimens and drug therapy) colorectal adenocarcinoma that was previously treated with FOLFIRI. The patients were resensitized to FOLFIRI after exposure to RRx-001 in the context of a phase-1 study. RRx-001 is a novel, hypomethylating and free-radical-inducing anticancer agent that activates nitrite reduction to NO under hypoxia and has an impact on epigenetic pathways. The repression of DNA methyltransferase 1 by RRx-001 may lead to demethylation and reexpression of silenced tumor suppressor genes, leading to resensitization. These examples provide insight into a nascent strategy to improve the prognosis in heavily pretreated cancer patients and suggest routes for further exploration. PMID:24575021

Reid, T; Dad, S; Korn, R; Oronsky, B; Knox, S; Scicinski, J

2014-01-01

120

First report of OPA1 screening in Greek patients with autosomal dominant optic atrophy and identification of a previously undescribed OPA1 mutation  

PubMed Central

Purpose To describe the genotype–phenotype correlation in four Greek pedigrees with autosomal dominant optic atrophy (ADOA) and OPA1 mutations. Methods Seven patients from four unrelated families (F1, F2, F3, F4) were clinically assessed for visual acuity, color vision, ptosis, afferent pupillary defects, and visual fields and underwent orthoptic assessment, slit-lamp biomicroscopy, and fundus examination to establish their clinical status. Genomic DNA was extracted from peripheral blood samples from all participants. The coding region (exons 1–28), including the intron-exon boundaries of the OPA1 gene, was screened in the probands of the four families, as well as in seven additional family members (four affected and three unaffected) with PCR and direct DNA sequencing. Results All patients presented bilateral decrease in best-corrected visual acuity and temporal pallor of the optic disc. The visual fields of the adult patients showed characteristic scotomata. Other signs were present in some patients such as decreased color discrimination and a gray crescent within the neuroretinal rim. After the OPA1 gene was sequenced, a previously undescribed heterozygous splice-site mutation c.784–1G>T in intron 7 was detected in family F2. In families F1, F3, and F4, a previously reported in-frame deletion c.876_878delTGT/p.(Val294del), the frameshift c.2366delA/p.(Asn789Metfs*11), and splice-site c.1140+5G>C mutations were detected, respectively. Conclusions This is the first report of molecular characterization of Greek patients with ADOA. Our findings provide additional information regarding the genotype-phenotype correlation and establish the role of the OPA1 gene in Greek patients with ADOA.

Koutsodontis, George; Tsilimbaris, Miltiadis; Fitsios, Athanasios; Chrousos, Georgia

2014-01-01

121

Splenic abscess due to brucellosis: a case report and a review of the literature.  

PubMed

Splenic abscess due to acute brucellosis is a rare event. We report a case of multiple splenic abscesses caused by Brucella melitensis in a 45-year-old woman and review the English language literature based on a PubMed/MEDLINE search of the last 50 years. The majority of the cases published in the literature were due to B. melitensis and a splenectomy was required in half of the cases. Antibiotics alone without surgical intervention can be successful in the treatment of patients with splenic brucellosis in the early stages of the disease. PMID:24433982

Yilmaz, Mesut; Arslan, Ferhat; Ba?kan, Ozdil; Mert, Ali

2014-03-01

122

Refracture of osteoporotic vertebral body concurrent with cement fragmentation at the previously treated vertebral level after balloon kyphoplasty: a case report.  

PubMed

Kyphoplasty has been shown to provide symptomatic relief of vertebral compression fractures refractory to medical therapy. However, few reports have focused on refracture of cemented vertebrae after kyphoplasty. The presence of cemented vertebrae refracture concurrent with cement fragmentation is an extremely rare condition. We reported an 86-year-old man with a T12 osteoporotic compression fracture undergoing the kyphoplasty treatment. The patient postoperatively continued to have back pain at the same level. The solid lumped polymethylmethacrylate (PMMA) mass and inadequate use and insufficient filling of PMMA cement were observed in postoperative radiographs and magnetic resonance image (MRI) examination. He refused to receive the surgical intervention, but had not strict compliance with oral anti-osteoporotic medications. Ten months postoperatively, refracture of osteoporotic vertebral body concurrent with cement fragmentation occurred at the previously kyphoplasty-treated vertebral level. Bone mineral analysis showed severe osteoporosis with a T-score of -4.0. The patient finally obtained therapeutic benefit of pain relief and bony union of T12 vertebral body by consistently adhering to anti-osteoporotic medication treatment. This case illustrated that patients who underwent kyphoplasty to treat osteoporotic vertebral compression fractures with intravertebral fracture should be strictly followed up and supervised in their anti-osteoporotic medication treatment. The interdigitation injection pattern of PMMA and sufficient PMMA filling with trabeculae in the kyphoplasty procedure also might prevent refracture of the cemented vertebrae concurrent with PMMA fragmentation. PMID:24554341

Li, Xigong; Lou, Xianfeng; Lin, Xiangjin; Du, Junhua

2014-05-01

123

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

PubMed Central

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.

2012-01-01

124

[The subcutaneous mucormycosis due to Lichtheimia corymbifera: A case report in an immunocompetent child].  

PubMed

Mucormycosis due to Lichtheimia (ex Absidia) corymbifera is a rare fungal infection, occurring most often in an environment of immune deficiency, rarely in an immunocompetent patient. It comes in different clinical forms, frequently misleading, hence the interest of a pathological and mycological examination that allows the diagnosis of certainty. The management of this condition should be introduced early because it affects the functional prognosis of the patient. In this study, the authors report a case of mucormycosis in a 10-year-old child, and with clinical immunocompetent less severe than the cases reported in the literature. PMID:23518022

Razouk, S; Sebbani, S; Agoumi, A; Benouchen, T; Malihi, A; Nacir, A; Abouhafsse, A; Al Hamany, Z; Tligui, H

2012-06-01

125

Case report: cranioplasty infection due to Roseomonas gilardii at a university hospital in turkey  

PubMed Central

Roseomonas is a pink-pigmented, nonfermentative, oxidative, Gram-negative coccobacilli that has clinical importance as opportunistic pathogen which can lead to infections especially in immunosuppressed individuals. It is relatively less reported in many centers. These microorganisms are detected after several days growth in culture environment, and typical pink, mucoid colonies are detected. We are reported a case of cranioplasty infection that took place in a patient with with cranial abscess formation due to Roseomonas gilardii at Izmir University School of Medicine Medicalpark Hospital.

Ece, Gulfem; Ruksen, Mete; Akay, Ali

2013-01-01

126

Antepartum intracranial hemorrhage due to unrecognized unilateral moyamoya disease: a case report  

Microsoft Academic Search

Purpose  Moyamoya (meaning a “hazy puff of smoke” in Japanese) disease is a rare cerebrovascular occlusive disease. Moyamoya disease\\u000a may become symptomatic for the first time during pregnancy. We report a case of antepartum intracranial hemorrhage due to\\u000a unrecognized unilateral moyamoya disease, which was subsequently diagnosed as HELLP syndrome during the postpartum period.\\u000a \\u000a \\u000a \\u000a \\u000a Study design  A case report of a 29-year-old Japanese

Jun Kakogawa; Miyuki Sadatsuki; Norio Masuya; Hideto Gomibuchi; Hiroyasu Ohno; Tetsuo Hara; Hiroko Oda; Akio Kimura; Shigeki Minoura

2011-01-01

127

Effectiveness of milrinone for cardiogenic shock due to massive pulmonary aspiration: a case report  

PubMed Central

Pulmonary aspiration of gastric contents is one of the most frightening complications during anesthesia. Although pulmonary aspiration of gastric contents in general surgical patients is not common and resulting long-term morbidity and mortality are rare, severe hypoxemia and other sequelae of pulmonary aspiration continue to be reported. We report a case of massive aspiration of gastric contents during induction of general anesthesia, resulting in cardiac arrest due to severe pulmonary hypertension and myocardial infarction. Sustained cardiac arrest and shock that did not respond the conventional resuscitation was successfully treated using milrinone. The patient was discharged without complications in 20 days.

Park, Jeong Heon; Kim, Dong Hee; Kim, Seok-Kon; Jeon, Dae Geun; Song, Jaegyok; Ji, Seung Heon; Lee, Gwan Woo; Kang, Bong Jin

2014-01-01

128

Cerebral Phaeohyphomycosis due to Cladophialophora bantiana - A Case Report and Review of Literature from India  

PubMed Central

Cerebral phaeohyphomycosis is a rare disease caused by dematiaceous fungi. It has poor prognosis irrespective of the immune status of the patient. Cladophialophora bantiana is the most commonly isolated species. We report a case of multiple brain abscesses caused by C. bantiana in an immune competent patient. The diagnosis was based on CT scan of head, direct examination and culture of the aspirate from the abscess. Despite complete surgical resection of the abscesses and antifungal therapy with amphotericin B and voriconazole the patient could not be saved. All the cases of cerebral phaeohyphomycosis due to this rare neurotropic fungus reported from India between 1962 and 2009 have also been reviewed.

Chhina, Deepinder Kaur; Kaushal, Vandana; Kaushal, Rakesh Kumar; Singh, Jasdeep

2014-01-01

129

Intestinal obstruction due to migration of a thermometer from bladder to abdominal cavity: a case report.  

PubMed

Intraperitoneal foreign bodies such as retained surgical instruments can cause intestinal obstruction. However, intestinal obstruction due to transmural migration of foreign bodies has rarely been reported. Here, we report a case of intestinal obstruction due to a clinical thermometer which migrated from the bladder into the abdominal cavity. A 45-year-old man was admitted to our hospital with a one-year history of recurrent lower abdominal cramps. Two days before admission, the abdominal cramps aggravated. Intestinal obstruction was confirmed with upright abdominal radiography and computerized tomography scan which showed dilation of the small intestines and a thermometer in the abdominal cavity. Then laparotomy was performed. A scar was observed at the fundus of the bladder and a thermometer was adhering to the small bowels and mesentery which resulted in intestinal obstruction. Abdominal cramps were eliminated and defecation and flatus recovered soon after removal of the thermometer. PMID:24605042

Nie, Jing; Zhang, Bo; Duan, Yan-Chao; Hu, Yue-Hua; Gao, Xin-Ying; Gong, Jian; Cheng, Ming; Li, Yan-Qing

2014-03-01

130

Intestinal obstruction due to migration of a thermometer from bladder to abdominal cavity: A case report  

PubMed Central

Intraperitoneal foreign bodies such as retained surgical instruments can cause intestinal obstruction. However, intestinal obstruction due to transmural migration of foreign bodies has rarely been reported. Here, we report a case of intestinal obstruction due to a clinical thermometer which migrated from the bladder into the abdominal cavity. A 45-year-old man was admitted to our hospital with a one-year history of recurrent lower abdominal cramps. Two days before admission, the abdominal cramps aggravated. Intestinal obstruction was confirmed with upright abdominal radiography and computerized tomography scan which showed dilation of the small intestines and a thermometer in the abdominal cavity. Then laparotomy was performed. A scar was observed at the fundus of the bladder and a thermometer was adhering to the small bowels and mesentery which resulted in intestinal obstruction. Abdominal cramps were eliminated and defecation and flatus recovered soon after removal of the thermometer.

Nie, Jing; Zhang, Bo; Duan, Yan-Chao; Hu, Yue-Hua; Gao, Xin-Ying; Gong, Jian; Cheng, Ming; Li, Yan-Qing

2014-01-01

131

Isolated shoulder palsy due to cortical infarction: a case report and literature review of clinicoradiological correlations.  

PubMed

Clinicoradiological correlations observed in patients with small cortical infarctions have supported somatotopic representation of different parts of body areas in primary motor cortex. However, isolated shoulder weakness because of infarction in precentral gyrus has rarely been described. We report an 80-year-old woman with isolated shoulder palsy because of cortical ischemic infarction in the base of the left precentral gyrus as confirmed by brain magnetic resonance imaging. In our patient, cardiogenic embolism or Trousseau syndrome associated with lung cancer was considered the cause of ischemic infarction. Physicians should consider small cortical infarction, when a patient complains of sudden onset of shoulder weakness without pain. In line with the previous reports, a responsible cortical lesion in our patient corresponded to motor shoulder area in the motor homunculus reported to be located more medially to the hand area. PMID:24008130

Kawasaki, Akiko; Suzuki, Keisuke; Takekawa, Hidehiro; Kokubun, Norito; Yamamoto, Masanari; Asakawa, Yohei; Okamura, Madoka; Hirata, Koichi

2013-11-01

132

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

PubMed Central

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.

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

2006-01-01

133

Failure to Find DUP25 in Patients with Anxiety Disorders, in Control Individuals, or in Previously Reported Positive Control Cell Lines  

PubMed Central

Investigation of the co-occurrence of panic and phobic disorders with joint laxity led to the identification of various forms of interstitial duplications involving human chromosome 15q24-q26 (named “DUP25”) in a Spanish population. DUP25 was observed in 68 of 70 (97%) patients assigned the diagnosis panic disorder/agoraphobia. DUP25 was also found in 14 of 189 (7%) control individuals. In the present study, we replicated the experimental conditions described by Gratacòs and colleagues in which fluorescence in situ hybridization was used to examine metaphase chromosomes of patients with panic disorder/social phobia and of control individuals from a southern region of the United Kingdom, the primary aim being to determine the prevalence of this chromosomal rearrangement in a geographically and ethnically distinct population. DUP25 was not observed in any of our 16 patients or 40 control samples or in three previously reported DUP25-positive control (Centre d'Etude du Polymorphisme Humain) cell lines, indicating a highly significant difference in the frequency of DUP25 between the study by Gratacòs and colleagues and the present investigation.

Tabiner, Melody; Youings, Sheila; Dennis, Nicholas; Baldwin, David; Buis, Christel; Mayers, Andrew; Jacobs, Patricia A.; Crolla, John A.

2003-01-01

134

Intussusception due to inflammatory fibroid polyp: A case report and comprehensive literature review  

PubMed Central

AIM: To give an overview of the literature on intussusception due to inflammatory fibroid polyp (IFP). METHODS: We present a new case of ileal intussusception due to IFP and a literature review of studies published in English language on intussusception due to IFP, accessed via PubMed and Google Scholar databases. For the search, the keywords used were: intussusception, IFP, intussusception and IFP, intussusception due to IFP, and IFP presenting as intussusception. The search covered all articles from 1976 to November 2011. RESULTS: We present a 38-year-old woman who was admitted 10 d after experiencing abdominal pain, vomiting, and nausea. Ultrasonography demonstrated small bowel intussusception. An ileal intussusception due to a mass lesion 50 cm proximal to the ileocecal junction was found during laparotomy. Partial ileal resection and anastomosis were performed. A diagnosis of ileal IFP was made based on the immunohistochemical findings. In addition, a total of 56 reports concerning 85 cases of intussusception due to IFP meeting the aforementioned criteria was included in the literature review. The patients were aged 4 to 81 years (mean, 49?±?16.2 years); 44 were women (mean, 51.8?±?14.3 years) and 41 were men (mean, 46?±?17.5 years). According to the location of the IFP, ileal intussusception was found in 63 patients, while 17 had jejunal, three had colonic, and two had ileojejunal intussusception. CONCLUSION: Although IFPs are rare and benign, surgery is the only solution in case of intestinal obstruction. Differential diagnosis should be made via immunohistochemical examination.

Akbulut, Sami

2012-01-01

135

Ileocolic intussusception due to a cecal endometriosis: Case report and review of literature  

PubMed Central

Abstract Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. We report a case of a woman who presented an ileocecal intussusception due to a cecal endometriosis. The patient gave two months history of chronic periombilical pain requiring regular hospital admission and analgesia. The symptoms were not related to menses. A laparotomy was performed and revealed an ileocolic intussusception. The abdominal exploration did not find any endometriosis lesion. Ileocaecal resection was performed. Microscopic examination showed a cystic component, lined by a regular cylindric epithelium. Foci of endometrial tissu were oberved in the cecal subserosa and muscularis mucosal, with irregular endometrial glands lined by cylindric epithelium without atypia immunostained with CK7, and characteristic endometrial stroma immunostained with CD10. Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. Diagnose of etiology remains challenging due to the absence of clinical and radiological specific characteristics. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2975867306869166

2012-01-01

136

Multiple ileal perforations due to regular diclofenac sodium injections: a case report  

PubMed Central

Background Although the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal tract have been well characterized, those specific to the lower gastrointestinal tract are less clear, as only a limited number of articles and case reports exist in the literature. Case presentation We describe a case of a 69-year-old woman who presented to the emergency department due to sudden onset abdominal distension and pain. Notably, she reported using intramuscular diclofenac sodium twice daily for 14 days after knee joint replacement surgery. The patient denied any other coexisting diseases. As a subsequent X-ray and computed tomography (CT) scan showed free air in the abdomen, an exploratory laparotomy was performed, revealing four free perforations in the terminal ileum. Findings on microscopic analysis were non-specific. Conclusion We report a unique case of multiple ileal perforations due to regular diclofenac sodium injections and contend that ileal perforation can be considered as a source for pneumoperitoneum with concomitant peritonitis in patients with a history of NSAID use if other possibilities are excluded.

2013-01-01

137

Biliary Peritonitis due to Spontaneous Perforation of Choledochus: A Case Report.  

PubMed

Spontaneous perforation of common bile duct (CBD) in an adult is an exceedingly rare phenomenon. It is mostly seen in infants due to congenital anomalies. The diagnosis of biliary tract perforations is often delayed due to their nonspecific symptoms, which results in high morbidity. Early diagnosis and aggressive therapy are mandatory to alleviate this condition. Delayed diagnoses and treatment may have more serious consequences in terms of morbidity as well as mortality. We herein report spontaneous perforation of CBD in a middle-aged male who presented to our accident and emergency department with acute abdominal pain. Exploratory laparotomy revealed a small perforation with necrosed margins in the supraduodenal part of CBD, which was managed by a T-tube drain. However, no apparent cause for the perforation was found. PMID:24426527

Laway, Mushtaq A; Bakshi, Iftikhar H; Shah, Mubbashir; Paray, Showkat A; Malla, Mohd Sadiq

2013-06-01

138

Delayed complete gastric outlet obstruction due to a dinner fork: report of a case.  

PubMed

Ingestion of foreign bodies can be a common problem especially among children, alcoholics, psychiatric patients, and senile patients, but ingestion of a metallic dinner fork is uncommon. Foreign bodies with smooth edges usually do not pose significant problems, but a sharp foreign object that is not retrieved at the earliest may penetrate the wall and cause complications. Ingested foreign bodies usually pass the intestinal tract without problems, and perforation occurs in less than 1%. In this paper, a case of rare gastric outlet obstruction due to a dinner fork, which was ingested 25 days before, is reported. PMID:20849060

Atila, Koray; Unek, Tarkan; Sevinç, Ali Ibrahim; Aydo?an, Baki; Serin, Ayfer; Bora, Seymen; Gülay, Hüseyin

2010-07-01

139

[Acute abdomen by gastric perforation due to foreign body from long stay: a case report].  

PubMed

The intake of foreign bodies is a common clinical entity in Gastroenterology, most of them are expelled spontaneously, but those that are long and sharp may cause complications in 1 to 5%, therefore requiring endoscopic extraction or surgical treatment sometimes. We report the case of a patient with a history of bulimia that came to the Guillermo Almenara Hospital for symptoms of acute abdominal pain due to gastric perforation by foreign body after many years there has been the intake and whose resolution was surgery. PMID:22476183

Garrido, Renato; Verástegui, Teresa; Huanqui, Juan Carlos; Cardenas, Bertha

2012-01-01

140

Tinea corporis due to Trichophyton verrucosum: report of a patient from the San'in District.  

PubMed

A 70-year-old Japanese housewife, a resident of Shimane Prefecture, developed an erythematous, annular skin lesion on her right forearm. Mycological examinations revealed that it was tinea corporis caused by Trichophyton verrucosum (T. verrucosum). This fungus was then shown to have been transmitted to her from young dairy cattle introduced from the Hokkaido District to the ranch of her son. To the best of our knowledge, she is the first reported patient with tinea due to T. verrucosum who was infected in the San'in District. PMID:8051322

Dekio, S; Jidoi, J

1994-05-01

141

Fever in returning travellers due to a noninfectious disease: Two case reports.  

PubMed

Each year, increasing numbers of people from developed countries travel to developing countries. It is not rare for these travellers to experience illness during or following their trips. It has been estimated that fever is present in 25% of those who seek medical attention following travel. In the majority of cases, the focus of the investigations centre around an infectious etiology, which can lead to a delay in establishing the noninfectious cause of fever. Two cases of fever, which were due to a noninfectious disease, are reported in returning travellers. PMID:19412384

Miller, Saul; Gabel, Kevin; Lee, Christine H

2008-05-01

142

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

NASA Technical Reports Server (NTRS)

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.

Crucian, Brian; Sams, Clarence F.

2013-01-01

143

Sudden, unexpected death due to glioblastoma: report of three fatal cases and review of the literature  

PubMed Central

Abstract Sudden death from an undiagnosed primary intracranial neoplasm is an exceptionally rare event, with reported frequencies in the range of 0.02% to 2.1% in medico-legal autopsy series and only 12% of all cases of sudden, unexpected death due to primary intracranial tumors are due to glioblastomas. We present three cases of sudden, unexpected death due to glioblastoma, with different brain localization and expression. A complete methodological forensic approach by means of autopsy, histological and immunohistochemical examinations let us to conclude for an acute central dysregulation caused by glioblastoma and relative complication with rapid increase of intracranial pressure as cause of death. Although modern diagnostic imaging techniques have revolutionized the diagnosis of brain tumors, the autopsy and the careful gross examination and section of the fixed brain (with coronal section) is still the final word in determining exact location, topography, mass effects and histology and secondary damage of brain tumor and contributed the elucidation of the cause of death. Immunohistochemistry and proteomic analysis are mandatory in such cases. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1218574899466985

2013-01-01

144

Magnetic resonance imaging findings in patients with delusional disorder due to diffuse cerebrovascular disease: a report of seven cases.  

PubMed

Delusions associated with cerebrovascular diseases have been sporadically reported. Although both psychiatrists and neurologists attempted to link delusions with anatomical locations of the brain lesion, comorbid psychiatric and neurological disorders make the interpretation of delusions difficult. The purpose of the present paper is to report the clinical features and magnetic resonance imaging (MRI) characteristics in patients with delusional disorder due to diffuse cerebrovascular diseases, and to redefine the concept of 'vascular delusion'. The clinical features and MRI findings were reviewed retrospectively in a series of seven patients with 'delusional disorder due to cerebrovascular disease' as defined in Diagnostic and Statistical Manual of Mental Disorders (DSMIV). The average age of onset is 64. No patient had a prior personal or family history of major psychiatric illness. The illness is presented as acute, subacute or stepwise course. Hypertension was present in all patients. Two had diabetes mellitus, and one had atrial fibrillation. Three had clinical evidence of previous cerebrovascular attacks, only one showed minor neurological deficits. Three had diffuse cortical slow wave in electroencephalogram. No patient had significant cognitive impairment but had multiple cortical and subcortical cerebrovascular lesions in MRI, with white-matter lesions (WML) in bilateral frontal areas. Delusional disorder due to diffuse cerebrovascular change is characterized by late-onset, stepwise course, and comorbid medical and neurological diseases. The results of vascular changes in the present study did not establish a cause-effect relationship and should be considered as multifactorial in pathogenesis. The findings suggested the hypothesis of neural circuit theory. Further studies in larger numbers of patients and newer neuroimaging techniques are needed to expand the knowledge learned from these findings. PMID:11285090

Su, K P; Hsu, C Y; Hsieh, S C; Shen, W W

2001-04-01

145

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...

146

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

PubMed Central

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.

2014-01-01

147

Ten-year outcome of serum metal ion levels after primary total hip arthroplasty: a concise follow-up of a previous report*.  

PubMed

We previously reported on the metal ion concentrations of cobalt, chromium, and titanium that were found in the serum of patients three years after they had undergone primary total hip arthroplasty as compared with the concentrations found in the serum of control patients who did not have an implant. This study is a concise update on the serum metal levels found in a cohort of these patients ten years after the time of hip implantation. Of the original seventy-five subjects, metal ion levels were available for forty patients (53%). Ten patients (hybrid group) had received a hybrid total hip replacement that consisted of a modular cobalt-alloy femoral stem with a cobalt-alloy femoral head that had been inserted with cement and a titanium acetabular socket that had been inserted without cement. Nine patients (cobalt-chromium [CoCr] group) had received an implant with an extensively porous-coated modular cobalt-alloy femoral stem and femoral head along with a titanium acetabular socket; the femoral and acetabular components had each been inserted without cement. Eight patients (titanium group) had undergone insertion of a proximally porous-coated modular titanium-alloy femoral stem with a cobalt-alloy femoral head and a titanium acetabular socket; the femoral and acetabular components had each been inserted without cement. Thirteen patients (control group) from the original control group of patients who had not received an implant served as control subjects. Serum metal levels were measured with use of high-resolution sector field inductively coupled plasma mass spectrometry. The hybrid total hip arthroplasty group had mean cobalt levels that were 3.2 times higher at 120 months than they were at baseline, and the cobalt levels in that group were significantly higher than those in the titanium total hip arthroplasty group at thirty-six, sixty, eighty-four, ninety-six, and 120 months (p < 0.01). The hybrid group had mean chromium levels that were 3.9 times higher at 120 months than they were at baseline, and the CoCr total hip arthroplasty group had chromium levels that were 3.6 times higher at 120 months than they were at baseline. The serum titanium levels were higher in the titanium group at all follow-up time intervals as compared with the levels in all other groups, and the level in the titanium group at 120 months was eighteen times higher than it was at baseline (p < 0.01). Patients with well-functioning primary metal-on-polyethylene total hip replacements had elevated serum metal levels for as many as ten years postoperatively. Furthermore, metal release at the modular femoral head-neck junctions, rather than passive dissolution from porous ingrowth surfaces, was likely the dominant source of serum cobalt and chromium. PMID:23515985

Levine, Brett R; Hsu, Andrew R; Skipor, Anastasia K; Hallab, Nadim J; Paprosky, Wayne G; Galante, Jorge O; Jacobs, Joshua J

2013-03-20

148

Gastrointestinal toxicity due to bitter bottle gourd (Lagenaria siceraria)--a report of 15 cases.  

PubMed

Traditional medicine is widely practiced in tropical countries. Bottle gourd (Lagenaria siceraria) fruit juice is advocated as a part of complementary and alternative medicine. If the bottle gourd juice becomes bitter it is considered toxic. We report 15 patients, who developed toxicity due to drinking bitter bottle gourd juice. Patients presented with abdominal pain, vomiting, hematemesis, diarrhea and hypotension within 15 min to 6-h after ingestion of bottle gourd juice. Endoscopy showed esophagitis, gastric erosions, ulcers and duodenitis. Hypotension was treated with crystalloids and inotropic support. All patients recovered in 1-4 days. Endoscopically the lesions healed in 2 weeks. Bitter bottle gourd can cause gastrointestinal toxicity with hematemesis and hypotension. Supportive management is the treatment and all patients recover within 1 week. PMID:21986853

Puri, Rajesh; Sud, Randhir; Khaliq, Abdul; Kumar, Mandhir; Jain, Sanjay

2011-09-01

149

Dropped head syndrome due to myogenic atrophy - a case report of surgical treatment.  

PubMed

We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment. Computed tomography revealed osseous contracture of cervical vertebral bodies in flexed position. Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment. Pathologic study confirmed myogenic atrophy in the cervical extensor muscles. We suggest that consideration for surgical management should be given to dropped head syndrome especially due to INEM. PMID:21247445

Zenmyo, Michihisa; Abematsu, Masahiko; Yamamoto, Takuya; Ishidou, Yasuhiro; Komiya, Setsuro; Ijiri, Kosei

2011-01-01

150

A patient presenting with acute abdomen due to metastatic small bowel melanoma: a case report  

PubMed Central

Introduction Malignant tumors of the small bowel are rare. Melanoma of the small intestine is in most cases metastatic from a primary skin lesion. Perforation of small bowel melanoma is an extremely rare entity. To the best of our knowledge this is the fifth case published to date. Case presentation We report a rare case of acute abdomen due to perforated metastatic small bowel melanoma in a 38-year-old Caucasian man. Conclusions In the majority of cases small bowel melanoma represents metastasis from cutaneous sites. Although rare, the possibility of abdominal metastatic melanoma presenting with the clinical picture of acute abdomen must be always considered by the operating surgeon in patients with a history of primary cutaneous malignant lesion.

2013-01-01

151

Perinephric abscess due to a coagulase-negative Staphylococcus: case report and review of the literature.  

PubMed

Perinephric abscess is an uncommon urinary tract infection that usually is caused by Staphylococcus aureus as a single pathogen or gram-negative bacilli as part of a polymicrobial process. We describe a man who presented with a right perinephric abscess due to coagulase-negative Staphylococcus as the only pathogen. The patient had bilateral nephrolithiasis, and he was treated successfully with percutaneous drainage of the abscess and parenteral antibiotics. Coagulase-negative staphylococci are increasingly reported to cause serious infections. This organism can no longer be routinely dismissed as a contaminant or colonizer. Repeated isolation of coagulase-negative Staphylococcus in the absence of other pathogens must be considered a high risk situation. PMID:8501804

Chitnavis, V; Magnussen, C R

1993-06-01

152

Hyponatremia associated coma due to pituitary apoplexy in early pregnancy: a case report.  

PubMed

Pituitary apoplexy in pregnancy is rare. Its clinical features may range from unspecific complaints to panhypopituitarism resulting even in coma and death. Therefore, alertness to signs and symptoms of acute loss of pituitary function in pregnancy is mandatory. We report a woman in her 7th week of her first gestation presenting with sudden coma due to severe hyponatremia. Secondary adrenal insufficiency could be identified as the underlying cause. Panhypopituitarism including central diabetes insipidus and spontaneous abortion developed during the follow-up. Magnetic resonance imaging showed pituitary apoplexy without a pre-existing pituitary mass. The clinical course was notable for severe complications, including neurological deficits through cerebral ischemia, but eventual recovery could be achieved. We discuss the diagnostic difficulties in the evaluation of pituitary disease in pregnancy. PMID:19916872

Krull, Ina; Christ, Emanuel; Kamm, Christian Philipp; Ganter, Christoph; Sahli, Rahel

2010-03-01

153

Zoonotic atypical pneumonia due to Chlamydophila psittaci: first reported psittacosis case in Taiwan.  

PubMed

Human psittacosis caused by Chlamydophila psittaci is one of the most common zoonotic atypical pneumonias featuring pulmonary as well as extrapulmonary infections. Most of the cases involve avian contact history especially with psittacine birds. Herein we report a 44-year-old male patient displaying atypical pneumonia symptoms of intermittent fever, dry cough, chest pain, dyspnea, headache, hepatitis, and hyponatremia. He had two sick cockatiels, one of which had died a month previously. A microimmunofluorescence test was performed to check the serum antibody levels against Chlamydophila psittaci. The serum IgM titer showed positive titer of 1:256, 1:256, and 1:128 on Days 11, 23, and 43 after disease onset, respectively. His fever subsided soon and clinical symptoms improved after minocycline was administrated on Day 12. The psittacosis case was confirmed by history of psittacine bird contact, clinical symptoms, treatment response, and positive IgM titer. To our knowledge, this is the first report of a psittacosis case in Taiwan. PMID:23927984

Cheng, Yu-Jen; Lin, Kun-Yen; Chen, Chun-Chen; Huang, Yen-Lin; Liu, Chun-Eng; Li, Shu-Ying

2013-07-01

154

Transient Pseudohypoaldosteronism due to Urinary Tract Infection in Infancy: A Report of 4 Cases.  

PubMed

Hyponatremia with hyperkalemia in infancy is an uncommon but life-threatening occurrence. In the first weeks of life, this scenario is often associated with aldosterone deficiency due to salt-wasting congenital adrenal hyperplasia. However, alternative diagnoses involving inadequate mineralocorticoid secretion or action must be considered, particularly for infants one month of age or older. We report four infants who presented with profound hyponatremia accompanied by urinary tract infection, ultimately leading to the diagnosis of transient pseudohypoaldosteronism. Our cases provide support for the idea that the renal tubular resistance to aldosterone is due to urinary tract infection itself rather than to underlying urinary tract anomalies typically found in these infants. Awareness of this condition is important so that serum aldosterone, urine sodium, and urine cultures may be obtained immediately in any infant presenting with hyponatremia and hyperkalemia in whom a diagnosis of congenital adrenal hyperplasia was not found. Adequate replacement with intravenous saline and antibiotic therapy is sufficient to correct sodium levels over 24-48 hours. PMID:19946403

Nandagopal, Radha; Vaidyanathan, Priya; Kaplowitz, Paul

2009-01-01

155

A case report of a chemical burn due to the misuse of glacial acetic acid.  

