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Sample records for australian case series

  1. Cutaneous mucormycosis and motor vehicle accidents: Findings from an Australian case series.

    PubMed

    Ingram, Paul R; Suthananthan, Arul E; Rajan, Ruben; Pryce, Todd M; Sieunarine, Kishore; Gardam, Dianne J; Heath, Christopher H

    2014-11-01

    Cutaneous disease is the third most frequent manifestation of mucormycosis. The clinical manifestations of and subsequent mortality due to cutaneous mucormycosis are dependent on the mode of acquisition and the host immune status. Here, we describe the epidemiology, clinical presentation, microbiology, and outcomes of 16 cutaneous mucormycosis infections managed in an Australian tertiary hospital over a 15-year period. The proportion with localized (56%), deep (38%), and disseminated (6%) cutaneous disease as well as the overall mortality (25%) were consistent with findings reported in the published literature. Two novel forms of hospital-acquired infection were reported following a sacral pressure sore and insertion of a foreign body during a bone graft procedure. The majority of patients were immunocompetent (75%) and/or suffered trauma (56%) with associated environmental contamination. A novel finding was that motor vehicle accidents (MVAs) accounted for 78% of all trauma-related cases, suggesting MVAs should receive greater recognition as a potential precipitant of cutaneous mucormycosis. Aggressive decontamination and debridement of devitalized tissue following trauma is therefore likely to play an important role in the prevention of this rare but potentially devastating infection. PMID:25288654

  2. Nonketotic hyperglycinemia case series

    PubMed Central

    Iqbal, Mehtab; Prasad, Manish; Mordekar, Santosh R.

    2015-01-01

    To present three cases who presented with neonatal hiccups and who were later diagnosed with nonketotic hyperglycinemia (NKH). Case series. We present three babies who presented in neonatal life with hiccups who later were diagnosed with NKH. Two babies presented on the 2nd day of life with hypotonia, poor feeding, and abnormal movements including jitteriness, hiccups, and twitching. The third baby only had transient hiccups lasting for a couple of days in the 1st week of life but later presented at 3 months of age with poor feeding, drowsiness, and jerky movements. All three cases needed extensive investigations before reaching the diagnosis including metabolic screen, lumbar puncture, electroencephalography, and computed tomography/magnetic resonance imaging. The first two babies needed intubation on their 2nd day of life because of apneas in whom later, the care was withdrawn after reaching the diagnosis of NKH because of poor prognosis. The third baby was discharged home on oral dextromethorphan and ketogenic diet. We discuss the importance of early recognition of symptoms (frequent hiccups) and investigation needed to reach the diagnosis early as it helps in making decision to either carry on treatment or withdraw care because of poor prognosis. It also helps in genetic counseling and prenatal diagnosis can be offered at the subsequent pregnancy. PMID:26962342

  3. Telling Tales: Australian Voices. Australian Studies in Language and Education Monograph Series.

    ERIC Educational Resources Information Center

    Moss, Peter

    This monograph contains a report of the field work stage of a research project, on the educational significance of the modern Australian oral tradition, which involved the collection of recordings of people telling tales, reminiscing, recalling personal events of significance, and recounting traditional Australian legends from non-Aboriginal…

  4. Kleptomania: a case series

    PubMed Central

    Saluja, Bharat; Chan, Lai Gwen; Dhaval, Dani

    2014-01-01

    Kleptomania is an enigmatic condition and is among the very few psychiatric disorders in which crime is medicalised and used as a legal defence. The scientific literature on kleptomania is scarce. Early literature and recent studies have shown a female preponderance, with an early age of onset of stealing in people with comorbid personality disorder(s). In a retrospective review of the case notes of theft offenders who had forensic psychiatric evaluations performed in a one-year period in 2010 at the Institute of Mental Health, Singapore, we found three patients who were diagnosed with kleptomania. In this report, we describe the pertinent clinical and sociodemographic characteristics, as well as the diagnostic issues of kleptomania in relation to the three cases. PMID:25630329

  5. Aligning IT and Business Strategy: An Australian University Case Study

    ERIC Educational Resources Information Center

    Dent, Alan

    2015-01-01

    Alignment with business objectives is considered to be an essential outcome of information technology (IT) strategic planning. This case study examines the process of creating an IT strategy for an Australian university using an industry standard methodology. The degree of alignment is determined by comparing the strategic priorities supported by…

  6. Coronary fistulas: a case series.

    PubMed

    Nada, Fennich; Fedoua, Elouali; Ghita, Saghi; Nadia, Bouzammour; Leila, Haddour; Jamila, Zarzur; Mohamed, Cherti

    2014-01-01

    Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms.

  7. Familial Chiari malformation: case series.

    PubMed

    Schanker, Benjamin D; Walcott, Brian P; Nahed, Brian V; Kahle, Kristopher T; Li, Yan Michael; Coumans, Jean-Valery C E

    2011-09-01

    Chiari malformations (Types I-IV) are abnormalities of the posterior fossa that affect the cerebellum, brainstem, and the spinal cord with prevalence rates of 0.1%-0.5%. Case reports of familial aggregation of Chiari malformation, twin studies, cosegregation of Chiari malformation with known genetic conditions, and recent gene and genome-wide association studies provide strong evidence of the genetic underpinnings of familial Chiari malformation. The authors report on a series of 3 family pairs with Chiari malformation Type I: 2 mother-daughter pairs and 1 father-daughter pair. The specific genetic causes of familial Chiari malformation have yet to be fully elucidated. The authors review the literature and discuss several candidate genes. Recent advances in the understanding of the genetic influences and pathogenesis of familial Chiari malformation are expected to improve management of affected patients and monitoring of at-risk family members.

  8. Case payment in Australian hospitals: any skeletons in the cupboard?

    PubMed

    Owens, H

    1991-01-01

    This paper examines two major concerns with the proposal to introduce case payment for Australian hospitals. The first relates to the potential negative impact on government budgetary outlays of an open-ended payment system based on output and the second to inherent incentives that may jeopardise quality of care. A number of options for capping payments are presented and the impact of the U.S. Medicare prospective payment system on quality described. PMID:10117330

  9. Case Studies in Australian Adult Education.

    ERIC Educational Resources Information Center

    Clark, Ralph J., Ed.; Rooth, S. John, Ed.

    This publication contains the following 24 case studies of adult education in Australia: "NSW Department of Agriculture Home Study Programme" (O'Neill); "Self-Help Adult Education: The University of the Third Age at the Brisbane CAE" (Swindell); "Marriage Enrichment Programme" (D. Kerr, C. Kerr); "Carringbush Library: A Place to Be" (Letcher);…

  10. Osseous genioplasty: A case series

    PubMed Central

    Deshpande, Sanjeev N.; Munoli, Amarnath V.

    2011-01-01

    Introduction: The chin (mentum) is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views. Osseous genioplasty, the alteration of the chin through skeletal modification, can lead to significant enhancement of the overall facial profile. Aim and Study Design: A case series was designed to study the long-term results of osseous genioplasty in Indian patients with regard to patient satisfaction, complications, and long-term stability. Materials and Methods: All subjects who underwent osseous genioplasty either alone or as a component of orthognathic surgery between January 1992 and December 2010, with a minimum follow-up of 2 years, were included. The genioplasty was performed using standard protocols of assessment and execution. Post-operative evaluation included patient satisfaction, complications and radiological evidence of long-term stability. A comprehensive score was formulated for the purpose of the study. Results: Thirty-seven subjects underwent osseous genioplasty with at least 2 years of follow-up in the study period. This included 17 male and 20 female subjects, with a mean age of 22.8 years (15-52 years) and a mean follow-up of 3 years 4 months (2 years to 4 years and 11 months). Nineteen subjects underwent isolated genioplasty while 18 underwent genioplasty as a part of orthognathic surgery. The procedures included advancement (22), pushback (9), side-to-side (4) and vertical reduction (2) genioplasty. Thirty-six subjects (97.3%) were extremely pleased with the results with only one subject expressing reservations, without, however, demanding any further procedure. There were no significant complications. The osteotomised segment was well maintained in its new position with good bony union and minimal resorption. Overall, 35 (94.6%) cases had excellent results and 2 (4.4%) cases had good results, according to the comprehensive score. Conclusions: Osseous genioplasty is a safe and

  11. Case Citations 1991. Eleventh Series.

    ERIC Educational Resources Information Center

    Sharp, Linda A., Ed.

    Case citations from five legal areas--college students, liability on campus, sport law, employment, and employment discrimination--are presented in this document. Each section offers brief summaries of cases and concludes with a table of cases. The first section on college students examines litigation involving student finances, disciplinary…

  12. Why Do Chinese-Australian Students Outperform Their Australian Peers in Mathematics: A Comparative Case Study

    ERIC Educational Resources Information Center

    Zhao, Dacheng; Singh, Michael

    2011-01-01

    International comparative studies and cross-cultural studies of mathematics achievement indicate that Chinese students (whether living in or outside China) consistently outperform their Western counterparts. This study shows that the gap between Chinese-Australian and other Australian students is best explained by differences in motivation to…

  13. Case, Teacher and School Characteristics Influencing Teachers' Detection and Reporting of Child Physical Abuse and Neglect: Results from an Australian Survey

    ERIC Educational Resources Information Center

    Walsh, Kerryann; Bridgstock, Ruth; Farrell, Ann; Rassafiani, Mehdi; Schweitzer, Robert

    2008-01-01

    Objective: To identify the influence of multiple case, teacher and school characteristics on Australian primary school teachers' propensity to detect and report child physical abuse and neglect using vignettes as short hypothetical cases. Methods: A sample of 254 teachers completed a self-report questionnaire. They responded to a series of 32…

  14. Hepatic sarcoidosis: a case series

    PubMed Central

    Ennaifer, Rym; Ayadi, Shema; Romdhane, Hayfa; Cheikh, Myriam; Nejma, Houda Ben; Bougassas, Wassila; Hadj, Najet Bel

    2016-01-01

    Sarcoidosis is a systemic non caseous granulomas disease. Liver is a common location but usually asymptomatic. Evidence based guidelines for this location treatment is lacking and the effect of corticosteroids may be inadequate. The aim of our study was to describe the clinical, biochemical, radiological and therapeutic features of seven patients with systemic sarcoidosis and liver involvement. A retrospective and descriptive monocentric study, over 3 years, including seven patients with systemic sarcoidosis and liver involvement. We included 5 women and 2 men with an average age of 43 years. Hepatic localization revealed sarcoidosis in 5 cases. Hepatomegaly was observed in all patients as well as abnormal serum liver function test reflected by anicteric cholestasis. Liver biopsy, showed in all granulomatous lesions consistent with sarcoidosis and severe fibrosis in 2 cases. Extra-hepatic manifestations were present in all patients represented mainly by pulmonary location. All patients were treated, five by corticosteroid and two with ursodeoxycholic acid (UDCA). Complete response was observed in one case, partial response in another case and corticosteroid refractoriness in one case. In two cases, corticosteroid therapy was introduced for less than 1 month, not allowing assessment of response. Antimalarials in combination with UDCA were used successfully in a patient with steroid-resistant liver disease. Liver involvement can reveal systemic sarcoidois. Given the risk of progression to severe liver disease, it must be screened in all patients with systemic sarcoidosis. Treatment is not systematic, and still based on corticosteroid therapy. In the absence of prospective randomized controlled trials, the efficacy of UDCA need to be proven. PMID:27795804

  15. Canine multifocal retinopathy in the Australian Shepherd: a case report

    PubMed Central

    Hoffmann, Ingo; Guziewicz, Karina E.; Zangerl, Barbara; Aguirre, Gustavo D.; Mardin, Christian Y.

    2013-01-01

    A 1-year-old Australian Shepherd (AS) was presented for a routine hereditary eye examination. During the examination multiple raised, brown to orange lesions were noted in the fundus, which could not be attributed to a known retinal disease in this breed. As they clinically most closely resembled canine multifocal retinopathy (cmr) and no indication of an acquired condition was found, genetic tests for BEST1 gene mutations were performed. These showed the dog to be homozygous for the cmr1 (C73T/R25X) gene defect. Furthermore, ultrasound (US), electroretinography (ERG), and optical coherence tomography were performed, confirming changes typical for cmr. Subsequently, the AS pedigree members were genetically and clinically tested, demonstrating autosomal recessive inheritance with no clinical symptoms in carrier animals, as was previously described for cmr. To our knowledge, this is the first reported case of canine multifocal retinopathy in the AS breed. Further investigations are under way. PMID:22432598

  16. Osseous sarcoidosis: a case series.

    PubMed

    Kuzyshyn, Halyna; Feinstein, David; Kolasinski, Sharon L; Eid, Hala

    2015-05-01

    Sarcoidosis is an inflammatory disorder characterized by noncaseating granulomas infiltrating affected organs. Any organ system can be involved, and more than 90 % of patients have a primary pulmonary manifestation. The incidence of radiographically evident bone involvement has been reported over a wide range: from 3 to 39 % depending on the population studied and imaging modalities used. Any bone may be affected in osseous sarcoidosis. Bilateral involvement of the phalanges of the hand and feet is most common. However, reports of long bone, skull, rib and vertebral involvement have appeared. To date, there are no specific tools for the assessment of skeletal disease activity in sarcoidosis. Plain radiograph picks lesions in the small bones of hands and feet greater than does in other bones. Bone scan is useful for defining the extent of the skeletal disease and bone marrow involvement. Magnetic resonance imaging usually demonstrates multifocal lesions within the vertebrae that are hypointense on T1-weighted images and hyperintense on T2-weighted images. In cases of multifocal bone lesions and an established diagnosis of sarcoidosis, a diagnosis of bone sarcoidosis should be considered in the differential diagnosis. Optimal treatment of osseous sarcoidosis remains controversial. We present five cases of multisystem sarcoidosis with skeletal involvement including long bones and vertebrae and a description of immunosuppressive therapies used in our patients. A literature review highlighting the diagnostic approach using radiographic imaging, as well as treatment strategies, is provided.

  17. Peripartum cardiomyopathy – case series

    PubMed Central

    Prasad, Gowri Sayi; Bhupali, Ashok; Prasad, Sayi; Patil, Ajit N.; Deka, Yashodhan

    2014-01-01

    Objectives To study the pattern of presentation, course of disease and outcome of pregnancy in Peripartum Cardiomyopathy. Methods A prospective study of sixteen cases of PPCM was conducted at Apple Saraswati Multispecialty Hospital and Dr. D.Y. Patil Medical College and Hospital, Kolhapur, Maharashtra, India from January 2006 to December 2012. Data included age distribution, parity, gestational age, symptoms and risk factors. Medical management and pregnancy outcome were documented. Serial echocardiography data was compiled for a period of one year. Results In our study 9/16 (56%) were primigravidae, 4/16 (25%) had pre-eclamsia and 6/16 (35%) had co-existing hypertension. The difference in Echocardiography parameters observed between recovered and non-recovered patients was significant: Left Ventricular End diastolic dimension (5.6 cm vs 6.06 cm), Left Ventricular Ejection Fraction (28.7% vs 22.4%) and Left Ventricular fractional shortening (17.5% vs 13.4%). Thirteen out of sixteen patients were followed up for a period of one year out of which 61% (8/13) patients recovered completely. There was one mortality. Conclusion PPCM is a diagnosis of exclusion. Majority were young primigravidae presenting postnatally. Pre-eclampsia and hypertension were risk factors. ECHO parameters were reliable predictors of recovery. Future pregnancies are better avoided. PMID:24814122

  18. Globalisation, Transnational Academic Mobility and the Chinese Knowledge Diaspora: An Australian Case Study

    ERIC Educational Resources Information Center

    Yang, Rui; Welch, Anthony R.

    2010-01-01

    The master discourses of economic globalisation and the knowledge economy each cite knowledge diasporas as vital "trans-national human capital". Based on a case study of a major Australian university, this article examines the potential to deploy China's large and highly-skilled diaspora in the service of Chinese and Australian scientific and…

  19. Students' Multilingual Resources and Policy-in-Action: An Australian Case Study

    ERIC Educational Resources Information Center

    French, Mei

    2016-01-01

    In the context of increasing linguistic and cultural diversity in Australian schools, it is important to consider the value of students' multilingual resources for learning. This paper reports on an ethnographic case study conducted in an Australian metropolitan secondary school where the student body represented more than 40 cultures and…

  20. Neuroretinitis in ocular bartonellosis: a case series

    PubMed Central

    Raihan, Abdul-Rahim; Zunaina, Embong; Wan-Hazabbah, Wan-Hitam; Adil, Hussein; Lakana-Kumar, Thavaratnam

    2014-01-01

    We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids. PMID:25120352

  1. The Primary School in Changing Times: The Australian Experience. Educational Management Series.

    ERIC Educational Resources Information Center

    Townsend, Tony, Ed.

