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As its website proclaims, the "Woman's Hour" on BBC Radio is designed for the purpose of "celebrating, informing and entertaining women." As part of a larger set of sites dedicated to like-minded resources for women from the BBC's Radio 4, this particular program tackles a number of germane subjects, including relationships, health, politics, and cooking. One of the definitive highlights is the drama section, where visitors can listen to radio versions of plays such as "The Reef" by Edith Wharton. Visitors can listen to the current edition of Woman's Hour, or elect to listen to previous programs from the same week. Guests are also invited to send in their own comments on timely topics and also offer their input on a series of moderated message boards.
A psychologist explains the renewed interest in the role of women in our society and examines and clarifies the issues by means of scientific data and opinion. Contents of the book cover: the revolution in a man's world, the girl grows up, sex and abilities, the female personality, the homemaker, women in the labor force, the employed woman, the…
In the 1970s, the Woman's Building in Los Angeles was a pivotal locus of activity for the feminist art movement. This website brings that history to life, providing information about its history, programs, projects, and the women behind the vision. A great place to start is with the History section which details the history of this important structure from its opening in 1973. Visitors will also find a photographic essay here that illuminates some of the work that has been housed within its walls. Moving on, the People section offers a bit of historical perspective on the women who founded the Woman's Building, including Judy Chicago and Sheila de Bretteville. The site is rounded out by the Programs area which features a listing of various seminars, exhibits, and lectures that took place on site.
Mary Cassatt: Modern Woman, an exhibition of about one hundred paintings and prints by this popular American Impressionist artist, was the 1998 Christmas-season blockbuster at the Art Institute of Chicago. The exhibition has travelled on to the Museum of Fine Arts, Boston, where advance tickets sold out just as quickly as they did in Chicago. MFA Boston provides this Web version of the show, which includes twenty Cassatts that you can see without leaving home. The Online Exhibition also features background information on each work of art, and a gift shop with online ordering that offers the exhibition catalogue and the same Mary Cassatt note cards, tote bags, and posters that you can purchase at the museums.
Lorena A. Hickok was a notable woman journalist of the early twentieth century whose career was greatly altered by her friendship with Eleanor Roosevelt. After reporting for several newspapers across the country, Hickok became one of the first women hired by the Associated Press wire service (AP) in 1928. She was assigned to cover Eleanor…
A 65-year-old woman had an eschar after a holiday to Spain. A skin biopsy showed findings consistent with an ulcer but tested negative for fungi, atypical mycobacteria and Leishmania parasites. Rickettsia conorii serology was negative. The diagnosis necrotic arachnidism was made based on the clinical picture. PMID:24642123
Berrevoets, Marvin A H; Meek, Inger L; de Mast, Quirijn
Besides the effects of the microgravity environment, and the psychological and psychosocial problems experienced in confined spaces, radiation is the main health detriment for long duration human space missions. The radiation environment encountered in space differs in nature from that on earth, consisting mostly of high energetic ions from protons up to iron, resulting in radiation levels far exceeding the ones present on earth for occupational radiation workers. Accurate knowledge of the physical characteristics of the space radiation field in dependence on the solar activity, the orbital parameters and the different shielding configurations of the International Space Station ISS is therefore needed. For the investigation of the spatial and temporal distribution of the radiation field inside the European COLUMBUS module the experiment DOSIS (Dose Distribution Inside the ISS) under the lead of DLR was launched on July 15th 2009 with STS-127 to the ISS. The experimental package was transferred from the Space Shuttle into COLUMBUS on July 18th. It consists of a combination of passive detector packages (PDP) distributed at 11 locations inside the European Columbus Laboratory and two active radiation detectors (DOSTELs) with a DDPU (DOSTEL Data and Power Unit) in a nomex pouch (DOSIS MAIN BOX) mounted at a fixed location beneath the European Physiology Module rack (EPM) inside COLUMBUS. The DOSTELs measured during the lowest solar minimum conditions in the space age from July 18th 2009 to June 16th 2011. In July 2011 the active hardware was transferred to ground for refurbishment and preparation for the DOSIS-3D experiment. The hardware will be launched with the Soyuz 30S flight to the ISS on May 15th 2012 and activated approximately ten days later. Data will be transferred from the DOSTEL units to ground via the EPM rack which is activated approximately every four weeks for this action. First Results for the active DOSIS-3D measurements such as count rate profiles, dose rates and LET spectra will be presented in comparison to the data of the DOSIS experiment as well as the DOSMAP experiment which has been performed during solar maximum in 2001.
Paraganglioma with tracheal location is a rare tumor. Twelve cases with involvement of the trachea have been reported in English literature, including six cases of solely tracheal paragangliomas. We present a case of a paraganglioma confined to the tracheal wall in a 33-year-old pregnant woman. The tumor was locally resected. Follow-up 17 months later showed no evidence of relapse. Based on the literature, we found that the most common symptoms are respiratory impairment and haemoptysis. None of the cases showed malignant behaviour. PMID:20594539
Djurhuus, Bjarki Ditlev; Krogdahl, Annelise Solveig; Godballe, Christian
Women’s early history provides a long tradition of attested textual evidence associating female bodily secretions with impurity,\\u000a particularly in relation to menstruation, childbirth, and sexual intercourse. But we notice among early medical texts the\\u000a mention of another female secretion, woman’s milk, and its use as a healing ingredient in medical recipes. This paper argues\\u000a that textual sources of woman’s milk
Developed by Professor Barbara Babcock at Stanford University's Law School (and the staff at the Robert Crown Law Library), this website is intended to serve as an online resource for "all who are interested in the subject of women lawyers in the United States." Working with her students and others, Professor Babcock has created an index of women lawyers; and for each entry, attached pertinent documents that are both historical and contemporary. The index includes such well-known names as Sandra Day O'Connor and others that may not be immediately recognizable to the casual visitor. Along with this index, there is an entire section devoted to the woman who started the entire project: Clara Shortridge Foltz. Foltz was the first female lawyer on the Pacific Coast (arriving from Indiana in 1878), and she kept an extensive career scrapbook, along with penning numerous letters and writing a draft of her autobiography before she died. In this section, visitors can read some of the numerous articles and speeches that Professor Babcock has authored or delivered on Foltz and her legacy. For those interested in additional works on the subject of women lawyers, there is an extensive bibliography of germane articles offered here as well.
Almost thirty years after Judith Godden looked afresh at the pioneer woman it seems that history, as a discipline, has gone some way towards attending to her call to complicate its treatment of (white) women's early experiences in the Australian colonies. The myth of the Pioneer Woman, however, remains as pervasive as ever and it remains tacked on, though now
The African American woman has commanded widespread public attention, but popular misconceptions of her socioeconomic role and status differ sharply from her actual situation. The following basic characteristics of the contemporary African American woman, drawn from census figures, are outlined: (1) demographically, females comprise a majority of…
The recent history of the battered woman's movement is an interesting study in social science politics. Wife-beating never actually held center stage in social reformation movements until the effort over the last three decades that emphasized changing the power relationship between women and men to one of equality. Professionals in the battered woman's movement are often viewed as having little
This paper explores a representation of overlapping categories of gender, disability and cyborgs in "Bionic Woman" (2007). The television show "Bionic Woman" (2007) is a popular culture representation that uniquely brings together these categories. Three themes emerged from an analysis of blogger discourse surrounding the show. The themes reveal…
Los resultados preliminares de un estudio clínico grande con asignación al azar de pacientes de 16 a 60 años de edad con leucemia mieloide aguda (LMA), un cáncer de la sangre y de la médula ósea, que no había sido tratada anteriormente, muestran que los pacientes que recibieron una alta dosis de daunorrubicina, un fármaco de quimioterapia disponible comercialmente, durante la terapia inicial vivieron más que los pacientes que recibieron una dosis normal del mismo fármaco.
The Woman’s Building Library represents women’s lives and writing at an historical moment characterized by paradox and transition. As almost every article in this special issue reveals, the books held in the library articulate tensions in women’s roles in late-nineteenth-century America and speak to shifts in women’s writing during the period. The shifts and tensions, transitions and paradoxes, contained in
Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. This study examined treatment discontinuation in IVF programmes, according to the woman’s age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and
Noémie Soullier; Jean Bouyer; Jean-Luc Pouly; Juliette Guibert; Elise de La Rochebrochard
The authors describe, for the first time, bilateral, sequential large dacryocystoceles during pregnancy and review the literature for this presentation. A 26-year-old, 15-week pregnant woman presented with OD epiphora, diplopia, and pain in the setting of an inferomedial orbital mass. Surgical exploration and histopathology were consistent with a dacryocystocele, and a dacryocystorhinostomy was curative. She returned at 34-week gestation, with an identical presentation on the left side. Review of the literature reveals that dacryocystoceles occasionally present in adults; however, bilateral involvement may be unusual. Bilateral dacryocystoceles have not been previously reported in a pregnant woman. PMID:24025998
Hirabayashi, Kristin E; Yang, Elizabeth; Echegoyen, Julio; Yoon, Steven J; Tao, Jeremiah P
A novel diffusion-edited 3D NMR experiment that incorporates a BEST-HMQC pulse sequence in its implementation is presented. Heteronuclear 3D DOSY NMR experiments are useful in elucidating the diffusion coefficients of individual constituents of a mixture, especially in cases where the proton NMR 2D DOSY spectra show considerable overlap. The present 3D BEST-DOSY pulse sequence provides a more sensitive and less time-consuming alternative to standard 3D HMQC-DOSY experiments. Cleanly separated subspectra of individual mixture components are obtained, leading to the determination of diffusion coefficients with better accuracy. The feasibility of the technique is demonstrated on a mixture of amino acids, on a mixture of small molecules with similar diffusion coefficients, and on a complex mixture with large dynamic range (commercial gasoline). The implications of using adiabatic decoupling schemes and band-selective shaped pulses for selective BEST-DOSY experiments on proteins are also discussed. PMID:21937251
In Pakistan, population growth rate is 2.2% and Total Fertility Rate (TFR) is as high as 5.4. It is the result of low Contraceptive Prevalence Rate (CPR) of only 28%. Due to low CPR, women have high rate of unwanted births in Pakistan. In this study using probit estimation on primary data, we have analyzed the woman=s characteristics responsible for low contraceptive prevalence among married women in urban areas of Punjab (Pakistan). For the purpose one thousand married women in the age group of 15-49 years, who were not currently pregnant were interviewed from urban areas of Bahawalpur and Lahore. The individual characteristics of married women were focused, although household characteristics, socio-economic conditions of the community where woman is living, religious and cultural factors are also important. It is found that age of woman, education of woman, woman`s status, her economic activity, income level and age at marriage were found major determinants of contraceptive prevalence in women. The policies towards the education of women, status of women, labor force participation of women and legal interventions towards the increase in marriage age are stressed to increase the CPR.
This is a collection of anthropological and sociological articles on the black woman. Essays cover the experiences of black women in Africa, the Caribbean, South America, and the United States in politics, business, the community, the arts, the family, and social change. Several themes are present throughout this anthology, including black women's…
This study explores ten Indian women's experience of 'being an educated woman.' These ten women have a bachelor's degree and hail from Bangalore city in India. The social phenomenon of being an educated person is a positive notion in postcolonial, Indian society. Girls' and women's education is regarded as important for their family and for the nation's progress. Academic research
Approximately 25% of postmenopausal women smoke cigarettes. Cigarette smoking has been linked to many diseases of the mature woman, both gynecologic and non-gynecologic. Cigarette smoking is associated highly with cardiovascular disease, and in women, it is estimated that 21% of all mortality from cardiovascular disease is related to cigarette smoking. Cigarette smokers demonstrate a markedly elevated prevalence for development of
Written for the woman just graduated from college who wants a big-city job, the book provides coverage of the job scene from New York to San Francisco and offers methods and suggestions on how to create an exciting new career. Tips on where to look for jobs, the resume, and the job interview are some of the introductory topics, followed by a…
A letter of recommendation can catapult a woman into the next phase of the interview process for a particular job--or land her in the slush pile. Word choice in describing this female candidate can make or break her career. Letters of recommendation--especially when a reference's word choice paints a negative, less than stellar picture of the…
The Black woman, as a member of two minorities, finds herself in an ambiguous role. An alignment with Black civil rights or feminist groups puts her in the position where Blacks or women will criticize or question her loyalties or fulfillment of her responsibilities. (CMG)
Sarcoma of the corpus uteri should be considered as a differential diagnosis in postmenopausal women presenting with severe abdominal pain, thought to be due to degenerative changes of leiomyoma uteri. We present a rare case of leiomyosarcoma in a postmenopausal White woman. Diagnosis was missed preoperatively for degenerating uterine fibroid. PMID:20418648
Reactions to the "woman the gatherer" theory, introduced in the 1970's as an alternative to the "man the hunter" thesis in anthropology, have been to accept, ignore it, or combine it with the hunting theory. The "man the hunter" model stresses that primitive males hunted for meat and provided food and protection for their mates and children who…
Knowledge on the forces acting on a woman's breast and on the mechanical properties of the breast tissues is important for studying the effects of plastic surgery techniques for breast reconstruction as well as for the design of cosmetic breast implants. Surprisingly, there are no data in the literature regarding mechanical loads on the breast tissues during daily or sport
The trials of a comfort woman was never revealed after the conclusion of WWII. More than half a century has passed before the name was uttered on the international stage. Why the sudden break of silence? What is the response of the Japanese government. In this paper, we discuss the issue of the comfort women and the the political implications
This biennial report is based on responses from 2,112 of the 4,453 non-student members of the Society of Women Engineers (SWE) who were surveyed during the winter of 1983-84. All responses to the survey questionnaire (included in an appendix) were considered in the data analysis. Any woman with an engineering degree, holding state engineering…
The use of battered woman syndrome evidence has been advocated in trials of battered women who assault or kill their abusers. The present article reviews existing legal and psychological literature addressing the use of this form of expert testimony. As the review will indicate, there are, at present, substantial gaps in our knowledge about its scientific status and its impact
Presents an interview with Dr. Joyce F. Brown, the first female and first African American president of the Fashion Institute of Technology in New York. Explores the intricacies of being a Black woman president, working in New York higher education systems, and training students for an industry not renowned for its diversity. (EV)
In this article, the author profiles Carolyn Brodie, winner of this year's Scholastic Library Publishing Award. One can be completely charmed by Brodie's soft-spoken Arkansas accent, warm demeanor, and genteel manners. While the graciousness is authentic, the woman behind it is fearless, with a clear vision for youth services, remarkable tenacity,…
The case of a Moroccan woman, age 25, who came into the emergency department with clinical tetany, is presented. She had experienced muscle spasms and paresthaesia of the upper limb over the previous few days. She had also experienced major diarrhoea for the previous 3 weeks. Investigations revealed a severe electrolyte disorder.
Introduction Radiographic density adversely affects the performance of X-ray mammography and can be particularly problematic in younger and high-risk women. Because of this limitation, there is significant ongoing effort to develop alternative cancer screening and detection strategies for this population. This pilot study evaluates the potential of Diffuse Optical Spectroscopic Imaging (DOSI) to image known tumors in dense breast tissue. Methods We performed a retrospective analysis on 24 radiographically dense breast cancer subjects measured with DOSI over a four-year period (Breast Imaging Reporting and Data System - BI-RADS, category 3 and 4, average age = 39 ± 7.6, average maximum size 31 ± 17 mm). Two previously-described DOSI contrast functions, the tissue optical index (TOI) and the specific tumor component (STC), which are based upon the concentrations and spectral signatures of hemoglobin, water and lipids, respectively, were used to form 2D optical images of breast tumors. Results Using TOI and STC, 21 out of 24 breast tumors were found to be statistically different from the surrounding highly vascularized dense tissue and to be distinguishable from the areolar region. For these patients, the tumor to normal contrast was 2.6 ± 1.2 (range 1.3 to 5.5) and 10.0 ± 7.5 (range 3.3 to 26.4) for TOI and STC, respectively. STC images were particularly useful in eliminating metabolic background from the retroareolar region which led to identification of two out of four retroareolar tumors. Conclusions Using both the abundance and the disposition of the tissue chromophores recovered from the DOSI measurements, we were able to observe tumor contrast relative to dense breast tissue. These preliminary results suggest that DOSI spectral characterization strategies may provide new information content that could help imaging breast tumors in radiographically dense tissue and in particular in the areolar complex.
Population aging is a demographic reality for Brazil. Consequently, in the next years it is expected a progressive increase in seeking health care services in the country by women with complaints related to climacterium. Parallel to it, assistance at this part of woman's life has been going through a paradigm shift which has imposed to health professionals a change of attitude in relation to this stage of woman's life. Today it is acknowledged that the climacterium is influenced by biological, psychosocial and cultural factors, whose knowledge is fundamental for planning a more qualified and humanized care. This article proposes a reflection on the paradigm shifts in assistance at climacterium, highlighting important aspects as multidisciplinarity and interdisciplinarity, so as to serve better this portion of population, and provide it with more integrated and individualized care, bringing together knowledge and sensitivity, and always aiming at a better quality of life. PMID:19430691
A case is presented of a 52-year-old woman in whom clinical and histopathologic findings suggested cicatricial alopecia. Our patient had an uncommon, but distinctive, clinical presentation. It was characterized by bandlike frontal hair loss. This was recently described as patterned cicatricial alopecia, presented in a recent study as postmenopausal frontal hairline recession with scarring. Our patient's case should be differentiated from recognized forms of scarring alopecia. PMID:9426971
A 69-year-old woman had a progressive demyelinating and axonal polyneuropathy and a monoclonal gammopathy. Physical examination showed hyperpigmentation, acrocyanosis, white nails and pitting oedema. Additional tests showed polycythemia, thrombocytosis, a high serum VEGF-level, clonal plasma cells on bone marrow biopsy and sclerotic lesions of a cervical rib and the cervical and thoracal spine. POEMS-syndrome was diagnosed. PMID:24642120
van der Meijden, Wilbert A G; Alsma, Jelmer; van Doorn, Pieter A
Multilingual aphasias are common because most people in the world know more than one language, but little is known of these syndromes except in patients who have had a stroke. We present a 76-year-old right-handed woman, fluent in English and Chinese, who developed anomia at age 70 and then progressed to aphasia. Functional neuroimaging disclosed mild left temporoparietal hypometabolism. Neurolinguistic
Christopher M. Filley; Gail Ramsberger; Lise Menn; Jiang Wu; Bessie Y. Reid; Allan L. Reid
\\u000a Diabetes increases the risk of complications during pregnancy. Starting in the preconception period and continuing throughout\\u000a pregnancy and postpartum, heightened surveillance is necessary in order to achieve a healthy outcome for both mother and neonate.\\u000a This chapter will outline the complications that may arise during pregnancies complicated by diabetes and suggest a management\\u000a scheme for the gravid woman with diabetes.
... This information in Spanish ( en español ) Your rights as a woman with HIV/AIDS Your job Privacy and ... Return to top More information on Your rights as a woman with HIV/AIDS Explore other publications ...
Twenty-four samples of heroin from different illicit drug seizures were analyzed using proton Nuclear Magnetic Resonance ((1)H NMR) and two-dimensional diffusion-ordered spectroscopy (2D DOSY) (1)H NMR. A careful assignment and quantification of (1)H signals enabled a comprehensive characterization of the substances present in the samples investigated: heroin, its main related impurities (6-acetylmorphine, acetylcodeine, morphine, noscapine and papaverine) and cutting agents (caffeine and acetaminophen in nearly all samples as well as lactose, lidocaine, mannitol, piracetam in one sample only), and hence to establish their spectral signatures. The good agreement between the amounts of heroin, noscapine, caffeine and acetaminophen determined by (1)H NMR and gas chromatography, the reference method in forensic laboratories, demonstrates the validity of the (1)H NMR technique. In this paper, 2D DOSY (1)H NMR offers a new approach for a whole characterization of the various components of these complex mixtures. PMID:24378299
The present study determined if the ideal man has changed over the years and who and what the ideal woman is. We asked students at Cameron University to rate the importance of character traits that define the ideal man and woman. Subjects also provided examples of famous people exemplifying the ideal, good, average, and inferior man and woman. We…
Weinstein, Lawrence; Laverghetta, Antonio V.; Peterson, Scott A.
Vanillin (4-hydroxy-3-methoxybenzaldehyde) is a phenolic aldehyde with limited solubility in water; in this work, we investigate its self-aggregation, as well as its complexation equilibria with ?-cyclodextrin by using nuclear magnetic resonance (NMR) and vibrational spectroscopy. In particular, diffusion-ordered NMR (DOSY) measurements allowing to detect diffusional changes caused by aggregation/inclusion phenomena lead to a reliable estimate of the equilibrium constants of these processes, while Raman spectroscopy was used to further characterize some structural details of vanillin self-aggregates and inclusion complexes. Although the self-association binding constant of vanillin in water was found to be low (Ka ?10), dimeric species are not negligible within the investigated range of concentration (3-65 mM); on the other hand, formation of ?-cyclodextrin self-aggregates was not detected by DOSY measurements on aqueous solutions of ?-cyclodextrin at different concentrations (2-12 mM). Finally, the binding of vanillin with ?-cyclodextrin, as measured by the DOSY technique within a narrow range of concentrations (2-15 mM) by assuming the existence of only the monomeric 1:1 vanillin/?-CD complex, was about an order of magnitude higher (Kc ? 90) than self-aggregation. However, the value of the equilibrium constant for this complexation was found to be significantly affected by the analytical concentrations of the host and guest system, thus indicating that Kc is an "apparent" equilibrium constant. PMID:24911963
Twenty herbal medicines or dietary supplements marketed as natural slimming products were analysed by diffusion ordered spectroscopy (DOSY) H-nuclear magnetic resonance (NMR) and DOSY-COSY H-NMR. The method allows analysis of the whole sample with the detection of both active and inactive ingredients in these complex matrices. Among the 20 formulations analysed, two were strictly herbal and four had a composition
J. Vaysse; S. Balayssac; V. Gilard; D. Desoubdzanne; M. Malet-Martino; R. Martino
Homelessness continues to increase in the United States. Families comprise the fastest growing segment of the homeless population, and estimates suggest that women head 90% of homeless families. Pregnant homeless women are exposed to more cumulative violence than are comparable low-income, housed women. Intervention strategies that may improve health care provided to pregnant homeless women include abuse and safety assessment protocols and the use of a hand-carried health record. These interventions are directed at efforts to preserve the woman's autonomy and confidentiality, reduce areas of client-provider conflict, and generally improve encounters between the client and the health care system. PMID:9836164
Progressive Multifocal Leucoencephalopathy (PML) is a rare and invariably fatal neurological disease that is seen patients with untreated HIV infection and as a complication of immune suppression with agents such as natalizumab. With the increasing occurrence of HIV, it is important to consider this condition in the differential diagnosis of patients with neurological features. We present the case of a young woman with a long history of HIV infection who presented with neurological symptoms; recognition of this diagnosis enabled identification of her poor compliance with treatment. The investigation and treatment of this condition is discussed. PMID:23539372
We report a case of lichen striatus in a 37-year-old woman in the third trimester of pregnancy. She presented at 35 weeks of pregnancy with a 6-week history of a pruritic rash on the left side of her abdomen. Examination revealed an erythematous papular eruption arranged in a linear fashion from the umbilicus to the left mid back. Histological examination demonstrated lichenoid perivascular and periadnexal inflammatory infiltrate and the presence of colloid bodies. The eruption resolved prior to delivery with the application of mometasone furoate 0.1% ointment. PMID:16008653
Takayasu arteritis is a chronic, progressive, autoimmune, idiopathic, large-vessel vasculitis that usually affects young adults. The disease has been reported to occur in all races and ethnicities. The diffuse nature of this vasculitis can affect multiple-organ systems to varying degrees. Herein, we report the case of a young woman whose exertional angina and claudication were the initial presentation of active Takayasu arteritis. During more than 4 years of ongoing treatment, therapy, and follow-up, she has displayed differing disease symptoms of varying intensity. We discuss the challenges of managing Takayasu arteritis in our patient and describe different treatments for this rare vasculitic disorder.
Saab, Fadi; Giugliano, Robert P.; Giugliano, Gregory R.
This article features a critical review of accumulated research and conceptual issues regarding Battered Woman Syndrome (BWS). BWS is recognized as important in providing legal defense to victims and as basis for diagnosis and treatment. However, there has been confusion as to the definition of BWS such as the use of violence committed against the woman as the defining characteristic. The study introduced by Walker demonstrated cycle of violence and learned helplessness to battered women. In addition, studies found out that BWS, manifested in a form of depression, low self-esteem, anxiety, physical symptoms, is evident in some abused women putting them at risk of suicide and homicide. Symptoms attributed to battering may also be a result of stress from a troubled relationship. The Learned Helplessness and Grief Theory (Campbell, 1989) explains the depression in battered women. Moreover, researchers are in disagreement of the factors that affect the level of trauma such as frequency of abuse, educational status and severity of sexual and emotional abuse. The issue on Post-Traumatic Stress Disorder and learned helplessness in BWS remained unresolved. Some researchers view battered women in the context of "survivors rather than victims". Furthermore, studies prove that battered women may experience stages of abuse where the manifestations of BWS are part of the steps to conflict resolution. Basing on these descriptions and findings, it is made clear that not all battered women experience BWS. PMID:12349358
The curriculum of US History has improved substantially in its presentation of women over the 40 years since Trecker's 1971 study of US History textbooks. While studies show increased inclusions, they also suggest that women have not yet claimed their own place in the school curriculum. This paper seeks to better understand the woman who is…
Leiomyoma is benign mesenchymal tumor, that frequently occur in uterus but it rarely happens in ovary. Ovarian leiomyomas are seen concomitantly with uterine leiomyoma in about 78% of cases. They often discover incidentally but their most clinical manifestations are abdominal pain and palpable mass. Herein, we reported a large ovarian leiomyoma in a 22-year-old woman with abdominal pain and palpable mass at lower abdominal region. Computed tomography scan revealed large adnexal mass. Microscopic appearance was typical for leiomyoma but because its rarity in ovary the immunohistochemical staining was done. Major differential diagnostic considerations for this tumor in ovary are fibroma/thecoma, sclerosing stromal tumor, and leiomyosarcoma. The immunohistochemical staining with desmin, inhibin, and ?-smooth muscle actin are helpful to rule out this differential diagnosis. PMID:24761396
Pregnancy is a rare occurrence in patients suffering from spinal cord injury (SCI). Pregnancy in these patients presents unique challenges to obstetric care providers, who need to become familiar with the general principles of care in this setting. SCI alters the function of multiple organ systems and chronic medical conditions are common in this patient population. Certain medical complications such as urinary tract infections and autonomic hyper-reflexia, or autonomic dysreflexia, are expectable and can be managed successfully. A multidisciplinary team should care for delivery in these patients. The authors present a case of a pregnancy in a paraplegic woman whose lesion was at the level of T4. She received epidural analgesia and had a caesarian section. From this case, the authors aim to point out the specific concerns of the management of pregnancy and delivery in this setting emphasising the importance of a multidisciplinary team, specially obstetricians and anaesthetists. PMID:24671318
Leiomyoma is benign mesenchymal tumor, that frequently occur in uterus but it rarely happens in ovary. Ovarian leiomyomas are seen concomitantly with uterine leiomyoma in about 78% of cases. They often discover incidentally but their most clinical manifestations are abdominal pain and palpable mass. Herein, we reported a large ovarian leiomyoma in a 22-year-old woman with abdominal pain and palpable mass at lower abdominal region. Computed tomography scan revealed large adnexal mass. Microscopic appearance was typical for leiomyoma but because its rarity in ovary the immunohistochemical staining was done. Major differential diagnostic considerations for this tumor in ovary are fibroma/thecoma, sclerosing stromal tumor, and leiomyosarcoma. The immunohistochemical staining with desmin, inhibin, and ?-smooth muscle actin are helpful to rule out this differential diagnosis.
2D DOSY 1H NMR has proved to be a useful technique in the identification of the molecular skeleton of the four major compounds of ethyl acetate extract of aerial parts of Bidens sulphurea (Asteraceae). The combination of this technique with HPLC, mass spectrometry and other NMR techniques enabled the identification of four flavonoid glycosides: quercetin-3-O-beta-D-galactopyranoside, quercetin-3-O-beta-D-glycopyranoside, quercetin-3-O-alpha-L-arabinofuranoside and quercetin-3-O-beta-D-rhamnopyranoside. PMID:19768723
Rodrigues, Edilene Delphino; da Silva, Denise Brentan; de Oliveira, Dionéia Camilo Rodrigues; da Silva, Gil Valdo José
Short relaxation times and small diffusion coefficients often impede reliable diffusion experiments due to insufficient signal to noise ratios, especially in low temperature studies, where in the case of small diffusion coefficients in combination with very short T(2) times and substantial convection, double-stimulated-echo experiments are required as last resort of convection-compensating DOSY pulse sequences. Therefore, the combination of a strong gradient amplifier of a diffusion unit with Z-gradient high resolution probes is tested for low temperature applications to combine the advantages of high (1)H resolution, flexible temperature, and multinuclear applications with short gradient durations and diffusion delay. The experimental spectra on phosphoramidite ligands and phosphoramidite-copper complexes show that signal to noise improvements up to 176% were achieved despite longer eddy current delays and increased noise levels. Calculational estimations of the enhancement factors predict special benefits for systems with short transversal relaxation times and small diffusion coefficients and promise even higher enhancement factors for noise level optimized combinations. In addition, an easy way is presented to find fast and effectively relaxation optimized DOSY parameters for the convection-compensated double-stimulated-echo pulse sequence of Jerschow and Müller. PMID:19384916
Zhang, Hongxia; Kerssebaum, Rainer; Gschwind, Ruth M
Thanks to UN literacy programs, Fanta, a Konkaran village woman living in Mali near the edge of the Sahara, has learned 1) to read, write, and do basic arithmetic; 2) to raise animals for food and income; 3) to raise her goats better and to prepare milk in healthier ways; and 4) to treat children with diarrhea with oral rehydration. Her village status has improved as women come to her for advice or to write letters for them. Prior to this type of UN program, the Niger River carried only disease, parasites, river blindness, and death for some 30% of the children in Konkaran who may die before the age of 5. Youphadee and her family, in Bangkok, Thailand, live in a sprawling Rajataphan slum with 400 other families; a UN Educational, Scientific and Cultural Organization (UNESCO) and government sponsored literacy program has taught her basic accounting to run her food business. With other women, she has formed a credit union which provides loans for family emergencies and for business investment. PMID:12179428
This paper is a report on a course to be offered by the author at the University of North Carolina, Chapel Hill entitled "Woman's History in the West." The author describes the difficulties she had in procuring information to present to her class. The course is outlined as follows: (1) the problems of studying woman's history; (2) the medieval…
This article explores society, religion and identity in the poetry of a 19th-century woman poet of Punjab. Widely regarded as the first woman poet of Punjab, Peero wrote her autobiography in verse. In the process, she transcended the individual limits set by her condition and moved to a general exposition of the position of women in Punjabi society. Subsequently, she
Of the contraceptive choices open to a post-partum woman with gestational diabetes, this discussion concentrates on low-dose oral contraceptives. Although gestational diabetes usually clears at delivery, 75% of these women will go on to developed impaired glucose tolerance or overt diabetes, especially if they are obese or if their glucose level had been high. Many elect permanent sterilization, but those requiring reversible contraception usually choose the IUD or the pill. IUDs carry a high risk of infection and are less effective in diabetics. The author compared a low-dose combined pill with 400 mcg norethindrone and 35 mcg ethinyl estradiol (Ovcon 35), and a pill containing levonorgestrel (Triphasil), to barrier contraception in 230 women with recent gestational diabetes. After 6-13 months of use 11-17% of each group had impaired glucose tolerance, and 15-20% of each group had diabetes (n.s.). Insulin levels rose from 28.5 mIU/mL to 59.7 in controls, 32.0 to 71.8 in Ovcon 35 users, and from 40.2 to 85.1 in Triphasil users (p0.05). HDL values rose significantly in the group taking Ovcon, and LDL values fell significantly in all 3 groups. These low-dose pills can be used safely in postpartum gestational diabetic women, as long as they do not smoke, are encouraged to lose weight, and have no sign of cardiovascular disease as evidenced by albuminuria and an ophthalmoscopic exam. PMID:1679421
Dos dosis de Cervarix, la vacuna contra virus del papiloma humano (VPH), fueron tan efectivas como la pauta normal actual de tres dosis después de cuatro años de seguimiento. El estudio de vacuna en Costa Rica, patrocinado por el NCI, fue diseñado para evaluar la eficacia de Cervarix en una población determinada.
To address the practical issues of polymer molecular weight determination, the first accurate polymer weight-average molecular weight determination method in diverse living/controlled polymerization via DOSY (diffusion-ordered NMR spectroscopy) is reported. Based on the linear correlation between the logarithm of diffusion coefficient (log D) and the molecular weights (log Mw), external calibration curves were created to give predictions of molecular weights of narrowly-dispersed polymers. This method was successfully applied to atom transfer radical polymerization (ATRP), reversible addition–fragmentation chain transfer (RAFT), and ring-opening metathesis polymerization (ROMP), with weight-average molecular weights given by this method closely correlated to those obtained from GPC measurement.
Li, Weibin; Chung, Hoyong; Daeffler, Christopher; Johnson, Jeremiah A.; Grubbs, Robert H.
The Center for Development and Population Activities (CEDPA) is a private voluntary organization (PVO) that has started a project using a woman to woman approach, along with the help of non-governmental organizations (NGOs), to deliver family planning services in developing nations. The project is called Access to Family Planning through Women Managers and has had its budget doubled to US $15 million through a 5 year cooperative agreement. The project takes women leaders from 10 different countries and trains them in effective ways to implement family planning services. The women bring with them the knowledge of local traditions and cultural knowledge that is essential for these types of programs to work. They also have the respect of the communities from which they came as well as access to networks of women that can be used to help further the cause. A very successful example of this project is in the Indian city of Ahmedabad. In 3 years the project has increased the number of female contraceptive users by 9000 with a 92.5% continuation rate. This figure is only 2% of the total population of 2 million; however, the project is still having a significant effect and has a very high success rate. The contraceptive prevalence rate in the slums has been raised from 12% to 61%. PMID:12317122
... Woman's Blood Pressure But study found negative social interactions didn't affect men, older women (*this news ... stressful. But new research suggests that negative social interactions may actually harm the health of middle-aged ...
... saved articles window. My Saved Articles » My ACS » Lymphedema: What Every Woman With Breast Cancer Should Know ... for breast cancer may be at risk for lymphedema in the arm, breast, and chest. Here we ...
We investigated perceptions between Brazilian and U.S. college students regarding a hypothetical case involving woman-to-woman\\u000a sexual harassment in which the sexual orientation of both the target and the alleged harasser was experimentally manipulated.\\u000a Thus, there were four different scenarios, which were randomly given to 952 college students (89% of whom reported to be White).\\u000a We found that the scenario that
Dosimetric studies in mammography are addressed by means of a Monte Carlo simulation program. The core of this program (DOSIS: dosimetry simulation studies) is a simulation model developed using FORTRAN 90, enriched with a graphical user interface developed in MS Visual Basic. User defined mammographic technique parameters affecting breast dose are imported to the simulation model and the produced results are provided by means of both absolute (surface dose, exposure at detector plane) and relative quantities (percentage depth dose, isodose curves). The program functionality has been demonstrated in the evaluation of various mammographic examination techniques. Specifically, the influence of tube voltage and filtration on the surface dose and the exposure at detector plane has been studied utilizing a water phantom. Increase of tube voltage from 25 to 30 kVp for a Mo/Mo system resulted in a 42% decrease of the surface dose for a thick breast (6 cm), without changing the exposure at the detector plane. Use of 1.02 mm Al filter for a W anode system operating at 30 kVp resulted in a 19.1% decrease of the surface dose delivered to a 5 cm water equivalent breast. Overall, W/Al systems appear to have improved dosimetric performance, resulting up to a 65% decrease of surface dose compared to Mo/Mo systems, for identical exposures at the detector plane and breast thicknesses. PMID:15899338
El NCI tiene planeado realizar entrevistas en profundidad para determinar cuál era la alimentación característica de las poblaciones indígenas americanas, hispanas (latinas) y chicanas que vivían en New Mexico a mediados de 1940 y utilizar información fácilmente disponible sobre la alimentación y el estilo de vida de las poblaciones blancas. Estas entrevistas representan un paso importante para hacer estimaciones de las dosis de radiación generadas por la prueba Trinity.
Dilute solutions of various dextran standards, a high-molar mass (HMM) commercial dextran from Leuconostoc spp., and HMM dextrans isolated from Weissella confusa and Leuconostoc citreum were analyzed with high-performance size-exclusion chromatography (HPSEC), asymmetric flow field-flow fractionation (AsFlFFF), and diffusion-ordered NMR spectroscopy (DOSY). HPSEC analyses were performed in aqueous and dimethyl sulfoxide (DMSO) solutions, while only aqueous solutions were utilized in AsFlFFF and DOSY. The study showed that all methods were applicable to dextran analysis, but differences between the aqueous and DMSO-based solutions were obtained for HMM samples. These differences were attributed to the presence of aggregates in aqueous solution that were less prevalent in DMSO. The study showed that DOSY provides an estimate of the size of HMM dextrans, though calibration standards may be required for each experimental set-up. To our knowledge, this is the first study utilizing these three methods in analyzing HMM dextrans. PMID:24274497
This article suggests increased attention to how medical discourses of gastrointestinal (GI) disorder and distress are fraught with social assumptions and consequences by examining nineteenth-century and contemporary medical texts focused on chronic constipation and Irritable Bowel Syndrome (IBS). I suggest that these medical discourses present what I call the "gastrointestinal woman," who is characterized as having unjustified anxiety and is to blame for her condition. My approach to understanding, and ultimately revising, the representation of the gastrointestinal woman is shaped by disability studies scholarship, which encourages intervention in problematic medical discourses and more active shaping of discourses of chronic pain and illness by those who have these conditions. PMID:23179643
The association between educational level and cycle outcomes was quantified by applying multivariable logistic and linear regression within a prospective cohort of 2,569 women commencing their first in vitro fertilization (IVF) cycle. Although a woman’s educational attainment was not associated with the likelihood of implantation failure, chemical pregnancy, spontaneous abortion, or live birth, the odds of cycle cancellation before egg retrieval were 40% lower among those with an college degree and 48% lower among those with graduate school attendance compared with women who had no college degree, suggesting that educational attainment is inversely associated with the likelihood of cycle cancellation.
Mahalingaiah, Shruthi; Berry, Katharine F.; Hornstein, Mark D.; Cramer, Daniel W.; Missmer, Stacey A.
In this paper, we introduce a study that we carried out in order to validate the use of a simplified pregnant woman model for the assessment of the fetus exposure to radio frequency waves. This simplified model, based on the use of a homogeneous tissue to replace most of the inner organs of the virtual mother, would allow us to deal with many issues that are raised because of the lack of pregnant woman models for numerical dosimetry. Using specific absorption rate comparisons, we show that this model could be used to estimate the fetus exposure to plane waves.