PubMed

As young and elastic skin is what everyone dreams of, various measures have been implemented including chemical, laser resurfacing and dermabrasion to improve the condition of ageing skin. However, the high cost of these procedures prevents the poor from having access to treatment. Glacial acetic acid is widely used as a substitute for chemical peeling because it is readily easily available and affordable. However, its use can result in a number of serious complications. A 28-year-old female patient was admitted to our hospital with deep second-degree chemical burns on her face caused by the application of a mixture of glacial acetic acid and flour for chemical peeling. During a 6-month follow-up, hypertrophic scarring developed on the both nasolabial folds despite scar management. Glacial acetic acid is a concentrated form of the organic acid, which gives vinegar its sour taste and pungent smell, and it is also an important reagent during the production of organic compounds. Unfortunately, misleading information regarding the use of glacial acetic acid for chemical peeling is causing serious chemical burns. Furthermore, there is high possibility of a poor prognosis, which includes inflammation, hypertrophic scar formation and pigmentation associated with its misuse. Therefore, we report a case of facial chemical burning, due to the misuse of glacial acetic acid, and hope that this report leads to a better understanding regarding the use of this reagent. PMID:20708991

Yoo, Jun-Ho; Roh, Si-Gyun; Lee, Nae-Ho; Yang, Kyung-Moo; Moon, Ji-Hyun

2010-12-01

156

Brain stem contusion due to tentorial coup injury: case report and pathomechanical analysis from normal cadavers.  

PubMed

This report is in two parts. First, a case report on a 20-year-old man with a localized brain stem contusion. Second, in order to elucidate the mechanism of this injury, an anatomical study was performed. Ten cadaver heads were analysed to reveal the variations of spatial anatomy around the tentorial incisura. The lateral tentorial incisura (lateral to brain stem) was situated at the level of pontomesencephalic junction and nearest to the brain stem along its course. The shortest distance between them averaged 1.0 mm (0-4 mm). Based on these findings, primary brain stem injury caused by tentorial incisura occurs at its lateral portion due to the shortest distance to the brain stem and near the level of pontomesencephalic junction. In patients with a tentorial incisura closely related to or touching the brain stem, tentorial coup injury to the brain stem may occur even with a relatively minor injury. In our case, repeated CT and MRI proved that the location of contusion was at the pontomesencephalic junction, coinciding with the level of the tentorial edge. The injury started at the surface of brain stem. The tentorial edge was close to brain stem in this case. These radiological findings support the hypothesis that the brain stem contusion was caused by a tentorial coup injury. PMID:11013669

Saeki, N; Yamaura, A; Sunami, K

1998-04-01

157

[Traumatic changes of intrathoracic organs due to external mechanical cardiopulmonary resuscitation. Case reports].  

PubMed

External mechanical resuscitation systems were developed for continuous and effective chest compression with the goal to increase the probability of spontaneous blood circulation renew. We describe results of four autopsy cases, where the external mechanical resuscitation by system Lucas (n=3) and AutoPulse (n=1) was performed prior to death. In all the cases were found traumatic changes which are commonly described in various studies such as skin abrasions on the chest, multiple rib fractures, fracture of the sternum and hematoma in the mediastinum or pericardium. In addition to these usual traumatic changes accompanying mechanical cardiopulmonary resuscitation we have observed injuries of intrathoracic organs, mainly the contusions of the heart and contusions and laceration of the lungs. In addition to these changes were in one case, associated with prolonged AutoPulse resuscitation, found ruptures of intima of the right common carotid artery. These injuries, with few exceptions, are not commonly described even over much wider number of examined persons. Injuries of the abdominal organs in connection with mechanical resuscitation, as described in a few case reports, were not present. However in one case there was found contusion of myocardium due to the external resuscitation by the Lucas system with clinical manifestation of sudden coronary incident even though the cause of death was massive thrombotic embolism to pulmonary arteries. All reported cases were similar in the relatively long-lasting mechanic cardiopulmonary resuscitation and prolonged time of dying of the patients. Keywords: cardiopulmonary resuscitation - Lucas - AutoPulse - intrathoracic injury. PMID:23964585

K?dela, Miroslav; Grossová, Iva; Strejc, P?emysl

2013-07-01

158

Beta cell dysfunction in patients with acute myocardial infarction but without previously known type 2 diabetes: a report from the GAMI study  

Microsoft Academic Search

Aims\\/hypothesis  Patients with acute myocardial infarction (AMI) but without previously known type 2 diabetes have a high prevalence of undiagnosed IGT and type 2 diabetes. Such perturbations have dismal prognostic implications. The aim of this study was to characterise AMI patients in terms of insulin resistance and beta cell function.Methods  A total of 168 consecutive AMI patients were classified by means of

M. Wallander; M. Bartnik; S. Efendic; A. Hamsten; K. Malmberg; J. Öhrvik; L. Rydén; A. Silveira; A. Norhammar

2005-01-01

159

Rare and severe complications of congenital adrenal hyperplasia due to 21-hydroxylase deficiency: a case report  

PubMed Central

Introduction We report the case of a patient with classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency who presented with unusual anatomical and biochemical features, namely massively enlarged adrenal glands, adrenogenital rest tissue and an unexpected endocrine profile. The contribution of the adrenocortical cells in the adrenals and testicles was determined by a cosyntropin stimulation test before and after adrenalectomy. To the best of our knowledge this is the first report of such a case in the literature. Case presentation A 35-year-old Caucasian man was admitted to the emergency room with an Addisonian crisis. He had been diagnosed with congenital adrenal hyperplasia in the neonatal period. He acknowledged poor adherence to treatment and irregular medical assistance. Physical examination revealed marked cutaneous and gingival hyperpigmentation, hypotension, and hard nodules in the upper pole of both testicles. Blood analysis showed mild anemia and hyponatremia and no evidence of acute infection. Endocrine evaluation showed very low cortisol levels, low dehydroepiandrosterone-sulfate and elevated corticotropin, 11-deoxycortisol and delta-4-androstenedione. The concentration of 17-hydroxyprogesterone was 20,400ng/dL. After the cosyntropin stimulation test the pattern was similar and there was no significant increase in cortisol or 17-hydroxyprogesterone. The abdominal computed tomography scan revealed grossly enlarged and heterogeneous adrenal glands (left, 12cm; and right, six cm). A bilateral adrenalectomy was performed and pathologic examination revealed adrenal myelolipomas with nodular cortical hyperplasia. The sonogram showed bilateral heterogeneous masses on the upper pole of both testes which corresponded to the nodular hyperplasia of adrenal rest tissues. The genetic study revealed compound heterozigoty (mutations R124H and R356W), suggestive of a phenotypically moderate disease. We performed a cosyntropin stimulation test after adrenalectomy. The steroidogenic profile displayed the same unusual features, indicating an important contribution from the adrenogenital cells. Conclusion This case illustrates that congenital adrenal hyperplasia due to 21-hydroxylase deficiency can progress to severe acute and chronic complications. The masses in the patient’s adrenal glands and testicles resulted from chronically elevated adrenocorticotropic hormone and growth of adrenocortical cells. The basal and stimulated steroid profile, before and after adrenalectomy, revealed an unexpected pattern, suggesting significant contribution of the testicular adrenal cells to the steroidogenesis.

2013-01-01

160

Drug-induced liver injury due to varenicline: a case report  

PubMed Central

Background Liver injury due to prescription and nonprescription medications is an expanding public health concern in the United States, with drug-induced liver injury (DILI) being the single most common reason for regulatory actions instituted by the Food and Drug Administration against certain medications and supplements. Case presentation A 69-year-old Latino man was referred to Hepatology Clinic for urgent evaluation of new onset jaundice, nausea and fatigue associated with a >40-fold increase in his transaminase levels and elevated INR and alkaline phosphatase. The patient had received a new prescription for varenicline to aid with smoking cessation approximately 3 weeks prior to his evaluation in Hepatology Clinic. Within 5?days of starting the varenicline, the patient developed new onset of nausea, vomiting, malaise and deep jaundice. The varenicline was discontinued on day 5 by the patient. Hepatologic evaluation revealed no evidence of acute viral hepatitis, autoimmune, metabolic or alcohol-related liver disorders. The patient’s past medical history was notable, however, for chronic hepatitis C. His liver enzymes and synthetic function completely normalized 9?weeks after discontinuation of the varenicline. Conclusion This report represents the second documented cases of drug-induced liver injury related to varenicline therapy, highlighting the need for clinician awareness regarding potential hepatotoxicity of varenicline, particularly among patients with pre-existing liver disease.

2012-01-01

161

Ileocolic intussusception due to giant ileal lipoma: Review of literature and report of a case  

PubMed Central

INTRODUCTION Intussusception in adults accounts for less than 5% of all intussusceptions. It occurs when a segment of intestine invaginates into itself. PRESENTATION OF A CASE We report a case of ileocolic intussusception in an adult caused by a giant ileal lipoma. DISCUSSION Intussusceptions can be classified as ileocolic, ileocecal, colo-colic and ileo-ileal. Most are due to neoplasms (60% malign and 24–40% benign). In the colon, the possibility of malignancy is higher than in small intestine. Lipomas are the most common benign mesenchymal intestinal tumors, accounting for less than 5% of all gastrointestinal tumors. They are more frequent in colon than small intestine. Small lipomas (less than 2 cm) are usually asymptomatic. Larger lesions may produce symptoms such as abdominal pain, obstruction or intussusception. Lipomas can be diagnosed with endoscopy, capsule endoscopy, barium enemas, CT and US. CONCLUSION Intussusceptions in adults is a rare condition, most of them are caused by a malign neoplasms followed by benign neoplasms. US and CT are useful for diagnosis. Surgery is mandatory.

Minaya Bravo, Ana Maria; Vera Mansilla, Cristina; Noguerales Fraguas, Fernando; Granell Vicent, Francisco Javier

2012-01-01

162

Ischemic colitis due to obstruction of mesenteric and splenic veins: A case report  

PubMed Central

Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.

Hwang, Seong-Su; Chung, Woo-Chul; Lee, Kang-Moon; Kim, Hyun-Jin; Paik, Chang-Nyol; Yang, Jin-Mo

2008-01-01

163

[Mendelian susceptibility to mycobacterial disease: a case report of disseminated infection due to Mycobacterium avium].  

PubMed

Mendelian susceptibility to mycobacterial disease (MSMD) is a rare genetic syndrome that predisposes patients to infections caused by weakly virulent mycobacterial species, such as bacillus Calmette-Guérin (BCG) vaccines and nontuberculous environmental mycobacteria in children free of classical immunodeficiencies. This syndrome consists of impaired antimycobacterial immunity (axis IL12/INF-?) constituting a new immune deficiency and outlining its major role in mycobacterial immunity. We report a new case of MSMD through the observation of a young girl with a disseminated infection due to Mycobacterium avium. The molecular defect was 2 autosomal recessive mutations of the IL12R?1 gene (gene encoding for the ?1 chain of the IL12 receptor) leading to the absence of the IL12 receptor on the activated T lymphocytes' surface. IL-12RB1 deficiency is the most common genetic etiology of MSMD. Today, there are 6 MSMD-causing genes, leading to 13 distinct genetic disorders. The clinical phenotype differs between patients. The description of the molecular and immunological basis of this syndrome has allowed us to explain the pathophysiology of antimycobacterial immunity and is essential to understanding and managing these diseases. PMID:23726680

Darleguy, A; Bost-Bru, C; Pagnier, A; Plantaz, D; Piolat, C; Nugues, F; Picard, C

2013-07-01

164

Pulmonary Hypertension due to a Pulmonary Artery Leiomyosarcoma: A Case Report.  

PubMed

Background. Primary pulmonary artery sarcomas are very rare and their histologic type, called leiomyosarcoma, is even rarer. Case Report. A 64-year-old woman presented with progressive weakness, fatigue, malaise, and dyspnea, and a marked elevation of pulmonary artery pressure was admitted. She was initially diagnosed with chronic pulmonary thromboembolism and chest computed tomography (CT) scan revealed that lobulated heterogeneous left hilar mass extended to precarinal and subcarinal space. MRI demonstrated a polypoid lesion at trunk with extension to left main pulmonary artery and its first branch. She was operated, a yellowish-shiny solid mass in pulmonary trunk was seen intraoperatively, and pulmonary endarterectomy was performed. Her tumor was pathologically diagnosed as pulmonary artery leiomyosarcoma. She died 3 months later after one chemotherapy course. Conclusion. Initially, the patient underwent surgery due to pulmonary embolism but, during the operation, the observed mass increased the probability of pulmonary artery neoplasm. Clinicians must consider pulmonary artery sarcoma when making the differential diagnosis for patients with pulmonary arteries masses. In addition to clinical prediction scores and CT and MRI findings to identify the patients with pulmonary artery sarcoma, PET scanning is the diagnosis of choice in differentiating embolism and neoplasm and is strongly recommended in these patients. PMID:23607029

Adeli, Seyyed Hassan; Nemati, Bardia; Jandaghi, Mahboubeh; Riahi, Mohammad Mahdi; Hosseinzadeh, Fatemeh; Salarvand, Fatemeh

2013-01-01

165

Pulmonary Hypertension due to a Pulmonary Artery Leiomyosarcoma: A Case Report  

PubMed Central

Background. Primary pulmonary artery sarcomas are very rare and their histologic type, called leiomyosarcoma, is even rarer. Case Report. A 64-year-old woman presented with progressive weakness, fatigue, malaise, and dyspnea, and a marked elevation of pulmonary artery pressure was admitted. She was initially diagnosed with chronic pulmonary thromboembolism and chest computed tomography (CT) scan revealed that lobulated heterogeneous left hilar mass extended to precarinal and subcarinal space. MRI demonstrated a polypoid lesion at trunk with extension to left main pulmonary artery and its first branch. She was operated, a yellowish-shiny solid mass in pulmonary trunk was seen intraoperatively, and pulmonary endarterectomy was performed. Her tumor was pathologically diagnosed as pulmonary artery leiomyosarcoma. She died 3 months later after one chemotherapy course. Conclusion. Initially, the patient underwent surgery due to pulmonary embolism but, during the operation, the observed mass increased the probability of pulmonary artery neoplasm. Clinicians must consider pulmonary artery sarcoma when making the differential diagnosis for patients with pulmonary arteries masses. In addition to clinical prediction scores and CT and MRI findings to identify the patients with pulmonary artery sarcoma, PET scanning is the diagnosis of choice in differentiating embolism and neoplasm and is strongly recommended in these patients.

Nemati, Bardia; Jandaghi, Mahboubeh; Riahi, Mohammad Mahdi; Hosseinzadeh, Fatemeh; Salarvand, Fatemeh

2013-01-01

166

Small Intestinal Obstruction with Intussusception due to Acute Myeloid Leukemia: A Case Report  

PubMed Central

Myeloid sarcoma is known to precede the development of acute myeloid leukemia (AML) and can be the only clinical manifestation. Gastrointestinal involvement by AML is rare with the commonest site being small intestine. Patients present with vague abdominal pain and/or obstruction. Prognosis is usually poor as most of them rapidly progress to AML. We report a case of 25-year-old man with complaints of abdominal pain and vomiting of one-year duration. OGD scopy revealed infiltration of lesser curvature of stomach. Subsequently patient came back within a week with signs and symptoms of acute intestinal obstruction for which an ileal resection was done. Although the histology of stomach biopsy and ileal segments showing similar features were thought to be non-Hodgkin's lymphoma, immunohistochemistry confirmed the diagnosis of myeloid sarcoma. Bone marrow investigations confirmed involvement by AML. Patient succumbed to the disease due to extensive involvement of AML. This case highlights the primary gastrointestinal manifestation of AML which can often prove to be a diagnostic difficulty clinically and histologically. Prompt diagnosis is essential to hasten the management.

Kini, Sangeeta; Amarapurkar, Anjali; Balasubramanian, Meenaskshi

2012-01-01

167

Postnasal drip due to inferior turbinate perforation after radiofrequency turbinate surgery: A case report  

PubMed Central

Management of inferior turbinate hypertrophy includes surgical options in case of failure with medical treatment and the main goal of turbinate surgery is to relieve the patient's symptoms of chronic nasal congestion while preserving mucosal surfaces with reduction of the submucosal and bony tissue. In this regard, radiofrequency volumetric tissue reduction has been a thermal technique associated with satisfactory results and fewer side effects. Historical detail on onset, timing, duration, and severity of symptoms and aggravating and relieving factors are important in the differential diagnosis of postnasal drip (PND). Here, we report development of intractable PND due to inferior turbinate perforation after radiofrequency turbinate surgery for the first time in the literature and the successful improvement via removal of pathological anatomic structure under nasal endoscopy–directed surgery in a 35-year-old female patient. The patient had a good functional outcome postoperatively with no further complications or signs of recurrence occurring, to date, within a postoperative follow-up period of 1 year.

2013-01-01

168

Description of a novel Janus kinase 3 P132A mutation in acute megakaryoblastic leukemia and demonstration of previously reported Janus kinase 3 mutations in normal subjects.  

PubMed

Gain-of-function (GOF) mutations of Janus kinase 2 (JAK2) are frequently seen in myeloproliferative disorders (MPDs). Meanwhile, JAK3 activating substitutions have been found in a few megakaryocytic cell lines and in primary myeloid leukemia (AMKL). Here, we sought to discover novel leukemogenetic mutations in de novo acute myeloid leukemia of non-Down syndrome (N-DS) by DNA sequencing. A total of 191 normal Caucasian individuals were studied to define single nucleotide polymorphisms (SNPs) within the JH2 and JH6 domains. Although known activating substitutions were observed in rare cases of acute myeloid leukemia (AML) (V722I [2/134] or P132T [1/119]), all samples were wild-type (WT) for the oncogenic A572V (119/119). Interestingly, a novel homozygous mutation (P132A) was discovered in a patient with acute megakaryoblastic leukemia and in vivo studies demonstrated that its ectopic expression was oncogenic in a mouse xenotransplant model. This study defines a novel JAK3 mutation among patients with N-DS AML and demonstrates that normal individuals can also display germline JAK3 substitutions, previously proven to have oncogenic properties, in vitro and in vivo. The discovery of these substitutions in normal donors encourages future studies to define new risk factors among patients with MPDs. PMID:21599579

Riera, Ludovica; Lasorsa, Elena; Bonello, Lisa; Sismondi, Francesca; Tondat, Fabrizio; Di Bello, Cristiana; Di Celle, Paola Francia; Chiarle, Roberto; Godio, Laura; Pich, Achille; Facchetti, Fabio; Ponzoni, Maurilio; Marmont, Filippo; Zanon, Carlo; Bardelli, Alberto; Inghirami, Giorgio

2011-09-01

169

Ovarian function and spontaneous pregnancy after combined heterotopic and orthotopic cryopreserved ovarian tissue transplantation in a patient previously treated with bone marrow transplantation: case report.  

PubMed

Cryopreservation of ovarian tissue has been proposed for storing gametes of young patients at high risk of premature ovarian failure. Autotransplantation has recently provided some promising results and is still the unique option to restore ovarian function from cryopreserved ovarian tissue in humans. In this article, we analyse data from the combined orthotopic and heterotopic transplantation of cryopreserved ovarian tissue that restored the ovarian function and fertility. Orthotopic transplantation of cryopreserved ovarian tissue at ovarian and peritoneal sites, together with a heterotopic transplantation at the abdominal subcutaneous site, was performed to restore the ovarian function of a 29-year-old woman previously treated with bone marrow transplantation (BMT) for Hodgkin's disease. Ovarian reserve markers progressively suppress within values 5 months after the transplantation (basal FSH 5 mUI/ml and inhibin B 119 ng/ml). Follicular development was observed at all transplantation sites but was predominant at the ovarian site. Six natural cycles were fully documented and analysed. The patient became spontaneously pregnant following the sixth cycle, but unfortunately she later miscarried. Combined orthotopic and heterotopic transplantations succeeded in the restoration of normal spontaneous cycles. Furthermore, this spontaneous pregnancy confirmed the efficiency of this procedure for restoring human fertility. PMID:16585122

Demeestere, Isabelle; Simon, Philippe; Buxant, Frédéric; Robin, Valérie; Fernandez, Sergio Aguilar; Centner, Julie; Delbaere, Anne; Englert, Yvon

2006-08-01

170

Renal artery stenosis due to neurofibromatosis type 1: case report and literature review  

PubMed Central

Background Neurofibromatosis type 1 (NF1) is a relatively common autosomal dominant disorder. The most common vascular abnormality in patients with NF1 is bilateral or unilateral renal artery stenosis. Case report A 16-year-old boy presented with a headache of 4-year duration and was found to be moderately hypertensive. On physical examination, axillary freckling and multiple café-au-lait spots were revealed over the trunk, while numerous small nodules were palpable on the limbs. Biopsy of subcutaneous nodule showed neurofibroma. Lisch nodules were identified on slit-lamp examination and grade I hypertensive retinopathy was present on fundoscopy. Clinical laboratory investigations revealed that renal and liver function tests, blood cells count, urinalysis, serum electrolytes, serum levels of renin and aldosterone, and 24-hour urine levels of catecholamines were all within normal ranges. Abdominal ultrasound and CT were normal. Both kidneys were of normal size. CT angiography showed right renal artery stenosis (>90%) at the ostium. The final diagnosis of NF1 with right renal artery stenosis and secondary hypertension was then made. The patient was treated with Procardin (30 mg/d) and improved with a significant decline in blood pressure. The main outcomes were to control blood pressure without necessarily proceeding with PTRA. We also present a review of the literature. Conclusions NF1 may present with hypertension due to renal artery stenosis in children. All young patients (<30 year) with hypertension should be clinically screened for secondary causes of hypertension, including NF1, so that renal revascularization can be offered before permanent end organ damage has occurred. First-line management using medication alone could be appropriate, keeping the interventional options for when the patient's condition deteriorates.

2014-01-01

171

The usefulness of chelation therapy for the remission of symptoms caused by previous treatment with mercury-containing pharmaceuticals: a case report  

PubMed Central

Introduction A great deal of data regarding the toxicology of mercury has been recently reported. Although the most common human exposures to mercury are currently mercury vapour from amalgam tooth fillings, methylmercury from seafood and ethylmercury as a preservative in vaccines, in the past mercury compounds have been used in the treatment of syphilis. Case presentation Mercury intoxication was found in a 67 year-old Italian man affected by neurological symptoms of apparently unknown origin. The patient developed syphilis forty years ago and then underwent therapy with mercurials to treat his chronic bacterial infection. We treated the patient with disodium edetate chelation therapy. Six months after the beginning of the therapy, the patient's neurological symptoms began to decrease, and were completely cured after two years of therapy. Conclusion This case supports the use of chelation therapy with disodium edetate to remove damages caused by mercury intoxication.

2009-01-01

172

A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review.  

PubMed

Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR) and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment. PMID:25047321

Takahashi, Toshiaki; Miyano, Go; Kayano, Hajime; Lane, Geoffrey J; Arakawa, Atsushi; Yamataka, Atsuyuki

2014-01-01

173

German risk study - main report: a study of the risk due to accidents in nuclear power plants  

Microsoft Academic Search

A translation of the Deutsche Risikostudie Kernkraftwerke, this report assesses the risks due to accidents caused by the operation of nuclear power plants in the Federal Republic of Germany. The study, performed under the direction of the Federal Ministry for Research and Technology, is organized into two phases: the current report presents an overview of the investigations and results of

A. W. Barsell; I. B. Wall

1981-01-01

174

[Acute renal failure due to multiple stings by Africanized bees. Report on 43 cases].  

PubMed

This study reports on acute renal failure (ARF) due to multiple stings by Africanized bees (AB) occurring in 43 cases collected between 1982 and 2007 (at the Nephrology Section, University of Antioquia School of Medicine and San Vicente de Paul University Hospital, Medellin, Colombia). No intervention on patient care was performed except for responding the Nephrology consult and prescribing dialysis. Data obtained from the medical records included demography; clinical presentation; laboratory results on admission; evolution of renal function to document improvement and normalization; intervals between stings and outcomes; number of dialysis sessions; length of follow-up and hospitalization; survival; and mortality. Not all patients had complete data and therefore, the number of observations is included where required. Mean age was 56 ± 26 yr (range 2-96); 37 (86%) were men; 38 (of 41 cases) came from rural areas (91%); 22 (of 39) were farmers (56.4%); 33 (of 41) lived in Medellin or in the department of Antioquia (80.5%). Number of stings per patient: ~ 900. Interval between stings and ARF < 48 hours: in 31 cases (72.1%; mean 2.6 ± 2.6 days; range 1-12); 37 (of 43) required dialysis (86%); mean number of sessions: 4.7 ± 3.3 (range 1-12). Survival occurred in 36 cases (83.7%) and mortality, in 7, all > 60 yr (16.3%). At last follow-up, renal function improvement was documented in 36 (83.7%) and normalization in 15 of them (41.7%). Interval until initiation of diuresis: 10.6 ± 6.8 days (range 1-25). Duration of hospitalization: 16.9 ± 8.7 days (range 1-39). Follow-up: 25.2 ± 18.3 days (range 1-75). Hematuria and oliguria occurred before 24 hours; there was an increase of CPK in 90%, of ALT in 96%, of AST in 89%, of DHL in 95%, and of BUN and creatinine in 100%. Based on our findings and on the review of the available information, we propose that this type of ARF occurs as a result of rhabdomyolysis with subsequent myoglobinuria, which lead to nephrotoxic acute tubular necrosis; a variable degree of direct nephrotoxicity, not quantifiable with current diagnostic methods, is also probably involved. A better knowledge of this entity by the medical community could improve care and prognosis of the patients who develop it. PMID:20613852

Mejía Vélez, G

2010-01-01

175

A small (sSMC) chromosome 22 due to a maternal translocation between chromosomes 8 and 22: a case report.  

PubMed

We report on a boy with partial trisomies for chromosomes 8 and 22 caused by the presence of a small supernumerary marker chromosome (sSMC), a der(22)t(8;22)(p22;q11.21), inherited from a t(8;22)(p22;q11.21) translocation carrier mother. He has mild mental retardation, unability to speak distinct words and several minor anomalies i.e. high forehead and hairline, telecanthus, upslanting palpebral fissures, depressed nasal bridge, nail hypoplasia, toe position anomaly and 5th finger clinodactyly. He has two maternal uncles and one maternal aunt with mental retardation. G-banding technique showed 47,XY,+mar whilst his mother's karyotype showed a balanced reciprocal translocation between the chromosomes 8 and 22. Fluorescence In Situ Hybridization (FISH) technique with probes for centromere 22 and 8pter were used to detect the origin of marker chromosome and confirmed the marker chromosome in the proband showing to be extra chromosomal material originated from chromosome 8 and 22. Additional genome wide microarray analysis, using the Affymetrix Nspl 250K SNP array platform was performed to further characterize the marker chromosome and resulted in a der(22)t(8;22)(p22;q11.21). Furthermore, cytogenetic analysis of three affected family members showed the same unbalanced translocation, due to 3:1 meiotic segregation. This indicated the viability of this unbalanced pattern and combined with the recurrent miscarriages by the proband's mother, the mechanism of transmitting extrachromosomal material is probably not a random process. Since, there is no similar translocation (8p;22q) reported and the chromosomal translocation largely exists of additional 8p22-8pter we compare the clinical outcomes with reported cases of 8p22-8pter triplication, although there is a part of genetic material derived from chromosome 22 present. This unique familial chromosome translocation case from Indonesia will give insight in the underlying mechanism of this recurrent chromosomal abnormality and clinical features of the patients will be compared to previously published cases. PMID:20420036

Mundhofir, F E P; Kooper, A J A; Winarni, T I; Smits, A P T; Faradz, S M H; Hamel, B C J

2010-01-01

176

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

PubMed Central

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.

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

2014-01-01

177

Polymicrobial Septicemia Due to Shigella Flexneri and Pseudomonas Aeruginosa: First Report  

PubMed Central

An invasion of the bloodstream by members of the genus Shigella is extremely rare. When it does occur, the etiologic agent is usually a single organism. A report of the first case of Shigella bacteremia that was complicated by Pseudomonas aeruginosa sepsis is reported.

Qadri, S. M. Hussain; Khalil, Salim H.

1987-01-01

178

Sepsis due to group G Streptococcus after a total hip arthroplasty. A case report.  

PubMed

A patient with a total hip arthroplasty developed an aggressive infection with group G Streptococcus. Very few similar cases have been reported, but they all resolved with antibiotics or drainage. A Girdlestone resection was necessary in our case because of loosening and extensive bony destruction. The true incidence may be greater than that reported and the prognosis may be worse. PMID:9349969

Pons, M; Pulido, A; v Leal; Viladot, R

1997-01-01

179

Pseudo-Foster Kennedy Syndrome due to unilateral optic nerve hypoplasia: a case report  

PubMed Central

Introduction Pseudo-Foster Kennedy Syndrome is described as unilateral optic disc swelling with contralateral optic atrophy in the absence of an intracranial mass causing compression of the optic nerve. This occurs typically due to bilateral sequential optic neuritis or ischaemic optic neuropathy. Case Presentation We describe a case of pseudo-Foster Kennedy Syndrome in a two year old boy with unilateral papilloedema due to a congenital optic disc anomaly in one eye preventing transmission of raised intracranial pressure to the optic nerve. Conclusion From our findings we conclude that congenital optic nerve hypoplasia is a cause of pseudo-Foster Kennedy Syndrome.

Bansal, Shveta; Dabbs, Timothy; Long, Vernon

2008-01-01

180

A rare cause of deep peroneal nerve palsy due to compression of synovial cyst - Case report  

PubMed Central

INTRODUCTION Synovial cyst is a rare cause of compression neuropathy and its differential diagnosis can be misleading. PRESENTATION OF CASE This article presents clinical, radiological, and histological findings of deep peroneal nerve palsy due to compression of a synovial cyst in a 30-year-old patient admitted with sudden drop foot. DISCUSSION Focal nerve entrapment in lower extremity due to synovial cystis a rare entity. Differential diagnosis is important. Surgical excision is the main treatment method with high success rate. CONCLUSION Synovial cyst compression which can be treated easily with surgical excision should be considered in rapidly progressed drop foot.

Erdil, Mehmet; Ozkan, Korhan; Ozkan, Feyza Unlu; Bilsel, Kerem; Turkmen, Ismail; Senol, Serkan; Sarar, Serhan

2013-01-01

181

Hepatic Fascioliasis due to Fasciola hepatica: A Two-Case Report  

Microsoft Academic Search

Two cases of hepatic fascioliasis due to Fasciola hepatica were retrieved from our surgical-pathol- ogy file since the hospital's foundation in 1969 up to 2005. The diagnosis of hepatic fascioliasis was based on detection of one live fluke in a large cystic lesion in the lobectomized liver specimen in one case and of deposited eggs in the large liver specimen

Rangsima Aroonroch

182

Cuboid oedema due to peroneus longus tendinopathy: a report of four cases  

Microsoft Academic Search

Objective: To highlight focal bone abnormality in the cuboid due to tendinopathy of the adjacent peroneus longus. Design: A retro- spective review was carried out of the relevant clinical and imaging fea- tures. Patients: Two male and two female patients were studied, mean age 51.5 years (range 32—67 years), referred with foot pain and imaging showing an abnormal cuboid thought

Paul O’Donnell; Asif Saifuddin

2005-01-01

183

Bilateral femoral neck fractures due to transient osteoporosis of pregnancy: a case report  

Microsoft Academic Search

We describe a case of bilateral femoral neck fractures secondary to transient osteoporosis of pregnancy, which were diagnosed after delivery due to the desire to avoid ionising radiation. These fractures were presumed to be secondary to transient osteoporosis of pregnancy and were treated successfully with internal fixation despite delayed presentation. We discuss the role of MRI in the evaluation of

Charles A Willis-Owen; Jas S Daurka; Alvin Chen; Angus Lewis

2008-01-01

184

Disseminated Aspergillosis due to Aspergillus niger in Immunocompetent Patient: A Case Report  

PubMed Central

Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised patients. Many cases of pulmonary, cutaneous, cerebral, and paranasal sinus aspergillosis in immunocompetent patient were defined in literature but disseminated aspergillosis is very rare. Here we present an immunocompetent case with extrapulmonary disseminated aspergillosis due to Aspergillus niger, totally recovered after effective antifungal treatment with voriconazole.

Ergene, Ulku; Akcali, Zeynep; Ozbalci, Demircan; Nese, Nalan; Senol, Sebnem

2013-01-01

185

Stump appendicitis and chorioamnionitis due to incomplete appendectomy: a case report.  

PubMed

Acute appendicitis represents the most common non-obstetric indication for surgical intervention in pregnant women, with a reported incidence of 1 in 1440 pregnancies. Stump appendicitis is a rare clinical situation when there is incomplete appendectomy. A rare case occurred of stump appendicitis and chorioamnionitis complicating after incomplete appendectomy. In this way the literature review suggests that only a few cases have been reported so far. We report a case of stump appendicitis and chorioamnionitis occurring three weeks after an appendectomy performed in another medical center. This will involve the discussion of clinical presentation, diagnosis, surgical management and literature review. PMID:22234765

Bell?, Sedat; Yalçinkaya, Cem; Ezer, Ali; Bolat, Filiz; Çolako?lu, Tamer; ??m?ek, Erhan

2011-10-01

186

Spontaneous ilio-iliac arteriovenous fistula due to an iliac artery aneurysm: a case-report.  