    Following substantial changes throughout the Australian education system, primary schools are no longer in the protected position of having a regulated flow of clients, a predetermined curriculum, and marginal levels of staff development. This book reviews the impact of this change on Australian primary schools, the people who are involved with…

  2. Transvestism as a Symptom: A Case Series

    PubMed Central

    Anupama, M.; Gangadhar, K. H.; Shetty, Vandana B.; Dip, P. Bhadja

    2016-01-01

    Transvestism, commonly termed as cross-dressing, means to dress in the clothing of opposite sex. We describe a series of three cases with transvestism as one of their primary complaints. The discussion sheds light on the various ways in which transvestism as a symptom can present in Psychiatry. In the first two cases, there was lower intelligence. In first and third case, there were other paraphilia along with transvestism. Second case had co-morbid obsessive-compulsive disorder (OCD) and had good response to selective serotonin reuptake inhibitor (SSRI). PMID:27011411

  3. Environmentally adjusted productivity measurement: an Australian case study.

    PubMed

    Nanere, Marthin; Fraser, Iain; Quazi, Ali; D'Souza, Clare

    2007-10-01

    This paper critically examines various methods for estimating productivity incorporating environmental effects for the Australian agricultural sector. The agricultural sector has been selected because of its strategic position in the economy of Australia. The findings of this study indicate that the application of environmentally adjusted productivity methods is a credible approach to measure productivity, in the context of sustainable development. Although the empirical findings of this research are case study specific, the results provide evidence supporting the adoption of these techniques to other sectors of the economy when measuring productivity and needing to be cognisant of sustainable development. The findings suggest that adjusting for the environmental impacts of soil erosion can result in higher or lower agricultural productivity depending on the assumptions we make regarding damage costs of erosion. It is argued in this paper that, for soil erosion in Australia, assumptions yielding higher productivity (i.e., upwardly adjusted) are justified. Finally, the findings of this study and the use of the methods presented point to important gaps in data availability. This gap needs to be addressed by policy makers if sustainable development objectives are to be credibly assessed using these techniques.

  4. Neuroblastoma and pediatric delirium: a case series.

    PubMed

    Traube, Chani; Augenstein, Julie; Greenwald, Bruce; LaQuaglia, Michael; Silver, Gabrielle

    2014-06-01

    Delirium occurs frequently in critically ill children, and children with neuroblastoma may be at particular risk. Early diagnosis and treatment may improve short- and long-term outcomes. In this case series, we present four critically ill children with neuroblastoma who were diagnosed with delirium in the post-operative period. In all four patients, the diagnosis of delirium facilitated targeted intervention and improvement. Heightened awareness by pediatric oncologists, surgeons, and intensivists may lead to earlier diagnosis and improvement in clinical outcomes.

  5. Inducible urticaria: Case series and literature review.

    PubMed

    Amaya, Daniel; Sánchez, Andrés; Sánchez, Jorge

    2016-01-01

    Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment. PMID:27622434

  6. Rethinking Leadership in the Academy: An Australian Case

    ERIC Educational Resources Information Center

    Bianchini, Stefano; Maxwell, Tudor; Dovey, Ken

    2014-01-01

    As with higher education institutions in other Organisation for Economic Cooperation and Development countries, Australian universities are facing significant challenges. One particular challenge is that of the declining quality of the teaching and learning experience within the academy. This paper describes an attempt to sustain the quality of a…

  7. Commercialization of Research: A Case Study of Australian Universities.

    ERIC Educational Resources Information Center

    Zhao, Fang

    2004-01-01

    Research commercialization is a crucial aspect of technological innovation and is a complex socio-economic and technological process. This paper explores the commercialization of university research, drawing on an empirical study of the development of research commercialization by Australian universities. The study addresses three main research…

  8. Skill Shortages: Prevalence, Causes, Remedies and Consequences for Australian Businesses. NCVER Monograph Series 09/2012

    ERIC Educational Resources Information Center

    Healy, Joshua; Mavromaras, Kostas; Sloane, Peter J.

    2012-01-01

    Although skill shortages are often portrayed as a significant problem for the Australian economy, there is surprisingly little evidence about their prevalence, causes and consequences. It is difficult to find robust evidence about where skill shortages occur, why they occur, what businesses try to do about them and whether their responses are…

  9. Paralytic Shellfish Poisoning: A Case Series

    PubMed Central

    Hurley, William; Wolterstorff, Cameron; MacDonald, Ryan; Schultz, Debora

    2014-01-01

    We describe a case series of seven patients presenting to an emergency department with symptoms of paralytic shellfish poisoning. They developed varying degrees of nausea, vomiting, diarrhea, weakness, ataxia and paresthesias after eating mussels harvested from a beach near their resort. Four patients were admitted to the hospital, one due to increasing respiratory failure requiring endotracheal intubation and the remainder for respiratory monitoring. All patients made a full recovery, most within 24 hours. The ability to recognize and identify paralytic shellfish poisoning and manage its complications are important to providers of emergency medicine. PMID:25035737

  10. Pseudocirrhosis: A Case Series and Literature Review

    PubMed Central

    Adike, Abimbola; Karlin, Nina; Menias, Christine; Carey, Elizabeth J.

    2016-01-01

    Pseudocirrhosis describes morphological changes of the liver that closely mimic cirrhosis, without the typical histopathological changes seen in cirrhosis. It most commonly occurs in patients with metastatic breast cancer, although it has been reported in other malignancies as well. Like in cirrhosis, portal hypertension is often seen in patients with pseudocirrhosis. Pseudocirrhosis is a rare but important complication of metastatic cancer. In this case series and literature review, we describe 6 patients with hormone-receptor-positive metastatic breast cancer. We report the significant morbidity associated with pseudocirrhosis in the course of treatment in patients with metastatic breast cancer.

  11. HUMAN TRICHOSTRONGYLIASIS: A HOSPITAL CASE SERIES.

    PubMed

    Phosuk, Issarapong; Intapan, Pewpan M; Prasongdee, Thidarat K; Changtrakul, Yossombat; Sanpool, Oranuch; Janwan, Penchom; Maleewong, Wanchai

    2015-03-01

    Trichostrongylus is a common nematode found to infect livestock throughout the tropics and can cause accidental zoonosis in humans. In the Lao PDR and Thailand, cases of human trichostrongyliasis have been reported sporadically but clinical data are limited. We retrospectively reviewed 41 cases of trichostrongyliasis who presented to Srinagarind Hospital, Thailand from 2005 to 2012. The diagnosis of trichostrongyliasis was made by finding their eggs in the stool of patients. Of the 41 cases reviewed, 30 were Thais and 11 from the Lao PDR; their age range was 26-86 years. Fifty-eight point five percent of the cases were male, 56.1% had a primary school or a lower education level, 56.1% were farmers or laborers, 63.4% lived in a rural area and 95.1% had underlying disease. Twenty-one patients were co-infected with Opisthorchis viverrini (14/21; 66.7%) and Strongyloides stercoralis (10/21; 47.6%) while the remaining (n = 20) had a single infection with Trichostrongylus only. All the trichostrongyliasis only patients who had underlying disease not related to the gastrointestinal (GI) tract had normal bowel habits and normal grossly appearing stool. GI symptoms, such as abdominal pain, flatulence, bloating, nausea, vomiting, anorexia, diarrhea and constipation, were not found in these patients suggesting they had a light infection. This study is the first report of the clinical features of a trichostrongyliasis case series from tertiary care hospital in Thailand. PMID:26513921

  12. A Case Study of a Greek Australian Traditional Dancer: Embodying Identity through Musicking

    ERIC Educational Resources Information Center

    Georgoulas, Renee; Southcott, Jane

    2015-01-01

    This article is a study of a bilingual and bicultural Pontian Greek Australian dancer. His musicking involves performing and teaching dancing. Dancing has been and continues to be a major part of the self-identity of the participant. This phenomenological single case study used interpretative phenomenological analysis to analyse the data collected…

  13. Prestige-Oriented Market Entry Strategy: The Case of Australian Universities

    ERIC Educational Resources Information Center

    Tayar, Mark; Jack, Robert

    2013-01-01

    Through an exploratory case study of four Australian universities this article finds that foreign market entry strategies are shaped by prestige-seeking motivations and a culture of risk aversion. From the market selection, entry mode and higher education literature, a conceptual model, embedded with four propositions, is presented. The model sees…

  14. Effective Implementation of E-Learning: A Case Study of the Australian Army

    ERIC Educational Resources Information Center

    Newton, Diane; Ellis, Allan

    2005-01-01

    Purpose--This case study identifies factors influencing the implementation of e-learning within the Australian Army training context. Design/methodology/approach--A grounded theory approach was used to gain an understanding of the concerns of stakeholders involved in e-learning implementation. This research included interviews with Army managers,…

  15. Catching a Wave: An Australian Case Study on Building Competence in Search of Competitive Advantage.

    ERIC Educational Resources Information Center

    Kellie, Deborah

    1998-01-01

    A case study of an Australian road construction company's skill development project is an example of an attempt to increase competitive advantage through competency acquisition. It remains to be seen whether reconstruction of the company will result in improved productivity and financial performance. (SK)

  16. Education Policy as Numbers: Data Categories and Two Australian Cases of Misrecognition

    ERIC Educational Resources Information Center

    Lingard, Bob; Creagh, Sue; Vass, Greg

    2012-01-01

    While numbers, data and statistics have been part of the bureaucracy since the emergence of the nation state, the paper argues that the governance turn has seen the enhancement of the significance of numbers in policy. The policy as numbers phenomenon is exemplified through two Australian cases in education policy, linked to the national schooling…

  17. REGULATION OF AUSTRALIAN MEDICAL PROFESSIONALS AND NATIONAL SECURITY: LESSONS FROM THREE CASE STUDIES.

    PubMed

    Faunce, Thomas; McKenna, Michael; Rayner, Johanna; Hawes, Jazmin

    2016-03-01

    In recent times, Australia's national security concerns have had controversial impacts on regulation of Australian medical practitioners in areas related to immigration detention. This column explores three recent case studies relevant to this issue. The first involves the enactment of the Australian Border Force Act 2015 (Cth), which has a significant impact on the regulation of medical professionals who work with people in immigration detention. The second involves the decision of the High Court of Australia in Plaintiff M68/2015 v Minister for Immigration and Border Protection [2016] HCA 1 that an amendment to Australian federal legislation justified sending children back to immigration detention centres in Papua New Guinea and Nauru. This legislation was previously heavily criticised by the Australian Human Rights Commissioner. The third concerns the deregistration of Tareq Kamleh, an Australian doctor of German-Palestinian heritage who came to public attention on ANZAC Day 2015 with his appearance online in a propaganda video for the Islamic State terrorist organisation al-Dawla al-Islamyia fil Iraq wa'al Sham, also known as Islamic State of Iraq and Syria (ISIS) or Daesh. Australia's professional regulatory system should presumptively respect professional virtues, such as loyalty to the relief of individual patient suffering, when dealing with doctors (whether in Australia or ISIS-occupied Syria) working under regimes whose principles appear inconsistent with those of ethics and human rights.

  18. REGULATION OF AUSTRALIAN MEDICAL PROFESSIONALS AND NATIONAL SECURITY: LESSONS FROM THREE CASE STUDIES.

    PubMed

    Faunce, Thomas; McKenna, Michael; Rayner, Johanna; Hawes, Jazmin

    2016-03-01

    In recent times, Australia's national security concerns have had controversial impacts on regulation of Australian medical practitioners in areas related to immigration detention. This column explores three recent case studies relevant to this issue. The first involves the enactment of the Australian Border Force Act 2015 (Cth), which has a significant impact on the regulation of medical professionals who work with people in immigration detention. The second involves the decision of the High Court of Australia in Plaintiff M68/2015 v Minister for Immigration and Border Protection [2016] HCA 1 that an amendment to Australian federal legislation justified sending children back to immigration detention centres in Papua New Guinea and Nauru. This legislation was previously heavily criticised by the Australian Human Rights Commissioner. The third concerns the deregistration of Tareq Kamleh, an Australian doctor of German-Palestinian heritage who came to public attention on ANZAC Day 2015 with his appearance online in a propaganda video for the Islamic State terrorist organisation al-Dawla al-Islamyia fil Iraq wa'al Sham, also known as Islamic State of Iraq and Syria (ISIS) or Daesh. Australia's professional regulatory system should presumptively respect professional virtues, such as loyalty to the relief of individual patient suffering, when dealing with doctors (whether in Australia or ISIS-occupied Syria) working under regimes whose principles appear inconsistent with those of ethics and human rights. PMID:27323633

  19. The case for greater Australian support for population issues.

    PubMed

    Schacht, C

    1992-07-01

    The 1989 Report of the Joint Committee on Foreign Affairs, Defence and Trade recommended rapid growth in aid, saying that if Australia is to achieve the internationally accepted aid goal of 0.7% of GNP within 5 years, then aid should reach 0.5% of GNP by 1992. Aid presently is at 0.34% of GNP. In the 1991-92 aid budget, population activities totaled around $7 million, with $1.7 million to the United Nations Population Fund and around $1.2 million to the International Planned Parenthood Federation, the World Health Organization's Human Reproduction Program, the Population Council, and the International Union for the Scientific Study of Population. Over the last 20 years, the percentage of Third World couples participating in voluntary family planning programs has risen to 50%. It is estimated that 300 million more families wish to limit their family size and would participate if they had the means to do so. An estimated 100 million women have inadequate access to contraception. Programs such as the Australian International Development Assistance Bureau (AIDAB)'s Activities Scheme work towards widening women's options. Literacy allows access to information on family planning and health care. The Australian Human Rights Delegation to China discussed population and family planning policies within China. Family planning officials admitted the problem of female infanticide in rural and remote areas. In Sichuan Province, for every 108 boys registered at birth in 1990, only 100 girls were registered. Officials also admitted the problem of having to rely on abortion for contraception. In China assistance is needed to make available contraceptive devices to Chinese women. In 1991, the Australian bilateral and multilateral aid for family planning was less than $10 million, of a total aid budget of $1100 million. An initial population funding to the level of around $10 million, rising to $60 million per year by the end of a 4-year program, would enable Australia to be

  20. Dance-related concussion: a case series.

    PubMed

    Stein, Cynthia J; Kinney, Susan A; McCrystal, Tara; Carew, Elizabeth A; Bottino, Nicole M; Meehan Iii, William P; Micheli, Lyle J

    2014-01-01

    Sport-related concussion is a topic of increasing public and media attention; the medical literature on this topic is growing rapidly. However, to our knowledge no published papers have described concussion specifically in the dancer. This case series involved a retrospective chart review at a large teaching hospital over a 5.5-year period. Eleven dancers (10 female, 1 male) were identified who experienced concussions while in dance class, rehearsal, or performance: 2 in classical ballet, 2 in modern dance, 2 in acro dance, 1 in hip hop, 1 in musical theater, and 3 were unspecified. Dancers were between 12 and 20 years old at the time of presentation. Three concussions occurred during stunting, diving, or flipping. Three resulted from unintentional drops while partnering. Two followed slips and falls. Two were due to direct blows to the head, and one dancer developed symptoms after repeatedly whipping her head and neck in a choreographed movement. Time to presentation in the sports medicine clinic ranged from the day of injury to 3 months. Duration of symptoms ranged from less than 3 weeks to greater than 2 years at last documented follow-up appointment. It is concluded that dancers do suffer dance-related concussions that can result in severe symptoms, limitations in dance participation, and difficulty with activities of daily living. Future studies are needed to evaluate dancers' recognition of concussion symptoms and care-seeking behaviors. Additional work is also necessary to tailor existing guidelines for gradual, progressive, safe return to dance. PMID:24844421

  1. Facial firework injury: a case series.

    PubMed

    Tadisina, Kashyap K; Abcarian, Ariane; Omi, Ellen

    2014-07-01

    Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future. PMID:25035740

  2. Dance-related concussion: a case series.

    PubMed

    Stein, Cynthia J; Kinney, Susan A; McCrystal, Tara; Carew, Elizabeth A; Bottino, Nicole M; Meehan Iii, William P; Micheli, Lyle J

    2014-01-01

    Sport-related concussion is a topic of increasing public and media attention; the medical literature on this topic is growing rapidly. However, to our knowledge no published papers have described concussion specifically in the dancer. This case series involved a retrospective chart review at a large teaching hospital over a 5.5-year period. Eleven dancers (10 female, 1 male) were identified who experienced concussions while in dance class, rehearsal, or performance: 2 in classical ballet, 2 in modern dance, 2 in acro dance, 1 in hip hop, 1 in musical theater, and 3 were unspecified. Dancers were between 12 and 20 years old at the time of presentation. Three concussions occurred during stunting, diving, or flipping. Three resulted from unintentional drops while partnering. Two followed slips and falls. Two were due to direct blows to the head, and one dancer developed symptoms after repeatedly whipping her head and neck in a choreographed movement. Time to presentation in the sports medicine clinic ranged from the day of injury to 3 months. Duration of symptoms ranged from less than 3 weeks to greater than 2 years at last documented follow-up appointment. It is concluded that dancers do suffer dance-related concussions that can result in severe symptoms, limitations in dance participation, and difficulty with activities of daily living. Future studies are needed to evaluate dancers' recognition of concussion symptoms and care-seeking behaviors. Additional work is also necessary to tailor existing guidelines for gradual, progressive, safe return to dance.

  3. Facial Firework Injury: A Case Series

    PubMed Central

    Tadisina, Kashyap Komarraju; Abcarian, Ariane; Omi, Ellen

    2014-01-01

    Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future. PMID:25035740

  4. The Amateur-Turned-Professional Syndrome: Two Australian Case Studies

    NASA Astrophysics Data System (ADS)

    Orchiston, Wayne

    In the nineteenth century, and particularly during the era which saw the gradual replacement of positional astronomy by astrophysics, amateur astronomers were able to make an important contribution to international astronomy. Many were blessed with instruments comparable to those found in professional observatories; they pursued the same astronomical research programs as their professional colleagues; published in the same journals; received the same medals and awards; and played key roles in the formation of the earliest astronomical groups and societies. In this healthy environment of amateur-professional co-operation it was possible for talented amateur astronomers to transfer to professional ranks, and the "amateur-turned-professional" (henceforth ATP) was a distinctive feature of late nineteenth century astronomy. In this paper we focus on two Australian-based ATPs, R.T.A. Innes and C.J. Merfield, and examine their contributions as amateur astronomers in Sydney before reviewing the circumstances surrounding their transfer to the Cape Observatory (South Africa) and Sydney Observatory, in 1896 and 1904, respectively.