New radiation therapy techniques such as IMRT present significant efficiency due to their highly conformal dose distributions. A consequence of the complexity of their dose distributions (high gradients, small irradiation fields, low dose distribution, ...) is the requirement for better precision quality assurance than in classical radiotherapy in order to compare the conformation of the delivered dose with the planned dose distribution and to guarantee the quality of the treatment. Currently this control is mostly performed by matrices of ionization chambers, diode detectors, dosimetric films, portal imaging, or dosimetric gels. Another approach is scintillation dosimetry, which has been developed in the last 15 years mainly through scintillating fiber devices. Despite having many advantages over other methods it is still at an experimental level for routine dosimetry because the Cerenkov radiation produced under irradiation represents an important stem effect. A new 2D water equivalent scintillating dosimeter, the DosiMap, and two different Cerenkov discrimination methods were developed with the collaboration of the Laboratoire de Physique Corpusculaire of Caen, the Comprehensive Cancer Center François Baclesse, and the ELDIM Co., in the frame of the MAESTRO European project. The DosiMap consists of a plastic scintillating sheet placed inside a transparent polystyrene phantom. The light distribution produced under irradiation is recorded by a CCD camera. Our first Cerenkov discrimination technique is subtractive. It uses a chessboard pattern placed in front of the scintillator, which provides a background signal containing only Cerenkov light. Our second discrimination technique is colorimetric. It performs a spectral analysis of the light signal, which allows the unfolding of the Cerenkov radiation and the scintillation. Tests were carried out with our DosiMap prototype and the performances of the two discrimination methods were assessed. The comparison of the dose measurements performed with the DosiMap and with dosimetric films for three different irradiation configurations showed discrepancies smaller than 3.5% for a 2 mm spatial resolution. Two innovative discrimination solutions were demonstrated to separate the scintillation from the Cerenkov radiation. It was also shown that the DosiMap, which is water equivalent, fast, and user friendly, is a very promising tool for radiotherapy quality assurance. PMID:18561640
Frelin, A M; Fontbonne, J M; Ban, G; Colin, J; Labalme, M; Batalla, A; Vela, A; Boher, P; Braud, M; Leroux, T
New radiation therapy techniques such as IMRT present significant efficiency due to their highly conformal dose distributions. A consequence of the complexity of their dose distributions (high gradients, small irradiation fields, low dose distribution, ...) is the requirement for better precision quality assurance than in classical radiotherapy in order to compare the conformation of the delivered dose with the planned dose distribution and to guarantee the quality of the treatment. Currently this control is mostly performed by matrices of ionization chambers, diode detectors, dosimetric films, portal imaging, or dosimetric gels. Another approach is scintillation dosimetry, which has been developed in the last 15 years mainly through scintillating fiber devices. Despite having many advantages over other methods it is still at an experimental level for routine dosimetry because the Cerenkov radiation produced under irradiation represents an important stem effect. A new 2D water equivalent scintillating dosimeter, the DosiMap, and two different Cerenkov discrimination methods were developed with the collaboration of the Laboratoire de Physique Corpusculaire of Caen, the Comprehensive Cancer Center Francois Baclesse, and the ELDIM Co., in the frame of the MAESTRO European project. The DosiMap consists of a plastic scintillating sheet placed inside a transparent polystyrene phantom. The light distribution produced under irradiation is recorded by a CCD camera. Our first Cerenkov discrimination technique is subtractive. It uses a chessboard pattern placed in front of the scintillator, which provides a background signal containing only Cerenkov light. Our second discrimination technique is colorimetric. It performs a spectral analysis of the light signal, which allows the unfolding of the Cerenkov radiation and the scintillation. Tests were carried out with our DosiMap prototype and the performances of the two discrimination methods were assessed. The comparison of the dose measurements performed with the DosiMap and with dosimetric films for three different irradiation configurations showed discrepancies smaller than 3.5% for a 2 mm spatial resolution. Two innovative discrimination solutions were demonstrated to separate the scintillation from the Cerenkov radiation. It was also shown that the DosiMap, which is water equivalent, fast, and user friendly, is a very promising tool for radiotherapy quality assurance.
Frelin, A-M.; Fontbonne, J-M.; Ban, G.; Colin, J.; Labalme, M.; Batalla, A.; Vela, A.; Boher, P.; Braud, M.; Leroux, T. [Laboratoire de Physique Corpusculaire, 6 Bd du Marechal Juin, F14050 Caen (France); Unite de Radiophysique, Centre Francois Baclesse, Avenue General Harris, BP 5026, F14076 Caen Cedex 5 (France); ELDIM, 1185 Rue d'Epron, F14200 Herouville Saint Clair (France)
The sexual imagery of Friedrich Nietzsche and English historian Michael Oakeshott in characterizing perspectives on the past, especially the comparison of the relationship of a historian to history with that of a man to a woman, are compared and discussed. (MSE)
The purpose of the report is the presentation of ideas and information to help the working woman save time, effort, and money. Chapter one offers suggestions for child care arrangements such as babysitters, transportation needs, and the possibilities for home employment. Chapter two includes shopping and specific management tips for both clothing…
A 68 year old woman with a lifelong history of chronic bronchitis was diagnosed as having cystic fibrosis. The diagnosis was based on a suggestive family history, steatorrhoea, bronchiectasis with respiratory insufficiency, and very high sweat sodium content. The patient was found to be heterozygous for the delta F 508 gene defect. Images
Written to aid a woman entering the job market for the first time or re-entering after a period of nonemployment, this guide supplies basic information about preparing for a job or a career. First, the preliminary step of self-assessment and assessing abilities and training is described, and a personal inventory form is suggested. Next, the…
Beginning in the mid-19th century, several generations of woman suffrage supporters lectured, wrote, marched, lobbied, and practiced civil disobedience to achieve what many people considered a radical change in the U.S. Constitution. Militant suffragists used tactics such as parades, silent vigils, and hunger strikes. In 1870 the 15th amendment to…
National Archives and Records Administration, Washington, DC.
This essay considers the performance context and aesthetics of "Journey Woman", a play devised to initiate a week-long rehabilitative groupwork programme for female prisoners. Although Geese Theatre UK are one of the country's longest-established companies specialising in drama work within the criminal justice sector, this 2006 piece is their…
Posterior reversible leukoencephalopathy syndrome (PRLS) is a neurologic condition, often presents with various clinical manifestations. It is rare during pregnancy. We herein report a case of PRLS in a 31-year-old woman, presented with preeclampsia, diagnosed by computer tomography, and successfully delivered the baby with caesarean section. At discharge, patient was fully recovered without any complication.
Mild aortic root dilation is relatively common in patients with acromegaly and does not usually require surgical intervention. A case involving a 27-year-old acromegalic woman who presented with heart failure and gross aortic root dilation that was successfully treated with a composite aortic graft prosthesis is described.
Wiper, Andrew; Eisenberger, M; McPartlin, A; El-Omar, M
Mild aortic root dilation is relatively common in patients with acromegaly and does not usually require surgical intervention. A case involving a 27-year-old acromegalic woman who presented with heart failure and gross aortic root dilation that was successfully treated with a composite aortic graft prosthesis is described. PMID:23592949
Wiper, Andrew; Eisenberger, M; McPartlin, A; El-Omar, M
The oral contraceptive chlormadinone acetate has been given for eight months to a woman who had developed jaundice during four pregnancies, and twice while taking a combined contraceptive pill. No side-effects or changes in liver function were observed. This is further evidence that progestogens used for contraception, and in particular those derived from hydroxyprogesterone, are less hepatotoxic than the oestrogenic components.
This article examines the life of education reformer Flora White, who both represented and deviated from the stereotypical new woman portrayed in popular literature of the late nineteenth and early twentieth century. White's decision to reject marriage and children in favor of a career resulted in greater financial insecurity and an unmet desire…
Providing information and activities designed to dispel sex role socialization, myths, and stereotypes as bases for prejudiced views, this teaching guide focuses on the American woman's image and diverse roles in our society. It is part of the Louisville Area Ethnic Heritage Studies Project described in ED 150 043. The project materials are…
Discusses reactions to an affirmative action program designed to enhance the role of women in psychology. Specifically, the 1st year of the Visiting Woman Program is evaluated, and the program's effectiveness is examined. 19 visits by women psychologists were made to university psychology departments in 1974. 17 were formally reported and served as data for the present report. Three-fourths of
An otherwise healthy 92-year-old woman was admitted to our department with shortness of breath and dysphagia 10 h after a fall in her bathroom. Medical checkup at another institution had not uncovered the causation of the complaints. Clinical and radiological examinations at our department then revealed an expanding retropharyngeal and prevertebral haematoma. Because of increasing dyspnoea, a lateral cervical approach
We report an unusual case of pandemic (H1N1) 2009–related encephalitis in an immunocompetent woman. Although rare cases of pandemic (H1N1) 2009 associated with encephalitis have been reported previously, in this patient, direct viral invasion of the central nervous system was shown by simultaneous detection of viral RNA and pleocytosis.
We report the case of a woman who presented with ST elevation and episodes of chest pain, mimicking an acute myocardial infarction. At coronary angiography no sign of coronary stenosis was found and ECG anomalies were related to asymmetric left ventricular hypertrophy and aortic stenosis. PMID:22903684
Brunetti, Natale Daniele; Correale, Michele; Sai, Rafel; Santoro, Francesco; Ieva, Riccardo; De Gennaro, Luisa; Di Biase, Matteo
Expert testimony regarding the battered woman syndrome is often presented at trial on behalf of women charged with killing their batterers. Where courts have admitted such testimony into evidence, they have done so on the theory that the testimony is needed to dispel common myths regarding battered women—e.g., erroneous beliefs that battered women are masochists, who are somehow responsible for
'With woman', 'woman centred' and 'in partnership with women' are new terms associated with midwifery care in Australia, and the underlying philosophy has emerged both as an antidote to the medicalisation of pregnancy and in a bid to reacquaint women with their natural capacity to give birth successfully and without intervention. A reorientation of midwifery services in the 1990s, a shift towards midwifery-led care (MLC) and the subsequent introduction of direct entry midwifery programs all contributed to this new direction. Central concepts are a focus on the childbearing woman and a valuing of women's experiences. While this philosophical re-alignment has been applauded by many midwives in terms of maternal empowerment and improved autonomy for midwives, there are nonetheless some concerns that, with its emphasis on normality, midwifery-led care is in danger of becoming an exclusionary model. Particular concerns include meeting the needs of a growing cohort of women, those with 'high risk' pregnancies, and the educational adequacy of direct entry midwifery programs. To date, there has been no thorough evaluation of this emerging midwifery philosophy in Australia. In order to open the debate, this paper aims to initiate a discussion of 'with woman' midwifery care as it applies to Australian practice. PMID:17518826
Looks at the ways in which the relationship between women and work was characterized during the late 1940s in "Woman Speaks," a combination newsreel/television show in Chicago. Expands upon the work of other historians and critics who have examined the representations of gender in early television marketing ploys and variety/situation comedy…
Back pain is a common symptom: up to 70% of UK adults experience this symptom by the age of 60 and most have moderate to severe pain. Back pain accounted for 12% of consultations to traditional acupuncturists in 2001 and is one of the most common reasons for consultation with an acupuncturist. This case report concerns a 54-year-old woman with
This article profiles Velma Dolphin Ashley, a Black woman educator who served as superintendent of schools in Boley (Oklahoma) from 1944 to 1956. During her superintendency, Ashley was responsible for instructional activities in a correctional institution for delinquent Black youth, as well as for administering the all-Black school district. (AF)
The purpose of this case study was to examine how a woman superintendent led her school district in the state of Florida. The approach I used to study her leadership was informed by the Leader Member Exchange (LMX) theory. At the base of this theory rests the fundamental premise that a leader forms different types of relationships with members and
This article features the life of the first woman mycologist (Flora Patterson). It describes her role (1) as a plant quarantine inspection officer, (2) in the identification of the chestnut blight fungus, and (3) as a contributor to the development of the U.S. National Fungus Collections. The article concludes with a description and discussion of her research involving leaf parasitic fungi.
The case of a 20 year old Ethiopian woman with cryptococcal meningitis and acquired immunodeficiency syndrome (AIDS) is presented. Though cryptococcal infections have been reported from many countries throughout the world, this is the first case reported from Ethiopia in a patient with the acquired immunodeficiency syndrome (AIDS). The clinical manifestations, diagnosis, and treatment are discussed, with a review of recent literature. PMID:1396620
This paper explores the aims and purpose of long term art therapy. This is done by focusing on the experience of a woman with learning disabilities whom we have called Isobel White (pseudonym). In this paper we set out a theoretical context and then consider key aspects of the therapy process. We have included excerpts from reflective discussions…
Spontaneous rupture of an abdominal aortic aneurysm into a retroaortic left renal vein is an uncommon occurrence. A 55-year-old woman presented with shortness of breath, vomiting, and diffuse abdominal pain that had radiated to her back and legs for the preceding 10 days. A pulsatile abdominal mass, hematuria, renal insufficiency, and heart failure were present at the initial evaluation. Computed tomography showed an infrarenal abdominal aortic aneurysm that communicated with a retroaortic left renal vein. After urgent surgical repair, cardiac and renal function were dramatically improved. To the best of our knowledge, this is the 1st reported case of a woman with such a fistula. We review treatments reported in the literature.
Actinic prurigo is a rare, often difficult-to-treat, idiopathic photodermatosis. Actinic prurigo is divided into a hereditary form appearing in the Native American population and a sporadic form occurring in non-Native Americans. We present a 28-year-old Caucasian woman who developed typical clinical signs and symptoms of actinic prurigo, just as had her mother and grandmother. The patient and her mother were HLA-A24 and HLA-DR 4 with the subtype HLA-DRB1*0408. Based on clinical symptoms and the HLA pattern, the diagnosis of actinic prurigo was made. Treatment with thalidomide led to resolution of the disease. This case report of a Caucasian woman suffering from a hereditary form of actinic prurigo questions the established classification of actinic prurigo into a hereditary Native American form and a sporadic form occurring in the non-Native American population. PMID:17081272
We report a case of anaphylaxis in a 35+5 week of pregnancy patient who came to the Emergency Room with shortness of breath, hypotension and loss on fetal wellbeing. Due to her medical history and given the clinical picture at that time, an anaphylactic shock was suggested as the most probable diagnose. The administration of dexchlorpheniramine and methylprednisolone resulted in an immediate and positive reaction. Simultaneously, an improvement in the fetus cardiotocographic record was objectified. The patient was hospitalized for 48 hours, after which she was discharged. In case of suspicion of anaphylaxis in a pregnant woman, four aspects should be handled: the severity of the anaphylaxis chart, individual complications regarding a pregnant woman, unfavorable effects of the regularly used treatment during that specific gestation, and the need of fetal extraction based of gestational age. PMID:24779274
Ferreres-García, Karla; de León-Luis, Juan; Seoane, Elena; García-Marqués, Enrique; Sanjuan, Cristina; Ortiz-Quintana, Luis
A 41-year-old woman had two months of intermittent migratory swellings in the trunk, face, and limbs associated with erythema, pruritus, and pain. Laboratory analysis showed moderate eosinophilia. The triad of eosinophilia, migratory lesions (nodular panniculitis), and raw fish consumption was highly suggestive of cutaneous gnathostomiasis. She was successfully treated with albendazole (400 mg twice a day for 21 days) and showed complete and permanent resolution of the lesions.
Vanegas, Edgar S.; Cendejas, Rafael Franco; Mondragon, Arturo
A 41-year-old woman had two months of intermittent migratory swellings in the trunk, face, and limbs associated with erythema, pruritus, and pain. Laboratory analysis showed moderate eosinophilia. The triad of eosinophilia, migratory lesions (nodular panniculitis), and raw fish consumption was highly suggestive of cutaneous gnathostomiasis. She was successfully treated with albendazole (400 mg twice a day for 21 days) and showed complete and permanent resolution of the lesions. PMID:24808244
Vanegas, Edgar S; Cendejas, Rafael Franco; Mondragón, Arturo
Most teratomas involving the thyroid gland are benign and occur in children. However, the adult cases reported are mostly malignant. Many of the cases previously described in the medical literature have fatal outcome because of spread of the tumor refractory to treatment. We report a case of primary malignant teratoma of the thyroid in a 38-year-old pregnant black woman. She was treated with a combination of surgery, and postoperative chemotherapy with good initial response. PMID:20637432
Pérez-Mies, Belen; Regojo Zapata, Rita M; García-Fernández, Eugenia; Serrano, M Nistal
Androgen secreting tumours are the least commonly encountered androgen excess disorders, having a prevalence of 0.2%. Androblastomas of the ovary comprise less than 0.5% of all ovarian tumours. Pure Leydig cell tumours are very rare and almost always show secretion of male sex hormones.A 41-year-old multipara Filipino woman presented with a 2-year history of amenorrhoea and virilisation characterised by hirsutism,
Maria Luisa Cecilia Rivera-Arkoncel; Debby Pacquing-Songco; Frances Lina Lantion-Ang
A 61-year-old woman came to the Emergency Department with a skin lesion located at her right upper leg. At the site of the lesion a subcutaneous injection of diclofenac had been administered for pain from nephrolithiasis. CT revealed a large infiltrate proximal in the right upper leg; histologic evaluation of the tissue showed an acute necrotizing inflammation. These findings are typical for Nicolau syndrome. PMID:24846114
Geerts, Jan-Willem H J; Siegel, Andrea M; Bosman, Anne
We present a case of a 51 year-old, premenopausal, non-smoker for many years woman with severe, two-coronary artery disease in the form of acute coronary syndrome (ACS), and severe hypercholesterolaemia as the predominant risk factor. The first clinical diagnosis of familial hypercholesterolaemia has been established at the time of diagnosis of ACS. Satisfactory effect of pharmacological treatment is achieved by a complex lipid-lowering therapy. PMID:23788092
Although a pregnant woman can now refuse any medical treatment needed by the fetus, the Court of Appeal has acknowledged that ethical dilemmas remain, adverting to the inappropriateness of legal compulsion of presumed moral duties in this context. This leaves the impression of an uncomfortable split between the ethics and the law. The notion of a pregnant woman refusing medical treatment needed by the fetus is troubling and it helps little simply to assert that she has a legal right to do so. At the same time, the idea that a pregnant woman fails in her moral duty unless she accepts any recommended treatment or surgery--however great the burden--is also not without difficulty. This article seeks to find a way between these two somewhat polarized positions by arguing that, instead of being a question primarily about whether legally to enforce moral obligations, the 'maternal-fetal conflict' begins with previously unrecognized difficulties in determining when a woman's prima facie moral rights invoked in the treatment context should 'give way' to the interests of the fetus. This difficulty is mirrored within the law. Thus, how can we tell when a pregnant woman has the moral or legal duty to submit to a caesarean section? Seen in this way, the conflict is a problem which lies at the interface between moral and legal rights and duties, showing that there are important conceptual links between the ethics and the law. Against this background, this article explores the limits of a pregnant woman's right to bodily integrity by focusing upon the idea of her moral duty to aid the fetus through her body. Here we find difficulties in determining the existence and extent of this somewhat extraordinary duty. Such a duty is contrasted with both negative and positive duties toward others in the course of 'general conduct.' Attention to the social context of pregnancy and the refusal of treatment within this is also instructive. Overall, the purpose is to foster understanding and acceptance of the current legal position. PMID:12452142
This article provides a comprehensive legislative history of North Carolina's Woman's Right to Know Act of 2011. The Act requires informed consent and a mandatory twenty-four hour waiting period for abortion, thus protecting a woman's right to make an informed choice. Informed consent provisions and mandatory waiting periods give individuals making decisions the information and time necessary to make informed choices. The Act further provides that an ultrasound be performed and explained no less than four hours and no more than seventy-two hours before the abortion. The article first provides a brief overview of sources of legislative history recognized in North Carolina. It then details the history of the Woman's Right to Know Act, from the first informed consent bill introduced in 1981, to the passage of the 201l law, and to the federal court case that followed. Finally it provides specific objections that were raised against the bill and responses to each. Legislators considering similar legislation need to be aware of the opposition they inevitably will encounter when passing such a bill. The author expects that this history and the ultimate success of North Carolina will encourage other states' legislators and lawyers and give them the tools to make their case effectively. PMID:22953381
With the advent of highly active antiretroviral therapy (HAART), women living with HIV can now enjoy longer lifespans in relative good health as well as the prospect of bearing children with an overwhelmingly low risk of vertical transmission. Thus, increasingly, seropositive women are now facing issues around longevity as well as those associated with fertility. The clinician caring for the HIV-infected woman must be alert to the gynecologic issues that are prevalent in this population. Among those faced by the gynecologist are menstrual abnormalities, lower genital tract neoplasia, sexually transmitted infections, the need for gynecologic surgery, and menopausal issues including osteopenia/osteoporosis. Contraception in HIV seropositive women presents unique management issues, because of the necessity for a dual role of prevention of both pregnancy and HIV transmission, the possible effect of birth control on HIV infection, and the interaction between birth control and HIV therapies. With ever increasing frequency, the gynecologist will be presented with the seropositive woman or couple who wishes to conceive. The purpose of this chapter is to review the current knowledge on the relationship between HIV infection and menstrual abnormalities, genital neoplasias, contraceptive options, surgical complications, and menopause with its associated disorders. Special considerations in the seropositive woman contemplating pregnancy will also be discussed. The treatment of pelvic infections is discussed elsewhere in this volume, and only changes in standard therapy because of concurrent HIV-infection will be discussed here.
...Imported for Exhibition Determinations: ``Woman in Blue, Against Blue Water'' by Edvard Munch SUMMARY: Notice is hereby...I hereby determine that the object ``Woman in Blue, Against Blue Water'' by Edvard Munch,...
...Imported for Exhibition Determinations: ``Vermeer's Woman in Blue Reading a Letter'' SUMMARY: Notice is hereby given of the...object to be included in the exhibition ``Vermeer's Woman in Blue Reading a Letter,'' imported from abroad for temporary...
The Woman’s Building Library at the World’s Columbian Exposition of 1893 included many texts that could be classified as “religious.” In bringing a large body of women’s publications together in one place, the Woman’s Building’s organizers called attention to women’s past achievements in order to carve out a larger space for women’s public participation. Yet the project of expanding women’s
This article examines the magazine Muslim Girl (started publication 2007) and explores how the representations on the magazine's pages construct a particular type of identity for Muslim women: an ‘idealized’ Muslim woman who is both North American\\/Western and Muslim. Such a woman is portrayed as liberal, educated, fashionable, a ‘can-do’ woman, who is also committed to her faith. This ‘ideal’
In this qualitative study, the career journey of one New Zealand woman was analysed. Three key findings emerged: the power of narrative as a vehicle for this woman's story, her movement towards greater authenticity and spiritual fulfilment as a mature woman, and the ongoing struggle for concurrent fulfilment from communal and agentic perspectives.…
Radial head fractures are common injuries, occurring in about 20% of all acute elbow injuries. Isolated radial head fractures are not common and include about 2% of all fractures around the elbow. Bilateral radial head fractures are rare and usually associated with severe trauma and associated fractures and dislocations. We report a case of bilateral undisplaced radial head fracture in a woman, following a simple fall. Early recognition, proper management, and physical therapy led to complete recovery and full functional movement of the elbow.
Shariff, Zakir; Patel, Kuntal J.; Elbo, A.; Guisasola, I.
This essay represents the first editorial of the series "Recollections, Reflections, and Revelations: Ethnobiologists and their First Time in the Field". In this memoir, the author details the evolvement and intellectual progression of her research focusing on wild food plant consumption within a remote community in the high steppes of Central Anatolia during the early Nineties. The author conveys a human learning journey as a woman and an ethnobiologist, reflecting on the methodological bottlenecks and solutions during her first ethnographic experience in the field.
Exstrophy of bladder is a rare congenital anomaly. Pregnancy following surgical correction of bladder exstrophy occurred in this woman. Improved techniques in urinary diversion operation have enabled a large number of patients with bladder exstrophy to achieve urinary control. They can live fairly normal lives and some have achieved pregnancy. Case reports of such exist in the literature. The present case is based on the experience of a 28 years old lady who had successful pregnancy and delivery following curative repair of this defect one and a half year ago. A living healthy male baby was delivered by elective cesarean section. PMID:23134933
Sayeeda, S; Begum, F; Akhter, N; Nahar, K; Kibria, S M
More women than ever before are both Human Immunodeficiency Virus-infected and menopausal, because of increased survival and more frequent diagnosis in older women. Such a woman has the combined burden of her infection, its treatment, comorbid conditions, and aging. Thus she is at risk for a variety of problems such as disorders of bone mineral density and deficiencies in cognitive functioning. In addition to this, she experiences menopause in a unique fashion, with more symptoms and perhaps at an earlier age. The clinician caring for her must take a proactive approach to this multitude of factors that may affect her health and well-being.
Hypercoagulable state during pregnancy and puerperium is associated with an increased risk of venous thromboembolic disease. Pulmonary embolism (PE) is the leading cause of maternal death in the developed world. Clinical assessment of PE may be difficult due to nonspecific signs and symptoms, especially in pregnant women. Diagnostic procedures using ionizing radiation may be harmful for the fetus while aggressive anticoagulation may expose the mother to bleeding complications The aim of this paper was to present a case of a 27-year-old pregnant woman with high-risk PE. PMID:24032267
The association between educational level and cycle outcomes was quantified by applying multivariable logistic and linear regression within a prospective cohort of 2,569 women commencing their first in vitro fertilization (IVF) cycle. Although a woman's educational attainment was not associated with the likelihood of implantation failure, chemical pregnancy, spontaneous abortion, or live birth, the odds of cycle cancellation before egg retrieval were 40% lower among those with an college degree and 48% lower among those with graduate school attendance compared with women who had no college degree, suggesting that educational attainment is inversely associated with the likelihood of cycle cancellation. PMID:21601850
Mahalingaiah, Shruthi; Berry, Katharine F; Hornstein, Mark D; Cramer, Daniel W; Missmer, Stacey A
Cystic fibrosis (CF) is a disease which predisposes individuals to recurrent infective exacerbations of suppurative lung disease; however, empyema is a rare complication in these patients. Empyemas secondary to Staphylococcus aureus and Burkholderia cepacia have been described in patients with CF. We report the case of pleural empyema with mixed S. aureus and Pseudomonas aeruginosa infection in a 34-year-old woman with CF, which was managed with ultrasound-guided pigtail catheter insertion, fibrinolysis, and antibiotic therapy. Physicians should be aware of this unusual complication in CF patients, especially those receiving an immunosuppressive therapy.
Prune belly syndrome is a rare congenital syndrome that primarily affects male fetuses. Affected men are universally infertile; however, there is a paucity of information published on the reproductive potential of affected women. Pregnancy outcomes in affected women have not been described in the literature. We describe the case of pregnancy in an affected woman. Her pregnancy progressed without complication. Her fetus had no stigmata of the syndrome. Her labour and delivery were, however, complicated by a prolonged second stage of labour and need for vacuum-assisted vaginal delivery. PMID:23203170
Hillman, R Tyler; Garabedian, Matthew James; Wallerstein, Robert J
Borrelial lymphocytoma (BL) is a rare cutaneous manifestation of Lyme borreliosis. Epidemiological data show that BL is more common in children than in adults. It presents as a single bluish-red swelling located on the earlobe in children, near the nipple in adults. In our paper, we present a case of a pregnant woman with BL, which appeared after tick bite and disappeared completely after antibiotic therapy. The aim of the paper was to emphasize that in tick-borne disease endemic areas BL should be taken into consideration in cases of skin lesions. PMID:22906496
Odontogenic myxoma (OM) is a rare benign but locally aggressive tumour of the jaws. It is usually seen in the second to third decade of life. Women are more frequently affected than men and it has more predilections for the mandible rather than the maxilla. OM presents as an asymptomatic swelling in most of the cases. Owing to the non-capsulated and aggressive nature of OM, a high rate of recurrence has been reported. Here we present a case of OM in a 52-year-old woman managed by segmental mandibulectomy. Sign of recurrence was seen after 18?months of follow-up. PMID:24859552
Besides the effects of the microgravity environment, and the psychological and psychosocial problems encountered in confined spaces, radiation is the main health detriment for long dura-tion human space missions. The radiation environment encountered in space differs in nature from that on earth, consisting mostly of high energetic ions from protons up to iron, resulting in radiation levels far exceeding the ones encountered on earth for occupational radiation workers. Accurate knowledge of the physical characteristics of the space radiation field in dependence on the solar activity, the orbital parameters and the different shielding configurations of the International Space Station ISS is therefore needed. For the investigation of the spatial and temporal distribution of the radiation field inside the European COLUMBUS module the DLR experiment DOSIS (Dose Distribution Inside the ISS) was launched on July 15th 2009 with STS-127 to the ISS. The experimental package was transferred from the Space Shuttle into COLUMBUS on July 18th. It consists in a first part of a combination of passive detector packages (PDP) distributed at 11 locations inside the European Columbus Laboratory. The second part are two active radiation detectors (DOSTELs) with a DDPU (DOSIS Data and Power Unit) in a nomex pouch (DOSIS MAIN BOX) mounted at a fixed location beneath the European Physiology Module (EPM) inside COLUMBUS. After the successful installation the active part has been activated on the 18th July 2009. Each of the DOSTEL units consists of two 6.93 cm PIPS silicon detectors forming a telescope with an opening angle of 120. The two DOSTELs are mounted with their telescope axis perpendicular to each other to investigate anisotropies of the radiation field inside the COLUMBUS module especially during the passes through the South Atlantic Anomaly (SAA) and during Solar Particle Events (SPEs). The data from the DOSTEL units are transferred to ground via the EPM rack which is activated approximately every four weeks for this action. The first data downlink was performed on July 31st 2009. First Results for the DOSTEL measurements such as count rate profiles, dose rates and LET spectra will be presented in comparison to the data obtained by other experiments.
Views on the importance of the woman's contributions to shaping culture and the role of female leadership at Mount Holyoke College are considered. According to historian Mary Ritter Beard, the "woman's tradition" of imparting a progressive social consciousness to the culture has been an important influence. Beard addressed Mount Holyoke in 1937 at…
Purpose Pelvic floor disorders including urinary incontinence, pelvic organ prolapse and fecal incontinence are common problems encountered by the older woman. With the increasing population of older American women, urologists and gynecologists can expect to provide evaluation and treatment of these conditions with increasing frequency. These conditions are amenable to both medical and surgical therapies. Materials and Methods Contemporary published articles (year 2003 to present) that included older women undergoing urogynecologic surgical procedures were included in this review. Current data on morbidity, mortality and/or surgical outcomes are presented along with evidence-based pre, intra and post-operative surgical management strategies. Results The older woman can expect similar operative risks as well as subjective and objective anatomic and quality-of-life outcomes as that of younger women undergoing pelvic floor surgery. Conclusion The decision for surgical intervention for the treatment of pelvic floor disorders should not be based on chronologic age alone. Prior to selection of a specific surgical procedure, all existing pelvic floor defects should be evaluated. Further research is required to understand the impact that surgery for pelvic floor disorders has on anatomic, physiologic, and functional outcomes in older women.
Gerten, Kimberly A.; Markland, Alayne D.; Lloyd, L. Keith; Richter, Holly E.
Introduction Few cases of neuromyelitis optica have been reported in Africa. This is the first case report of neuromyelitis optica in Uganda. It highlights the need to have a high index of suspicion to promptly identify and appropriately treat these patients. Case presentation We present the case of a 24-year-old woman of Bantu origin who presented initially with bilateral loss of vision and weakness of the lower limbs in 2010 that resolved completely after a few days. Eight months later, she presented with bilateral lower limb weakness and urinary incontinence that improved completely following steroid use. This was followed four months later with an episode of quadriparesis that was treated with steroids and azathioprine with some improvement currently using a walking aide. Conclusions The patient described here represents a phenotypic expression of a recurrent (multiphasic), steroid-sensitive, inflammatory demyelinating disorder of the central nervous system occurring in a black Ugandan woman. This case highlights the occurrence of Devic’s disease within our setting and the need to properly diagnose this condition even in a resource-limited setting to prevent disability.
Objective: To present the case of a postmenopausal woman, who was suspected of having an ovarian cyst. Instead, a cystadenoma of the appendix was discovered during laparoscopy. Methods: A 64-year-old postmenopausal nulliparous woman was admitted to our hospital because of a cystic lesion, which had been detected in the course of a routine gynecological examination. The patient underwent vaginal ultrasound, magnetic resonance tomography, and laparoscopy. Results: During vaginal ultrasound, a dumbbell-shaped anechogenic cystic structure 70 × 32 × 22 mm in diameter was found in the region of the right adnexa. Magnetic resonance tomography revealed no additional information. During diagnostic laparoscopy, the cystic lesion was found to be a distended appendix. A laparoscopic appendectomy was performed. Subsequent histological analysis revealed a villous mucinous cystadenoma of the appendix with low-grade intraepithelial neoplasia. Conclusion: Gynecologists should routinely consider this disease in the differential diagnosis of right lower dumbbell abdominal cysts. Eleven percent to 20% of mucoceles are caused by mucinous cystadenocarcinomas, which carry the risk of peritoneal tumor implantation caused by rupture or laparoscopic resection. Therefore, it should be mandatory that a general surgeon be involved in the laparoscopic procedure and the conversion to laparotomy for resection of the structure.
Demmel, M.; Ott, J.; Promberger, R.; Huber, J.C.; Mayerhofer, K.
Besides the effects of the microgravity environment, and the psychological and psychosocial problems encountered in confined spaces, radiation is the main health detriment for long dura-tion human space missions. The radiation environment encountered in space differs in nature from that on earth, consisting mostly of high energetic ions from protons up to iron, resulting in radiation levels far exceeding the ones encountered on earth for occupational radiation workers. Accurate knowledge of the physical characteristics of the space radiation field in dependence on the solar activity, the orbital parameters and the different shielding configurations of the International Space Station ISS is therefore needed. The DOSIS (Dose Distribution inside the ISS) experiment, under the project and science lead of DLR, aims for the spatial and tempo-ral measurement of the radiation field parameters inside the European Columbus laboratory onboard the International Space Station. This goal is achieved by applying a combination of passive (Thermo-and Optical luminescence detectors and Nuclear track etch detectors) and active (silicon telescope) radiation detectors. The passive radiation detectors -so called pas-sive detector packages (PDP) are mounted at eleven positions within the Columbus laboratory -aiming for a spatial dose distribution measurement of the absorbed dose, the linear energy transfer spectra and the dose equivalent with an average exposure time of six months. Two active silicon telescopes -so called Dosimetry Telescopes (DOSTEL 1 and DOSTEL 2) together with a Data and Power Unit (DDPU) are mounted within the DOSIS Main Box at a fixed loca-tion beneath the European Physiology Module (EPM) rack. The DOSTEL 1 and DOSTEL 2 detectors are positioned at a 90 angle to each other for a precise measurement of the temporal and spatial variation of the radiation field, especially during crossing of the South Atlantic Anomaly (SAA). The DOSIS hardware was launched with the Space Shuttle Endeavour to the International Space Station on 15 July 2009 and installed by European Astronaut Frank de Winne on 18 July 2009. The first PDP set was downloaded after an exposure time of 124 days in November 2009 and a second PDP set was installed in November 2009. The active part of the instrument suit is working since July 2009. The presentation will give an overview about the DOSIS experiment as well as first results from the passive and active radiation detector measurements. The Austrian activities within this experiment were supported by the Austrian Space Appli-cations Programme (ASAP) of the Federal Ministry for Transport, Innovation and Technology under contract no. 819643. The Polish contribution to this work was supported by the Min-istry of Science and Higher Education, grant No. DWM/N118/ESA/2008. The Hungarian contribution was supported by the ESA PECS grant No. C98066.
The purpose of this case study is to understand how a lesbian survivor coped with traumatic stress resulting from woman-to-woman sexual violence in a rural context. This research was grounded on the feminist paradigm, and the case study approach was used for data collection and analysis. The results indicate that the lesbian survivor encountered numerous obstacles to admitting the rape and seeking help. A number of these perceived challenges were associated with the rural sociocultural context (e.g., conservative culture, religious fundamentalism, low levels of anonymity, small gay/lesbian communities, and geographical isolation), myths of lesbian utopia, a heterosexist legal system, and a lack of lesbian-friendly helping resources. Despite being confronted with numerous challenges, the survivor demonstrated her resilience through the use of a variety of strategies to cope with the rape aftermath and detrimental social reactions. Positive social support from her gay and lesbian friends also facilitated her recovery. The findings highlight the importance of considering the intersection of trauma and cultural oppression in understanding lesbian survivors' experiences with same-sex sexual assault. PMID:21491312
A 34-year-old 13-week pregnant woman presented with hypertension refractory to medical therapy and on workup was found to have a right adrenal mass. Due to her persistent increased blood pressure she was advised urinary vanillylmandelic acid (VMA) and its level was raised. MRI of the abdomen showed a well-circumcised lesion in the right adrenal of 3.0×2.5?cm suggestive of pheochromocytoma. The patient was started on antihypertensives including ?-blockers and ?-blockers and planned for right open adrenalectomy. Intraoperatively, blood pressure was raised up to 180/110?mm?Hg on slight manipulation of adrenal gland which was controlled with glyceryl-trinitrate and volatile agents. Postoperatively urinary VMA decreased to normal range and all antihypertensives were gradually stopped. She had uneventful pregnancy and delivered vaginally. This case report highlights the importance of surgical management of pheochromocytoma in second trimester of pregnancy to avoid catastrophic complications later in pregnancy. PMID:24850551
A 27-year-old woman, immigrated from Libanon, pregnant and at term was admitted with pain in the lower abdomen. The history was badly recognized because of the patient's inability to speak Danish. X-ray revealed a fracture of the left acetabulum with a minor central dislocation of the femoral head. During a new seizure she had another fracture of the right acetabulum also with a minor central dislocation of the femoral head and an undisplaced fracture of the proximal humerus on the left side. She was then delivered by a caesarean section. The seizures were later found to be due to grand mal type epileptic attacks. This case underlines the importance of a careful clinical and radiological investigation of patients with complaints of pain related to the central joints after seizures. PMID:9741279
Camus' short story “An Adulterous Woman” from his collection Exile and the Kingdom narrates the experience of Janine, wife of a French Algerian cloth-trader, who accompanies her husband on a business trip to the Saharan interior at mid-20th century. The desert landscape and its weather play an integral role in the plot. Blending realism and fantasy that borders on science fiction, the narrator characterizes the sky as an animate cosmological energy whose virility is masked by sunlight during the day. Released after sundown and portrayed as a liberator at the climax of the story, the shaman-like night sky descends upon Janine as a shower of stars that leaves her with an existential sense of self. This paper explores themes of astronomy and existentialism that Camus develops through Janine's “adultery” with a cosmological force, supplemented by visual imagery related to the aesthetic and scientific cultural contexts of the story and Camus' era.
This is a descriptive research, with qualitative approach, which aimed at analyze the interaction process between woman and her partner starting from the diagnosis of infection by the human papilomavirus (HPV). It was accomplished in 13 communities in the cities of Duque de Caxias and Nova Iguaçu, Rio de Janeiro state, Brazil, from October/2006 to September/2008. Twenty women, diagnosed with HPV infection related to oncogenic high risk, were interviewed. The Symbolic Interactionism and Grounded Theory perspectives guided data collection and analysis. The results revealed that the HPV diagnosis means serious challenges in the women's relationship with her partner mainly regarding to the adoption of preventive initiatives. It is concluded that these issues lead to the need of a humanized care in order to favor the women's empowerment. PMID:23887779
Vargens, Octavio Muniz da Costa; Silva, Carla Marins; Azevedo E Silva, Gulnar; Girianelli, Vânia Reis
Serious cardiac complications occurring during noncardiac surgery in a young and otherwise normal person can be quite alarming for the anesthesiologist. We report here the case of a young, healthy woman who immediately after an uncomplicated spinal surgery developed a clinical picture suggestive of an acute myocardial infarction (MI) with positive relevant investigations. However, she had an abrupt and full clinical recovery and complete normalization of her cardiac investigations within a few days of this event and thereafter continued to lead a normal, symptom-free life unlike the usual course in an MI; her coronary angiography was also normal. A diagnosis of perioperative stress-induced cardiomyopathy or Takotsubo cardiomyopathy was subsequently made. This condition is characterized by a rapid, severe, but reversible, cardiac dysfunction triggered by physical or mental stress. Awareness of this entity should help anesthesiologists manage better this infrequent, but potentially life-threatening, perioperative complication.