PubMed

A spontaneous arterio-venous ilioiliac fistula (AVF) caused by an iliac artery aneurysm (IAA) is a rare complication. We present the case of a 75-year-old man with previous aortic surgery 11 years before who was admitted at the Emergency Department for acute gluteal pain. He was suspected for a hip problem because of cup loosening on X-ray. A lumbar CT-scan to rule out nerve compression showed an aneurysm of the left common and internal iliac artery that was ruptured into the iliac vein. The AVF was treated endovascularly under local anesthesia by a sandwich technique (covered stent at the venous side and coils at the arterial side) with good results. The case demonstrates that lifelong follow-up of a patient with previous aortic surgery is mandatory. PMID:22571082

Vandereyken, F; Schwagten, V; Hertoghs, M; Beaucourt, L; D'Archambeau, O; Hendriks, J

2012-01-01

187

Traumatic Brain Injury Due to Bull Assault in a Girl: a Case Report  

PubMed Central

ABSTRACT Traumatic brain injury is a common condition in the emergency services, affecting the pediatric and adult population significantly. Patterns of head injury as well as management principles in children are important differences compared to adults. Traumatic brain injury by bull rush is usually seen in adults but has not been described in children-report a pediatric cranial trauma present bull rush, which to our knowledge is the first report in the literature of this nature.

ALVIS-MIRANDA, Hernando Raphael; CASTELLAR-LEONES, Sandra Milena; VELASQUEZ-LOPERENA, Dufays Danith; VILLA-DELGADO, Rosmery; ALCALA-CERRA, Gabriel; MOSCOTE-SALAZAR, Luis Rafael

2013-01-01

188

Over a millon Creatine Kinase due to a heavy work-out: A case report  

PubMed Central

Rhabdomyolysis induced by exercise is a very well known entity, several cases has been reported in the literature related with strenuous activities, weight lifting, marathon running, overexertion in an untrained person, knee bends, etc. We reported an interesting case of exercise-induced rhabdomyolysis in a 25 year old Hispanic male, after resuming his regular physical activity, with the highest creatine kinase described in the literature, successfully treated with aggressive hydration only and no complications.

Casares, Pablo; Marull, Jorge

2008-01-01

189

Obstructive jaundice due to von Hippel-Lindau disease-associated pancreatic lesions: A case report  

PubMed Central

von Hippel-Lindau (VHL) disease is an autosomal dominantly inherited neoplastic syndrome that may lead to pancreatic masses and obstructive jaundice. The present study describes the case of a 20-year-old male who suffered from obstructive jaundice due to VHL disease-associated pancreatic lesions whose primary symptom was dizziness, followed by the appearance of jaundice. Since the excision of the renal cell carcinomas was not possible, the patient also refused surgery to resect the pancreatic head mass. A metallic stent was placed at the stenosis site of the common bile duct. Percutaneous transhepatic cholangiography (PTCD) surgery was later performed following complete blockage of the stent, however, to date, the patient continues to rely on PTCD. VHL disease-associated pancreatic lesions are rarely the direct cause of mortality, however, obstructive jaundice due to these lesions may be lethal. Therefore, the treatment of patients with incurable renal or central nervous system tumors and obstructive jaundice presents a problem.

LIANG, XIAOYU; HU, FANGUO; MA, ZHICHENG; LI, NAN; CHEN, YAN; ZHANG, JIE

2014-01-01

190

Local vibration of transmission line towers due to flood flow. Technical report  

SciTech Connect

Local vibration of transmission line tower due to flood affects the lattices close to ground level, the lattices being slender. This is specially the case with broad based tangent towers for single conductor lines, since the stresses in the lattices are nominal and these have to be designed on the consideration of upper limit of slenderness ratio. Sustained flood flow can cause dynamic stresses resulting in yielding of the lattices ultimately leading to failure of the tower itself. Provision of intermediate supports for the lattices at suitable locations can bring down the amplitude of vibration and hence dynamic stresses. Interference with the vortex shedding by provision of wire winding or strakes, are also suitable steps to keep down the high dynamic stress due to flood flow.

Not Available

1982-05-01

191

Subclinical pneumonia due to serotypes D-K of Chlamydia trachomatis. Case reports of two infants.  

PubMed

Pneumonia due to serotypes D-K of Chlamydia trachomatis occurred in a 10-week-old baby, who had been successfully treated with chlortetracycline eye ointment for chlamydial ophthalmia neonatorum, and in a 7-week-old baby being treated for the same condition. Clinical signs of pneumonia were minimal. Such chlamydial pneumonia in infants must be under-diagnosed. Infants with chlamydial ophthalmia neonatorum are now routinely treated with erythromycin suspension by mouth in addition to chlortetracycline eye ointment. PMID:7427706

Dunlop, E M; Harris, R J; Darougar, S; Treharne, J D; Al-Egaily, S S

1980-10-01

192

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

Microsoft Academic Search

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

K. O. Merewether; K. C. Chen

1993-01-01

193

A case of human enteric myiasis due to larvae of Hermetia illucens (Family: Stratiomyiadae): first report in Malaysia.  

PubMed

A case of true enteric myiasis in a 7-year-old girl is reported. Two larvae were obtained from the vomitus of the patient. After processing and identification, the larvae were found to be those of Hermetia illucens (Soldier Fly). This is the first case of true enteric myiasis due to these larvae in Malaysia. PMID:8935136

Lee, H L; Chandrawathani, P; Wong, W Y; Tharam, S; Lim, W Y

1995-12-01

194

Is Caregiver-Adolescent Disagreement Due to Differences in Thresholds for Reporting Manic Symptoms?  

PubMed Central

Abstract Introduction Cross-informant disagreement is common and results in different interpretations of a youth's behavior. Theoretical explanations for discrepancies typically rely on scale level analyses. This article explores whether caregivers and adolescents differ in when they notice and report symptoms of youth mania depending on the severity of overall manic disturbance. Method Participants were 459 adolescent-caregiver pairs recruited at either a community mental health center or an academic medical center. Adolescents were most likely to have a primary diagnosis of unipolar depression (37%) or attention-deficit/hyperactivity disorder/disruptive behavior disorder (36%). Nineteen percent of adolescents received a bipolar spectrum disorder diagnosis (4% bipolar I and 15% bipolar II, cyclothymia, or bipolar not otherwise specificed). Caregivers were primarily biological mothers (74%) or grandparents (8%). Adolescents and caregivers independently completed the Mood Disorder Questionnaire (MDQ) about the adolescent. Results Item response theory analyses of the entire sample indicated that in general, both caregivers and adolescents reserved endorsement of mania symptoms for the most severely ill half of participants. Comparisons of caregiver and adolescent report of symptoms on the MDQ indicated two significant differences. Caregivers were more likely to report irritability at significantly lower severity of mania than adolescents. Adolescents endorsed only increased energy or hyperactivity at lower severities than caregivers. Conclusions Adolescents and caregivers will have different concerns and might report different symptoms consistent with whom the symptom impacts first. Caregivers are more likely to report behaviors such as irritability, whereas adolescents are more likely to report subjective feelings such as feeling more energetic or more hyperactive.

Youngstrom, Eric A.; Freeman, Megan J.; Youngstrom, Jennifer Kogos; Findling, Robert L.

2011-01-01

195

Emergency adrenalectomy due to acute heart failure secondary to complicated pheochromocytoma: a case report  

PubMed Central

Pheochromocytomas are catecholamine producing tumors arising mostly from chromaffin cells of the adrenal medulla. The most common clinical presentation is hypertension, mainly in the form of paroxymal episodes. Cardiovascular manifestations include malignant arrhythmia and catecholamine cardiomyopathy, mimicking acute coronary syndromes and acute heart failure. There are reports of pheochromocytomas presenting as acute coronary syndrome and rapidly leading to cardiogenic shock; the failure of intensive medical treatment in these cases has prompted the need for emergency adrenalectomy as the only remaining option. We report on a case of complicated pheochromocytoma presenting as cardiogenic shock, in which emergency adrenalectomy was performed following a total lack of response to intensive medical treatment.

2011-01-01

196

Massive gastro-intestinal haemorrhage due to vascular ectasia of the duodenum. A case report.  

PubMed

Vascular ectasia of the duodenum as an unusual source of upper gastro-intestinal bleeding in a patient with cirrhotic portal hypertension and oesophageal varices is reported. Morphological structure and situation of ectatic duodenal vessels indicate the possible coexistence of variceal distension and angiodysplasia. PMID:1411803

Arendse, M P; Jaskiewicz, K; Funnell, I

1992-09-01

197

Deep neck infection due to Lactococcus lactis cremoris: a case report.  

PubMed

This report describes the first case of deep neck infection resulting from Lactococcus lactis subsp. cremoris. The case is associated with the consumption of unpasteurized milk and occurred in a patient with a buccal mucosa tumor. Anti-infective therapy with ceftriaxone and metronidazole resulted in complete resolution. PMID:15756569

Koyuncu, M; Acuner, I C; Uyar, M

2005-09-01

198

Pulmonary nocardiosis due to Nocardia otitidiscaviarum in an immunocompetent host- A rare case report  

Microsoft Academic Search

Nocardiosis is a localized or disseminated infection caused by soil-borne aerobic actinomycetes. Pulmonary nocardiosis is a rare infection mostly occurring in immunocompromised patients. We reported a case of 36 year old immunocompetent non-smoker female patient with no premorbid illness who presented with fever, cough with scanty sputum, hemoptysis, left sided chest pain and exertional dyspnea for two weeks. There was

Kusugodlu Ramamoorthi; Baise Chandrappagouda Pruthvi; Neeleshwara Radhakrishna Rao; Jayaprakash Belle; Kiran Chawla

2011-01-01

199

Dropped head syndrome due to myogenic atrophy --- a case report of surgical treatment  

Microsoft Academic Search

We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment.

Michihisa Zenmyo; Masahiko Abematsu; Takuya Yamamoto; Yasuhiro Ishidou; Setsuro Komiya; Kosei Ijiri

2011-01-01

200

Brain Abscess Due to Listeria Monocytogenes: First Case Report in Thailand  

Microsoft Academic Search

Brain abscess with bacteremia caused by Listeria monocytogenes in a young woman with immune thrombocytopenic purpura was reported. The clinical features included fever, headache, and left-side weakness. Computed tomography and magnetic resonance imaging of the brain showed a large single abscess at the right frontoparietal area. L. monocytogenes was isolated from a blood culture. The patient promptly received a surgical

Somporn Srifeungfung

201

Acute respiratory distress syndrome due to systemic lupus erythematosus with hemophagocytic syndrome: an autopsy report  

Microsoft Academic Search

This report concerns a patient with systemic lupus erythematosus (SLE) who died of acute respiratory distress syndrome (ARDS) 1 day after the onset of pulmonary symptoms. Autopsy demonstrated severe hemophagocytosis in the bone marrow and histopathology indicating a marked increase in vascular permeability in both lungs and kidneys. In this patient, active SLE and associated hemophagocytic syndrome may have induced an

Kazuma Kaneko; Masayuki Matsuda; Yoshiki Sekijima; Waki Hosoda; Takahisa Gono; Kenichi Hoshi; Hisashi Shimojo; Shu-ichi Ikeda

2005-01-01

202

Pyomyositis and septic hip arthritis due to bacteroides fragilis. A case report.  

PubMed

Bacteroides fragilis is a rare cause of pyomyositis or septic arthritis. We present the case of a 74-year-old otherwise healthy male who presented with fever and right hip pain ten days after a course of intramuscular injections. Magnetic resonance imaging (MRI) showed septic arthritis of the right hip joint and pyomyositis of the right gluteus minimus muscle. Blood cultures and pus aspirated from the muscle grew Bacteroides fragilis. The patient was treated successfully with surgical debridement and metronidazole, administered for six weeks intravenously and five weeks orally. Simultaneous pyomyositis and hip septic arthritis due to Bacteroides fragilis is rare, but should be considered possible after intramuscular injections. PMID:21786258

Papanikolaou, Athanasios; Tzavara, Vassiliki; Chini, Maria; Papatheodorou, Athanasios

2011-01-01

203

Reversible facial pain due to hydrocephalus with trigeminal somatosensory evoked response changes. Case report.  

PubMed

A patient with hydrocephalus due to aqueductal stenosis suffered facial pain which was relieved after the insertion of a ventriculoperitoneal shunt. The trigeminal somatosensory evoked response (TSER) of the affected side showed lower amplitudes and longer latencies as compared to the unaffected side. Following surgery, the waves regained higher amplitudes and shorter latencies. An episode of shunt malfunction was accompanied by recurrent facial pain and impairment of the TSER. Both improved after revision of the shunt. The possible etiology of facial pain in patients with hydrocephalus is discussed. PMID:7086520

Findler, G; Feinsod, M

1982-08-01

204

[Sick sinus syndrome possibly due to lopinavir-ritonavir: report of two cases].  

PubMed

We describe herein two cases of sick sinus syndrome possibly due to lopinavir-ritonavir in HIV-infected individuals. The heart rate dropped to 30 to 40 beats per minute in both cases, but patients remained asymptomatic and recovered promptly after discontinuation of lopinavir-ritonavir. The time until onset varied; one patient developed bradyarrhythmia 9 days after the initial dose, and another 4 hours after. Since lopinavir-ritonavir is a frequently used antiretroviral agent, clinicians must be aware of this potentially lethal adverse effect. PMID:24195172

Sasaki, Shugo; Yanagisawa, Naoki; Suganuma, Akihiko; Imamura, Akifumi; Ajisawa, Atsushi

2013-09-01

205

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

PubMed Central

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.

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

2013-01-01

206

Severe osteomalacia due to undiagnosed coeliac disease: three case reports of Tunisian women.  

PubMed

We describe three cases of osteomalacia presenting in Tunisian women, all of whom had previously-undiagnosed coeliac disease (CD). Direct enquiry revealed an important weight loss and a history of diarrhoea in two patients, and a 15-year history of anaemia in one patient. Laboratory tests showed severe anaemia in the three cases. Reduced calcium was found in two cases, and corrected calcium was found in one case. Radiological examination showed fissure in two cases. The diagnosis of osteomalacia was made by clinical, biochemical and radiological features. Antigliadin, antireticulin, antiendomysial and anti-tissue transglutaminase antibodies were all positive in the three cases, and a small-bowel biopsy confirmed the diagnosis of CD. Treatment with gluten-free diet (GFD), supplemental calcium and vitamin D was initiated for the three patients, but only one patient complies strictly with the GFD; she showed a marked resolution of her symptoms. PMID:15977009

Landolsi, Hanène; Bouajina, Elyès; Mankaï, Amani; Zeglaoui, Hela; Skandrani, Karim; Ghedira, Ibtissem

2006-01-01

207

Posterior atlantoaxial subluxation due to os odontoideum combined with cervical spondylotic myelopathy : a case report  

PubMed Central

In patients with os odontoideum and posterior atlantoaxial subluxation are extremely rare. No reports have described posterior atlantoaxial subluxation associated with os odontoideum combined with cervical spondylotic canal stenosis, both of which require surgical treatment. We report one case of a 75-year-old female who underwent arthrodesis between the occiput and C3 using a hook-and-rod system and also a double-door laminoplasty from levels C3 to C7. The claw mechanism was applied between the C2 lamina and the C3 inferior articular process. The posterior atlantoaxial subluxation was completely reduced by the method that the rod gradually pushed the posterior arch of C1 anteriorly during connection to the occiput. Twelve months after surgery, the patient showed improvement in preoperative clumsiness and gait disturbance, and the latest plain radiographs showed solid osseous fusion, with no loss of correction or instrumentation failure.

Hirabayashi, Shigeru; Yamada, Hironobu; Kobayashi, Yousuke; Sekiya, Shigeki; Sakai, Hiroya

2007-01-01

208

Posterior atlantoaxial subluxation due to os odontoideum combined with cervical spondylotic myelopathy: a case report.  

PubMed

In patients with os odontoideum and posterior atlantoaxial subluxation are extremely rare. No reports have described posterior atlantoaxial subluxation associated with os odontoideum combined with cervical spondylotic canal stenosis, both of which require surgical treatment. We report one case of a 75-year-old female who underwent arthrodesis between the occiput and C3 using a hook-and-rod system and also a double-door laminoplasty from levels C3 to C7. The claw mechanism was applied between the C2 lamina and the C3 inferior articular process. The posterior atlantoaxial subluxation was completely reduced by the method that the rod gradually pushed the posterior arch of C1 anteriorly during connection to the occiput. Twelve months after surgery, the patient showed improvement in preoperative clumsiness and gait disturbance, and the latest plain radiographs showed solid osseous fusion, with no loss of correction or instrumentation failure. PMID:18097691

Motosuneya, Takao; Hirabayashi, Shigeru; Yamada, Hironobu; Kobayashi, Yousuke; Sekiya, Shigeki; Sakai, Hiroya

2008-09-01

209

Bowel cancer and previous mesh surgery  

Microsoft Academic Search

We report two cases of large bowel cancer adjacent to mesh following previous abdominal sacrocolpopexy. As far as we are aware,\\u000a there have been no previous reports of bowel cancer associated with mesh either in the form of a rectal erosion or mesorectal\\u000a migration. In both cases, the mesh was part of the surgical field when operating for the large

Sapna Ahuja; Oliver Chappatte; Michael Thomas; Alistair Cook

2011-01-01

210

Small Bowel Ischemia due to Jejunum Volvulus in Pregnancy: A Case Report  

PubMed Central

The diagnosis of intestinal obstruction in pregnancy is difficult, as the symptoms may mimic pregnancy-associated complaints. The surgical management is challenging, as the mortality rate of midgut volvulus in pregnancy is high. We report the case of a 35-year-old woman at 21 weeks and 5 days of gestation with small bowel obstruction who presented to our institution with a 24?h history of colicky abdominal pain and nausea and who finally had a successful open repair.

Vassiliou, Ioannis; Tympa, Aliki; Derpapas, Michalis; Kottis, Georgios; Vlahos, Nikolaos

2012-01-01

211

First Report of Intestinal Myiasis Due To Eristalis tenax in Iran  

PubMed Central

Eristalis tenax, belonging to order Diptera, family Syrphidae seldomly causes intestinal myiasis. Intestinal myiasis caused by E. tenax larvae is a rare manifestation found in both humans and other vertebrate animals. We report a 22-year-old woman presented with this myiasis. The larva in her stool sample was identified as E. tenax related to its typical morphology and authentic clues. Lack of specific control measures in the domestic water supply system was the most probable cause of this infestation.

Youssefi, MR; Sefidgar, SAA; Tabari, M Abouhosseini

2010-01-01

212

First Report of Intestinal Myiasis Due To Eristalis tenax in Iran.  

PubMed

Eristalis tenax, belonging to order Diptera, family Syrphidae seldomly causes intestinal myiasis. Intestinal myiasis caused by E. tenax larvae is a rare manifestation found in both humans and other vertebrate animals. We report a 22-year-old woman presented with this myiasis. The larva in her stool sample was identified as E. tenax related to its typical morphology and authentic clues. Lack of specific control measures in the domestic water supply system was the most probable cause of this infestation. PMID:22347248

Youssefi, Mr; Sefidgar, Saa; Tabari, M Abouhosseini

2010-06-01

213

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

PubMed

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

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

2012-11-01

214

Anaesthetic Consideration in Macroglossia Due to Lymphangioma of Tongue: A Case Report  

PubMed Central

Summary Successful airway management of an infant or child with macroglossia prerequisites recognition of a potential airway problem. We describe our experience with a debilitated 13-year-old girl who presented with severe macroglossia, secondary to lymphangioma of the tongue. Along with the social discomfort she had inability to speak, eat or drink properly and exposure-induced dryness. Such patients are a challenge for the anaesthesiologists due to the anticipated difficult intubation associated with the oral mucosa occupying lesion. It also becomes pertinent to rule out any of the associated congenital anomalies. The importance of a thorough preoperative evaluation and attention to difficult intubation and maintenance of airway is emphasized. We endeavor to review the available literature regarding patient's perioperative management of such patients.

Tewari, Anurag; Munjal, Munish; Kamakshi; Garg, Shuchita; Sood, Dinesh; Katyal, Sunil

2009-01-01

215

Uterine inversion due to a leiomyoma on postpartum day 41: a case report.  

PubMed

Uterine leiomyomas are common tumors in women of reproductive age and are frequently detected during pregnancy. The major complications during pregnancy include abortion, preterm delivery, abruptio placentae, intrauterine growth retardation, dystocia, and postpartum hemorrhage. Little attention is given to uterine leiomyomas postpartum compared to leiomyomas prior to childbirth. In the present case, a 27-year-old woman, gravida 1 para 1, presented with massive vaginal bleeding, urinary retention and lower abdominal pain on postpartum day 41. She was diagnosed with uterine inversion due to leiomyoma. After a vaginal myomectomy, the uterus was re-placed with a combined vaginal and abdominal approach. Because of timely medical intervention, the patient managed to overcome the crisis and her reproductive organs were successfully preserved. PMID:21736668

Shirota, Kyoko; Ota, Takeharu; Tsujioka, Hiroshi; Miyamoto, Shingo

2011-07-01

216

[Case report of recurrent hydrocephalus due to uveo-meningeal syndrome].  

PubMed

A 43-year-old woman suffered from bilateral uveitis and was suspected of sarcoidosis. General fatigue slowly progressed, and urinary incontinence and disturbance of consciousness also developed. When she was admitted to our hospital by ambulance, her conciousness was disturbed, GCS 3-4-6. Enlargement of all ventricles was shown and cell count was moderately elevated. She underwent VP shunt and fully recovered. However, her activity become disturbed again and, after five months, only her left lateral ventricle dilated. We presumed it was caused by the occlusion of the foramen of Monro. Neuroendoscopic inspection of the right lateral ventricle via a left precoronal burrhole revealed a thick, yellish membrane that occluded the foramen of Monro. She received a left VP shunt and cured. She was diagnosed as having recurrent hydrocepalus due to the uveo-meningeal syndrome. We present this first case and discuss this syndrome associated hydrocephalus. PMID:17969335

Yamamoto, Yayoi; Suzuki, Kensuke; Yamazaki, Tomosato; Takano, Shingo; Matsumura, Akira

2007-10-01

217

Infections due to Achromobacter xylosoxidans. Case report and review of the literature.  

PubMed

Achromobacter xylosoxidans is an uncommon nosocomial pathogen known to cause many serious infections. A 69-year-old woman with diabetes mellitus and chronic renal failure was admitted with pulmonary edema. The patient developed fever and pulmonary infiltrate with bilateral pleural effusions while she was on a respirator in the intensive care unit. Culture of sputum, pleural fluid and blood grew A. xylosoxidans. Bilateral chest tubes were inserted and the patient was treated for one month with piperacillin and trimethoprim-sulfamethoxazole. Gradual response, both clinically and radiologically, was noted after prolonged therapy. A review of the literature on infections due to A. xylosoxidans, the unique susceptibility pattern of the organism to various antibiotics and the use of combination therapy in Achromobacter infections are discussed. PMID:3818105

Chandrasekar, P H; Arathoon, E; Levine, D P

1986-01-01

218

Ileocolic intussusception due to intestinal metastatic melanoma. Case report and review of the literature.  

PubMed

The small intestine is a frequent site of melanoma metastases and the most common cause of secondary intestinal tumors. Even though, its presentation with intestinal obstruction due to intussusception is very rare. We present a 47-year-old woman with a medical history of facial melanoma operated 17 years ago and recently diagnosed of cervical recurrence who complained of abdominal pain of one week duration accompanied with vomiting and abdominal distension. Computed tomography (CT) scan revealed marked distension of the small intestine with features suggesting intussusception of the distal ileum. At laparoscopic exploration a massive ileocolic intussusception was found with invagination of the last 60 cm of ileum inside the cecum and ascending colon. Surgical reduction revealed a tumor of approximately 2 cm in the distal end of the intussuscepted intestine acting as the lead point. Resection of non-viable ileum along with the tumor and end-to-end anastomosis was performed. Many other lesions of smaller size were found distantly in the proximal small bowel but were not treated. The patient had a full recovery and was discharged three days after surgery. Pathological examination showed metastatic melanoma and a positron emission tomography (PET) scan confirmed disseminated disease with brain metastasis. The patient died three months after surgery. Intestinal occlusion due to metastatic disease is a rare condition but should be taken into account particularly in patients with history of cancer. Surgical intervention with a mini-invasive laparoscopic approach is feasible. Intestinal resection and anastomosis is mandatory for either curative or palliative intentions providing a satisfactory treatment. PMID:22096701

Alvarez, Fernando A; Nicolás, Matías; Goransky, Jeremías; Vaccaro, Carlos A; Beskow, Axel; Cavadas, Demetrio

2011-01-01

219

Postoperative Bowel Perforation due to Heterotopic Ossification (Myositis Ossificans Traumatica): A Case Report and Review of the Literature  

PubMed Central

Heterotopic ossification (HO) is the ectopic development of normal bone within soft tissue that can occur after traumatic injury. It is uncommon and may be missed or misdiagnosed, which can lead to complications. We report the case of an 84-year-old male with a previous history of a laparotomy who underwent resection of an intra-abdominal tumor through a midline incision. On postoperative day six, the patient was taken to the operating room, as succus was draining from the incision. Upon re-exploration, sharp bone-like material was found in the wound directly adjacent to an enterotomy. Pathology confirmed mature lamellar bone and the diagnosis of HO. This is the first report of postoperative intestinal perforation secondary to HO in a midline wound. We report this case to encourage accurate reporting of HO and its morbidity and complications for the benefit of appropriate surgical planning and epidemiologic tracking of outcomes.

Lao, Victoria Valinluck; Lao, Oliver B.; Figueredo, Edgar

2011-01-01

220

Acute respiratory distress syndrome due to systemic lupus erythematosus with hemophagocytic syndrome: an autopsy report.  

PubMed

This report concerns a patient with systemic lupus erythematosus (SLE) who died of acute respiratory distress syndrome (ARDS) 1 day after the onset of pulmonary symptoms. Autopsy demonstrated severe hemophagocytosis in the bone marrow and histopathology indicating a marked increase in vascular permeability in both lungs and kidneys. In this patient, active SLE and associated hemophagocytic syndrome may have induced an increase in the production of inflammatory cytokines, which immediately induced ARDS. Since fatal ARDS can occur as a life-threatening complication of SLE, careful observation is necessary, particularly when there are clinical findings suggestive of associated hemophagocytic syndrome. PMID:15338452

Kaneko, Kazuma; Matsuda, Masayuki; Sekijima, Yoshiki; Hosoda, Waki; Gono, Takahisa; Hoshi, Kenichi; Shimojo, Hisashi; Ikeda, Shu-ichi

2005-04-01

221

Cardiovascular collapse due to right heart failure following ethanol sclerotherapy: a case report  

PubMed Central

Ethanol sclerotherapy for the treatment of low-flow vascular malformations can cause catastrophic cardiopulmonary complications, including pulmonary embolism and pulmonary hypertension, that can result in right heart failure and fatal arrhythmias, leading to death. We here report a case of abrupt cardiovascular collapse that developed immediately following ethanol sclerotherapy in 31-year-old female patient who had a large arteriovenous malformation in her leg. Anesthesiologists should be aware of the fatal cardiopulmonary complications that are associated with ethanol sclerotherapy and consider the use of invasive hemodynamic monitoring, such as pulmonary artery pressure monitoring, when large doses of ethanol are required.

Jo, Jun Young; Chin, Ji-Hyun; Park, Pyung Hwan

2014-01-01

222

[Gangrene of the penis due to strangulation by a rubber band : a case report].  

PubMed

We report a case of strangulation of the penis by a rubber band. A 79-year-old man placed a rubber band tightly around the corona of his glans penis in order to prevent urinary incontinence. After five days, he was taken to our hospital in an ambulance for high temperature and general malaise. We found the rubber band and removed it immediately. Gangrene of the penis continued and he did not recover from sepsis, so we performed partial penectomy. After the operation, he completely recovered. Penile strangulation using a soft constricting object such as a rubber band might result in severe complications and we should be careful. PMID:24759505

Sasaki, Yutaro; Oda, Shinpei; Fujikata, Shiro; Tanimoto, Shuji; Kan, Masaharu

2014-03-01

223

Recurrent laryngeal nerve palsy due to impacted dental plate in the thoracic oesophagus: case report  

PubMed Central

Background Retained oesophageal foreign bodies must be urgently removed to prevent potentially serious complications. Recurrent laryngeal nerve palsy is rare and has not been reported in association with a foreign body in the thoracic oesophagus. Case presentation We present a case of a dental plate in the thoracic oesophagus that caused high dysphagia. Delayed diagnosis led to a recurrent laryngeal nerve palsy, which persisted despite successful surgical removal of the foreign body. Conclusion Oesophagoscopy is essential to fully assess patients with persistent symptoms after foreign body ingestion, irrespective of the level of dysphagia. Recurrent laryngeal nerve palsy may indicate impending perforation and should prompt urgent evaluation and treatment.

Sutcliffe, Robert P; Rohatgi, Ashish; Forshaw, Matthew J; Mason, Robert C

2007-01-01

224

Massive lower gastrointestinal tract bleeding due to splenic artery aneurysm: a case report.  

PubMed

True aneurysm of the splenic artery is the third most common intraabdominal aneurysm and constitutes 60% of all visceral aneurysms. The incidence of splenic artery aneurysms ranges from 0.01% to as high as 10.4% in the elderly. In approximately 30% of cases, the aneurysm may rupture into a viscus. Aneurysmal rupture into the colon is a potentially fatal but extremely uncommon complication. We report a case of splenic artery aneurysm communicating with the descending colon, presenting as massive lower gastrointestinal tract bleeding. The patient was treated and survived the episode. In English literature, fewer than 15 cases have been described with only two patients surviving. PMID:17484977

Rao, Sanjiv; Sivina, Manuel; Willis, Irvin; Sher, Taimur; Habibnejad, Samira

2007-05-01

225

Fulminant neonatal sepsis due to Streptococcus alactolyticus -A case report and review.  

PubMed

Group D streptococci have rarely been associated with neonatal infections. We report a case of fulminant respiratory distress syndrome (RDS) caused by Streptococcus alactolyticus in a term neonate. Gram staining revealed gram-positive cocci and culture grew group D streptococci in samples taken from trachea, ear, and nasopharynx. Streptococcus alactolyticus was identified using automated microbial identification system (Vitek 2). Histopathology showed massive pulmonary inflammation with intra-alveolar granulocytosis and secondary pulmonary bleeding as etiology of fatal outcome. To our knowledge, this is first case presenting neonatal infection caused by Streptococcus alactolyticus. PMID:24475920

Toepfner, Nicole; Shetty, Sindhu; Kunze, Mirjam; Orlowska-Volk, Marzenna; Krüger, Markus; Berner, Reinhard; Hentschel, Roland

2014-07-01

226

Bilateral testicular self-castration due to cannabis abuse: a case report  

PubMed Central

Introduction The self-mutilating patient is an unusual psychiatric presentation in the emergency room. Nonetheless, serious underlying psychiatric pathology and drug abuse are important background risk factors. A careful stepwise approach in the emergency room is essential, although the prognosis, follow-up, and eventual rehabilitation can be problematic. We present a unique and original case of bilateral self-castration caused by cannabis abuse. Case Presentation We report a case of a 40-year-old Berber man, who was presented to our emergency room with externalization of both testes using his long fingernails, associated with hemodynamic shock. After stabilization of his state, our patient was admitted to the operating room where hemostasis was achieved. Conclusion The clinical characteristics of self-mutilation are manifold and there is a lack of agreement about its etiology. The complex behavior associated with drug abuse may be one cause of self-mutilation. Dysfunction of the inhibitory brain circuitry caused by substance abuse could explain why this cannabis-addicted patient lost control and self-mutilated. To the best of our knowledge, this is the first case report which presents an association between self-castration and cannabis abuse.

2011-01-01

227

Cutaneous vasculitis and reactive arthritis following respiratory infection due to Chlamydia pneumoniae: report of a case.  