  5. Case series in cognitive neuropsychology: promise, perils, and proper perspective.

    PubMed

    Rapp, Brenda

    2011-10-01

    Schwartz and Dell (2010) advocated for a major role for case series investigations in cognitive neuropsychology. They defined the key features of this approach and presented a number of arguments and examples illustrating the benefits of case series studies and their contribution to computational cognitive neuropsychology. In the Special Issue on "Case Series in Cognitive Neuropsychology" there are six commentaries on Schwartz and Dell as well as a response to the six commentaries by Dell and Schwartz (2011 this issue). In this paper, I provide a brief summary of the key points made in Schwartz and Dell, and I review the promise and perils of case series design as revealed by the six commentaries. I conclude by placing the set of papers within a broader perspective, providing some clarification of the historical record on case series and single-case approaches, raising some cautionary notes for case series studies and situating both case series and single-case approaches within the larger context of theory development in the cognitive sciences.

  6. Dengue associated hemophagocytic lymphohistiocytosis: a case series.

    PubMed

    Pal, Priyankar; Giri, Prabhas Prasun; Ramanan, A V

    2014-06-01

    Hemophagocytic lymphohistiocytosis is a rare complication of dengue. We present 8 cases of dengue associated hemophagocytic lymphohistiocytosis diagnosed in our hospital during the dengue outbreak of 2012. All the cases were treated with a short (4 weeks) course of steroids along with supportive measures, and showed an excellent response.

  7. [Hypophysitis autoimmune. Case series and literature review].

    PubMed

    Pérez, Guadalupe; Almeda-Valdés, Paloma; Cuevas-Ramos, Daniel; Juárez-Comboni, Sonia Citlali; Higuera-Calleja, Jesús; Gómez-Pérez, Francisco Javier

    2013-01-01

    Autoimmune hypophysitis is a rare condition that must be considered in the differential diagnosis of any pituitary tumor. We present a series of nine patients with clinical and radiologic diagnosis of autoimmune hypophysitis that were admitted to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) in Mexico City between 2000-2012. Clinical, biochemical, imaging features (on MRI), treatment, and follow-up are described, and a review on this disease is presented.

  8. Sudden Death Following Exercise; a Case Series

    PubMed Central

    Najari, Fares; Alimohammadi, Alimohammad; Ghodrati, Parisa

    2016-01-01

    Introduction: Natural and unexpected death that happens within less than one hour of first symptom occurrence is called sudden death. Cardiovascular diseases are the main known reason of sudden death and more than 75% of sudden deaths in athletes are assigned to it. Here we reported the autopsy results of all cases with sudden death following exercise that were referred to forensic center of Tehran, Iran, from 2009 to 2014. Methods: In this cross sectional study all subjects who were registered to forensic medicine center of Tehran, Iran, from 2009 to 2014, as a case of sudden death following exercise were evaluated. Demographic data and medical history as well as autopsy and toxicology findings were retrospectively gathered using profiles of the deceased. Results were reported using descriptive analysis. Results: 14 cases were registered as sudden death following exercise in forensic medicine profiles during the study period. Exploring the files of the mentioned deceased, revealed five non-compatible cases in this regard. Finally, 9 eligible cases were enrolled (88.9% male). The mean age of the deceased was 28.66 ± 10.86 years (range: 7 – 40). Toxicological tests were available for 7 cases, one of which was positive for tramadol. Sudden death following football was reported most frequently (44.4%). Only 3 (33.3%) cases had herald signs such as chest pain, syncope, or loss of consciousness. 1 case (11.11%) had a positive history of sudden death in relatives. Conclusion: Although most sudden death victims are asymptomatic until the event, all those who suffer from symptoms such as chest pain, shortness of breath, dizziness, fatigue and irregular heart rate during physical activities, should be screened regarding common probable causes of sudden death. PMID:27274521

  9. Eat, drink and gamble: marketing messages about ‘risky’ products in an Australian major sporting series

    PubMed Central

    2013-01-01

    Background To investigate the alcohol, gambling, and unhealthy food marketing strategies during a nationally televised, free to air, sporting series in Australia. Methods/approach Using the Australian National Rugby League 2012 State of Origin three-game series, we conducted a mixed methods content analysis of the frequency, duration, placement and content of advertising strategies, comparing these strategies both within and across the three games. Results There were a total of 4445 episodes (mean = 1481.67, SD = 336.58), and 233.23 minutes (mean = 77.74, SD = 7.31) of marketing for alcoholic beverages, gambling products and unhealthy foods and non-alcoholic beverages during the 360 minutes of televised coverage of the three State of Origin 2012 games. This included an average per game of 1354 episodes (SD = 368.79) and 66.29 minutes (SD = 7.62) of alcohol marketing; 110.67 episodes (SD = 43.89), and 8.72 minutes (SD = 1.29) of gambling marketing; and 17 episodes (SD = 7.55), and 2.74 minutes (SD = 0.78) of unhealthy food and beverage marketing. Content analysis revealed that there was a considerable embedding of product marketing within the match play, including within match commentary, sporting equipment, and special replays. Conclusions Sport is increasingly used as a vehicle for the promotion of range of ‘risky consumption’ products. This study raises important ethical and health policy questions about the extent and impact of saturation and incidental marketing strategies on health and wellbeing, the transparency of embedded marketing strategies, and how these strategies may influence product consumption. PMID:23914917

  10. Lesson Two: Terra Australis. Australian Studies High School Series. History Unit.

    ERIC Educational Resources Information Center

    Waldron, John

    This lesson, one of four stand-alone lessons that examine Australia as an aspect of world history, points out that Australia's unique geographic characteristics and history serve as a useful case study of key global concepts. The lesson focuses on exploration and control of trade routes during the Age of Discovery. The lesson has two parts. In…

  11. Pneumothorax, music and balloons: A case series

    PubMed Central

    Dejene, Shiferaw; Ahmed, Fahim; Jack, Kastelik; Anthony, Arnorld

    2013-01-01

    We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation. PMID:23922614

  12. Amnesia for autobiographical memory: a case series.

    PubMed

    Chadda, R K; Singh, N; Raheja, D

    2002-07-01

    Functional amnesia for autobiographical memory is a rare but pathognomic sign of dissociative disorders. Amnesia for part of one's personal history is sometimes also seen in other functional disorders like depression and schizophrenia but autobiographical amnesia in these disorders is relatively rar . Phenomenologically the autobiographical memory loss, amnesia for events during the amnestic episode and change of identity (as in fugae and dissociative identity disorder) are all expressions of altered memory organisation. This paper reports three cases of autobiographical amnesia with clinical diagnoses of dissociative disorder unspecified type, dissociative amnesia and schizophrenia that were treated successfully. The phenomenon of autobiographical amnesia is discussed in the background of these cases.

  13. Rare Mimickers of Exostosis: A Case Series

    PubMed Central

    Perubhotla, Lakshmi Manasa

    2016-01-01

    Exophytic growths from bones are a common entity. Osteochondroma is the most common benign exophytic lesion and we tend to diagnose every benign looking exophytic lesion as osteochondroma. Here we reported two entities of cases, one was Nora’s lesion and another one was supracondylar process of humerus, both of which were mimickers of osteochondroma and their salient and differentiating features from osteochondromas.

  14. On a Particular Case of Series

    ERIC Educational Resources Information Center

    de Oliveira, E. Capelas

    2008-01-01

    We present a general formula for a triple product involving four real numbers. As a particular case, we get the sum of a triple product of four odd integers. Some interesting results are recovered. We derive a general formula for more than four odd numbers.

  15. The state, the market, and general practice: the Australian case.

    PubMed

    White, K N

    2000-01-01

    This article examines the development of general practice in the latter half of the 20th century, documenting the issues of concern to both the profession and the state. General practice developed hand in hand with the welfare state in Australia. As the structural changes associated with restructuring of the welfare state have advanced, so have the fortunes of general practice declined, despite significant attempts in the 1970s and 1980s to "save" general practice by both the profession and the state. These structural changes have operated on two fronts, the economic and the cultural. On the economic, changes to the employment of general practitioners clearly indicate ongoing proletarianization, particularly in a changing environment of labor-capital relations. At the cultural level, development of the self-help and the women's movements and the elective affinity of these groups with the individualism of the new right are leading to deprofessionalization. The author advances this argument in a review of general practice over the last 40 years and in a case study of community health services. Theoretically he argues for a combination of the proletarianization and the deprofessionalization theses.

  16. Eruption cysts: A series of two cases

    PubMed Central

    Dhawan, Preeti; Kochhar, Gulsheen Kaur; Chachra, Sanjay; Advani, Shweta

    2012-01-01

    Eruption cysts are benign cysts that appear on the mucosa of a tooth shortly before its eruption. They may disappear by themselves but if they hurt, bleed or are infected they may require surgical treatment to expose the tooth and drain the contents. Here we present 2 case reports of eruption cysts presenting with different chief complaint. The treatment included incising the eruption cyst and draining the contents of the cyst. PMID:23559935

  17. Stiff-Person Syndrome: Case Series

    PubMed Central

    Jung, Yu Jin; Jeong, Han G.; Kim, Ryul; Kim, Han-Joon; Jeon, Beom S.

    2014-01-01

    Stiff-person syndrome (SPS) is a rare disorder, characterized by progressive fluctuating muscular rigidity and spasms. Glutamic acid decarboxylase (GAD) antibody is primarily involved in the pathogenesis of SPS and SPS is strongly associated with other autoimmune disease. Here we report three cases of patients with classical SPS finally confirmed by high serum level of GAD antibodies. All of our patients respond favorably to gamma amino butyric acid-enhancing drugs and immunotherapies. PMID:24926406

  18. Rare Mimickers of Exostosis: A Case Series

    PubMed Central

    Perubhotla, Lakshmi Manasa

    2016-01-01

    Exophytic growths from bones are a common entity. Osteochondroma is the most common benign exophytic lesion and we tend to diagnose every benign looking exophytic lesion as osteochondroma. Here we reported two entities of cases, one was Nora’s lesion and another one was supracondylar process of humerus, both of which were mimickers of osteochondroma and their salient and differentiating features from osteochondromas. PMID:27630926

  19. Warthin's tumour: a retrospective case series.

    PubMed

    Taylor, T R; Cozens, N J A; Robinson, I

    2009-11-01

    Warthin's tumour (benign cystadenolymphoma) is the second most common salivary gland tumour after pleomorphic salivary adenoma, and it is commonly encountered in routine head and neck ultrasonography. Tissue diagnosis can be achieved by fine-needle aspiration. Infarction and inflammatory response following fine-needle aspiration is previously described in excision specimens. We describe 7 cases of radiologically infarcting Warthin's tumours in situ in a retrospective analysis of 76 patients, and demonstrate an approximate incidence of at least 9% of infarction following fine-needle aspiration in lesions left in situ. We recommend the possibility of infarction and associated clinical symptoms being incorporated into pre-fine-needle aspiration patient counselling.

  20. [Charles Bonnet syndrome. A 45-case series].

    PubMed

    Santos-Bueso, Enrique; Serrador-García, Mercedes; Porta-Etessam, Jesús; Rodríguez-Gómez, Octavio; Martínez-de-la-Casa, José M; García-Feijoo, Julián; García-Sánchez, Julián

    2015-04-16

    Introduccion. El sindrome de Charles Bonnet (SCB) es un cuadro clinico que se caracteriza por la presencia de alucinaciones visuales, principalmente complejas, en pacientes con estado cognitivo conservado e importante deterioro de la vision. El incremento del SCB se debe al aumento de la esperanza de vida y al desarrollo de patologias asociadas al envejecimiento, como la degeneracion macular asociada a la edad. Pacientes y metodos. Se estudian las caracteristicas de una serie de 45 pacientes diagnosticados de SCB en la unidad de neurooftalmologia del Hospital Clinico San Carlos. Los pacientes procedian de las unidades de patologia macular, glaucoma, superficie ocular y urgencias, en las que fueron diagnosticados de SCB, que se confirmo en la unidad multidisciplinar formada por oftalmologia, neurologia y psiquiatria del mismo hospital. Resultados. El 66,66% eran mujeres, de mas de 80 anos (68,88%), principalmente con degeneracion macular asociada a la edad (37,77%). Las alucinaciones que los pacientes presentaban con mas frecuencia eran personas y caras (35,55%), en color (66,66%), en movimiento (80%), con un tiempo de evolucion de 6-12 meses (26,66%), frecuencia de tres episodios al dia (35,55%) y de 3-5 minutos de duracion (35,55%). Conclusiones. El SCB es un complejo sindrome cuya incidencia se esta incrementando en nuestras consultas y que precisa un abordaje multidisciplinar entre oftalmologos, neurologos y psiquiatras para evitar diagnosticos erroneos y proporcionar un tratamiento adecuado. Son necesarios nuevos estudios para un conocimiento mas profundo y adecuado del SCB.

  1. Successful management of hamstring injuries in Australian Rules footballers: two case reports

    PubMed Central

    Hoskins, Wayne T; Pollard, Henry P

    2005-01-01

    Hamstring injuries are the most prevalent injury in Australian Rules football. There is a lack of evidence based literature on the treatment, prevention and management of hamstring injuries, although it is agreed that the etiology is complicated and multi-factorial. We present two cases of hamstring injury that had full resolution after spinal manipulation and correction of lumbar-pelvic biomechanics. There was no recurrence through preventative treatment over a twelve and sixteen week period. The use of spinal manipulation for treatment or prevention of hamstring injury has not been documented in sports medicine literature and should be further investigated in prospective randomized controlled trials. PMID:15967047

  2. Tubercular and bacterial coinfection: A case series.

    PubMed

    Arora, Anshum Aneja; Krishnaswamy, Uma Maheswari; Moideen, Riyaz P; Padmaja, Mantha Satya

    2015-01-01

    Tuberculosis (TB) is a major public health issue in India. Although dual infection with tuberculosis and bacteria/fungi has been reported in immunocompromised patients, their co-occurrence in individuals with preserved immunity may complicate the clinical presentation, leading to inadequate treatment and unsatisfactory outcomes. In patients with pulmonary tuberculosis, the occurrence of tubercular lesions in atypical locations may further confound the clinical picture if only one of the pathogens is isolated, initially leading to a suboptimal therapeutic response. A strong index of suspicion and additional diagnostic testing may be required for diagnosis and treatment of the second infection. We report three unusual cases of concurrent tubercular and bacterial infection, of which two are pulmonary and one is extrapulmonary. PMID:25814806

  3. PLATEAU IRIS SYNDROME--CASE SERIES.

    PubMed

    Feraru, Crenguta Ioana; Pantalon, Anca Delia; Chiselita, Dorin; Branisteanu, Daniel

    2015-01-01

    Plateau iris is characterized by closing the anterior chamber angle due to a large ciliary body or due to its anterior insertion that alters the position of iris periphery in respect to the trabecular meshwork. There are two aspects that need to be differentiated: plateau iris configuration and plateau iris syndrome. The first describes a situation when the iris root is flat and the anterior chamber is not shallow, the latter refers to a post laser iridotomy condition in which a patent iridotomy has removed the relative pupillary block, but goniscopically confirmed angle closure recurs without central shallowing of the anterior chamber. Isolated plateau iris syndrome is rare compared to plateau iris configuration. We hereby present two case reports of plateau iris syndrome in young patients who came to an ophthalmologic consult by chance.