A 28-year-old Malay woman presented with recurrent abdominal pain for five years. She had delivered her child seven months earlier. She was found to have bicytopenia, with a haemoglobin level of 7.9 g/dL and a platelet count of 85 x 10(9)/L. Computed tomography revealed a wandering spleen. Complications of a wandering spleen, for which splenectomy is advocated, include functional asplenia (due to torsion of the splenic pedicle), splenic infarction or splenic vessel thrombosis. A splenectomy was performed and at operation, splenomegaly with a long mesentery was found. Splenic histology was negative for malignancy. The bicytopenia resolved postoperatively, and she remains well. PMID:17384868
Pseudodystonia is the term used to define abnormal postures, which are not due to the disorders of the basal ganglia and is encountered very rarely in clinical practice and often difficult to distinguish from true dystonia syndromes. We report a rare case of a battered woman who was managed as restricted resistant dystonia with pharmacotherapy and intrathecal baclofen and referred for considering deep brain stimulation (DBS). The patient turned out to be a case of pseudodystonia due to bilateral hip dislocation. This was due to assault by a close relative and the history was masked by the patient for more than one and a half years. In a patient with late onset dystonia, who is resistant to the recommended treatment for dystonia along with atypical clinical features and electrophysiological parameters, pseudodystonia should always be considered as a possible diagnosis and evaluated for causes of the same.
Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor
Ectopic deciduosis is most often located in the ovaries, cervix and uterus, but can also be located on peritoneal surfaces of pelvic- and abdominal organs. The findings from surgical biopsies taken during pregnancy are mostly asymptomatic and incidental. Deciduosis of the appendix is rare, but it is a known differential diagnosis to acute appendicitis in pregnancy. We report a 27-year-old woman, Gravida 1, Para 0 in gestational week 35, who presented with acute right abdominal pain. She underwent an acute caesarean section for possible abruptio placentae. Acute appendicitis was a differential diagnosis. Peroperative findings revealed an inflamed and enlarged appendix suspicious for tumour. A pathological examination of the appendix showed decidual changes through the entire wall without signs of appendiceal endometriosis. In conclusion, symptomatic ectopic deciduosis in pregnancy is rare and may imitate acute appendicitis. This is an important differential diagnosis in pregnant women with tumour-suspect findings. PMID:17948611
Krukenberg tumors mostly occur after 40 years. Metastatic ovarian tumors in young age are very rare and reported to be 2% of all the cases. Thirty percent of all ovarian neoplasms occurring during childhood and adolescence are malignant. A 25-year-old woman, parity- 2, presented with abdominal distension, pain in abdomen and amenorrhea. On examination, 18 weeks lump was palpable, firm to hard in consistency, non-tender and mobile. On ultrasonography bilateral ovarian tumors were reported, without any peritoneal free fluid. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Microscopic examination revealed signet ring cells with glandular differentiation, diffusely invading the ovarian parenchyma. Tumor cells exhibited strong, diffuse immunopositivity for CEA with focal strong immunopositivity for CK7 and CK20 and immunonegativity for SATB2. Diagnosis of Krukenberg tumor was made. Endoscopic biopsy confirmed the diagnosis of adenocarcinoma stomach. This case is reported because of its rarity in younger age group. PMID:24739850
Ingestion of alendronate sodium (Fosamax) had been reported to sometimes cause erosive or ulcerative esophagitis. Despite its widespread use and several case reports describing the clinical and endoscopic presentation, there has been limited discussion on the histologic appearances of the esophagitis caused by the medication. Here we describe one case of an elderly woman who presented with alendronate-induced esophagitis. The histopathologic changes that make this case unique are the large, “bizarre” squamous epithelial cells and scattered dyskaratotic cells, two findings not well described in previous reports. These unique features add to the histologic spectrum of alendronate-induced esophageal injury, and shall help differentiating this type of esophagitis from those with other etiologies.
The quest for youth and longevity has been an interest of humankind for millennia, so it is not surprising that recording statistics on human longevity is done with great interest. On September 26, 2002, it was announced that Vu Thi Dao of northern Vietnam may in fact be the world's oldest person, although her birth certificate only lists the year in which she was born, and not the exact date. Officially, the oldest living person is Kamato Hongo, a Japanese woman who celebrated her 115th birthday on September 16th. Currently, the oldest living man is 113-year old Yukichi Chuganji of Japan. For the past few decades, the average life-span of Americans has been increasing, with a report released on September 12th, 2002, by the National Center for Health Statistics indicating that the life-expectancy of Americans stands at 76.9 years. Unfortunately, the report also indicates that the death rate from diabetes, largely the result of increased obesity, is rising dramatically.The first link leads to a news story on the recent information regarding the Vietnamese woman who may be the world's oldest person. The second site is a recent report by the National Institute on Aging about the survival and coping strategies of the aging. The third link leads to a recent press release from the Pan American Health Organization regarding the public policy implications of providing adequate support to the aging throughout the Americas. The fourth and fifth sites are longer reports dealing with the current trends in aging and health in the United States and across the world, respectively. The sixth link is a news article profiling the work of Professor Andrew Prentice of the London School of Hygiene and Tropical Medicine and his research into obesity in the United Kingdom and the United States. Finally, the seventh site provides information about the current longevity record-holders from the Guinness Book of World Records.
Unexplained infertility (UI) is a difficult diagnosis in the field of obstetrics and gynaecology. This report describes TENS treatment as an adjunct therapy for a 30-year-old woman with long-standing UI who was scheduled to undergo ovarian stimulation for in vitro fertilization (IVF) and embryo transfer. She had three unsuccessful intrauterine insemination treatments. Her last IVF treatment also failed. The treatment consisted of burst-TENS for seven sessions, which was applied daily from the second day of induction of ovulation (IO) to hCG administration. The transvaginal ultrasonography with pulsed Doppler curves was performed to measure the uterine artery impedance indices of Pulsatility Index (PI) and Resistance Index (RI). Before TENS application, on the first day of IO, the PI and RI for right side uterine artery were 3.96 and 0.96, respectively. For left uterine artery, the PI and RI were 6.92 and 1, respectively. After treatment with TENS, on the day of hCG administration, the PI and RI for right side uterine artery were 3.39 and 0.90, respectively. On the left side, they were PI=2.62 and RI=0.86. IVF was performed and on the day of oocytes collection, 22 oocytes were collected and inseminated. Fertilization was confirmed 16 hours after insemination by visualization of 2 pronuclei. A singleton pregnancy was achieved by the presence of a fetal sac during an ultrasound examination. It is concluded that the addition of TENS resulted in remarkable reduction of uterine artery PI and RI and a successful pregnancy after IVF for this woman with UI. PMID:20690870
Medicine is not a science. It is an art that uses science to explore what William Harvey called "nature's closest secrets," that we may better minister to her children. We still need to remove some crackpot theories that have crept in, such as "holism." Even neurosurgery has a few. But we are beginning to humanize the traditional detached indifference and become the doctors we were meant to be. Our patients will be better for it. Society will be better for it. We will be better for it . In discussing the women's liberation movement in America, Reverend William Sloan Coffin once stated, "The woman who most needs liberating is the woman who lives inside of each man." This, I think, is the great awakening that the increasing influence of female physicians has brought about. Early twentieth century physicians, armed with a new science, became efficient fighters of disease. Disease was the enemy, the cure was the victory, and the patient was too often merely the environment in which the encounter was fought. This is what was taught in medical school and residency. It was necessary to learn the lesson well in order to be protected against the pain of others and to abort any insidious tendency to identify with their misery. Many teachers believed in preventing the enervating perils of "emotional involvement." This is not to say that physicians were unkind to their patients, merely that they kept their distance. Patients were treated with respect and even with a kind of formalized dignity. Physicians were as gentle as they knew how to be. But they were men apart. They towered over the sick as an adult towers over a child. Today something within men is being liberated. To a great extent, I believe that women physicians have been essential in bringing this change to medicine. We now know that physicians are not compromised by allowing themselves to feel some of what their patients feel. They are strengthened by it. A patient's life, the setting of his illness, the rending of his soul, the anguish of his family and the hope for his recovery have all become as much a part of good care as knowledge of the serum sodium and what to do about it. Men have become better nurturers, more empathetic. And the thing that is being liberated from inside men is something that society has always seen as a feminine quality. The peak of the healer's art is in bringing both science and empathy to bear on disease. This is what being a physician should mean.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8091297
The prevalent sociocultural belief about the psychoses and schizophrenia is that intensive psychoanalytic therapy is ineffective if not destructive and contraindicated, and that the treatment of choice is a combination of psychopharmacology and educational techniques designed to provide symptom relief and rehabilitation. The literature contains few detailed reports of successful intensive psychotherapy that might contradict these beliefs. The psychoanalytic psychotherapy of a woman I shall call Sara, who met DSM criteria for chronic paranoid schizophrenia, is presented in detail. Its success in bringing about a fundamental personality transformation from a seriously self-destructive state in which she was unable to care for herself to one in which she became a mature creative person is confirmed by a follow up two decades after termination. The therapy transpired over an 11-year period and was conducted for the most part four times per week. It was supported by numerous hospitalizations in the early years as well as pharmacotherapy which she was able to relinquish prior to termination. During treatment Sara separated both physically and psychologically from an undifferentiated destructive relationship with her mother, internalized the capacity to think and represent emotions, and integrated disparate elements of personality to form a cohesive self. She developed psychosexually and formed a mature gender identity. She achieved the capacity for intimacy and motherhood, and had a successful career. PMID:23216397
In the Western world, the diagnosis and management of Plasmodium vivax malaria in pregnant women can be challenging, and the pathogenesis of adverse outcomes for both the mother and the foetus is still poorly known. The authors describe the case of a 29-year-old Pakistani woman at the 29th week of her second pregnancy, who was admitted to the Hospital following the abrupt onset of fever. At the time of admission, she had been living in Italy without travelling to any malaria-endemic areas for eight months. She was diagnosed with vivax malaria after a thin blood smear revealed the presence of plasmodial trophozoites and gametocytes and treated accordingly. Due to the onset of oligohydramnios, she underwent caesarian section at the 31st week of pregnancy with no further complications. Histological examination of the placenta showed no evidence of plasmodial infection, but was inconclusive. It is unclear whether oligohydramnios is a complication of pregnancy-related Plasmodium vivax malaria. Given the long latency of hypnozoites, every febrile pregnant patient with a previous stay in an endemic area should be screened for malaria with a thick and a thin blood smear.
Androgen secreting tumours are the least commonly encountered androgen excess disorders, having a prevalence of 0.2%. Androblastomas of the ovary comprise less than 0.5% of all ovarian tumours. Pure Leydig cell tumours are very rare and almost always show secretion of male sex hormones. A 41-year-old multipara Filipino woman presented with a 2-year history of amenorrhoea and virilisation characterised by hirsutism, androgenic alopecia, masculine habitus and clitoromegaly. Diagnostic evaluation showed markedly elevated serum testosterone and normal dehydroepiandrosterone sulfate. Normal ovaries were seen on initial transvaginal ultrasound. A low dose dexamethasone suppression test suggested an ovarian source. A left adrenal nodule was seen on CT scan. Doppler transvaginal ultrasound revealed a solid lobulated structure in the right ovary. The patient underwent surgery and histopathology showed a Leydig cell tumour, hilar type. Serum testosterone levels normalised 3 days after surgery. Specific clinical and biochemical investigation of androgen secreting neoplasms is very important for correct diagnosis of these rare tumours. PMID:22802276
Rivera-Arkoncel, Maria Luisa Cecilia; Pacquing-Songco, Debby; Lantion-Ang, Frances Lina
Androgen secreting tumours are the least commonly encountered androgen excess disorders, having a prevalence of 0.2%. Androblastomas of the ovary comprise less than 0.5% of all ovarian tumours. Pure Leydig cell tumours are very rare and almost always show secretion of male sex hormones. A 41-year-old multipara Filipino woman presented with a 2-year history of amenorrhoea and virilisation characterised by hirsutism, androgenic alopecia, masculine habitus and clitoromegaly. Diagnostic evaluation showed markedly elevated serum testosterone and normal dehydroepiandrosterone sulfate. Normal ovaries were seen on initial transvaginal ultrasound. A low dose dexamethasone suppression test suggested an ovarian source. A left adrenal nodule was seen on CT scan. Doppler transvaginal ultrasound revealed a solid lobulated structure in the right ovary. The patient underwent surgery and histopathology showed a Leydig cell tumour, hilar type. Serum testosterone levels normalised 3 days after surgery. Specific clinical and biochemical investigation of androgen secreting neoplasms is very important for correct diagnosis of these rare tumours.
Rivera-Arkoncel, Maria Luisa Cecilia; Pacquing-Songco, Debby; Lantion-Ang, Frances Lina
Adenomatoid odontogenic tumours (AOT) are uncommon odontogenic lesions characterized histologi-cally by duct-like structures derived from the epithelial component of the lesion and can be distinctly classified into follicular, extrafollicular and extraosseous variants (Neville BW, Damm DD, Allen CM, et al. Adenomatoid Odontogenic Tumor. A Text Book for Oral and Maxillofacial Pathology, 2(nd) edition, 621-3). Most of these tumours develop in the second or third decade of life and have a distinct predilection for women. The follicular variant accounts for 75% of reported cases (Curran AE, Miller EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:557-60) and is associated with the crown of an impacted tooth, commonly the maxillary canine. We present a rare case of extrafollicular AOT mimicking a periapical cyst that originated in a woman in her first trimester of pregnancy and enlarged rapidly thereafter. The lesion was enucleated and sent for histopathology and immunohistochemistry, which revealed AOT with a cystic component with no dependence on oestrogen or progestrone for its growth. This case of AOT introduces us to the unique variation in its presentation and the difficulty in differentiation from periapical disease of inflammatory origin. PMID:23739254
Peganum harmala L. is a plant widely distributed in the Mediterranean region. It is commonly used in traditional medicine in Morocco as sedative and abortifacient but exposes users to the risk of overdose and poisoning. The pharmacologically active compounds of this plant include a number of ?-carboline and quinazoline alkaloids responsible of its pharmacological and toxicological effects. We report the case of a 24-year-old woman, 22 weeks pregnant, intoxicated with the seeds of Peganum harmala L. On admission, she had disturbance of consciousness, uterine contraction, and oliguria. Laboratory tests revealed renal failure and liver injury, and she benefited then from hemodialysis. During hospitalization, she was intubated after deterioration of consciousness and presented a spontaneous expulsion of the fetus. After extubation, she kept unusual sequelae: cerebellar ataxia and peripheral polyneuropathy. Physicians in regions using Peganum harmala L. as traditional medicine must be able to detect symptoms of its toxicity, in order to establish early gastrointestinal decontamination. The prognosis of this intoxication is variable; most cases can be managed successfully; but in high doses of intoxication, evolution can be fatal.
A 32-year-old woman presented with a 10-day history of fever (38.0 degrees C), headaches, nausea, vomiting and a 6-month history of diabetes insipidus and amenorrhoea. Two months previously she had undergone a surgical drilling of the right mastoid area because of mastoiditis. Endocrine investigation showed elevated serum prolactin levels, secondary adrenal and gonadal failure and a normal thyroid function. Cranial MRI scan revealed a contrast enhancing intrasellar mass (approximately 2 cm) of heterogeneous appearance with suprasellar extension and thickening of the pituitary stalk. Lumbar puncture was suggestive of aseptic meningitis. The Ziehl-Neelsen stain of cerebrospinal fluid (CSF) and the tuberculin skin test were both negative. The pituitary mass was removed with a transsphenoidal approach. Histological examination demonstrated destruction of the adenohypophysis by epithelioid granulomas with partial caseous necrosis and microabscess formation, suggestive of a mycobacterial infection. A polymerase chain reaction analysis performed on paraffin-embedded tissue was positive for mycobacterial DNA. According to the individual 16S sequence, it was identified as Mycobacterium malmoense, an atypical nontuberculous mycobacterium (NTM). In conclusion, this is the first case of an isolated pituitary granuloma caused by an NTM infection in a nonimmunosuppressed patient. PMID:11849256
A 69-year-old woman was initially seen with constant abdominal pain in the epigastrium and right upper quadrant, with nausea and vomiting of three days' duration. On examination, moderate tenderness and guarding in the right upper quadrant of the abdomen were noted. A leukocytosis of 11,000/cu mm, with a mild shift to the left, was present. Findings from a sonogram and hepatobiliary scan were consistent with a diagnosis of acute cholecystitis for which intravenous (IV) antibiotic therapy was instituted. Results of radiological studies performed on the second hospital day showed a small-bowel obstruction. On surgical exploration, a gangrenous segment of the terminal ileum was resected and an end-to-end anastomosis was performed. The resected bowel demonstrated hemorrhagic infarction with evidence of focal organizing venous thrombosis in the mesentery. The patient was initially started on a regimen of IV heparin and then switched to oral coumarin. On the fourth day of coumarin therapy, massive swelling, tenderness, and erythema were noted to involve the entire right breast. Six months later, the patient was readmitted because of an acute pulmonary embolism. A residual 4x5-cm mass was present in the central portion of the right breast. The overlying skin was slightly retracted. Mammography showed an extensive masslike density behind the right nipple, with evidence of periareolar retraction. Coumarin-induced mammary necrosis was diagnosed.
An 85-year-old woman, who had been given a diagnosis of myelodysplastic syndrome with refractory anemia 2 years previously and required blood transfusion once a month, was admitted with complaints of fever, general fatigue, and dry cough. A chest X-ray film showed multiple small nodules in bilateral lung fields which were not observed 1 month previously. Although smear and culture tests for acid-fast bacilli in her bronchoalveolar lavage fluid, urine, and bone marrow aspiration fluid were all negative, miliary tuberculosis was strongly suspected. Antituberculosis drugs were administered, but neither her symptoms nor chest X-ray findings improved. Five months later, right oculomotor nerve palsy, followed by left abducens nerve paralysis occurred. Lumber puncture examination revealed lymphocytosis, and increased protein and ACE levels, suggesting neurosarcoidosis. A transbronchial lung biopsy specimen demonstrated non-caseating epithelioid granulomas. Oral administration of 30 mg/day prednisolone improved her symptoms as well as the chest X-ray findings. PMID:21226301
Southern Sudanese have been displaced due to tribal conflicts and civil war between the Islamic Khartoum government in the North and the predominantly Christian South. This article narrates the plight of displaced Southern Sudanese women, particularly that of a woman named Rebecca Akwach during her journey towards Nzara to escape air raids by the Khartoum government. The war that plagued Southern Sudan for the past 11 years has burdened numerous women with the responsibility of bringing up their children single-handedly. Most of the husbands have been killed in battle, separated through displacement, or have fled to other countries. Approximately 500 displaced people, including pregnant women, have walked some 300 km westward to a small town in western Ethiopia. During their ordeal, meals was reduced to once daily or none at all, while others barter whatever valuables they have for food. Malnutrition, malaria, diarrhea, respiratory tract infection and measles were prevalent. Pregnant women have an added burden of carrying valuables and small children who cannot walk 10 km a day. Akwach and other sojourners are now in Nzara and are waiting for the allocation of land where they can temporarily settle. PMID:12349363
Tuberous sclerosis is an autosomal dominant disorder characterized by involvement of skin, nervous system, kidneys, and lungs. It results from mutations in 1 of 2 genes: TSC1 (encoding hamartin) or TSC2 (encoding tuberin), leading to dysregulation and activation of the mammalian target of rapamycin (mTOR) pathway. Constitutive activation of mTOR signaling has recently been reported in systemic lupus erythematosus (SLE), and inhibition of this pathway may benefit patients with SLE nephritis. We report a case of a young woman with tuberous sclerosis who developed fulminant SLE, with lower extremity edema, massive proteinuria, and class IV lupus glomerulonephritis. She died despite treatment with high-dose steroids, plasmapheresis, and cyclophosphamide. Although there are no prior reports of coexistence of these 2 rare diseases, this case is of considerable interest because of the possibility that activation of mTOR by the TSC mutations may have led to activation of the immune system and the development of unusually severe SLE.
Singh, Namrata; Birkenbach, Mark; Caza, Tiffany; Perl, Andras; Cohen, Philip L.
The emergence of the ‘modern woman’ in Inter-War Britain was the result of a process which began at the end of the previous century. The new modern woman was symbolic of youth and freedom; she embraced life and spent her time in the pursuit of fun and enjoyment. The female body was, in many ways, one of the central focuses
The purpose of this annotated bibliography is twofold. The first purpose is to address the question raised by Phyllis Holman Wiesbard, "Where are women on the 'net?" The second purpose is to explore how teachers can use the documents found on the world wide web to teach woman suffrage in their classrooms. Woman suffrage has proved to be a fruitful…
This essay narrates the biography and dance aesthetics of Myra Beltran, a pioneering, independent and contemporary woman dance artist in the Philippines. Featured here are the history, alternative aesthetics, philosophy, and influences of Myra Beltran's works. It comes from the point of view of an author who is also a woman, dancer, and writer…
Participants (N = 200) were presented with a criminal homicide trial involving a battered woman who had killed her abuser. Within the trial, both the response history (passive, active) and presence of expert testimony pertaining to battered woman syndrome (present, absent) were systematically varied. As well, half of the participants in each of these conditions were provided with a nullification
Participants (ND 200) were presented with a criminal homicide trial involving a bat- tered woman who had killed her abuser. Within the trial, both the response history (passive, active) and presence of expert testimony pertaining to battered woman syn- drome (present, absent) were systematically varied. As well, half of the participants in each of these conditions were provided with a
This qualitative study explores the educational experiences of an African-American adult woman with disabilities. The intersections of gender, race and disability are theorized through the lenses of disability, feminist and critical theory. Specifically, I address the following three questions. What are the experiences of an African-American woman…
This case study presents the findings from a qualitative research project about a Black woman scholar, the first non-White female to serve as chair of a department and the associate dean of the college in its 100 year history. The study focuses on the experiences of a Black woman scholar as a chairperson and the learning she achieved during her…
Kathleen Blake Watkins Coleman, known to her readers as "Kit," was a late nineteenth-century journalist who tried to escape the limitations of the woman's sphere in journalism through travel writing, while still complying with the expectation that she describe her adventures from a "woman's point of view." Among her many accomplishments, "Kit"…
In this descriptive study, women's professional lives with a focus on what it means to be a woman in Turkish academia and on whether being a woman differs from being a man in an academic context was put under scrutiny. For this purpose, a questionnaire was conducted among 41 women academics currently working at the Faculties of Education in…
The story presented in this booklet is concerned with the life of an eighty year old Chinese immigrant woman living in Hawaii. The narration provides a brief overview of the woman's birth, childhood, early adulthood in China, and immigration to Hawaii. Her life in Hawaii is described in terms of the work she did, her arranged marriage, her…
Serving as America's only female newspaper editor during the election of 1832, Anne Royall became possibly the first public “Jackson Woman” by supporting the chief executive's bid for re-election in her sheet titled Paul Pry. A closer look at Royall's recollections from her travels in Alabama from 1818 to 1822 shows her to be a blooming “Jackson Woman” developing before
Reported here is the case of a pregnant woman who developed a severe Chlamydophila abortus infection after indirect contact with infected goats resulting in preterm stillbirth. The woman fully recovered after treatment with doxycycline. In the goat herd with which her husband worked Chlamydophila abortus was actively circulating, as shown by positive serology. When pregnant women present with rapidly worsening
A. Meijer; A. Brandenburg; J. de Vries; J. Beentjes; P. Roholl; D. Dercksen
The feasibility of obtaining high quality homonuclear or heteronuclear diffusion-ordered 13C NMR data is shown to be greatly improved by using 13C isotopically-enriched samples. Stable isotope-enhanced diffusion ordered (SIE-DOSY) 13C NMR has been applied to 13C-enriched carbohydrates, and has been used to determine diffusion coefficients for pentose and hexose monosaccharides, and a disaccharide and trisaccharide. These 2D spectra were obtained with as little as 8 min of acquisition time. Fully resolved 3D DOSY-HMQC NMR spectra of [U- 13C]xylose, [U- 13C]glucose, and [1- 13C gal]lactose were obtained in 5 h. Sample derivatization with [ carbonyl- 13C]acetate (peracetylation) extends the usefulness of the technique to included non-labeled sugars; the 13C-carbonyl - carbohydrate ring proton 1H- 13C correlations also provide additional structural information, as shown for the 3-D DOSY-HMQC analysis of a mixture of maltotriose and lactose per-[ carbonyl- 13C]acetates.
INTRODUCTION Lumbar herniation is uncommon, with traumatic etiology being rare. Traumatic lumbar hernias are usually caused by seatbelt injury in motor vehicle accidents. It is exceedingly uncommon to see lumbar hernias in an unrestrained passenger of a motor vehicle accident. PRESENTATION OF CASE We present a case of a traumatic inferior lumbar hernia in a young woman who was an unrestrained driver of a vehicle involved in a high-speed collision, with multiple rollover and ejection. CT scans of the abdomen and pelvis suggested soft tissue injury involving muscles in the left lower posterior flank with traumatic herniation of the colon and small bowel. Emergent midline abdominal laparotomy confirmed herniation in the left lower quadrant. After abdominal closure, in the prone position, an extensive laceration over the left flank also confirmed herniation. Due to its dirty nature, the wound was irrigated, lavaged and covered with wound vacuum-assisted closure placement. The decision was made in favor of delayed elective hernia repair. DISCUSSION Lumbar hernias are usually caused by sudden force to the abdomen, leading to increased intra-abdominal pressure. This pressure combined with areas of weakness in the superior and/or inferior triangle lead to herniation. Uncommonly, the contents of lumbar hernias can strangulate or incarcerate leading to bowel obstruction. This can often be prevented by detection with CT and laparotomy. CONCLUSION Lumbar herniation of traumatic etiology is rare. Early detection with CT and/or exploratory laparotomy is important to avoid increases in size of the defect and bowel strangulation and incarceration.
Woolbert, Ashley; Calasanz, Emily R.; Nazim, Muhammad
This article describes the activities of film director Shireen Pasha in promoting truth in the mass media in Pakistan. Pasha is described as one who finds it inexcusable in a state-subsidized system that national problems of poverty are not aired openly. Pasha has pursued the goal of exposing the real lives of Pakistanis on film in contrast to the publicly aired segments of "pretty girls in nice drawing rooms." Foreign channels available through satellite communications technology are viewed by Pasha as inappropriate with regard to people's needs and uncreative. Pakistan began with one channel, PTV, which recently refused to air her documentary on living conditions in Pakistan's rural areas "The Travelogue Pakistan." "The Walled City of Lahore" was her film about life in the old city. Both films poetically depicted the honor of humans and their struggle to stay alive. Some of her documentaries are made to show the value of indigenous skills, centuries old know-how, and traditions, regardless of the poverty. Pasha is described as fighting with PTV management over use of resources. Pasha desires to invest in training people to do documentaries or be more field-oriented rather than investing in equipment. Pasha joined PTV in 1975 and left in 1990. Pasha is recognized for her isolation as a woman in the business world, her commitment to exposing remote cultures and truth, and the odds she must confront in attaining her goals. Pasha is committed to doing extensive research, usually conducted during the summer months, in order to construct a credible story line that is produced usually during the winter months. One model of film story line is defined as one where women are portrayed as starting from an indigenous skill or knowledge and shifting to a greater position of power and control over their lives. Pasha believes that people who make films have the responsibility to evoke a reaction in people and to offer solutions. Two acclaimed films, which were supported by USAID and the government, were "Before It's Too Late" and "Only One Way." Both deal with resource issues and the environment. She is currently director of her own film house, The Film Makers, in Lahore. After graduating from the National College of Arts in 1968, she furthered her education in the US in the history of art. PMID:12290699
In 1909, at the height of the woman suffrage controversy and during the golden age of postcards, the Dunston-Weiler Lithograph Company of New York produced a twelve-card set of full-color lithographic cartoon postcards opposing woman suffrage. The postcard images reflect, and depart from, verbal arguments concerning woman suffrage prevalent during…
Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways,…
This article looks at how al-KhansaÊ¾, a seventh-century woman poet of the Arabian Peninsula, can be seen as a crossover artist between the Arabicand English-speaking poetic worlds. Al-KhansaÊ¾ is a striking poetic figure partly because she is revered within the Arab world as the first Arab woman poet and writer but also because she holds a similarly prominent role in
Novel organic-inorganic hybrids of various sizes were generated by reaction of 1,8-octanediphosphonic acid (ODP) and (NH4 )6 Mo7 O24 in aqueous solution. The formation of rodlike hybrids with variable numbers of covalently bound ODP and polyoxomolybdate (POM) units can be tuned as a function of increasing (NH4 )6 Mo7 O24 concentration at fixed ODP concentration. The chemical structure of the ODP/POM hybrids was characterized by (1) H, (31) P, and (95) Mo NMR spectroscopy. Heteronuclear (31) P DOSY (diffusion- ordered NMR spectroscopy) and molecular mechanics (MM) calculations were applied to determine the size and shape of the nanosized hybrids generated at various ODP/POM ratios. For this purpose, the structures of ODP/POM hybrids with variable numbers of ODP and POM units were optimized by MM and then approximated as cylinder-shaped objects by using a recently described mathematical algorithm. The thus-obtained cylinder length and diameter were further used to calculate the expected diffusion coefficients of the ODP/POM hybrids. Comparison of the calculated and experimentally determined diffusion coefficients led to the most probable ODP/POM hybrid length for each sample composition. The (31) P DOSY results show that the length of the hybrids increases with increasing POM concentration and reaches a maximum corresponding to an average of 8?ODP/7?POM units per chain at a sample composition of 20?mM ODP and 14?mM POM. With excess POM, above the latter concentration, the formation of shorter-chain hybrids terminated by Mo7 clusters at one or both ends was evidenced on further increasing the POM concentration. The results demonstrate that the combination of (31) P DOSY and MM, although virtually unexplored in POM chemistry, is a powerful innovative strategy for the detailed characterization of nanosized organic-inorganic POM-based hybrids in solution. PMID:24729454
Shestakova, Pavletta; Absillis, Gregory; Martin-Martinez, Francisco J; De Proft, Frank; Willem, Rudolph; Parac-Vogt, Tatjana N
In the present case study, a care encounter between an older multilingual (Farsi/Swedish/English) Persian woman and staff in an ordinary, Swedish residential home is investigated. The woman is perceived as suffering from dementia symptoms, but has not received any formal diagnosis of the disease. More specifically, the study focuses on how the woman's contributions in her mother tongue, Farsi, are responded to by a carer, who is also multilingual and speaks Swedish as a second language (L2), but has a very limited knowledge of Farsi. The data consists of recorded material from a mundane morning activity in the residential home, as the woman is undressed and prepared to go to the shower. The method employed is conversation analysis, and the study addresses the interactional outcome of this type of multilingual encounters, highlighting the way the establishment of mutual understanding is negatively affected by the fact that the participants do not or only to a limited extent share a common language. Analysis of the data shows that most of the woman's contributions in Farsi are responded to in L2-Swedish by the carer, primarily by means of seven different response practices: soothing talk, instrumental talk, minimal responses, explicit expressions of understanding, mitigating talk, questions, and appraisal. The findings are discussed in light of new demands on Swedish (and Western) care- and health care systems to adapt to the increasing number of multilingual, older people, who will become residents in care facilities and attend day centers within the coming years. PMID:24443089
Primary breast lymphoma (PBL) of the breast is a rare type of localized non-Hodgkin lymphoma, which is usually of the B-cell. The majority of breast lymphoma present as a unilateral painless breast masses in an older woman, average age at diagnosis 55-60. A less common but distinctive presentation is a young woman of childbearing age who presents during or immediately after pregnancy. We present a 23-year-old postpartum woman with bilateral breast swelling. After surgical drainage and debridement and pathologic examination, the diagnosis of breast Burkitt lymphoma (BL) was confirmed. Chemotherapy was immediately started for her and the patient showed a good response with complete remission.
This new addition to Library of Congress' American Memory makes 448 images culled from approximately 2,650 photographs in the Records of the National Woman's Party, and held by the Manuscript Division at Library of Congress, available online. The National Woman's Party was the militant wing of the suffrage movement, whose members engaged in public protests, such as picketing, pageants, parades, hunger strikes, and demonstrations, often resulting in arrests and imprisonment, all to bring publicity to the cause of women's right to vote. Pictures reflecting this broad range of tactics, dating from 1875 to 1938 (the majority from 1913 and 1922) are showcased at the website. The gallery entitled Suffrage Prisoners presents portraits of roughly 60 National Woman's Party activists who were jailed for their role in suffrage protests.
In June 1987, a Washington, DC, court, stating that it had an interest in protecting viable fetal life, ordered a 27-year-old woman dying of cancer to undergo a cesarean section to deliver a 26 1/2-week fetus. The child died within hours, and the woman within days, of the surgery. The ruling was appealed. In April 1990, the court vacated its order, stating that because the court had not first determined the woman's wishes, either as expressed by herself or through a substituted judgment, it was not possible to find a state interest in protecting fetal life which outweighed her own. Beyond this legal issue lie the ethical questions of appropriate care for the pregnant, terminally ill woman. This article argues that it is important to distinguish a decision not to deliver at this time from a decision to terminate a pregnancy. Further, because a cesarean section, unless there is a threat to her life, is not of any clear benefit to the woman, it is wrong to insist that a dying woman must always endure burdensome treatment for the sake of a viable fetus. Should the mother decide to take on such burdens, it is important also to recognize that a cesarean section is not always in the interest of the fetus simply because it is viable. Given the ambiguity of the prognosis for survival and the risks of significant handicaps for the preterm or low birth weight fetus, it may be ethically appropriate to omit an act on behalf of the fetus. Finally, the fact that the fetus' only chance of survival is a preterm delivery does not make the delivery ethically mandatory. The issue is not whether a preterm delivery is the fetus' only hope, but whether a preterm delivery is in the interest of the fetus. PMID:1956747
Objective To report a case of a 31-year-old woman with renal angiomyolipoma (RAML) who presented with progressive massive haematuria\\u000a with successive pregnancies.\\u000a \\u000a \\u000a \\u000a Clinical presentation A 28-year-old woman presented with mild haematuria in the third trimester of her second pregnancy. This was due to bleeding\\u000a from a left RAML. Patient became pregnant for a third time. The RAML increased in size and patient
Awni Al-Ateeqi; Rola H. Ali; Elijah O. Kehinde; Khalida Mujaibel; Adel Al-Hunayan; Jehad Al-Harmi
Despite its many similarities to her better-known novel Belinda, Maria Edgeworth's Angelina is not usually read as a work about lesbianism--even though it begins with the heroine eloping to live with another woman. This article explores same-sex relationships in Angelina and suggests reasons for the work's comparative neglect by lesbian criticism. It examines the process by which the heroine's "unknown friend," the novelist Araminta, moves from being "nobody," a textual construct, to a woman all too thoroughly and grotesquely embodied; and it discusses the role of queer objects, including literary texts, in that process of embodiment. PMID:23855941
We herein report the case of a 37-year-old type 1 diabetic pregnant woman treated with an insulin pump. Although the patient's glycemic control deteriorated following progesterone treatment for the prevention of preterm delivery and miscarriage, it was improved by adjusting the basal insulin rate on the days of progesterone treatment. Excess progesterone is known to impair both insulin sensitivity and secretion. The present case is the first report to evaluate deterioration of glycemic control induced by progesterone treatment and to determine the dose of insulin required in a type 1 diabetic pregnant woman whose insulin secretion was completely depleted. PMID:23318859
Objective. To assess aetiology of a POF in a 33-year-old woman and, if possible, plan a cure. Design. Case report. Setting. medical genetics diagnostic unit in a university hospital. Patient. A 33-year-old woman with premature ovarian failure (POF). Intervention(s). Genetic counseling, karyotyping, FISH study. Result(s). Turner-like diagnosis. Conclusion(s). Most cases of POF remain idiopathic. Turner syndrome can occur in very different phenotypes; cytogenetic and molecular profiling can provide a definitive diagnosis in cases with nonclassical phenotype.
Colao, Emma; Granata, Teresa; Vismara, Marco F. M.; Bombardiere, Francesco; Nocera, Donatella; Luciano, Elisa; Perrotti, Nicola; Malatesta, Paola
Williamsia serinedens has been isolated from soil but has not yet been implicated in human disease. We report the first case of perinatal sepsis caused by a dual-morphotype form of Williamsia serinedens in a 31-year-old pregnant woman hospitalized with preterm labor. PMID:20463157
Yassin, Atteyet F; Lombardi, Salvatore J; Fortunato, Stephen J; McNabb, Paul C; Carr, Mark B; Trabue, Christopher H
We report a case of congenital rubella syndrome in a child born to a vaccinated New Jersey woman who had not traveled internationally. Although rubella and congenital rubella syndrome have been eliminated from the United States, clinicians should remain vigilant and immediately notify public health authorities when either is suspected. PMID:24447409
Pitts, Samantha I; Wallace, Gregory S; Montana, Barbara; Handschur, Elizabeth F; Meislich, Debrah; Sampson, Alethia C; Canuso, Suzanne; Horner, Jennifer; Barskey, Albert E; Abernathy, Emily S; Icenogle, Joseph P
Caesarean wound dehiscence that is severe enough to result in bowel herniation is exceptionally rare. This case describes a woman who experienced wound dehiscence following each of her two Caesarean sections, with bowel herniation present in the second case. The contribution of her comorbid hidradenitis suppurativa will be discussed.
Caesarean wound dehiscence that is severe enough to result in bowel herniation is exceptionally rare. This case describes a woman who experienced wound dehiscence following each of her two Caesarean sections, with bowel herniation present in the second case. The contribution of her comorbid hidradenitis suppurativa will be discussed. PMID:24876503
This article is a poetic retelling of insight gained as a Black woman surviving graduate school. The purpose of this autoethnographic narrative is to document a few pivotal graduate school experiences that illustrate all that it means to become disciplined in and by higher education. Although the violence committed in such a privileged space may…
In this study, we report a rare case of choroidal melanoma in an eye with oculodermal melanocytosis (Nevus of Ota). A 56-year-old Taiwanese woman with oculodermal melanocytosis in the right eye was found to have an ipsilateral uveal melanoma. Histopathology of the enucleated eye confirmed the diagnosis of malignant choroidal melanoma of mixed cell type. A search of the literature
Ya-Chi Chen; Cheng-Hsien Chang; Shiuh-Liang Hsu; Min-Wen Hsu; Chia-Ling Lee
If the emerging novel of the mid-eighteenth century developed new means of constructing and manipulating its readership, much may be gained by studying the novel in one of its most blatantly manipulative forms. This essay examines John Cleland's Memoirs of a Woman of Pleasure, the first pornographic novel in English, under the hypothesis that on the level of narrative technique
The study, a literature review, examines the critical factors affecting re-entry women's access to jobs and their chances of obtaining and retaining work at a level appropriate to their capacities. An examination of the re-entry woman deals with socialization and self-concept, changing attitudes, and new expectations. Bias against women among the…
This illustrated reader contains Passamaquoddy versions of two traditional Wabnaki legends about Pukcinsquehs, the Tree-Stump Woman, who changes herself into a mosquito, and Koluskap, a giant, who turns people into fish. It is one of a series of readers containing Passamaquoddy legends and is intended for use in a bilingual education setting. Each…
Wabnaki Bilingual Educational Program, Indian Township, ME.