PubMed

Unlike Chlamydia trachomatis and C. psittaci, the association of C. pneumoniae infection with immunological complications, such as reactive arthritis (ReA) or erythema nodosum (EN) has been rarely reported. Here we present the case history of a patient with C. pneumoniae community acquired pneumonia (CAP) who subsequently developed a ReA and a cutaneous vasculitis. A 45-year-old HLA B27 negative male developed an asymmetric and additive arthritis and a cutaneous leukocytoclastic vasculitis with IgM and complement papillary deposition along hypodermic vessel walls about three weeks after the onset of respiratory symptoms. The diagnosis of chronic Chlamydia pneumoniae infection was based on serology and PCR. Cultural and serological investigations for other infectious agents commonly involved in ReA were negative. This is the first report on the occurrence of two immune-based complications, associated to Chlamydia pneumoniae infection. Therefore, since this infection is very common in our population, although often asymptomatic, should be systematically considered as a common causative agent of ReA and of vasculitis. PMID:12508779

Cascina, A; Marone Bianco, A; Mangiarotti, P; Montecucco, C M; Meloni, F

2002-01-01

228

Hemifacial spasm due to cerebellopontine angle meningiomas--two case reports.  

PubMed

A 54-year-old female and a 49-year-old female presented with complaints of hemifacial spasm. Both patients underwent surgery to remove cerebellopontine angle meningiomas. In one case, no vascular compression was observed at the root exit zone. The tumor was removed subtotally leaving residual tumor adhered to the lower cranial nerves. The hemifacial spasm disappeared immediately after the operation. The residual tumor was treated using gamma knife radiosurgery. In the other case, the root exit zone of the facial nerve was compressed by both the tumor and anterior inferior cerebellar artery and the tumor was removed totally. Postoperatively, the hemifacial spasm disappeared, but the patient suffered facial nerve paresis and deafness that was probably due to intraoperative manipulation. However, the facial nerve paresis gradually improved. Cerebellopontine angle meningioma with hemifacial spasm must be treated by surgical resection limited to preserve cranial nerve function. Subtotal removal with subsequent radiosurgery to treat the remaining tumor tissue is one option for the treatment of cerebellopontine angle meningioma. PMID:11255633

Iwai, Y; Yamanaka, K; Nakajima, H

2001-02-01

229

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

PubMed

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

Hiraki, Akiyoshi; Kikuchi, Masahiro

2014-01-01

230

Brain injury due to air gun shot: report of three adult cases.  

PubMed

Air guns (AGs) are arms that use air or another compressed gas to propel a projectile. Generally, brain injury may occur in children due to their incomplete skull development; however, the less-resistant and thin region of the skull in adults may also be penetrated by an AG shot. In this paper, we present three adult cases treated in our clinic for brain injury caused by an AG. The first case had brain and skull damage related to the high pressure of the compressed gas, and the others additionally had foreign bodies in their brain. All of the patients were operated. Two were discharged without neurological deficit; the third case had a permanent slight hemiparesis. Average follow-up was 11 months and no abscess formation was observed in this period. AGs are known as low-velocity arms; however, they have the potential to cause brain injury, and brain penetration may occur especially in the relatively less resistant and thin sites of the skull such as the orbit and temporal and occipital bones. As cerebrospinal fluid leakage is one of the expected conditions, urgent surgery is usually required. PMID:21038129

Dalg?ç, Ali; Okay, Onder; Ergüngör, Fikret Mehmet; Uçkun, Ozhan; Nacar, Osman Ar?kan; Y?ld?r?m, Ali Erdem

2010-09-01

231

Defecation pain and coccydynia due to an anteverted coccyx: a case report  

PubMed Central

Introduction Defecation pain is a common problem with many etiologies implicated. Elucidating a cause requires a thorough medical history, examination and appropriate investigations, which may include endoscopy, barium enema, examination under anesthesia and magnetic resonance imaging or computed tomography. Coccydynia is a term used to describe pain in the region of the coccyx, often due to abnormal mobility of the coccyx. Non-surgical management options remain the gold-standard for coccydynia with surgery being reserved for complicated cases. Case presentation This is a case of a 67-year-old Caucasian man who presented with a two-and-a-half-year history of worsening rectal pain. Conclusion To the best of our knowledge, we describe the first case in the literature of an abnormally mobile anteverted coccyx causing predominantly defecation pain and coccydynia, successfully treated by coccygectomy. When first-line investigations fail to elucidate a cause of defecation pain one must, in the presence of unusual symptoms, consider musculoskeletal pathologies emanating from the coccyx and an orthopedic consultation must then be sought for diagnostic purposes.

2012-01-01

232

Recurrent adult jejuno-jejunal intussusception due to inflammatory fibroid polyp - Vanek's tumour: a case report  

PubMed Central

Background Adult intussusception is a rare but challenging condition. Preoperative diagnosis is frequently missed or delayed because of nonspecific or sub-acute symptoms. Case presentation We present the case of a sixty-two year old gentleman who initially presented with pseudo-obstruction. Computerised tomography displayed a jejuno-jejunal intussusception, which was treated by primary laparoscopic reduction. The patient re-presented with acute small bowel obstruction two weeks later. He underwent a laparotomy showing recurrent intussusception and required a small bowel resection with primary anastomosis. Histological examination of the specimen revealed that the intussusception lead point was due to an inflammatory fibroid polyp (Vanek’s tumour) causing double invagination. Conclusions Adult intussusception presents with a variety of acute, intermittent, and chronic symptoms, thus making its preoperative diagnosis difficult. Although computed tomography is useful in confirming an anatomical abnormality, final diagnosis requires histopathological analysis. Vanek’s tumours arising within the small bowel rarely present with obstruction or intussusception. The optimal surgical management of adult small bowel intussusception varies between reduction and resection. Reduction can be attempted in small bowel intussusceptions provided that the segment involved is viable and malignancy is not suspected. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7292185123639943

2014-01-01

233

[Case report: Löffler's syndrome due to Ascaris lumbricoides mimicking acute bacterial community--acquired pneumonia].  

PubMed

In this study we present a patient with Loeffler's syndrome caused by Ascaris lumbricoides who presented with the clinical findings of community-acquired pneumonia (CAP). Our patient, who was twenty-five years old, and who had had symptoms such as coughing, expectorating, dyspnea and fever for approximately ten days, was hospitalized. We auscultated polyphonic rhonchuses at the both hemithoraxes. A chest X-ray revealed bilateral lower zone patch consolidation. Acute bacterial community acquired pneumonia (CAP) was diagnosed due to these findings and empirical antibiotic treatment was begun. Repeated sputum Gram stains were negative, and both sputum and blood cultures were sterile. A sputum smear was negative for acid-fast bacilli. The patient's fever and respiratory complaint did not respond to the empirical antibiotics therapy. During the course of advanced investigations, we measured peripheric eosinophilia, and high levels of total Eo and total IgE, and observed Ascaris lumbricoides eggs during stool examination. The patient was given a diagnosis of Loeffler's syndrome. Thereupon the patient was treated successfully with one dose of albendazol 400 mg. In conclusion, we suggest that Loeffler's syndrome must be considered early in the differential diagnosis for CAP when peripheric eosinophilia is seen in patients if they live in an endemic area for parasitic disease. PMID:19851973

Acar, Ali; Oncül, Oral; Cavu?lu, Saban; Okutan, O?uzhan; Kartalo?lu, Zafer

2009-01-01

234

Hepatotoxicity due to tocilizumab and anakinra in rheumatoid arthritis: two case reports  

PubMed Central

Elevation of liver enzymes in patients with rheumatoid arthritis treated with the biological agents, tocilizumab and anakinra, is now well documented. However, histological characterization of these effects and outcomes has not been defined. Here we report toxic liver effects in two women with rheumatoid arthritis, refractory to all nonbiological therapies, following treatment with anakinra and tocilizumab. Liver biopsy in both cases showed focal necrosis of hepatocytes as a hallmark of drug toxicity, along with steatosis and early fibrosis. In addition, the patient treated with anakinra demonstrated inflammatory changes. Tocilizumab was continued with no further deterioration in liver function. Withdrawal of anakinra led to rapid normalization of liver function. The biological agents, tocilizumab and anakinra, may result in significant histological hepatic changes, including necrosis, but despite this, the outcome appears to be good.

Mahamid, Mahmud; Paz, Kalman; Reuven, Mader; Safadi, Rifaat

2011-01-01

235

Intestinal obstruction due to a left paraduodenal hernia: a case report  

PubMed Central

Introduction A left paraduodenal hernia is a rare congenital malrotational anomaly of the midgut that occurs in the paraduodenal fossa of Landzert to the left of the fourth duodenum. It is responsible for approximately 1% of small bowel obstructions. Case presentation We report a case of left paraduodenal hernia combined with small bowel obstruction in a 47-year-old Mediterranean woman who had a history of recurrent abdominal pain. An abdominal computed tomography scan showed a saclike mass clustered in the left upper quadrant but failed to yield a clear diagnosis. We describe the surgical anatomy of this disease and the emergency surgical management together with a short review of the literature. Conclusions Even though a left paraduodenal hernia is rare, it must be suspected in any upper intestinal occlusion. The high morbidity and mortality rate of complicated cases should motivate preventive treatment in case of incidental operative discovery.

2013-01-01

236

Drug overdose due to malfunction of a patient-controlled analgesia machine -A case report-  

PubMed Central

Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future.

Yi, Yuri; Kang, Seongsik

2013-01-01

237

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

SciTech Connect

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.

Griffin, O.M.

1982-01-13

238

Asymptomatic elevation of liver enzymes due to levetiracetam: a case report.  

PubMed

Levetiracetam is a commonly used broad-spectrum anticonvulsant efficacious in both partial and generalized seizures. It has an extremely favorable side effect profile with few drug-drug interactions, low potential for hematological and hepatic toxicity, and thus has rapidly become the preferred drug in patients with traumatic brain injuries who need seizure prophylaxis. We report, here, a patient who was started on levetiracetam for seizure prophylaxis after developing large bifrontal-parietal traumatic subdural hematomas (SDH) following a fall from a horse necessitating bifrontal craniotomies for evacuation. The patient developed an asymptomatic elevation of the liver enzymes. The liver enzymes trended back to normal after levetiracetam was stopped, and topiramate was initiated in its place. PMID:23420283

Sethi, Nitin K; Sethi, Prahlad K; Torgovnick, Josh; Arsura, Edward; Cukierwar, Frances

2013-01-01

239

Pulmonary hypertension due to presence of isolated partial anomalous pulmonary venous connection: A case report.  

PubMed

Anomalous pulmonary venous return is an uncommon congenital malformation which can be broadly categorized into partial or total, of which the former is more common. The anomaly is considered to be partial if some of the pulmonary veins drain into the systemic circulation and total if all the pulmonary veins drain into systemic circulation. Isolated partial anomalous pulmonary venous return (PAPVC) is an uncommon finding and is a very uncommon cause of pulmonary arterial hypertension. Whilst many patients with PAPVC remain asymptomatic, some may present at a later age with symptoms related to left-to-right shunt, pulmonary hypertension and right heart failure. We are presenting an interesting case report of an 18 years old patient who presented with exertional dyspnea and fatigue conforming to NYHA class II symptom status. Trans-esophageal echocardiography revealed isolated obstructive PAPVC as the cause for pulmonary hypertension without other demonstrable left-to-right shunts. PMID:24653588

Kumar, Tarun; Patra, Soumya; Ramalingam, Rangaraj; Agrawal, Navin; Agarwal, Ashish; Manjunath, Cholenahalli Nanjappa

2013-12-01

240

Functional and structural analysis of partial optic nerve avulsion due to blunt trauma: Case report  

PubMed Central

Partial optic nerve avulsion (ONA) secondary to finger gouging is an uncommon but devastating injury. A 21-year-old man who had an acute vision loss after accidentally getting poked by himself in his right eye when he fell down during jogging is reported. The patient was diagnosed with partial ONA. Magnetic resonance imaging revealed intact optic nerve. Optical coherence tomography (OCT) revealed deep cavity at the inferior-temporal half of the optic disc. Retinal nerve fiber layer thickness was also thin at the inferior quadrant with circumpapillary OCT scan. Visual field test and electrophysiological tests showed functional abnormality compatible with optic nerve lesion. Diagnostic tools for anatomical and functional evaluation may reveal the course of this injury.

Mumcuoglu, Tarkan; Durukan, Hakan A; Erdurman, Cuneyt; Hurmeric, Volkan; Gundogan, Fatih C

2010-01-01

241

Skin necrosis of scrotum due to endovascular embolisation: a case report.  

PubMed

The aim of our case report was to analyse the results obtained with the Matriderm® system and autologous skin grafting for the surgical treatment of skin necrosis of scrotum as a result of endovascular embolisation. We recruited one patient with scrotum skin necrosis as a result of endovascular embolisation admitted at the department of Plastic and Reconstructive Surgery, University of Rome 'Tor Vergata'. The patient underwent Matriderm® system and autologous skin grafting for skin necrosis treatment. After a single treatment, reduction of the skin necrosis was obtained, after 30 days from the surgical treatment. Patient experienced a reduction in pain and a complete restoration of the loss in volume and quality of skin was noticed. Matriderm® system and autologous skin grafting is a simple, safe and feasible technique. When comparing this treatment with others, Matriderm® is a simpler, more economic and less time-consuming method, and does not require sophisticated laboratory facilities. PMID:21883935

Cervelli, Valerio; Brinci, Lorenzo; Palla, Ludovico; Spallone, Diana; Izzo, Valentina; Curcio, Cristiano Beniamino; Lucarini, Lucilla; De Angelis, Barbara

2012-02-01

242

Drug-induced liver injury due to "natural products" used for weight loss: A case report  

PubMed Central

Taking herbal-extracts to lose weight is an underestimated health hazard. Often, these products contain active agents that can cause acute liver damage. In this case report, a 22-year-old female patient, who presented with a feature of cholestatic syndrome, was so sure that the “natural products” were not dangerous that she did not inform her physicians that she had taken them, making their task that much more challenging. Clinical presentation mimicked acute cholecystitis and the patient underwent a cholecystectomy. Surgery was without any consequences and complications, although it did not completely cure the illness. She later admitted to having taken herbal remedies and this led to the correct diagnosis of phytotherapy-related hepatotoxicity and a successful therapeutic approach. The true incidence of phytotherapy-related hepatotoxicity and its pathogenic mechanisms are largely unknown. It is important to increase the awareness of both clinicians and patients about the potential dangers of herbal remedies.

Tarantino, Giovanni; Pezzullo, Martina Gilda; Dario di Minno, Matteo Nicola; Milone, Francesco; Pezzullo, Luigi Sossio; Milone, Marco; Capone, Domenico

2009-01-01

243

[Rectal ulceration due to using the Fexi-Seal fecal management system: a case report].  

PubMed

The Flexi-Seal Fecal Management System is a device designed to offer improved care to critical care patients with fecal incontinence. Studies have proven the safety and effectiveness of the device, but there are scarce reports on the adverse events. This article presents two cases of critical care patients who developed complications associated with the use of the Flexi-Seal FMS. The System proved to be effective for the treatment; however, it requires special care in the handling, particularly regarding the periodical relief of pressure from the retention balloon and the correct positioning of the collection bag on the bed, so as to avoid excessive traction. The Flexi-Seal is useful to manage diarrhoea in critical patients, improving their well-being and reducing associated complications. Nevertheless, there is a need to improve knowledge related to the complications that may occur. PMID:22031391

Monge, Francisco Javier Carmona; Angorrilla, Irene Álvarez; Aguado, Elena Sánchez; Ruiz, Felisa Rodríguez

2011-10-01

244

Paraplegia due to recurrent multiple hydatid cyst of the spine: A case report  

PubMed Central

Recurrence after surgical treatment of hydatid cyst of the spine is extremely common. Preexisting fibrosis, fragility of the cyst wall, confluent cysts and proximity to vital structures makes radical excision difficult and repeated recurrences are inevitable. This case report describes a recurrent hydatid cyst presenting as three separate cysts in the dorsal spine in a middle-aged male. The extradural cyst caused paraplegia. The extraspinal cyst presented as an extrapleural mass in relation with the eighth, ninth and the tenth ribs near the costo-vertebral junction. The three cysts were resected en masse. Complete neurological recovery occurred with no recurrence at four years follow-up. Resection of the hydatid cyst en masse offers the best chance of cure and must be attempted in all cases. A prolonged chemotherapy should be administered in all cases.

Chaudhary, Kshitij; Bapat, Mihir; Badve, Siddharth

2008-01-01

245

Intractable epilepsy due to angiocentric glioma: A case report and minireview  

PubMed Central

The aim of this case report and minireview was to investigate the diagnosis of and therapeutic approaches for angiocentric glioma (AG) and to summarize the clinical manifestations and the pathological and imaging characteristics of the disease. Intraoperative cortical electroencephalogram (ECoG) monitoring was performed to locate the epileptic foci in a child with AG who presented with intractable epilepsy, prior to the total resection of the tumor being performed under the microscope. The clinical features, imaging characteristics, intraoperative conditions, surgical methods and pathological results were analyzed and compared with the literature. The review revealed that to date, the clinical features of the 52 reported cases of AG (including this case) have been mainly characterized by epilepsy. High T2-weighted image (WI) and fluid-attenuated inversion recovery (FLAIR) signals may be detected with magnetic resonance imaging (MRI) scanning of the cranium; however, no enhancement signals are detected by enhanced scanning. The prognosis following surgical resection is favorable. The lesions in the present case demonstrated clear boundaries with a central cystic affection accompanied by an arachnoid cyst on the left temporal pole. Pathological examination revealed that the lesion was positive for glial fibrillary acidic protein (GFAP), S-100 protein, vimentin, epithelial membrane antigen (EMA), cluster of differentiation 99 (CD99) and D2-40. The Ki-67/MIBk-1 labeling index was ~1%. In conclusion, AG exhibits characteristic features in imaging; however, its diagnosis depends on histopathological examination. The prognosis of total surgical resection is good and intraoperative ECoG may be used to assist positioning.

CHEN, GUOQIANG; WANG, LIN; WU, JINTING; JIN, YONGJIAN; WANG, XIAOSONG; JIN, YULAN

2014-01-01

246

First report of a human case of polycystic echinococcosis due to Echinococcus vogeli from neotropical area of Peru, South America.  

PubMed

We report a human case of polycystic hidatidosis due to Echinococcus vogeli from Contamana (Department of Loreto) village located in the central jungle of Peru. The patient is a 44 year-old lady, teacher, who carried a painless liver mass since a year ago. She was submitted to abdominal surgery and the liver mass was removed and showed multiple cysts containing colorless liquid as is showed in the polycystic hidatidosis. The morphology and measure of the hooks obtained from the liquid contained in the cysts are from Echinococcus vogeli. It is the first report of this parasitism in Perú. PMID:15057334

Somocurcio, José R; Sánchez, Elizabeth L; Náquira, César; Schilder, José; Rojas, Francisco; Chacón, Pedro; Yabar, Alejandro

2004-01-01

247

Idiopathic autoimmune hemolytic anemia due to lecithin overdose: a case report  

PubMed Central

Introduction Idiopathic Autoimmune Hemolytic Anemia is a potentially fatal condition which requires prompt and potent treatment. Diagnosis of idiopathic autoimmune hemolytic anemia requires both serologic evidence of autoantibody presence and hemolysis. Although most of the times it is considered idiopathic, several underlying causes have been identified, like autoimmune and connective tissue diseases, viral infections, drugs or hyper function of the immune system. To our knowledge, this is the first case in the international literature describing lecithin-induced autoimmune hemolytic anemia. Case Presentation This case report is to highlight a rare but dangerous adverse reaction to overdose of lecithin. A 38 year old white female from Greece, presented to our emergency room with progressive fatigue over a period of ten days and icteric discoloration of her skin and conjunctiva. The patient had been taking lecithin supplements (1200 mg, 3 capsules a day) over a period of ten days for weight loss. She reports that the last 3 days, prior to the examination, she took 5 capsules/day, so that the supplement would take effect more rapidly. Her past medical, social and family history showed no disturbance. Relatives of the patient were requested to submit any blood-tests taken over a period of 20 days prior to the onset of symptoms caused by Lecithin. All tests proved that all functions were within normal scale. Her physical examination revealed pallor and jaundice without palpable hepatosplenomegaly. Blood biochemistry tests showed total bilirubin 7.5 mg/dl, with indirect bilirubin 6.4 mg/dl and complete blood count showed hemoglobin 7.6 g/dl with blood levels 21.4%. Conclusion In every case of idiopathic autoimmune hemolytic anemia the administration of pharmaceutical substances should always be examined, except for the standard reasons that cause it. In this case the cause of hemolysis was attributed to the excessive intake of lecithin capsules for the loss of body weight. It is important that clinicians and immunologists are aware of this adverse effect.

2009-01-01

248

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

SciTech Connect

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.

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

1993-11-01

249

Life-threatening infection due to community-acquired methicillin-resistant Staphylococcus aureus : case report and review  

Microsoft Academic Search

We report an unusual case of serious, multifocal, invasive infection due to community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in a 10-year-old girl with favorable outcome. The child manifested femoral osteomyelitis, pyomyositis, deep femoral\\u000a vein thrombosis, pneumonia, encephalopathy, and disturbances of almost all organs. She remained in a critical condition for\\u000a a week. Fever persisted for 6 weeks and acute phase reactants remained

Kalomoira Kefala-Agoropoulou; Efthimia Protonotariou; Danai Vitti; Sofia Sarafidou; Athanasia Anastasiou; Konstantinos Kollios; Emmanuel Roilides

2010-01-01

250

Rhinocerebral mucormycosis due to Rhizopus oryzae in a diabetic patient: a case report.  

PubMed

Mucormycosis is an opportunistic fulminant fungal infection, which affects nose and paranasal sinuses by direct invasion or through the blood vessels mainly in diabetic and immunocompromised patients. In the present study, a rhino-orbito-cerebral mucormycosis in a 24-year-old female with diabetes mellitus as underlying disease was reported. Computed tomography (CT scan) demonstrated an increase in the soft tissue densities in the left nasal cavity, maxillary and ethmoid sinuses and destruction of the antral wall with soft tissue densities in the pterygopalatine fossa and retromaxillary fissure. In histopathology, wide ribbon-shape non-septate hyphae were seen in tissue sections stained with hematoxylin-eosin (H&E). The etiologic fungus isolated from tissue biopsy on mycological media was identified by the amplification and sequencing of the 5.8S RNA gene and of the adjacent internal transcriber spacer domains, ITS1/ITS4, as Rhizopous oryzae. Recognition of the unique patterns of this high mortality rhinocerebral fungal infection in patients with diabetes is a key to early diagnosis and successful treatment. PMID:23721995

Erami, M; Shams-Ghahfarokhi, M; Jahanshiri, Z; Sharif, A; Razzaghi-Abyaneh, M

2013-06-01

251

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

PubMed Central

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.

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

2014-01-01

252

Phytocontact Dermatitis due to Mustard Seed Mimicking Burn Injury: Report of a Case  

PubMed Central

Mustard seeds have been used in traditional folk medicine as a stimulant, diuretic, and purgative and to treat a variety of ailments including peritonitis and neuralgia. Mustards are still used today in mustard plasters to treat rheumatism, arthritis, chest congestion, aching back, and sore muscles. To make a mustard plaster, mix equal parts of flour and powdered mustard and spread it as a paste on a doubled piece of soft cloth. Apply mustard plaster to the affected area for a maximum of 15 minutes. Prolonged application can result in burns to the skin and nerve damage. Skin lesions occur within hours after exposure, and there is no significant therapy procedure. This case report is about a patient with second-degree burn, occurred when a mixture including mustard seed was exposed to her skin in the pain therapy of the osteoarthritis in her left knee. There are no studies analyzing treatment of skin burns induced by mustard seed in the literature. While in this type of burns our experience is limited, we think that conservative approach should be first choice of treatment.

Yabanoglu, Hakan; Akbulut, Sami; Karakayali, Feza

2012-01-01

253

Death due to bioterrorism-related inhalational anthrax: report of 2 patients.  

PubMed

On October 9, 2001, a letter containing anthrax spores was mailed from New Jersey to Washington, DC. The letter was processed at a major postal facility in Washington, DC, and opened in the Senate's Hart Office Building on October 15. Between October 19 and October 26, there were 5 cases of inhalational anthrax among postal workers who were employed at that major facility or who handled bulk mail originating from that facility. The cases of 2 postal workers who died of inhalational anthrax are reported here. Both patients had nonspecific prodromal illnesses. One patient developed predominantly gastrointestinal symptoms, including nausea, vomiting, and abdominal pain. The other patient had a "flulike" illness associated with myalgias and malaise. Both patients ultimately developed dyspnea, retrosternal chest pressure, and respiratory failure requiring mechanical ventilation. Leukocytosis and hemoconcentration were noted in both cases prior to death. Both patients had evidence of mediastinitis and extensive pulmonary infiltrates late in their course of illness. The durations of illness were 7 days and 5 days from onset of symptoms to death; both patients died within 24 hours of hospitalization. Without a clinician's high index of suspicion, the diagnosis of inhalational anthrax is difficult during nonspecific prodromal illness. Clinicians have an urgent need for prompt communication of vital epidemiologic information that could focus their diagnostic evaluation. Rapid diagnostic assays to distinguish more common infectious processes from agents of bioterrorism also could improve management strategies. PMID:11722269

Borio, L; Frank, D; Mani, V; Chiriboga, C; Pollanen, M; Ripple, M; Ali, S; DiAngelo, C; Lee, J; Arden, J; Titus, J; Fowler, D; O'Toole, T; Masur, H; Bartlett, J; Inglesby, T

2001-11-28

254

Bilateral L5 Radiculopathy Due to Osteoporotic L1 Vertebral Fracture: A Case Report  

PubMed Central

Background: The true incidence of osteoporotic vertebral fractures is not well defined because many osteoporotic vertebral fractures are asymptomatic. Although the true incidence of neurological compromise as a result of osteoporotic vertebral fractures is not known, it is thought to be low. In this case report, we present a case of L1 osteoporotic vertebral fracture causing bilateral L5 nerve root compression and manifestation of bilateral foot-drop. Methods: Pedicle screws were inserted in the vertebrae, 2 above and 2 below the L1 vertebra. A temporary rod was placed on the left. An L1 right hemilaminectomy via a posterior approach and a corpectomy were performed. The spinal cord was decompressed. Anterior fusion was carried out by placing titanium mesh cage into the vertebrectomy site as a strut graft via posterior approach, and posterolateral fusion with spongious allografts were added to the procedure. Results: Two years later the patient was completely symptom free and receiving medical treatment for osteoporosis, which was diagnosed as primary type. Conclusion: If a fracture is detected on the posterior wall of the vertebral body in computerized tomography (CT) examination with plain radiographs, a magnetic resonance imaging (MRI) examination should be conducted in the presence of symptoms and physical findings suggestive of neurological compression. Follow-up neurological examinations should be carried out, and it should be kept in mind that most of the neurological symptoms may develop late and manifest as radiculopathy. The majority of the osteoporotic vertebral fractures can be managed conservatively with bed rest and orthosis, but cases with accompanying neurological deficit should be managed surgically using decompression and stabilization by fusion and instrumentation.

Tezer, Mehmet; Ozturk, Cagatay; Erturer, Erden; Aydogan, Mehmet; Hamzaoglu, Azmi

2006-01-01

255

Bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by infected pressure ulcer: case report and review of the literature.  

PubMed

CONTEXT Coagulase-negative staphylococci are common colonizers of the human skin and have become increasingly recognized as agents of clinically significant nosocomial infections. CASE REPORT The case of a 79-year-old male patient with multi-infarct dementia who presented systemic inflammatory response syndrome is reported. This was attributed to bacteremia due to Staphylococcus cohnii ssp. urealyticus, which was grown on blood cultures originating from an infected pressure ulcer. The few cases of Staphylococcus cohnii infection reported in the literature consist of bacteremia relating to catheters, surgical prostheses, acute cholecystitis, brain abscess, endocarditis, pneumonia, urinary tract infection and septic arthritis, generally presenting a multiresistant profile, with nearly 90% resistance to methicillin. CONCLUSIONS The reported case is, to our knowledge, the first case of true bacteremia due to Staphylococcus cohnii subsp. urealyticus caused by an infected pressure ulcer. It shows that this species may be underdiagnosed and should be considered in the differential diagnosis for community-acquired skin infections. PMID:23538597

Soldera, Jonathan; Nedel, Wagner Luis; Cardoso, Paulo Ricardo Cerveira; d'Azevedo, Pedro Alves

2013-03-01

256

Validity of Caregivers' Reports on Head Trauma Due to Falls in Young Children Aged Less than 2 Years  

PubMed Central

Objective: The clinical presentations of head trauma due to falls among young children aged less than 2 years are controversial, particularly in Japan, as the history of trauma recounted by a caretaker is not always reliable. The purpose of this study was to assess the validity of caregiver’s reports on head trauma due to falls in young children aged less than 2 years in Japan. Methods: All patients <2 years of age presenting with head trauma resulting from a fall who were admitted to 3 children’s hospitals in Japan from January 2001 to December 2005 were retrospectively reviewed (N = 58). The clinical presentations were compared among groups categorized by the heights from which the patient fell (short (?120 cm) or long (>120 cm)) and the surface on which the patient landed (carpet, tatami (Japanese mattress), hardwood floor, or concrete). Results: Patients who suffered short falls were more likely to present with subdural hemorrhage (SDH) than those who suffered long falls (74% and 40%, respectively, P = 0.027). More specifically, 62% of short falls showed SDH indicative of shaken baby syndrome (e.g. multilayer SDH). Neurological symptoms, cyanosis, and SDH were more commonly observed in patients who landed on carpeted or tatami surfaces than in those who landed on hardwood or concrete floors. Conclusions: Short falls and landing on soft surfaces resulted in the presentation of severer clinical symptoms than did long falls and landing on hard surfaces, suggesting that the validity of caretakers’ reports on infant or young children’s head trauma due to falls is low. Further research is warranted to investigate the cause of infant head trauma due to falls.

Fujiwara, Takeo; Nagase, Hiroaki; Okuyama, Makiko; Hoshino, Takahiro; Aoki, Kazunori; Nagashima, Tastuya; Nakamura, Hajime

2010-01-01

257

Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review  

PubMed Central

Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000?mL fluid in the collecting system of the kidney mimicking an ascites in an adult male.

Tazi, Mohammed Fadl; Riyach, Omar; Ahallal, Youness; Mellas, Soufiane; Khallouk, Abdelhak; El Fassi, Mohammed Jamal; Farih, Moulay Hassan

2012-01-01

258

Traumatic spigelian hernia due to handlebar injury in a child: a case report and review of literature.  

PubMed

Traumatic abdominal wall hernia is a rare clinical entity despite the high incidence of blunt abdominal trauma. In children, traumatic abdominal wall injury can occur even after minor trauma without any associated intra-abdominal injury. We report a case of Spigelian hernia due to a handlebar injury in a male child of 9 years, who came for treatment 5 weeks after the injury. Ultrasonography confirmed the clinical diagnosis of traumatic Spigelian hernia. The case was taken up for open surgery and anatomical repair was done with prolene. The patient had an uneventful postoperative course. PMID:24426630

Thakur, Sudhir Kumar; Gupta, Salabh; Goel, Saurabh

2013-06-01

259

Isolated angioedema of the bowel due to C1 esterase inhibitor deficiency: a case report and review of literature  

PubMed Central

Introduction We report a rare, classic case of isolated angioedema of the bowel due to C1-esterase inhibitor deficiency. It is a rare presentation and very few cases have been reported worldwide. Angioedema has been classified into three categories. Case presentation A 66-year-old Caucasian man presented with a ten-month history of episodic severe cramping abdominal pain, associated with loose stools. A colonoscopy performed during an acute attack revealed nonspecific colitis. Computed tomography of the abdomen performed at the same time showed a thickened small bowel and ascending colon with a moderate amount of free fluid in the abdomen. Levels of C4 (< 8 mg/dL; reference range 15 to 50 mg/dL), CH50 (< 10 U/mL; reference range 29 to 45 U/ml) and C1 inhibitor (< 4 mg/dL; reference range 14 to 30 mg/dL) were all low, supporting a diagnosis of acquired angioedema with isolated bowel involvement. Our patient's symptoms improved with antihistamine and supportive treatment. Conclusion In addition to a detailed comprehensive medical history, laboratory data and imaging studies are required to confirm a diagnosis of angioedema due to C1 esterase inhibitor deficiency.

2011-01-01

260

When algorithms falter: a case report of a very small melanoma excised due to the dermatoscopic "ugly duckling" sign  

PubMed Central

We present a case report of a 3.5 mm diameter superficial spreading melanoma on the upper back of a 27-year-old woman, signed out as Clark level 2, Breslow thickness 0.2 mm with regression to 0.45 mm. The patient, with Fitzpatrick type 1 skin and minimal actinic damage, had presented for a routine skin check with no previous history of skin cancers. At the age of 17 she had received chemotherapy and radiotherapy for Ewing’s sarcoma of the right hip with pulmonary metastases. The skin lesion was assessed as dermatoscopically symmetrical and was not predicted as a melanoma by any algorithmic method. The provisional diagnosis of melanoma was made on the basis that this lesion was completely different in dermatoscopic pattern to her other nevi, a dermatoscopic “ugly duckling” lesion. We draw attention to the recently established link between defects in the STAG2 gene and Ewing’s sarcoma, glioblastoma and melanoma.