  4. Takotsubo Cardiomyopathy: Case Series and Literature Review

    PubMed Central

    Cavayero, Chase; Kar, Pran; Kar, Sunny

    2016-01-01

    Although originally considered to be uncommon, Takotsubo cardiomyopathy is becoming increasingly visible, annually comprising an increasing portion of suspected diagnoses of acute coronary syndrome. This condition is characterized by reversible left ventricular akinesis without significant coronary artery obstruction. This case study presents five patients diagnosed with Takotsubo cardiomyopathy, as confirmed by echocardiogram and angiography. All of the patients presented with classic myocardial chest pain and elevated troponins. Following diagnosis, they were treated with supportive measures, particularly angiotensin-converting enzyme inhibitors, and beta-blockers. All patients made a full recovery. Though the mechanism of Takotsubo has not been fully elucidated, hypotheses suggest it may be related to excessive catecholamine levels causing either myocardial stunning or coronary vasospasm. Recognition and understanding of this unusual pathology are essential because it can lead to improved clinical management. PMID:27446769

  5. Chemotherapy-induced Spontaneous Pneumothorax: Case Series.

    PubMed

    Hendarsih, Een; Fadjari, Trinugroho H; Oehadian, Amaylia

    2016-04-01

    We present 2 patients who developed spontaneous pneumothorax (SP) following rapid regression of lymphoma and rhabdomyosarcoma with lung metastases. Case 1, a 43-year old man was admitted to our hospital with dyspnea 10 days before admission. He denied any recent trauma or previous treatment for lung tuberculosis. Three weeks prior to admission, he received first cycle of CHOP for non-Hodgkin's lymphoma stage II BE. Chest X-ray consistent with right pneumothorax. After treatment with chest tube drainage for about 1 month, the patient recovered and chemotherapy could be continued without further complications. Case 2, a 35- year old man was admitted to other hospital with dyspnea and chest pain on day 4 after second cycle of systemic combined chemotherapy for rhabdomyosarcoma stage IV (lung metastases) with doxorubicin, ifosfamide, mesna, and dacarbazine. Chest X-ray showed hydropneumothorax on right and left lung. After treatment with chest tube drainage about 2 weeks, the patient recovered and chemotherapy could be continued without further complications. The mechanism of pneumothorax following chemotherapy is not clearly understood yet, however, several hypotheses have been considered: 1) the rupture of a subpleural bulla after chemotherapy; 2) the rupture of an emphysematous bulla in an over expanded portion of the lung which is partially obstructed by a neoplasm; 3) tumor lyses or necrosis due to cytotoxic chemotherapy directly induces the formation of fistula. Dyspnea and chest pain suddenly appear during successful chemotherapy for metastatic chemosensitive tumors should alert the physician to the possibility of SP. The treatment is directed toward lung re-expansion. Chemotherapy induced pneumothorax should be considered as oncologic emergency. PMID:27550883

  6. Hereditary prosopagnosia: the first case series.

    PubMed

    Grueter, Martina; Grueter, Thomas; Bell, Vaughan; Horst, Juergen; Laskowski, Wolfgang; Sperling, Karl; Halligan, Peter W; Ellis, Hadyn D; Kennerknecht, Ingo

    2007-08-01

    Prosopagnosia is defined as a specific type of visual agnosia characterised by a discernible impairment in the capacity to recognise familiar people by their faces. We present seven family pedigrees with 38 cases in two to four generations of suspected hereditary prosopagnosia, detected using a screening questionnaire. Men and women are impaired and the anomaly is regularly transmitted from generation to generation in all pedigrees studied. Segregation is best explained by a simple autosomal dominant mode of inheritance, suggesting that loss of human face recognition can occur by the mutation of a single gene. Eight of the 38 affected persons were tested on the Warrington Recognition Memory Test for Faces (RMF; Warrington, 1984), famous and family faces tests, learning tests for internal and external facial features and a measure of mental imagery for face and non-face images. As a group, the eight participants scored significantly below an age- and education-matched comparison group on the most relevant test of face recognition; and all were impaired on at least one of the tests. The results provide compelling evidence for significant genetic contribution to face recognition skills and contribute to the promise offered by the emerging field of cognitive neurogenetics. PMID:17710825

  7. Salon sink radiculopathy: a case series.

    PubMed

    Stitik, T P; Nadler, S F; Foye, P M

    1999-01-01

    Cervical radiculopathy can be diagnosed on physical examination with the Spurling test, which narrows neural foramina via neck extension along with coupled rotation and side-bending. In the presence of cervical radiculopathy, this test can reproduce radicular symptoms by transmitting compressive forces to affected nerve roots as they traverse the neural foramina. Treatment of cervical radiculopathy includes patient education to avoid obvious postures that exacerbate radicular symptoms and to assume positions that centralize discomfort. A potentially harmful position to which many patients are unwittingly subjected at least several times per year occurs when their hair is being shampooed in a salon sink before a haircut. This posture causes neck extension and is combined with rotation and side-bending as the patient's head is being manipulated during the shampooing. When the stylist then also applies a mild compressive force while shampooing the patient's hair, hyperextension of the neck is produced. We present two patients with cervical radiculopathy that was significantly exacerbated after the patient's hair had been shampooed in a salon sink; subsequently, these patients required oral administration of steroids. These cases illustrate that patients with suspected or known cervical radiculopathy should be forewarned to avoid this otherwise seemingly innocuous activity.

  8. Pica in iron deficiency: a case series

    PubMed Central

    2010-01-01

    Introduction Pica is an unusual condition where patients develop cravings for non-nutritive substances that can cause significant health risks. We report three patients with pica, two of them showing evolutionary changes associated with pica and the third demonstrating a peculiar nature of pica, which has yet to be reported. Case presentation We describe three patients who presented with symptoms of pica. The first patient is a 36-year-old Caucasian woman who had dysfunctional uterine bleeding associated with daily ingestion of two super-sized cups of ice as iced tea. The second patient is a 62-year-old Caucasian man who presented with bleeding from colonic polyps associated with drinking partially frozen bottled water. Lastly, the third patient, a 37-year-old Hispanic woman, presented with dysfunctional uterine bleeding and habitually chewed rubber bands. All three patients presented with hematological parameters diagnostic for iron deficiency anemia. Conclusion Pica has been practiced for centuries without a clear etiology. We have noticed that the younger community of academic and community physicians are not aware of the importance of complaints related to pica. None of our patients we describe here, as well as their primary care physicians, were aware of the importance of their pica related symptoms. Pica symptoms abated in one of our patients upon iron supplementation, while the other two are currently under treatment as of this writing. We believe pica is an important sign of iron deficiency that should never be ignored, and the craving for any unusual substance should compel clinicians to search for occult blood loss with secondary iron deficiency. PMID:20226051

  9. Varieties of Misdiagnosis in ASD: An Illustrative Case Series

    ERIC Educational Resources Information Center

    Van Schalkwyk, Gerrit I.; Peluso, Francesco; Qayyum, Zheala; McPartland, James C.; Volkmar, Fred R.

    2015-01-01

    The relationship between autism spectrum disorders (ASD) and psychotic disorders (PD) is a focus of continued interest. There are substantial conceptual and clinical difficulties associated with diagnosing comorbid PD in individuals who have ASD. In this case series, we report on five cases where adolescents with previously diagnosed ASD were also…

  10. Etiologies of Autism in a Case-Series from Tanzania

    ERIC Educational Resources Information Center

    Mankoski, Raymond E.; Collins, Martha; Ndosi, Noah K.; Mgalla, Ella H.; Sarwatt, Veronica V.; Folstein, Susan E.

    2006-01-01

    Most autism has a genetic cause although post-encephalitis cases are reported. In a case-series (N = 20) from Tanzania, 14 met research criteria for autism. Three (M:F = 1:2) had normal development to age 22, 35, and 42 months, with onset of autism upon recovery from severe malaria, attended by prolonged high fever, convulsions, and in one case…

  11. Mechanics, Problems and Contributions of Tertiary Strategic Alliance: The Case of 22 Australian Universities.

    ERIC Educational Resources Information Center

    Saffu, Kojo; Mamman, Aminu

    1999-01-01

    A study of international strategic alliances involving 22 Australian universities indicates that a majority of universities have frameworks for internationalization initiatives, with top institutional management instrumental in initiating joint ventures with overseas institutions despite limited resources. Australian universities believe they…

  12. Familial expansile osteolysis: An Australian case report of a Paget's Disease Mimic.

    PubMed

    Topham, Dean Grant; Sampson, Matthew John

    2016-06-01

    We report a case of familial expansile osteolysis (FEO) with multimodality imaging findings and histopathological correlation in a 42-year-old man presenting to a South Australian Emergency Department. FEO is a unique metabolic bone condition that is similar in some respects to Paget's disease but distinct enough in its clinical, radiological and histological findings to be classified as a separate disease process. It is inherited in an autosomal dominant pattern and typified by increased osteoclast activity, medullary expansion, and hearing and dental problems. These changes can lead to significant morbidity with individuals affected suffering from bone pain and pathological fractures. To the best of the authors' knowledge, there are no reported cases in the literature documenting this disease in Australia. PMID:27258166

  13. Finite case series or infinite single-case studies? Comments on "Case series investigations in cognitive neuropsychology" by Schwartz and Dell (2010).

    PubMed

    Lambon Ralph, Matthew A; Patterson, Karalyn; Plaut, David C

    2011-10-01

    In this commentary, though acknowledging that a case-series approach in neuropsychology is not always possible, we set out a series of considerations that in our view make this approach generally superior to single-case study. We argue that case-series designs are crucial for theory-testing, assessment of computational models, evaluation of inter-patient variation (including selection criteria, patient homogeneity/heterogeneity, premorbid individual differences, etc.) and to establish solid foundations for the interpretation of behavioural dissociations and associations. We conclude by suggesting that, alongside other neuroscience techniques, case-series cognitive neuropsychology provides a crucial contribution to the future of clinical and cognitive neuroscience.

  14. Isolated gingival overgrowths: A review of case series.

    PubMed

    Raizada, Shruti; Varghese, Jothi M; Bhat, K M; Gupta, Kanishk

    2016-01-01

    Clinicians are often intrigued by the varied manifestations of the gingival tissue. Gingival overgrowth is a common clinical finding and most of them represent a reactive hyperplasia as a direct result of plaque-related inflammatory gingival disease. These types of growth generally respond to good plaque control, removal of the causative irritants, and conservative tissue management. This case series highlights three different cases of localized gingival overgrowth and its management with emphasis on the importance of patient awareness and motivation. PMID:27307683

  15. Isolated gingival overgrowths: A review of case series

    PubMed Central

    Raizada, Shruti; Varghese, Jothi M.; Bhat, K. M.; Gupta, Kanishk

    2016-01-01

    Clinicians are often intrigued by the varied manifestations of the gingival tissue. Gingival overgrowth is a common clinical finding and most of them represent a reactive hyperplasia as a direct result of plaque-related inflammatory gingival disease. These types of growth generally respond to good plaque control, removal of the causative irritants, and conservative tissue management. This case series highlights three different cases of localized gingival overgrowth and its management with emphasis on the importance of patient awareness and motivation. PMID:27307683

  16. Isolated gingival overgrowths: A review of case series.

    PubMed

    Raizada, Shruti; Varghese, Jothi M; Bhat, K M; Gupta, Kanishk

    2016-01-01

    Clinicians are often intrigued by the varied manifestations of the gingival tissue. Gingival overgrowth is a common clinical finding and most of them represent a reactive hyperplasia as a direct result of plaque-related inflammatory gingival disease. These types of growth generally respond to good plaque control, removal of the causative irritants, and conservative tissue management. This case series highlights three different cases of localized gingival overgrowth and its management with emphasis on the importance of patient awareness and motivation.

  17. Burdens Too Difficult to Carry? A Case Study of Three Academically Able Indigenous Australian Masters Students Who Had to Withdraw

    ERIC Educational Resources Information Center

    Chirgwin, Sharon Kaye

    2015-01-01

    Previous research into attrition rates of Indigenous Australian Higher Degree by Research (HDR) candidates has focused on institutional barriers, highlighting cultural disparities. This case study of three academically able candidates who withdrew before completion from an institution designed to meet the needs of Indigenous students describes…

  18. Use of Cantilever Mechanics for Impacted Teeth: Case Series

    PubMed Central

    Paduano, Sergio; Spagnuolo, Gianrico; Franzese, Gerardo; Pellegrino, Gioacchino; Valletta, Rosa; Cioffi, Iacopo

    2013-01-01

    This paper describes the orthodontic treatment, and the biomechanics of cantilevers for the impaction of permanent teeth in youngs, adolescents, and adults. In these case series, multibracket straightwire fixed appliances, together with cantilever mechanics, were used to treat the impaired occlusion. PMID:24511332

  19. Cacogeusia following pine nut ingestion: a six patient case series.

    PubMed

    Hampton, Rachael L; Scully, Crispian; Gandhi, Shan; Raber-Durlacher, Judith

    2013-01-01

    This is a retrospective case series of 6 patients complaining of a bad taste (cacogeusia) specifically metallogeusia, following the ingestion of pine nuts.(1) The taste arose always within 48h of ingestion, and in all but one patient spontaneously resolved within 14 days. Pine nuts also have a potential for triggering anaphylaxis.(2).

  20. Globalisation and Internationalisation: Models and Patterns of Change for Australian Academic Librarians

    ERIC Educational Resources Information Center

    Becker, Linda K. W.

    2006-01-01

    This is the final article in a series examining globalisation and the role of Australian librarians in internationalising library, university, and international practice in higher education. It describes case studies of Australian academic libraries in which a successful pattern for internationalisation emerged. The conclusions of the research are…

  1. A Case of Ancylostoma ceylanicum Infection Occurring in an Australian Soldier Returned from Solomon Islands

    PubMed Central

    Speare, Rick; Bradbury, Richard Stewart; Croese, John

    2016-01-01

    A 26-year-old male member of the Australian Defense Force presented with a history of central abdominal pain of 4 weeks duration and peripheral eosinophilia consistent with eosinophilic enteritis. Acute hookworm disease was diagnosed as the cause. Adult worms recovered from feces after therapy with albendazole were morphologically consistent with Ancylostoma ceylanicum. As the patient had been deployed with the Regional Assistance Mission to Solomon Islands for 6 months prior to this presentation, it is very likely that the A. ceylanicum was acquired in Solomon Islands. Until now, it has been assumed that any Ancylostoma spp. recovered from humans in Solomon Islands is A. duodenale. However, this case demonstrates that human hookworm infection acquired in the Solomon Islands could be caused by A. ceylanicum. PMID:27658607

  2. A Case of Ancylostoma ceylanicum Infection Occurring in an Australian Soldier Returned from Solomon Islands.

    PubMed

    Speare, Rick; Bradbury, Richard Stewart; Croese, John

    2016-08-01

    A 26-year-old male member of the Australian Defense Force presented with a history of central abdominal pain of 4 weeks duration and peripheral eosinophilia consistent with eosinophilic enteritis. Acute hookworm disease was diagnosed as the cause. Adult worms recovered from feces after therapy with albendazole were morphologically consistent with Ancylostoma ceylanicum. As the patient had been deployed with the Regional Assistance Mission to Solomon Islands for 6 months prior to this presentation, it is very likely that the A. ceylanicum was acquired in Solomon Islands. Until now, it has been assumed that any Ancylostoma spp. recovered from humans in Solomon Islands is A. duodenale. However, this case demonstrates that human hookworm infection acquired in the Solomon Islands could be caused by A. ceylanicum. PMID:27658607

  3. Toscana virus infections: a case series from France.

    PubMed

    Dupouey, J; Bichaud, L; Ninove, L; Zandotti, C; Thirion-Perrier, L; de Lamballerie, X; Charrel, R N

    2014-03-01

    Toscana virus (TOSV) is a neglected sandfly-borne pathogen in Mediterranean countries. Although discovered four decades ago, articles that describe the clinical aspects are scarce and consist mostly of case reports, with few series of cases. We studied retrospectively symptomatic TOSV infections in patients hospitalized in Marseille (France) from 2004 to 2011. Seventeen patients were classified as probable or confirmed cases. Fourteen cases (82%) occurred between June and September, and 3 cases in March, April and November. Two cases were potentially imported from Croatia and Tuscany. All patients presented with fever and neurological signs were observed such as aseptic meningitis (n = 6), muscular symptoms (n = 3), or encephalitis (n = 4). The outcome was always favorable. At the acute stage, anti TOSV IgM were observed in 14/17 patients, neutralization tests were positive for 3/8 patients, and RT-PCR confirmed TOSV infections in 5/8 CSF specimens.

  4. Firecracker eye injuries during Deepavali festival: a case series.

    PubMed

    Kumar, Ravi; Puttanna, Manohar; Sriprakash, K S; Sujatha Rathod, B L; Prabhakaran, Venkatesh C

    2010-01-01

    We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries.

  5. Firecracker eye injuries during Deepavali festival: A case series

    PubMed Central

    Kumar, Ravi; Puttanna, Manohar; Sriprakash, K S; Sujatha Rathod, B L; Prabhakaran, Venkatesh C

    2010-01-01

    We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries. PMID:20195044

  6. Firecracker eye injuries during Deepavali festival: a case series.

    PubMed

    Kumar, Ravi; Puttanna, Manohar; Sriprakash, K S; Sujatha Rathod, B L; Prabhakaran, Venkatesh C

    2010-01-01

    We report a large series of ocular injuries caused by fire-crackers. This study was a hospital-based, singlecenter, retrospective case series in which the records of 51 patients with ocular injuries were analyzed. Injuries were classified according to Birmingham eye trauma terminology system (BETTS). Visual outcomes before and after the intervention were recorded. Ten patients were admitted for further management. As ocular firecracker injuries result in significant morbidity, public education regarding proper use of firecrackers may help in reducing the incidence of ocular injuries. PMID:20195044

  7. Indications and Case Series of Intentional Replantation of Teeth

    PubMed Central

    Asgary, Saeed; Alim Marvasti, Laleh; Kolahdouzan, Alireza

    2014-01-01

    This case series aims to comprehensively introduce intentional replantation with a focus on its indications and case selection in endodontics. In all represented cases, calcium enriched mixture (CEM) cement is used for root-end filling. This case series demonstrates twenty cases of IR and extraoral root-end resection and filling with CEM cement. All the selected teeth had a failed endodontic treatment and required surgical/nonsurgical endodontic (re)treatment or extraction. Subsequent to gentle tooth extraction, an appropriate root-end cavity was prepared and filled with CEM cement. Then the tooth was replanted; maximun procedure time was 15 min. A total of 18 cases (90%) were successful over a mean follow-up period of 15.5 months. It can be concluded that intentional replantation with careful case selection can have a high success rate over 2 years. Intentional replantation may be a suitable treatment option for both trained general practitioners and specialists provided that the extraction is simple and straightforward. PMID:24396380

  8. Indications and case series of intentional replantation of teeth.

    PubMed

    Asgary, Saeed; Alim Marvasti, Laleh; Kolahdouzan, Alireza

    2014-01-01

    This case series aims to comprehensively introduce intentional replantation with a focus on its indications and case selection in endodontics. In all represented cases, calcium enriched mixture (CEM) cement is used for root-end filling. This case series demonstrates twenty cases of IR and extraoral root-end resection and filling with CEM cement. All the selected teeth had a failed endodontic treatment and required surgical/nonsurgical endodontic (re)treatment or extraction. Subsequent to gentle tooth extraction, an appropriate root-end cavity was prepared and filled with CEM cement. Then the tooth was replanted; maximun procedure time was 15 min. A total of 18 cases (90%) were successful over a mean follow-up period of 15.5 months. It can be concluded that intentional replantation with careful case selection can have a high success rate over 2 years. Intentional replantation may be a suitable treatment option for both trained general practitioners and specialists provided that the extraction is simple and straightforward.