This article argues that some leaders within the US antiabortion movement are pursuing a frame extension in order to attract new adherents to their cause. While the dominant rhetoric of the movement today focuses on the fetus and the immorality of abortion, pro-woman rhetoric has reemerged that leverages both the language of women's rights as well as science in order
A study examined the coverage of women in one midwestern college newspaper and three midwestern city newspapers during 1992, the Year of the Woman. Bylines, references, and the roles portrayed in newspaper photographs were examined to determine how local newspapers covered the record number of women running for political office, the record number…
Over 400 college students used the Bem Sex Role Inventory (BSRI) to describe either a typical, desirable, or ideal man or woman. Findings obtained from Bem's androgeny score are contrasted with those from its component masculinity and femininity scale scores. Recommendations are made for using the component scores as separate variables. (Author/GC)
Malignant melanomas of the uterus, either primary or metastatic, are extremely rare. They can be mistaken as other tumors, such as uterine sarcomas during diagnosis. We describe here the first case of a metastatic melanoma of the uterus with peritoneal seeding in a young woman. It was first diagnosed as a uterine sarcoma from a frozen-section biopsy.
To determine the relationship between attitudes and feelings of the middle woman, aged 35-55, and the present youth culture, both intrapsychic factors and environmental conditioning, as well as historic/cultural reasons were examined, using an attitudinal survey, administered to a sample population of middle to upper class suburban women.…
A 71-year-old woman presented with acute inferior homonymous quadrantanopia initially mimicking acute ischemic stroke. As clinical signs and symptoms progressed to akinetic mutism with myoclonus the diagnosis of the Heidenhain variant of Creutzfeldt-Jakob disease was made. Brain MRI 4 days after symptom onset revealed ribbon-like high signal intensity in the medial occipital cortex. PMID:24210803
Multiple factors which increase a woman's breast cancer risk have been identified. These range from conditions such as lobular carcinomain situ which increase risk to relatively high levels, to reproductive factors such as nulliparity which are associated with only a small increase in risk. When determining an individual's risk, all her potential breast cancer risk factors must be considered. In
A 28 year old white woman with no medical history presented to the emergency room with symptomatic non-sustained ventricular tachycardia. She was asymptomatic up to a few days before presentation. Her physical examination was essentially normal and hence did not help with the differential diagnosis of the problem. Bronchoscopic transbronchial biopsy led to the final diagnosis of cardiac sarcoidosis.
M Heath; H Deubner; E J Stern; J E Cooke; E A Gill
We present a 33-year-old woman with deep venous thrombosis of the left iliac vein and the left lower limb. A computed tomography scan of her abdomen revealed a hypoplastic inferior vena cava and agenesis of the right kidney. Congenital anomalies of the inferior vena cava are uncommon and are sometimes an unrecognized cause of deep venous thrombosis. PMID:24216406
Research suggests that maintaining good physical and mental health helps prevent some women from being abused by their male partners, and that social support is inversely related to male-to-female vic- timization. This study examined the role of mental and physical health and two forms of social sup- port (all of which we define as elements of resilience) in predicting woman
Langerhans cell histiocytosis (LCH) is a very rare disease of female genital tract, most commonly seen in vulva and unusual in postmenopausal period. Herein, we report the 8th case of pure vulvar LCH in a postmenopausal woman. We pay attention to the differential diagnosis in postmenopausal state, features of pathologic diagnosis, and treatment options.
Kurt, Sefa; Kopuz, Aycan; Solakoglu Kahraman, Dudu; Tasyurt, Abdullah
We report one case of mature mediastinal teratoma with pulmonary extension surgically diagnosed in a 22-year-old woman complaining of recurrent hemoptyses for which no etiological explanation could be found. Thoracic surgery was only decided on after three embolizations proved ineffective.
Filaire, M. [Clermont-Ferrand University Hospital, Service de chirurgie thoracique (France); Michel-Letonturier, M. [Clermont-Ferrand University Hospital, Service de radiologie B, viscerale et vasculaire (France); Garcier, J. M.; Escande, G. [Clermont-Ferrand University Hospital, Service de chirurgie thoracique (France); Boyer, L. [Clermont-Ferrand University Hospital, Service de radiologie B, viscerale et vasculaire (France)], E-mail: email@example.com
We report this country's first nonsurgical donor ovum transfer pregnancy in a functionally agonadal woman who had received chemotherapy and radiation for Hodgkin's lymphoma. For women with ovarian failure, nonsurgical uterine lavage and ovum transfer may provide an opportunity for motherhood that was not possible previously.
SECTION 1 A 52-year-old Korean woman with a history of poorly controlled Type 1 diabetes presented for eval- uation of abnormal movements of her right arm and leg. The movements began insidiously in her right hand and arm, progressing over several months to involve the right foot as well. She was unaware of the movements until her husband noticed them.
Sarah M. Kranick; Raymond S. Price; Sashank Prasad; Howard I. Hurtig; Mitchell S. V. Elkind
Rhinocladiella mackenziei is a recognized cause of endemic cerebral phaeohyphomycosis in the Middle East area. Surgical resection of the abscesses and posaconazole treatment have improved the ominous prognosis of this disease. We describe the case of a native Afghan woman living in France who presented with brain abscesses due to R. mackenziei.
This essay intervenes in contemporary scholarship on Sandra Cisneros's "Woman Hollering Creek" (1991) by examining the canciones she uses as epigraphs and their relationship to the multiple nationalisms that Chicana/os actively negotiate. I argue that Cisneros's decision to include powerfully nationalist Mexican cancion traditions directs the…
The social sciences portray the Chicana or Mexican American woman almost exclusively as a submissive maternal figure. The tenacity with which the social sciences have perpetuated stereotypes about Chicanas appears to be related to an on-going trend to support studies of interpersonal or cultural characteristics of Chicanas and a resistance to undertake evaluations of systemic discrimination against Mexican American women.
Context Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, etiology and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms, and most cases are diagnosed at emergency laparotomy. Case report We present the diagnosis and management of our patient, a pregnant woman, who had adult intussusception due to a heterotopic pancreas .
Situs inversus totalis (SIT) is an uncommon anomaly characterized by transposition of organs to the opposite side of the body in a mirror image of normal. We report on an adult woman, born and resident in Brazilian Amazonia, presenting acute pain located at the left hypochondrium and epigastrium. During clinical and radiological evaluation, the patient was found to have SIT
Mauro Neiva Fernandes; Ivan Nazareno Campos Neiva; Francisco de Assis Camacho; Lucas Crociati Meguins; Marcelo Neiva Fernandes; Emília Maíra Crociati Meguins
While the role of individual characteristics has been examined for extramarital sexual involvement, the literature has yet to document personal factors associated with the termination of an affair. In doing so, this study examines the impact of a woman's sex role attributes (“masculinity”) and attitudes toward sex (erotophobia-erotophilia) on her decision to terminate an extramarital affair. Masculinity was not related
The article examines the resurgence of the modified twin presumptions of resulting trust and advancement in family cases in Singapore, comparing the Singapore position with the current UK law as elucidated in Stack v Dowden. It analyses the impact that the heavily fact–based inquiry enjoined by the Singapore Court of Appeal has on the woman in the relationship. The operation
This article describes the results of a phenomenological study undertaken to understand the meaning of the experience of being a woman enterprise leader. The experience of women is challenging due to an imbalance in the representation of female executives, barriers to advancement and disconnects in development strategies. In-depth interviews were conducted with 12 participants resulting in five essential themes that
This paper attempts to understand a remarkable point whether we can argue, quoting Hamlet's remark 'frailty, thy name is woman', that Shakespeare is a misogynist. With that end in view it analyses the situations which lead Hamlet to hold a special kind of prejudice against women. Hence, it examines the justification of his misogynistic remarks in the play. Here the
The typical woman officer from the nation's largest industrial, banking, retail and utility companies is married, at least 50 years of age, has had some college, was born into a family of low or lower middle class income, and has a work salary of less than $30,000. While the number of women officers in leading business organizations is small, the…
On 2 September 2003, the England and Wales Court of Appeal (Criminal Division) denied the appeal against sentence by a woman living with hepatitis C who stabbed a police officer repeatedly with a used syringe while resisting arrest. The court confirmed the nine-year sentence. PMID:15108663
This leaders' guide, composed of three sections, is based on other booklets of the "Choices and Careers" series. "Traditional Roles" uses "Being an Indian Woman" for background information and promotes discussion of traditional roles of Indian women and points out stereotypes still existing. Bridging the gap between the past and present, it…
A thirty-five years old woman during her twelfth pregnancy presented fever and pain at the left thigh. After cesarean delivery dyspnea added to the first two symptoms and pulmonary embolism was suspected. A clinical history revaluation suggested a diagnosis of infectious endocarditis and femoural osteomielitis due to a septic embolus. PMID:11382170
Picardi, A; Navajas, F; De Iorio, F; Amicarelli, M; Spoto, S; De Galasso, L; Vespaciani Gentilucci, U; Scarlata, S; Zardi, E; Di Cuonzo, G
Student participants (N = 316) viewed a videotaped simulated case involving a woman who had entered a self-defense plea in the shooting death of her abusive husband. As successful claims of self-defense rest on the portrayal of a defendant who has responded reasonably to his/her situation, the implications of various forms of expert testimony in…
Over the years women have played crucial roles in societal leadership. Within the past decade more women have emerged in taking positions of leadership in many areas concerning U.S. education in particularly the highest public position in education, Superintendent. Obtaining, sustaining, and maintaining high positions of power for any career woman…
The concept of wellness provides a positive view of life development that can support psychological support and counseling. There is little in the literature about wellness and seniors, especially women. This study describes one senior woman's wellness across the life span by addressing two research questions: (a) What are the experiences of one…
A rare and instructive case of myocardial infarction in a 29-year-old woman was presented. In this case it was clinically suspected that myocardial infarction was due to metastatic choriocarcinoma of the heart. This was confirmed by autopsy. It was emphasized that metastatic choriocarcinoma of the heart could be a cause of myocardial infarction in young women. PMID:563480
Chronicles an anorexic woman's exploration of her experience of hope in recovery. A single-participant design using heuristic case study and photography was used. Content and thematic analyses of photos and journal entries led to the emergence of four themes. Implications for clinical training, research, and practice regarding the benefits of…
Contributes to scholarship advancing the understanding of human communication by examining the rhetorical invention strategies of suffrage rhetoric in the cultural context of World War I. Shows how the political cartoons published in the mainstream Suffrage Movement's "The Woman Citizen" constructed women as strong, competent, and essential to the…
In Holung County, Kirin, China, by means of revolutionary criticism and reviewing the ongoing struggle since the establishment of woman and child health centers, the significance of Chairman Mao's directive, "in medical and health work, put the stress on the rural areas", was enhanced. The direction and the objective of work in woman and child health became clarified. To meet the needs of the rural areas, ideological revolutionization of medical and health workers is imperative. The Branch Party Committee of the Woman and Child Health Center frequently organize to study the works of Marx, Engels, Lenin, and Chairman Mao. With local women and child health workers, staff study to raise their consciousness. The staff of 7 of the Center work in the production teams or brigades throughout the year, propagating Party policies, investigating and studying problems. They train health workers and provide technical advice in the effort to promote woman and child health service in the area. The county Woman and Child Health Center was established in 1953 when there were only 3 midwives in the whole county. Since the Great Proletarian Cultural Revolution, a contingent of health workers and barefoot doctors has been developed and consolidated. Currently, each production team had 1-2 health workers and 1 midwife. Each production brigade has a cooperative medical service station and a woman and child health section with 2-3 barefoot doctors and 1-2 health care workers. In general, each commune has 1-2 medical doctors and, birth planning and woman and child health counseling station. Work essentially includes the following items. First and foremost is ideological work. Every possible opportunity is taken to educate woman and child health workers to raise their consciousness of the idoelogical and political line. Next comes training of the woman and child health personnel. Modern midwifery has been popularized in the county since 1955. At the end of 1974, 59.8% of the children of 1-3 years of age were attending nurseries and 65.5% of those 4-7 years of age were in the kindergarten. In managing these institutions special attention is paid to the following activities: training child care workers; prevention and treatment of communicable diseases; physical exercise; and physical examinations. In 1972 it was found that contraceptive use in East City Commune had increased from 26 to 60%. The Commune Party Committee had employed a strategy of combining the birth planning program with the woman and child health service. Also the health of nearly every child was so successfully safeguarded that even parents with only 1 child were free to practice contraception without fear of becoming childless. Using that commune's experience, 85.5% of the county's women have been screened since May 1972 for women's disease and treated with traditional Chinese medicinal herbs. This has greatly increased contraceptive practice. PMID:822994
Images of Black women in Hispanic literature tend to be the work of White authors or Black male authors who, however well-intentioned, cannot articulate the direct, lived experience of the black, Hispanic woman. Moreover, the image of the Black woman in Spain and Latin America is the result of a slavocratic, patriarchal system and, therefore,…
We question the validity of traditional polling about the likelihood of respondents to vote for a woman president and argue that the use of such polls may overestimate sexism and underestimate the role that party identification and individual characteristics play in deciding about whether to vote for a woman president. Our analysis of data collected in May–June 2004 show that
Participants (N = 172) were presented with a criminal homicide trial involving a battered woman who had killed her abuser. Within the trial stimulus, the imminence of the batterer’s threat was systematically manipulated such that participants were presented with either a case in which the woman killed her abuser during a direct confrontation or while he lay sleeping. Within these
Regina A. Schuller; Elisabeth Wells; Sara Rzepa; Marc A. Klippenstine
This article presents a conversation with three women college leaders on how their respective Ohio colleges are faring in the economy, leadership and what tops their presidential agendas these days. Patricia L. Hardaway was appointed president of Wilberforce University in April 2008. An attorney and graduate of the historically Black university,…
Antiphospholipid syndrome is a systemic autoimmune disease with thrombotic tendency. Consensus guidelines for pregnancy with antiphospholipid syndrome recommend low-dose aspirin combined with unfractionated or low-molecular-weight heparin because antiphospholipid syndrome causes habitual abortion. We report a 36-year-old pregnant woman diagnosed with antiphospholipid syndrome receiving anticoagulation treatment. The patient developed left abdominal pain and gross hematuria at week 20 of pregnancy. An initial diagnosis of left ureteral calculus was made. Subsequently abdominal-pelvic computed tomography was required for diagnosis because of the appearance of severe contralateral pain. Computed tomography revealed serious renal hemorrhage, and ureteral stent placement and pain control by patient-controlled analgesia were required. After treatment, continuance of pregnancy was possible and vaginal delivery was performed safely. This is the first case report of serious renal hemorrhage in a pregnant woman with antiphospholipid syndrome receiving anticoagulation treatment and is an instructive case for urological and obstetrical practitioners. PMID:21350603
In this article the author explains the social role of Muslim woman in a postmodern society through a public symbol of her identity--the veil. The article's thesis is that the Muslim women's manifestation of their Islamic denomination through veiling and wearing appropriate clothes (in the case of men through growing beards and wearing clothes considered appropriate for them) signifies an expression of a new, Islamic shaped identity. This is a postmodern identity based on modernity rather than a fundamental reaction to modernity. The veil, a public symbol of Muslim identity, is often given a different meaning by its observers than the person actually wearing it. Therefore, the intention of this article is to analyze the elements of a particular, postmodern identity that a Muslim woman's veil, as a public symbol, represents. PMID:17243538
Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women's knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China. PMID:17599276
In 1929, the National Woman's Party set up headquarters in the Sewall-Belmont House on Capitol Hill in Washington, DC. Their leader, Alice Paul, was a tireless advocate for woman's rights, well known for drafting the first Equal Rights Amendment in 1921. This lesson plan from the National Park Service explores this historic home and Paul's work through primary documents, maps, images, and classroom activities. The Table of Contents area contains a number of sections, including Locating the Site: Maps, Determining the Facts: Readings, and Visual Evidence: Images. The site is rounded out by classroom activities, which include explorations into oral history and investigations into the history of liberties denied and enjoyed by various groups of citizens.
This paper presents the computational electromagnetic dosimetry inside an anatomically based pregnant woman models exposed to electromagnetic wave during magnetic resonance imaging. The two types of pregnant woman models corresponding to early gestation and 26 weeks gestation were used for this study. The specific absorption rate (SAR) in and around a fetus were calculated by radiated electromagnetic wave from highpass and lowpass birdcage coil. Numerical calculation results showed that high SAR region is observed at the body in the vicinity of gaps of the coil, and is related to concentrated electric field in the gaps of human body such as armpit and thigh. Moreover, it has confirmed that the SAR in the fetus is less than International Electrotechnical Commission limit of 10W/kg, when whole-body average SARs are 2W/kg and 4W/kg, which are the normal operating mode and first level controlled operating mode, respectively.
Hydrocephalus is a medical condition characterized by enlargement of cerebral ventricles due to abnormal cerebrospinal fluid accumulation. Hydrocephalic women with cerebrospinal fluid (CSF) shunts are now surviving to reproductive age, but still there are doubts regarding the mode of delivery, analgesia and anesthesia. Postpartal complications are more frequently described in deliveries ended by cesarean section than in spontaneous vaginal deliveries. We present a case of labor in the 32-year old woman, with congenital hydrocephalus and a preexisting ventriculoperitoneal (VP) shunt. After thorough review of current literature, we came to conclusion that without absolute neurosurgical indication or acute development of listed symptoms (headaches, irritability, light sensitivity, hyperesthesia nausea, vomiting, vertigo, migraines, seizures, weakness in the arms or legs, strabismus and double vision) the best way to finish the pregnancy of woman with VP shunt is spontaneous vaginal delivery with the use of epidural analgesia, mediolateral episiotomy and vacuum extraction. PMID:24611354
This site is one of several projects related to the foundation of a National Museum of Women's History in Washington, DC. Although the physical museum itself is yet to be built, NMWH the organization has been sponsoring and collaborating in Women's history initiatives nationwide. The first exhibit in the NMWH cybermuseum marks the 150th anniversary of the Seneca Falls Convention and "examines the development of a distinct female political culture and imagery that evolved to promote voting rights for women." Users can browse the gallery of 50 images or take a more in-depth tour of the woman's suffrage movement. The former offers fast-loading and nicely-digitized images of a variety of artifacts with brief descriptions. The latter traces the history of the woman suffrage movement and its political imagery with topical paragraphs and selected images. Additional resources include a timeline, quiz, and collection of related resources.
A 67-year-old woman with a 15-year history of seropositive rheumatoid arthritis developed acute night pain in both shoulders. Examination revealed bilateral swelling and joint mobility impairment. Ultrasonography disclosed joint effusions which were hemorrhagic on aspiration. Radiographs showed the presence of a four-part fracture of both humeral heads. Bilateral humeral head fractures can occur spontaneously in patients with rheumatoid arthritis and
Empyema of gallbladder is generally a rare disease and it is even rarer in the traditional African population where incidence of cholelithiasis is much lower compared with the Caucasian population. This is a presentation to highlight massive empyema of the gallbladder in a 58 year old woman who had no prior history of gallstone disease and who was treated with open cholecystectomy. The outcome was successful and she was followed up for a year.
Lawal, Oladejo Olukayode; Akinkuolie, Andrew Akinbolaji; Adisa, Adewale Oluseye
A very rare case of suicide by stab wound of a fistula for hemodialysis access in an elderly woman is reported. The incidence of suicide attempts in people undergoing hemodialysis is well known. Nevertheless, suicide means do not usually include stab wounds of the arteriovenous access. Various pattern differences between homicidal and suicidal stab wounds, characteristics of suicide in the elderly, and approaches to the investigation of such cases are briefly discussed. PMID:10990291
Marc, B; Baudry, F; Zerrouki, L; Ghaith, A; Garnier, M
The occurrence of two primary tumors simultaneously is relatively common. However, the occurrence of three kinds of gynecological\\u000a tumors simultaneously is extremely rare. Here we presented a 79-year-old woman who had simultaneously three primary gynecological\\u000a tumors which were relatively uncommon. Those tumors were myxoid leiomyosarcoma and endometrial mucinous adenocarcinoma in\\u000a the uterus and a Leydig cell tumor in the right
The case history is presented of a normally fit and well 28-year-old woman with idiopathic right ventricular outflow tract ventricular tachycardia (RVOT VT). Presentation was with a broad complex tachycardia unresponsive to first-line anti-arrhythmic drugs and DC cardioversion (immediate recurrence) but highly sensitive to flecainide and eventually successfully treated with catheter ablation. Assessment and management of broad complex tachycardia is
BACKGROUND:Bladder exstrophy is an uncommon anomaly rarely associated with uterus didelphys. Fertility is limited by associated vaginal malformations, which have traditionally required surgical reconstruction.CASE:A woman with a history of bladder exstrophy and hypoplastic vagina presented complaining of painful intercourse. The patient underwent vaginal dilator treatment after corrective surgery for the bladder defect. Without any further fertility therapy she subsequently conceived
Eliran Mor; Peyman Saadat; Rebecca Z Sokol; Richard J Paulson
Treatment of multicentric or multifocal anogenital intraepithelial neoplasia is challenging, especially if the patient has immunodeficiency. We report the case of a woman with idiopathic CD4 lymphocytopenia and vulval and perianal intraepithelial neoplasia with early invasive disease, who responded well to radiotherapy combined with chemotherapy. Chemoradiotherapy is often used in the primary treatment of anal carcinomas, but has rarely been reported as a treatment for premalignant anogenital conditions. PMID:22439786
Tomson, N; Sterling, J; Miller, R; Wilson, C; Baldwin, P
Background: Previous studies have shown an increased risk of cervical dysplasia in women infected with human immunodeficiency virus (HIV), as well as an increased risk of progression to higher-grade lesions. It is not known whether the rate of progression is accelerated over that in immunocompetent women.Case: During September 1991, an HIV-positive woman underwent conization of the cervix showing carcinoma in
Kevin Holcomb; Mitchell Maiman; Therese Dimaio; Jason Gates
The incidence of cardiac masses increased as echocardiography is becoming increasingly popular. Benign tumors of the heart\\u000a constitute about 72% of all primary cardiac neoplasms and hemangioma accounts for 5–10% of benign cardiac tumors. Cardiac\\u000a hemangiomas are generally asymptomatic and diagnosed incidentally during echocardiography or magnetic resonance imaging (MRI).\\u000a We reported a 52-year-old woman presented with atypical chest pain and
M. Azra Tanrikulu; Beste Ozben; A. Altug Cincin; Ozdil Baskan; Mehmet Agirbasli
A woman 46 years old presented with recurrent, brief, sudden-onset episodes of confusion, aimless motor overactivity and lability of mood, from which she recovered completely. She was admitted on each occasion to a medical unit with a provisional diagnosis of organic mental disorder and thoroughly examined. No organic etiology was identified. This patient meets the criteria for cycloid psychosis. The implications for diagnosis, investigations and management are discussed.
Thyrotoxic patients may occasionally present with affective disorders. Here, we discuss a case of a 61-year-old woman with misidentification and persecutory delusions, olfactory hallucinations, and apathy associated with thyrotoxicosis. After definitive antithyroid and antipsychotic agent haloperidol treatments, the patient was released within 4 weeks. Thyrotoxic psychosis with apathy is a rare entity that can be misdiagnosed as affective psychosis. Haloperidol may be an alternative treatment in resolving psychotic features beside the treatment of hyperthyroid state. PMID:23551412
Desmoplastic Small Round Cell Tumour (DSRCT) is a rare, highly aggressive, mesenchymal tumour that arises from the peritoneal cavity. It is commonly seen in adolescent and young adult males and its occurrence in females is uncommon. We are reporting here a rare case of DSRCT in a young woman, which clinically masqueraded as an ovarian malignancy, with metastasis to liver, lung, spleen and peritoneum. The cytologic findings, Histomorphological and immunohistochemical features have been discussed, with a brief review of literature. PMID:24551689
Non-compaction cardiomyopathy, a genetic primary cardiomyopathy, is being increasingly diagnosed. Pregnant women with non-compaction cardiomyopathy are more susceptible to complications, such as heart failure, arrhythmias and embolic events. This paper reports the case of a pregnant woman with non-compaction cardiomyopathy under treatment and asymptomatic, who received epidural analgesia during labor and delivery. The clinical course is described and a brief review is presented. PMID:24035538
Intussusception is the most frequent complication of Peutz-Jeghers Syndrome (PJS), but usually seen in child age. It is a predictable, but infrequent complication in adults with PJS. However, there is no report about intussusception in pregnancy period secondary to Peutz-Jeghers (PJ) polyps in the literature. In this paper, we present a rare intussusception case in a pregnant woman with PJS, which was diagnosed with magnetic resonance imaging, and discuss this condition with a brief literature review. PMID:24448402
Adenocarcinoma of the esophagus has increased dramatically within the United States and continues to have a poor prognosis despite aggressive treatment. Identifying potential risk factors is critical for the early detection and treatment of this disease. The present case report describes a very young woman who developed adenocarcinoma of the esophagus after only a brief history of bulimia. These findings suggest that even in very young patients, bulimia may represent a risk factor for adenocarcinoma of the esophagus. PMID:18047676
Shinohara, Eric T; Swisher-McClure, Samuel; Husson, Michael; Sun, Weijing; Metz, James M
Adenocarcinoma of the esophagus has increased dramatically within the United States and continues to have a poor prognosis despite aggressive treatment. Identifying potential risk factors is critical for the early detection and treatment of this disease. The present case report describes a very young woman who developed adenocarcinoma of the esophagus after only a brief history of bulimia. These findings suggest that even in very young patients, bulimia may represent a risk factor for adenocarcinoma of the esophagus.
Shinohara, Eric T; Swisher-McClure, Samuel; Husson, Michael; Sun, Weijing; Metz, James M
A 28-year-old woman with polycystic ovarian syndrome (PCOS) had attempted four assisted conception treatments, all of which were complicated by lack of response of the endometrium to the hypo-oestrogenic state induced with gonadotrophin releasing hormone analogue (GnRHa). Consequently, two treatment cycles were abandoned, one prior to the ovulation induction of a fresh IVF treatment and the other prior to oestrogen
Using a national-level US homicide database that includes more than 400,000 homicides committed from 1976-1994, I calculated rates of uxoricide (the murder of a woman by her romantic partner) by type of relationship (cohabiting or marital), ages of the partners, and age difference between partners. Women in cohabiting relationships are about nine times more likely to be killed by their
This paper is a clinical description of the presentation, therapy, and pharmacological management of a 28-year-old woman who had nine admissions to a psychiatry ward, the last four within one year. It became clear that the treatments, which the patient had received concurrently for ten years for a pituitary adenoma and for psychotic symptoms, were counteractive. The case highlights the importance of the role of prolactin in psychosis and of an interdisciplinary team approach when patients present with complex symptoms.
Klippel Trenaunay syndrome (KTS) is a rare congenital disease characterized by a triad of cutaneous hemangioma, varicose veins and bone or soft tissue hypertrophy. Cases of pregnancy complicated by KTS are rare. There is an increased risk of thrombo-embolic disease and hemorrhage during pregnancy. Both obstetric and anesthetic management of KTS in pregnancy can be rather complicated. We present a successful management of pregnancy in an African woman with KTS at Yaounde General Hospital, Cameroon.
Kemfang, Jean Dupont Ngowa; Dobgima, Walter Pisoh; Motzebo, Regine Mbouopda; Ngassam, Anny; Fokou, Marcus; Kasia, Jean-Marie
Genital tuberculosis involving the ovary in a non-immunocompromised individual is rare. We report a case of coexisting ovarian serous cystadenoma and tuberculosis in a 29-year-old Indian woman. Clinical examination revealed the presence of an abdominal mass suspicious for ovarian neoplasm. Histopathological evaluation revealed ovarian neoplasm and concomitant tuberculosis. To the best of our knowledge, and after an extensive search of the literature, the coexistence of benign ovarian neoplasm and tuberculosis has not been previously documented. PMID:24005462
Psychotherapy typically addresses the intrapsychic arena in order to accomplish self-awareness and self-actualization. When dealing with clients froma collective\\/ authoritarian cultural background, the intrapsychic arena is secondary to the intrafamilial one. Application of psychotherapy that aims to help the collective person express her authentic feelings and uncover repressed contents confronts the collective\\/authoritarian culture. A case of an Arab woman living
A 24-year-old woman with no significant past medical or surgical history presented with diffuse abdominal pain and distention with decreased frequency of bowel movements for 1 month. A computerized tomography scan showed a massively dilated cecum suggesting obstruction. Exploratory laparotomy revealed bowel obstruction secondary to a band of fibroadipose tissue associated with paratubal cysts originating from the left fallopian tube. Removal of the band was performed with thorough examination of the bowel confirming absence of perforation or necrosis. PMID:21356530
Frayer, Elizabeth A; George, Ryan M; Caughran, Jamie L
We report a 42-year-old woman with an asymptomatic solitary targetoid patch on her shin of 1 month duration. Histopathologic evaluation revealed intact epidermis with vascular proliferation in the papillary dermis. Vascular channels were irregular, thin walled, and dilated. They were lined by prominent endothelial cells having plumped protruding nuclei and scanty cytoplasm. There was a mild extravasation of red blood cells and mild lymphocytic infiltration around blood vessels in the upper and mid dermis. PMID:22863633
Introduction Streptococcus pneumoniae is an uncommon etiologic agent in soft-tissue infections. Case presentation We report the case of a 35-year-old Caucasian woman who presented to our facility with puerperal pneumococcal mastitis, and review the only other three cases of pneumococcal mastitis described in the medical literature. Conclusions The roles of the various pneumococcal vaccines in preventing this disease are discussed.
A 27-year-old nulliparous woman presented with large finger-like projections protruding from her vagina. Intraoperatively there were deposits in the pouch of Douglas. Clinical presentation and history of vaginal bleeding suggested malignancy. Histopathology of both the vaginal and pouch of Douglas masses showed endometrial glands and stroma. There was no architectural complexity or cytological atypia of glands or stroma. Immunohistochemistry for
Seema Kaushal; Vatsla Dadhwal; Sandeep R Mathur; Ruma Ray; Prashant Durgapal; Deepika Deka
Objective: Electrical stimulation of pudendal urethral afferents generates coordinated micturition in animals and bladder contractions in men after spinal cord injury (SCI), but there is no evidence of an analogous excitatory urethra-spinal-bladder reflex in women. The objective of this study was to determine whether electrical stimulation of the urethra could evoke bladder contractions in a woman with SCI. Case Report: A 38-year-old woman with a C6 ASIA A SCI who managed her bladder with clean intermittent catheterization and oxybutynin demonstrated neurogenic detrusor overactivity on urodynamics. Oxybutynin was discontinued 2 days prior to urodynamic testing with a custom 12F balloon catheter mounted with ring-shaped electrodes located in the bladder neck, mid urethra, and distal urethra. The inflated balloon was placed against the bladder neck to stabilize the catheter electrodes in place along the urethra. However, the balloon limited emptying during contractions. Urodynamics were performed at a filling rate of 25 mL/minute until a distention-evoked bladder contraction was observed. The urethra was stimulated over a range of bladder volumes and stimulus parameters to determine whether electrical stimulation could evoke a bladder contraction. Findings: Electrical stimulation via urethral electrodes evoked bladder contractions that were dependent on bladder volume (>70% capacity) and the intensity of stimulation. Conclusions: This is the first report of an excitatory urethra-spinal-bladder reflex in a woman with SCI. Future studies will determine whether this reflex can produce bladder emptying.
Kennelly, Michael J; Arena, Kimberly C; Shaffer, Nell; Bennett, Maria E; Grill, Warren M; Grill, Julie H; Boggs, Joseph W
To answer questions about staff's ability to identify, assess, and support victims of woman abuse, St. Joseph's Hospital, Hamilton, Ontario, Canada, organized a task group that included a cross section of staff and representatives of a local women's shelter. A comprehensive literature review strongly confirmed the need for a program that would provide staff with relevant information about abused women and challenge them to examine their values and beliefs. The task group constructed a questionnaire that included six different scales measuring various aspects of respondents' beliefs and attitudes about woman assault. The educational program for the pilot units included a training video, in-service workshops, a resource training manual, and an assessment tool to assist staff in screening female patients. The survey identified some key areas of concern, including some widely held misconceptions about the causes of abuse. After the educational program, test scores showed significant changes, particularly on scales that measured belief in popular myths and the degree to which respondents held perpetrators responsible for their actions. Overall, the project demonstrated that values and beliefs related to woman assault can be significantly affected by an educational approach that combines information sharing with the opportunity for dialogue and questions. PMID:10157053
In 1959, Brigadier General Donald Flickinger and Dr. W. Randolph Lovelace II suggested that it would be more practical from an engineering standpoint to send women rather than men into space due to their lower body weights and oxygen requirements. When the Air Force decided not to pursue this project, Dr. Lovelace assumed leadership of the Woman in Space Program and began medical and physiological testing of a series of accomplished women aviators at the Lovelace Medical Clinic in Albuquerque, NM, in 1960. The tests that these women underwent were identical to those used to test the original Mercury astronauts, with the addition of gynecological examinations. Thirteen of the nineteen women tested passed these strenuous physiological exams (for comparison, 18 of 32 men tested passed); a subset of these pilots was further tested on a series of psychological exams that were similar to or, in some instances, more demanding than those given to male Mercury candidates. Despite these promising results, further testing was halted, and the Woman in Space Program was disbanded in 1962. Although the Woman in Space Program received a great deal of publicity at the time, the story of these women was somewhat lost until they were reunited at the 1999 launch of the shuttle Columbia, commanded by Colonel Eileen Collins.
Kathy Ryan (United States Army Institute of Surgical Research); Jack A Loeppky (Veterans Affairs Medical Center); Donald E Kilgore Jr. (Lovelace Foundation for Medical Education and Research)
In the aftermath of slavery and the resulting social, economic, and political effects, Black women have become the victims of negative stereotyping in mainstream American culture. Such stereotypes include the myth of the angry Black woman that characterizes these women as aggressive, ill tempered, illogical, overbearing, hostile, and ignorant without provocation. Symptoms presented by Black women during mental health treatment may reinforce this myth. However, many of the negative characteristics of the angry Black woman developed in response to external stressors and historical factors. Black women also have a unique experience with and expressions of anger that shape the presenting symptoms interpreted by the mental health clinician. This myth and corresponding negative stereotypes significantly affect Black women intrapsychically, interpersonally, and are likely to influence the efficacy of mental health treatment. Understanding and treatment of Black women in a mental health context should be influenced by the cultural norms and sociopolitical dynamics affecting these clients. Successful mental health treatment requires cultural competence and clinicians who are well prepared to navigate the inherent complexities of culture with clients. Awareness of the angry Black woman mythology, including its genesis, manifestations, and the unique experiences of Black women, may raise the standards of cultural competence for clinicians and provide more successful treatment outcomes in working with this population. A case example illustrates the assiduity essential to practicing in a culturally competent manner. A client is presented from a traditional psychotherapeutic perspective and then viewed through a lens that integrates psychotherapeutic practice with conscious awareness of the mythology and stereotypes impacting Black women. Implications for culturally relevant practice are discussed. PMID:24188294
Venous thromboembolism (VTE) remains a significant cause of postoperative morbidity and mortality. There are few reports on acute symptomatic pulmonary embolism (PE) following urogynaecological surgery. The authors report a case of an adult woman who developed a massive acute PE early on postoperative day 1 following a complex reconstructive surgery. Following anticoagulation treatment and placement of an inferior vena cava filter, the patient recovered and was discharged without discomfort on the ninth postoperative day. While recognition of the early occurrence of VTE is important to ensure optimal patient care following major pelvic surgery, this case highlights the need to reconsider VTE prophylaxis protocols in moderate to high-risk populations undergoing elective surgery.
Splenic lesions due to tuberculosis are extremely rare in immunocompetent indi-viduals and delays in diagnosis are frequent. Here, we describe a 49-year-woman presenting with pyrexia-of-unknown origin with no evidence of any immunodefi-ciency. Computed tomography of the abdomen showed an enlarged spleen having multiple small focal hypodense lesions; the later were confirmed to be of tubercu-lous etiology on histopathological examination. She had favorable response with anti-tubercular chemotherapy. We report this case of tuberculosis spleen in an im-munocompetent individual for its rarity and to highlight the fact that these patients can be managed by medical treatment effectively.
Abstract We report the case of a 36-year-old woman with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, and corticosteroid replacement therapy since birth. She manifested persistent virilization and high testosterone levels that were attributed to nonadherence to medical treatment. The patient was referred to our gender unit for genitoplastic surgery. We recommended the patient for left oophorectomy after detecting an ovarian mass. Pathologic findings confirmed an ovarian hilus cell tumor. Testosterone levels fell back to normal and masculinization disappeared but ACTH remained elevated. This case represents a very rare type of primary ovarian tumor that must be considered in persistent virilizing symptoms in women with CAH. PMID:24702195
A 45-year-old premenopausal woman presented with an 18-month history of a band-like area of fibrosing alopecia affecting the frontoparietal scalp. She also had marked thinning of the eyebrows. The histopathology was consistent with frontal fibrosing alopecia (FFA). Several months later she developed multiple pruritic papules on the wrists and feet. The clinical presentation and histopathology were consistent with cutaneous lichen planus. Although FFA has been reported to occur with mucosal lichen planus this is the first reported case of FFA associated with cutaneous lichen planus. This provides further evidence that FFA is a variant of lichen planopilaris. PMID:11869213
Faulkner, Catherine F; Wilson, Niall J; Jones, Stephen K
Postmenopausal frontal fibrosing alopecia (PFFA) is a rare alopecia that develops in the frontoparietal scalp of postmenopausal women. Etiology of PFFA is unknown. Most of cases of PFFA have been reported in European and North American countries. Herein, we report a Japanese case of PFFA associated with Sjögren's syndrome. A 66-year-old woman had had slowly progressive, band-like, scarring alopecia on her frontoparietal scalp. Hair follicles on the margin showed follicular keratosis. Histologically, fibrosis and lymphocytic infiltration were mild. This case suggests that PFFA may show mild inflammatory reaction and mild fibrosis in Japanese women. The association with immunological disorders including Sjögren's syndrome should be studied further. PMID:19120768
Strontium ranelate is an effective drug that was developed for treating osteoporosis. Here, we report the case of a 62-year-old woman who developed headache and diffuse scalp hair loss 1 week after receiving strontium ranelate treatment for osteoporosis. The treatment was subsequently stopped because of the intractable headache. Nevertheless, the patient continued to lose hair for 6 weeks following treatment discontinuation. Histopathological analysis of scalp tissues revealed anagen effluvium. The patient's hair started regrowing slowly 2 months after treatment with strontium ranelate was discontinued. PMID:22525979
Deep infiltrating endometriosis (DIE) is a well-known cause of pelvic pain and infertility. Malignant transformation of DIE is rare but can be suggested by MRI. We report a case of a spontaneous pregnancy in a woman with suspicion of malignant transformation of DIE with fistulisation to the posterior uterine isthmus through to the cervical canal. The pregnancy was closely monitored and an uneventful caesarian section was performed at 34?weeks of gestation. This case raises the issue of the relevance of imaging techniques and management of pregnancy. PMID:24899016
Standard autopsy of young victims with sudden cardiac death commonly does not identify a specific pathological diagnosis. In such cases, sudden cardiac death may be secondary to a genetic condition predisposing the patient to ventricular arrhythmias. Failure to identify a genetic etiology for an unexpected sudden death may leave surviving family members at risk for a similar tragedy. The case of a 21-year-old woman who died suddenly while at rest is presented. Molecular genetic analysis of tissue retrieved from the regional coroner's office identified a novel missense mutation in the KCNH2 gene, a gene known to cause the long QT syndrome. PMID:17876385
Rutberg, Julie; Green, Martin S; Gow, Robert M; Geraghty, Michael T; Honeywell, Christina; Ewen, John; Birnie, David H; Tang, Anthony; Lemery, Robert; Gollob, Michael H
A 30-year-old African woman in Kenya succumbed to severe swollen regional lymph nodes, development of painful boils and ulcer formation and rashes at specific tick-biting sites together with an intermittent fever and headache following repeated tick bites of Rhipicephalus pulchellus. She later developed nuchal lymphadenopathy-like condition and an eschar with edematous margins at bitten sites. A sustained high fever and fatigue then followed. She became well after treatment with antibiotics and topical application of anti-histamine daily for a week. This pose dangers of emerging tick-borne pathogens such as this one as their epidemiology, biology, socio-economics and prognosis remain unknown.