Inskip, Mike; Magee, Jill; Weedon, David; Rosendahl, Cliff

2013-01-01

261

Prolonged hypothermia due to olanzapine in the setting of renal failure: a case report and review of the literature.  

PubMed

Temperature dysregulation is an infrequent but previously documented adverse effect of antipsychotic medications. The majority of documented cases involve durations of hypothermia of less than 24 h. We present the case of a patient on therapeutic olanzapine for bipolar disease with dehydration from gastroenteritis leading to acute kidney injury in the setting of stage III chronic kidney disease, who presented with severe hypothermia of 31.2°C (88.2°F). He required active rewarming in the intensive care unit for a total of 9 days. This is the second case report of prolonged hypothermia from olanzapine in the setting of kidney disease. Clinicians should be aware that patients with renal dysfunction may be at increased risk for prolonged hypothermia from olanzapine. PMID:24294486

Kansagra, Ankit; Patel, Sanket; Wilcox, Susan Renee

2013-12-01

262

Massive hemoptysis and complete unilateral lung collapse in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome: a case report  

PubMed Central

Background We report an extremely rare case of massive hemoptysis and complete left-sided lung collapse in pregnancy due to pulmonary tuberculosis in a health care worker with good maternal and fetal outcome. Case presentation A 33-year-old human immuno deficiency virus seronegative African health care worker in her fourth pregnancy with two previous second trimester miscarriages and an apparently healthy daughter from her third pregnancy presented coughing up copious amounts of blood at 18 weeks and two days of gestation. She had a cervical suture in situ for presumed cervical weakness. Computed tomography of her chest showed complete collapse of the left lung; subsequent bronchoscopy was apparently normal. Her serum ?-human chorionic gonadotropin, tests for autoimmune disease and echocardiography were all normal. Her lung re-inflated spontaneously. Sputum for acid alcohol fast bacilli was positive; our patient was commenced on anti-tuberculosis medication and pyridoxine. At 41 weeks and three days of pregnancy our patient went into spontaneous labor and delivered a live born female baby weighing 2.6 kg with APGAR scores of nine and 10 at one and five minutes respectively. She and her baby are apparently doing well about 10 months after delivery. Conclusion It is possible to have massive hemoptysis and complete unilateral lung collapse with spontaneous resolution in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome.

2013-01-01

263

Hypercortisolaemia due to ectopic adrenocorticotropic hormone secretion by a nasal paraganglioma: a case report and review of the literature  

PubMed Central

Background Adrenocorticotropic hormone-producing extraadrenal paragangliomas are extremely rare. We present a case of severe hypercortisolemia due to ectopic adrenocorticotropic hormone secretion by a nasal paraganglioma. Case presentation A 70-year-old Caucasian woman was emergently admitted to our department with supraventricular tachycardia, oedema of face and extremities and hypertensive crisis. Initial laboratory evaluation revealed severe hypokalemia and hyperglycemia without ketoacidosis, although no diabetes mellitus was previously known. Computed tomography revealed a large tumor obliterating the left paranasal sinus and a left-sided adrenal mass. After cardiovascular stabilisation, a thorough hormonal assessment was performed revealing marked adrenocorticotropic hormone-dependent hypercortisolism. Due to the presence of a cardiac pacemaker magnetic resonance imaging of the hypophysis was not possible. [68Ga-DOTA]-TATE-Positron-Emission-Tomography was performed, showing somatostatin-receptor expression of the paranasal lesion but not of the adrenal lesion or the hypophysis. The paranasal tumor was resected and found to be an adrenocorticotropic hormone-producing paraganglioma of low-proliferative rate. Postoperatively the patient became normokaliaemic, normoglycemic and normotensive without further need for medication. Genetic testing showed no mutation of the succinatdehydrogenase subunit B- and D genes, thus excluding hereditary paragangliosis. Conclusion Detection of the adrenocorticotropic hormone source in Cushing’s syndrome can prove extremely challenging, especially when commonly used imaging modalities are unavailable or inconclusive. The present case was further complicated by the simultaneous detection of two tumorous lesions of initially unclear biochemical behaviour. In such cases, novel diagnostic tools - such as somatostatin-receptor imaging - can prove useful in localising hormonally active neuroendocrine tissue. The clinical aspects of the case are discussed and relevant literature is reviewed.

2013-01-01

264

Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus: report of a case and review of Myroides infections.  

PubMed

The genus Myroides comprises aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods formerly classified as Flavobacterium odoratum. Members of the genus are widely distributed in the environment, especially in water, and usually behave as low-grade opportunistic pathogens, having been found to cause urinary tract infection, endocarditis, ventriculitis, and cutaneous infections in severely immunocompromised patients. We report a case of soft tissue infection, septic shock, and pneumonia due to M. odoratimimus in an immunocompetent male. To our knowledge, this is the first description of life-threatening infection caused by this organism in an immunocompetent host. We have also reviewed the medical literature on the genus Myroides. PMID:21246247

Benedetti, P; Rassu, M; Pavan, G; Sefton, A; Pellizzer, G

2011-04-01

265

Sudden cardiac arrest due to subtotal absence of left-sided pericardium--case report and review of the literature.  

PubMed

Congenital absence of the pericardium is a very rare cardiac malformation, usually diagnosed fortuitously on autopsy or surgery. Symptoms related to these abnormalities are usually benign, and fatalities reported in the literature are almost exclusively secondary to herniation of the heart through a partial defect. We present the unusual case of a 44-year-old woman admitted for sudden cardiac arrest. Initial evaluation suggested acute anterior myocardial infarction, but further investigation ruled out coronary heart disease. No arrhythmia could be initiated on electrophysiological study, and absence of most of the left pericardium was confirmed by cardiac magnetic resonance imaging. After the exclusion of common etiologies such as idiopathic ventricular fibrillation, transient great vessel torsion due to hypermobility of the heart with secondary malignant arrhythmia was considered to be the most likely mechanism for the sudden cardiac arrest. A review of the available literature on clinical presentation, diagnostic tools, and therapeutic options is also presented. PMID:22698265

Steinberg, Christian; Pelletier, Marie-Josée; Perron, Jean; Kumar, Andreas; Champagne, Jean

2013-01-01

266

Thyroid carcinoma and primary amenorrhea due to Mayer-Rokitansky-K?ster-Hauser syndrome: a case report  

PubMed Central

Introduction This case report describes an association between an exceptionally rare congenital anomaly and differentiated thyroid carcinoma. Mayer-Rokitansky-Küster-Hauser syndrome is characterized by vaginal aplasia associated with other Müllerian duct abnormalities. Its penetrance varies, as does the involvement of other organs. The association with thyroid carcinoma appears to be exceptionally rare, and warrants further attention. Case presentation We present the case of a 19-year-old Caucasian woman with amenorrhea and thyroid disease, with an unusually late diagnosis of gynecological abnormality. Management of her amenorrhea included investigation for congenital anomalies, including Mayer-Rokitansky-Küster-Hauser syndrome. Endocrine evaluation included a detailed analysis of sex hormone levels and thyroid function. The results of a physical examination and neck ultrasonography revealed abnormalities of the thyroid gland, which led to a diagnosis of thyroid cancer. To the best of our knowledge, thyroid cancer has not previously been reported in association with Mayer-Rokitansky-Küster-Hauser syndrome. However, genetic links between Mayer-Rokitansky-Küster-Hauser syndrome and thyroid cancer have not been investigated. The association may therefore be coincidental. Conclusions All women with primary amenorrhea should undergo complete investigation of the genital tract and the endocrine axis. Careful examination of the thyroid gland is recommended.

2012-01-01

267

Irreducible dislocation of the thumb interphalangeal joint due to displaced flexor pollicis longus tendon: case report and new reduction technique.  

PubMed

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

Naito, Kiyohito; Sugiyama, Yoichi; Igeta, Yuka; Kaneko, Kazuo; Obayashi, Osamu

2014-08-01

268

Lower Gastrointestinal Bleeding due to Non-Steroid Anti-Inflammatory Drug-Induced Colopathy Case Report and Literature Review  

PubMed Central

The adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal (GI) tract and small intestine are well established. The effect of such therapy on the large intestine, so called NSAID-induced colopathy, is less well described. NSAID-induced colopathy usually involves the right colon due to a higher concentration of the drug at this site, but the rectum may also be involved. NSAIDs possibly damage the normal large intestine, which presents as ulceration, colitis and stricture. Even though several studies found that NSAIDs can cause diverticular bleeding and perforation, flare-up of inflammatory bowel disease ,and play a role as an etiologic factor in lymphocytic colitis. Inflammatory bowel diseases , malignancy and infectious colitis must be ruled out before establishing the diagnosis of NSAID –induced colopathy. Discontinuation of the offending drug is mandatory. Here, we have reported the case of a 43-year-old female, NSAID user due to low back pain, who was admitted to the hospital with painless hematochezia.

Mokhtare, Marjan; Valizadeh, Seyed Mohammad; Emadian, Omid

2013-01-01

269

Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst  

PubMed Central

Background: Tuberculous peritonitis (TBP) is a well-known complication of ventriculo-peritoneal (VP) shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM). However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported. Case Description: A 21-year-old male presented with nausea, abdominal pain, and headache. VP and cysto-peritoneal (CP) shunts had been inserted to treat hydrocephalus due to a suprasellar arachnoid cyst, replaced the VP and removed the CP in his childhood. Computed tomography demonstrated acute hydrocephalus and an abdominal pseudocyst surrounding the distal end of the peritoneal tube. Initial laboratory data showed elevated white blood cell count and C-reactive protein level, but no causative pathogen was identified. External drainage of cerebrospinal fluid (CSF) and of the fluid in the peritoneal cyst was established, and empirical antibiotic therapy was initiated. Bacterial cultures eventually revealed Mycobacterium tuberculosis infection, and TBP was diagnosed. The patient responded well to antituberculosis (anti-TB) agents and insertion of a ventriculo-pleural shunt. Conclusion: This case highlights the possibility of CSF shunt failure and concomitant neurological sequelae from TB infection even when the pathogen has not invaded the central nervous system, as in TBM. Moreover, TBP is rare in developed countries and therefore may be misdiagnosed because of nonspecific clinical features and low sensitivity of common TB screening methods.

Takase, Hajime; Tatezuki, Junya; Ikegaya, Naoki; Yamamoto, Daisuke; Hashimoto, Mizuki; Takagi, Makoto; Mochimatsu, Yasuhiko; Kawahara, Nobutaka

2014-01-01

270

Therapeutic approach to "downhill" esophageal varices bleeding due to superior vena cava syndrome in Behcet's disease: a case report  

PubMed Central

Background One of the rare presentations of superior vena cava syndrome is bleeding of "downhill" esophageal varices (DEV) and different approaches have been used to control it. This is a case report whose DEV was eradicated by band ligation for the first time. Case presentation We report a 42-year-old man who is a known case of Behcet's disease. The patient's first presentation was superior vena cava syndrome due to thrombosis followed by bipolar ulcers and arthralgia. He received warfarin, prednisolone and azathioprine. The clinical course of the patient was complicated by one episode of hematemesis without abdominal pain when the patient's PT was in therapeutic range. After resuscitation and correction of PT with fresh frozen plasma transfusion, upper gastrointestinal endoscopy was done. Prominent varices were seen in the upper third of the esophagus, tapering to the middle part without acute bleeding. Stomach and duodenum were normal. Color ultrasonography evaluation of the portal, hepatic and splenic veins was negative for thrombosis. Band ligation was done and the patient's bleeding did not recur. Conclusion Band ligation is a safe and effective method for controlling DEV bleeding in patients with uncorrectable underlying disorders.

Tavakkoli, Hamid; Asadi, Mehrnaz; Haghighi, Mahshid; Esmaeili, Abbas

2006-01-01

271

Congenital Adrenal Hyperplasia due to 17-alpha-hydoxylase/17,20-lyase Deficiency Presenting with Hypertension and Pseudohermaphroditism: First Case Report from Oman.  

PubMed

This is the first report of congenital adrenal hyperplasia (CAH) due to combined 17?-hydroxylase/17,20 lyase deficiency in an Omani patient who was initially treated for many years as a case of hypertension. CAH is an uncommon disorder that results from a defect in steroid hormones biosynthesis in the adrenal cortex. The clinical presentation depends on the site of enzymatic mutations and the types of accumulated steroid precursors. A 22-year-old woman who was diagnosed to have hypertension since the age of 10 years who was treated with anti-hypertensive therapy was referred to the National Diabetes and Endocrine Centre, Royal Hospital, Oman. The patient also had primary amenorrhea and features of sexual infantilism. Full laboratory and radio-imaging investigations were done. Adrenal steroids, pituitary function and karyotyping study were performed and the diagnosis was confirmed by molecular mutation study. Laboratory investigations revealed adrenal steroids and pituitary hormones profile in addition to 46XY karyotype that are consistent with the diagnosis of CAH due to 17?-hydroxylase deficiency. Extensive laboratory workup revealed low levels of serum cortisol (and its precursors 17?-hydroxyprogesterone and 11-deoxycortisol), adrenal androgens (dehydroepiandrosterone sulfate and androstenedione), and estrogen (estradiol); and high levels of mineralocorticoids precursors (11-deoxycorticosterone and corticosterone) with high levels of ACTH, FSH and LH. Mutation analysis revealed CYP17A1-homozygous mutation (c.287G>A p.Arg96Gln) resulting in the complete absence of 17?-hydroxylase/17,20-lyase activity. The patient was treated with dexamethasone and ethinyl estradiol with cessation of anti-hypertensive therapy. A review of the literature was conducted to identify previous studies related to this subtype of CAH. This is the first biochemically and genetically proven case of CAH due to 17?-hydroxylase/17,20-lyase deficiency in Oman and in the Arab World described in the literature. PMID:24498484

Mula-Abed, Waad-Allah S; Pambinezhuth, Fathima B; Al-Kindi, Manal K; Al-Busaidi, Noor B; Al-Muslahi, Hilal N; Al-Lamki, Mohammad A

2014-01-01

272

Congenital Adrenal Hyperplasia due to 17-alpha-hydoxylase/17,20-lyase Deficiency Presenting with Hypertension and Pseudohermaphroditism: First Case Report from Oman  

PubMed Central

This is the first report of congenital adrenal hyperplasia (CAH) due to combined 17?-hydroxylase/17,20 lyase deficiency in an Omani patient who was initially treated for many years as a case of hypertension. CAH is an uncommon disorder that results from a defect in steroid hormones biosynthesis in the adrenal cortex. The clinical presentation depends on the site of enzymatic mutations and the types of accumulated steroid precursors. A 22-year-old woman who was diagnosed to have hypertension since the age of 10 years who was treated with anti-hypertensive therapy was referred to the National Diabetes and Endocrine Centre, Royal Hospital, Oman. The patient also had primary amenorrhea and features of sexual infantilism. Full laboratory and radio-imaging investigations were done. Adrenal steroids, pituitary function and karyotyping study were performed and the diagnosis was confirmed by molecular mutation study. Laboratory investigations revealed adrenal steroids and pituitary hormones profile in addition to 46XY karyotype that are consistent with the diagnosis of CAH due to 17?-hydroxylase deficiency. Extensive laboratory workup revealed low levels of serum cortisol (and its precursors 17?-hydroxyprogesterone and 11-deoxycortisol), adrenal androgens (dehydroepiandrosterone sulfate and androstenedione), and estrogen (estradiol); and high levels of mineralocorticoids precursors (11-deoxycorticosterone and corticosterone) with high levels of ACTH, FSH and LH. Mutation analysis revealed CYP17A1-homozygous mutation (c.287G>A p.Arg96Gln) resulting in the complete absence of 17?-hydroxylase/17,20-lyase activity. The patient was treated with dexamethasone and ethinyl estradiol with cessation of anti-hypertensive therapy. A review of the literature was conducted to identify previous studies related to this subtype of CAH. This is the first biochemically and genetically proven case of CAH due to 17?-hydroxylase/17,20-lyase deficiency in Oman and in the Arab World described in the literature.

Mula-Abed, Waad-Allah S.; Pambinezhuth, Fathima B.; Al-Kindi, Manal K.; Al-Busaidi, Noor B.; Al-Muslahi, Hilal N.; Al-Lamki, Mohammad A.

2014-01-01

273

Hemolytic disease of the newborn due to anti-jkb: case report and review of the literature.  

PubMed

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

Velasco Rodríguez, Diego; Pérez-Segura, G; Jiménez-Ubieto, A; Rodríguez, M A; Montejano, L

2014-06-01

274

Fatal Mycobacterium colombiense/cytomegalovirus coinfection associated with acquired immunodeficiency due to autoantibodies against interferon gamma: a case report  

PubMed Central

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.

2013-01-01

275

Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report  

PubMed Central

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.

2012-01-01

276

Hospital evacuations due to hazardous materials incidents  

Microsoft Academic Search

In a previous study 12 Washington State hospitals reported evacuations due to hazardous materials incidents. A telephone survey was conducted to further describe these incidents. Ten hospitals responded to the survey, including one institution reporting two incidents. The incidents included threatened explosions or releases in three cases and actual chemical exposures in eight cases. The actual exposures included irritant gases

Jefferey L Burgess

1999-01-01

277

Graft Duodenal Perforation due to Internal Hernia after Simultaneous Pancreas-Kidney Transplantation: Report of a Case  

PubMed Central

Although complications including graft thrombosis, graft pancreatitis, and rejection have been well documented after pancreas transplantation, the occurrence of graft duodenal perforation is uncommon. In this article, we report a case of graft duodenal perforation due to internal hernia after simultaneous pancreas-kidney transplantation (SPK). A patient with type I diabetes mellitus and diabetic nephropathy had undergone SPK from a cadaveric donor. One year later, she was admitted to our hospital for severe lower abdominal pain with preshock status. She was immediately examined by abdominal computed tomography and both peripancreas graft fluid accumulation and severe dilatation of the ileum were detected. On emergency operation, two punched holes located at the graft duodenal side near the suture line and an obstruction of herniated bowel behind the graft pancreas were detected. These holes were repaired and the internal hernia was reduced. However, a control of the intraabdominal infection was very difficult despite intensive treatment with antibiotics and additional abdominal drainage. Finally, a graft pancreatectomy was unavoidably required. When complications, including symptomatic intraabdominal infection, require re-laparotomy after pancreas transplantation, the therapeutic focus should be switched from salvaging the graft to the preservation of life.

Fumimoto, Yuichi; Tanemura, Masahiro; Hoshida, Yoshihiko; Nishida, Toshirou; Sawa, Yoshiki; Ito, Toshinori

2008-01-01

278

Obstructive uropathy due to prolapsed lower ureters and bladder in patients with severe procidentia: A report of two cases  

PubMed Central

INTRODUCTION Pelvic organ prolape is not uncommon in multi-parous or elderly women. It is one of the rare but important causes of obstructive uropathy. Herein, we report two cases of severe procidentia that were referred with obstructive uropathy due to prolapsed bladder and ureters. PRESENTATION OF CASE The first case was a 78-year-old woman, with severe pelvic organ prolape and secondary bilateral hydroureteronephrosis and post-renal failure. She was treated successfully by bilateral nephrostomy insertion and then pessary insertion. The second case was a 75-year-old woman who referred with the same presentation, but treated surgically with burch colposuspention and synchronous bilateral ureteral stent insertion. DISCUSSION Pelvic organ prolapse is not uncommon in old women. In addition to physical problems of procidentia, it may cause acute renal failure (ARF), chronic renal failure (CRF), and finally end stage renal disease (ESRD) if undiagnosed. CONCLUSION In every aged female case with obstructive uropathy and/or bilateral hydroureteronephrosis with unknown causes, gynecologic examination should be performed for early detection of possible pelvic organ prolapse. Appropriate management is necessary to prevent renal failure from uterine prolapse (UP).

Moslemi, Mohammad Kazem; Abedinzadeh, Mehdi; Nazari, Alireza

2013-01-01

279

Heroin Addicts Reporting Previous Heroin Overdoses Also Report Suicide Attempts  

ERIC Educational Resources Information Center

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…

Bradvik, Louise; Frank, Arne; Hulenvik, Per; Medvedeo, Alvaro; Berglund, Mats

2007-01-01

280

Laparoscopic cholecystectomy due to acute calculous cholecystitis in 16 weeks' in vitro fertilization and embryo transfer pregnancy: report of the first case.  

PubMed

The most common cases of acute abdomen during pregnancy are acute appendicitis followed by acute cholecystitis. The case presented is a 33-year-old patient in 16 weeks' in vitro fertilization and embryo transfer pregnancy who developed acute cholecystitis. Previously there were two unsuccessful cycles, one complicated with ovarian hyperstimulation syndrome. Due to clinical deterioration during intravenous antibiotic therapy laparoscopic cholecystectomy was performed and acute cholecystitis found. The postoperative course was uneventful. During the first 24 h tocolysis with intravenous fenoterol in addition to peroral atenolol 2 ? 50 mg was administered. Postoperative course was uneventful with further normal pregnancy. Elective cesarean section was made in term pregnancy (39 weeks) with singleton with Apgar 10/10. Current guidelines do not recommend prophylactic tocolysis in pregnant population with acute abdomen but there is no mention of the IVF-ET subpopulation of patients. Also, there are no guidelines for thromboprophylaxis in such patients with increased risk of thromboembolic accidents. To our knowledge this is the first case report of a laparoscopic cholecystectomy during IVF-ET gestation. PMID:23298928

Augustin, G; Vrcic, H; Zupancic, B

2012-01-01

281

Abnormality of the Foramen Spinosum due to a Variation in the Trajectory of the Middle Meningeal Artery: A Case Report in Human  

PubMed Central

Originating from the maxillary artery, the middle meningeal artery (MMA) is predominantly periosteal irrigating the bone and dura mater. It enters the floor of the middle cranial fossa through the foramen spinosum, travels laterally through a middle fossa bony ridge, and curves over the previous upper-greater wing of the sphenoid, where it in a variable point is divided into frontal and parietal branches. The complex sequence of the MMA development gives many opportunities for variant anatomy. In a Caucasian cadaver skull of an approximately 35-year-old individual belonging to the didactical collection of the Laboratory of Human Anatomy at the University of Santa Cruz do Sul, Brazil, it was noted that the right foramen spinosum has an abnormal shape. In this report, we discuss an abnormality of the foramen spinosum due to a variation in the trajectory of the MMA. Thus, the present study shall be important for health sciences and those who have some interest in pathologies associated with the MMA.

Ellwanger, Joel Henrique; Campos, Deivis de

2013-01-01

282

Lessons learned from previous dengue outbreaks  

PubMed Central

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.

Wiwanitkit, Viroj

2014-01-01

283

TESTING AND ANALYSIS OF CAP CONCRETE STRESS AND STRAIN DUE TO SHRINKAGE, CREEP, AND EXPANSION FINAL REPORT  

SciTech Connect

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.

Guerrero, H.; Restivo, M.

2011-08-01

284

National Coal Research Programme. Status Report of the Programme 'Air Pollution Due to the Emission of Coal Fired Installations'.  

National Technical Information Service (NTIS)

The goal of the National Coal Research Programme is the elimination of barriers to the reintroduction of coal in the Netherlands. The programme 'Air pollution due to the emission of coal fired installations' (Dutch abbreviation 'LUK') was initiated. The a...

1984-01-01

285

Alzheimer random walk model: two previously overlooked diffusion regimes.  

PubMed

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. PMID:23214629

Cressoni, J C; Viswanathan, G M; Ferreira, A S; da Silva, M A A

2012-10-01

286

Survival after prolonged resuscitation with 99 defibrillations due to Torsade De Pointes cardiac electrical storm: a case report  

Microsoft Academic Search

A 48-year-old previously healthy woman suffered witnessed cardiac arrest in hospital. She achieved return of spontaneous circulation and was transferred to the intensive care unit. During the following 3 hours, she suffered a cardiac electrical storm with 98 episodes of Torsade de Pointes ventricular tachycardia rapidly degenerating to ventricular fibrillation. She was converted with a total of 99 defibrillations. There

Anders Rostrup Nakstad; Christian Eek; Dag Aarhus; Anne Larsen; Kristina Hermann Haugaa

2010-01-01

287

[Successful control of hyper-cortisolemia due to ACTH-producing thyroid carcinoid by laparoscopic bilateral adrenalectomy : a case report].  

PubMed

A 22-year-old man was referred to our hospital because of facial edema and increasing body weight. Under the diagnosis of Cushing syndrome due to an adrenocorticotropic (ACTH)-producing thyroid tumor, thyroidectomy with regional lymph node dissection was performed. Histopathological diagnosis was thyroid carcinoid. In spite of the operation, serum ACTH and cortisol concentrations increased again due to mediastinal lymph node metastasis. His hyper-cortisolemia was resistant to drug therapy. Then, laparoscopic bilateral adrenalectomy was performed. After the operation, hyper-cortisolemia and clinical symptoms markedly improved. An additional chemotherapy is implemented because of new metastasis in the mediastinum lymph nodes. PMID:23945320

Kojima, Yuta; Kamimura, Noritaka; Yamamoto, Hayato; Murasawa, Hiromi; Okamoto, Akiko; Imai, Atsushi; Hatakeyama, Shingo; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Ohyama, Chikara

2013-07-01

288

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

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

Triggiani, Vincenzo; Guastamacchia, Edoardo; Lolli, Ivan; Troccoli, Giuseppe; Resta, Francesco; Sabbà, Carlo; Ruggieri, Nadia; Tafaro, Emilio

2006-01-01

289

First Case Report of Bloodstream Infection Due to a Candida Species Closely Related to the Novel Species Candida pseudorugosa  

PubMed Central

Candida pseudorugosa is a novel species closely related to Candida rugosa for which only one case has been reported. We report the first case of a bloodstream infection in humans caused by a Candida sp. closely related to C. pseudorugosa. We contribute evidence to show this organism as a potential human pathogen that may be misidentified by conventional methods, also pointing out its lower sensitivity to azoles and other antifungal agents.

Cordoba, Susana; Isla, Guillermina; Fernandez, Norma; Garcia, Susana; Mazza, Mariana; Murisengo, Omar Alejandro; Vivot, Walter; Szusz, Wanda; Davel, Graciela; Tiraboschi, Iris Nora; Bosco-Borgeat, Maria Eugenia

2012-01-01

290

Acute-on-chronic liver failure due to thiamazole in a patient with hyperthyroidism and trilogy of Fallot: case report  

Microsoft Academic Search

BACKGROUND: Thiamazole is a widely used antithyroid agent that has been approved for the treatment of hyperthyroidism. Although thiamazole-induced hepatotoxicity is a main side effect, it may progress to liver failure in a very few cases. CASE PRESENTATION: We described a 24-year-old patient with hyperthyroidism and trilogy of Fallot, who developed liver failure due to thiamazole. Liver biopsy showed intrahepatic

Chuan Shen; Cai-Yan Zhao; Fang Liu; Ya-Dong Wang; Jun Yu

2010-01-01

291

Responsibility for reporting patient death due to hospital error in Japan when an error occurred at a referring institution.  

PubMed

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

Maeda, Shoichi; Starkey, Jay; Kamishiraki, Etsuko; Ikeda, Noriaki

2013-12-01

292

[Remission due to CYVADIC chemotherapy of primary leiomyosarcoma derived from mesentelium of the sigmoid colon: a case report].  

PubMed

We report a case of leiomyosarcoma of mesenthelium origin, which was successfully treated with a combination of cyclophosphamide, vincristine, adriamycin and dacarbazine (CYVADIC). A 56-year-old woman received three courses of adjuvant CYVADIC chemotherapy after initial surgery consisting of tumorectomy, sigmoidectomy, descending colostomy, cystectomy and ureterostomy. A six-month disease-free period was attained obtained. A recurrent tumor showed remarkable reduction after three courses of CYVADIC chemotherapy. This case may be the first report of successful chemotherapy against a leiomyosarcoma of mesenthelium origin in Japan. PMID:10500540

Takano, M; Kita, T; Kikuchi, Y; Nagata, I

1999-09-01

293

Arthroscopic decompression of an entrapped suprascapular nerve due to an ossified superior transverse scapular ligament: a case report  

Microsoft Academic Search

INTRODUCTION: Suprascapular neuropathy is an uncommon cause of shoulder pain and weakness and therefore is frequently misdiagnosed. As a consequence, misdiagnosis can include inappropriate conservative treatment or unsuccessful surgical procedure. CASE PRESENTATION: A rare case is reported of a 54-year-old woman who suffered from suprascapular nerve entrapment syndrome. The patient was subjected to arthroscopy of the left shoulder, where a

Neoptolemos N Sergides; Dimitrios D Nikolopoulos; Euangelos Boukoros; George Papagiannopoulos

2009-01-01

294

Cantharidin Poisoning due to Blister Beetle Ingestion in Children: Two case reports and a review of clinical presentations.  

PubMed

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

Al-Binali, Ali M; Shabana, Medhat; Al-Fifi, Suliman; Dawood, Sami; Shehri, Amer A; Al-Barki, Ahmed

2010-08-01

295

Extensive chronic xanthogranulomatous intra-abdominal inflammation due to Mycoplasma hominis mimicking a malignancy: a case report  

Microsoft Academic Search

INTRODUCTION: While infectious peritonitis is a common occurrence in patients with liver cirrhosis, Mycoplasma is rarely identified as a causative agent. CASE PRESENTATION: We report the case of a 43-year-old Caucasian woman presenting with an extensive abdominal conglomerate tumor mimicking malignancy. A histologic specimen showed a xanthogranulomatous inflammation. Subsequently, Mycoplasma hominis was identified as the specific causative infectious agent using

Luc Biedermann; Dominik J Schaer; Matteo Montani; Rudolf Speich; Beat Müllhaupt

2009-01-01

296

Angioplasty in acute middle cerebral artery stroke due to atrial fibrillation selected by CT perfusion: a case report  

PubMed Central

We report the experience of a case of acute stroke in a patient affected by Rendu Osler syndrome and atrial fibrillation. The combination of dynamic computerized tomography perfusion scans and the use of a high-compliance balloon allowed increasing the treatment window for intra-arterial recanalization over 6 h after stroke onset in a patient with middle cerebral artery occlusion.

2011-01-01

297

Primary Purulent Pericarditis with Cardiac Tamponade due to Oropharyngeal Polymicrobial Infection: A Case Report and Literature Review  

PubMed Central

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.

Yost, Gregory; Good, Christopher W; White, Charles F; Nepal, Hitekshya

2014-01-01

298

Primary Purulent Pericarditis with Cardiac Tamponade due to Oropharyngeal Polymicrobial Infection: A Case Report and Literature Review.  

PubMed

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy. PMID:24782969

Bhatarai, Mukul; Yost, Gregory; Good, Christopher W; White, Charles F; Nepal, Hitekshya

2014-04-01

299

Sciatica and Incomplete Paraplegia After Spontaneous Haematoma of the Spinal Cord Due to a Cumarine - Induced Coagulopathy: Case Report  

PubMed Central

Spontaneous spinal haematoma is a rare cause of sciatica. We present a case of a 73 year old patient, who was admitted to our department and suffered from spontaneous sciatica over 24 hours. During the examination, the patient presented undulating symptoms of paraplegia, varying from incomplete loss of power in the left lower limb to complete plegia. The patient presented multiple diseases like biological aortic valve replacement, diabetes, hypertonia in her medical history, etc. Due to an additional absolute arrhythmia she ingested a cumarine medication. The tomographic imaging revealed a spontaneous lumbar and cranial subarachnoidal haematoma.

Artner, Juraj; Leucht, F; Schulz, C; Cakir, B

2012-01-01

300

Survival after prolonged resuscitation with 99 defibrillations due to Torsade De Pointes cardiac electrical storm: a case report.  

PubMed

A 48-year-old previously healthy woman suffered witnessed cardiac arrest in hospital. She achieved return of spontaneous circulation and was transferred to the intensive care unit. During the following 3 hours, she suffered a cardiac electrical storm with 98 episodes of Torsade de Pointes ventricular tachycardia rapidly degenerating to ventricular fibrillation. She was converted with a total of 99 defibrillations. There was no response to the use of any recommended anti arrhythmic drugs. However, the use of bretylium surprisingly stabilized her heart rhythm and facilitated placing of a temporary pacemaker. Overdrive pacing prevented further arrhythmias and was life saving. A number of beneficial factors may have contributed to the good neurological outcome. Further investigations gave no explanation for her cardiac electrical storm. PMID:20137096

Nakstad, Anders Rostrup; Eek, Christian; Aarhus, Dag; Larsen, Anne; Haugaa, Kristina Hermann

2010-01-01

301

BIOPSY PROVEN ACUTE TUBULAR NECROSIS DUE TO RHABDOMYOLYSIS IN A DENGUE FEVER PATIENT: A CASE REPORT AND REVIEW OF LITERATURE  

PubMed Central

Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.

Repizo, Liliany P.; Malheiros, Denise M.; Yu, Luis; Barros, Rui T.; Burdmann, Emmanuel A.