  9. Pregnancy in patients with mucopolysaccharidosis: a case series.

    PubMed

    Stewart, Fiona J; Bentley, Andrew; Burton, Barbara K; Guffon, Nathalie; Hale, Susan L; Harmatz, Paul R; Kircher, Susanne G; Kochhar, Pavan K; Mitchell, John J; Plöckinger, Ursula; Graham, Sue; Sande, Stephen; Sisic, Zlatko; Johnston, Tracey A

    2016-09-01

    The mucopolysaccharidoses (MPS disorders) are rare inherited diseases associated with multi-organ accumulation of glycosaminoglycans, leading to musculoskeletal, respiratory, cardiac, neurological, ophthalmological, otolaryngological, and gastrointestinal abnormalities. As a result of improvements in diagnosis, multi-disciplinary care, and therapies such as enzyme replacement therapy and hematopoietic stem cell transplantation, an increasing number of patients with MPS are reaching adulthood and are involved in family planning. Data on fertility and pregnancy outcome in MPS is sparse and comprises primarily isolated case reports. To address this evidence gap, we present a case series on fertility and pregnancy in eight mothers and five fathers with MPS. This case series demonstrates that women with MPS have high-risk pregnancies and deliveries secondary to their underlying disease. However, with appropriate pre-conceptual multi-disciplinary evaluation, optimization and discussion regarding potential risks, combined with regular multi-disciplinary maternal and fetal surveillance in a tertiary center, the outcome of most pregnancies in this case series seems to be favorable with all babies developing normally. Partners of fathers with MPS had uncomplicated pregnancies and deliveries. All children were healthy, with normal growth and development. PMID:27622143

  10. Performance Related Pay in Australian Universities: The Case of Swinburne University

    ERIC Educational Resources Information Center

    Harkness, Peter; Schier, Mark

    2011-01-01

    Performance related pay is not common in Australian universities. A number of Australian universities have begun to show interest in implementing more individualised pay arrangements. Swinburne University of Technology, in Melbourne, has chosen, contrary to the wishes of many of its staff, to be a path-breaker and has introduced a performance…

  11. Educational Issues for Children of Itinerant Seasonal Farm Workers: A Case Study in an Australian Context

    ERIC Educational Resources Information Center

    Henderson, Robyn

    2004-01-01

    Although many Australian children change schools during the course of a school year, the children of itinerant seasonal farm workers can move residences as well as schools on a regular basis, often two or three times annually. Surprisingly, however, educational itinerancy has not been widely researched, particularly in Australian contexts. The…

  12. Subpontic osseous hyperplasia: a case series and literature review.

    PubMed

    Lee, Connie A; Lee, Michael B; Matthews, Chad R; Tatakis, Dimitris N

    2014-01-01

    A subpontic osseous hyperplasia (SOH) is a slow-growing, non-neoplastic bone growth that uniquely affects mandibular posterior edentulous ridges underneath pontics of fixed partial dentures. An SOH can result in significant periodontal and restorative complications, however, it is usually corrected by surgical excision. This report presents a series of SOH cases, illustrates SOH management approaches, and reviews the literature on SOH clinical presentations.

  13. Hereditary vitamin D rickets: a case series in a family.

    PubMed

    Surender, Kumar; Kochar, I P S; Ahmad, Ayesha; Kapoor, Meenal

    2014-11-01

    Hereditary vitamin D-resistant rickets (HVDRR) is an autosomal recessive disorder characterized by end-organ resistance to 1α,25-dihydroxyvitamin D3 (1,25D3). Clinically, the syndrome is recognized by severe early onset rickets with bowing of the lower extremities, short stature, and often alopecia. Here, we report a case series on three siblings who had HVDRR with varied clinical findings.

  14. Hereditary Nonsyndromic Gingival Fibromatosis: Report of Family Case Series

    PubMed Central

    Peeran, Syed Wali; Ramalingam, Karthikeyan; Peeran, Syed Ali; Mugrabi, Marei Hamed; Abdulla, Khaled Awidat

    2013-01-01

    Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation. PMID:24191204

  15. Moulding Faces at an Early Age-A Case Series

    PubMed Central

    Sunny, Sunil; Mathew, Neethu; Parambath, Anvar Kizhakke; Madhusudanan, Amla

    2016-01-01

    Certain malocclusions have to be treated at an early age to avoid surgeries for the correction in the future. Introduction of functional appliances has reduced the elimination and correction of skeletal as well as dental discrepancies. Proper case selection taking into consideration skeletal and dental age with the use of various diagnostic aids helps us to identify and treat the malocclusions before it is too late. In this case series, we report three patients with skeletal jaw malrelationship treated with functional and orthopaedic appliances. PMID:27656599

  16. Moulding Faces at an Early Age-A Case Series.

    PubMed

    Sunny, Sunil; Thomas, Rinu; Mathew, Neethu; Parambath, Anvar Kizhakke; Madhusudanan, Amla

    2016-08-01

    Certain malocclusions have to be treated at an early age to avoid surgeries for the correction in the future. Introduction of functional appliances has reduced the elimination and correction of skeletal as well as dental discrepancies. Proper case selection taking into consideration skeletal and dental age with the use of various diagnostic aids helps us to identify and treat the malocclusions before it is too late. In this case series, we report three patients with skeletal jaw malrelationship treated with functional and orthopaedic appliances. PMID:27656599

  17. Seldinger technique for nasal intubation: a case series.

    PubMed

    Abrons, Ron O; Vansickle, Ryan A; Ouanes, Jean-Pierre P

    2016-11-01

    Nasotracheal intubation can be both challenging and traumatic, especially in cases of atypical anatomy. We present a series of 3 such cases in which an endotracheal tube introducer (bougie) was used to facilitate successful, atraumatic, nasotracheal intubation via Seldinger technique. The technique described can guide a nasotracheal tube through narrow nasal passages, small pharyngeal spaces, and past acute laryngeal approach angles, all without transoral manipulation of the tube. The technique is easy to perform, uses a routine skill set, and can be advantageous in numerous clinical scenarios. PMID:27687457

  18. Time series analysis of the impact of tobacco control policies on smoking prevalence among Australian adults, 2001–2011

    PubMed Central

    Coomber, Kerri; Durkin, Sarah J; Scollo, Michelle; Bayly, Megan; Spittal, Matthew J; Simpson, Julie A; Hill, David

    2014-01-01

    Abstract Objective To determine the impact of tobacco control policies and mass media campaigns on smoking prevalence in Australian adults. Methods Data for calculating the average monthly prevalence of smoking between January 2001 and June 2011 were obtained via structured interviews of randomly sampled adults aged 18 years or older from Australia’s five largest capital cities (monthly mean number of adults interviewed: 2375). The influence on smoking prevalence was estimated for increased tobacco taxes; strengthened smoke-free laws; increased monthly population exposure to televised tobacco control mass media campaigns and pharmaceutical company advertising for nicotine replacement therapy (NRT), using gross ratings points; monthly sales of NRT, bupropion and varenicline; and introduction of graphic health warnings on cigarette packs. Autoregressive integrated moving average (ARIMA) models were used to examine the influence of these interventions on smoking prevalence. Findings The mean smoking prevalence for the study period was 19.9% (standard deviation: 2.0%), with a drop from 23.6% (in January 2001) to 17.3% (in June 2011). The best-fitting model showed that stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns independently explained 76% of the decrease in smoking prevalence from February 2002 to June 2011. Conclusion Increased tobacco taxation, more comprehensive smoke-free laws and increased investment in mass media campaigns played a substantial role in reducing smoking prevalence among Australian adults between 2001 and 2011. PMID:24940015

  19. Ocular Dirofilariasis: A Case Series of 8 Patients

    PubMed Central

    Kalogeropoulos, Chris D.; Stefaniotou, Maria I.; Gorgoli, Konstantina E.; Papadopoulou, Chrissanthy V.; Pappa, Chrysavgi N.; Paschidis, Costas A.

    2014-01-01

    Purpose: Dirofilaria repens is an endemic parasite in Mediterranean countries that mostly affects animals. Rarely, however, it can infect humans. This case series presents patients with ocular infections due to D. repens. Materials and Methods: A chart review was performed of patients with ocular dirofilariasis after the year 2000, treated at a tertiary referral centre in Greece. Data were collected on the ocular, microbiological, or/and histopathological aspects and treatment. Results: Eight cases of unilateral ocular dirofilariasis were identified, of which 5 were subconjunctival (1 masquerading as nodular scleritis) and were removed through a conjunctival incision, 2 cases were intravitreal and were removed with vitrectomy, and 1 was intraorbital (adjacent to the roof of the orbit). The latter appeared as an encapsulated mass and subsequent histological examination revealed the presence of the parasite. Of the 8 cases recorded after the year 2000, 7 appeared within the last 6 years (4 cases within the last 3 years). The majority of cases involved residents of the Ionian Islands (7 of 8 cases). Conclusions: D. repens can affect various ocular and periocular tissues. A progressive increase in the incidence of dirofilariasis was observed, which is potentially associated with climate changes in warm and moist areas where this parasite is endemic. PMID:25371636

  20. Toxin-induced chemosensory dysfunction: A case series and review

    PubMed Central

    Smith, Wendy M.; Davidson, Terence M.; Murphy, Claire

    2013-01-01

    Background Toxic chemical exposures are estimated to account for 1–5% of all olfactory disorders. Both olfactory neurons and taste buds are in direct contact with environmental agents because of their relatively unprotected anatomic locations, thereby making them susceptible to damage from acute and chronic toxic exposures. The aim of this study was to illustrate different aspects of the diagnostic and therapeutic approach to this disorder using a series of case reports and review of the literature. Methods Cases were selected for inclusion based on a retrospective chart review of patients who presented to a university-based nasal dysfunction clinic with toxin-induced olfactory or gustatory dysfunction between January 1985 and December 2008. Workup included complete history, otolaryngologic examination, psychophysical testing, and imaging. Results Patient ages ranged from 31 to 67 years (mean, 49.3 years). Etiology of chemosensory impairment included exposure to ammonia, isodecanes, hairdressing chemicals, chemotherapy, gasoline, and intranasal zinc. Five of the seven patients (71%) presented with olfactory dysfunction alone, one patient (14%) presented with dysgeusia alone, and one patient (14%) presented with both smell and taste loss. Only one patient (14%) reported parosmias. Tests of olfaction revealed normosmia in one patient (14%), mild-to-moderate hyposmia in one patient (14%), and severe hyposmia to anosmia in five patients (72%). Both patients who reported taste disorders had hypogeusia on testing. Conclusion This case series illustrates the wide spectrum of this disorder and provides a framework for the workup and treatment of these patients. PMID:19958605

  1. Integration and Typologies of Vulnerability to Climate Change: A Case Study from Australian Wheat Sheep Zones

    NASA Astrophysics Data System (ADS)

    Huai, Jianjun

    2016-09-01

    Although the integrated indicator methods have become popular for assessing vulnerability to climate change, their proliferation has introduced a confusing array of scales and indicators that cause a science-policy gap. I argue for a clear adaptation pathway in an “integrative typology” of regional vulnerability that matches appropriate scales, optimal measurements and adaptive strategies in a six-dimensional and multi-level analysis framework of integration and typology inspired by the “5W1H” questions: “Who is concerned about how to adapt to the vulnerability of what to what in some place (where) at some time (when)?” Using the case of the vulnerability of wheat, barley and oats to drought in Australian wheat sheep zones during 1978–1999, I answer the “5W1H” questions through establishing the “six typologies” framework. I then optimize the measurement of vulnerability through contrasting twelve kinds of vulnerability scores with the divergence of crops yields from their regional mean. Through identifying the socioeconomic constraints, I propose seven generic types of crop-drought vulnerability and local adaptive strategy. Our results illustrate that the process of assessing vulnerability and selecting adaptations can be enhanced using a combination of integration, optimization and typology, which emphasize dynamic transitions and transformations between integration and typology.

  2. Integration and Typologies of Vulnerability to Climate Change: A Case Study from Australian Wheat Sheep Zones

    PubMed Central

    Huai, Jianjun

    2016-01-01

    Although the integrated indicator methods have become popular for assessing vulnerability to climate change, their proliferation has introduced a confusing array of scales and indicators that cause a science-policy gap. I argue for a clear adaptation pathway in an “integrative typology” of regional vulnerability that matches appropriate scales, optimal measurements and adaptive strategies in a six-dimensional and multi-level analysis framework of integration and typology inspired by the “5W1H” questions: “Who is concerned about how to adapt to the vulnerability of what to what in some place (where) at some time (when)?” Using the case of the vulnerability of wheat, barley and oats to drought in Australian wheat sheep zones during 1978–1999, I answer the “5W1H” questions through establishing the “six typologies” framework. I then optimize the measurement of vulnerability through contrasting twelve kinds of vulnerability scores with the divergence of crops yields from their regional mean. Through identifying the socioeconomic constraints, I propose seven generic types of crop-drought vulnerability and local adaptive strategy. Our results illustrate that the process of assessing vulnerability and selecting adaptations can be enhanced using a combination of integration, optimization and typology, which emphasize dynamic transitions and transformations between integration and typology. PMID:27670975

  3. Fabry's Disease: Case Series and Review of Literature

    PubMed Central

    Wani, Muzaffar Maqsood; Khan, Imran; Bhat, Riyaz Ahmad; Ahmad, Muzaffar

    2016-01-01

    Fabry's disease is an X-linked lysosomal storage disorder caused by a deficiency of alpha-galactosidase A enzyme with the progressive accumulation of globotriaosylceramide in vascular endothelial cells leading to cardiovascular, renal, gastrointestinal, neuropathic, lenticular, and dermatological manifestations. It is a rare cause of end-stage renal disease. It classically affects males whereas 10–15% of female heterozygote carriers are affected depending on localization. Both the FD and its association with ESRD is rare. With this background, this case series of five patient's along with the review of literature is presented here. PMID:27398254

  4. Management of Ectopically Erupting Maxillary Incisors: A Case Series.

    PubMed

    Suresh, Kotumachagi Sangappa; Uma, H L; Nagarathna, J; Kumar, Pravin

    2015-01-01

    Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  5. Anterior Segment Findings in Vitamin A Deficiency: A Case Series.

    PubMed

    Rubino, Pierangela; Mora, Paolo; Ungaro, Nicola; Gandolfi, Stefano A; Orsoni, Jelka G

    2015-01-01

    Vitamin A deficiency is a rare but vision threatening disorder in the developed world, which can lead to blindness for severe keratomalacia with cornea scarring and perforation or night blindness due to impaired dark adaptation. Conversely, the disease is quite common in developing countries, as a consequence of chronic malnutrition. The correct diagnosis and therapy with prompt vitamin A supplementation avoid blindness. We report a series of 3 local cases with different age and causes for vitamin A deficiency. The diagnostic workup, therapy, and prognosis are discussed. PMID:26509090

  6. Fabry's Disease: Case Series and Review of Literature.

    PubMed

    Wani, Muzaffar Maqsood; Khan, Imran; Bhat, Riyaz Ahmad; Ahmad, Muzaffar

    2016-01-01

    Fabry's disease is an X-linked lysosomal storage disorder caused by a deficiency of alpha-galactosidase A enzyme with the progressive accumulation of globotriaosylceramide in vascular endothelial cells leading to cardiovascular, renal, gastrointestinal, neuropathic, lenticular, and dermatological manifestations. It is a rare cause of end-stage renal disease. It classically affects males whereas 10-15% of female heterozygote carriers are affected depending on localization. Both the FD and its association with ESRD is rare. With this background, this case series of five patient's along with the review of literature is presented here. PMID:27398254

  7. Case Series of Synthetic Cannabinoid Intoxication from One Toxicology Center

    PubMed Central

    Katz, Kenneth D.; Leonetti, Adam L.; Bailey, Blake C.; Surmaitis, Ryan M.; Eustice, Eric R.; Kacinko, Sherri; Wheatley, Scott M.

    2016-01-01

    Synthetic cannabinoid use has risen at alarming rates. This case series describes 11 patients exposed to the synthetic cannabinoid, MAB-CHMINACA who presented to an emergency department with life-threatening toxicity including obtundation, severe agitation, seizures and death. All patients required sedatives for agitation, nine required endotracheal intubation, three experienced seizures, and one developed hyperthermia. One developed anoxic brain injury, rhabdomyolysis and died. A significant number were pediatric patients. The mainstay of treatment was aggressive sedation and respiratory support. Synthetic cannabinoids pose a major public health risk. Emergency physicians must be aware of their clinical presentation, diagnosis and treatment. PMID:27330661

  8. Management of Ectopically Erupting Maxillary Incisors: A Case Series

    PubMed Central

    Suresh, Kotumachagi Sangappa; Uma, HL; Nagarathna, J

    2015-01-01

    ABSTRACT Eruption disturbances related to the position include ectopic eruption and transpositions. The occurrence of ectopic eruption is most commonly associated with maxillary incisors. The normal eruption, position and morphology of these teeth are crucial to craniofacial development, facial esthetics as well as phonetics. It is essential that the clinicians have thorough knowledge of the eruption disturbances in order to make an appropriate, as well as timely intervention, as dictated by the complexity of the problem. How to cite this article: Suresh KS, Uma HL, Nagarathna J, Kumar P. Management of Ectopically Erupting Maxillary Incisors: A Case Series. Int J Clin Pediatr Dent 2015;8(3):227-233. PMID:26604543

  9. Meningitis admitted to a military hospital: a retrospective case series.

    PubMed

    Harrell, Travis; Hammes, John S

    2012-10-01

    Meningitis is a common admission diagnosis. No case series or descriptive studies on meningitis have recently been published. Additionally, no recent data exist on meningitis in the U.S. Military Health System. We reviewed charts of adult patients admitted to Naval Medical Center San Diego between January 2004 and December 2008 with an admission diagnosis of meningitis. Charts were excluded if they did not meet our case definition of meningitis, if missing data, or if meningitis was nosocomial or iatrogenic. We reviewed results of cerebrospinal fluid cultures during this period. We compared rates and characteristics, and outcomes of bacterial and aseptic meningitis. Two hundred twenty-one cases met our criteria. Of these, 208 were aseptic. Cerebrospinal fluid polymerase chain reaction testing was positive for enteroviruses and herpes simplex viruses in 42 (20.2%) and 17 (8.2%) cases, respectively. Of culture/polymerase chain reaction/serologically positive cases, the pathogens were Neisseria meningitidis (3), Streptococcus pneumoniae (3), viridans streptococci (2), Cryptococcus neoformans (2), Coccidioides immitis (2), and Mycobacterium tuberculosis (1). Three patients had poor outcomes: one died from S. pneumoniae and two had long-term neurologic deficits. Meningitis is a common admission diagnosis, but serious virulent pathogens are uncommon and adverse outcomes are rare.