This report describes a patient with autoimmune myelofibrosis accompanied by Sjögren's syndrome (SS). A 36-year-old woman was admitted due to petechiae, purpura, gingival bleeding, dyspnea on exertion, and a lack of concentration. She had pancytopenia and was diagnosed with SS. A bone marrow study showed hypercellular marrow with reticulin fibrosis. Lymphocytic infiltrates and aggregates composed of a mixture of T and B cells in the marrow were also observed. A chromosomal analysis of the marrow cells showed 47, XXX and an analysis of peripheral lymphocytes revealed 47, XXX/46, XX mosaic results. The patient's cytopenia resolved following treatment with oral prednisolone. PMID:24694497
Takotsubo cardiomyopathy typically affects post-menopausal women who experience severe psychological or physical stress. It can also develop after medical procedures or surgery. Although the underlying mechanism has not been clearly elucidated, catecholamine overload is one of the most plausible etiologies. Herein we report a case of takotsubo-like left ventricular (LV) dysfunction in a 28-year old woman who underwent Cesarean delivery. She presented with acute heart failure and pulmonary edema immediately after the delivery. Her echocardiography showed severe LV dysfunction and apical ballooning. This case is clinically and pathophysiologically similar to peripartum cardiomyopathy.
Inflammatory myofibroblastic tumor, also known as inflammatory pseudotumor, plasma cell granuloma or inflammatory myofibroblastoma, is characterized histopathologically by myofibroblastic spindle cells with inflammatory cell infiltrates composed of plasma cells, lymphocytes and eosinophils. Inflammatory myofibroblastic tumor is typically seen in children or young adults and is most commonly localized to the lungs, but it can occur anywhere in the body. To date, however, only a few cases involving the stomach have been reported. Herein, we present a case of gastric inflammatory myofibroblastic tumor in an adult woman with an initial symptom of high fever.
Ischemic colitis is generally considered a disease of the elderly. The causes of ischemic colitis include low-flow states due to cardiac dysfunction or hypovolemia and certain medications including estrogen. Here we report a case of ischemic colitis in a 26-year-old woman. She had no specific medical history except taking oral-contraceptives for a long time. The mechanism of estrogen-induced ischemic colitis is not clearly understood. But we recommend that oral-contraceptives should be considered as a cause of ischemic colitis in young women. PMID:22741124
Seon, Choon Sik; Park, Young Sook; Park, Se Hwan; Ryu, Sang Ryol; Jo, Yun Ju; Kim, Seong Hwan; Son, Byoung Kwan; Ahn, Sang Bong
Introduction Traumatic macular holes (TMH) are well-known complications of ocular contusion injury. Spontaneous closure occurs in approximately\\u000a 50% of cases, but rarely after the age of thirty. We report a case of spontaneous closure of a full thickness macular hole\\u000a due to a blunt trauma and we suggest possible mechanisms for this closure.\\u000a \\u000a \\u000a \\u000a \\u000a Case presentation A 50-year-old Greek woman was referred with
Mayssa B Nasr; Chrysanthos Symeonidis; Ioannis Tsinopoulos; Sofia Androudi; Tryfon Rotsos; Stavros A Dimitrakos
Therapeutic hypothermia is method used to improve the neurological status of patients who are at risk of ischaemia after myocardial infarction. We report a case of a 28-year-old woman who suffered acute myocardial infarction complicated by ventricular fibrillation. The patient was successfully resuscitated. Invasive and non-invasive medical treatment was applied including therapeutic hypothermia. Success was achieved due to adequate public reaction, fast transportation, blood vessel revascularization and application of therapeutic hypothermia. The patient was successfully discharged after one week of treatment, and just minor changes in heart function were present.
A 22-year-old woman presented with three weeks history of intermittent left loin pain, on radiological evaluation by U\\S and MRI revealed left renal pelvic mass, ureterorenoscopy and biopsy taken, but couldn't reveal definitive diagnosis other than presence of a malignant process. Left nephroureterctomy was performed. Grossly there is a polypoid mass attached to the upper pole of the kidney by stalk. Light microscopic examination and immunohistochemical staining confirm a diagnosis of Botryoid-type of embryonal rhabdomyosarcoma. Treatment and follow up to 1 year is mentioned. Reviewing the literature the presented case is the second of this tumor in adult renal pelvis. PMID:24669131
Aplasia or hypoplasia of the uterus and the vagina are pivotal elements of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Psychosexual functioning of women with MRKH syndrome remains to be fully elucidated. Detailed analysis of sexuality of a 31-year-old woman with MRKH syndrome (type MURCS) and with a history of surgical creation of the vagina was performed. Both, biological and psychosocial determinants were investigated in great detail. Genital malformations were found to have significant impact on the sexual identity and sexual behavior of the patient. PMID:24191522
Patient: Female, 46 Final Diagnosis: Unilateral adneksial and renal agenesis Symptoms: Menometrorrhagia Medication: — Clinical Procedure: Total abdominal hysterectomy and unilateral salphingoopherectomy Specialty: Obstetrics and gynecology Objective: Rare disease Background: Unilateral renal and adnexal agenesis is quite rare. Absence of any uterine abnormality accompanying current urogenital abnormalities is even rarer. Case Report: We report on the case of a 46-year-old multiparous woman, incidentally diagnosed to have unilateral renal, ovarian, and tubal agenesis just before hysterectomy due to menometrorrhagia and myoma uteri. Conclusions: Any diagnosis of a urogenital abnormality necessitates investigation of comorbid renal or genital abnormalities.
Gursoy, Asl? Yarc?; Akdemir, Nermin; Hamurcu, Ugur; Gozukucuk, Murat
Acute myocardial infarction in pregnancy is rare and life-threatening for both the mother and the fetus. We present the case of a 31-year-old previously healthy woman with no risk factors at 32 weeks of gestation who applied with vomiting, dyspnea and orthopnea. A respiratory arrest developed followed by loss of the fetal viability, cardiac arrest, and failure of resuscitation. We aim to raise awareness about the clinical approach to pregnant patients who are to be considered with a broad spectrum of differential diagnosis.
Goker, Asli; Civi, Melek; Bayturan, Ozgur; Kuscu, N. Kemal
Introduction Infective endocarditis presenting with arthralgia is rare. Group B streptococcus tricuspid endocarditis as a postpartum complication is even rarer. The present case is an example of both. Case presentation We report the case of a 30-year-old Caucasian woman who presented with painful swelling of her wrists and ankles. Conclusion Even when the clinical presentation of systemic inflammation is more suggestive of a primary rheumatological disorder, it is important to remember that bacterial infection can also present in this manner. Group B streptococcus tricuspid valve endocarditis is a rare, but recognized, postpartum complication.
A 38-year-old woman presented with 2 days history of left-flank pain. She had similar episodes of abdominal pain as well as chest pain several times, but symptoms disappeared spontaneously. Each time she developed pain, there was no fever. After ruling out common causes of recurrent abdominal pain, familial Mediterranean fever (FMF) was considered as a potential diagnosis. Genetic tests revealed multiple heterozygote mutations, which may be associated with FMF. Patients with Mediterranean fever mutations may present with atypical presentations without fever, like in this case. Astute clinical suspicion is required to make an accurate diagnosis.
Acute intermittent porphyria (AIP) is a rare autosomal dominant metabolic disorder' affecting the production of heme, the oxygen-binding prosthetic group of hemoglobin. It is characterized by a deficiency of the enzyme hydroxymethylbilane synthase; without this cytoplasmic enzyme, heme synthesis cannot finish, and the metabolite porphobilinogen accumulates in the cytoplasm. Some additional factors must also be present such as drugs, hormones, dietary changes, infections diseases and surgery that trigger the appearance of symptoms, which include neurological disorders, abdominal pain, constipation, and muscle weakness. We present a perioperative course of a pregnant woman with porphyria in association with hypothyroidism and its anesthetic management. PMID:22428497
Dumas, Roberto P; Silva, Elizabeth F V; Resende, Marco Antonio C; Pantoja, Alberto V; Barros, Antonio Celso G S
Mucocele of the appendix is an uncommon but potentially dangerous pathological entity that presents in a variety of ways. Therefore, optimal surgical therapy is controversial; while some authors adopt a simple appendectomy, others recommend extensive resection, such as right hemicolectomy. We report the case of an 83 years old woman who presented with cystic neoformation in the right iliac fossa that was preoperatively considered an appendiceal mass. We electively performed a laparoscopic resection that histological examination defined as a mucinous cystadenoma. No recurrence was observed in the follow-up period of 9 mo.
Kaya, Cemal; Yazici, Pinar; Omeroglu, Sinan; Mihmanli, Mehmet
Mondor’s disease is characterized by thrombophlebitis of the superficial veins of the breast and the chest wall. The list of causes is long. Various types of clothing, mainly tight bras and girdles, have been postulated as causes. We report a case of a 34-year-old woman who referred typical symptoms and signs of Mondor’s disease, without other possible risk factors, and showed the cutaneous findings of the tight bra. Therefore, after distinguishing benign causes of Mondor’s disease from hidden malignant causes, the clinicians should consider this clinical entity.
Ischemic colitis is generally considered a disease of the elderly. The causes of ischemic colitis include low-flow states due to cardiac dysfunction or hypovolemia and certain medications including estrogen. Here we report a case of ischemic colitis in a 26-year-old woman. She had no specific medical history except taking oral-contraceptives for a long time. The mechanism of estrogen-induced ischemic colitis is not clearly understood. But we recommend that oral-contraceptives should be considered as a cause of ischemic colitis in young women.
Seon, Choon Sik; Park, Se Hwan; Ryu, Sang Ryol; Jo, Yun Ju; Kim, Seong Hwan; Son, Byoung Kwan; Ahn, Sang Bong
Leiomyomas are benign tumours commonly occurring in the uterine wall. They are rarely seen in the vaginal wall leading to pressure symptoms on urinary tract. Indentation of leiomyoma from anterior vaginal wall into the bladder is rare and hence we report one such case. A 55 year old Caucasian woman presented to urology clinic with recurrent Urinary tract infection and pressure symptoms. After the diagnosis of a vaginal mass, she was referred to Gynaecology clinic. During the excision of the vaginal mass its indentation into the bladder was noted. Histology report confirmed the diagnosis of benign leiomyoma.
Leiomyomas are benign tumours commonly occurring in the uterine wall. They are rarely seen in the vaginal wall leading to pressure symptoms on urinary tract. Indentation of leiomyoma from anterior vaginal wall into the bladder is rare and hence we report one such case. A 55 year old Caucasian woman presented to urology clinic with recurrent Urinary tract infection and pressure symptoms. After the diagnosis of a vaginal mass, she was referred to Gynaecology clinic. During the excision of the vaginal mass its indentation into the bladder was noted. Histology report confirmed the diagnosis of benign leiomyoma. PMID:20181160
Homocysteine (Hcy), a sulfur-containing amino acid that is formed by demethylation of dietary methionine to cystein. Elevated homocysteine level is known to be associated with coronary artery disease. We present a case of acute myocardial infarction in a 25-year-old woman, associated with hyperhomocysteinaemia. Her other risk factors for coronary artery disease were smoking, a moderately high LDL level, and a family history of sudden cardiac death. This case illustrates the need to include plasma homocysteine measurement in the setting of acute coronary syndromes in women with premature atherosclerosis, even in the presence of traditional risk factors for coronary artery disease. PMID:24265888
Background: Primary and secondary infertility are the most common presenting symptom in patients with pelvic tuberculosis (PT). Endometriosis is commonly associated with an increased risk of infertility. Case: Here, we report a rare case of coexisting PT and endometriosis in a 30-year- old woman, and the effects of controlled ovarian stimulation on reactivation of pathogen. Conclusion: Coexisting endometriosis and tuberculosis of fallopian tube and ovary, as in present case, may alter clinical and radiological features, leading to difficulty in diagnosis. Early diagnosis with surgical exploration and adequate treatment can improve the chances of conception and also minimize morbidity.
An indirect inguinal hernia containing an incarcerated fallopian tube and ovary is extremely rare in adult females. The current report describes a woman of reproductive years presenting with an irreducible indirect hernia which required the surgical intervention of a general surgeon as well as counseling regarding future fertility by a gynecologist. The diagnosis was made by physical and sonographic examination and was confirmed by CT scan and surgical intervention. We suggest a multimodel and multidisciplinary approach in order to safely and efficiently preserve ovarian and fertility function in young women who present with an inguinal hernia containing reproductive organs.
We represent a simplified surgical method for posterior pelvic exenteration in a woman by using the transvaginal way in addition to classic abdominal approach. A modified posterior pelvic exenteration technique was performed in a patient with bulky pelvic tumor. The transvaginal way was used for the deep perineal dissection when the abdominal dissection was arrested. An ultralow coloanal anastomosis was completed by using the transvaginal way. After the recovery period, the patient was discharged from hospital without any complication. The transvaginal access should be reminded in the circumstances of the abdominal dissection arrested in posterior pelvic exenteration operations in women. PMID:24082597
A 73-year-old woman presented with a six-day history of abdominal pain that had started in the epigastrium, but recently had become more intense in the right lower quadrant. Peptic ulcer had been diagnosed three years prior to presentation and had been managed medically. On physical examination, epigastric tenderness as well as guarding and rebound tenderness in the right lower quandrant were present. Mild leukocytosis was reported. Computed tomography demonstrated a 5-cm retrocecal mass with low attenuation (fluid content) surrounded by an irregularly thickened uncalcified wall. Multiple areas of tissue debris were seen extending into the mass, but no true separation was present.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a woman with alcoholic cirrhosis and a progressive history of weakness on her right side fell four weeks ago. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 57-year-old woman has a history of bladder tumors. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in genitourinary pathology.
This is a case study presented by the University of Pittsburgh Department of Pathology in which a 64-year-old woman is complaining of dizziness and hearing loss. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in neuropathology.
Idiopathic transient osteoporosis of the hip is a rare condition that was first described in a series women in their third trimester of pregnancy. The clinical course is usually benign and self-limiting. Magnetic resonance is very useful for the diagnosis. Differential diagnoses include avascular necrosis of the femoral head, septic arthritis of the hip, osteomyelitis, stress fractures, primary or secondary neoplastic processes, and referred pain from the spine or genitourinary tract in pregnant women. The authors present a case of idiopathic transient osteoporosis of the pelvis in a young nonpregnant woman with insidious hip pain with no antecedent infection or trauma. PMID:19455507
Escolà, Anna; Pons, Miquel; Pasarin, Alex; Majó, Joan
We present a normotensive, pregnant woman with severe haemolytic anaemia in the third trimester of pregnancy. Owing to normal platelet count diagnoses other than HELLP syndrome were considered and investigated. The patient was treated with nitrofurantoin 3 weeks before presentation and she turned out to have a deficiency of glucose-6-phosphate dehydrogenase. After treatment with blood transfusion, vitamin B12 and folic acid the patient recovered completely. Caesarean delivery was performed because of maternal hypertension and fetal distress at 33 weeks' gestation. PMID:24789148
van de Mheen, Lidewij; Smits, Simone M; Terpstra, Wim E; Leyte, Anja; Bekedam, Dick J; van den Akker, Eline S A
Introduction Many antiepileptic drugs decrease the efficacy of combined hormonal contraceptives due to their inducing effect on cytochrome P450 liver metabolism. Less is known about the pharmacokinetics and outcomes of concomitant use of the etonogestrel implant and hepatic enzyme-inducing medications. Case presentation A 22-year-old Hispanic woman with a long-standing seizure disorder treated with carbamazepine for 9 years became pregnant after 25 months of etonogestrel implant use. Conclusions Hepatic enzyme-inducing drugs may reduce the efficacy of contraceptive implants. Contraceptive counseling for patients with medical co-morbidities requiring hepatic enzyme-inducing medications should include this information.
Non-obstetrical surgery during the first trimester is stressful to both the mother and the fetus. Anesthesiologists are also stressed, not only because of the effects of surgery itself, but also because of the uncertain influences of anesthesia thrown upon on the fetus. The authors present a case of breast surgery successfully performed on a woman 8 weeks pregnant requiring removal of breast abscess by the application of thoracic paravertebral block without any complications. Thoracic paravertebral block may be a safe anesthetic method for non-obstetric surgery during early pregnancy.
Park, Sang Il; Han, Kyu Cheol; Lee, Sun Yeul; Youn, Ann Misun; Yoon, Seok Hwa; Choi, Youn Hee
Objective. To report an unusual case of ovarian Leydig cell hyperplasia resulting in virilization in a postmenopausal woman. Methods. Patient's medical history and pertinent literature were reviewed. Results. A 64-year-old woman presented with virilization with worsening hirsutism, deepening of her voice, male musculature, and male pattern alopecia. Her pertinent past medical history included type 1 diabetes, hyperlipidemia, and hypertension. Her pertinent past surgical history included hysterectomy due to fibroids. On further work-up, her serum total testosterone was 506?ng/dL (nl range: 2–45) and free testosterone was 40?pg/mL (nl range: 0.1–6.4). After ruling out adrenal causes, the patient underwent an empiric bilateral oophorectomy that showed Leydig cell hyperplasia on pathology. Six weeks postoperatively, serum testosterone was undetectable with significant clinical improvement. Conclusion. Postmenopausal hyperandrogenism can be the result of numerous etiologies ranging from normal physiologic changes to ovarian or rarely adrenal tumors. Our patient was found to have Leydig cell hyperplasia of her ovaries, a rarely reported cause of virilization.
Mehta, Jaya M.; Miller, Jeffrey L.; Cannon, Anthony J.; Mardekian, Stacey K.; Kenyon, Lawrence C.; Jabbour, Serge A.
A 35-year-old woman, a non-smoker with a normal body mass index, 'felt wheezy' and developed profound hypoxia 30 min after preterm vaginal delivery at 24+ weeks of gestation. She denied other symptoms, had no fever but was tachycardic and tachypnoeic with normal blood pressure. Pulmonary embolism, amniotic fluid embolism, cardiomyopathy, arrhythmias, sepsis and non-cardiogenic pulmonary oedema were considered as differential diagnoses. Chest X-ray showed an increased pulmonary vasculature, but the blood tests, ECG, echocardiogram and CT pulmonary angiogram were essentially normal. She was managed on a high dependency area with high-flow oxygen and intravenous antibiotics. She improved dramatically and the oxygen requirements dropped to 2 L over the next 4 h. It is plausible that this woman had acute non-cardiogenic pulmonary oedema secondary to a combination of risk factors. This case highlights the importance of a methodical and multidisciplinary approach for a prompt diagnosis and successful treatment of an acutely ill parturient. PMID:24648478
In Greece, sectional hair analysis, in addition to clinical examination, has been used as a valuable tool for the confirmation of a person's history of drug use. The present report concerns the toxicologic analysis of the exhumed remains and hair samples of an 18-year-old woman. Postmortem toxicologic analysis of blood and urine confirmed recent opiate and cannabis use and indicated that death was associated with heroin abuse. Several months later, the woman's family asked for exhumation and reexamination of the body, insisting that the cause of death was homicide. The investigating judge ordered exhumation and new medicolegal examination of the body. The investigation of the drug profile along the hair shaft was undertaken by analyzing hair sections 1 cm from the hair root for morphine, 6-monoacetylmorphine, heroin, and cannabinoids. The total lengths of the hair samples ranged from 8 to 11 cm. The total morphine levels in the hair sections corresponding to the 3-month period before death were significantly lower (1.5-2.85 ng/mg) than those of the 4- to 10-month period before death (7.4-14.8 ng/mg). An interpretation of these results may be occasional drug use (with considerable attenuation of use during the last 3 months before death). Decrease of tolerance to heroin caused by abstinence and relapse in use could have been the cause of death. PMID:11444668
Tsatsakis, A M; Tzatzarakis, M N; Psaroulis, D; Levkidis, C; Michalodimitrakis, M
Klebsiella pneumoniae necrotizing fasciitis is a rare infection in regions outside of Asia. Here, we present a case of necrotizing fasciitis of the leg caused by K. pneumoniae in a 92-year-old French woman hospitalized in a geriatric rehabilitation unit. The patient initially presented with dermohypodermitis of the leg that developed from a dirty wound following a fall. A few hours later, this painful injury extended to the entire lower limb, with purplish discoloration of the skin, bullae, and necrosis. Septic shock rapidly appeared and the patient died 9 hours after the onset of symptoms. The patient was Caucasian, with no history of travel to Asia or any underlying disease. Computed tomography revealed no infectious metastatic loci. Blood cultures showed growth of capsular serotype K2 K. pneumoniae strains with virulence factors RmpA, yersiniabactin and aerobactin. This rare and fatal case of necrotizing fasciitis caused by a virulent strain of K. pneumoniae occurred in a hospitalized elderly woman without risk factors. Clinicians and geriatricians in particular should be aware of this important albeit unusual differential diagnosis.
Groundwater resources of the Hanging Woman Creek basin, Montana include Holocene and Pleistocene alluvial aquifers and sandstone , coal, and clinker aquifers in the Paleocene Fort Union Formation. Surface water resources are composed of Hanging Woman Creek, its tributaries, and small stock ponds. Dissolved-solids concentrations in groundwater ranged from 200 to 11,00 mg/L. Generally, concentrations were largest in alluvial aquifers and smallest in clinker aquifers. Near its mouth, Hanging Woman Creek had a median concentration of about 1,800 mg/L. Mining of the 20-foot to 35-foot-thick Anderson coal bed and 3-foot to 16-foot thick Dietz coal bed could increase dissolved-solids concentrations in shallow aquifers and in Hanging Woman Creek because of leaching of soluble minerals from mine spoils. Analysis of saturated-paste extracts from 158 overburden samples indicated that water moving through mine spoils would have a median increase in dissolved-solids concentration of about 3,700 mg/L, resulting in an additional dissolved-solids load to Hanging Woman Creek of about 3.0 tons/day. Hanging Woman Creek near Birney could have an annual post-mining dissolved-solids load of 3,415 tons at median discharge, a 47% increase from pre-mining conditions load. Post-mining concentrations of dissolved solids, at median discharge, could range from 2,380 mg/L in March to 3,940 mg/L in August, compared to mean pre-mining concentrations that ranged from 1,700 mg/L in July, November, and December to 2,060 mg/L in May. Post-mining concentrations and loads in Hanging Woman Creek would be smaller if a smaller area were mined. (USGS)
Objective: To present a clinical report of the coexistence of tirotoxicosis and diabetic ketoacidosis in childhood. Methods: Besides the clinical history, different studies were performed in order to evaluate her endocrine and metabolic conditions: thyroid hormone serum levels, hemathology, serum electrolites and arterial blood gases. Thyroid gammagraphy and radioiodine uptake of the thyroid gland were performed. Results: A 10-year-old school-girl,
Maríalexandra Maneiro Nieto; Nacary Sánchez Chacón; Luis Jaimes Orozco; Ana Rosa Moreno
Progressive multifocal encephalopathy (PML) is a rare demyelinating disease that typically presents in immunodeficient patients. We report a case of a previously healthy 62-Year-Old woman who suffered from an unsteady gait, throbbing headaches, and progressive left-sided weakness and numbness. Stroke was initially suspected based on imaging and symptoms. A series of follow-up magnetic resonance images of the brain showed a right parietal lesion growing in size as the patient became unable to walk and experienced increasing lethargy and confusion. A biopsy of the lesion was positive for the John Cunningham virus (JCV). A diagnosis of PML was made and she was started on mefloquine. No improvement was seen on this treatment and her condition worsened. Although PML remains uncommon in immunocompetent individuals, it cannot be ruled out based on their immune status. Although the exact cause remains uncertain, underlying or transient states of immunosuppression may be responsible for reactivation of the JCV in these patients.
Gourineni, Venkata C.; Kumar, Yogesh; Bordea, Doru; Sena, Kanaga N.
Supraventricular tachycardia is uncommon in pregnancy. It is defined as intermittent pathological and usually narrow complex tachycardia >120 beats/min which originates above the ventricle, excluding atrial fibrillation, flutter and multifocal atrial tachycardia. It is usually self-limiting or relatively easily treated with most cases responding to physical or pharmacological therapies. We describe a case of a woman in the third trimester of pregnancy who developed treatment-resistant supraventricular tachycardia and required induction of labour and delivery to stop the arrhythmia. A multidisciplinary team approach with a critical care trained nurse and a midwife, continuous arterial blood pressure monitoring, transthoracic echocardiography, and neuraxial analgesia facilitated safe birth in the delivery suite and termination of the arrhythmia. PMID:24360330
The case of a young woman from Guadeloupe developing severe megaloblastic anemia is reported. She presented with fever and hemolysis (she had heterozygotic beta-thalassemia) after a six month history of diarrhea. She was shown to have folate deficiency, steatorrhea, vitamin K and B12 malabsorption. She responded well to intravenous folinic acid and tetracyclines. Diagnosis was based on the following criteria: a) no other cause of malabsorption was found despite a comprehensive inquiry, b) the pattern of the illness corresponded to the definition of disease. Three particular aspects are outlined: the acute onset, malabsorption of vitamin B12 requiring prolonged and combined treatment, and the unusual place in which the disease was contracted. PMID:1582543
Introduction Bilateral ectopic pregnancies are increasing due to an increase in the incidence of pelvic inflammatory disease and increase in assisted reproductive techniques. Spontaneous conception after bilateral ectopic pregnancies is extremely rare. Case presentation A 33-year-old Indian woman presented with ruptured ectopic pregnancy associated with hemoperitoneum for which she underwent a laparotomy. The diagnosis of bilateral ectopic pregnancies was made during surgery. Salpingectomy was done on one side and the other tube was conserved with salpingostomy. Six months after surgery, she conceived spontaneously and a transvaginal ultrasound examination revealed a 5-weeks live intrauterine pregnancy. Conclusion A meticulous surgical technique conserving one fallopian tube resulted in subsequent viable intrauterine pregnancy. The approach to such a case along with steps to minimize tubal damage is presented.
Burkitt's lymphoma (BL) is an aggressive B-cell malignancy with very high proliferation rate, more common in males than females. Here, we describe a case of Burkitt's lymphoma in a 24-week pregnant woman with cervical and abdominal involvement. The common genetic event of virtually all BL is a reciprocal chromosomal translocation involving the proto-oncogene MYC and one of the Ig gene heavy or light chain loci. Supportive treatment was administered until early delivery, after which the patient was treated according to protocol LMB96. Pregnancy and tumorogenesis share some important events such as immunologic tolerance, angiogenesis, and editing the host immune response. Little is known about the relationship between these events in pregnancy and in tumorogenesis.
Zagalo, Carlos; Pierdomenico, Francesca; Cabecadas, Jose; David Santos, Pedro
Primary cutaneous adenoid-cystic carcinoma (PCACC) is a rare slow-growing neoplasm of disputed histogenesis characterized by a cribriform pattern at histology and local aggressive behaviour. Up to date about 60 cases of PCACC have been reported in the literature. This tumour is most common in the scalp, affects middle-aged and older individuals (mean age 59) and has predilection for women. We describe an unexpected case of PCACC in a 32-years-old woman referred to our clinic for a subcutaneous nodule in the scalp showing a slow growth and indolent course. The differential diagnosis and the clinical management of this PCACC patient, successfully treated with a wide local excision, are presented and discussed.
A spiculated mass on a mammogram is highly suggestive of malignancy. We report the case of a 32-year-old woman with a radial sclerosing lesion that mimicked breast cancer on mammography. She visited her physician after palpating a lump in her left breast. Mammography showed architectural distortion in the upper inner quadrant of the left breast. Ultrasonography showed a low echoic area with an ambiguous boundary. Core needle biopsy was performed because of the suspicion of malignancy. Histological examination did not reveal any malignant cells. After 6 months, the breast lump became larger and the patient was referred to our hospital. Mammography performed in our hospital showed a spiculated mass, and therefore mammotome biopsy was performed. Histological examination revealed dense fibroelastic stroma with a wide variety of mastopathic changes, leading to a diagnosis of a radial sclerosing lesion. One year after the biopsy, the lump on her left breast had disappeared and mammography showed no spiculated mass.
Sheehan's syndrome (SS) presents with hypopituitarism after parturition, usually preceded by postpartum hemorrhage. The first symptom of the disorder is lactation failure because of lactotroph cell necrosis. Recovery of lactotroph function after initial insult has not been reported in the literature. We describe the evaluation of a case of SS in whom lactotroph function recovered after the second pregnancy. A young woman delivered her first child at the age of 25 years; delivery was followed by severe postpartum hemorrhage and required blood transfusion. Sheehan's syndrome was diagnosed because of lactotroph, corticotroph, thyrotroph and somatotroph failure and empty sella on MRI. She conceived twice spontaneously and had normal lactation after the second delivery; investigations confirmed the normal basal and stimulable prolactin levels. We presume that recovery of lactotroph function after the second pregnancy in a patient with SS is possibly because of stimulatory effect of estrogen and progesterone on residual lactotroph cells.
Laway, Bashir A.; Mir, Shahnaz A.; Zargar, Abdul H.
Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation resulting from irreversible changes in the hormonal and reproductive functions of the ovaries and is associated with a large number of symptoms ranging from physical to psychological. Some of the common oral manifestations are oral burning sensation with associated mucosal infections, pain, altered taste perception, and alveolar bone loss. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to devise newer methods that would add along to the treatment modalities advised by gynecologists in relieving menopausal women from above symptoms. The present case report describes an innovative method of fabricating a metal base denture in an edentulous female that would help perimenopausal/menopausal/post-menopausal edentulous women feel hot/cold sensations of food/liquids, thereby giving them relief from pain, better taste perception, and relief from associated allergic and candidal infections that are common with conventional acrylic base dentures. PMID:24082754
A 56-year-old woman was admitted to hospital due to stress-dependent hoarseness and hypertensive urgency. The patient reported peaks of blood pressure of 210/160 mm Hg in combination with hoarseness. With indirect mirror examination, the ear-nose-and throat doctor diagnosed a paralysis of the vocal cord on the left side. The authors suspected a mass affecting the vagus nerve and performed a CT-scan with iodinated contrast material of the neck and thorax. Surprisingly the CT-scan showed an aneurysm of the aortic arch with a dilatation up to 4.8 cm, a kinking of 120° and a chronic dissection in the aneurysm. During exercise or elevated blood pressure this aneurysm expanded and made a compression of the nervus laryngeus recurrens on the left side. Thus, there is an explanation for the patient’s hoarseness on exertion and during hypertensive urgency.
Latus, Joerg; Franke, Ulrich; Alscher, M Dominik; Braun, Niko
A 48-year-old woman with systemic lupus erythematosus diagnosis was on naproxen, hidroxichloroquine and acetylsalicylic acid. She had self-suspended all medication and resumed 1 year later. Five days after the medication was resumed, she developed acute hepatitis, with biochemical hepatic cytolysis, hypergamaglobulinaemia and a serum antinuclear antibody titre of 1/2560. Idiopathic autoimmune hepatitis was considered, but drug-induced liver injury could not definitely be ruled out. Patient declined liver biopsy. Oral prednisolone was started. Within 3 months with prednisolone being tapered to 10 mg/day, a new flare occurred. Liver biopsy was performed and it favoured autoimmune hepatitis diagnosis. We discuss the diagnostic options and treatment approach in a patient with autoimmune disease and possible drug-induced liver injury who initially declined liver biopsy. PMID:23563681
Barosa, Rita; Ramos, Lídia Roque; Fonseca, Cristina; Freitas, João
Posterior reversible encephalopathy syndrome (PRES) is a temporary condition that is diagnosed clinically, neurologically, and radiologically. Its symptoms vary, and nonspecific headaches, confusion, impairment of consciousness, nausea, vomiting, and visual impairment may occur. Acute hypertension often accompanies these symptoms. Patients can also suffer from convulsions, cortical visual impairment, and coma. Diagnosis can be difficult due to focal neurologic signs. Nevertheless, knowing the clinical risk factors can lead to the right diagnosis. It has been reported that this condition may also occur during organ transplantation, immunosuppressive treatment, and autoimmune diseases and chemotherapy, and also patients with eclampsia. In this paper, a 21-year-old, 31-week pregnant woman, who had been diagnosed with PRES and thanks to early diagnosis and treatment had fully recovered and discharged from the intensive care unit, is presented, and the relevant literature is discussed. PMID:22937277
Posterior reversible encephalopathy syndrome (PRES) is a temporary condition that is diagnosed clinically, neurologically, and radiologically. Its symptoms vary, and nonspecific headaches, confusion, impairment of consciousness, nausea, vomiting, and visual impairment may occur. Acute hypertension often accompanies these symptoms. Patients can also suffer from convulsions, cortical visual impairment, and coma. Diagnosis can be difficult due to focal neurologic signs. Nevertheless, knowing the clinical risk factors can lead to the right diagnosis. It has been reported that this condition may also occur during organ transplantation, immunosuppressive treatment, and autoimmune diseases and chemotherapy, and also patients with eclampsia. In this paper, a 21-year-old, 31-week pregnant woman, who had been diagnosed with PRES and thanks to early diagnosis and treatment had fully recovered and discharged from the intensive care unit, is presented, and the relevant literature is discussed.
Ovarian pregnancy is a rare form of extra uterine pregnancy. Serous cyst adenoma is a benign variant of epithelial cell tumors of ovary. The coexistence of a cyst adenoma with an ovarian pregnancy in the same ovary is extremely rare. Some studies suggested that infertility or ovulation-inducing drugs can be involved in increased risk of ovarian tumors and ovarian pregnancies. A 28-year-old infertile woman presented with a ruptured ovarian pregnancy following ovulation induction with metformin. She had a concurrent benign serous cyst adenoma in the same ovary. Resection of both ovarian pregnancy and tumoral mass were performed. The ovary was preserved. Removal of gestational tissue and preservation of the involved ovary are the best options for management of ovarian pregnancy in young patient. Although there is an association between infertility/ovulation inducting medications and ovarian gestation, their connections with serous cyst adenoma are undetermined. PMID:24696771
A 93-year-old woman with a history of hypertension was noted to have a mass in the left atrium prolapsing partially through the mitral valve on a routine surface echocardiogram in 2002. A transesophageal echocardiogram was then performed revealing an irregular mass with an appearance of protruding fronds of tissue. The echogenicity of the mass was inhomogeneous with some areas of punctate calcification, and the mass was attached to the interatrial septum. The echocardiographic appearance of the mass was almost pathognomic of atrial myxoma, and this is the oldest patient yet to have been diagnosed with a probable myxoma. The patient did not want surgical removal of the mass. She is still asymptomatic at the age of 95 years. PMID:15891245
This is a presentation of a doctoral thesis of 1870. The author was English but the thesis and the examinations were in French. Elizabeth Garrett Anderson, usually referred to as E.G.A., was the first woman in Britain to obtain the title of M.D., but not the first in Europe. Nadeshda Prokofevna Suslova, a Russian, received her M.D. in 1867 in Zurich, the most liberal university at that time, soon to be flooded by female students from Russia. E.G.A. had been applying to the few possible European universities but she settled for Paris after the Empress Eugenie had decided that she should be accepted there. This meant that she could succeed without having to be a Paris resident, just by writing a thesis and passing a series of examinations presided over by Paul Broca. This was important as she was already conducting private and dispensary practice, and could not find a locum (she insisted on a woman). E.G.A. had suffered many setbacks, for being a woman, as such being unacceptable in dissection rooms and operating theatres, and generally in a professional career where women were unheard of. She was finally permitted to receive her medical diploma from the Worshipful Society of Apothecaries of London. She wrote about her thesis: "I have chosen Headache as its subject. I had to find a subject which could be well studied without post-mortem observations, of which I can have but very few in either private or dispensary practice; and I wished also to take a large subject, one that demanded some insight into the harmony that exists between the main physiological functions." Marcia Wilkinson (M.W.), who worked in the Elizabeth Garrett Anderson Hospital in London for 35 years, heard there of E.G.A.'s thesis on migraine and sent for it from Paris. In 1966 she translated it into English from the original French, being interested both in the subject and in the person of this resolute and lucid woman. When H. Isler found the French thesis in the British Library he intended to translate it but, after discussion, we decided on a joint effort (95% of the translation is by M.W.; very few details were changed, and some footnotes added for better understanding). We think that E.G.A.'s text is a classic, showing profound understanding, sound practical advice, and also, in its theoretical part, the limits of neurophysiological knowledge in Paris when Brown-Sequard was "charge des cours" there. We may add that in her various examinations she had to answer questions, in French, on the use of footprints by the police, the general nature of fishes, toxic fishes, electric fishes, cod liver oil, and the secretion of tears. She earned much applause from the public, which consisted of male French students, and the overt appreciation of Paul Broca, head examiner, and Dr Wurtz, the Dean of the Faculte de Médecine. The impact of her thesis in the 19th century was modest. It appears to be rather marginal in the German literature of the early 20th century, but it has imprinted the management of migraine at the City of London Migraine Clinic in the last thirty years. The importance of nutrition, regular meals, regular habits, the need to supplement analgesics with antiemetics, and the treatment of the attack with rest, and great quantities of hot tea, were certainly related to E.G.A.'s doctrine. The internationally prevailing recommendation to give antiemetics, and then only analgesics, as well as the combination of both in one tablet, may thus be traced back to E.G.A. via the teachings of M.W. and Nat Blau. PMID:10099853
Gitelman syndrome is a rare hereditary disorder of the thiazide-sensitive NaCl transporter in the distal renal tubular cells, but mimicking of such hereditary tubular disorders has been described in different autoimmune diseases (Sjögren syndrome, SLE, ...). A 62-year-old woman with painful red eyes and sicca syndrome presented at the ophthalmological department. The diagnostic evaluation identified a Sjögren syndrome with early endophthalmitis as the reason for the red eyes. Results of laboratory examination indicated severe hypokalemia, metabolic alkalosis and hypomagnesemia, although this had not been seen years earlier. Together with the urine analysis, a rare case of an acquired Gitelman syndrome was diagnosed. Substitution with potassium and magnesium improved the initial symptoms of weakness, but renal electrolyte wasting persisted even after treatment of Sjögren syndrome. In patients with autoimmune disease, laboratory analysis of serum electrolytes should be performed because different acquired tubular disorders can lead to severe hypokalemia. PMID:16794762
Acute abdomen with hemoperitoneum is a very rare entity in postmenopausal women due to gynecologic conditions. A 54-year-old, postmenopausal woman was brought to emergency department with severe abdominal pain. Physical examination revealed acute abdomen findings with 15?cm pelvic mass on the right adnexal region. Immediate exploratory laparotomy was performed. During laparotomy 1000?cc of bloodstained fluid, ruptured and actively bleeding large mass arising from right ovary was observed. Right salpingo-oopherectomy was performed in emergency conditions, and pathology report revealed an adult type of granulosa cell tumor. After this result, staging surgery was performed and patient was diagnosed as granulosa cell tumor stage 1?c. Cisplatin, etoposide, and bleomycin chemotherapy was given. Clinicians should be aware of granulosa cell tumors which may occur at any age and prone to rupture. Frozen section will be helpful in order to avoid incomplete surgeries especially in postmenopausal women presented with intra-abdominal bleeding.
Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation resulting from irreversible changes in the hormonal and reproductive functions of the ovaries and is associated with a large number of symptoms ranging from physical to psychological. Some of the common oral manifestations are oral burning sensation with associated mucosal infections, pain, altered taste perception, and alveolar bone loss. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to devise newer methods that would add along to the treatment modalities advised by gynecologists in relieving menopausal women from above symptoms. The present case report describes an innovative method of fabricating a metal base denture in an edentulous female that would help perimenopausal/menopausal/post-menopausal edentulous women feel hot/cold sensations of food/liquids, thereby giving them relief from pain, better taste perception, and relief from associated allergic and candidal infections that are common with conventional acrylic base dentures.