2014-01-01

302

Extensive chronic xanthogranulomatous intra-abdominal inflammation due to Mycoplasma hominis mimicking a malignancy: a case report  

PubMed Central

Introduction While infectious peritonitis is a common occurrence in patients with liver cirrhosis, Mycoplasma is rarely identified as a causative agent. Case presentation We report the case of a 43-year-old Caucasian woman presenting with an extensive abdominal conglomerate tumor mimicking malignancy. A histologic specimen showed a xanthogranulomatous inflammation. Subsequently, Mycoplasma hominis was identified as the specific causative infectious agent using a broad-range (eubacterial) polymerase chain reaction. To the best of our knowledge, this is the first reported case of an intra-abdominal Mycoplasma infection presenting as a conglomerate tumor. Conclusion An unusual presentation of an inflammatory process in the abdomen or an insufficient response to conventional therapy should prompt clinicians to consider atypical infectious agents in the differential diagnosis. This case illustrates the potential of newer diagnostic methods, since certain fastidious microorganisms may not be diagnosed and treated appropriately using conventional means.

2009-01-01

303

Exsanguinating upper GI bleeds due to Unusual Arteriovenous Malformation (AVM) of stomach and spleen: a case report  

PubMed Central

Background In this paper we are reporting one case of exsanguinating upper gastrointestinal tract (GIT) bleed requiring massive blood transfusion and immediate life saving surgery. Case presentation A 30 years old female, 12 weeks pregnant was referred to our hospital from the earth-quake affected area of Kashmir with history of upper abdominal pain, haematemesis and melaena for one week. After stabilizing the patient, upper gastro-intestinal endoscopy was performed. It revealed gastric ulcer just distal to the gastro-esophageal junction on the lesser curvature. Biopsy from the ulcer edge led to profuse spurting of the blood and patient went into state of shock. Immediate resuscitation led to rebleeding and recurrence of post haemorrahagic shock. Conclusion The patient was immediately explored and total gastrectectomy with splenectomy concluded as life saving procedure. A review of literature was conducted to make this report possible.

Khan, Mohammad Iqbal; Baqai, Muhammad Tariq; Baqai, Mohammad Fahd; Mufti, Naveed

2009-01-01

304

Diabetes insipidus due to herpes encephalitis in a patient with diffuse large cell lymphoma. A case report.  

PubMed

The major causes of central diabetes insipidus are neoplastic or infiltrative lesions of the hypothalamus or pituitary, severe head injuries and pituitary or hypothalamic surgery. Central diabetes insipidus caused by viral infections has been rarely reported in immunosuppressed patients, such as those with acquired immunodeficiency syndrome or Cushing's syndrome. We report the case of a 48-year-old woman suffering from diffuse large cell lymphoma, who developed hypotonic polyuria, hypernatriaemia and somnolence after the first course of chemotherapy with CHOEP and rituximab. Diabetes insipidus was diagnosed by low urine osmolarity and an undetectable vasopressin concentration. MRI revealed no pituitary abnormalities but encephalitis, and lumbar punction confirmed herpes zoster infection. To the best of our knowledge this is the first description of central diabetes insipidus in a lymphoma patient caused by an opportunistic CNS-infection. PMID:16450314

Scheinpflug, K; Schalk, E; Reschke, K; Franke, A; Mohren, M

2006-01-01

305

Biopsy proven acute tubular necrosis due to rhabdomyolysis in a dengue fever patient: a case report and review of literature.  

PubMed

Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures. PMID:24553615

Repizo, Liliany P; Malheiros, Denise M; Yu, Luis; Barros, Rui T; Burdmann, Emmanuel A

2014-01-01

306

Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus : report of a case and review of Myroides infections  

Microsoft Academic Search

The genus Myroides comprises aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods formerly classified as Flavobacterium odoratum. Members of the genus are widely distributed in the environment, especially in water, and usually behave as low-grade opportunistic\\u000a pathogens, having been found to cause urinary tract infection, endocarditis, ventriculitis, and cutaneous infections in severely\\u000a immunocompromised patients. We report a case of soft tissue infection,

P. Benedetti; M. Rassu; G. Pavan; A. Sefton; G. Pellizzer

2011-01-01

307

Acute abdomen due to spontaneous splenic rupture as the first presentation of lung malignancy: a case report  

PubMed Central

Introduction Spontaneous splenic rupture is well recognized in the context of hematological malignancies (lymphoproliferative and myeloproliferative disorders); a few case reports have also linked solid tumors, such as pancreatic and liver cancer, with the occurrence of spontaneous splenic rupture. This is the first case report of lung cancer as a likely cause of spontaneous splenic rupture. Case presentation A 61-year-old Caucasian woman presented to our hospital with non-specific symptoms. She developed an 'acute' abdomen and went into a state of shock within twelve hours of her presentation. She was diagnosed with spontaneous splenic rupture with radiology and following a laparotomy. She made an uneventful recovery postoperatively and was simultaneously found to have a bronchial adenocarcinoma. Conclusion Spontaneous splenic rupture is a potentially fatal but often unrecognized cause of acute abdomen. It should be routinely considered in the differential diagnosis of acute ('surgical') abdomen and when present it should be promptly dealt with, most commonly with a laparotomy. Once the diagnosis is confirmed there should be an aggressive drive to identify an underlying etiology; malignancy is the commonest culprit. Solid tumors should be considered as underlying causes despite being less common than hematological neoplasms. This case report demonstrates lung malignancy as an underlying precipitating cause of spontaneous splenic rupture.

2011-01-01

308

Delayed diagnosis of an atypical rupture of an unscarred uterus due to assisted fundal pressure: a case report  

PubMed Central

Introduction Although rare, rupture of an unscarred uterus is one of the most dangerous obstetric complications, resulting in maternal and fetal jeopardy. Case presentation A 30-year-old grand multiparous Turkish woman without any history of uterine surgery gave birth vaginally at 37 weeks of gestation with fundal pressure applied in the second stage of labor. Transabdominal sonography performed 32 hours after delivery due to postural hypotension and a drop in hemoglobin values in the postpartum period revealed massive intra-abdominal free fluid. On emergency laparotomy, serosal rupture of the uterus on the left posterior side was observed. She underwent a subtotal hysterectomy and did well postoperatively. Conclusion Postural hypotension in postpartum patients without any evident vaginal bleeding may be an early sign of possible uterine rupture, even if the vital signs are stable. Early diagnosis is important if maternal morbidity and mortality are to be decreased.

Kolusari, Ali; Yildizhan, Recep; Adali, Ertan; Sahin, Hanim Guler

2009-01-01

309

Septic shock due to community-acquired Pseudomonas aeruginosa necrotizing fasciitis: A case report and literature review  

PubMed Central

Necrotizing fasciitis is a rare but fatal infection, characterized by the rapid progression of necrosis of the fascia, skin, soft tissue and muscle. The most common bacteria associated with necrotizing fasciitis is group A streptococcus, although other pathogens have also been implicated. In the present study, a case of community-acquired necrotizing fasciitis, complicated with septic shock and multiple organ dysfunction syndromes due to Pseudomonas aeruginosa, is presented. Despite intensive medical treatment, the condition of the patient deteriorated rapidly and the patient subsequently succumbed to multiple organ failure. In view of the rapid progression and high mortality rate of this disease, early surgery, as well as novel therapeutic approaches for septic shock are required to improve the outcome for patients.

ZHAO, GUANG-JU; HONG, GUANG-LIANG; LIU, JIE-QUAN; LU, YANG; LU, ZHONG-QIU

2014-01-01

310

[Upper tract urothelial carcinoma associated with giant hydronephrosis due to ligation of a ureter: a case report].  

PubMed

A 73-year-old woman was referred to our hospital with a complaint of left lumbar backache. Computed tomography (CT) revealed left giant hydronephrosis containing high-density fluid suspected of hemorrhage in the renal pelvis and swelling of cervical and mediastinal lymph nodes. Positron emission tomography (PET)-CT showed a small high uptake lesion in the left kidney parenchyma, and cervical and mediastinal lymph nodes. Percutaneous pelvic puncture yielded discharge of hemorrhagic fluid with negative cytology. Preoperative diagnosis was left giant hydronephrosis due to ligation of a left ureter at uterine myomectomy 43 years ago with renal hemorrhage caused by recent back injury, and cervical and mediastinal lymph node involvement of unknown origin. Because severe lumbar backache persisted, we performed palliative left nephrectomy and biopsy of cervical lymph nodes. The pathological diagnosis was invasive urothelial carcinoma with squamous differentiation and lymph node involvement. PMID:24759501

Kuromoto, Akito; Namiki, Shunichi; Satake, Yohei; Yamashita, Shinichi; Mitsutzuka, Koji; Saito, Hideo; Kaiho, Yasuhiro; Arai, Yoichi

2014-03-01

311

Critical pulmonary infection due to nontuberculous mycobacterium in pediatric leukemia: report of a difficult diagnosis and review of pediatric series.  

PubMed

Nontuberculous mycobacterial infections are rare but severe complications of chemotherapy in children. In children with prolonged lymphopoenia after mieloablative regimens, symptoms can be nonspecific and fever and pulmonary impairment are the most common clinical features. Diagnosis is challenging for physicians and microbiologists and often requires invasive techniques. We report a girl affected by acute lymphoblastic leukemia, who developed a disseminated infection sustained by Mycobacterium avium complex. Identification of the microorganism was obtained by open lung biopsy and evidence of mycobacterium genome. We also reviewed 15 literature cases of disseminated infections of nontuberculous mycobacterium in children with leukemia. PMID:23528901

Arlotta, Annalisa; Cefalo, Maria G; Maurizi, Palma; Ruggiero, Antonio; Dodi, Icilio; Riccardi, Riccardo

2014-01-01

312

"Mushroom cloud": a giant left ventricular pseudoaneurysm after a myocardial infarction due to myocardial bridging - a case report  

PubMed Central

Left ventricular pseudoaneurysm is an uncommon complication after transmural myocardial infarction, occurring when a free wall rupture is contained by adhesions of the overlying pericardium preventing acute tamponade. In this report, an unusual case of a 61 year-old male with a giant apical left ventricular pseudoaneurysm after an unnoticed myocardial infarction is presented. On coronary angiogram myocardial bridging of the distal left anterior descending artery was judged to be the infarct related lesion. The echocardiographic diagnosis allowed for a timely surgical intervention which resulted in the patient's full recovery.

Gomes, Renata; Andrade, Maria Joao; Santos, Miguel; Lima, Sonia; Gouveia, Raquel A; Ferreira, Manuel M; Silva, Jose Aniceto

2009-01-01

313

Babesiosis due to the canine Babesia microti -like small piroplasm in dogs - first report from Portugal and possible vertical transmission  

Microsoft Academic Search

Background  Canine babesiosis (or piroplasmosis) is endemic in northern Portugal, but molecularly confirmed cases of infection with small\\u000a piroplasms have not been reported in the country. Three German shepherd dogs - a bitch and its 2-month old pup and an unrelated\\u000a male - clinically suspected of piroplasmosis were assessed for babesial infection.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Parasitemia with small piroplasms was detected by microscopy in

Paula Brilhante Simões; Luís Cardoso; Manuela Araújo; Yael Yisaschar-Mekuzas; Gad Baneth

2011-01-01

314

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

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

Jaiswal, Neeshma; Upadhyay, S K; Malhotra, Anshu; Blend, Charles K; Dronen, Norman O; Malhotra, Sandeep K

2014-01-01

315

Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report  

PubMed Central

Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.

2009-01-01

316

Subarachnoid hemorrhage after an ischemic attack due to a bacterial middle cerebral artery dissecting aneurysm: case report and literature review.  

PubMed

A 78-year-old woman suffered sudden-onset left hemiparesis. There were no remarkable infectious findings. Computed tomography (CT) demonstrated a low-intensity area supplied by the right middle cerebral artery (MCA). The diagnosis was cerebral ischemia and she was conservatively treated with hyperosmotic fluids. Two days after the ischemic stroke she suddenly became comatose. CT showed diffuse subarachnoid hemorrhage (SAH) in the basal cistern associated with a right intra-Sylvian and a right frontal subcortical hematoma. Three-dimensional (3D)-CT angiography demonstrated occlusion of the M2 portion of the right MCA. Four days after the ischemic onset she died of brain herniation. Autopsy revealed arterial dissection in the intermediate membrane of the right MCA bifurcation and occlusion of the M2 portion of the thrombosed right MCA. Gram staining showed remarkable bacterial infection in the thrombus. SAH after an ischemic attack due to MCA dissection is extremely rare. We suspect that bacterial infection was involved in the formation of her fragile dissecting aneurysm. PMID:24140774

Saito, Atsushi; Kawaguchi, Tomohiro; Hori, Emiko; Kanamori, Masayuki; Nishimura, Shinjitsu; Sannohe, Seiya; Kaimori, Mitsuomi; Sasaki, Tatsuya; Nishijima, Michiharu

2014-01-01

317

Autotransfusions of Previously Frozen Blood in Elective Gynecologic Surgery.  

National Technical Information Service (NTIS)

Autotransfusions of previously frozen red cells in patients undergoing elective gynecologic surgery are reported. When red cell volume and total circulating hemoglobin levels are used as criteria, a 4 week interval between the initial and second bleed pro...

T. A. Daane C. R. Valeri R. K. Barton

1969-01-01

318

Tourniquet failure during total knee replacement due to arterial calcification: case report and review of the literature.  

PubMed

Use of a tourniquet for performing surgery in order to create a bloodless surgical field and reduce blood loss has been in use for many years. Tourniquets may fail perioperatively for various reasons, leading to ongoing bleeding. An important cause of tourniquet failure is calcification of the underlying artery. A patient undergoing total knee replacement surgery in whom the tourniquet failed, secondary to femoral artery calcification is reported. The implications of tourniquet use in patients with arterial calcification, including acute distal ischaemia, aneurysm formation and vessel fracture will be discussed. Recommendations include: thorough vascular assessment of all patients preoperatively, awareness of the possibility of tourniquet failure particularly in vasculopaths, and the provision of an alternative perioperative management plan such as use of a cell saver device, should the tourniquet fail. PMID:20192092

Barr, Lynne; Iyer, Uma Shridhar; Sardesai, Anand; Chitnavis, Jai

2010-02-01

319

A Case Report of Iatrogenic Pulmonary Artery Injury due to Chest-Tube Insertion Repaired under Cardiopulmonary Bypass  

PubMed Central

The authors presented a case of a 50-year-old patient with multiple trauma who suffered from the inadvertent cannulation of the main pulmonary artery at the second attempt of left chest drainage. Pulmonary artery injury has been suspected because early chest tube production was 2300?mL of blood. CT scan showed injury of the trunk of the pulmonary artery, left hemothorax, and suspect damage of the right branch of the pulmonary artery. That chest tube touched the posterior wall of ascending aorta. Surgical approach was median sternotomy. Exploration showed a perforation of the trunk of pulmonary artery without lesion of the right pulmonary branch and the posterior wall of the ascending aorta. The lesion was repaired under normothermic partial cardiopulmonary bypass. Postoperative period was free of events. Review of the literatures for this rare case report has been done.

Gabriel, Ciss Amadou; Adama, Dieng Papa; Salmane, Ba Papa; Magaye, Gaye; Souleymane, Diatta; Mohamed, Leye; Lamine, Fall; Birame, Sene Etienne; Assane, N'diaye; Oumar, Diarra; Oumar, Kane; Mouhamadou, N'diaye

2013-01-01

320

Donepezil-induced cervical dystonia in Alzheimer's disease: a case report and literature review of dystonia due to cholinesterase inhibitors.  

PubMed

We herein report an 81-year-old woman with Alzheimer's disease (AD) in who donepezil, a cholinesterase inhibitor (ChEI), caused cervical dystonia. The patient had a two-year history of progressive memory disturbance fulfilling the NINCDS-ADRDA criteria for probable AD. Mini-Mental State Examination score was 19/30. The remaining examination was normal. After a single administration of donepezil (5 mg/day) for 10 months, she complained of dropped head. Neurological examination and electrophysiological studies supported a diagnosis of cervical dystonia. Antecollis disappeared completely at 6 weeks after cessation of donepezil. Dystonic posture can occur at various timings of ChEI use. Physicians should pay more attention to rapidly progressive cervical dystonia in ChEI-treated AD patients. PMID:24785894

Ikeda, Ken; Yanagihashi, Masaru; Sawada, Masahiro; Hanashiro, Sayori; Kawabe, Kiyokazu; Iwasaki, Yasuo

2014-01-01

321

Alveolar echinococcosis of liver presenting with neurological symptoms due to brain metastases with simultaneous lung metastasis: a case report.  

PubMed

Alveolar echinococcosis (AE) is a chronic and serious, even lethal, parasitic infection caused by the helminth Echinococcus multilocularis (EM). AE is an endemic disease in Turkey and it is particularly common in people living in the eastern Anatolia Region. In addition to various clinical presentations, symptoms which lead to diagnosis, however, are usually associated with the metastatic lesions. We herein reported a 62-year-old man who had liver alveolar hydatid disease with simultaneous lung and brain metastasis. We think there was only one therapeutic option, namely medical treatment with albendazol, which is the usual treatment for patients living in eastern Anatolia and who are admitted late resulting in a subsequent inoperable situation. Thus, radiological screening studies for the public in this region may increase the possibility of surgical treatment for alveolar hydatid disease. PMID:19156614

Aydinli, Bülent; Aydin, Unal; Yazici, Pinar; Oztürk, Gürkan; Onba?, Omer; Polat, K Yalçin

2008-01-01

322

Life-threatening hypersplenism due to idiopathic portal hypertension in early childhood: case report and review of the literature  

PubMed Central

Background Idiopathic portal hypertension (IPH) is a disorder of unknown etiology and is characterized clinically by portal hypertension, splenomegaly, and hypersplenism accompanied by pancytopenia. This study evaluates the pathogenic concept of the disease by a systematic review of the literature and illustrates novel pathologic and laboratory findings. Case Presentation We report the first case of uncontrolled splenic hyperperfusion and enlargement with subsequent hypersplenism leading to life-threatening complications of IPH in infancy and emergent splenectomy. Conclusions Our results suggest that splenic NO and VCAM-1, rather than ET-1, have a significant impact on the development of IPH, even at a very early stage of disease. The success of surgical interventions targeting the splenic hyperperfusion suggests that the primary defect in the regulation of splenic blood flow seems to be crucial for the development of IPH. Thus, beside other treatment options splenectomy needs to be considered as a prime therapeutic option for IPH.

2010-01-01

323

Fulminant systemic capillary leak syndrome due to C1 inhibitor deficiency complicating acute dermatomyositis: a case report  

PubMed Central

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.

2014-01-01

324

Primary cutaneous cryptococcosis in an immunocompetent patient due to Cryptococcus gattii molecular type VGI in Brazil: a case report and review of literature.  

PubMed

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 ? 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

Nascimento, Erika; Bonifácio da Silva, Maria Emília Nadaletto; Martinez, Roberto; von Zeska Kress, Marcia Regina

2014-07-01

325

Successful percutaneous treatment for massive hemorrhage due to infectious pseudoaneurysm in the abdominal wall after percutaneous endoscopic gastrostomy: a case report  

PubMed Central

Background Percutaneous endoscopic gastrostomy (PEG) is often performed for alimentation and to prevent weight loss in patients with feeding problems due to central neurologic diseases such as cerebral infarction or intracranial hemorrhage. Although infection at the skin site after PEG placement is a typical late complication of PEG, a ruptured infectious pseudoaneurysm caused massive bleeding adjacent to the tract is rare. Prompt treatment is required to avoid the hemorrhage shock, however surgical ligation is difficult to obtain the arrest of bleeding in damaged skin due to the infection. Case presentation A 70-year-old male was bedridden due a cerebral infarction suffered 1 year previously. APEG was placed because of feeding problems, and a push-type, 20-Fr gastrostomy tube was inserted through the anterior abdominal wall. On day 16 after PEG placement, the patient had massive bleeding from the PEG site due to the rupture of infectious pseudoaneurysm and developed a decreased level of consciousness and hypotension. Treatment by percutaneous direct injection of a mixture of n-butyl-cyanoacrylate (NBCA)-lipiodol was performed and achieved good hemostasis is obtained. Conclusions A rare case of an infectious pseudoaneurysm that developed in the abdominal wall and caused massive bleeding at a PEG placement site was described. Percutaneous injection of a mixture of n-butyl-cyanoacrylate (NBCA)-lipiodol under ultrasound guidance is an effective treatment in this case.

2014-01-01

326

Duplication of 20qter and deletion of 20pter due to paternal pericentric inversion: Patient report and review of 20qter duplications.  

PubMed

Duplications of the terminal long arm of chromosome 20 are rare chromosomal anomalies. We report a male infant found on array comparative genomic hybridization analysis to have a 19.5?Mb duplication of chromosome 20q13.12-13.33, as well as an 886?kb deletion of 20p13 at 18,580-904,299?bp. This anomaly occurred as the recombinant product of a paternal pericentric inversion. There have been 23 reported clinical cases involving 20qter duplications; however, to our knowledge this is only the second reported patient with a paternal pericentric inversion resulting in 46,XY,rec(20)dup(20q). This patient shares many characteristics with previously described patients with 20qter duplications, including microphthalmia, anteverted nares, long ears, cleft palate, small chin, dimpled chin, cardiac malformations, and normal intrauterine growth. While there is variable morbidity in patients with terminal duplications of 20q, a review of previously reported patients and comparison to our patient's findings shows significant phenotypic similarity. © 2014 Wiley Periodicals, Inc. PMID:24954807

Starr, Lois J; Truemper, Edward J; Pickering, Diane L; Sanger, Warren G; Olney, Ann Haskins

2014-08-01

327

Recurrent Meningitis and Subarachnoid Hemorrhage Due to Salmonella in an HIV+ Patient: Case Report and Mini-Review of the Literature.  

PubMed

Meningitis due to non-typhi salmonella is infrequent in HIV-positive adults.We report a case of a patient with >300 CD4+ cells/mm3 who presented with five episodes of recurrent meningitis, focal subarachnoid hemorrhage and cerebral vasculitis ultimately attributed to Salmonella choleraesuis infection. Even within the cART era invasive salmonellosis can occur in unusual ways in HIV-infected patients. PMID:21772932

Belloso, Waldo H; Romano, Marina; Greco, Graciela S; Davey, Richard T; Perelsztein, Ariel G; Sánchez, Marisa L; Ajzenszlos, Martín R; Otegui, Inés M

2011-01-01

328

Oncogenic osteomalacia, a rare paraneoplastic syndrome due to phosphate wasting--a case report and review of the literature.  

PubMed

An appropriate phosphate homeostasis is absolutely required for correct bone mineralization and remodeling, for diverse signaling pathways as well as cell membrane formation. Its disequilibrium results in serious complications like hypophosphatemia and excessively reduced fractional tubule phosphate reabsorption (TRP). A rare cause of such a disturbed phosphate balance is tumor-induced osteomalacia (TIO)--a phosphate wasting disorder sometimes associated with certain mesenchymal tumors. These primitive tumors secrete so-called phosphatonins--recently identified factors involved in the regulation of phosphate homeostasis such as the secreted frizzled related protein 4 (sFRP-4), the fibroblast growth factors 7 and 23 (FGF-7/-23), or the matrix extracellular phosphoglycoprotein (MEPE). Progressive muscular weakness and spontaneous bone fractures caused by inadequate osteoid mineralization are the characteristic clinical symptoms, which completely resolve after tumor resection. Here we report a new case of TIO caused by tumor secreted FGF-23 and review the literature to facilitate the correct diagnosis of this rare disorder. PMID:19000546

Woznowski, M; Quack, I; Stegbauer, J; Büchner, N; Rump, L C; Schieren, G

2008-11-01

329

Continuous intrathecal infusion of opioid and bupivacaine in the treatment of refractory pain due to postherpetic neuralgia: a case report.  

PubMed

This report details the course of a 77-year-old patient suffering mild pain from operated tongue cancer and excruciating, intractable pain from thoracic (T6-T8) post-herpetic neuralgia (PHN), The mouth pain was treated with nonopioid analgesics, as the patient had personal objections to opioid treatment. All the components of the pain from his PHN (continuous burning pain, intermittent lancinating stabbing pain, and tactile allodynia) were successfully treated with an Intrathecal Infusion of buprenorphine (0.03 mg/ml) and bupivacaine (4.75 mg/ml) administered via an externalized intrathecal catheter with the tip located at T9-T10 intervertebral disc. The treatment started three months after the appearance of the herpetic eruption and lasted 294 days until the patient died of malnutrition and the progression of his tongue cancer. During treatment, he experienced satisfactory pain relief from his PHN; the mean visual analogue scores (VASmean), recorded on a scale from 0 to 10, ranged from 1 to 2, compared to 9 to 10 before starting the intrathecal treatment. Analgesia was established with 0.2-0.315 mg/day of intrathecal buprenorphine and 90-100 mg/day of intrathecal bupivacaine. His undisturbed nocturnal sleep increased from 4 to 5-6 hours. The side-effects from the bupivacaine (urine retention requiring insertion of an indwelling urinary catheter, paresthesias, and mild pareses) were recorded. The patient could ambulate without support while on 90-100 mg/day of intrathecal bupivacaine. During a series of high-pressure oxygen treatments in a pressure chamber to treat an infection at the site of his tumor, the intrathecal infusion was interrupted. Thus, repeated observation of the intervals of severe pain and of analgesia were possible. PMID:22150940

Dahm, P; Nitescu, P; Appelgren, L; Curelaru, I

1998-04-01

330

Acute respiratory failure due to hemothorax after posterior correction surgery for adolescent idiopathic scoliosis: a case report  

PubMed Central

Background Although posterior correction and fusion surgery using pedicle screws carries the risk of vascular injury, a massive postoperative hemothorax in a patient with adolescent idiopathic scoliosis (AIS) is quite rare. We here report a case of a 12-year-old girl with AIS who developed a massive postoperative hemothorax. Case presentation The patient had a double thoracic curve with Cobb angles of 63° at T2-7 and 54° at T7-12. Posterior correction and fusion surgery was performed using a segmental pedicle screw construct placed between T2 and T12. Although the patient's respiration was stable during the surgery, 20 minutes after removing the trachea tube, the patient’s pulse oximetry oxygen saturation suddenly decreased to 80%. A contrast CT scan showed a massive left hemothorax, and a drainage tube was quickly inserted into the chest. The patient was re-intubated and a positive end-expiratory pressure of 5 cmH2O applied, which successfully stopped the bleeding. The patient was extubated 4 days after surgery without incident. Based on contrast CT scans, it was suspected that the hemothorax was caused by damage to the intercostal arteries or branches during pedicle probing on the concave side of the upper thoracic curve. Extensive post-surgical blood tests, echograms, and CT and MRI radiographs did not detect coagulopathy, pulmonary or vascular malformation, or any other possible causative factors. Conclusion This case underscores the potential risk of massive hemothorax related to thoracic pedicle screw placement, and illustrates that for this serious complication, respiratory management with positive airway pressure, along with a chest drainage tube, can be an effective treatment option.

2013-01-01

331

SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study  

PubMed Central

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.

Randmaa, Maria; Martensson, Gunilla; Leo Swenne, Christine; Engstrom, Maria

2014-01-01

332

Habitual snoring in children with previous allergic sensitization.  

PubMed

Previous studies have reported a high prevalence of allergy in children with Habitual Snoring (HS), but the relationship between allergy in the early years of life and the subsequent development of this Sleep Disordered Breathing (SDB) is yet to be elucidated. The purpose of the present study was to determine the role of early, under 36 months of age, allergic sensitization to food (with or without sensitization to airborne allergens) in determining the development of HS 8-10 years after. One hundred and forty-eight children (10-14 years, mean age 12 years) with a history of food allergy were selected. Under the age of 36 months, atopic status was assessed by skin prick test for a panel of airborne and food allergens. Questionnaires filled in by parents were used to collect information on children's snoring and associated symptoms. HS was defined as snoring three or more times per week. At 1-3 years of age 54 children were positive to food allergens alone, and 94 were positive also to airborne allergens. After 8-10 years of life, when patients were aged between 10 and 14 years, habitual snoring was reported in 37 children. Furthermore, among the 54 children under three years of age sensitized only to food, 8 became HS while of the 94 children sensitized to both food and inhalants allergens 29 developed HS. The difference between those two groups was statistically significant (p=0.04). We reported a significant risk of developing HS in children with early allergic sensitization. Specifically this risk was higher when food allergy was associated with inhalant allergy. The onset of upper airway inflammation due to allergic triggers in subjects under three years of age may be related to the subsequent development of SDB after 8-10 years. PMID:23755775

Zicari, A M; Occasi, F; Cesoni Marcelli, A; Lollobrigida, V; Celani, C; Indinnimeo, L; Tancredi, G; De Castro, G; Duse, M

2013-01-01

333

Microvascular Reconstruction After Previous Neck Dissection  

Microsoft Academic Search

Background: Microvascular reconstruction of defects in the head and neck is more challenging in patients who have undergone a previous neck dissection, owing to prior resection of potential cervical recipient blood vessels used for free flap perfusion. Objective: To evaluate the reliability and safety of free flap reconstruction in patients with previous neck dis- section. Patients and Methods: Sixty free

Christian Head; Joel A. Sercarz; Elliot Abemayor; Thomas C. Calcaterra; Jeffrey D. Rawnsley; Keith E. Blackwell

2002-01-01

334

Hepatotoxicity due to troglitazone: report of two cases and review of adverse events reported to the United States Food and Drug Administration  

Microsoft Academic Search

Two patients (a 48-year-old woman and a 62-year-old man) developed clinical and laboratory signs of hepatotoxicity due to troglitazone (Rezulin), a thiazolidinedione used in treatment of diabetes mellitus. There was no clear clinical evidence of drug allergy, although the woman experienced colitis before the onset of recognized hepatotoxicity. Liver biopsies showed bridging necrosis and fibrosis in the woman and hepatitis

James Kohlroser; Jijy Mathai; James Reichheld; Barbara F. Banner; Herbert L. Bonkovsky

2000-01-01

335

Delivery after previous cesarean: a risk evaluation  

Microsoft Academic Search

Objective: To examine the risks of vaginal delivery after previous cesarean and to find criteria to help decide whether a trial of labor or an elective repeat cesarean should be preferred.Methods: We evaluated 29,046 deliveries after previous cesarean registered in a pooled database of 457,825 deliveries used to assess quality control in gynecology and obstetrics departments in Switzerland.Results: Among the

J. Christoph Rageth; Claudia Juzi; Heidi Grossenbacher

1999-01-01

336

Case report of a neonate with ocular toxoplasmosis due to congenital infection: estimation of the percentage of ocular toxoplasmosis in Greece caused by congenital or acquired infection  

PubMed Central

We report a case of a newborn male child with congenital toxoplasmosis. During pregnancy seroconversion occurred and positive titers of antitoxoplasmic antibodies (immunoglobulin M and G) were found in the mother, in the third trimester. She received treatment with spiramycin. After birth, the neonate presented with chorioretinitis and intracranial calcifications. The neonate received treatment with pyrimethamine, sulfadiazine, and leucovorin for 1 year. In addition to using a previously described method, we report for the first time in Greece an estimation regarding the percentage of ocular toxoplasmosis caused by congenital or acquired infection. We estimate that ocular toxoplasmosis in Greece is caused in 7% of the cases by congenital infection, and in 93% of the cases by acquired infection.

Asproudis, Ioannis; Koumpoulis, Ioannis; Kalogeropoulos, Chris; Sotiropoulos, Georgios; Papassava, Margarita; Aspiotis, Miltiadis

2013-01-01

337

Fatal mycotic aneurysms due to Scedosporium and Pseudallescheria infection.  

PubMed

Angioinvasive complications of Scedosporium infections are rare. We report two cases of mycotic aneurysm, following apparent localized infection, due to Scedosporium apiospermum and Pseudallescheria boydii. The thoracoabdominal aorta was affected in one patient, and cerebral vessels were affected in the other. Despite voriconazole therapy and surgical resection, the patients died. Previously reported cases are reviewed. PMID:21430108

Ong, Adrian; Blyth, Christopher C; Bency, Rosamma; Vicaretti, Mauro; Harun, Azian; Meyer, Wieland; Shingde, Meena; Gilroy, Nicky; Chapman, Jeremy; Chen, Sharon C-A

2011-05-01

338

Fatal Mycotic Aneurysms Due to Scedosporium and Pseudallescheria Infection?  

PubMed Central

Angioinvasive complications of Scedosporium infections are rare. We report two cases of mycotic aneurysm, following apparent localized infection, due to Scedosporium apiospermum and Pseudallescheria boydii. The thoracoabdominal aorta was affected in one patient, and cerebral vessels were affected in the other. Despite voriconazole therapy and surgical resection, the patients died. Previously reported cases are reviewed.