  10. Laser-assisted flapless crown lengthening: a case series.

    PubMed

    McGuire, Michael K; Scheyer, E Todd

    2011-01-01

    As part of the paradigm shift toward more minimally invasive surgical procedures, increasing numbers of references to laser-mediated flapless crown lengthening are noted in the published literature. The vast majority of these references are noncontrolled case reports or technique-focused articles. Therefore, prospective, randomized controlled studies that objectively examine the safety and efficacy of flapless crown lengthening are lacking. The current case series represents an initial attempt to examine some of the clinical issues posed by this minimally invasive flapless approach. Ultimately, only well-designed controlled clinical trials can yield the type of evidence-based data necessary to categorize this approach to crown lengthening as standard-of-care treatment.

  11. Can Masturbatory Guilt Lead to Severe Psychopathology: A Case Series

    PubMed Central

    Aneja, Jitender; Grover, Sandeep; Avasthi, Ajit; Mahajan, Sudhir; Pokhrel, Prabhakar; Triveni, Davuluri

    2015-01-01

    Masturbation is common in all societies. Despite being common, it is admonished culturally and almost all religions prohibit masturbation and consider it an act of immorality. The prohibition for masturbation leads to a lot of cultural beliefs, including certain myths, which influence sexual behavior of the person. The impact of these common cultural myths associated with masturbation, are clinically understood as Dhat syndrome and masturbatory guilt. Although there is a reasonable literature on Dhat syndrome, there is limited literature with regard to masturbatory guilt especially linking the same with axis-I psychopathology. In this case series, three cases of masturbatory guilt are presented in whom masturbatory guilt was associated with manifestation of severe psychopathology. This report suggests that masturbatory guilt must be enquired for in patients presenting with severe mental disorder. PMID:25722518

  12. Congenital Chikungunya Virus Infection in Sincelejo, Colombia: A Case Series.

    PubMed

    Villamil-Gómez, Wilmer; Alba-Silvera, Luz; Menco-Ramos, Antonio; Gonzalez-Vergara, Alfonso; Molinares-Palacios, Tatiana; Barrios-Corrales, María; Rodríguez-Morales, Alfonso J

    2015-10-01

    Congenital chikungunya virus (CHIK) infection has been infrequently reported, even more so during the current 2013-15 outbreak in Latin America. In this study, the consequences of CHIK on pregnancy outcomes and particularly consequences in infants born to infected women were assessed in a case series from a single private institution in the north of Colombia. During September 2014 to February 2015, seven pregnant women with serological and reverse transcription-polymerase chain reaction-positive test for CHIK delivered eight infants with CHIK. These newborns required admission to pediatric intensive care, and related support, owing to severe clinical manifestations, which included respiratory distress, sepsis, necrotizing enterocolitis, meningoencephalitis, myocarditis, edema, bullous dermatitis and pericarditis. There were three deaths (case fatality rate of 37.5%). Pregnant women and newborns with CHIK long term should be followed up, given the implications of chronic sequelae (e.g. chronic inflammatory rheumatism in women) as well as recently described neurocognitive impairment in infants.

  13. Optic Neuropathy in Thyroid Eye Disease: A Case Series

    PubMed Central

    Seng, Wong Hon; Isa, Hazlita Dato' Mohd

    2016-01-01

    In patients with thyroid disease, ocular involvement or thyroid ophthalmopathy is common, irrespective of their thyroid status. A common feature of thyroid eye disease is eyelid retraction, which leads to a classical starry gaze (Kocher sign). Treatment with radioactive iodine (RAI) is a known therapy for hyperthyroidism. However, this treatment may lead to or worsen thyroid ophthalmopathy. We report a case series of two patients with thyrotoxicosis, who presented with an atypical and subtle occurrence of thyroid eye disease (TED) soon after RAI therapy. One of the patients was initially diagnosed and treated for dry eyes; however, over a period of time, the patient's vision progressively deteriorated. Clinical and radiological investigations confirmed thyroid ophthalmopathy with low serum thyroid hormone levels. Both patients recovered well after immediate intensive intravenous steroid treatment. These cases highlight the importance of recognizing partial ptosis as one of the presenting signs of active TED among general practitioners and physicians. PMID:27274392

  14. Chediak-Higashi Syndrome: A Case Series from Karnataka, India.

    PubMed

    Rudramurthy, Pradeep; Lokanatha, Hemalata

    2015-01-01

    Chediak-Higashi syndrome (CHS) is a rare autosomal recessive disease, characterized by partial oculocutaneous albinism, frequent pyogenic infections, and the presence of abnormal large granules in leukocytes and other granulecontaining cells. The abnormal granules are readily seen in blood and marrow granulocytes. Other clinical features include silvery hair, photophobia, nystagmus and hepatosplenomegaly. However, the presence of abnormal giant intracytoplasmic granules in neutrophils and their precursors are diagnostic of CHS. Here, we present a series of five cases, out of which four presented in the accelerated phase. In all the five cases, the giant granules were noted predominantly in the cytoplasm of lymphocytes, which is a rare occurrence compared to those present in the granulocytes. PMID:26538743

  15. Asthma caused by potassium aluminium tetrafluoride: a case series.

    PubMed

    Laštovková, Andrea; Klusáčková, Pavlina; Fenclová, Zdenka; Bonneterre, Vincent; Pelclová, Daniela

    2015-01-01

    The objective of this study is to describe a case-series of potassium aluminium tetrafluoride (KAlF(4))-induced occupational asthma (OA) and/or occupational rhinitis (OR). The study involves five patients from a heat-exchanger production line who were examined (including specific inhalation challenge tests) for suspected OA and/or OR caused by a flux containing almost 100% KAlF(4) - with fluorides' workplace air concentrations ranging between 1.7 and 2.8 mg/m(3). No subject had a previous history of asthma. All five patients had a positive specific challenge test (three patients were diagnosed with OA alone, one with OR and one with both OR and OA). At the follow-up visit, after three years on average, all patients needed permanent corticosteroid therapy (four topical, one oral). After elimination from the exposure, only one of the observed subjects gave an indication of an improvement, two subjects stabilized and two worsened. Our case series focuses on the correlation between patients' exposure to fluorides in air-conditioner production and the subsequent occurrence of OR/OA. Currently, it is uncertain whether these OR/OA were caused by hypersensitivity or irritation. PMID:26212411

  16. Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series

    PubMed Central

    Pavia, Steven; Fischer, Rebecca; Roy, Richard

    2015-01-01

    Objective The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). Methods This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. Results All pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients’ pain scores from the initial visit of 8.3 ± 1.6 to the last visit at 1.4 ± 1.1 with an 80.9% ± 15.4% improvement. The average number of visits was 13.6 ± 8.2. Conclusion All patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms. PMID:26793040

  17. Nystagmus in Enlarged Vestibular Aqueduct: A Case Series

    PubMed Central

    White, Judith; Krakovitz, Paul

    2015-01-01

    Enlarged vestibular aqueduct (EVA) is one of the commonly identified congenital temporal bone abnormalities associated with sensorineural hearing loss. Hearing loss may be unilateral or bilateral, and typically presents at birth or in early childhood. Vestibular symptoms have been reported in up to 50% of affected individuals, and may be delayed in onset until adulthood. The details of nystagmus in patients with EVA have not been previously reported. The objectives were to describe the clinical history, vestibular test findings and nystagmus seen in a case series of patients with enlarged vestibular aqueduct anomaly. Chart review, included computed tomography temporal bones, infrared nystagmography with positional and positioning testing, caloric testing, rotary chair and vibration testing. Clinical history and nystagmus varied among the five patients in this series. All patients were initially presumed to have benign paroxysmal positional vertigo, but repositioning treatments were not effective, prompting referral, further testing and evaluation. In three patients with longstanding vestibular complaints, positional nystagmus was consistently present. One patient had distinct recurrent severe episodes of positional nystagmus. Nystagmus was unidirectional and horizontal. In one case horizontal nystagmus was consistently reproducible with seated head turn to the affected side, and reached 48 d/s. Nystagmus associated with enlarged vestibular aqueduct is often positional, and can be confused with benign paroxysmal positional vertigo. Unexplained vestibular symptoms in patients with unilateral or bilateral sensorineural hearing loss should prompt diagnostic consideration of EVA. PMID:26557362

  18. Clinical experience with wound biofilm and management: a case series.

    PubMed

    Hurlow, Jennifer; Bowler, Philip G

    2009-04-01

    Biofilm is a relatively new concept in the fields of infectious disease, wound infection, and healing. Although scientific research and "noise" regarding wound biofilm is increasing, little is known about the presentation, diagnosis, potential implications, and management strategies regarding wound biofilms. A series of four clinical cases is utilized to demonstrate the existence of wound biofilm. All patients presented with or developed a film on the wound bed that appeared to be distinct from slough; wounds also were failing to progress. Although the slough in some of the wounds was easily removed with traditional debridement methods, removal of the film required physical disruption with a curette or dry gauze. All wounds eventually progressed to healing. Considering the biofilm concept and available preclinical research, it is evident from this small case series that the appearance of biofilm in wounds is quite different from slough and requires different management strategies for its control. The evolving biofilm paradigm could profoundly change approaches to wound management. Additional research is needed in this evolving aspect of wound management.

  19. Asthma caused by potassium aluminium tetrafluoride: a case series

    PubMed Central

    LAŠTOVKOVÁ, Andrea; KLUSÁČKOVÁ, Pavlina; FENCLOVÁ, Zdenka; BONNETERRE, Vincent; PELCLOVÁ, Daniela

    2015-01-01

    The objective of this study is to describe a case-series of potassium aluminium tetrafluoride (KAlF4)-induced occupational asthma (OA) and/or occupational rhinitis (OR). The study involves five patients from a heat-exchanger production line who were examined (including specific inhalation challenge tests) for suspected OA and/or OR caused by a flux containing almost 100% KAlF4 − with fluorides’ workplace air concentrations ranging between 1.7 and 2.8 mg/m3. No subject had a previous history of asthma. All five patients had a positive specific challenge test (three patients were diagnosed with OA alone, one with OR and one with both OR and OA). At the follow-up visit, after three years on average, all patients needed permanent corticosteroid therapy (four topical, one oral). After elimination from the exposure, only one of the observed subjects gave an indication of an improvement, two subjects stabilized and two worsened. Our case series focuses on the correlation between patients’ exposure to fluorides in air-conditioner production and the subsequent occurrence of OR/OA. Currently, it is uncertain whether these OR/OA were caused by hypersensitivity or irritation. PMID:26212411

  20. Intensive outpatient comprehensive behavioral intervention for tics: A case series

    PubMed Central

    Blount, Tabatha H; Lockhart, Ann-Louise T; Garcia, Rocio V; Raj, Jeslina J; Peterson, Alan L

    2014-01-01

    Recent randomized clinical trials have established the efficacy of Comprehensive Behavioral Intervention for Tics (CBIT) in treating children and adults with Tourette syndrome and persistent tic disorders. However, the standard CBIT protocol uses a weekly outpatient treatment format (i.e., 8 sessions over 10 wk), which may be inconvenient or impractical for some patients, particularly patients, who are required to travel long distances in order to receive care. In contrast, an intensive outpatient program may increase accessibility to evidence-based behavioral treatments for Tourette syndrome and other persistent tic disorders by eliminating the necessity of repeated travel. This case series evaluated the use of an intensive outpatient program CBIT (IOP CBIT) for the treatment of 2 preadolescent males (ages 10 and 14 years) with Tourette syndrome. The IOP CBIT treatment protocol included several hours of daily treatment over a 4-d period. Both children evidenced notable reductions in their tics and maintained treatment gains at follow-up. Moreover, both patients and their parents expressed treatment satisfaction with the IOP CBIT format. This case series addresses an important research gap in the behavioral treatment of tic disorders literature. The patients’ treatment outcomes indicate that IOP CBIT is a promising treatment that warrants more systematic investigation. PMID:25325069

  1. Hypophosphataemia among severely-malnourished children: case series.

    PubMed

    Yoshimatsu, Shoji; Chisti, Mohammod Jobayer; Hossain, Md Iqbal; Islam, Md Munirul; Fukushima, Takashi; Wagatsuma, Yukiko; Smith, Jonathan Harvey; Sumazaki, Ryo; Ahmed, Tahmeed

    2012-12-01

    Phosphorus is an essential substance in our body, and hypophosphataemia (HP) is well-described in rickets, refeeding syndrome, diabetic ketoacidosis (DKA), and in chronic alcohol-abuse. However, to our knowledge, HP among severely-malnourished children has not been studied in detail, and information on prevalence, severity, and treatment is scarce. Currently, there are only a few published case reports of HP. This case series describes three cases of HP that presented to Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Our first case required mechanical ventilation for respiratory distress associated with severe hypokalaemia (K 1.1 mmol/L) and moderate hypophosphataemia (P 2.1 mg/dL). The second case presented with severe sepsis which was associated with symptomatic hypocalcaemia (Ca 1.68 mmol/L), hypokalaemia (K 1.82 mmol/L), and severe hypophosphataemia (P 0.9 mg/dL). The third case presented with pneumonia and sepsis which were complicated by hypokalaemia (K 2.05 mmol/L) and severe hypophosphataemia (P 1.1 mg/dL). Marked lethargy and severe hypotonia were associated with HP in all of these cases. Manifestations of HP are diverse and can occur in association with other electrolyte imbalances, especially among malnourished children. Malnutrition, combined with sepsis, is one of the major killers of children younger than 5 years of age, and both malnutrition and sepsis can cause HP. It is concluded that the underlying causes of morbidity, including HP, should be actively sought and treated to reduce the mortality of children aged below five years.

  2. Traumatic Peripheral Neuropraxias in Neonates: A Case Series

    PubMed Central

    Bhandekar, Heena Sudhir; Korday, Charusheela Sujit

    2014-01-01

    Traumatic peripheral nerve palsies in the newborn are uncommon but are a cause of severe anxiety in parents. Erb’s palsy, brachial plexus, radial nerve and facial nerve are the common nerves affected. Perinatal injuries are the most frequent cause of traumatic peripheral neuropraxias / nerve palsies. Usually these neuropraxias are self-limited with good recovery with conservative management in majority of cases.Ten neonates with peripheral neuropraxias were included in this retrospective study based on a review of these cases over a period of three and a half years. Their clinical profile, presenting symptoms, predisposing factors and management were analyzed. We encountered five neonates with erb’s palsy, three with facial palsy and two had radial nerve affection. Risk factors in our series included large babies, prolonged or difficult labour, instrumental delivery and shoulder dystocia. All cases of peripheral nerve involvement were managed conservatively with physiotherapy. Nine neonates were discharged and showed gradual improvement and one patient unfortunately succumbed due to severe birth asphyxia. Parental counseling and rehabilitation play an important part in management of these cases. PMID:25478423

  3. Provision of a Medicines Information Service to Consumers on Facebook: An Australian Case Study

    PubMed Central

    Chen, Timothy F; Spagnardi, Sarah; Beer, Troy; Aslani, Parisa

    2015-01-01

    Background Social networking sites (SNSs) have changed the way people communicate. They may also change the way people seek health advice. Objective This study describes the provision of a medicines information service on Facebook to individual consumers. It aimed to discuss the pros and cons, and inform health and pharmacy stakeholders and researchers about the opportunities and challenges of providing such a service. Methods We adopted an exploratory approach using a case study method. Results NPS MedicineWise, an independent, not-for-profit Australian organization, runs a public question-and-answer service on Facebook, dubbed Pharmacist Hour. Consumers following the organization’s Facebook page are invited to post medication-related questions often with a suggested health topic. A wide range of questions and comments are posted related to medication usage. The pharmacist answers the queries, providing evidence-based medicines information and using consumer-friendly language, during the specific 1-hour period. The most popular questions in the past 12 months were related to adverse effects, treatment options for conditions, and drug interactions. The service had a mean number of engagements (defined as a like or share of the Pharmacy Hour post) of 38 (SD 19) people and a mean 5 (SD 3) questions per session. Conclusions The Pharmacist Hour Facebook service addresses the medicines information needs of consumers and indirectly promotes other appropriate and relevant NPS MedicineWise products and services to further assist consumers. The service offers a new medium for a quality use of medicines organization committed to promoting awareness about the correct and safe use of medicines in Australia. PMID:26596328

  4. Are clerical workers proletarian? A case study of the Australian Public Service.

    PubMed

    Matheson, Craig

    2007-12-01

    This paper explores whether clerical workers have been proletarianized by using the Australian Public Service (APS) as a case study. It shows that before the late 1980s the market, work and status situations of APS clerks were predominantly proletarian since they were typified by limited career prospects, low skill requirements, restricted autonomy; low organizational status and estrangement from senior management. This proletarian class situation was reflected in an order taker's culture of informality, cynicism, hedonism and alienation. Since the late 1980s however technological change and workplace restructuring have markedly reduced the number of unskilled and lower paid jobs in the APS, thereby belying widespread predictions of deskilling. I conclude that proletarianization is more likely to have arisen from a decline in the status of clerical work during the course of the twentieth century rather than from a process of deskilling. Notwithstanding the fact that their class situations were predominantly proletarian, most clerks have identified as middle class. We can attribute this not only to the fact that their class situations differ from those of manual workers, as noted by Lockwood, but also to a widespread tendency to identify as middle class, the tendency of many female clerks to base their class identity on their husband's occupation and the fact that popular stereotypes tend to equate class with occupation. It is difficult to decide if clerks are proletarian since 1. Their class situations display a mixture of proletarian and middle-class characteristics 2. They exhibit diverse class identities, social origins, marriage partners and cultural attributes and 3. They occupy different positions on different aspects of inequality. We are therefore unable to allocate them en bloc to a single uniform class. I conclude that while a minority of clerks are proletarian most are better described as middle class. PMID:18076387

  5. Health inequalities, physician citizens and professional medical associations: an Australian case study

    PubMed Central

    Furler, John; Harris, Elizabeth; Harris, Mark; Naccarella, Lucio; Young, Doris; Snowdon, Teri

    2007-01-01

    Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners) and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values, engaging both external

  6. Glaucoma Surgery in Pregnancy: A Case Series and Literature Review

    PubMed Central

    Razeghinejad, Mohammad Reza; Masoumpour, Masoumeh; Eghbal, Mohammad Hossein; Myers, Jonathan S.; Moster, Marlene R.