Steroid 5-alpha-reductase 2 deficiency is a rare disorder leading to male pseudohermaphroditism, a condition characterized by incomplete differentiation of male genitalia in 46,XY patients. Here, we report a case of a 21-year-old woman from Ardabil who presented with primary amenorrhea, ambiguous genitalia, and lack of breast development. All of the serum hormone profiles were normal except for raised serum total testosterone. Testosterone to DHT ratio (T/DHT) was elevated before (15.72) and further increased after hCG stimulation (32.46). A chromosomal study revealed a 46,XY karyotype. A bilateral gonadectomy, recessive cliteroplasty, urethroplasty, and vaginoplasty were performed and hormonal replacement therapy using estrogen was started. In conclusion, the diagnosis of 5-alpha-reductase 2 deficiency may be suspected in infants with ambiguous genitalia or in adolescents or young adults with the characteristic phenotype and serum hormone profiles. PMID:24383016
Extrauterine or extraintestinal leiomyomas are extremely uncommon especially in the pre-peritoneal area or within the anterior abdominal wall muscles. These tumors have been ascribed to intraoperative seeding during resection of a fibroid or a leiomyoma of gut, to exogenous hormone replacement therapy or a major derangement of glucose and/or lipid metabolism. So far, there is no published report of de novo origin of anterior abdominal wall pure leiomyoma in the literature. The author herein reports a case of perimenopausal multiparous woman without any listing of previous gynecological surgery or hormone therapy who presented with a large pre-peritoneal intramuscular leiomyoma of the anterior abdominal wall. The patient underwent complete primary resection with amelioration of her symptoms.
Choriocarcinoma is a highly malignant tumor of trophoblastic origin. Most cases occur in association with preceding gestational events. However, on very rare occasions, nongestational choriocarcinoma arises from germ cell or trophoblastic differentiation in different types of carcinoma. This article reports the case of a 58-year-old woman with primary nongestational choriocarcinoma of the uterus that developed 19 years after her final pregnancy and 4 years after menopause. A total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathological examination showed choriocarcinoma of the uterus without components of other germ cell tumors. Karyotype analysis of the tumor cells demonstrated XX. We confirmed its nongestational origin by DNA polymorphism analysis at 15 short tandem repeat loci. After surgery, the patient was given four courses of combination chemotherapy. She is still alive and there has been no evidence of recurrence 3 years after surgery. PMID:22653351
INTRODUCTION Fibroadenomas are among the most common tumours of the female breast, occurring most frequently in women of child-bearing age, especially those under 30 years. PRESENTATION OF CASE We report a case with a total of 27 fibroadenomas presenting bilaterally of a 46-year-old woman. The histopathologic and immunophenotypic features of the fibroadenomata are described. DISCUSSION Most fibroadenomas are present as single mass, however the presence of multiple fibroadenomata can be seen in 15–20% of the patients. It has been reported that the average number of masses in cases of multiple fibroadenomas is 3–4 in a single breast but occurrence of more than five fibroadenomas in an individual patient is much less common. CONCLUSION There are few reports of multiple fibroadenomas. We report this case hoping to expand the literature and to provide insight to aetiology of multiple fibroadenoma formation and advice on management.
Recognition of carbon monoxide is difficult due to its plain physical-chemical properties. Carbon and gas operating heating systems may cause severe poisoning. Carbon-monoxide intoxication may generate severe hypoxic damage and it may cause death. The authors present the case of severe carbon monoxide poisoning affecting one young child and five adults, including a pregnant woman. Because the availability of hyperbaric oxygen therapy is limited in Hungary, urgent cesarean section was performed to avoid intrauterine hypoxic damage. The authors note that there are no standardized non-invasive methods for measuring fetal carbon-monoxide level and that the level of carbon monoxide accumulation is higher and the clearance is longer in the fetus than in the mother. The pathophysiology of carbon monoxide intoxication and therapeutic options in pregnancy are discussed. Orv. Hetil., 2014, 155(22), 871-875. PMID:24860052
Gara, Edit; Gesztes, Eva; Doroszlai, Richárd; Zacher, Gábor
We report an unusual case of severe abdominal arterial thrombosis in a young woman using oral desmopressin. Only a few cases with cerebrovascular accidents and coronary syndromes have been described so far, which could be attributed to intravenous administration of desmopressin. Because extensive diagnostic and laboratory investigations for (un)common coagulation disorders could not identify an alternative explanation associated with arterial thrombosis, we hypothesise that desmopressin in an oral dose of at least 200 ug once daily must have been sufficient to cause this dramatic vascular complication. Supportive of our hypothesis, we found remarkably high levels of factor VIII activity, Von Willebrand factor (vWF) antigen and vWF ristocetin cofactor activity (268%, 740%, 590% respectively). To the best of the authors' knowledge, this is the first report suggesting a relationship between oral desmopressin use and life-threatening abdominal arterial thrombosis. PMID:22155434
Schrijver, E J M; Deenik, W; Chon, H; Koedam, N; Spoelstra-de Man, A M E
Introduction De Garengeot first described the presence of the appendix within a femoral hernia in 1731. Case presentation We report the case of a 66-year-old Caucasian woman who presented with acute appendicitis within an incarcerated femoral hernia. This is the first reported case of de Garengeot's hernia in the Balkan area. Conclusions Appropriate management without incurring any delay for radiological imaging can be promising for an uneventful postoperative course. The treatment of choice of this disease entity is emergency surgery and consists in simultaneous appendectomy through the hernia incision and primary hernia repair. In patients with large hernia defects or in older people the use of mesh for repairing the hernia defect can be an excellent choice.
Acute pulmonary embolism is a leading cause of death during pregnancy and delivery in the United States. We describe the case of a 25-year-old woman who presented in car-diogenic shock in week 38 of her first pregnancy. After the emergent cesarean delivery of a healthy male neonate, the mother underwent immediate surgical pulmonary embolec-tomy. We confirmed the diagnosis of pulmonary embolism intraoperatively by means of transesophageal echocardiography and removed large clots from the patient's pulmonary arteries. Mother and child were doing well, 27 months later. In addition to presenting our patient's case, we discuss the other relevant reports and the options for treating massive pulmonary embolism during pregnancy.
Steroid 5-alpha-reductase 2 deficiency is a rare disorder leading to male pseudohermaphroditism, a condition characterized by incomplete differentiation of male genitalia in 46,XY patients. Here, we report a case of a 21-year-old woman from Ardabil who presented with primary amenorrhea, ambiguous genitalia, and lack of breast development. All of the serum hormone profiles were normal except for raised serum total testosterone. Testosterone to DHT ratio (T/DHT) was elevated before (15.72) and further increased after hCG stimulation (32.46). A chromosomal study revealed a 46,XY karyotype. A bilateral gonadectomy, recessive cliteroplasty, urethroplasty, and vaginoplasty were performed and hormonal replacement therapy using estrogen was started. In conclusion, the diagnosis of 5-alpha-reductase 2 deficiency may be suspected in infants with ambiguous genitalia or in adolescents or young adults with the characteristic phenotype and serum hormone profiles.
Background. Ovarian pregnancy is a rare form of ectopic pregnancy. It is often difficult to distinguish from tubal pregnancy, and diagnosis and management are frequently a challenge. Case. A 33-year-old nulligravida woman presented with light vaginal bleeding and bilateral lower quadrants abdominal pain. Beta-human chorionic gonadotropin (beta-hCG) level (592?mUI/mL) and clinical and ultrasound (US) findings were suspicious for tubal pregnancy. On the third day, despite beta-hCG decrease (364?mUI/mL), she complained of severe pain in the lower abdomen, and physical examination revealed abdominal rebound tenderness. US showed a large amount of fluid in the abdominal cavity. Because of the unstable clinical condition, emergency laparoscopy and resection of left ovarian ectopic pregnancy were performed. Histology confirmed ovarian gestation. Conclusion. This case shows that ectopic pregnancy rupture may occur despite low levels of beta-hCG. Hemoperitoneum is not contraindication to laparoscopy. PMID:23198195
Polycystic ovary syndrome (PCOS) and Graves' disease are the common causes of menstrual irregularity leading to infertility in women of child-bearing age. A 21-year-old female patient visited us with complaints of oligomenorrhea and hand tremor. She was diagnosed as having PCOS and hyperthyroid Graves' disease, simultaneously. She had low body weight (BMI: 16.4 kg/m(2)), mild hirsutism, and thyrotoxicosis. The patient was treated with anti-thyroid drug and beta-blocker for about two years, and then recovered to normal thyroid function. Although some studies have suggested a connection between PCOS and autoimmune thyroiditis, no study indicated that PCOS is associated with Graves' disease until now. Here, we describe the first case report of a lean woman with normal insulin sensitivity presenting PCOS and Graves' disease simultaneously. PMID:21963738
Jung, Jung Hwa; Hahm, Jong Ryeal; Jung, Tae Sik; Kim, Hee Jin; Kim, Ho Soo; Kim, Sungsu; Kim, Soo Kyoung; Lee, Sang Min; Kim, Deok Ryong; Choi, Won Jun; Seo, Yeong Mi; Chung, Soon Il
Introduction Cerebellar glioblastoma is an uncommon adult lesion. The pathogeny and prognosis of cerebellar glioblastoma are still incompletely elucidated. Case presentation We report the case of a 19-year-old Moroccan woman. A neurologic examination revealed the presence of cerebellar signs. A diagnosis of cerebellar glioblastoma is rarely made before surgery. An encephalic computer tomography scan and magnetic resonance imaging increased the accuracy of defining the nature of the lesion. Magnetic resonance imaging showed a heterogeneously enhancing mass in the vermis and the right cerebellar hemisphere. After surgery, glioblastoma was histologically confirmed. Post-operative radiotherapy followed. The outcome of our patient was favorable after one year of follow-up. Conclusions We report an unusual case of cerebellar gliobastoma. Cerebellar glioblastoma multiforme should be considered in the differential diagnosis of a cerebellar mass lesion.
In this article, the authors construct a story of one woman's (Justine's) experience of learning to run within the context of a beginners group. Building on existing scholarship on narrative, aging, and physical activity, this work is part of a larger ethnographic project examining subjective accounts of the physically active aging body across the life course. Concerned with often simplistically linear problems of representation, the authors present a messy text that represents the complex and fluid nature of Justine's embodied tale. The aim is to show the intersection of biographical (storied) identity with health behavior choices and to interrogate the process of challenging narrative foreclosure. By using the emerging genre of messy text as a creative analytic practice, the authors avoid prompting a single, closed, convergent reading of Justine's story. Instead, they provoke interpretation within the reader as witness and expand the ways in which research on aging and physical activity has been represented. PMID:23981478
Most HIV-infected individuals are coinfected by Herpes simplex virus type 2 (HSV-2). HSV-2 reactivates more frequently in HIV-coinfected individuals with advanced immunosuppression, and may have very unusual clinical presentations, including hypertrophic genital lesions. We report the case of a progressive, hypertrophic HSV-2 lesion in an HIV-coinfected woman, despite near-complete immune restoration on antiretroviral therapy for up to three years. In this case, there was prompt response to topical imiquimod. The immunopathogenesis and clinical presentation of HSV-2 disease in HIV-coinfected individuals are reviewed, with a focus on potential mechanisms for persistent disease despite apparent immune reconstitution. HIV-infected individuals and their care providers should be aware that HSV-2 may cause atypical disease even in the context of near-comlpete immune reconstitution on HAART.
The most common metastasis site of breast cancer are the local and distant lymph nodes, bone, lungs, liver and brain. We report a 86-year-old woman with an unusual abdominal subcutaneous metastasis of breast cancer. The patient was diagnosed with invasive lobular breast cancer and had been treated six months earlier with modified radical mastectomy. Later she presented a painless mass on the middle upper abdominal wall. She was subsequently admitted to the hospital to perform a whole body CT scan, confirming the presence of the abdominal mass in epigastric region, causing a partial compression of the stomach. Histopathological studies confirmed that the abdominal mass was a rare subcutaneous metastatic lesion of breast origin. The patient underwent a surgical intervention to remove the metastasis and she recovered fully. PMID:22696888
Metere, A; Di Cosimo, C; Chiesa, C; Esposito, A; Giacomelli, L; Redler, A
At 17th week of pregnancy, a 28-year-old woman was diagnosed as having herpes simplex encephalitis and treated with intravenous acyclovir. Follow-up by the serial ultrasound examinations, intrauterine growth retardation (IUGR) was found. During the course of disease, cordocentesis was performed to evaluate the risk of the disease and the infant's chromosomal constitution. No herpes simplex virus infection on cord blood sample was observed; however, chromosomal analysis revealed: 46,XX/47,XX,+2/47,XX,+11/47,XX,+19/48,XX,+11. After termination of pregnancy, the fetus was found as having ventricular septum defect. The presence of the triploid cell lines mocaicism involving chromosome 2 and 19 were confirmed by the analysis of fetal skin tissues. No attributable finding to herpes simplex virus infection and acyclovir treatment was found, and the presence of the triploid cell lines mocaicism were appeared to be purely coincidental. PMID:11444361
Introduction The most serious erratic migration of paragonimiasis is a cerebral paragonimiasis. Infection in the temporal and occipital lobes of the brain has been previously reported in cerebral paragonimiasis. Here, we report a case of chronic brainstem paragonimiasis. Case presentation A 29-year-old Chinese woman presented to our hospital complaining of a sudden onset, three days previously, of double vision and dizziness. A computed tomography scan and diffusion-weighted images looked like an ischemic stroke. However, conglomerates of multiple ring-like enhancements on contrast magnetic resonance imaging, and the characteristic appearance of the ‘tunnel sign’, were found on further examination. Our patient was treated with praziquantel to prevent the spread of the paragonimiasis. She was followed up three months later and showed good recovery. Conclusions Conglomerates of multiple ring-like enhancements on contrast magnetic resonance imaging and the characteristic appearance of the ‘tunnel sign’ were important for the diagnosis of chronic brainstem paragonimiasis.
Endometriosis is a common disease in women of childbearing age and is defined as the presence of endometrial glands and stroma in organs outside of the uterine cavity. Appendiceal endometriosis is very uncommon and accounts for a small fraction of all cases of extrapelvic endometriosis. Cases of that which occur during pregnancy are extremely rare with an incidence that ranges between 3 and 8 deliveries per 10 000. This makes the diagnosis extremely difficult and represents a challenge in the management of the patient. In this report we describe the case of a pregnant woman who underwent ileocecectomy for perforated appendicitis stemming from endometriosis and subsequent pre-term delivery of a 31-week-old fetus. PMID:24968435
Lebastchi, Amir H; Prieto, Peter A; Chen, Charlie; Lui, Felix Y
Endometriosis is a common disease in women of childbearing age and is defined as the presence of endometrial glands and stroma in organs outside of the uterine cavity. Appendiceal endometriosis is very uncommon and accounts for a small fraction of all cases of extrapelvic endometriosis. Cases of that which occur during pregnancy are extremely rare with an incidence that ranges between 3 and 8 deliveries per 10 000. This makes the diagnosis extremely difficult and represents a challenge in the management of the patient. In this report we describe the case of a pregnant woman who underwent ileocecectomy for perforated appendicitis stemming from endometriosis and subsequent pre-term delivery of a 31-week-old fetus.
Lebastchi, Amir H.; Prieto, Peter A.; Chen, Charlie; Lui, Felix Y.
A 33-year-old Caucasian pregnant woman (26 weeks' gestation) presented to the emergency department. She had a 2-day history of severe itching of the scalp and steadily worsening swelling of the face over the previous 12 h, which had extended to the neck. She had no difficulty breathing. The itching and swelling had developed 3 days after she had used hair dye. The patient had no history of allergic responses to hair dye or black henna tattoos. A diagnosis of type IV delayed hypersensitivity reaction was made. Permanent hair dyes are the most frequently used professional hair dyes and are most commonly based on paraphenylenediamine (PPD) or related chemicals. PPD is known to be one of the most potent allergens which cause allergic contact dermatitis. After treatment with intravenous antihistamines and steroids, the facial swelling reduced and the patient had completely recovered by the following day. PMID:24686800
van Genderen, Michel E; Carels, Ginette; Lonnee, Edward R; Dees, Adriaan
Oral combined contraceptive pill (OCCP) is popular as birth control pills. Like all other drugs, they are not free from risks. Women taking certain types of OCCP have higher risk of developing deep vein thrombosis (DVT). A 29 year old married woman had taken OCCP for 3.5 months, developed deep vein thrombosis of left leg. Hereditary and acquired causes of DVT were excluded. She was treated with parenteral and oral anticoagulants simultaneously and was advised to discontinue OCCP. Initially the risk of blood clot was believed to be due to dose of estrogen but recent study relates it to the type of progesterone involved in OCCP. Thus, it is still a matter of debate, whether to associate risk of DVT to the amount of estrogen alone or also to the type of progestin. Apart from careful selection of patients, one should also look for the risk of venous thromboembolism irrespective of type of OCCP prescribed.
This study aimed to identify the social representations of the nurse specialist in maternal health and obstetrical care under the gaze of the pregnant woman using a qualitative study of 50 pregnant women in three municipalities of the Northwest Portugal, which carry out their antenatal care in the health center of their residence area. Data were collected through semi-structured interviews between February and July 2007 and analyzed based on content analysis. The results showed that the nurse midwife is faced as a friend, guide and support in helping to experience the whole process inherent in the birth. This research can be a contribution for the improvement of the quality of care provided during pregnancy. PMID:25054696
Martins, Maria de Fátima da Silva Vieira; Remoaldo, Paula Cristina Almeida Cadima
Summary Background A serious complication of heparin treatment, heparin-induced thrombocytopenia (HIT) is rarely observed in pregnant women. Drug therapy during pregnancy should always be chosen to minimize fetal risk. The management of HIT in pregnancy represents a medical challenge. Unlike heparins, the anticoagulants used in patients with HIT do cross the placenta, with unknown fetal effects. Case Report We present a case of a 24-year-old female presenting for care at 34 weeks of gestation with acute pulmonary embolism treated initially with unfractionated heparin (UFH) and low molecular weight heparin (LMWH), who developed HIT. She was then successfully treated with fondaparinux. Conclusions To the best of our knowledge, this is one of the first case reports describing a successful use of fondaparinux in the treatment of HIT in a third-trimester pregnant woman, providing a novel approach for this subset of patients.
Introduction. Cardiac failure during pregnancy is usually related to preeclampsia/eclampsia, rarely to hyperthyroidism. While hyperthyroidism can easily lead to hypertensive cardiac failure and may harm the fetus, it is sometimes difficult to distinguish hyperthyroidism from normal pregnancy. Case Presentation. We encountered a case of 41-year-old pregnant woman with hypertensive cardiac failure. Because we initially diagnosed as pre-eclampsia/eclampsia, Caesarian section was performed. However, her symptoms still persisted after delivery. After thyroid function test results taken on the day of admission were obtained on the fourth day, we could diagnose that her cardiac failure was caused by thyrotoxic crisis. Conclusions. Hypertensive cardiac failure due to hyperthyroidism during pregnancy is rare and difficult to diagnose because of similar presentation of normal pregnancy. However, physicians should be aware of the risks posed by hyperthyroidism during pregnancy.
Triple-negative breast cancer phenotype (estrogen receptor-, progesterone receptor- and human epidermal growth receptor 2-negative) is one of the most aggressive molecular subtypes, accounting for 15-20% of all breast tumors. There is no standard treatment for this setting of patients except anthracyclines and taxanes, but not all elderly patients can tolerate these kinds of agents. We describe the case of an elderly woman affected by triple-negative breast cancer with bone and brain metastases who has been treated for five years with metronomic capecitabine. At the moment, the patient has stable disease and enjoys good quality of life. She had initially been diagnosed with a poor Karnofsky index, which has actually improved from 50 to 90. Metronomic capecitabine treatment has clearly improved her quality of life, as documented by the results of the Functional Assessment of Cancer Therapy Breast. PMID:25075060
A 25-year-old woman was referred to our hospital with persistent upper abdominal pain. Preoperative imaging studies revealed a hilar bile duct stricture with portal venous encasement, and the patient underwent curative resection involving extended left hepatectomy and segmental portal vein resection. The pathological findings demonstrated a well-differentiated tubular adenocarcinoma of the bile duct with regional lymph node metastasis (stage IIIB according to the UICC TNM classification), as well as the overexpression of p53 proteins and the K-ras gene mutation in tumor cells. The patient has shown no evidence of recurrence in the 10 months since the operation. Although there are several reports of relatively young adults with cholangiocarcinoma, the majority of such patients demonstrate either an anomalous arrangement of the pancreaticobiliary duct system or primary sclerosing cholangitis. The absence of any morphological abnormalities in this patient's biliary system implicates de novo carcinogenesis as the most likely cause of the cholangiocarcinoma. PMID:23580078
A 35-year-old woman with postoperative recurrent Graves' disease presented with a 5-day history of a red swelling on the right cheek associated with 4 days of remittent hyperpyrexia. Investigations revealed fever, a gangrenous ulcer on the right cheek, submandibular lymphadenopathy, and thyroid gland enlargement. Her white blood cell count, immunoglobulins, and lymphocyte subsets were unremarkable. Thyroid function tests showed low thyroid-stimulating hormone, high free thyroxine, and elevated radioactive iodine uptake. Repeated pus cultures grew Pseudomonas aeruginosa, but blood cultures were negative. An ill-demarcated erythematous plaque occurred on the right leg on hospital day 3. She was treated with intravenous antibiotics with topical gentamicin, recombinant bovine basic fibroblast growth factor, and radioiodine therapy with anti-thyroid drugs. The ulcer healed leaving a depressed scar at 35 days after discharge. This patient may represent the first case of P. aeruginosa ecthyma gangrenosum and cellulitis in postoperative recurrent Graves' disease. PMID:24560831
A 95-year-old woman had been treated over the past 8 years for progressive dysphagia. When her condition worsened, blood tests revealed the presence of leucocytosis and eosinophilia in the absence of anaemia or thrombocytopenia. Within 11 days of diagnosis, the patient died of respiratory failure. Necropsy showed normal thyroid tissue and an absence of infectious disease. However, an upper mediastinal tumour was found and was histopathologically diagnosed as a neoplastic transformation of the ectopic thyroid. Only 1% of endothoracic goitres present as ectopic or autonomous goitre with no parenchymal or vascular connection to the thyroid gland. This case represents a very rare situation in which a leukemoid reaction and peripheral hypereosinophilia were observed as a manifestation of an anaplastic thyroid carcinoma in an ectopic mass.
Camargos, Einstein Francisco; Pandolfi, Marcela Basso; Toledo, Maria Alice V; Quintas, Juliana Lima; Moreira-Junior, Sebastiao; de Azevedo, Ana Emilia Borges; Tavares, Alexandre Cavalca
Psoriasis is a multi-factorial disease with various clinical manifestations. We present a case of unilateral psoriasis associated with ipsilateral lymphedema that developed after mastectomy for breast cancer. A 42-year-old Korean woman was referred to our clinic with a 1-month history of multiple erythematous scaly patches on the right arm, back, and breast and was diagnosed with psoriasis by a skin biopsy. Three years previously, she had been diagnosed with breast cancer (T1N2), underwent a right quadrantectomy and axillary lymph node dissection, and completed adjuvant chemotherapy followed by high-dose adjuvant radiotherapy. She had started rehabilitation therapy on the right arm for secondary lymphedema 30 months previously. Because of the long interval between radiation and psoriasis, we speculated that changes in the local milieu caused by the lymphedema might be a causative factor. We hereby report a rare case of unilateral psoriasis following post-mastectomy lymphedema.
Kim, Minji; Jung, Jae Yoon; Na, Se Young; Na, Sun Jae; Lee, Jong Hee
A woman with Carney complex presented at age 22 years with abdominal pain and hirsutism. As a baby, she had excision of a right eyelid lesion and at age 14 years removal of a left lower eyelid nodule that subsequently recurred. Investigation revealed an elevated level of serum testosterone and a 2-cm left ovarian tumor. A left salpingo-oophorectomy was performed. Postoperatively, the abdominal pain was relieved, the serum level of testosterone was normalized, and the hirsutism was ameliorated. The tumor featured sheets of eosinophilic cells with lipochrome pigment, myeloid metaplasia, stromal metaplasia, and markedly abnormal blood vessels. Immunocytochemically, the tumor cells were positive for vimentin, synaptophysin, inhibin A and calrenin. Because of the clinical setting in which the neoplasm occurred, it is unlikely that the occurrence was unrelated to Carney complex..
We describe the pathologic and clinical presentation of a very rare, fatal case of luteinized thecoma with sclerosing peritonitis in a 40-year-old woman, who had a history of total abdominal hysterectomy and a left salpingo-oophorectomy in 2003. The patient presented with abdominal pain, and radiologic examinations revealed a 10-cm heterogenous right pelvic mass with partial necrosis. The patient eventually underwent an exploratory laparotomy, which revealed an ovarian tumor with multiple implants in the peritoneal cavity. The ovarian lesion was made up of spindle cells among clusters of luteinized stromal cells that expanded to the ovarian cortex. Tumor cells were positive for vimentin, estrogen and progesterone receptors, and CCD68 (focally) and negative for CD34, ?-smooth muscle actin, ?-catenin, and desmin by immunohistochemical studies. Luteinized cells were positive for ?-inhibin and calretinin. Tumor cells exhibited low Ki-67 proliferation indices. The patient died because of the sclerosing peritonitis component of the disease. PMID:24300532
We report a 22-year-old woman who presented with asthenia, weight loss and hypotension in which extensive pituitary and adrenal investigations were diagnostic of isolated adrenocorticotropic hormone deficiency (IAD) of pituitary origin. Magnetic resonance imaging of the hypothalamus and pituitary showed a normal-sized pituitary, with no mass lesion. The diagnosis of IAD probably secondary to lymphocytic hypophysitis (LYH) was made. IAD is able to be the way of presentation of LYH, although the disease could or could not turn into a panhypopituitarism. Prompt recognition of this potentially fatal condition is important because of the availability of effective treatment. Indeed, regular endocrine and imaging follow up is important for patients with IAD and normal initial pituitary imaging results to detect early new-onset pituitary hormones deficiencies or imaging abnormalities. PMID:24251125
Inflammatory myofibroblastic tumor (IMT) of the stomach in adults is extremely rare, with unpredictable prognosis. We present a 55-year-old woman with a gastric IMT. She experienced sudden abdominal pain 4 d previously. Physical examination showed mild abdominal tenderness in the hypogastrium, but no palpable abnormal abdominal mass. Abdominal CT showed a mass of approximately 8 cm in the gastrocolic ligament. On laparoscopic exploration, unexpected hemoperitoneum of approximately 1.5 L of blood was found, and an exophytic gastric mass of approximately 10 cm, appeared from the anterior wall of the gastric body along the greater curvature. Laparoscopy further showed that non-clotting blood in the abdominal cavity seemed to be from the gastric tumor. After conversion to open surgery for more precise evaluation of the cause of hemoperitoneum and the large friable tumor, gastric wedge resection, including the tumor, was conducted. The final diagnosis was consistent with IMT that originated from the gastric wall.
Park, Seong-Heum; Kim, Jong-Han; Min, Byung Wook; Song, Tae Jin; Son, Gil Soo; Kim, Seung Joo; Lee, Sang Woo; Chung, Hwan-Hoon; Lee, Ju Han; Um, Jun Won
The paper reports on the psychoanalytically-oriented psychotherapy of a very obese woman who, after a rather prolonged therapy, "decided" to reduce. During the weight loss process, significant reactions were noted from her son, daughter, brothers, sisters-in-law, customers, employees, husband, and therapist, which became crucial interferences with the continuing weight loss and specific resistances in the therapy. The identification of and the working through of these resistances significantly increased and consolidated her self-understanding. In that the response to major psychological changes was minimal as compared to the response to her physical change, it is hypothesized that physical change is more basically related to sense of self-continuity and hence more threatening to experience and observe. PMID:1052086
Context We report the autopsy of a 65-year-old woman who underwent a C3–C7 laminoplasty 4 years after the diagnosis of cervical spondylotic myelopathy (CSM). Her sensory disturbance, spasticity, and vesicorectal disturbance, which corresponded to long tract sign, had improved after surgery. Findings Cross sections at the C4–C5 level showed a triangular shape because of atrophied ventral gray matter. Moreover, despite the scarce glial scar formation around the cystic cavity, regeneration of gray matter had not occurred. In the white matter, the posterior and lateral funiculi were shrunken including three to four segments. Conclusion Pathological change of white matter did not coincide with relief of clinical symptoms in this case. These findings indicate that it may be better to operate earlier in cases of CSM, because delay may lead to irreversible histological change.
Background Ovarian mature cystic teratomas are common, benign, pelvic tumors that are easily detected by pelvic ultrasonography. However, patients with recurrent teratomas are rarely noted, and cases of bilateral teratomas are even less common. Case presentation A young woman with a recurrent, right ovarian teratoma had previously undergone surgical removal 2 times. After the second surgery, she underwent regular out-patient follow-up, and no residual tumor was observed. However, 3 years after the second surgery, she developed recurrent, bilateral ovarian teratomas, in conjunction with elevated carbohydrate antigen-125 levels. Conclusion Routine checking of the contralateral ovary during the surgical procedure along with frequent postoperative pelvic sonography for both ovaries in the patient at high recurrence rich is necessary. Additionally, the features of that kind tumor may mislead the surgeon into performing more extensive surgery that might compromise the fertility of young patients.
It has been reported that bone density is increased in patients with treated hypoparathyroidism, though it is unclear whether this increase is attributable to the condition itself or to its treatment. We have recently investigated a 70 year old woman with untreated hypoparathyroidism from the time of thyroid surgery at the age of 29 years. Bone mineral content of the non-dominant distal forearm was 3.7 standard deviations above the mean normal value found in 23 healthy volunteers of comparable menopausal age, and was also above the mean normal value found in premenopausal women. The vertebral mineral density of her lumbar spine (measured by quantitative computed tomography) was 3.0 standard deviations above the mean normal value. These findings suggest that high bone density is a feature of hypoparathyroidism per se and that postmenopausal bone loss may be significantly attenuated in this condition.
Orr-Walker, B.; Harris, R.; Holdaway, I. M.; Foote, G.; Reid, I. R.
A 38-year-old woman sought treatment with cranio-facial dysplasia involving the cranium, maxilla and the mandible. Her chief complaint was a mandibular swelling, which had appeared about 2 years previously, had gradually enlarged, and was associated with spontaneous pain. X-ray film examination revealed a ground-glass opacity with blurred demarcation and a 99 Tc medronate bone scan disclosed an increase in tracer uptake in the cranium, maxilla and mandible. The rest of the skeleton was not affected. Histological examination of the lesions revealed solid proliferation of spindle-shaped cells associated with islands of osteid and bone trabecullae with Chinese letter pattern and numerous multinucleated giant cells consistent with fibrous dysplasia. The continued osteoblastic activity of involved bones, coupled with the medical condition of the patient, restricted the management of the patient to largely supportive and palliative care. PMID:10483072
Hand pain is a relatively common complaint, and careful anamnesis and clinical examination may reveal its aetiology. Multiple joint involvement suggests either osteoarthritis or inflammatory arthritis. In the returning traveller, a more exotic explanation might be the case. A 31 year old woman was referred to our outpatient clinic for evaluation due to peripheral joint arthralgia. The symptoms started six months earlier, on the same day she returned from a three-week holiday in India. There were no signs of inflammatory arthritis or osteoarthritis. Blood tests were normal. Chikungunya virus serology was positive. The patient received symptomatic treatment with nonsteroid anti-inflammatory drugs and improved over a period of months. We describe the first case of Chikungunya fever diagnosed in our hospital. PMID:23160592
Power, Øystein Alexander; Brun, Johan Gorgas; Blomberg, Bjørn
Pellagra is a rare condition that has been known for many years to be related to niacin deficiency. Clinically known as the 4 "D" symptoms for dermatitis, diarrhea, dementia, and even death, skin changes remain one of the most important features of this pathology, leading frequently to the diagnosis. Pellagra is mostly seen in poor populations with a deficient diet; still, it is sporadically observed in developed countries, usually in association with digestive disorders. We report a new case of pellagra in a 29-year-old woman in whom the diagnosis of megaduodenum was made. Megaduodenum is a rare condition that can be idiopathic or secondary to visceral myopathy or neuropathy. Parenteral supplementation with niacin has resulted in a quick response of dermatological and psychiatric symptoms. To our knowledge, no case of pellagra due to megaduodenum has been reported in literature. PMID:23232750
Zaraa, Inès; Belghith, Ikram; El Euch, Dalenda; Karoui, Samy; Mokni, Mourad; Fillali, Azza; Ben Osman, Amel
Celiac disease (CD) is frequently associated with neurological disorders, but very few reports concern the association with ischemic stroke. A 26-year-old woman affected by CD with secondary amenorrhea, carrier of a homozygous 5,10-methylenetetrahydrofolate reductase mutation with hyperhomocysteinemia, was affected by two occipital ischemic strokes within a period of 5 mo. At the time of the second stroke, while she was being treated with folic acid, acetylsalicylic acid and a gluten-free diet, she had left hemianopsia, left hemiparesthesias, and gait imbalance. Brain magnetic resonance imaging showed a subacute right occipital ischemic lesion, which was extended to the dorsal region of the right thalamus and the ipsilateral thalamo-capsular junction. Antitransglutaminase and deamidated gliadin peptide antibodies were no longer present, while antinuclear antibodies, antineuronal antibodies and immune circulating complexes were only slightly elevated. Since the patient was taking folic acid, her homocysteine ??levels were almost normal and apparently not sufficient alone to explain the clinical event. A conventional cerebral angiography showed no signs of vasculitis. Finally, rare causes of occipital stroke in young patients, such as Fabry's disease and mitochondrial myopathy, encephalomyopathy, lactic acidosis and stroke-like symptoms, were also excluded by appropriate tests. Thus, the most probable cause for the recurrent strokes in this young woman remained CD, although the mechanisms involved are still unknown. The two main hypotheses concern malabsorption (with consequent deficiency of vitamins known to exert neurotrophic and neuroprotective effects) and immune-mediated mechanisms. CD should be kept in mind in the differential diagnosis of ischemic stroke in young patients. PMID:22807619
Celiac disease (CD) is frequently associated with neurological disorders, but very few reports concern the association with ischemic stroke. A 26-year-old woman affected by CD with secondary amenorrhea, carrier of a homozygous 5,10-methylenetetrahydrofolate reductase mutation with hyperhomocysteinemia, was affected by two occipital ischemic strokes within a period of 5 mo. At the time of the second stroke, while she was being treated with folic acid, acetylsalicylic acid and a gluten-free diet, she had left hemianopsia, left hemiparesthesias, and gait imbalance. Brain magnetic resonance imaging showed a subacute right occipital ischemic lesion, which was extended to the dorsal region of the right thalamus and the ipsilateral thalamo-capsular junction. Antitransglutaminase and deamidated gliadin peptide antibodies were no longer present, while antinuclear antibodies, antineuronal antibodies and immune circulating complexes were only slightly elevated. Since the patient was taking folic acid, her homocysteine ??levels were almost normal and apparently not sufficient alone to explain the clinical event. A conventional cerebral angiography showed no signs of vasculitis. Finally, rare causes of occipital stroke in young patients, such as Fabry’s disease and mitochondrial myopathy, encephalomyopathy, lactic acidosis and stroke-like symptoms, were also excluded by appropriate tests. Thus, the most probable cause for the recurrent strokes in this young woman remained CD, although the mechanisms involved are still unknown. The two main hypotheses concern malabsorption (with consequent deficiency of vitamins known to exert neurotrophic and neuroprotective effects) and immune-mediated mechanisms. CD should be kept in mind in the differential diagnosis of ischemic stroke in young patients.
Abstract We aim to present the first case of a pregnancy achieved by administering sildenafil (Viagra) to a woman not responding to controlled ovarian hyperstimulation (COH) with the sole use of gonadotropins. A 37-year-old woman underwent COH, as part of an intracytoplasmic sperm injection (ICSI) cycle, with the combination of r-FSH and HMG for 13?d, without evidence of follicular growth. The addition of oral sildenafil at a dose of 50?mg per day for a total of five doses improved the ovarian response and resulted in the retrieval of 10 oocytes. Three embryos were transferred to the uterine cavity resulting in a successful pregnancy and, eventually, the delivery of a healthy neonate. Conclusively, the use of sildenafil as an adjunct to COH protocols may enhance ovarian response in a woman with poor ovarian response (POR) and merits further research. PMID:24617843
We report on the case of a severely osteoporotic elderly Japanese woman with bisphosphonate-associated osteonecrosis of the jaw (ONJ), who was treated successfully with teriparatide. A 79-year-old woman with severe osteoporosis and bisphosphonate-associated ONJ was treated with teriparatide after debridement of the necrotic tissue in the jaw bone. Computed tomography (CT) images revealed the bone defect in the mandible after debridement of the necrotic tissue associated with ONJ. According to the attending dentist, the ONJ healed after 2 months of therapy. After 3 months of treatment, a robust increase in the serum level of the bone formation marker, serum intact procollagen type 1 N-terminal propeptide, was noted and a repeat CT revealed improvement of the bone defect of the mandible. These results suggest the beneficial effects of teriparatide therapy in the severely osteoporotic elderly woman with ONJ. PMID:22734599
Objectives To report a twin pregnancy achieved by assisted reproductive techniques in a woman with severe congenital bicuspid aortic\\u000a valve stenosis.\\u000a \\u000a \\u000a \\u000a Methods Intracytoplasmic sperm injection and embryo transfer was performed in a 38-year-old woman with a complaint of infertility\\u000a for 8 years due to male factor and who previously had the diagnosis of severe congenital bicuspid aortic stenosis. Clinical\\u000a and echocardiography follow-up during
Cemal Tamer Erel; Sanli Erkan; Omer Yavuz Simsek; Serdar Kucukoglu
Background: The vaginal contraceptive ring is a hormonal contraceptive that releases etonogestrel and ethinyl estradiol. Cerebral venous sinus thrombosis (CVST) is a rare but serious complication of hormonal contraceptive use. Case: We present a case of CVST in a 33-year-old nulligravid woman who was using a vaginal contraceptive ring. At the time of presentation, she had been using the ring
This article demonstrates how one woman's identity changed as she was empowered through her participation in a sewing cooperative community of practice. A community of practice framework allows examination of participation in ongoing negotiated interactions in which people construct expert and novice identities as they work together. Identity, as…
For high school and adult readers this autobiography of Polingaysi Qoyawayma (Elizabeth Q. White) relates a Hopi Indian woman's struggle to adjust to an alien culture and to develop teaching methods to bridge the gap between Indians and the white world. Information on Hopi legends and ceremonies introduce the reader to the Hopi way of life. Born…
The case of an 18-year-old woman with a 47,XY,+13 karyotype in lymphocytes and a 45,X0 karyotype in all other tissue analyzed is presented. The proposita shows no stigmata of the Patau syndrome and no masculinization. PMID:2737672
Anatomical models of pregnant women are used in several applications, such as numerical dosimetry, to assess the potential effects of electromagnetic fields on biological tissues, or medical simulation. Recent advances in medical imaging have enabled the generation of realistic and detailed models of human beings. The construction of pregnant woman models remains a complex task, since it is not possible
Lazar Bibin; J. Anquez; J. P. de la Plata Alcalde; T. Boubekeur; E. D. Angelini; I. Bloch
We report on a woman with malignant mesothelioma of the peritoneum. This is the first report of a subject with this disease who revealed a history of asbestos ingestion by asbestos-contaminated food. She presented with episodes of sweating and fever, ascites, and weight loss. At laparotomy, small tumor deposits were noted on the peritoneum. The omental cake was removed, together
P. J. M. van Kesteren; J. Bulten; C. P. T. Schijf; H. Boonstra; L. F. A. G. Massuger
Although physical activity can have substantial mental and physical health benefits, people with cerebral palsy usually lead sedentary lives. To understand, at an individual level, this inactivity, we interviewed a 29-year-old minimally active woman with cerebral palsy (Alana) about the meanings and experiences of physical activity throughout her…
Gaskin, Cadeyrn J.; Andersen, Mark B.; Morris, Tony
Discusses recent feminist theory, in particular feminist theory related to "cyborg" identity and examines some media representations of a woman-of-color superintendent. Suggests that the cyborg image offers alternative ways to consider the issue of diversity and educational leadership, including the superintendency. (Author/SLD)
While Hanoch Levin's dramatic works have received, and rightly so, considerable critical attention, his prose works have earned (relatively) scant critical analysis. This paper attempts to analyse Hanoch Levin's second and last collection of prose pieces—??? ???? ?????? ??? ????? (A man standing behind a seated woman)—in which some of the traits characteristics of his prose have reached their consummate
In this autobiography, Lori Arviso Alvord describes her journey to become the first Navajo woman surgeon and her realization of the benefits of Navajo philosophy to the healing process. Raised on the Navajo reservation by a White mother and a Navajo father and grandmother, Alvord learned to walk in two worlds. Encouraged to get an education, she…
This essay demonstrates Austen's ability to combine two ironical ideologies in her simple romantic stories, using the basic ideological principles to promote her central concern. Austen recreates her cultural society realistically to the extent that it takes her readers into middle class Georgian England characterized by conflicts of dominance, and the question of the woman's puritism, her worth, and romantically,
The purpose of this case/phenomenological study was to examine a collegiate administrative search and selection process and the experience of an African American woman who was selected to the position of chancellor. A case concerning the search process of a regional campus of Ivy Tech Community College of Indiana was identified and chosen.…
Rosai-Dorfman disease is a rare entity predominantly affecting children and young adults, characterized in 83-95% of cases by painless bilateral cervical lymphadenopathy. We report the unusual case of a 41-year-old woman with Rosai-Dorfman disease that presented as a solitary lesion of the radius without other clinical manifestations.