Ong, Adrian; Blyth, Christopher C.; Bency, Rosamma; Vicaretti, Mauro; Harun, Azian; Meyer, Wieland; Shingde, Meena; Gilroy, Nicky; Chapman, Jeremy; Chen, Sharon C.-A.

2011-01-01

339

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

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

Vaidyanathan, Subramanian; Soni, Bakul; Singh, Gurpreet; Hughes, Peter; Selmi, Fahed; Mansour, Paul

2013-01-01

340

Acute meningoencephalomyelitis due to varicella-zoster virus in an AIDS patient: report of a case and review of the literature.  

PubMed

Varicella-zoster virus (VZV) meningoencephalomyelitis is a rare but severe neurological complication of VZV reactivation in immunocompromised patients. We report the case of an HIV-infected individual who developed an acute and severe meningoencephalomyelitis accompanied by a disseminated cutaneous eruption due to VZV. The presence of VZV DNA in cerebrospinal fluid was confirmed by polymerase chain reaction (PCR) technique. The patient started undergoing an intravenous acyclovir therapy with a mild recovery of neurological manifestations. Varicella-zoster virus should be included as a cause of acute meningoencephalomyelitis in patients with AIDS. Early diagnosis followed by specific therapy should modify the rapid and fulminant course for this kind of patients. PMID:22231256

Corti, Marcelo; Trione, Norberto; Villafañe, María Florencia; Risso, Daniel; Yampolsky, Claudio; Mamanna, Lilia

2011-01-01

341

Tinea incognito due to Trichophyton mentagrophytes.  

PubMed

Tinea incognito is a ringworm infection modified by corticosteroids. We report a case of a 2-year-old girl who developed tinea incognito due to Trichophyton mentagrophytes after applying methylprednisolone aceponate for 3 months. Diagnosis was confirmed by histopathologic and mycological examination, which led to the identification of Trichophyton mentagrophytes var. mentagrophytes, a zoophilic dermatophyte. Previous corticosteroid use in dermatophyte infections can alter their clinical appearance leading to misdiagnosis and delay in appropriate therapy. PMID:17302756

Sánchez-Castellanos, María Elena; Mayorga-Rodríguez, Jorge Arturo; Sandoval-Tress, Cecilia; Hernández-Torres, Mercedes

2007-01-01

342

Association between primary hyperparathyroidism and previous irradiation  

SciTech Connect

The association between primary hyperparathyroidism and previous irradiation was investigated in two study groups. Among 36 patients with hyperparathyroidism, 4 (11%) knew of having received radiation therapy. In the second group of 323 patients with a history of radiation exposure and nodular thyroid disease, 4 (1%), thus far, were found to have hyperparathyroidism.

Tamura, K.; Shimaoka, K.; Spaulding, S.; Shedd, D.

1982-04-01

343

Previously Suicidal Adolescents: Predictors of Six-Month Outcome  

PubMed Central

Objective To determine the baseline variables, including borderline personality disorder (BPD), associated with the six-month outcome of previously suicidal adolescents (n=263) presenting to an emergency department and treated predominantly as out-patients. Methods Multivariate logistic regression was used to analyze the associations between baseline variables and suicidality at six-month follow-up. Results BPD, previous suicide attempt(s), drug use and female gender were associated with subsequent suicidality. Conclusions These findings corroborate previously reported risk factors for recurring suicidality among adolescents and broaden their generalizability to those presenting to an emergency department, many diagnosed with BPD.

Greenfield, Brian; Henry, Melissa; Weiss, Margaret; Tse, Sze Man; Guile, Jean-Marc; Dougherty, Geoffrey; Zhang, Xun; Fombonne, Eric; Lis, Eric; Lapalme-Remis, Sam; Harnden, Bonnie

2008-01-01

344

Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature.  

PubMed

The abuse of household and other commercially available products containing volatile organic solvents is underrecognized. Not infrequently intentional butane inhalation results in high morbidity and mortality. A fatal outcome of butane abuse can be caused by asphyxia, cardiac arrhythmia or trauma. The reported number of cases in which death was the consequence of pure butane inhalation is limited, and in most cases a mixture of propellants was involved. This report covers two cases of sudden death due to the sniffing of a cigarette lighter refill containing butane. Autopsy was followed by toxicological, pathohistological and immunohistochemical analysis. Butane gas was confirmed in samples of blood, urine, brain and lungs by the gas chromatography method - "headspace" technique. Histology showed almost identical changes in the lungs and heart in both cases. The morphology of heart damage on standard H/E stains was of special interest because it displayed all the characteristics of chronic and acute myocardial hypoxia found in the absence of atherosclerotic heart disease. In order to confirm early cardiac death caused by asphyxia due to butane inhalation a panel of immunohistochemical agents was used: Myoglobin, Desmin, Fibronectin, Fibrinogen and CC9. PMID:21420651

Novosel, Irena; Kova?i?, Zdravko; Gusi?, Stjepan; Batelja, Lovorka; Nesti?, Marina; Seiwerth, Sven; Skavi?, Josip

2011-04-01

345

G6PD deficiency with hemolytic anemia due to a rare gene deletion--a report of the first case in Malaysia.  

PubMed

A 2-year-old Chinese boy was referred to Hospital UKM for investigation of recurrent episodes of dark-coloured urine and pallor since birth. He was born prematurely at 34 weeks gestation and developed severe early-onset neonatal jaundice requiring exchange blood transfusion. Screening at birth showed Glucose-6-phosphate dehydrogenase (G6PD) deficiency. On admission, physical examination revealed pallor, jaundice and mild hepatomegaly. Results of laboratory investigations showed a hemoglobin level of 11.0 g/dl with a hemolytic blood picture, reticulocytosis of 20% and red cell G6PD activity reported as undetectable. The patient's DNA was analysed for G6PD mutations by PCR-based techniques and DNA sequencing and results showed a 24 bp deletion of nucleotide 953-976 in the exon 9 of the G6PD gene. DNA analysis was also performed on blood samples of the patient's mother and female sibling confirming their heterozygous status, although both showed normal red cell G6PD activity levels. The patient was discharged well and his parents were appropriately advised on the condition and the importance of taking folic acid regularly. This is a first case report in Malaysia of G6PD deficiency causing chronic-hemolytic anemia. The rare 24 bp deletion causes the G6PD Nara variant, previously reported only in two other unrelated males, a Japanese and a Portuguese both with chronic hemolytic anemia. PMID:16753852

Ainoon, O; Boo, N Y; Yu, Y H; Cheong, S K; Hamidah, H N

2006-04-01

346

False-positive Xpert(®) MTB/RIF assays in previously treated patients: need for caution in interpreting results.  

PubMed

Xpert(®) MTB/RIF is the initial diagnostic test of choice for tuberculosis (TB). It is not known if false-positive results are more common in previously treated patients. We report four patients with successful treatment for TB up to 5 years previously who presented with respiratory tract infection and were Xpert-positive, but had negative TB cultures and clinical improvement without anti-tuberculosis treatment. We hypothesise that the Xpert results were false-positive due to the presence of dead Mycobacterium tuberculosis bacilli in lungs and sputum. Further work is required to determine the specificity of Xpert in previously treated patients. PMID:24902569

Boyles, T H; Hughes, J; Cox, V; Burton, R; Meintjes, G; Mendelson, M

2014-07-01

347

[Management of pregnancies with a previous cesarean].  

PubMed

The cesarean rate in France has reached 21% in 2010. With a maintained fertility rate, management of a pregnant woman with a previous caesarean scar is becoming a daily situation for most obstetrical teams. Considering the small rate of vaginal birth after cesarean (VBAC), we will try to establish an up-to-date review of the benefits and risks of encouraging trial of VBAC. This information can help professionals provide adequate counselling women or couples. PMID:22609031

Bonneau, C; Nizard, J

2012-10-01

348

Acute coronary syndrome due to early multiple and complete fractures in sirolimus-eluting stent: a case report and brief literature review.  

PubMed

Despite drug eluting stents (DES), as compared to bare metal stents, have reduced in-stent restenosis, complex and long lesions remains a challenge for interventional cardiologist. Their treatment is often associated with an unfavorable outcome, related to in-stent restenosis, stent thrombosis, and target lesion revascularization. These complications may derive from the contact between metallic structures and coronary artery endothelium, and consequent overexpression of platelet activating factors, growth factors, and inflammatory cytokines. Recently, an additional mechanism has emerged as new cause of these complications: "stent fracture." Several factors are involved in this phenomenon including material and stent platform, target vessel features, stent implantation technique, and implant duration. We reported a case of 69 years old man with rare early and complex DES fractures on right coronary that caused acute coronary syndrome 36 hr after a previous percutaneous coronary intervention. PMID:22431372

Amico, Francesco; Geraci, Salvatore; Tamburino, Corrado

2013-01-01

349

Survey context and question wording affects self reported annoyance due to road traffic noise: a comparison between two cross-sectional studies  

PubMed Central

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.

2012-01-01

350

Previous Open Rotor Research in the US  

NASA Technical Reports Server (NTRS)

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.

VanZante, Dale

2011-01-01

351

Auto-amputation of penis due to carcinoma: still a threat in the era of modern medicine: report of two cases.  

PubMed

Incidence of penile carcinoma is decreasing worldwide. Nevertheless, the incidence of penile cancer is still significant in various tropical countries, and it often presents in advanced stage. We report two unique cases of penile auto-amputation due to advanced cancer and review relevant literature. Both the patients presented with ulcerative lesion replacing penile base following automatic sloughing of the whole penis and voiding dysfunction. In addition, the first patient had metastatic inguinal lymph nodes. Supra-pubic urinary diversion was the initial management in both the patients. The first patient was treated with combined chemo-radiation, but he succumbed to death following two cycles of chemotherapy. The second patient was successfully treated with total penectomy and perineal urethrostomy. He recovered well but was lost to follow-up. PMID:23442462

Ghosh, Bastab; Manikandan, Ramanitharan; Dorairajan, Lalgudi N; Kumar, Santosh

2013-01-01

352

Spontaneous tibiotalar arthrodesis as a complication of acute tibial osteomyelitis due to Panton-Valentine leukocidin-producing Staphylococcus aureus: a case report  

PubMed Central

Introduction Strains of Panton-Valentine leukocidin-producing Staphylococcus aureus producing a new pattern of disease have emerged worldwide. Infection with these bacteria typically presents as a life-threatening infection of soft tissues and bones, and may cause potentially devastating consequences. Case presentation We report a case of osteoarticular infection caused by Panton-Valentine leukocidin-producing Staphylococcus aureus. A 12-year-old Caucasian girl presented with acute osteomyelitis of the tibia associated with toxic shock syndrome, which was complicated by an unexpected spontaneous ankle arthrodesis. Conclusions Osteoarticular infections due to Panton-Valentine leukocidin-producing Staphylococcus aureus appear to be severe, and are characterized by their tendency to evolve towards serious complications. This case highlights the need for early and aggressive surgical procedures in conjunction with appropriate antimicrobial therapy and regular long-term follow-up.

2012-01-01

353

Characterization of a rare case of Ullrich congenital muscular dystrophy due to truncating mutations within the COL6A1 gene C-Terminal domain: a case report  

PubMed Central

Background Mutations within the C-terminal region of the COL6A1 gene are only detected in Ullrich/Bethlem patients on extremely rare occasions. Case presentation Herein we report two Brazilian brothers with a classic Ullrich phenotype and compound heterozygous for two truncating mutations in COL6A1 gene, expected to result in the loss of the ?1(VI) chain C2 subdomain. Despite the reduction in COL6A1 RNA level due to nonsense RNA decay, three truncated alpha1 (VI) chains were produced as protein variants encoded by different out-of-frame transcripts. Collagen VI matrix was severely decreased and intracellular protein retention evident. Conclusion The altered deposition of the fibronectin network highlighted abnormal interactions of the mutated collagen VI, lacking the ?1(VI) C2 domain, within the extracellular matrix, focusing further studies on the possible role played by collagen VI in fibronectin deposition and organization.

2013-01-01

354

Babesiosis due to the canine Babesia microti-like small piroplasm in dogs - first report from Portugal and possible vertical transmission  

PubMed Central

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.

2011-01-01

355

Recurrent cholangitis by biliary stasis due to non-obstructive afferent loop syndrome after pylorus-preserving pancreatoduodenectomy: report of a case.  

PubMed

Abstract We report a 71-year-old man who had undergone pylorus-preserving pancreatoduodenectomy (PPPD) using PPPD-IV reconstruction for cholangiocarcinoma. For 6 years thereafter, he had suffered recurrent cholangitis, and also a right liver abscess (S5/8), which required percutaneous drainage at 9 years after PPPD. At 16 years after PPPD, he had been admitted to the other hospital because of acute purulent cholangitis. Although medical treatment resolved the cholangitis, the patient was referred to our hospital because of dilatation of the intrahepatic biliary duct (B2). Peroral double-balloon enteroscopy revealed that the diameter of the hepaticojejunostomy anastomosis was 12 mm, and cholangiography detected intrahepatic stones. Lithotripsy was performed using a basket catheter. At 1 year after lithotripsy procedure, the patient is doing well. Hepatobiliary scintigraphy at 60 minutes after intravenous injection demonstrated that deposit of the tracer still remained in the upper afferent loop jejunum. Therefore, we considered that the recurrent cholangitis, liver abscess, and intrahepatic lithiasis have been caused by biliary stasis due to nonobstructive afferent loop syndrome. Biliary retention due to nonobstructive afferent loop syndrome may cause recurrent cholangitis or liver abscess after hepaticojejunostomy, and double-balloon enteroscopy and hepatobiliary scintigraphy are useful for the diagnosis of nonobstructive afferent loop syndrome. PMID:25058778

Sanada, Yukihiro; Yamada, Naoya; Taguchi, Masanobu; Morishima, Kazue; Kasahara, Naoya; Kaneda, Yuji; Miki, Atsushi; Ishiguro, Yasunao; Kurogochi, Akira; Endo, Kazuhiro; Koizumi, Masaru; Sasanuma, Hideki; Fujiwara, Takehito; Sakuma, Yasunaru; Shimizu, Atsushi; Hyodo, Masanobu; Sata, Naohiro; Yasuda, Yoshikazu

2014-01-01

356

Basal ganglia stroke due to mild head trauma in pediatric age - clinical and therapeutic management: a case report and 10 year literature review.  

PubMed

Ischemia of the basal ganglia as an immediate consequence of minor head injury in children is rare (< 2% of all ischemic stroke in childhood) and is due to vasospasm of the lenticulostriate arteries. The clinical history of these lesions is particularly favourable because they are usually small, and also because the facial-brachial-crural hemiparesis typical of this pathology usually regresses after a period ranging from several weeks to several months, despite the persistence of an ischemic area on MRI. This is due to the well known neuronal plasticity of the CNS, in particular, of the primary motor cortex. The most effective therapeutic approach appears to be the conservative one, although the best treatment regimen is still not well defined.Young patients should be closely monitored and treated conservatively with osmotic diuretics to reduce perilesional edema. At the same time, however, it is very important to exclude, by means of instrumental and laboratory studies, conditions that could favour the onset of ischemia, including emboligen heart disease, thrombophilia and acute traumatic arterial dissections. Generally speaking, the prognosis in these cases is good. The authors describe their experience treating a 10-month old baby girl, with a left lenticular nucleus ischemia and report a literature review. PMID:21210991

Landi, Alessandro; Marotta, Nicola; Mancarella, Cristina; Marruzzo, Daniele; Salvati, Maurizio; Delfini, Roberto

2011-01-01

357

[Mushroom ileus without previous intestinal obstruction].  

PubMed

A case is described of obstruction of the small bowel after consumption of 500 g edible mushrooms (Cantharellus cibarius). No fibrous bands or adhesions were found on laparotomy. When preparing the meal the mushrooms were not cut up, nor were they properly chewed due to the patient's defective dental prosthesis. 11 days after the meal the patient passed largely intact mushrooms. In retrospect the impacted mushrooms could be assumed on X-ray after barium meal. Since even without intra-abdominal adhesions impacted mushrooms can cause mechanical obstruction, it is recommended that mushrooms be cut up, chewed well and consumed only in moderate portions even when large quantities are available. PMID:2814413

Gerber, P

1989-10-21

358

Microstructure of a nitrided steel previously decarburized  

NASA Astrophysics Data System (ADS)

In this study the effects of a surface-controlled decarburization on the structure of a nitrided steel are analyzed. Samples of a quenched and tempered 42CrMo4 steel were decarburized by heating in air at different depths and submitted to gaseous nitriding. After decarburization and nitriding, the microstructure of surface layers was investigated by optical microscopy (OM) and scanning electron microscopy (SEM). The nitrogen and carbon profiles in the diffusion layers were determined by SEM equipped with a wavelength dispersive spectrometer (EPMA-WDS) and by glow discharge optical spectrometry (GDOS). The effect of nitriding was determined by microhardness measurements. Our results indicate that a previous decarburization only slightly affects the surface hardness, but reduces the conventional nitriding depth. The decarburization also favors the nitrogen take-up and produces increased nitrogen concentrations in the compound layer and in the narrow zone beneath it.

Calliari, I.; Dabalà, M.; Ramous, E.; Zanesco, M.; Gianotti, E.

2006-12-01

359

[Cutaneous melanoma associated with previous nevus].  

PubMed

The malignant melanoma is a neoplasia originated from the melanocytes located in the skin and other locations. Even though there is not information regarding its incidence and prevalence in our country, its most important risk factors are known. The melanoma can originate de novo or from previous melanocytic lesions. The concept that a melanocytic nevus can serve as a precursor lesion is supported by clinical and histological evidence. An observational, retrospective and analytical study was carried out in the Hospital Privado de Córdoba. The objective was to determine which is the frequency of association of malignant melanomas that develop on previous nevus. A total of 134 melanomas were analyzed. In 32 cases (24%), the melanomas were histologically associated with nevus, in individuals with Breslow's depth bigger than 1 mm the percentage of association was 16.3% while in those exhibiting Breslow smaller than 1 mm the percentage of association was 38.1%. Having evaluated the melanomas in relation to the Breslow and Clark classification, we observed that the nevus associated melanoma group showed less Breslow thickness and low Clark levels, which, by statistical analysis were shown to be significant predictors of the probabilty of finding this association (p < 0.027). This study demonstrates that the tumor thickness by itself is an independent predictive factor of the association melanoma-nevus. However, the rest of the variables studied did not throw significant results from the statistical point of view. In conclusion, patients must be educated for the control of new pigmented injuries as well as for the modification of preexisting nevi. PMID:19897439

Gutiérrez, María P; Barengo, Mónica; Mainardi, Claudio; Garay, Iliana; Kurpis, María; Ruiz Lascano, Alejandro

2009-01-01

360

Progressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine: a case report and literature review  

PubMed Central

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.

Zhang, Chao; Ruan, Dike; He, Qing; Wen, Tianyong; Yang, Pushan

2014-01-01

361

Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: A case report and literature review  

PubMed Central

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.

2012-01-01

362

Sudden death in custody due to pituitary apoplexy during long restriction in a sitting position: a case report and review of the literature.  

PubMed

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

Sun, Tingyi; Liu, Liang; Sunnassee, Ananda; Zhuo, Luo; Zhu, Shaohua

2013-10-01

363

Congruency sequence effects are driven by previous-trial congruency, not previous-trial response conflict  

PubMed Central

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.

Weissman, Daniel H.; Carp, Joshua

2013-01-01

364

Forest NEP is significantly driven by previous year's weather  

NASA Astrophysics Data System (ADS)

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.

Zielis, S.; Etzold, S.; Zweifel, R.; Eugster, W.; Haeni, M.; Buchmann, N.

2013-10-01

365

Accessing previous mental sleep experience in REM and NREM sleep.  

PubMed

This study investigated the processes by which contents previously stored in memory are retrieved and inserted into mental sleep experience (MSE). MSE reports were collected from six subjects awakened three times on each of eight nights in two alternate sequences of awakenings (NREM-REM-NREM; REM-REM-REM). The occurrences of interrelations between contents of report pairs were scored using Clark's (1970) feature matching model. These were greater for same night pairs than for different night pairs, and did not differ with respect to sequence of awakenings or order of report pairs (first-second, second-third, first-third). Contents of previous MSEs, therefore, seem to be accessible in both sleep types for insertion into current MSE. The interrelated units were more frequently lexical than propositional, with more paradigmatic than syntagmatic relationships in report pairs from both sequences of awakenings. Thus, the re-elaboration of contents of previous MSEs seems to occur mainly at the level of single contents in both types of sleep, with similar modalities of processing. PMID:2590707

Fagioli, I; Cipolli, C; Tuozzi, G

1989-08-01

366

Operations on previously operated patients with hypospadias.  

PubMed

The therapy of severe degrees of hypospadias is exclusively surgical. A great number of different methods have been described; nevertheless, only a few techniques have proved successful. Between 1976 and 1980 21 children with various forms of hypospadias were admitted to our department for primary operation. Nineteen of these 21 children had to have a straightening operation. In 2 children a more pronounced glans defect was corrected in one session by Ombrédanne's method. During the same period 9 patients were admitted for secondary corrections, having been operated on elsewhere for hypospadias. In two patients aged 6 and 7 years respectively, several fistulae had to be closed. In 7 patients a complete secondary correction had to be performed in at least two sessions. The average age of these 7 patients was 19,4 years at the time of the secondary operation. Secondary corrections are also indicated in cases of multiple fistulae, of unremedied chordee, underdevelopment or an abnormal position of the penis, in cases of strictures in the area of the reconstructed urethra, and, finally, in cases with hairball stones due to hair formations on the skin. The fistulae following the reconstruction of the urethra are closed using sliding grafts from the penis or penoscrotal skin. In extensive fistulae, as well as pronounced strictures of the reconstructed urethra, a complete Johansson (1953) procedure is necessary. In large secondary corrections, there are many cases in which the entire armamentarium of plastic surgery must be utilized. PMID:6425982

Frick, J; Kunit, G

1984-01-01

367

Mycobacterium microti: More Diverse than Previously Thought?  

PubMed Central

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.

Smith, N. H.; Crawshaw, T.; Parry, J.; Birtles, R. J.

2009-01-01

368

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

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.

O'Rourke, M.J.; Ballantyne, D.

1992-06-30

369

Carboxyhemoglobin formation due to transient exposure to high level carbon monoxide: Experimental results and an explanatory model. Final report, 18 August 1987-30 September 1994  

SciTech Connect

Fifteen men were exposed to 6,683 PPM C180 for 3.1 - 6.6 min. Venous and arterial blood sample were drawn at one-min intervals beginning at the start of exposure and finishing 1 0 min later. Simultaneously, VA was calculated from the measured values of VE and deadspace. VE was measured by integrating digitized continuous measures of inhaled and exhaled gas. All parameters of the nonlinear Coburn-Forster-Kane equation (CFKE) were measured on the individual subject except for the Haldane affinity ratio. Predictions of venous blood COHb in samples collected ca. two min after cessation of exposure were accurately predicted by the CFKE. Both venous and arterial COHb were inaccurately predicted during COHb formation, however. Venous levels were overpredicted during formation due to delayed appearance of COHb. Individual subjects differed markedly in the delay of COHb appearance in venous blood. Arterial COHB was consistently underestimated either by the CFKE or by predictions based on venous blood samples. Thus, exposure of such organs as brain or heart to COHb can be higher than expected from previous knowledge when transient CO exposure is involved. An explanation is suggested for the observed differences between arterial and venous COHb on the basis of the regional circulation of the forearm, where both samples were taken. Because regional circulation patterns are known to vary with physical training, the differences in physical training between subjects may account for the observed variation. An expanded model was derived from the Coburn-Forster-Kane equation that reflects the above hypothesis. Most of the parameter values for the expanded model were measured on individual subjects. Literature values were used for other parameters.

Hazucha, M.J.; Smith, M.V.; Benignus, V.A.; Bromberg, P.A.

1994-09-01

370

Due Process in Gifted Education.  

ERIC Educational Resources Information Center

A national survey of all 50 states concerning the availability of due process procedures for gifted students and the number and nature of recent hearings produced the following information: 28 states currently provide due process or mediation for conflicts concerning gifted students and 7 states reported holding 26 due process hearings from…

Karnes, Frances A.; Troxclair, Debra A.; Marquardt, Ronald G.

1998-01-01

371

The effect of previous traumatic injury on homicide risk.  

PubMed

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

Griffin, Russell L; Davis, Gregory G; Levitan, Emily B; MacLennan, Paul A; Redden, David T; McGwin, Gerald

2014-07-01

372

[Improvement of cerebral hemodynamic and metabolic parameters in a patient who presented intracranial hypertension due to superior sinus thrombosis after lumbo-peritoneal shunt: case report].  

PubMed

Cerebral hemodynamic and metabolic changes in intracranial hypertension associated with sinus thrombosis have not been well documented. We report pre- and post-treatment changes in cerebral hemodynamic and metabolic parameters in a 50-year-old male who presented intracranial hypertension due to sinus thrombosis, using single-photon emission computed tomography (SPECT) and positron emission tomography (PET). He complained of headache, nausea and double vision and was admitted to our hospital. Neurological examinations on admission revealed papilledema on both sides. Cerebrospinal fluid pressure was 28 mmHg. Cerebral angiography showed occlusion of the superior sagittal sinus and retrograde filling of the ascending cortical veins in the bilateral frontal lobes. 123I-IMP SPECT and 15O-gas PET showed a reduction of cerebral blood flow and oxygen metabolism and an extreme elevation of cerebral blood volume in the bilateral cerebral hemispheres. His complaints resolved after lumbo-peritoneal shunt. Postoperative SPECT/PET studies demonstrated improvement of hemodynamic and metabolic parameters. Intracranial hypertension and associated venous congestion were most likely related to hemodynamic and metabolic abnormalities. PMID:15773319

Hokari, Masaaki; Kuroda, Satoshi; Ishikawa, Tatsuya; Iwasaki, Yoshinobu

2005-03-01

373

The role of post-mortem CT (PMCT) imaging in the diagnosis of pericardial tamponade due to hemopericardium: A case report.  

PubMed

Hemopericardium (HP) is frequently found at autopsy, but it represents a challenge for the forensic pathologist when having to assess its etiopathological relationship in causing death, particularly in those cases where ante-mortem clinical and instrumental data are not available. The diagnosis of pericardial tamponade (PT), in fact, is based on signs, symptoms and instrumental evidence and not only on the presence of HP. Post-mortem imaging techniques are actually considered a useful and non-invasive method able to enhance traditional procedures in demonstrating critical forensic findings; consequently, post-mortem imaging methods have been widely introduced in forensic investigations. We report a case of death clearly due to PT caused by ruptured dissected aneurysm of the aorta, submitted to post-mortem CT (PMCT) and PMCT angiography prior to autopsy. PMCT imaging permitted to solve the case without performing autopsy. In the paper we identify PMCT findings suggestive of PT with the aim of verifying the possibility to use post-mortem evidence to retrospectively demonstrate an in vivo dynamic clinical condition, such as PT. PMID:24636310

Filograna, Laura; Flach, Patricia M; Bolliger, Stephan A; Thali, Michael J

2014-05-01

374

[Two elderly case reports of renal excretion type drug poisoning caused by dehydration that was due to poor eating in home care].  

PubMed

The elderly patients are susceptible to acute renal failure due to dehydration or infection. Therefore, the drug should be administered with caution. We report two cases of acute renal failure from dehydration that led to a subsequent drug poisoning. Case 1: An 85-year-old woman with a history of colorectal cancer surgery was admitted to our emergency department for appetite loss and weakness. Because she was given a normal amount of drugs under the condition of poor oral intake, she was hospitalized by digitalism. Case 2: A 72-year-old woman was admitted to our emergency department for disturbance of consciousness and appetite loss. The medication given by a staff in geriatric health services facility appeared to have caused a pilsicainide poisoning. As the elderly patients were given a normal amount of drugs under the poor oral intake condition, blood levels of renal excretion type drug had increased in both cases. Medication management for the elderly should be comprehensively considered the background of the individual. PMID:21368531

Ibata, Takeshi; Hinokiyama, Hiromi; Nakashita, Chisako; Mito, Saori; Doi, Seiko; Shiki, Satomi; Hata, Akiko; Sato, Miyuki; Komuro, Ryutaro; Iijima, Hohei

2010-12-01

375

Infant diarrhoea due to Escherichia coli 091 K? H7  

Microsoft Academic Search

A small outbreak of infective diarrhoea occurred among babies in hospital at Winchester, England. The causal agent was found to be a strain of Escherichia coli 091 K? H7 which was resistant to several antibiotics. Epidemic diarrhoea due to E. coli 091 has previously been reported from south Germany.

M. H. Hughes; J. L. Greaves; K. A. Bettelheim

1968-01-01

376

Mycoplasma hominis necrotizing pleuropneumonia in a previously healthy adolescent  

PubMed Central

Background Mycoplasma hominis is a fastidious micro-organism causing systemic infections in the neonate and genital infections in the adult. It can also be the cause of serious extra-genital infections, mainly in immunosuppressed or predisposed subjects. Case Presentation We describe a case of severe pneumonia and pericarditis due to Mycoplasma hominis in a previously healthy adolescent who did not respond to initial therapy. Conclusions Mycoplasma hominis could be an underestimated cause of severe pneumonia in immunocompetent patients and should be particularly suspected in those not responding to standard therapy.

2010-01-01

377

Ewing sarcoma superimposed on a previous osteochondroma in multiple osteochondromatosis.  

PubMed

It has been reported that patients with hereditary multiple exostoses (called multiple osteochondromatosis by the World Health Organization) are at increased risk for malignant transformation of osteochondromas to secondary chondrosarcomas. A review of the literature found 14 cases showing transformation of osteochondromas into osteosarcomas; however, Ewing sarcoma has never been reported superimposed on an osteochondroma. This article presents the case of a boy who underwent biopsy of a previously existent osteochondroma for which the pathology report showed cytologic and immunohistochemical properties consistent with Ewing sarcoma. A 13-year-old boy with hereditary multiple exostoses (multiple osteochondromatosis) presented to an orthopedic clinic because of waxing and waning pain superficial to a previous osteochondroma on the lateral aspect of the right leg, below the knee, of 1 month's duration. On examination, inflammation was noted over a bony mass associated with tenderness to palpation of the affected area. There was no evidence of penetrating injury or trauma, and the patient reported no constitutional symptoms, including fever. Radiographs showed marked osteolysis and signs of periosteal reaction. Magnetic resonance imaging showed evidence of cortical bone erosion and extension of the mass into soft tissue. Malignant transformation was suspected, and the patient underwent biopsy. The pathology findings were consistent with Ewing sarcoma. The highly uncommon presentation of this malignancy must serve as a red flag to other physicians who treat patients with hereditary multiple exostoses. Ewing sarcoma tends to be of higher grade and have a worse prognosis than other malignancies that are more commonly seen in these patients. PMID:24762849

Marrero Barrera, Pablo A; Marrero Ortiz, Pablo V

2014-04-01

378

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

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

Wiedenmann, A; Langhammer, W; Botzenhart, K

2001-12-01

379

Photosensitivity due to thiazides.  

PubMed

Thiazides are widely used diuretics that first became available in the 1950s. The first reports of photosensitivity reactions to thiazides were published shortly after the introduction of these drugs, but few cases have been described since. We review all the cases of photosensitivity due to thiazides published up to December 2011. We found 62 cases, 33 in women and 29 in men. The most common presentation was eczematous lesions in a photodistributed pattern, and the most common causative agent was hydrochlorothiazide. The results of photobiological studies were published in only some of the cases reviewed. In most cases, phototesting revealed an abnormal response to UV-A alone or to both UV-A and UV-B. In some cases, the results of phototesting were normal and only photopatch testing yielded abnormal results. Diagnosis of photosensitivity due to thiazides requires a high degree of suspicion. Ideally, diagnosis should be confirmed by a photobiological study. PMID:23664250

Gómez-Bernal, S; Alvarez-Pérez, A; Rodríguez-Pazos, L; Gutiérrez-González, E; Rodríguez-Granados, M T; Toribio, J

2014-05-01

380

77 FR 44113 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...  

Federal Register 2010, 2011, 2012, 2013

...Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes...Type Certificate previously held by Israel Aircraft Industries, Ltd.) Model Gulfstream...report from the Civil Aviation Authority of Israel (CAAI), which is the...

2012-07-27

381

Pregnancy hemoperitoneum and placenta percreta in a patient with previous pelvic irradiation and ovarian failure  

SciTech Connect

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.