    2016-01-01

    Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed. All 3 patients had juvenile open-angle glaucoma and were on various anti-glaucoma medications, including oral acetazolamide. The first case described underwent trabeculectomy without antimetabolites in both eyes because of uncontrolled intraocular pressure with topical medications. The surgery was done with topical lidocaine jelly and subconjunctival lidocaine during the second and third trimesters. The second patient had an Ahmed valve implantation in both eyes during the second and third trimesters because of uncontrolled IOP with topical medications and no response to selective laser trabeculoplasty. Surgery was done with topical tetracaine and subconjunctival and sub-Tenon’s lidocaine. The third case had a Baerveldt valve implantation under general anesthesia in the second trimester. In selected pregnant glaucoma patients with medically uncontrolled intraocular pressure threatening vision, incisional surgery may lead to good outcomes for the patient with no risk for the fetus. PMID:27582594

  7. Esophageal Intramural Pseudodiverticulosis and Concomitant Eosinophilic Esophagitis: A Case Series.

    PubMed

    Scaffidi, Michael A; Garg, Ankit; Ro, Brandon; Wang, Christopher; Yang, Tony T C; Plener, Ian S; Grin, Andrea; Colak, Errol; Grover, Samir C

    2016-01-01

    Background. Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign chronic disease characterized by flask-like outpouchings of the esophageal wall. It is unknown whether there is a genuine association between EIPD and eosinophilic esophagitis (EoE). Aims. To investigate a possible relationship between EIPD and EoE. Methods. Patients with radiographic or endoscopic evidence of pseudodiverticulosis were identified from the database at a single academic center. Cases were analyzed in three areas: clinical information, endoscopic findings, and course. Results. Sixteen cases of esophageal pseudodiverticulosis were identified. Five patients had histologic evidence of eosinophilic esophagitis. Patients with EoE had pseudodiverticula in the mid-to-distal esophagus while those with EIPD had pseudodiverticula predominantly in the proximal esophagus (p < 0.001). EoE with pseudodiverticulosis occurred in younger patients (p < 0.019). Food bolus obstructions were more common in patients with EoE and pseudodiverticulosis than in EIPD (p < 0.034). Conclusions. This is the first case series supporting a potential association between EoE and pseudodiverticulosis. We also identify characteristic features of pseudodiverticulosis that may raise clinical suspicion of underlying eosinophilic esophagitis. PMID:27648438

  8. Glaucoma Surgery in Pregnancy: A Case Series and Literature Review.

    PubMed

    Razeghinejad, Mohammad Reza; Masoumpour, Masoumeh; Eghbal, Mohammad Hossein; Myers, Jonathan S; Moster, Marlene R

    2016-09-01

    Glaucoma management in pregnant patients is a real challenge, especially when the glaucoma is not controlled with medications. We report the results of 6 incisional glaucoma surgeries for the management of medically uncontrolled glaucoma patients during pregnancy. This retrospective, case series was conducted on the 6 eyes of 3pregnant patients with uncontrolled glaucoma using maximum tolerable medications. Details of the glaucoma surgical management of these patients as well as their postoperative care and pregnancy and clinical outcomes on longitudinal follow-up are discussed. All 3 patients had juvenile open-angle glaucoma and were on various anti-glaucoma medications, including oral acetazolamide. The first case described underwent trabeculectomy without antimetabolites in both eyes because of uncontrolled intraocular pressure with topical medications. The surgery was done with topical lidocaine jelly and subconjunctival lidocaine during the second and third trimesters. The second patient had an Ahmed valve implantation in both eyes during the second and third trimesters because of uncontrolled IOP with topical medications and no response to selective laser trabeculoplasty. Surgery was done with topical tetracaine and subconjunctival and sub-Tenon's lidocaine. The third case had a Baerveldt valve implantation under general anesthesia in the second trimester. In selected pregnant glaucoma patients with medically uncontrolled intraocular pressure threatening vision, incisional surgery may lead to good outcomes for the patient with no risk for the fetus. PMID:27582594

  9. Esophageal Intramural Pseudodiverticulosis and Concomitant Eosinophilic Esophagitis: A Case Series

    PubMed Central

    Scaffidi, Michael A.; Garg, Ankit; Ro, Brandon; Wang, Christopher; Yang, Tony T. C.; Plener, Ian S.; Grin, Andrea; Colak, Errol

    2016-01-01

    Background. Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign chronic disease characterized by flask-like outpouchings of the esophageal wall. It is unknown whether there is a genuine association between EIPD and eosinophilic esophagitis (EoE). Aims. To investigate a possible relationship between EIPD and EoE. Methods. Patients with radiographic or endoscopic evidence of pseudodiverticulosis were identified from the database at a single academic center. Cases were analyzed in three areas: clinical information, endoscopic findings, and course. Results. Sixteen cases of esophageal pseudodiverticulosis were identified. Five patients had histologic evidence of eosinophilic esophagitis. Patients with EoE had pseudodiverticula in the mid-to-distal esophagus while those with EIPD had pseudodiverticula predominantly in the proximal esophagus (p < 0.001). EoE with pseudodiverticulosis occurred in younger patients (p < 0.019). Food bolus obstructions were more common in patients with EoE and pseudodiverticulosis than in EIPD (p < 0.034). Conclusions. This is the first case series supporting a potential association between EoE and pseudodiverticulosis. We also identify characteristic features of pseudodiverticulosis that may raise clinical suspicion of underlying eosinophilic esophagitis. PMID:27648438

  10. Esophageal Intramural Pseudodiverticulosis and Concomitant Eosinophilic Esophagitis: A Case Series

    PubMed Central

    Scaffidi, Michael A.; Garg, Ankit; Ro, Brandon; Wang, Christopher; Yang, Tony T. C.; Plener, Ian S.; Grin, Andrea; Colak, Errol

    2016-01-01

    Background. Esophageal intramural pseudodiverticulosis (EIPD) is an idiopathic benign chronic disease characterized by flask-like outpouchings of the esophageal wall. It is unknown whether there is a genuine association between EIPD and eosinophilic esophagitis (EoE). Aims. To investigate a possible relationship between EIPD and EoE. Methods. Patients with radiographic or endoscopic evidence of pseudodiverticulosis were identified from the database at a single academic center. Cases were analyzed in three areas: clinical information, endoscopic findings, and course. Results. Sixteen cases of esophageal pseudodiverticulosis were identified. Five patients had histologic evidence of eosinophilic esophagitis. Patients with EoE had pseudodiverticula in the mid-to-distal esophagus while those with EIPD had pseudodiverticula predominantly in the proximal esophagus (p < 0.001). EoE with pseudodiverticulosis occurred in younger patients (p < 0.019). Food bolus obstructions were more common in patients with EoE and pseudodiverticulosis than in EIPD (p < 0.034). Conclusions. This is the first case series supporting a potential association between EoE and pseudodiverticulosis. We also identify characteristic features of pseudodiverticulosis that may raise clinical suspicion of underlying eosinophilic esophagitis.

  11. The laparoscopic management of Swyer syndrome: Case series.

    PubMed

    Malhotra, Neena; Dadhwal, Vatsla; Sharma, Kandala Aparna; Gupta, Deepika; Agarwal, Sumita; Deka, Dipika

    2015-01-01

    Swyer syndrome, also known as 46 XY pure gonadal dysgenesis, is a rare endocrine disorder. Affected individuals are phenotypically female with female genitalia, normal Mullerian structures, absent testicular tissue, and a 46 XY chromosomal constitution. We report a series of eight cases of Swyer syndrome, of which six were managed by laparoscopic gonadectomy. The two other cases had to undergo an exploratory laparotomy in view of their presentation with adnexal masses. Two of the girls were siblings. The chief presenting complaint was primary amenorrhea. Four girls also presented with a history of poor development of secondary sexual characters. The average age at presentation was 16.19±2.85 years. The average height was 158.33 ±4.63 cm, and the average weight was 49.33±8.44 kg. Breast development was either Tanner 2 or 3 in four girls, whereas three girls had a Tanner 1 underdeveloped breasts. Axillary and pelvic hair was sparse in all the girls. The vagina was well canalized in all the girls. Hormonal evaluation revealed hypergonadotropic hypogonadism with a mean follicle-stimulating hormone (FSH) level of 95.81 mIU/L and a mean luteinizing (LH) level of 24.15 mIU/L. Imaging analysis revealed the presence of a small uterus in all the cases, except one. Bilateral ovaries were either not visualized or streak gonads were present. Adnexal mass was detected in two of the six cases with raised carcinoembryonic antigen (CA) 125 levels in one case. Genetic analysis revealed a karyotype of 46 XY in six girls, 46 XY/45 X in one, and the culture repeatedly failed in one girl. Because of the risk of malignancy, bilateral gonadectomy was performed in all cases. Histopathological analysis revealed that three of the six cases had dysgerminoma. The patients have been started on hormone replacement therapy. Laparoscopy is a minimally invasive modality for the definitive diagnosis and treatment of cases with Swyer syndrome. An early diagnosis of Swyer syndrome is possible

  12. Coblation cryptolysis to treat tonsil stones: a retrospective case series.

    PubMed

    Chang, Christopher Y; Thrasher, Richard

    2012-06-01

    We introduce a novel and potentially effective approach in the treatment of tonsil stones using Coblation technology. A retrospective pilot case series was performed demonstrating the effectiveness of a technique that we call Coblation tonsil cryptolysis. This technique is unique in that it can be performed in adult patients without sedation using only local anesthesia, much like laser tonsil cryptolysis. As with laser cryptolysis, pain is significant for only a few days and most adults can resume normal diet and activity within 1 week. In contrast, tonsillectomy entails significant morbidity for several weeks. However, Coblation avoids the significant disadvantages of laser use, including the potential for airway fire, retinal damage from reflected scatter, dealing with plume from vaporized tissues, oral/facial burns, and the high cost of purchasing and maintaining laser equipment. After a single session of Coblation tonsil cryptolysis, a significant decrease and even elimination of tonsil stones can potentially be achieved.

  13. Depression in Children with HIV Infection: A Case Series

    PubMed Central

    Caballero, Joshua; Koranyi, Katalin I.; Brady, Michael T.; Nahata, Milap C.

    2005-01-01

    About 46,000 individuals younger than 25 years of age currently have a diagnosis of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). During their lifetime, approximately one-third of patients with HIV may develop depression. While antidepressants have been studied in adults with HIV, no data exist to support the use of antidepressants in children and adolescents with HIV. We report a case series of seven pediatric patients with HIV who were prescribed antidepressants. Six of seven patients had mild to moderate improvements in depressive symptoms. None of our patients experienced any suicidal ideations, and adverse events were minor. No drug-drug interactions were reported, and no significant changes in CD4 counts, CD4 percentages, or viral loads occurred during antidepressant therapy. Placebo-controlled, randomized studies are needed to confirm our results in this patient population. PMID:23118626

  14. Pink esthetics in periodontics - Gingival depigmentation: A case series.

    PubMed

    Thangavelu, Arthiie; Elavarasu, Sugumari; Jayapalan, Piranitha

    2012-08-01

    Smile expresses a feeling of joy, success, sensuality, affection, and courtesy, and reveals self-confidence and kindness. The harmony of the smile is determined not only by the shape, the position, and the color of the teeth, but also by the gingival tissues. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of "black gums" are common, particularly in patients having a very high smile line. Thus, perio-esthetic treatment modalities strive to achieve a harmonious inter-relationship of the pink with white, which is imperative of all treatment procedures. For depigmentation of gingival, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, scraping, electrosurgery, and diode laser have been tried for depigmentation, which are simple, effective, and yield good results, along with good patient satisfaction.

  15. Pink esthetics in periodontics – Gingival depigmentation: A case series

    PubMed Central

    Thangavelu, Arthiie; Elavarasu, Sugumari; Jayapalan, Piranitha

    2012-01-01

    Smile expresses a feeling of joy, success, sensuality, affection, and courtesy, and reveals self-confidence and kindness. The harmony of the smile is determined not only by the shape, the position, and the color of the teeth, but also by the gingival tissues. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of “black gums” are common, particularly in patients having a very high smile line. Thus, perio-esthetic treatment modalities strive to achieve a harmonious inter-relationship of the pink with white, which is imperative of all treatment procedures. For depigmentation of gingival, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, scraping, electrosurgery, and diode laser have been tried for depigmentation, which are simple, effective, and yield good results, along with good patient satisfaction. PMID:23066249

  16. Toward Optimal Outcome Following Pivotal Response Treatment: A Case Series

    PubMed Central

    Ventola, Pamela E.; Oosting, Devon R.; Keifer, Cara M.; Friedman, Hannah E.

    2015-01-01

    There is a growing literature on children with autism spectrum disorder (ASD) who respond favorably to behavioral treatment, which is often termed “optimal outcome.” Rates and definitions of optimal outcome vary widely. The current case series describes an empirically validated behavioral treatment approach called Pivotal Response Treatment (PRT). We present two preschool-aged children who received an intensive course of PRT and seem to be on a trajectory toward potential optimal outcome. Understanding response to treatment and predictors of response is crucial, not necessarily to predict who may succeed, but to individualize medicine and match children with customized treatment programs that will be best tailored to their unique and varied needs. PMID:25745373

  17. Lupus arthropathy: a case series of patients with rhupus.

    PubMed

    Fernández, Andrés; Quintana, Gerardo; Rondón, Federico; Restrepo, José Félix; Sánchez, Alvaro; Matteson, Eric L; Iglesias, Antonio

    2006-03-01

    Among the clinical manifestations of systemic lupus erythematosus (SLE) is an arthropathy, which is usually nonerosive. In many cases the joint involvement is mild. A subset of patients have deforming, nonerosive Jaccoud's arthropathy, and a minority have an arthropathy with clinical findings similar to rheumatoid arthritis (RA) that has been called "rhupus." We report our series of eight patients (seven female, one male) with rhupus arthropathy. Patients were between the ages of 17 and 38 years (average: 30.3 years) at disease onset. All had deforming or Jaccoud's arthropathy, and three had erosive disease. The arthritis was typically the first disease manifestation. Other symptoms of lupus including vasculitis and glomerulonephritis appeared after an average of 2.8 years. All had positive antinuclear antibody and rheumatoid factor. Rhupus arthritis is not a combination of RA and SLE, but should be regarded as a variant of the arthropathy of lupus.

  18. Toe Necrosis, Etiologies and Management, a Case Series

    PubMed Central

    Issa, Abdelfatah Abou; Newman, Mackenzie; Simman, Richard

    2014-01-01

    Toe necrosis may have vast different etiologies. These include ischemia, embolus, and others. (1) The most common etiology is ischemia. It is a reduction in blood supply to a viable tissue that can lead to susceptibility to infection and tissue death. Peripheral ischemia, which is rooted in the lower limbs, is a major risk factor for toe necrosis because the basal metabolic requirements of tissue are not being sufficiently met. As a result, pain, ulcers, and gangrene commonly occur. (2) Other causes of direct and indirect toe necrosis and related lower limb gangrene include mechanical trauma, infectious, pharmacological sensitivity, cancer, blue toe syndrome, and other granulomatous diseases, such as Churg-Strauss syndrome. We present a case series of toes necrosis which resulted from different etiologies and their management. PMID:26199887

  19. Mirtazapine in pregnancy and lactation: data from a case series.

    PubMed

    Smit, Mirte; Wennink, Hanneke; Heres, Marion; Dolman, Koert M; Honig, Adriaan

    2015-04-01

    Depression is a common disorder in pregnancy and associated with adverse effects for both mother and neonate. Pharmacological treatment and prevention options include mirtazapine. In a series of 56 cases, we investigated neonatal outcome after intrauterine exposure to mirtazapine and exposure through lactation in the first days postpartum.No increase in any neonatal complication was observed. None of the infants exposed to mirtazapine in the first trimester were born with a major malformation. Of the 54 infants exposed to mirtazapine in the third trimester, 14 were diagnosed with poor neonatal adaptation syndrome (PNAS). This incidence (25.9%) is similar to the incidence of PNAS after intrauterine exposure to other antidepressants. The incidence of PNAS after exposure to mirtazapine was significantly diminished in children who were partially or fully breastfed (18.6% versus 54.5%, P = 0.024). PMID:25689290

  20. Peripheral cemento-ossifying fibroma: case series literature review.

    PubMed

    Verma, Esha; Chakki, Arunkumar Bhimashankar; Nagaral, Sharanbasappa Chandrashekar; Ganji, Kiran Kumar

    2013-01-01

    THE CONCEPT OF FIBROOSSEOUS LESIONS OF BONE HAS EVOLVED OVER THE LAST SEVERAL DECADES AND NOW INCLUDES TWO MAJOR ENTITIES: fibrous dysplasia and ossifying fibroma. Peripheral cemento-ossifying fibroma is a relatively rare tumour classified between fibroosseous lesions. It predominantly affects adolescents and young adults, with peak prevalence between 10 and 19 yrs. The cemento-ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of confusion regarding terminology and the criteria for its diagnosis. The cemento-ossifying fibroma is odontogenic in origin, whereas ossifying fibroma is of bony origin. Lesions histologically similar to peripheral ossifying fibroma have been given various names in existing literature. Therefore, we present and discuss in this paper a series of cases of peripheral cemento-ossifying fibroma emphasizing the differential diagnosis.