We describe the first case of hip prosthetic infection due to Lactococcus garvieae. The patient, a 71-year-old woman fishmonger, developed a hip infection 7 years after total hip arthroplasty. The origin of infection was possibly due to the manipulation or intake of seafood or fish contaminated with Lactococcus garvieae. PMID:21367987
We describe the first case of hip prosthetic infection due to Lactococcus garvieae. The patient, a 71-year-old woman fishmonger, developed a hip infection 7 years after total hip arthroplasty. The origin of infection was possibly due to the manipulation or intake of seafood or fish contaminated with Lactococcus garvieae.
The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 school children in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. Journal availability: British Medical Journal, 1172 Commonwealth Ave., Boston, MA 02134. (Author)
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.
Proceedings of a 1975 conference on child care and the working woman for representatives from national women's organizations, child advocacy groups, labor unions, religious and consumer associations, and private individuals are contained in this report along with a summary of the 1975 report of the subcommittee on social services and welfare and…
The value of systematic mammographic screening has been studied in a total of 11 randomized trials - some of doubtful methodological quality - on various populations of women; the earliest dates from the 1960s. However, older women have been under-represented in these trials, as only six of them registered patients over 60 years of age. The proportion of women aged over 70 years was low and there are no data for patients older than 74. Several meta-analyses have been conducted and a plausible estimate of the impact of screening is a 16% reduction in breast cancer mortality (95% confidence interval 9-23%). Some meta-analyses provide "post hoc subgroup analyses" by age and these have found a greater benefit of screening for women of older age, with estimates of risk reductions of 17%, 27% and 22% for cohorts of women aged 55-64, 60-69 and 65-74; these figures are significantly different from 0. In comparison, for women in the age groups 40-49, 45-54 and 50-59 the estimated risk reductions were 9%, 7% and 12%. Nevertheless, there has been no formal demonstration of an interaction with age. When these estimates are translated into the number of women who need to be screened in order to avoid one death from breast cancer during 15 years of follow-up, the figure lies between 1370 and 4120. The probability of not dying from breast cancer within 15 years of screening for a 65-year-old woman is estimated to be in the range 98.85-99.11%, compared with 98.73% for a woman who does not undergo screening. These benefits should be balanced against the possible disadvantages of screening, including false positive results, overdiagnosis and overtreatment. One of the meta-analyses concluded that the rate of total mastectomies was significantly increased after screening. Although most scientific recommendations agree that screening should be proposed to all women aged 50-69 years, the benefits and disadvantages of mammography should be fully explained, in order to allow them to make a truly informed decision. PMID:20451335
A middle-aged woman was admitted to the hospital after being found unconscious at home. A brain CT scan excluded an intracranial bleed or other focal abnormality. Laboratory analysis showed hyponatraemia (sodium: 121 mmol L(-1)) and a low plasma osmolality, with normal sodium excretion and urine osmolality. A diagnosis of hyponatraemic coma was made. The patient was treated with water restriction; 24 h later the sodium was 135 mmol L(-1) and the patient was neurologically fully recovered. The patient, who suffered from von Willebrand's disease, had received desmopressin and ibuprofen for analgesia 2 days before after a dental intervention. She had received desmopressin several times in the past without any complications. A few patients treated with desmopressin for coagulation abnormalities have been reported to develop water intoxication and severe hyponatraemia resulting in seizures and coma. By inhibiting prostaglandin synthesis, non-steroid anti-inflammatory agents (NSAIDs) potentiate the effect of water reabsorption in the renal tubules of vasopressin, therefore enhancing water retention. Desmopressin and NSAIDs should not be used in combination in patients with bleeding disorders, but it is often followed in clinical practice. In addition, this is probably not an unusual situation in patients treated with desmopressin for other 'non-haemorrhagic' indications. This report emphasizes the need for practitioners to be aware of this rare but severe complication. PMID:12614377
Gomez García, E B; Ruitenberg, A; Madretsma, G S; Hintzen, R Q
We present a case of plasma cell predominant lymphoplasmacyte-rich meningioma with numerous crystalline inclusions. A 72-year-old woman presented with 1-year history of memory disturbance and an MRI revealing a right frontal extra-axial mass. Histology showed a benign meningioma with multifocal accumulation of numerous large cells with abundant eosinophilic cytoplasm, filled with lamellar inclusions and bipyramidal crystals. In addition, some classic plasma cells, mastocytes and lymphocytes were also detected. The crystal-containing cells were positive by CD79a and PGM1 and expressed polyclonal light chains, with kappa predominance. Electron microscopy showed crystals with needle or rectangular shape in plasma cells. Plasma cell inclusions have been reported occasionally in reactive inflammatory lesions but more frequently in plasma cell tumors and lymphoplasmacytic lymphoma, maybe associated with crystal-storing histiocytosis. Although plasma cell predominant lymphoplasmacyte-rich meningioma is not uncommon, to our knowledge, similar crystalline inclusions in plasma cells have not been reported previously in meningioma. PMID:18363938
INTRODUCTION Prevalence of multiple primary malignancies is slowly increasing due to prolonged survival of cancer patients with advances in diagnostic and therapeutic modalities. The reasons may be environmental modifications, genetic predisposition or therapy induced. We describe a case of a 64-year-old woman with three different metachronous primary malignancies managed at our center since 4 years. PRESENTATION OF CASE First primary diagnosed in our patient was adenocarcinoma of small intestine which is a rare gastrointestinal malignancy. For this she underwent surgical resection followed by chemotherapy. After 21 months she developed infiltrating duct carcinoma of breast which was managed with modified radical mastectomy and chemotherapy. Again after latent period of 10 months patient had papillary adenocarcinoma of ovary for which she was administered chemotherapy. During follow up tumor was found to be chemoresistant and again she underwent cytoreductive surgery followed by chemotherapy. DISCUSSION In present case patient did not have significant risk factors for development of carcinoma of small intestine, breast and ovary. Our patient underwent surgical excision three times and received total 16 chemotherapy cycles of different regimens during management of all three primary malignancies. Development of second and higher order primary malignancy after successful management of previous one should be always kept in mind. CONCLUSION Awareness, suspicion of multiple primary malignancy and aggressive diagnostic work up plays crucial role in their detection at earlier stage for better outcome. In addition choice of appropriate chemotherapeutic agents and their regimens remains the cornerstone while managing the patients with multiple primary malignancies.
A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th(10-11) in the epidural space, accessed via the L(2-3) interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day. After she had experienced several chemical abortions, finally she got pregnant via artificial insemination. She had an uneventful delivery of a healthy baby by cesarean resection under spinal anesthesia. In a patient with CRPS who has an implanted SCS system and wishes to get pregnant, the electrode lead into the low thoracic epidural space should be accessed via the high lumbar intervertebral space in consideration of a future requirement for spinal or epidural anesthesia for cesarean section. The generator should be placed in the buttock to prevent impairment of the SCS system being caused by the enlarged abdomen during pregnancy. Although we were apprehensive of adverse effects owing to the electromagnetic field force and change of blood flow in the pelvic viscera, our patient had a successful delivery. SCS is a favorable option for patients with CRPS who wish to get pregnant. PMID:23011119
Introduction Mucinous cystadenoma of the liver is a rare (less than 5%) neoplasm. This condition is more common in young women and accounts for non-specific symptoms. Cyst adenomas commonly affect the intrahepatic system (90%) and are rarely found in the extrahepatic biliary system or affecting both the systems. Case presentation A 39-year-old Sinhalese woman presented with features of obstructive jaundice and was found to have a biliary neoplasm on imaging. In the absence of a definitive diagnosis despite extensive imaging she underwent preoperative endoscopic biliary drainage followed by a left hemihepatectomy with Roux-en-Y hepaticojejunostomy. A pathological examination of the specimen revealed an obstruction of the bile duct caused by a biliary mucinous cystadenoma affecting both the intrahepatic and extrahepatic systems. Conclusions Biliary mucinous cystadenoma rarely present with obstructive jaundice affecting both intrahepatic and extrahepatic ducts. Exhaustive investigation might not help in the diagnosis and may need to be treated based on clinical judgment. The definitive treatment modality is surgery due to its malignant potential. The operative procedure is technically demanding and is best performed at specialist centers to minimize complications.
Injuries caused by glass occur frequently, in particular in children, and make up an estimated 3% to 5% of all emergency visits, most frequently involving lacerations of hands, feet, and face. About 30% to 40% of glass injuries occur at home and often involve so-called architectural glass or bottles and glass containers. Accidents reported in association with showering mostly refer to falls or scalding by hot water. However, an increasing number of shower screens are made of tempered glass, which may potentially brake. Such injuries may be potentially severe, causing laceration of extremity arteries; requiring hospitalization or outpatient treatment for injuries; causing absence from work. These injuries are likely underreported in the medical literature but could have potential medicolegal consequences for the patient. We report a case of multiple lacerations developed in a third-trimester pregnant woman caused by the spontaneous shattering of a shower screen glass and discuss the apparent unawareness to this potential hazard in the scientific literature. PMID:19091281
Patient: Female, 70 Final Diagnosis: Chronic Heaptitis C Symptoms: Coma Medication: — Clinical Procedure: Plamapheresis Specialty: Neurology Objective: Unusual clinical course Background: Hepatitis C Virus (HCV)-related chronic hepatitis can be associated with mixed cryoglobulinemia (MC). Although several MC cases have been described, the wide variety of symptoms often makes diagnosis challenging. Case Report: We describe a sudden onset of coma in a 70-year-old woman with an undiagnosed chronic hepatitis C infection related to MC. Head CT did not show any important pathology. Laboratory tests showed leucocytosis, but it was not possible to identify any pathogenic microorganism. Examination of cerebrospinal fluid did not show any pathology. There was a strongly positive test result for rheumatoid factor (409 U/l) and hypocomplementemia (C4 0.04 g/l). Laboratory assay was positive for antibodies against HCV and HCV RNA. The cryoglobulins were positive and after treatment with plasmapheresis her conditions improved. Conclusions: In this case, the cryoglobulins laboratory exam was very helpful for the diagnosis. This test could be considered in the early management of elderly patients with sudden onset of coma.
Pagano, Gennaro; Komici, Klara; Femminella, Grazia Daniela; de Lucia, Claudio; Ianniciello, Marta; Leosco, Dario; Ferrara, Nicola; Rengo, Giuseppe
We have investigated a woman and her daughter with an early onset, slowly progressive myopathy. Muscle biopsy showed in both cases severe atrophy with marked fatty replacement. Frequent fibers with internalized nuclei were present but no typical features of centronuclear myopathy. There were also many fibers with deep invaginations of the plasma membrane. The presence of necklace fibers provided clue to correct genetic diagnosis. Both patients had a novel heterozygous splice site mutation in the myotubularin gene, MTM1 (c.867+1G>T). Analysis of MTM1 cDNA revealed that the mutation resulted in aberrant splicing with variable exon skipping. The expression of normal transcripts was markedly reduced and there was reduced expression of myotubularin protein. Although the expression of the allele without the mutation was reduced we did not obtain evidence of skewed X-chromosome inactivation. Other factors than skewed X-inactivation may cause allele inactivation and manifestation of severe myopathy in heterozygous carriers of pathogenic MTM1 mutations. PMID:22101172
Hedberg, Carola; Lindberg, Christopher; Máthé, Gyöngyvér; Moslemi, Ali-Reza; Oldfors, Anders
The Women On the Move through Activity and Nutrition (WOMAN) Study is the first randomized clinical trial of nonpharmacological intervention designed to modify lipoproteins, weight loss and exercise among postmenopausal women using noninvasive measures of atherosclerosis as the primary endpoint. The trial was initially designed to test whether intervention as compared to health education would be more effective in slowing progression of subclinical atherosclerosis among women on hormone therapy (HT), estrogen or estrogen+progestin. It was designed and implemented prior to the results of the Women's Health Initiative (WHI). The trial was since modified to include women who had been on HT but went off after the results of the WHI were reported. Eligible women were between the ages of 52-62, had waist circumference ?80 cm, low density lipoprotein cholesterol between 100-160 mg% and controlled blood pressure. The intervention is low in total and saturated fat, trans fats, higher in fiber and promotes loss of 7-10% of body weight and includes at least 150 minutes of physical activity per week. The study has recruited 508 women. The primary endpoints are change in extent of carotid intima media wall thickness as measured by carotid ultrasound, pulse wave velocity as a measure of vascular stiffness and coronary artery calcium using electron beam computed tomography. Body composition is measured by dual-energy x-ray absorptiometry.
Kuller, Lewis H.; Kriska, Andrea M.; Kinzel, Laura S.; Simkin-Silverman, Laurey R.; Sutton-Tyrrell, Kim; Johnson, B. Delia; Conroy, Molly B.
A 39-year-old woman was admitted to hospital due to perforated relapsing duodenal ulcer. Clinical, laboratory, and surgical examinations revealed a peripancreatic lymph node gastrinoma as the cause of Zollinger-Ellison syndrome. Further examinations established multiple endocrine neoplasia type 1 (MEN1) with a germline mutation at codon 1153 (T->A) in exon 7, causing an amino-acid change, from isoleucine to asparagine (Ile348Asn), in the MEN1 gene. The following findings strongly supported a diagnosis of primary lymph node gastrinoma: a rapid fall of the serum gastrin level after operation, the continuous normalization of the serum gastrin level before and after secretin stimulation, the lack of any symptoms, and the absence of another tumor for 13 years after surgical resection of the tumor-bearing lymph node. A review of similar cases in the world literature reveals that not all gastrinomas in lymph nodes are the result of metastastic spread. A long-term symptom-free follow-up after the excision of a lymphnode gastrinoma is the only reliable criterion for the diagnosis of a primary lymph node tumor. To our knowledge, this is the only well-documented case of a primary lymph node gastrinoma in a patient with MEN1. Our case supports the idea that any gastrinoma in patients with MEN1 should be surgically resected for cure if possible. PMID:17013727
Cherubism is classified within the group of benign osteo-fibrous lesions. Aside from facial deformities, it may account for major complications. It has been observed that the disease is caused by a mutation in the gene SH3BP2 (SH3-domain binding protein 2), which is located at chromosome 4pl6.3. Here we present two cases of familial cherubism, uncle and nephew, with variable clinical involvement (“Expressivity”), and one case of a woman (sister and mother, respectively), who transmitted cherubism without suffering the disease. In this article we have shown that, in familial cherubism cases, the mutation is inherited through an autosomal dominant transmission. Mutations affecting gene SH3BP2 cause variable clinical involvement (variable expressivity), involvement can be moderate, severe or may result merely in asymptomatic carriers. Since the possibility of transmission reaches 50% of chances, we believe that it is important to develop genetic counseling for both patients and carriers, in order to prevent or minimize new affected offspring.
Survival beyond the age of 10 years is rare among 18-trisomic individuals. Most of these long-term survivors, when more than one tissue is studied, are normal/trisomy mosaics. They are usually mentally severely retarded with a variety of anomalies. There is another group of mosaic individuals: 7 women and a 13-year-old girl, with a low frequency of 18-trisomic cells, normal or mildly retarded intelligence, and minor anomalies. Two of them were diagnosed after delivering malformed stillborn infants. One of them was the mother of a trisomy 18 patient who was coincidentally found to have trisomy 18 mosaicism. Pigmentary dysplasia, previously called hypomelanosis of Ito, is a disorder with linear, swirly, or patchy, hypo- or hyperpigmented areas of skin, resulting from migration and interaction of melanoblasts of different pigmentary potential. The disorder is often accompanied by mosaic chromosomal abnormalities, including mosaic trisomy 18. Here we report a 26-year-old woman with low frequency trisomy 18 mosaicism, normal intelligence, and pigmentary dysplasia, who gave birth to an 18-trisomic girl. 12 refs., 1 fig.
Ukita, Masahiko; Hasegawa, Masaaki; Nakahori, Takashi [Kurashiki Central Hospital (Japan)] [Kurashiki Central Hospital (Japan)
Angiography is a useful diagnostic tool in cases with massive gastrointestinal bleeding such as angiodysplasia and varicosis when endoscopy is not available. Angiodysplasia and varicosis have distinguishable characteristic features on angiography, such as the presence of a nidus, visible late-draining veins, and the typical vascular tuft. We recently treated a rare case of congenital angiodysplasia without the characteristic angiodysplasia features on angiography. Instead, the patient presented with a very rare case of idiopathic jejunal varicosis. A 42-year-old woman visited the emergency room with the chief complaint of melena for three days and a hemoglobin level of 5.9 g/dL. An abdominal CT angiogram showed varicosis at the jejunal mesentery. Angiography of the superior and inferior mesenteric arteries showed tortuous and dilated jejunal and ileal branches during the venous phase, suggesting a vascular malformation such as varicosis of the jejunum. Surgical exploration with intraoperative endoscopy revealed diffuse engorged veins and a 1.0-cm-diameter superficial ulcer covered with a blood clot that was 70 cm from the ligament of Treitz. A 100-cm segment of jejunum was resected. Histological examination revealed that the lesion was angiodysplasia, not varicosis. The final diagnosis was congenital angiodysplasia.
Uhm, Min Sik; Kim, Nayoung; Nah, Jong Chun; Jung, Youn Mu; Kang, Sung-Bum; Kim, Duck-Woo; Kim, Baek-hui; Kang, Sung-Gwon
This study focused on the experience of a young woman with breast cancer and sought to understand the progression of her falling ill, dying and death based on the significance attributed to the events of her life. It concentrates on the idea that one dies from how one has lived and in the way that a new meaning is attributed to this life over the course of time. It is qualitative research that is presented as a situational study that enabled the construction of Beth's Life Line using her Life History in which, judging from her narratives, events considered significant by her and that confirmed her way of living, stand out and are reflected in her death. Besides the detailed description of how the interview meetings occurred, it also discusses two central categories of the study, called "Ebbing of life - the small deaths experienced by Beth" and "Beth living out her dying and death." The study emphasizes the need for the health professionals to assume responsibility for a kind of care that does not only seek a cure, but also focuses on the human dimension, aiming to ensure well-being and maintenance of life, while this is still possible. PMID:23989574
Dolina, Janderléia Valéria; Bellato, Roseney; de Araújo, Laura Filomena Santos
Patients with fever, flank pain, and dysuria frequently are encountered in the emergency department. Acute pyelonephritis is the most likely diagnosis; however, its clinical and radiologic presentation consistently overlap with that of acute renal infarction. Ultrasound is unable to distinguish early infarction from nonabscessed acute pyelonephritis. Hence, computed tomography or magnetic resonance imaging are needed. We report the case of a 68-year-old woman who presented with fever, flank pain, and dysuria, along with respiratory distress and tachycardia. Elevated values for inflammatory indexes suggested a diagnosis of acute pyelonephritis, and subsequent contrast-enhanced computed tomography showed hypodense wedge-shaped areas in both kidneys. However, the presence of a thin rim of capsular enhancement (cortical rim sign), the absence of perirenal inflammatory changes, and the location of the lesions apart from defined calyces suggested the alternative diagnosis of renal infarction. The underlying cause was not identified until an episode of acute dyspnea revealed paroxysmal arrhythmia. Our case demonstrates that a thorough knowledge of the imaging findings of renal infarction and acute pyelonephritis is essential to correctly making the diagnosis. PMID:24767880
Piccoli, Giorgina B; Priola, Adriano M; Vigotti, Federica N; Guzzo, Gabriella; Veltri, Andrea
Risk-reducing salpingo-oophorectomy for reducing future cancer risk in women with hereditary breast and ovarian cancer syndrome is rarely performed in Japan; therefore, the cancer preventive effect of risk-reducing salpingo-oophorectomy for hereditary breast and ovarian cancer syndrome among the Japanese population remains unclear. Here, we report the first case of serous tubal intraepithelial carcinoma identified through a risk-reducing salpingo-oophorectomy in a Japanese woman with hereditary breast and ovarian cancer syndrome and who had a deleterious germline mutation of E1214X in BRCA1, but not a BRCA2 mutation. A pre-operative examination revealed multiple uterine leiomyomas but no adnexal mass. Robotic-assisted bilateral salpingo-oophorectomy together with hysterectomy was performed. A pathological examination identified serous tubal intraepithelial carcinoma in the right fallopian tube with no dissemination. Serous tubal intraepithelial carcinoma is implicated as an origin of invasive cancer of the fallopian tube with peritoneal dissemination; prophylactic salpingo-oophorectomy is currently the only method to identify this occult cancer. Our case demonstrated that risk-reducing salpingo-oophorectomy can detect occult cancers, including serous tubal intraepithelial carcinoma, thereby preventing future cancer development in the Japanese hereditary breast and ovarian cancer syndrome population. PMID:24719479
INTRODUCTION The development of empyema as a result of an intra-abdominal pathology is a rare condition. PRESENTATION OF CASE We present a 31-year-old woman at 28 weeks’ gestation who was referred to our hospital with diagnosis of pneumonia with pleural effusion. She presented with signs of septicemia and fetal distress. A thoracic-abdominal-pelvic CT-scan showed a right pleural effusion with a retroperitoneal collection in contact with the pleural space. Due to her critical condition, immediate surgical exploration and pregnancy interruption was decided. The fetus was delivered by cesarean with satisfactory vitality. After abdominal exploration, a retrocecal appendicular abscess was evidenced and appendectomy was performed. Subsequently, the right chest was accessed through a posterolateral thoracotomy. An empyema with lung abscess and purulent fluid accessing from the retroperitoneum at the posterior pleural space was found. Due to parenchymal compromise, a right inferior lobectomy was performed. The patient had an uneventful recovery and was discharged at postoperative day 10. DISCUSSION A septic condition in a pregnant patient with significant thoraco-abdominal infection requires an aggressive approach, with interruption of pregnancy and urgent exploration of the chest and abdomen. CONCLUSION When an empyema is developed in absence of lung disease or other intrathoracic cause, intra-abdominal origin should be considered.
Dietrich, Agustin; Nicolas, Matias; Iniesta, Jose; Smith, David Eduardo
INTRODUCTION Spigelian hernias are a rare type of hernia through the Spigelian aponeurosis. Spigelian hernias are very uncommon and constitute only 0.12% of all abdominal wall hernias. These hernias are located in the aponeurosis of the internal oblique muscle and transverse abdominal muscle. PRESENTATION OF CASE A 30-year-old woman at 28 weeks’ gestation was admitted to the obstetrics department due to pain and swelling in the anterior abdominal right region. On inspection, we suspected either a lipoma, a spontaneous hematoma, a tumor of the abdominal wall, or a Spigelian hernia. A Doppler USG and abdominal and pelvic Magnetic Resonance Imaging revealed necrobiotic fibroma of the uterus in Spigelian hernia. The patient was started on dual analgesic and corticotherapy. Overall, the patient improved one week after the acute episode and had no further pain during her gynecologic follow-up. DISCUSSION We have reported a first case of Spigelian hernia that was complicated by uterine fibroid. The clinical presentation varies, depending on the contents of the hernial sac and the degree of herniation. MRI is the preferred method for accurately identifying masses of the abdominal wall. Our treatment options were based on the extent of the acute-phase reaction and the venous thrombosis. CONCLUSION It is important to differentiate this rare Spigelian hernia from other hernias as the treatment for this hernia is medical rather than surgical. Before the final choice of treatment is made, digestive surgeons should bear this rare hernia in mind.
Introduction This report documents a rare case of Chryseobacterium indologenes urinary tract infection in Senegal. Chryseobacterium indologenes is an uncommon human pathogen reported in hospital outbreaks in Taiwan and there have been some sporadic cases reported in Europe and in the USA mainly from immune-suppressed patients. Case presentation This case report describes a 42-year-old woman of Wolofa ethnicity who was hospitalized in our Department of Internal Medicine in a Senegalese university teaching hospital, with acute leukemia who died of severe sepsis 10 days following her hospitalization. A strain of Chryseobacterium indologenes isolated from her urine sample was resistant to several beta-lactams including ampicillin (minimum inhibitory concentrations ?256?g/mL), cefotaxime (minimum inhibitory concentrations 32?g/mL) and imipenem (minimum inhibitory concentrations ?32?g/mL), whereas it was susceptible to piperacillin (minimum inhibitory concentrations 16?g/mL), cefepime (minimum inhibitory concentrations 4?g/mL), ceftazidime (minimum inhibitory concentrations 4?g/mL), trimethoprim-sulfamethoxazole (minimum inhibitory concentrations ?0.25?g/mL) and all tested quinolones including nalidixic acid (minimum inhibitory concentrations ?2?g/mL). Conclusions Chryseobacterium indologenes although uncommon, is an important pathogen causing infection in hospitalized patients. The management of this infection needs better identification, drug susceptibility testing and monitoring of immunosuppressed patients with long hospitalizations.
To determine the attitude of the woman's attitude before of menopause an her relation with the climacteric symptom. Descriptive transversal, observational study through of survey structured to 425 patients in age of 50 years over, that attended to gynecology of May 1997 to July 1998, with natural menopause and antecedent of hormonoterapy for but of a year. It being investigated menopause age, at this moment appears 25 climacteric symptoms in agree to literature. Group A: patient's with positive attitude as compared to the menopause (180). The average age was 54.4 years and the age, which appears the menopause was 47.4 years. Group B: patient with negative attitude as compared the menopause (245). The average age of the patients was 53.2 years and the menopause age of 46.7 years. 57.6% of the patients expressed unfavorable concepts about the menopause. The frequent symptoms were fatigue, irritability, instability emotional, and depression. The have p > 0.001 in patient with negative attitude. The negative predisposition of the patient before the menopause favors the frequently of psychological symptoms. PMID:10496053
Rates of obesity in the United States have increased rapidly over the past several decades, and physicians should be prepared to care for obese patients in a nonjudgmental manner, being cognizant of the medical, social, and ethical implications of obesity. It is the responsibility of the physician to recognize the medical risks that are associated with obesity and to counsel the patient regarding these risks in an unbiased manner, respecting her autonomy and maintaining her dignity. Classifying obesity as a medical condition can serve to reduce bias toward obese patients and to change the approach toward the patient from one of blame to one of caring. It is unethical for physicians to refuse to accept a patient or decline to continue care that is within their scope of practice solely because the patient is obese. However, if physicians lack the resources necessary for the safe and effective care of the obese patient, consultation or referral or both are appropriate. Obesity education that focuses on the specific medical, cultural, and social issues of the obese woman should be incorporated into physician education at all levels. PMID:24848919
Disorders of the pulmonary lymphatic system include macro- and microcystic lymphatic malformations, primary or secondary lymphangiectasias, generalized lymphatic anomalies, diffuse pulmonary lymphangiomatosis, and combinations of lymphatic and other tissue anomalies, including lymphangioleiomyomatosis (LAM). We report a case of a patient with a newly defined entity classified as kaposiform lymphangiomatosis (KLA). This 50-year-old nonsmoking Hispanic woman presented with a 20-year history of cough, hemoptysis, chyloptysis, and pleuritic chest pain. Laboratory evaluation demonstrated a low normal platelet count, elevated d-Dimer, low normal fibrinogen, and elevated fibrin split products. Chest computerized tomography imaging showed enlarged hypodense lymph nodes in the mediastinum and hila, and peribronchovascular thickening, without evidence of cystic parenchymal lesions. Magnetic resonance imaging of the chest showed cystic mediastinal lymph nodes with heterogeneously increased T2 and decreased T1 signal intensity. Fiberoptic bronchoscopy revealed hyperemic mucosa with granular appearance suggestive of a submucosal infiltrative process. Pathological specimens revealed dilated, malformed lymphatic channels within the pleura, pulmonary septa, and bronchovascular bundles, and foci of perilymphatic and intralymphatic spindle cells which reacted with the Prospero homeobox protein 1 (PROX-1) immunostain. The morphology and immunohistochemistry results were consistent with a diagnosis of KLA. This newly recognized clinical-pathological entity among intrathoracic lymphatic anomalies is distinguished from generalized lymphatic anomaly and diffuse pulmonary lymphangiomatosis in part by characteristic hematological abnormalities and hemorrhagic complications, including hemoptysis, as experienced by our patient. PMID:24460439
Gynaecologic diseases unrelated to pregnancy are not generally associated with sudden death, which limits the number of case reports published in the field of forensic medicine. Presented in this paper is a fatal case in a middle aged woman with an early stage endometrial cancer and a series of gynaecologic diseases, in whom such typical features of sudden death were not applicable. Forensic autopsy revealed the hypoplasia of left circumflex coronary artery, Stage 1B endometrial cancer, endometriosis, polycystic ovary syndrome (PCOS) and micro pituitary adenoma, whereas histochemical analyses confirmed hyperprolactinemia and hyperestradiolemia. It was considered that the hypoplasia of coronary artery, chronic anaemia and electrolyte imbalance due to endometrial cancer all collaborated to induce acute cardiac failure. The association between prolactinoma, PCOS and endometrial cancer was also suggested, though they are rarely observed synchronously. It was speculated that the deceased had been anaemic for a substantial period of time and lacked clear subjective symptoms, which made the antemortem diagnosis of her underlying diseases difficult. Forensic pathologists must always consider the possibility of gynaecologic diseases taking significant part in a fatal cause of reproductive-aged women. PMID:24835015
An 18-year-old postpartum woman with HIV, on lamivudine-zidovudine, lopinavir-ritonavir and raltegravir, presented with a 1-week history of rash and fevers. Initially admitted to obstetrics and gynaecology service for treatment of possible endometritis, she was transferred to the HIV medicine service for high fever, respiratory distress, hypotension and tachycardia. On admission, she was febrile (102°F) with findings of cervical and submandibular lymphadenopathy, diffuse morbilliform rash, generalised pruritus, facial oedema, and oedematous hands and feet. Consultations to various specialty services were initiated to rule out infectious, dermatological, rheumatological and drug-induced aetiologies. On the fourth day of hospitalisation, laboratory findings of significant eosinophilia and hepatitis (alanine aminotransferase 147 IU/L and aspartate aminotransferase 124 IU/L), in conjunction with the identification of the timing of medication use, led to a diagnosis of DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome secondary to raltegravir. After discontinuing raltegravir and starting prednisone, her DRESS symptoms completely resolved. PMID:24798353
Yee, Brittany Elizabeth; Nguyen, Nghia Hoang; Lee, Daniel
A woman in her late-teens ran downstairs and out into the street to escape from violence by her boyfriend. She ran approximately 150 m and was suddenly collapsed immediately after stopping to call for help. She underwent cardiopulmonary resuscitation, which was unsuccessful. Autopsy revealed some minor injuries on the face, trunk and extremities. Meanwhile, the left coronary artery was originated from the right sinus of Valsalva, and the orifice had a slit-like appearance. Additionally, the main trunk of the left coronary artery coursed between the aortic sinus and the pulmonary trunk. Microscopically, the heart (240 g) showed small foci of contraction band necrosis and wavy changes. This type of coronary artery anomaly makes up only 0.0375% among all varieties of the anomaly according to a report of the US. However, it has a greater risk of sudden cardiac death during physical exercise. Taking the eyewitness testimony into account, we determined that the 150 m run at full speed, rather than the assault itself, had caused acute coronary insufficiency, leading the death of the decedent. PMID:19269230
Background Dementia is generally considered an irreversible process of cognitive decline that can be caused by different neurodegenerative diseases. However, in some cases, dementia is caused by a non-neurodegenerative disease, such as an affective disorder. In these cases, the dementia can be reversible. Nevertheless, cognitive symptoms due to an affective disorder are often difficult to distinguish from a depressed mood due to a neurodegenerative disease. Especially in elderly patients with a history of affective disorder, a potentially reversible cause can be missed. Case presentation We describe a 60-year-old white woman with bipolar disorder, depressive symptoms, a movement disorder and severe cognitive impairment, in whom a neurodegenerative disease was seriously considered. She was referred to our clinic for further investigation because initial treatment of the depressive episode with antidepressants, mood stabilizers and electroconvulsive therapy (ECT) had not been successful. However, despite extensive evaluation, we could not find evidence for a neurodegenerative disease and the patient mostly recovered after discontinuation of different psychotropic medications and treatment with nortriptyline. Conclusions Our case shows that improvement of severe cognitive impairment in individual cases is possible. In our opinion, this underlines the necessity of a careful re-evaluation of the patient’s symptoms at presentation and the course of the disease as well as a critical review of the prescribed medications.
Abernethy malformation is a rare anomaly with partial or complete congenital absence of the portal vein and subsequent development of extrahepatic portocaval shunts. We present the case of a 28-year-old woman who was incidentally diagnosed with type II Abernethy malformation and multiple aneurysms during an investigation for nonspecific abdominal pain and fever. The patient had been diagnosed with Caroli's disease at the age of 10 and liver cirrhosis, portal hypertension a few years before. To the best of our knowledge, this is the first case reported with all such congenital anomalies associated together. Ultrasound, computed tomography, including three-dimensional reconstruction, and magnetic resonance imaging were performed which revealed a side-to-side shunt between the extrahepatic portal vein and the inferior vena cava, multiple aneurismal cystic dilation of the spleen artery and left renal artery, and extensive intrahepatic bile duct cysitic dilation with calculus formation. Etiology, clinical significance and management strategies with regard to these abnormalities are discussed. PMID:23396746
Background Simulation as a pedagogical approach has been used in health professional education to address the need to safely develop effective clinical skills prior to undertaking clinical practice. However, evidence for the use of simulation in midwifery is largely anecdotal, and research evaluating the effectiveness of different levels of simulation fidelity are lacking. Woman centred care is a core premise of the midwifery profession and describes the behaviours of an individual midwife who demonstrates safe and effective care of the individual woman. Woman centred care occurs when the midwife modifies the care to ensure the needs of each individual woman are respected and addressed. However, a review of the literature demonstrates an absence of a valid and reliable tool to measure the development of woman centred care behaviours. This study aims to determine which level of fidelity in simulated learning experiences provides the most effective learning outcomes in the development of woman centred clinical assessment behaviors and skills in student midwives. Methods/Design Three-arm, randomised, intervention trial. In this research we plan to: a) trial three levels of simulation fidelity - low, medium and progressive, on student midwives performing the procedure of vaginal examination; b) measure clinical assessment skills using the Global Rating Scale (GRS) and Integrated Procedural Performance Instrument (IPPI); and c) pilot the newly developed Woman Centred Care Scale (WCCS) to measure clinical behaviors related to Woman-Centredness. Discussion This project aims to enhance knowledge in relation to the appropriate levels of fidelity in simulation that yield the best educational outcomes for the development of woman centred clinical assessment in student midwives. The outcomes of this project may contribute to improved woman centred clinical assessment for student midwives, and more broadly influence decision making regarding education resource allocation for maternity simulation.
Martha Washington ÃÂ¢Ã¢ÂÂ¬Ã¢ÂÂ a hot first lady?http://www.guardian.co.uk/world/2009/feb/04/martha-george-washington-computer-portraitFresh Look at Martha Washingtonhttp://www.washingtonpost.com/wp-dyn/content/discussion/2009/02/02/DI2009020201374.htmlRare Letter from Martha to George Washington Returns to Mount Vernonhttp://www.mountvernon.org/visit/plan/index.cfm/pid/508/Gilder Lehman Institute of American History: Martha Washington to Francis B. Washingtonhttp://www.gilderlehrman.org/collection/docs_archive/docs_archive_balance.htmlFirst Ladieshttp://www.whitehouse.gov/about/first_ladies/National First Ladies' Libraryhttp://www.firstladies.org/Looking at portraits from the past can only provide one a snapshot of the given subjects' life. If most people are familiar with an iconic image from the later years of a subject's life, that image may be how most people visualize and remember a figure. One only need think of someone like Benjamin Franklin to be reminded of this curious fact. Another such personage is Martha Washington, who people tend to think of as somewhat dowdy and a bit matronly. This image may change as a result of a rather interesting portrait of Martha Washington as a young woman, created by a team of forensic anthropologists at the Louisiana State University Forensic Anthropology and Computer Enhancement Services group. Drawing on contemporary accounts written during Washington's life and a miniature watercolor-on-ivory portrait of Washington in middle age, the team used age regressions to create an image of Washington in her 20s. This version of Washington reveals an elegant looking young woman, bedecked in a deep purple dress complete with silk high heels. One of the historians who wrote a recent biography of Washington (and who also assisted with the research for this new portrait) commented, "I wanted to rescue her from old-ladyhood." The first link will take visitors to a news article from this Wednesday's Guardian which reports on this new rendering of Martha Washington. The second link leads to the transcript of an online chat held by Washington Post writer Brigid Schulte where she answers readers' queries about Martha Washington and her life. Moving on, the third link will take readers to the text of one of the two extant letters written from Martha Washington to George Washington, courtesy of the Mount Vernon Ladies Association. The fourth link leads to the text of a letter written in 1789 by Martha Washington to her niece and illustrates her conflicting feelings about political life. The fifth link leads to the White House's official First Ladies page. Here visitors can learn about every First Lady from Martha Washington to Michelle Obama. Finally, the last link leads to the homepage of the National First Ladies' Library in Canton, Ohio.