Pridjian, G.; Rich, N.E.; Montag, A.G. (Univ. of Chicago, IL (USA))

1990-05-01

382

Marked hydronephrosis and hydroureter after distigmine therapy in an adult male patient with paraplegia due to spinal cord injury: a case report  

PubMed Central

Introduction Distigmine, a long-acting anti-cholinesterase, is associated with side effects such as Parkinsonism, cholinergic crisis, and rhabdomyolysis. We report a spinal cord injury patient, who developed marked hydronephrosis and hydroureter after distigmine therapy, which led to a series of complications over subsequent years. Case presentation A 38-year-old male developed T-9 paraplegia in 1989. Intravenous urography, performed in 1989, showed normal kidneys, ureters and bladder. He was prescribed distigmine bromide orally and was allowed to pass urine spontaneously. In 1992, intravenous urography showed bilateral marked hydronephrosis and hydroureter. Distigmine was discontinued. He continued to pass urine spontaneously. In 2006, intravenous urography showed moderate dilatation of both pelvicalyceal systems and ureters down to the level of urinary bladder. This patient was performing self-catheterisation only once a day. He was advised to do catheterisations at least three times a day. In December 2008, this patient developed haematuriawhich lasted for nearly four months.. He received trimethoprim, then cephalexin, followed by Macrodantin, amoxicillin and ciprofloxacin. In February 2009, intravenous urography showed calculus at the lower pole of left kidney. Both kidneys were moderately hydronephrotic. Ureters were dilated down to the bladder. Dilute contrast was seen in the bladder due to residual urine. This patient was advised to perform six catheterisations a day, and take propiverine hydrochloride 15 mg, three times a day. Microbiology of urine showed Klebsiella oxytoca, Pseudomonas aeruginosa, and Enterococcus faecalis. Cystoscopy revealed papillary lesions in bladder neck and trigone. Transurethral resection was performed. Histology showed marked chronic cystitis including follicular cystitis and papillary/polypoid cystitis. There was no evidence of malignancy. Conclusion Distigmine therapy resulted in marked bilateral hydronephrosis and hydroureter. Persistence of hydronephrosis after omitting distigmine, and presence of residual urine in bladder over many years probably predisposed to formation of polypoid cystitis and follicular cystitis, and contributed to prolonged haematuria, which occurred after an episode of urine infection. This case illustrates the dangers of prescribing distigmine to promote spontaneous voiding in spinal cord injury patients. Instead of using distigmine, spinal cord injury patients should be advised to consider intermittent catheterisation together with oxybutynin or propiverine to achieve complete, low-pressure emptying of urinary bladder.

Mansour, Paul; Soni, Bakul M; Hughes, Peter L; Singh, Gurpreet; Oo, Tun

2009-01-01

383

Interpeduncular heterotopia in Joubert syndrome: a previously undescribed MR finding.  

PubMed

The so-called molar tooth sign is the radiologic hallmark of JSRD. Joubert syndrome is a rare, most often autosomal-recessive disorder with a characteristic malformation of the midhindbrain. We describe 3 patients with JSRD and the additional MR finding of tissue resembling heterotopia in the interpeduncular fossa, which in one patient was combined with a more extensive intramesencephalic heterotopia. Interpeduncular heterotopia has not been reported previously, either in the context of JSRD or as a separate entity. This new imaging feature enlarges the spectrum of brain stem abnormalities in JSRD. In view of the underlying ciliopathy, it seems likely that the interpeduncular heterotopia results from misdirected migration. PMID:21636654

Harting, I; Kotzaeridou, U; Poretti, A; Seitz, A; Pietz, J; Bendszus, M; Boltshauser, E

2011-08-01

384

Statin-induced myopathy in a patient with previous poliomyelitis.  

PubMed

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

Martikainen, Mika H; Gardberg, Maria; Kohonen, Ia; Lähdesmäki, Janne

2013-11-01

385

Clinical and radiological deterioration due to Mycobacterium szulgai in an asthmatic patient.  

PubMed

We report the case of a 23-year-old asthmatic woman who had clinical and radiological deterioration due to Mycobacterium szulgai infection and good response to anti-mycobacterial treatment without any structural abnormalities in previous lung imaging studies. M. szulgai may be considered a pathogen able to cause deterioration of respiratory health even in patients with previously normal lungs. PMID:22240435

Marjani, Majid; Mansouri, Nahal; Tabarsi, Payam; Baghaei, Parvaneh; Farnia, Parissa; Sheikholslami, Fatemeh-Maryam; Mansouri, Davood

2012-01-01

386

Atrial fibrillation after taser exposure in a previously healthy adolescent.  

PubMed

We are reporting a previously healthy adolescent who developed atrial fibrillation after being tased. He has a structurally normal heart on echocardiogram, normal electrolyte level and thyroid function test results, and a urine toxicology screen positive for marijuana. The patient ultimately required external defibrillation to convert his cardiac rhythm to normal sinus rhythm and has had no recurrent arrhythmias since hospital discharge (approximately 1 year). This is the first reported case of atrial fibrillation developing after a Taser shot, occurring in an adolescent without other risk factors. This case illustrates the arrhythmogenic potential of a Taser in otherwise healthy young individuals, and further study of occurrence of Taser-induced arrhythmias is warranted. PMID:20016356

Multerer, Sara; Berkenbosch, John W; Das, Bibhuti; Johnsrude, Christopher

2009-12-01

387

Endovascular treatment of recurrent intracranial aneurysms following previous microsurgical clipping with the Pipeline Embolization Device.  

PubMed

The treatment of intracranial aneurysms with microsurgical clipping is associated with a very low rate of recurrence. However, in cases of aneurysm recurrence after previous clipping, microsurgical dissection due to adhesions and fibrosis may be challenging, and it may be difficult to safely occlude the recurrent lesion without the risk of significant morbidity. Flow-diverting stents have drastically changed the landscape of endovascular neurosurgery. We present two patients with large, recurrent supraclinoid internal carotid artery (ICA) aneurysms which were previously clipped 17 and 23years ago at outside institutions. Both recurrent lesions were treated with the Pipeline Embolization Device (PED; ev3 Endovascular, Irvine, CA, USA) without radiographic or clinical complications. In the first patient, the 15mm aneurysm significantly decreased in size at 6month angiographic follow-up. The 21mm aneurysm in the second patient was completely occluded 7months following PED treatment. The moderate degree of in-stent stenosis present on initial follow-up imaging resolved on angiography 11months post-treatment. The management of recurrent aneurysms after clipping is sparsely reported in the literature due to its infrequent occurrence. In carefully selected cases, flow-diverting stents may be used for complex aneurysms of the distal ICA, even for those which have recurred following microsurgical clipping. PMID:24529950

Ding, Dale; Starke, Robert M; Evans, Avery J; Jensen, Mary E; Liu, Kenneth C

2014-07-01

388

Event sequence variability in healthy swallowing: building on previous findings.  

PubMed

This study builds on previous work by Kendall, Leonard, and McKenzie, which investigated event sequence variability for 12 paired events during swallowing by healthy volunteers. They identified four event pairs that always occurred in a stereotyped order and a most common occurring overall order of events during swallowing. In the current study, we investigated overall event sequencing and the same four paired events in a sample of swallows by healthy young (under 45 years old) volunteers. Data were collected during a 16-swallow lateral videofluoroscopy protocol, which included manipulations of bolus volume, barium density, bolus viscosity, and swallow cueing. Our results agreed with previous findings that variable event sequencing is found in healthy swallowing, and, in regard to obligatory sequencing of two paired events, movement of the arytenoids toward the base of the epiglottis begins prior to upper esophageal sphincter (UES) opening and maximum hyolaryngeal approximation occurs after UES opening. However, our data failed to replicate the previous findings that there is obligatory sequencing of maximum pharyngeal constriction after maximal UES distension and the UES opens before bolus arrival at the UES. The most common observed overall event sequence reported by Kendall et al. was observed in only 4/293 swallows in our dataset. Manipulations of bolus volume, bolus viscosity, barium concentration, swallow cueing, and swallow repetitions could not completely account for the differences observed between the two studies. PMID:24390702

Molfenter, Sonja M; Leigh, Chelsea; Steele, Catriona M

2014-04-01

389

Mixed allergic bronchopulmonary fungal disease due to Pseudallescheria boydii and Aspergillus.  

PubMed Central

A 24 year old asthmatic woman with mixed allergic bronchopulmonary fungal disease due to Pseudallescheria boydii and Aspergillus is reported. No previous cases due to P boydii have been described. This patient provides evidence that fungi other than Aspergillus species may cause the condition. Images

Lake, F R; Tribe, A E; McAleer, R; Froudist, J; Thompson, P J

1990-01-01

390

Widely Used Pesticides with Previously Unknown Endocrine Activity Revealed as in Vitro Antiandrogens  

PubMed Central

Background Evidence suggests that there is widespread decline in male reproductive health and that antiandrogenic pollutants may play a significant role. There is also a clear disparity between pesticide exposure and data on endocrine disruption, with most of the published literature focused on pesticides that are no longer registered for use in developed countries. Objective We used estimated human exposure data to select pesticides to test for antiandrogenic activity, focusing on highest use pesticides. Methods We used European databases to select 134 candidate pesticides based on highest exposure, followed by a filtering step according to known or predicted receptor-mediated antiandrogenic potency, based on a previously published quantitative structure–activity relationship (QSAR) model. In total, 37 pesticides were tested for in vitro androgen receptor (AR) antagonism. Of these, 14 were previously reported to be AR antagonists (“active”), 4 were predicted AR antagonists using the QSAR, 6 were predicted to not be AR antagonists (“inactive”), and 13 had unknown activity, which were “out of domain” and therefore could not be classified with the QSAR (“unknown”). Results All 14 pesticides with previous evidence of AR antagonism were confirmed as antiandrogenic in our assay, and 9 previously untested pesticides were identified as antiandrogenic (dimethomorph, fenhexamid, quinoxyfen, cyprodinil, ?-cyhalothrin, pyrimethanil, fludioxonil, azinphos-methyl, pirimiphos-methyl). In addition, we classified 7 compounds as androgenic. Conclusions Due to estimated antiandrogenic potency, current use, estimated exposure, and lack of previous data, we strongly recommend that dimethomorph, fludioxonil, fenhexamid, imazalil, ortho-phenylphenol, and pirimiphos-methyl be tested for antiandrogenic effects in vivo. The lack of human biomonitoring data for environmentally relevant pesticides presents a barrier to current risk assessment of pesticides on humans.

Orton, Frances; Rosivatz, Erika; Scholze, Martin; Kortenkamp, Andreas

2011-01-01

391

A Sarcoma at the Site of Previous Extravasation of Adriamycin  

PubMed Central

We report the case of a 66-year-old man presenting with a high-grade pleomorphic sarcoma at the left elbow 16 years after the extravasation of adriamycin given for a malignant ifbrous histiocytoma of the tibia.We suggest that this sarcoma originated in a multistep way over many years, out of the chronic inflammatory tissue that developed due to a non-specific cellular damage at the nuclear level, interfering with normal cell replication necessary for normal healing tissue healing. As a result, the non-healed chronic inflammatory tissue transformed over several years into a preneoplastic mesenchymal tumour and later into a high-grade pleomorphic sarcoma.

Ceulemans, Joris; Sciot, Raf; Debiec-Rychter, Maria; van Oosterom, Allan T.

2002-01-01

392

Lower sensitivity of screening mammography after previous benign breast surgery.  

PubMed

Few data are available on the effect of previous benign breast surgery on screening mammography accuracy. We determined whether sensitivity of screening mammography and tumor characteristics are different for women with and without previous benign breast surgery. We included a consecutive series of 317,398 screening mammograms of women screened between 1997 and 2008. During 2-year follow-up, clinical data, breast imaging, biopsy and surgery reports were collected from women with screen-detected or interval breast cancers. Screening sensitivity, tumor biology and tumor stages were compared between 168 women with breast cancer and prior ipsilateral benign breast surgery and 2,039 women with breast cancer but without previous ipsilateral, benign breast surgery. The sensitivity of screening mammography was significantly lower for women with prior surgery [64.3% (108/168) versus 73.4% (1,496/2,039), p = 0.01]. The concomitant increased interval cancer risk remained significant after logistic regression adjustment for age and breast density (OR = 1.5, 95% CI: 1.1-2.1). Comparing screen-detected cancers in women with and without prior breast surgery, no significant differences in estrogen receptor status (p = 0.56), mitotic activity (p = 0.17), proportions of large (T2+) tumors (p = 0.6) or lymph node positive tumors (p = 0.4) were found. Also for interval cancers, no differences were found in estrogen receptor status (p = 0.41), mitotic activity (p = 0.39), proportions of large tumors (p = 0.9) and lymph node positive tumors (p = 0.5) between women with and without prior breast surgery. We conclude that sensitivity of screening mammography is significantly lower in women with previous benign breast surgery than without, but tumor characteristics are comparable both for screen detected cancers and interval cancers. PMID:21328339

van Breest Smallenburg, Vivian; Duijm, Lucien E M; Voogd, Adri C; Groenewoud, Johanna H; Jansen, Frits H; van Beek, Mike; Louwman, Marieke W J

2012-01-01

393

Fatality Assessment and Control Evaluation (FACE) Report for Michigan: Tub Refinisher Died Due to Methylene Chloride Overexposure While Stripping a Bathtub.  

National Technical Information Service (NTIS)

In the winter of 2010, a 52-year-old male tub re-glazer died due to overexposure to methylene chloride (MC) vapor while stripping a bathtub in an apartment bathroom using Tal-Strip II Aircraft Coating Remover (Tal-Strip II). Methylene chloride was the pri...

2011-01-01

394

Successful Treatment of Intermittent Claudication Due to Spinal Canal Stenosis Using Beraprost Sodium, a Stable Prostaglandin I2 AnalogueA Case Report  

Microsoft Academic Search

The syndrome of intermittent claudication can be induced not only by vascular insuffi ciency of the lower limbs but also by diseases of the spinal cord and cauda equina. The authors describe a sixty-year-old man with intermittent claudication due to spinal canal stenosis who was successfully treated with beraprost sodium, a stable prostaglandin I2 analogue. This drug has a long

Hiroyuki Kato; Sei Emura; Kiyoko Ngashima; Hayato Kishikawa; Toshinobu Takashima; Keizo Ohmori

1997-01-01

395

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.  

National Technical Information Service (NTIS)

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...

K. F. Watts

1992-01-01

396

A previously unreported locality record for the Gila monster (Heloderma suspectum)  

USGS Publications Warehouse

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.

Lovich, Jeff; Haxel, Gordon

2011-01-01

397

22 CFR 40.91 - Certain aliens previously removed.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Certain aliens previously removed. 40.91 Section 40...IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year...

2010-04-01

398

Hypotension due to Chemotherapy in a Patient with Small Cell Lung Cancer and Lambert-Eaton Myasthenic Syndrome Undergoing Hemodialysis: A First Case Report  

PubMed Central

We present the first case of small cell lung cancer with Lambert-Eaton myasthenic syndrome during hemodialysis (HD). A 72-year-old male patient receiving HD experienced progressive muscle weakness. He was diagnosed with small cell lung cancer with Lambert-Eaton myasthenic syndrome due to an increased serum level of anti-voltage-gated calcium channel antibody and aspiration cytology on endobronchial ultrasonography for the swelling of a subcarinal lymph node. He received chemotherapy consisting of carboplatin (300 mg/m2) and etoposide (50 mg/m2), to which he had a partial response. However, the second therapy course could not be administered because of the unexpected development of severe hematological adverse events, which also prevented him from undergoing further HD. This case indicates that caution should be taken when using chemotherapy for such patients because of hypotension due to chemotherapy, with which it is impossible to undergo HD.

Kuwata, Taiji; Uramoto, Hidetaka; Baba, Tetsuro; Tanaka, Fumihiro

2012-01-01

399

Epididymal Polar Dissociation: A Previously Undescribed Anatomical Variant  

PubMed Central

The normal male external genitalia include the testicles with the epididymis attached posteriorly and the vas deferens arising from this. This case describes an anatomical variation of this normal anatomy not previously reported in the literature. A 17-year-old boy presented with symptoms of intermittent testicular torsion and underwent scrotal exploration. On the left side there was a bell-clapper deformity with the epididymis separated into two parts with the lower pole high in the scrotum and attached to the tunica vaginalis. A normal vas deferens was seen to arise from the isolated lower pole of the epididymis. There was no connection between the vas deferens and the testis or upper pole of epidiymis. This case reminds us of the possibility of anatomical variations and the importance of keeping them in mind to prevent complications at time of surgery.

McCain, Stephen; McCain, Scott; Mark, David; Brown, Robin

2014-01-01

400

Epididymal polar dissociation: a previously undescribed anatomical variant.  

PubMed

The normal male external genitalia include the testicles with the epididymis attached posteriorly and the vas deferens arising from this. This case describes an anatomical variation of this normal anatomy not previously reported in the literature. A 17-year-old boy presented with symptoms of intermittent testicular torsion and underwent scrotal exploration. On the left side there was a bell-clapper deformity with the epididymis separated into two parts with the lower pole high in the scrotum and attached to the tunica vaginalis. A normal vas deferens was seen to arise from the isolated lower pole of the epididymis. There was no connection between the vas deferens and the testis or upper pole of epidiymis. This case reminds us of the possibility of anatomical variations and the importance of keeping them in mind to prevent complications at time of surgery. PMID:24883220

McCain, Stephen; McCain, Scott; Mark, David; Brown, Robin

2014-01-01

401

Possibilities of sterility therapy in a patient with a premature menopause due to an X-chromosomal anomaly - a case report.  

PubMed

Our report concerns a patient with a climacterium praecox and an X-chromosomal anomaly (86% 46, XX; 7% 47, XXX; 7% 45, X0) desiring to give birth. She conceived once after down-regulation of the gonadotrophins by means of a cyclical hormone replacement therapy followed by gonadotrophin stimulation, as well as a second time under down-regulation with a GnRH-analogue and gonadotrophin stimulation. On the basis of the case report and of the literature, a possible interval therapy in such a patient, especially one even with increasing ovarian insufficiency, will be portrayed and discussed. PMID:11137332

Nawroth, F; Foth, D; Stute, P; Schmidt, T; Römer, T

2000-12-29

402

[Disseminated cutaneous histoplasmosis due to Histoplasma capsulatum var. duboisii associated with AIDS. A case report in Abidjan, Côte d'Ivoire].  

PubMed

Histoplasmosis is a deep mycosis whose capsulatum variety is recognized as being an AIDS-defining infection. However AIDS associated with Histoplasma capsulatum var. duboisii is rarely reported. We report a case of cutaneous duboisii histoplasmosis associated with AIDS which has been mistaken for molluscum contagiosum for many months. The diagnosis has been confirmed by means of a biopsy of a nodule followed by an anatomo-pathological examination. The medical treatment was successfully based on combination Triomune (stavudine + lamividine + nevirapine) and itraconazole. PMID:18431996

Sangaré, A; Yoboué, P; Ahogo, C; Ecra, E; Kaloga, M; Gbery, I; Kanga, J M

2008-02-01

403

Do attitudes of families concerned influence features of children who claim to remember previous lives?  

PubMed Central

Background: Reported cases of nearly 2600 children (subjects) who claim to remember previous lives have been investigated in cultures with and without belief in reincarnation. The authenticity in most cases has been established. Aims: To study the influence of attitudes of parents of the subjects, families of the deceased person with whom they are identified and attention paid by others on the features of the cases. Settings and Design: The study is based on field investigations. Materials and Methods: Data is derived from analysis of a larger series of an ongoing project. Information on initial and subsequent attitudes of subjects? mothers was available for 292 and 136 cases, respectively; attitudes of 227 families of deceased person (previous personality) with whom he is identified, and the extent of attention received from outsiders for 252 cases. Observations and interviews with multiple firsthand informants on both sides of the case as well as some neutral informants supplemented by examination of objective data were the chief methods of investigation. Results: The initial attitude of mothers varied from encouragement (21%) to neutral or tolerance (51%) to discouragement (28%). However, it changed significantly from neutrality to taking measures to induce amnesia in their children for previous life memories due to various psychosocial pressures and prevalent beliefs. Families of the previous personalities, once convinced, showed complete acceptance in a majority of cases. Outside attention was received in 58% cases. Conclusions: The positive attitude of parents might facilitate expression of memories but subsequently attitudes of persons concerned do not seem to alter features of the cases.

Pasricha, Satwant K.

2011-01-01

404

Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature  

Microsoft Academic Search

The abuse of household and other commercially available products containing volatile organic solvents is underrecognized. Not infrequently intentional butane inhalation results in high morbidity and mortality. A fatal outcome of butane abuse can be caused by asphyxia, cardiac arrhythmia or trauma. The reported number of cases in which death was the consequence of pure butane inhalation is limited, and in

Irena Novosel; Zdravko Kova?i?; Stjepan Gusi?; Lovorka Batelja; Marina Nesti?; Sven Seiwerth; Josip Škavi?

2011-01-01

405

Ground subsidence due to mining operations. October 1976-November 1989 (Citations from the COMPENDEX data base). Report for October 1976-November 1989  

SciTech Connect

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.)

Not Available

1990-01-01

406

[Effective CDDP arterial infusion with DSM for liver metastasis of malignant melanoma complicating DIC due to intratumoral hemorrhage--a case report].  

PubMed

A 65-year-old male, who had been diagnosed with melanoma of stage IIB and treated by chemotherapy since 2003 at the Dermatology Department, was referred to our department for liver metastasis of melanoma that had become resistant to chemotherapeutic agents. In 2006, he started receiving hepatic arterial infusion of CDDP. He was admitted to the hospital on an emergency basis for general fatigue the next May. Blood tests revealed anemia and thrombocytopenia. Contrast CT showed aggravation of liver metastasis. Contrast ultrasonography revealed nodular contrast enhancement at the margin of the tumor. On the basis of image findings and blood test results, DIC due to intratumoral hemorrhage was diagnosed. CDDP arterial infusion with DSM resulted in improved DIC, and he was able to be discharged. Taken together, attention has to be paid to the potential for emergency complications of DIC due to liver metastasis of melanoma with intratumoral hemorrhage. Moreover, it was shown that arterial infusion with DSM was effective for liver metastasis of melanoma. PMID:18931594

Takada, Kohichi; Kato, Junji; Kawano, Yutaka; Takahashi, Sho; Hayashi, Tsuyoshi; Ishiwatari, Hirotoshi; Miyanishi, Koji; Takimoto, Rishu; Kobune, Masayoshi; Sagawa, Tamotsu; Sato, Tsutomu; Sato, Yasushi; Yamashita, Toshiharu; Natori, Hiroshi; Niitsu, Yoshiro

2008-10-01

407

Duodenal perforation due to a kink in a nasojejunal feeding tube in a patient with severe acute pancreatitis: a case report  

PubMed Central

Introduction Nasojejunal feeding tube placement can be achieved by fluoroscopic or endoscopic techniques. Significant complications due to nasojejunal feeding tube placement, such as hydrothorax, duodenal perforation and retroperitoneal emphysema, are very rare. We present a case of massive retroperitoneal emphysema and abscess because of duodenal perforation caused by a kink in a nasojejunal feeding tube. Case presentation A 34-year-old Chinese woman was admitted to our intensive care unit due to hypertriglyceridemia and severe acute pancreatitis. As she suffered from acute respiratory distress syndrome and required mechanical ventilation, a nasojejunal feeding tube was placed by transnasal endoscopic technique. The procedure took place at her bedside. Half a month later, she had a high fever and abdominal distension. An abdominal radiography was performed and showed that the nasojejunal feeding tube was kinking on the third portion of the duodenum and the tip of the nasojejunal feeding tube was inserted into the right retroperitoneum on the second portion of the duodenum. Conclusion When a nasojejunal feeding tube is placed through the transnasal endoscopic technique, an abdominal radiography should be used to confirm the tube's position and indicate if it is kinking or beyond the ligament of Treitz.

2010-01-01

408

Instantaneous death due to transorbital reverse penetration of a screw in an accidental fall: unusual autopsy case report and review of the literature.  

PubMed

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

Gioia, Sara; Bacci, Mauro; Lancia, Massimo; Carlini, Luigi; Suadoni, Fabio

2014-03-01

409

Ectopic acromegaly due to a GH-secreting pituitary adenoma in the sphenoid sinus: a case report and review of the literature  

PubMed Central

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.

2013-01-01

410

Global Distribution of Extreme Precipitation and High-Impact Landslides in 2010 Relative to Previous Years  

NASA Technical Reports Server (NTRS)

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.

Kirschbaum, Dalia; Adler, Robert; Adler, David; Peters-Lidard, Christa; Huffman, George

2012-01-01

411

Observations on water system and pipeline performance in the Limon area of Costa Rica due to the April 22, 1991 earthquake. Technical report  

Microsoft Academic Search

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

M. J. ORourke; D. Ballantyne

1992-01-01

412

Pseudo-tumor of the scrotum, a rare clinical presentation of dirofilariasis: a report of two autochtonous cases due to Dirofilaria repens  

PubMed Central

In Europe, human dirofilariasis refers to a group of autochtonous parasitic infections caused by tissue nematodes of the genus Dirofilaria, responsible for two distinct clinical presentations: Dirofilaria immitis usually presenting as pulmonary lesions and Dirofilaria repens as subcutaneous nodules. Rare in humans, genital involvement manifests itself as pseudotumor nodules affecting the scrotum, epididymis, or spermatic cord. We report on two cases of Dirofilaria repens infections, involving the spermatic cord and epididymis.

Leccia, Nathalie; Patouraux, Stephanie; Carpentier, Xavier; Boissy, Christian; Giudice, Pascal Del; Parks, Scott; Michiels, Jean Francois; Ambrosetti1,5, Damien

2012-01-01

413

An uncommon presentation for a severe invasive infection due to methicillin-resistant Staphylococcus aureus clone USA300 in Italy: a case report  

Microsoft Academic Search

BACKGROUND: Methicillin resistant Staphylococcus aureus (MRSA) has been considered for many years a typical nosocomial pathogen. Recently MRSA has emerged as a frequent cause of infections in the community. More commonly, community-acquired (CA)-MRSA is a cause of infections of the skin and soft-tissues, but life-threatening infections such as necrotizing pneumonia and sepsis can occasionally occur. CASE PRESENTATION: This report describes

Piero Valentini; Gabriella Parisi; Monica Monaco; Francesca Crea; Teresa Spanu; Orazio Ranno; Mirella Tronci; Annalisa Pantosti

2008-01-01

414

Left atrial myxosarcoma with previously detected intestinal metastasis.  

PubMed

Primary cardiac myxosarcoma is a rare disease; it is exceedingly rare for symptoms of systemic metastasis to precede diagnosis of the primary cardiac tumor. We describe the case of a previously healthy 60-year-old man with left atrial myxosarcoma, who had first presented with jejunal intussusception due to intestinal polyposis. Three months after resection of the jejunum, the patient experienced cerebral infarction and pulmonary edema. Further physical evaluation, which included echocardiography for the 1st time, revealed a mass in the left atrium that protruded through the mitral valve into the left ventricle. At emergency cardiac surgery, we found that the tumor involved multiple sites of the left atrium, the pulmonary veins, and the mitral anterior leaflet. Two months after surgery, the patient died of massive cerebral hemorrhage. Necropsy disclosed multiple recurrences of the cardiac myxosarcoma and widespread metastatic lesions. The intestinal polyps that had been resected originally were diagnosed, on retrospective histopathologic examination, as metastases of the myxosarcoma. In this unusual case, the metastatic lesions were the 1st clinical manifestations of a malignant cardiac tumor. PMID:17420810

Takami, Yoshiyuki; Masumoto, Hiroshi; Terasawa, Akihiro; Kanai, Michio; Sugiura, Hiroshi

2007-01-01

415

Transient disappearance of Q waves of previous myocardial infarction due to exercise-induced ischemia of the contralateral noninfarcted myocardium  

Microsoft Academic Search

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

J. E. Madias; B. Manyam; M. Khan; V. Singh; C. Tziros

1997-01-01

416

Transient disappearance of Q waves of previous myocardial infarction due to exercise-induced ischemia of the contralateral noninfarcted myocardium.  

PubMed

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

Madias, J E; Manyam, B; Khan, M; Singh, V; Tziros, C

1997-04-01

417

Mycobacterial brain tuberculomas due to Bacille Calmette-Gu?rin intravesical chemotherapy for bladder cancer: A case report and literature review  

PubMed Central

Bacille Calmette-Guérin (BCG) immunotherapy is widely used for the treatment of superficial bladder cancer. The authors believe that the present report is one of the first to document cerebral BCG tuberculoma in a 73-year-old immunocompetent man, three years after intra-vesical BCG immunotherapy. His workup revealed no identifiable extracranial source. He responded well to treatment with rifampin, ethambutol and moxifloxacin. Patients undergoing intravesical BCG therapy should be closely monitored for the development of this complication. Prolonged antitubercular therapy, possibly including moxifloxacin, appears to be beneficial in the treatment of central nervous system tuberculous infections.

Golub, Vitaly; Malhotra, Prashant; Patel, Shital

2011-01-01

418

Direct sonographic-guided superior gluteal artery access for treatment of a previously treated expanding internal iliac artery aneurysm.  

PubMed

Isolated internal iliac artery aneurysms are relatively uncommon compared with all aortoiliac aneurysms. Transcatheter treatment with coil embolization is an attractive noninvasive alternative to surgical resection. However, if the aneurysm is insufficiently treated with only proximal coil embolization without concurrent embolization of distal runoff vessels, there is a risk of aneurysm expansion from retrograde collateral flow. We present a case of previously treated internal iliac aneurysm that underwent late rapid expansion. Due to occlusion of the internal iliac artery, direct sonographic-guided puncture of the superior gluteal artery was made in order to access the aneurysm. We believe this is the first reported case of such treatment. PMID:23642921

Herskowitz, Michael M; Walsh, James; Jacobs, David T

2014-01-01

419

Wildlife Loss Estimates and Summary of Previous Mitigation Related to Hydroelectric Projects in Montana, Volume Three, Hungry Horse Project.  

SciTech Connect

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.

Casey, Daniel

1984-10-01

420

Behavior degradation due to 1100-rad pulsed radiation exposure (5. 8:1 neutron/gamma ratio). Final report, June-December 1982  

SciTech Connect

A self-paced, 3-light, 3-lever discrete avoidance behavioral task was used for further study of behavioral performance effects of a high-neutron, low-gamma radiation pulse exposure (average 1100 rads midline tissue, 5,8:1 neutron/gamma ratio). Eight rhesus monkeys were exposed at the White Sands Missile Range Fast Burst Reactor and tested daily for up to 5 days after exposure. On the exposure day, all eight subjects had significantly degraded response accuracy, seven had increased reaction-time scores, seven experienced productive emesis. One day after exposure, most subjects performed near baseline levels except for occasional brief period(s). At 2 days, two subjects were unable to meaningfully perform the behavioral task and were euthanatized. The other six subjects were more variable than on the previous day. Three subjects experienced additional emetic episodes. At 5 days, only two of the remaining four animals performed at any reasonable degree. It is unlikely that any animal could have performed on the sixth day.

Brown, G.C.; Yochmowitz, M.G.; Hubbard, G.B.; Hardy, K.A.; Hughes, D.M.

1984-10-01

421

Bilateral orbital infarction and retinal detachment in a previously undiagnosed sickle cell hemoglobinopathy African child.  

PubMed

Bone infarction involving the orbit in sickle cell disease is not common. Bilateral orbital infarction in a previously undiagnosed sickle cell hemoglobinopathy has not been previously reported. In this report, we present a case of an 11-year-old previously undiagnosed sickle cell disease Nigerian girl with severe acute bilateral orbital infarction and retinal detachment to highlight that hemoglobinopathy induced orbital infarction should be considered in African children with acute onset proptosis with or without previous history of sickle cell hemoglobinopathy. PMID:23901183

Helen, Onakpoya Oluwatoyin; Ajite, K O; Oyelami, O A; Asaleye, C M; Adeoye, A O

2013-05-01

422

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

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.

Watts, K.F.

1992-09-01

423

Report of a female patient with mental retardation and tall stature due to a chromosomal rearrangement disrupting the OPHN1 gene on Xq12  

PubMed Central

We report on a patient with mental retardation, seizures and tall stature with advanced bone age in whom a de novo apparently balanced chromosomal rearrangement 46,XX,t(X;9)(q12;p13.3) was identified. Using array CGH on flow-sorted derivative chromosomes (array painting) and subsequent FISH and qPCR analysis, we mapped and sequenced both breakpoints. The Xq12 breakpoint was located within the gene coding for oligophrenin 1 (OPHN1) whereas the 9p13.3 breakpoint was assigned to a non-coding segment within a gene dense region. Disruption of OPHN1 by the Xq12 breakpoint was considered the major cause of the abnormal phenotype observed in the proband.

Menten, Bjorn; Buysse, Karen; Vermeulen, Stefan; Meersschaut, Valerie; Vandesompele, Jo; Ng, Bee L.; P.Carter, Nigel; Mortier, Geert R.; Speleman, Frank

2009-01-01

424

14 CFR 60.17 - Previously qualified FSTDs.  

Code of Federal Regulations, 2010 CFR

...Previously qualified FSTDs. 60.17 Section 60.17 Aeronautics and Space FEDERAL...CONTINUING QUALIFICATION AND USE § 60.17 Previously qualified FSTDs. ...use of such an FSTD after May 30, 2014 for flight crewmember...

2010-01-01