Objective. To report one case of seizure following administration of ofloxacin. Case Summary. A 38-year-old woman with alcohol dependence but no prior history of seizure disorder admitted in our inpatient alcohol detoxification program was prescribed ofloxacin four days after admission for a lower urinary tract infection. She was currently prescribed diazepam 30?mg per day. This treatment was continued without modification following admission. Forty eight hours after starting ofloxacin and after receiving five doses of oral ofloxacin, the patient experienced a seizure. Ofloxacin treatment was stopped and no further seizures occurred. Neurological examination of the patient, laboratory tests, computerized tomography with contrast enhancement and electroencephalography did not detect any abnormalities. Up to the last consultation, six months after admission, the patient has reported no recurrence of the seizure. Discussion. Quinolone antibiotics vary in their ability to induce seizures, with ofloxacin having one of the least potentials. In the present case, the seizure could be attributed in all probability to taking ofloxacin; since she had no previous history of seizures, she did not present an alcohol withdrawal syndrome, benzodiazepine treatment was not modified, the seizure occurred 48?h after taking ofloxacin, but seven days after stopping drinking, no alternative aetiologies for the seizure could be identified and no seizure recurrence was reported over the following seven months. Of reported cases of seizures in patients treated with fluoroquinolones, none concerned patients with alcohol dependence or patients treated with benzodiazepines. Conclusions. The present case alerts us to the possibility that seizures may occur in alcohol dependent patients treated with benzodiazepines who concomitantly prescribed a fluoroquinolone. These widely-used antibiotics should thus be prescribed with caution to patients undergoing detoxification for alcohol dependence, particularly if they are also taking benzodiazepines, irrespective of whether they have a previous history of seizures or not.
A 32-year-old woman (148 cm, 59 kg, gravida 2, para 2) with quadruplet pregnancy was admitted to our hospital for the threatened preterm labor at 23 weeks and 2 days of gestation. She was treated with ritodrine, magnesium sulfate and nifedipine to maintain tocolysis. Betamethasone was administered to accelerate fetal lung maturity. After ritodrine dose was increased at 23 weeks and 5 days of gestation, she developed dyspnea with desaturation. Acute pulmonary edema was revealed on chest X-ray. The decision was made to proceed with emergency cesarean delivery. On arrival at the operating room, the blood pressure was 123/53 mmHg, heart rate 111 beats x min(-1), and oxygen saturation (SpO2) 84% with supplemental oxygen 15 l x min(-1) via a reserved face mask. Noninvasive positive pressure ventilation (NPPV) was initiated with S/T mode (FIO2 1.0, inspiratory positive airway pressure 10 cmH2O, expiratory positive airway pressure 6 cmH2O). The dyspnea was improved with her SpO2 100%. Spinal anesthesia was performed at L 34 using 2.5 ml of 0.5% bupivacaine and 100 microg morphine. Throughout the operation (operation time 44 minutes), she did not develop dyspnea under NPPV. NPPV was discontinued after the operation. Her SpO2 declined, and pulmonary edema on chest X-ray was exacerbated. She was transferred to the intensive care unit and NPPV was continued for 22 hours after the operation. She was discharged from the intensive care unit on the next day and was discharged from the hospital on the 6th postoperative day. PMID:24864580
The Women on the Move through Activity and Nutrition (WOMAN) study was designed to test whether a nonpharmacological intervention including qualitative and quantitative dietary changes to induce weight loss and increased physical activity levels would reduce blood triglyceride levels and number of low-density lipoprotein particles (LDL-P). Such decreases in lipoproteins and other risk factors could reduce or slow progression of subclinical cardiovascular disease (CVD). Study participants were randomized to either the intervention (Lifestyle Change) or assessment (Health Education) group. Most of the intervention ended at the 30-month visit. The last 48-month examination was completed in 9/2008. There was very substantial weight loss and increased exercise during the first 30 months of the trial resulting in significant decreases in CV risk factors. Most of the intervention effect was lost through 48 months. Weight loss was 3.4 kg in Lifestyle Intervention and 0.2 kg in the Health Education at 48 months (P = 0.000). There were no significant changes at 48 months in lipid levels, blood pressure (BP), glucose, insulin, or in the subclinical measures of coronary calcium, carotid intima media thickness, or plaque. There was a significant decrease in long-distance corridor walk time in the Lifestyle vs. Health Education groups. Significant lifestyle changes can be achieved that result in decreases in CV risk factors. Whether such changes reduce CV outcomes is still untested in clinical trials of weight loss or exercise. Long-term maintenance of successful lifestyle changes, weight loss and reduced risk factors is the hurdle for lifestyle interventions attempting to prevent CV and other chronic diseases.
Kuller, Lewis H.; Pettee Gabriel, Kelley K.; Kinzel, Laura S.; Underwood, Darcy A.; Conroy, Margaret B.; Chang, Yuefang; Mackey, Rachel H.; Edmundowicz, Daniel; Tyrrell, Kim S.; Buhari, Alhaji M.; Kriska, Andrea M.
Introduction We present the case of a patient with non-infectious osteomyelitis of the mandible, which is a recognized but unusual condition of unknown cause. Case presentation A 14-year-old Caucasian girl presented with pain and edema in the left side of her jaw. A clinical examination led to a diagnosis of osteomyelitis and she was treated with antibiotics. Our patient continued antibiotic treatment for osteomyelitis and underwent decortication. Histology based on a biopsy showed new bone formation and chronic inflammation, and a diagnosis of sclerotic osteomyelitis was made. Over the next few years, she experienced pain on the left side of her jaw and increasing edema, and the size of the left side of her jaw bone increased. She was then sent to our Department of Medicine at the age of 16 years. Her symptoms included pain in the left side of her jaw that scored 4 on a visual analogue scale of 1 to 10. A diagnosis of bone disease was made based on bone scintigraphy and single photon emission computed tomography that showed hot spots in the affected left side of the jaw. Our patient was treated with a single dose of intravenous zoledronic acid (5mg) at age 17 years, which was repeated after 12 months. The bone pain was significantly reduced six months after treatment and had disappeared 24 months after treatment. Conclusion We report an unusual localization of non-infectious osteomyelitis of the jaw in a young woman. Even though the presentation was in the jaw, her condition improved after intravenous bisphosphonate treatment, as evaluated by reduced clinical symptoms, bone turnover evaluation as assessed by biochemical bone markers, and reduced activity on bone scintigraphy.
The vaginal microbiota, in particular Lactobacillus species, play an important role in female health through modulation of immunity, countering pathogens and maintaining a pH below 4.7. We report the isolation and genome sequence of Lactobacillus pentosus strain KCA1 (formally known as L. plantarum) from the vagina of a healthy Nigerian woman. The genome was sequenced using Illumina GA II technology. The resulting 16,920,226 paired-end reads were assembled with the Velvet tool. Contigs were annotated using the RAST server, and manually curated. A comparative analysis with the available genomes of L. pentosus IG1 and L. plantarum WCFS1 showed that over 15% of the predicted functional activities are found only in this strain. The strain has a chromosome sequence of 3,418,159 bp with a G+C content of 46.4%, and is devoid of plasmids. Novel gene clusters or variants of known genes relative to the reference genomes were found. In particular, the strain has loci encoding additional putative mannose phosphotransferase systems. Clusters of genes include those for utilization of hydantoin, isopropylmalate, malonate, rhamnosides, and genes for assimilation of polyglycans, suggesting the metabolic versatility of L. pentosus KCA1. Loci encoding putative phage defense systems were also found including clustered regularly interspaced short palindromic repeats (CRISPRs), abortive infection (Abi) systems and toxin-antitoxin systems (TA). A putative cluster of genes for biosynthesis of a cyclic bacteriocin precursor, here designated as pentocin KCA1 (penA) were identified. These findings add crucial information for understanding the genomic and geographic diversity of vaginal lactobacilli. PMID:23527145
Anukam, Kingsley C; Macklaim, Jean M; Gloor, Gregory B; Reid, Gregor; Boekhorst, Jos; Renckens, Bernadet; van Hijum, Sacha A F T; Siezen, Roland J
We report the first case of primary solid pseudopapillary tumor of the ovary with aggressive behavior and fatal outcome in a 45-year-old woman. The patient presented with weight loss, decrease of appetite, and abdominal bloating for the last several weeks. Computed tomography scan revealed an ovarian mass, omental caking, complex ascites, and 2 hepatic lesions. The pancreas was unremarkable. Grossly, the ovarian mass showed severe capsular adhesion, and the cut surface was cystic and solid. On histologic examination, the tumor was composed of diffuse solid pseudopapillary and pseudocystic patterns. The neoplastic cells were uniform and round with very dispersed chromatin. The cytoplasm was faintly pink. There was mild atypia, but the mitotic rate was as high as 62 per 50 high-power field, and the Ki-67 was elevated at 20%. The tumor exhibited severe necrosis. Numerous foci of lymphovascular invasion were also seen. The tumor cells were positive for cytokeratin (focal) and for ?-catenin (cytoplasmic and nuclear patterns). They were negative for chromogranin, synaptophysin, thyroglobulin, calcitonin, hepatocyte-paraffin 1, epithelial membrane antigen, calretinin, and ?-inhibin. Electron microscopic study revealed nests of tumor cells with oval nuclei. The cytoplasm contained numerous pleomorphic mitochondria interspersed among short strands of rough endoplasmic reticulum. The tumor involved the fallopian tube, omentum, cul-de-sac, and abdominal wall. The pelvic washing was also positive for tumor cells. Despite chemotherapy, the patient's condition had worsened, and she died of her disease 8 months after the initial diagnosis. We discuss the differential diagnosis of this tumor and the hypothesis of its origin. PMID:21778097
The vaginal microbiota, in particular Lactobacillus species, play an important role in female health through modulation of immunity, countering pathogens and maintaining a pH below 4.7. We report the isolation and genome sequence of Lactobacillus pentosus strain KCA1 (formally known as L. plantarum) from the vagina of a healthy Nigerian woman. The genome was sequenced using Illumina GA II technology. The resulting 16,920,226 paired-end reads were assembled with the Velvet tool. Contigs were annotated using the RAST server, and manually curated. A comparative analysis with the available genomes of L. pentosus IG1 and L. plantarum WCFS1 showed that over 15% of the predicted functional activities are found only in this strain. The strain has a chromosome sequence of 3,418,159 bp with a G+C content of 46.4%, and is devoid of plasmids. Novel gene clusters or variants of known genes relative to the reference genomes were found. In particular, the strain has loci encoding additional putative mannose phosphotransferase systems. Clusters of genes include those for utilization of hydantoin, isopropylmalate, malonate, rhamnosides, and genes for assimilation of polyglycans, suggesting the metabolic versatility of L. pentosus KCA1. Loci encoding putative phage defense systems were also found including clustered regularly interspaced short palindromic repeats (CRISPRs), abortive infection (Abi) systems and toxin-antitoxin systems (TA). A putative cluster of genes for biosynthesis of a cyclic bacteriocin precursor, here designated as pentocin KCA1 (penA) were identified. These findings add crucial information for understanding the genomic and geographic diversity of vaginal lactobacilli.
Anukam, Kingsley C.; Macklaim, Jean M.; Gloor, Gregory B.; Reid, Gregor; Boekhorst, Jos; Renckens, Bernadet; van Hijum, Sacha A. F. T.; Siezen, Roland J.
Patient: Female, 32 Final Diagnosis: Chondroblastoma Symptoms: Pain Medication: — Clinical Procedure: — Specialty: Oncology Objective: Unusual clinical course Background: 1% of all bone tumors are Chondroblastomas. Chondroblastomas, initially considered to be an osteoclastoma variant are benign, cartilaginous tumors which usually occur in the epiphysis of long bones, especially in the humerus, tibia, and femur, most common in children and young adults between the ages of 10 and 20 years. 4% of all chondroblastomas settle in the talus whereas cuneiform and other tarsal bones are very rare sites for the development of this benign chondroid lesion. Case Report: A case of chondroblastoma involving the medial cuneiform of the left foot of a 32-year-old woman is described. The patient presented with moderate localized pain and tenderness over the medial aspect of her left foot. Radiographs showed a lytic expansile lesion within the right cuneiform bone indicating a bone tumor. Biopsy demonstrated cellular areas made up of round, polygonal cells, with round-oval nucleus and chondroblasts that appear with a thin calcification rim. Intralesional curettage and synthetic bone grafting with PRP (Platelet-Rich Plasma) application was performed for its treatment. After 18 month follow up, osteointegration was observed with the defect completely filled and the patient was free of disease and pain. Conclusions: A painful, expansile, thin, sclerotic lesion detected at the cuneiform should arise suspicion for chondroblastoma even at age over 20 years. Meticulous curettage of the lesion from a small window with removal of the lesion followed by injectable phosphocalcic cement application with autologous PRP can be considered as a curative and technically simple treatment method.
This abstract summarizes my research, transcription and editing of Francis Jacob's 170-page handwritten astronomical diary. This diary is a unique example of a time in early Portland history, illustrating the mind of a young woman who was interested in science and astronomy. Reflected in her diary are the discoveries and mention of leading astronomers of the day like Emerson Bernard and Edward Pickering. Francis Jacobs lived in an era of the great refractors For example, ``The Leviathan," built by Lord Rosse in Ireland was completed in 1847. In this 72-inch telescope, stars of 18th magnitude could be seen. The first spiral nebulae to be revealed was M51 - known today as the Whirlpool Galaxy. The Earl was the first to suggest that these spirals could actually be rotating masses of stars. At the turn of the century, study of observational astronomy was rooted in naked eye observing, study of binary stars and nebula. This was a time when women were becoming interested in the sciences and had begun to play an important role in science and astronomy. It was an incredible inspiration for other women across the country to hear what was happening on the astronomical frontiers at Harvard. Some constellation asterisms used in Francis Jacob's diary were different than they are today. One asterism in particular, the Egyptian Cross, is relatively unknown now. The summer triangle and winter circle asterisms were used in her notes and obviously popular in her era, as today. Her written comments included some Messier catalogue numbers and in some case written on her sketches and diagrams nicknames, such as the 'Dumbbell' nebula. She also referred to M99 as `St. Katherine's Wheel', a nickname that is not in common use today.
Introduction: Clitromegaly can be congenital or acquired with the former type being more prevalent. The main etiology behind the acquired type is hormonal imbalance affecting mainly adult women. This type is seen mostly in association with polycystic ovarian syndrome, hyperthecosis, ovarian tumors, and clitoral cysts or it can be drug-induced. Clitoral leiomyoma is a rare benign tumor of female genitalia and is an uncommon cause of clitromegaly. Case Report: We reported a 42-year-old premenopausal woman with a progressively increasing mass since five years ago, who had attended our clinic with urinary retention. It was a fungating mass with ulceration arising from the crus of the clitoris with the size was 11 × 9 cm. After detailed laboratory investigations, she had normal karyotyping. Hormonal assay for testosterone, dehydroepiandrosterone sulphate, and follicle stimulating hormone, luteinizing hormone, parathormone, and prolactin levels revealed values within the normal range. Twenty-four hours urinary excretion levels of free cortisol and ketosteroids were within normal limits. Beta-hCG level was also in normal range. Thyroid function tests and X-ray chest results were normal. Contrast enhanced computed tomography (CECT) of the abdomen showed no abnormality in adrenals and there was no pituitary enlargement on brain MRI. Pelvis MRI showed a large 11 × 9 × 8 cm clitoral mass. Diagnostic biopsy done from ulcer margin was suggestive of leiomyoma. The mass was completely excised preserving the tip of clitoris. The histopathology showed spindle-shaped cells arranged in palisading form. On immunohistochemistry, tumor cells were positive for smooth muscle actin (SMA) as well as for estrogen and progesterone receptor (ER/PR), confirming the diagnosis of leiomyoma. The patient was regularly followed, and was doing well with no voiding difficulty. Conclusions: We reported the world largest clitoral leiomyoma presenting with symptoms of acute urinary retention. MRI has important role in diagnosis and biopsy is confirmative with spindle-shaped cells arranged in palisading pattern and simple excision would be curative.
Introduction Pneumomediastinum is known to occur during labor. Patients typically present with chest pain and symptoms may be suspicious, for example of pulmonary embolism or aortic dissection. The condition itself, however, is rather harmless and self-limiting. Takotsubo cardiomyopathy is associated with psychologically or physiologically stressful events and its symptoms mimic myocardial infarction. Yet, symptoms often improve quickly as the initially impaired cardiac function is usually restored within days or weeks. Although the initial presentation of the patient in this case report was dramatic, the clinical course was positive and the patient could be quickly dismissed in a good general condition. To the best of our knowledge, no presentation of a combined occurrence of postpartum pneumomediastinum and reverse (inverted) takotsubo cardiomyopathy exists. Case presentation We present the case of a 30-year-old Caucasian woman with sudden onset of thoracic back and chest pain approximately 24 hours after an otherwise unremarkable vaginal delivery. A contrast-enhanced chest computed tomography showed cervical and mediastinal emphysema without proof for pulmonary embolism or aortic dissection. She received a symptomatic analgesic treatment and was dismissed to the obstetrics department for monitoring. Within hours, slightly increased levels of troponin I were observed without corresponding electrocardiography changes. Immediate cardiac catheterization and a cardiovascular magnetic resonance imaging (performed within 24 hours) revealed basal to midventricular hypokinesia, but were otherwise unremarkable. A low-dose treatment for congestive heart failure was initiated, under which symptoms subsided within days. She was dismissed after 12 days in a good general condition. Conclusions Although the clinical presentation of the combination of the diseases initially was dramatic, the prognosis is positive. In the context of the preceding delivery, knowledge about the postpartum pneumomediastinum lets the radiologist of the emergency department quickly make this diagnosis. The takotsubo cardiomyopathy, however, needs broader diagnostics to not miss intervention-requiring causes.
INTRODUCTION: To the best of our knowledge, soft tissue sarcomas have not prevously been reported as a complication during pregnancy. CASE PRESENTATION: A 28-year-old Caucasian woman was diagnosed with a transperitoneal sarcoma during pregnancy. Morphological, immunohistochemical, chromosomal and mutational analyses pointed towards a high-grade endometrial stromal sarcoma. Although surgery and chemotherapy are possible during pregnancy, we were unable to perform
Frédéric Amant; Kristel Van Calsteren; Maria Debiec-Rychter; Liesbeth Heyns; Katya Op De Beeck; Xavier Sagaert; Bart Bollen; Ignace Vergote
We report on a 58-year-old Caucasian woman who went to a general practitioner about recurrent abdominal pain, night sweats\\u000a and weight loss of a few weeks’ duration. Once gynaecological disease had been ruled out, the patient was admitted to hospital\\u000a with severe abdominal pain and intestinal obstruction and a right-sided hemicolectomy was performed. Following the investigation\\u000a of osteolytic lumbar vertebrae,
C. Röcken; Doris Radun; Bernhard Glasbrenner; Peter Malfertheiner; Albert Roessner
We report the case of a pregnancy in a 25-year-old woman who was born with ectopia vesicae and split pelvis, but had not undergone any reconstructive or diversion surgery in childhood. Her antenatal period was uneventful and the infant was delivered by cesarean section at term due to breech presentation. The baby had no congenital anomalies. The postoperative period was uneventful and they were discharged from the hospital in a good general condition. PMID:23279661
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
A 78-year-old woman who presented with chest pain, on a background of hypertension and varicose veins, was found to have a non-ST segment elevation myocardial infarction with coronary angiography demonstrating dissections of all three major arteries distally. She was treated medically, with anticoagulation and risk factor management as the primary therapies. This is the first reported case of triple spontaneous coronary artery dissection treated medically, along with angiographic follow-up demonstrating complete resolution. PMID:23880400
Introduction: McCune-Albright syndrome (MAS) is characterized by peripheral precocious puberty, cafe´-au-lait spots, and polyostotic fibrous dysplasia. This syndrome is due to a post-zygotic mutation of the GNAS1 gene with mosaic distribution and unilateral predominance. Clinical manifestations depend on the tissues carrying the mutation. We describe the ovarian function before and after unilateral ovariectomy in a woman with MAS and bilateral
Vincent Lavoue; Karine Morcel; Philippe Bouchard; Charles Sultan; Catherine Massart; Jean-Yves Grall; Serge Lumbroso; Marie-Christine Laurent
This case report describes a previously healthy 35-year-old woman, with an episode of fever, neutropenia, thrombocytopenia and elevation of biochemical markers of liver injury, 10 days after beginning drug therapy with dexketoprofen trometamol. Infectious and autoimmune causes of neutropenia, and viral or autoimmune hepatitis were excluded. The resolution following withdrawal of dexketoprofen trometamol confirms the possibility of an adverse drug reaction. PMID:18211621
Zabala, S; Calpe, M J; Pérez, G; Lerín, F J; Mouronval, L
We present the case of a rare vulva tumour, in a 33 years Cameroonian old woman and managed in Obstetrics and Gynecology Unit of Yaoundé Central Hospital in Cameroon. It was a painless pedunculated vulva tumour which developed over a period of six months. This gigantic rapidly growing tumour, was treated with simple surgical resection. After surgical resection, histology confirmed an angioneurofibroma hamartoma. There has been no recurrence and presently the patient is symptom-free.
Ymele, Florent Fouelifack; Bechem, Efuetnkeng; Njotang, Philip Nana; Nangue, Charlette; Fouedjio, Jeanne Hortence; Damtheou, Sadjoli; Enoh, Robinson Mbu
Severe acute pancreatitis is a common critical disease, which may cause severe complications such as sepsis and multiple organ\\u000a dysfunction syndrome (MODS), and has a high mortality. A 31-year-old woman with 25-weeks pregnancy presented with hyperlipidemic\\u000a pancreatitis, sepsis and MODS. Based on conventional treatment, 125 h of continuous veno-venous hemofiltration (CVVH) and\\u000a 3 sessions of hemoperfusion (HP) were carried out. The
Pulmonary arteriovenous malformations (PAVM) consist of an abnormal connection between the pulmonary artery and vein bypassing the pulmonary capillary bed. Pulmonary arteriovenous fistulae are characterized by a right-to-left shunt of variable magnitude, and they may be accompanied by other congenital anomalies. We describe a case of pulmonary arteriovenous fistula with a secundum type atrial septal defect (ASD) in a 38-year-old woman, who underwent successful transcatheter closure of both the ASD and PAVM. PMID:22407420
Kucukoglu, M S; Sinan, U Y; Kilickesmez, K O; Salt?k, I L; Dursun, M; Gurmen, T
An asymptomaticBabesiainfection was confirmed by laboratory diagnoses. The intraerythrocytic protozoan (designed TW1) isolated from a 51-year-old Taiwanese woman appeared to be morphologically consistent with small-form piroplasm, and measurements indicated that it had a body size of 1.5 to 2.5 mm in diameter. The typical features of ring, binary, and tetrad forms were observed in Giemsa-stained thin blood smears. A persistent
CHIEN-MING SHIH; LI-PING LIU; WEN-CHING CHUNG; S. J. ONG; ANDCHIH-CHIEN WANG
Aneurysm of the innominate artery is uncommon compared with other peripheral aneurysms, and holds the potential for rupture,\\u000a embolization, or thrombosis as well as various complications caused by compression to the adjacent structures. The most effective\\u000a treatment for this condition is surgical resection, but the earlier reports described high mortality rates. We report the\\u000a case of an 83-year-old asymptomatic woman
Through analysis of a local configuration of race and gender in the global migration picture, this essay picks up on one of the important themes discussed in Global Woman: the challenges, complexities, struggles, and dilemmas of the “micro” West\\/non–West contact zone. Using data from my research into relationships between (black) African migrants and non-African Australian women, I explore the way
The influence of traditional or egalitarian gender role stereotypes on perceptions of domestic violence was investigated when\\u000a the woman's race and her provocation of and resistance to domestic violence were varied. Two hundred eighty-eight European\\u000a American participants who varied in their gender role stereotype beliefs provided culpability ratings. A factor analysis reduced\\u000a culpability items to six concepts. Biases against the
This 35-year-old woman had a history of slow enlargement of the right breast over a 2-year period. Two months before she first sought clinical attention, she noted a sanguineous discharge from the nipple. She was otherwise in good health. On physical examination there was a hard 6-cm mass occupying much of the lateral hemisphere of the right breast. No axillary
Jerrold H. Mink; Ilene Weitz; A. Robert Kagan; Richard J. Steckel
A fatal case of influenza A infection with Staphylococcus aureus superinfection in a previously healthy 49-year-old woman presenting as sudden, unexpected death is reported. Autopsy revealed severe necrotizing tracheobronchitis and hemorrhagic pneumonia. Microscopic examination of the trachea and bronchi showed mucosal necrosis and a dense lympho-monocytic infiltration of all layers. The lungs showed focal hemorrhagic pneumonia. No pathological changes were
Repeated chromosomal analysis of peripheral blood lymphocytes and skin fibroblasts from a woman referred for amenorrhoea,\\u000a streak gonads, hyperthyroidism, adiposity and elevated ?-fetoprotein levels but no other manifestations of known chromosomal\\u000a breakage syndromes demonstrated an increased spontaneous chromosomal breakage rate (ISCBR). Chromatid and chromosomal breaks\\u000a were more numerous than sporadic rearrangements and dicentric chromosomes. Exposure of the cells to mitomycin
Hans-Christoph Duba; Harald G. Weirich; Helga Weirich-Schwaiger; Barbara Utermann; David Nachbaur; Elisabeth Sölder; Gerd Utermann
The authors report a case of a 31-year-old woman from India with history of seizure disorder who presented with sudden onset right hemiparesis and right-sided upper motor neuron type facial palsy. No identifiable risk factors were noted on admission and all laboratory investigations were negative. MR angiography helped in arriving at the diagnosis of moyamoya disease as the aetiology of her symptoms.
The literature on the current health problems of women is reviewed, clarifying the conditions and updating present knowledge of women's health within the context of medical and social research. Both medical professionals and women have begun to address women's health issues with 4 major issues receiving particular emphasis: the charge that physicians fail to take women's complaints seriously; the allegation that the population of women is being drugged; the accusation that women experience excessive surgical procedures; and the notion that sexism is inherent in American medical education. Focus on these issues is not the answer. Women, individually and collectively, need to clarify issues of women's health within the context of modern research and understanding. The literature is reviewed in the categories of prepubescent females, adolescence and the young woman, women's reproductive lives, life styles of the middle years, external and internal abuse, and aged women. The estimated annual occurrence of 60,000-100,000 cases of incest and/or sexual abuse among prepubescent females makes it a women's health issue of serious dimension. The victims are overwhelmingly female with a ratio of 10 females to 1 male child. Appetite disorders, known as patharexia, are a major public health problem of female adolescents. After depression, they represent the most common emotional illness among young girls and women. Anorexia nervosa, bulimarexia, and bulimia all are characterized by body image and distortion and the victim's obsessive desire to be thin. A more conforming, but still inappropriately adapted, response to social expectations for women is teen pregnancy. Teenagers who decide to have their babies often are those with the fewest options. Voluntary childlessness, late age childbirth, and issues of reproductive freedom are having social, political, and economic impact on the lives of all women. The prevailing social context of sexism and inequality contributes to the origin and persistence of problems of women patients, as demonstrated by the correlation between subordinate group status and mental health. Many changes have been initiated as a result of pressure from individual women and from the women's health care movement. For example, medical schools are reforming their training in values, ethics, and human relations. Women have begun to assume more control over their own lives and well being. Women's groups such as the Boston Women's Health Collective have set the pattern for a proliferation of self-help manuals available to the general readership. Recent media attention has focused on such women's health issues as family violence, incest, and battering. Women have challenged the medical professionals in their treatments, and medical professionals need to see beyond individual symptoms to the context of illness in women. Complete health for women can be a new model for other social movements. PMID:3522518
The present study has the visibilizar purpose the violence that affects the women, having as main elements precipitants of the aggressor's violent attitude the ingest of alcohol and/or it drugs. The objectives of the present study are: to know the meanings that the woman attributes to the violence; to recognize the different factors related to the occurrence of the family violence and to identify like the consumption of drugs is processed in the couple. The study type is exploratory and descriptive, the qualitative methodology, the empiric cutting was used six women they constituted it who went to carry out its accusation to the police station of women from Lima. The discoveries show that the time of union oscillated between two months and eighteen years, happening the abuse in case the whole time of union. With regard to the type of suffering violence that of more magnitude was the physics; in a subtler way the psychological one, the sexual violence was not referred, the money and jealousy were referred as focuses desencadenantes of the discussions, those that are associated to the use of alcohol and it drugs in the aggressor. The established categories were: the type of violence undergone by the women, the context of the violence, the repercussion of the violence undergone by the women in its health and the reaction of violence undergone by means of the denunciation. As main conclusions we have that the violence against the women is revealed like social and sanitary topic, with repercussions in the morbi-mortality and in terms of warm of the women's life, in the field of the health, it is necessary to recognize the women in situations of violence, to consider as factors of risk for the couple the use of the alcohol and drugs, the women hide for shame the problem that you/they live, the personnel of health it should be able to diagnose the violence in their different forms, expressed by complaints or chronic pains without apparent causes. PMID:15303199
Introduction Tuberculosis is a chronic infectious disease, and the morbidity associated with it has major health implications. When tuberculosis affects the genital organs of young females, it has the devastating effect of causing irreversible damage to their fallopian tubes, resulting in a possible tubercular pyosalpinx and infertility. However, the disease often remains silent or presents with very few specific symptoms. In adolescents and young women, tuberculosis can also present with hypogastric recurrent symptoms and affectation of the general state, but because in our country genital tuberculosis is uncommon, its diagnosis is unlikely. Case presentation We describe the case of an 18-year-old Spanish woman who had been sexually active for 1 year, nulliparous, who presented with hypogastric discomfort and repeated urinary symptoms complicated with pelvic inflammatory disease after a hysterosalpingography. Genital tuberculosis was not suspected. The echographical findings and tumor markers mimicked those of ovarian tumors, and she was also a carrier of a genitourinary malformation (pelvic kidney and septate uterus). A laparotomy was performed and revealed large pelvic abscesses. On her right adnexum, the large pyosalpinx was free (floating pyosalpinx). Drainage, adhesiolysis and bilateral salpingectomy were performed, and cultures were taken. Histopathological study showed bilateral granulomatous abscessificated salpingitis with suspicion of genital tuberculosis, and cultures were positive for Mycobacterium tuberculosis. She followed a tuberculostatic treatment for 6 months. Eight years later, she presents with normal menstruations and is waiting for an in vitro fertilization cycle. Conclusions No other reported case showing similar association of genital tuberculosis and genitourinary malformation was found. The associated genitourinary malformation in this case probably has no relation but it could contribute to diagnosis delay and/or to reactivate the pathology. The hysterosalpingographical findings and the observation of a floating pyosalpinx must alert the clinician to genital tuberculosis, but the diagnosis is suggested by the histopathological studies and confirmed by cultures. In this case study, the necessity of considering the risk of pelvic inflammatory disease reactivation after hysterosalpingography, of suspecting the diagnosis of genital tuberculosis and of establishing the differential diagnosis with ovarian tumors in the presence of large pyosalpinges is highlighted.
The authors report a new case of primary renin-secreting renal carcinoma in a pregnant woman. The clinical, radiological and pathological findings mimicked an oncocytoma and the diagnosis was confirmed by immunohistochemical study. PMID:1284676
Molinié, V; Dauge-Geffroy, M C; Delmas, V; Potet, F
Background In spite of many similarities in the psychopathology of anorexia nervosa (AN) and bulimia nervosa (BN), the 2 groups seem to differ in terms of body image disturbances. Therefore, the aim of the present study was to compare neuronal correlates of viewing photographs of one’s own body and another woman’s body in patients with these forms of eating disorders as well as controls. Methods We performed functional magnetic resonance imaging while women with AN (n = 13), BN (n = 15) and healthy controls (n = 27) viewed 16 standardized pictures of their own body and another woman’s body, taken while the participants were wearing a bikini. Results When viewing their own body, participants with AN and BN showed reduced activity in the inferior parietal lobule compared with healthy women. In response to looking at another woman’s body, participants with AN had higher amygdala activity than did those in the BN and control groups. Limitations The generalizability of the results is limited by the small sample size. Conclusion Our data suggest decreased attentional processes in AN and BN toward one’s own body, possibly reflecting body-related avoidance behaviour. Enhanced limbic activity elicited by looking at another woman’s body in participants with AN might be a neural correlate of stronger emotional activation and enhanced vigilance, possibly resulting from social comparison processes. Our study reveals hints about body image–associated alterations in brain activity, which seem to be more pronounced among women with AN than among those with BN.
South Africa's concurrent epidemics of HIV, substance use, and gender-based violence point to the urgent need for interventions that address the intersectional nature of these issues. A community-based randomized trial assessed the efficacy of an adapted evidence-based Woman-Focused HIV intervention addressing all three issues with sex workers and non-sex workers. At 6-month follow-up, non-sex workers in the Woman-Focused intervention reported
Wendee M. Wechsberg; William A. Zule; Winnie K. Luseno; Tracy L. Kline; Felicia A. Browne; Scott P. Novak; Rachel Middlesteadt Ellerson
Objective: To report a successful pregnancy in a woman with panhypopituitarism who received 3 months of pretreatment with growth hormone (GH) before ovulation induction. Prior attempts at ovulation induction had failed for this patient.Design: Case report.Setting: Department of Endocrinology.Patient(s): A 32-year-old woman with panhypopituitarism and secondary infertility.Intervention(s): GH (1 IU\\/day) alone for 3 months; during the next cycle, 1 IU\\/day
Agnès Salle; Marc Klein; Véronique Pascal-Vigneron; Brigitte Dousset; Jacques Leclere; Georges Weryha
Introduction Pregnancy has been linked to increased rates of arteriovenous malformation rupture. This link remains a matter of debate and very few studies have addressed the management of arteriovenous malformation in pregnancy. Unruptured arteriovenous malformations in pregnant woman generally warrant conservative management due to the low rupture risk. When pregnant women present with ruptured arteriovenous malformation, however, surgery is often indicated due to the increased risk of re-rupture and associated mortality. Endovascular embolization is widely accepted as an important component of contemporary, multimodal therapy for arteriovenous malformations. Although rarely curative, embolization can facilitate subsequent surgical resection or radiosurgery. No previous reports have been devoted to the endovascular management of an arteriovenous malformation in a pregnant woman. Case presentation A 23-year-old Caucasian woman presented with headache and visual disturbance after the rupture of a left parieto-occipital arteriovenous malformation in the 22nd week of her pregnancy. After involving high-risk obstetric consultants and taking precautions to shield the fetus from ionizing radiation, we proceeded with a single stage of endovascular embolization followed soon after by open surgical resection of the arteriovenous malformation. There were several goals for the angiography in this patient: to better understand the anatomy of the arteriovenous malformation, including the number and orientation of feeding arteries and draining veins; to look for associated pre-nidal or intra-nidal aneurysms; and to partially embolize the arteriovenous malformation via safely-accessible feeders to facilitate surgical resection and minimize blood loss and operative morbidity. Conclusion From our experience and review of the literature, we maintain that ruptured arteriovenous malformations in pregnancy may be managed in a similar manner to those in non-gravid women. Precautions should be taken to reduce the operative time and exposure of the fetus to ionizing radiation and contrast agents.
Obesity is a major metabolic disorder, in which ghrelin plays a significant role. The objective of this study was to characterize the morphology of ghrelin cells in the stomach and duodenum and the levels of ghrelin and leptin in the serum of a 52-year-old obese woman. Material for the study was obtained from the stomachs and duodenum, of obese and control women. Each subject had been treated at the Intensive Care Unit of the Clinical University Hospital in Bia?ystok, due to brain damage, due to primary cardiac arrest. After brain death was diagnosed and individual death was confirmed by doctors, stomach and duodenum samples were collected from each body. Paraffin sections were stained with hematoxylin and eosin and processed for immunolocalization of ghrelin. The density of ghrelin cells in each part of the gastrointestinal tract was estimated under a light microscope with a digital camera. Ghrelin-IR cells were also analyzed in terms of morphometric features such as length, width and area. The ghrelin and leptin concentrations in each blood sample were measured by ELISA. Immunohistochemical studies revealed a small number of ghrelin cells in the stomach and duodenum which did not reflect the high level of hormone. The obese woman had lower number of ghrelin cells in the stomach and duodenum and elevated ghrelin and leptin levels in serum. It can therefore be assumed that additional source of ghrelin and probably changes in activity of ghrelin o-acylotransferase, are responsible for the high concentration of ghrelin in the obese woman. PMID:23806576
Kasacka, Irena; Arciszewski, Maciej; ?ebkowski, Wojciech
Anomalous origin of the left coronary artery connected to the pulmonary artery (ALCAPA) is a rare congenital defect with a high mortality rate in infancy if left untreated. It may cause myocardial ischaemia and can lead to myocardial infarction, mitral dysfunction, cardiac arrhythmias, heart failure and sudden death. Without operation, survival into adulthood is rare. We report clinical findings, diagnostic characteristics and therapy in a 31-year-old woman with ALCAPA and preserved left ventricular function. ImagesFigure 1Figure 2Figure 3
A 33-year-old woman with presumed essential hypertension and symptoms equivalent to New York Heart Association class II was suspected of heart failure and referred to echocardiography. The patient's ECG showed a left bundle branch block. Electrolytes, serum creatinine and estimated-glomerular filtration rate as well as urine test for protein were all normal. The patient had no peripheral oedema. The transthoracic echocardiography confirmed systolic and diastolic dysfunction and an ejection fraction of 25% and left ventricular hypertrophy. Ultrasound of renal arteries and renal CT angiography (renal CTA) revealed a significant stenosis and an aneurysm corresponding to the right renal artery with challenges to traditional interventions. PMID:24990850
An unusual case is presented of a fertile woman heterozygous for a balanced X-autosome translocation t(X;12) (q22;p12) with a break-point (Xq22) in the critical region of the X chromosome. The karyotypes of her daughter, who is infertile, and one of her two sons are 47,XXX,t(X;12)(q22;p12) and 46,XY,t(X;12)(q22;p12) respectively. The literature on balanced X-autosome translocations in males and females involving both
K. Madan; P. G. A. Hompes; J. Schoemaker; C. E. Ford
To our knowledge, this is the first description of the computed tomographic appearance of a displaced right upper lobe bronchus. The case reported is that of a 43 year-old woman who had known congenital heart disease and systemic hypertension. The computed tomographic study demonstrated a displaced right upper lobe bronchus; a persistent left superior vena cava; pulmonary hypertension with associated dilatation of the right chambers of the heart consistent with a longstanding left to right shunt; and subsequent development of pulmonary hypertension. PMID:6229390
Introduction Combination antituberculosis drug therapy remains the mainstay of treating tuberculosis. Unfortunately, antituberculosis drugs\\u000a produce side effects including (toxic) impaired visual function, which may be irreversible. We report a case of antituberculosis-drug-induced\\u000a impaired visual function that was reversed following early detection and attention.\\u000a \\u000a \\u000a \\u000a \\u000a Case presentation A 37-year-old Yoruba woman, weighing 48 kg, presented to our facility with impaired visual functions and mild
Necrotizing fasciitis is an uncommon but a potentially fatal condition and can affect any part of the body. Most patients have pre-existing conditions that render them susceptible to infection, although etiology is unclear. Diagnosis is primarily clinical and is often delayed because of the unfamiliarity of the condition among clinicians. Management consists of immediate resuscitation, early surgical debridement, and administration of broad spectrum intravenous antibiotics. We report a case of a 70 year old woman who presented with a painful erythematous rash, was admitted as a case of cellulitis, later developed worsening of symptoms and septic shock, and was diagnosed as necrotizing fasciitis.
Benign cardiac fibroma is rarely reported in adults. Its clinical symptoms are related to outflow obstruction or dysrhythmias. We present the case of a 70-year-old woman who had a syncopal episode from ventricular tachycardia caused by cardiac fibroma. Because of unfavorable tumor anatomy, the patient was not a candidate for surgical excision, and she declined orthotopic heart transplantation. To prevent sudden cardiac death, we placed an implantable cardioverter-defibrillator, and the patient remained well throughout the 2-year follow-up period. To our knowledge, this is the first report of implantable cardioverter-defibrillator therapy to treat an adult patient's unresectable cardiac fibroma.