  1. Scrambler therapy for patients with cancer pain - case series -.

    PubMed

    Park, Hong Sik; Sin, Woo Kyung; Kim, Hye Young; Moon, Jee Youn; Park, Soo Young; Kim, Yong Chul; Lee, Sang Chul

    2013-01-01

    More than 80% of cancer patients experience cancer pain. Among them, more than 50% experience moderate to severe pain. To control cancer pain, a variety of methods have been used, including medications and nerve blocks. In some patients, however, it is impossible to perform nerve blocks due to caner metastasis into the epidural space, while in other patients, opioid dose escalation is impossible due to opioid side effects; thus, cancer pain management is difficult. Scrambler therapy is a novel approach for pain control that uses EKG-like pads, which are applied above and below the site of pain. Scrambler therapy synthesizes 16 different types of nerve action potentials that provide "non-pain" information via cutaneous nerves. The advantages of this treatment are that it is non-invasive and safe and has no significant side effects. In this case series, we report the treatment results of using scrambler therapy in three cancer patients with intractable pain. PMID:23342211

  2. Adverse Events Associated with Yoga: A Systematic Review of Published Case Reports and Case Series

    PubMed Central

    Cramer, Holger; Krucoff, Carol; Dobos, Gustav

    2013-01-01

    While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices. PMID:24146758

  3. 'Mrs L.'s case': a celebrated South Australian surgical case.

    PubMed

    Elmslie, R G

    1991-10-01

    This paper concerns a dispute at the Adelaide Hospital in September 1896 between Professor Archibald Watson, Pathologist, Honorary Consulting Surgeon and sole remaining University teacher at the hospital, and Alexander Disney Leith Napier, who had arrived from England to fill the place of the honorary surgeons who had resigned from the hospital. Watson accused Napier of incompetence in his management of 'Mrs L.', who died after a femoral hernia operation. Mrs L had a form of internal hernia causing intestinal obstruction, whereas all the medical attendants, including Watson, originally thought an old femoral hernia was the cause of her illness. By fortuitous coincidence the operation on the femoral hernia could have cured the internal hernia if the band of omentum attached to the femoral hernia had been divided. Watson became aware of the band at the post-mortem and then asserted that the operation should have taken it into account. Napier complained to the Board of the Hospital, alleging that Watson had misrepresented the facts when he conducted the post-mortem on the patient and that he was disloyal to the hospital. The Board found the complaint proved and invited Watson to resign; he declined and was dismissed. Undaunted, Watson circulated a privately printed pamphlet (entitled 'Mrs L.'s case'), which re-stated the events of the case and graphically described his post-mortem findings. It was submitted to the Chairman of a Select Committee of the Legislative Council of South Australia established to review the running of the hospital. The Committee recommended the setting up of a Royal Commission but the Government let the matter lapse.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Transitioning Beliefs in Teachers of Chinese as a Foreign Language: An Australian Case Study

    ERIC Educational Resources Information Center

    Moloney, Robyn; Xu, HuiLing

    2015-01-01

    With the economic rise of China, there is global demand for effective teaching and learning of Chinese as a foreign language (CFL). There has been limited sustained success in Chinese language learning in Australian schools, however, and this has been attributed, amongst other factors, to pedagogy employed by teachers. Today, it is commonplace to…

  5. Impact in Vocational Education and Training Research: The Case of the Australian VET Research Consortium

    ERIC Educational Resources Information Center

    Harris, Roger; Clayton, Berwyn

    2010-01-01

    "Impact" is a notion that is not very well understood in research. Within Australian higher education, it has been bandied about within such frameworks as the "Research Quality Framework" ("RQF") and Excellence in Research for Australia (ERA). Vocational education and training (VET) research is not immune from these movements, and increasingly,…

  6. Patterns of Student Enrolment and Attrition in Australian Open Access Online Education: A Preliminary Case Study

    ERIC Educational Resources Information Center

    Greenland, Steven J.; Moore, Catherine

    2014-01-01

    Swinburne University of Technology has experienced tremendous growth in open access online learning and as such is typical of the many Australian institutions that have ventured into online tertiary education. While research in online education continues to expand, comparatively little investigates students' enrolment and attrition. This research…

  7. Conceptions of Good Teaching by Good Teachers: Case Studies from an Australian University

    ERIC Educational Resources Information Center

    Duarte, Fernanda P.

    2013-01-01

    This paper contributes to the debate on what constitutes good teaching in early 21st Century higher education, through an examination of the experience of five outstanding lecturers from a business school in an Australian university. It is based on a qualitative study that explored their perceptions on what constitutes "good teaching". Resonating…

  8. Using Aptitude Testing to Diversify Higher Education Intake--An Australian Case Study

    ERIC Educational Resources Information Center

    Edwards, Daniel; Coates, Hamish; Friedman, Tim

    2013-01-01

    Australian higher education is currently entering a new phase of growth. Within the remit of this expansion is an express commitment to widen participation in higher education among under-represented groups--in particular those from low socioeconomic backgrounds. This paper argues that one key mechanism for achieving this goal should be the…

  9. Student Perceptions of Internationalization of the Curriculum: An Australian Case Study

    ERIC Educational Resources Information Center

    Absalom, Matthew; Vadura, Katharine

    2006-01-01

    One of the recent imperatives in higher education worldwide has been internationalization of the curriculum. The object of this article is to explore student perceptions of internationalization across diverse course offerings within one school of the University of South Australia (UniSA). UniSA is notable in the Australian context as a university…

  10. The Impact of Journal Ranking Fetishism on Australian Policy-Related Research: A Case Study

    ERIC Educational Resources Information Center

    Young, Suzanne; Peetz, David; Marais, Magalie

    2011-01-01

    In Australia, the Excellence in Research (ERA) exercise, first conducted in 2008 and continuing relatively unchanged in 2012, determines the level of research funding made available to Australian universities. However, the use of journal rankings as part of ERA is argued to be problematic (Cooper & Poletti 2011). Through a survey of academics in a…

  11. Face and object imagery in congenital prosopagnosia: a case series.

    PubMed

    Tree, Jeremy J; Wilkie, Jaimie

    2010-10-01

    It has been reported that congenital prosopagnosics may have a general imagery deficit or an imagery deficit specific to faces. However, much of this evidence is based on self-report questionnaires, rather than experimentally based testing (Grüter et al., 2007, 2009). This study tested face and non-face based imagery in a case series of congenital prosopagnosics, utilising both questionnaire based and forced choice accuracy measures. Our findings indicate that all the prosopagnosics showed impaired face based imagery, which contrasted with normal performance on imagery of objects and colours - a pattern that is consistent with reports of acquired prosopagnosia (Barton, 2008; Michelon and Biederman, 2003). Given all our experimentally based testing indicated face imagery impairments, despite no such problems being seen on self-report questionnaires, we would argue that testing based only on the latter must be interpreted with some caution. Overall, we would advocate that our findings demonstrate a category specific visual imagery impairment in congenital prosopagnosia, such that general imagery skill can be intact in such cases.

  12. Alkali-related ocular burns: a case series and review.

    PubMed

    Bunker, Daniel J L; George, Robert J; Kleinschmidt, Andrew; Kumar, Rohit J; Maitz, Peter

    2014-01-01

    Alkali burns are known to possess high pathological potential because of their inherent ability to lyse cell membranes and penetrate intraocular structures with devastating results. The authors aimed to evaluate the most common cause of this presentation, the current treatment approaches to injury, and eventual outcome as related to severity. The authors performed a retrospective review of all patients who sustained chemical-related ocular injuries seen at the Concord Hospital Burns Unit, Australia between January 2005 and March 2012. Management was based on cooperation between ophthalmic staff and the burns unit, with emphasis on early aggressive intervention and rigorous follow-up. The records of 39 patients who presented with chemical-related injury were assessed, 12 of whom had confirmed alkali burns involving the cornea. The most commonly implicated agent was sodium hydroxide, usually in the context of otherwise trivial domestic accidents. Acute medical management included copious irrigation and the use of analgesics, cycloplegics, and topical antibiotics. In half the cases, steroid drops and oral vitamin C were also used. Ten of the 12 patients (83%) had return to premorbid visual acuity. Complications included cicatrical ectropion (n = 1), pseudoexfoliative syndrome (n = 1), and symblepharon (n = 1). Surgical correction was needed in the one patient with cicatrical ectropion. This case series shows that appropriate acute management minimizes the potentially devastating sequelae of ocular alkali burns. Emphasis should be placed on prevention of domestic and workplace injuries when using alkaline products.

  13. The Histopathological Spectrum of Pyogenic Granuloma: A Case Series.

    PubMed

    Marla, Vinay; Shrestha, Ashish; Goel, Khushboo; Shrestha, Sajeev

    2016-01-01

    Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i) cellular phase, (ii) capillary phase/vascular phase, and (iii) involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH) and non-lobular capillary hemangioma (non-LCH). Case Presentation. In this series, four cases (varied age groups and both genders) of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification. PMID:27382492

  14. The Histopathological Spectrum of Pyogenic Granuloma: A Case Series

    PubMed Central

    Shrestha, Sajeev

    2016-01-01

    Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i) cellular phase, (ii) capillary phase/vascular phase, and (iii) involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH) and non-lobular capillary hemangioma (non-LCH). Case Presentation. In this series, four cases (varied age groups and both genders) of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification. PMID:27382492

  15. Face and object imagery in congenital prosopagnosia: a case series.

    PubMed

    Tree, Jeremy J; Wilkie, Jaimie

    2010-10-01

    It has been reported that congenital prosopagnosics may have a general imagery deficit or an imagery deficit specific to faces. However, much of this evidence is based on self-report questionnaires, rather than experimentally based testing (Grüter et al., 2007, 2009). This study tested face and non-face based imagery in a case series of congenital prosopagnosics, utilising both questionnaire based and forced choice accuracy measures. Our findings indicate that all the prosopagnosics showed impaired face based imagery, which contrasted with normal performance on imagery of objects and colours - a pattern that is consistent with reports of acquired prosopagnosia (Barton, 2008; Michelon and Biederman, 2003). Given all our experimentally based testing indicated face imagery impairments, despite no such problems being seen on self-report questionnaires, we would argue that testing based only on the latter must be interpreted with some caution. Overall, we would advocate that our findings demonstrate a category specific visual imagery impairment in congenital prosopagnosia, such that general imagery skill can be intact in such cases. PMID:20434142

  16. Soil formation rates determined from Uranium-series isotope disequilibria in soil profiles from the southeastern Australian highlands

    NASA Astrophysics Data System (ADS)

    Suresh, P. O.; Dosseto, A.; Hesse, P. P.; Handley, H. K.

    2013-10-01

    The sustainability of soil resources is determined by the balance between the rates of production and removal of soils. Samples from four weathering profiles at Frogs Hollow in the upper catchment area of the Murrumbidgee River (southeastern Australia) were analyzed for their uranium-series (U-series) isotopic composition to estimate soil production rates. Sequential leaching was conducted on sample aliquots to assess how U-series nuclides are distributed between primary and secondary minerals. Soil is increasingly weathered from bottom to top which is evident from the decrease in (234U/238U) ratios and increase in relative quartz content with decreasing soil depth. One soil profile shows little variation in mineralogy and U-series geochemistry with depth, explained by the occurrence of already extensively weathered saprolite, so that further weathering has minimal effect on mineralogy and geochemistry. Al2O3 is mobilized from these soils, and hence a silicon-based weathering index treating Al2O3 as mobile is introduced, which increases with decreasing soil depth, in all profiles. Leached and unleached aliquots show similar mineralogy with slight variation in relative concentrations, whereas the elemental and isotopic composition of uranium and thorium show notable differences between leached and unleached samples. Unleached samples show systematic variations in uranium-series isotopic compositions with depth compared to leached samples. This is most likely explained by the mobilization of U and Th from the samples during leaching. Soil residence times are calculated by modeling U-series activity ratios for each profile separately. Inferred timescales vary up to 30 kyr for unleached aliquots from profile F1 to up to 12 kyr for both leached and unleached aliquots from profile F2. Muscovite content shows a linear relationship with U-series derived soil residence times. This relationship provides an alternative method to estimate residence timescales for profiles with

  17. Are Staphylococcus intermedius Infections in Humans Cases of Mistaken Identity? A Case Series and Literature Review.

    PubMed

    Viau, Roberto; Hujer, Andrea M; Hujer, Kristine M; Bonomo, Robert A; Jump, Robin L P

    2015-09-01

    Staphylococcus intermedius and Staphylococcus pseudintermedius are difficult to distinguish using conventional microbiological methods. Molecular diagnostic tools change our understanding of the epidemiology of these 2 organisms. In this study, we present (1) a detailed review of the current literature on molecular diagnostics and (2) a case series in which misidentification was proven in 1 case. We conclude that S pseudintermedius is a more common human pathogen than previously recognized.

  18. Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases.

    PubMed

    Gee, Paul; Schep, Leo J; Jensen, Berit P; Moore, Grant; Barrington, Stuart

    2016-01-01

    Background A new class of hallucinogens called NBOMes has emerged. This class includes analogues 25I-NBOMe, 25C-NBOMe and 25B-NBOMe. Case reports and judicial seizures indicate that 25I-NBOMe and 25C-NBOMe are more prevalently abused. There have been a few confirmed reports of 25B-NBOMe use or toxicity. Report Observational case series. This report describes a series of 10 patients who suffered adverse effects from 25B-NBOMe. Hallucinations and violent agitation predominate along with serotonergic/stimulant signs such as mydriasis, tachycardia, hypertension and hyperthermia. The majority (7/10) required sedation with benzodiazepines. Analytical method 25B-NBOMe concentrations in plasma and urine were quantified in all patients using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Peak plasma levels were measured between 0.7-10.1 ng/ml. Discussion The NBOMes are desired by users because of their hallucinogenic and stimulant effects. They are often sold as LSD or synthetic LSD. Reported cases of 25B- NBOMe toxicity are reviewed and compared to our series. Seizures and one pharmacological death have been described but neither were observed in our series. Based on our experience with cases of mild to moderate toxicity, we suggest that management should be supportive and focused on preventing further (self) harm. High doses of benzodiazepines may be required to control agitation. Patients who develop significant hyperthermia need to be actively managed. Conclusions Effects from 25B-NBOMe in our series were similar to previous individual case reports. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25C-NBOMe). Violent agitation frequently present along with signs of serotonergic stimulation. Hyperthermia, rhabdomyolysis and kidney injury were also observed.

  19. Acute interstitial pneumonitis. Case series and review of the literature.

    PubMed

    Vourlekis, J S; Brown, K K; Cool, C D; Young, D A; Cherniack, R M; King, T E; Schwarz, M I

    2000-11-01

    Acute interstitial pneumonitis (AIP) is an acute, idiopathic interstitial lung disease characterized by rapidly progressive diffuse pulmonary infiltrates and hypoxemia requiring hospitalization. The case-fatality ratio is high. Previous reports suggested that survivors of the acute event have a favorable outcome. We undertook this study to examine the natural history of survivors. We had observed several patients who experienced recurrent episodes of AIP and chronic progressive interstitial lung disease. We sought to determine longitudinal survival in these patients and to compare our experience with that in the medical literature. Overall, we identified 13 biopsy-proven cases of AIP. The mean patient age was 54 years in our review, which is identical to previous reports. Twelve patients were hospitalized and all 12 required mechanical ventilation. Overall hospital survival was 67%. All patients demonstrated abnormalities in gas exchange at presentation. Radiographs typically demonstrated bilateral patchy densities that progressed to a diffuse alveolar filling pattern in nearly all cases. All biopsy specimens showed organizing diffuse alveolar damage. Longitudinal data were available for 7 patients. Two died of AIP recurrences. A third died of complications of heart failure shortly after hospital discharge. One patient progressed to end-stage lung disease and required lung transplantation. Two patients experienced persistent pulmonary symptoms, accompanied in 1 by progressive lung fibrosis. One patient had nearly complete recovery of lung function 2 years following AIP. (Follow-up information was unavailable for 2 survivors.) In our literature review, 5 of 7 patients reported experienced some recovery of lung function. One case of progressive interstitial lung disease requiring lung transplantation was reported. The reported mortality was much higher than in our experience (74% versus 33%). The mean time from symptom onset to death was 26 days, compared with 34

  20. Double tibial osteotomy for bow leg patients: A case series

    PubMed Central

    Nazem, Khalilollah; Fouladi, Arash; Chinigarzadeh, Mozhdeh

    2013-01-01

    Background: High tibia osteotomy (HTO) is a common surgical operation for correction of genu varum deformity. In some patients, there are concurrent tibia vara and genu varum (bow leg). This study aimed to consider the possibility of better correction of bow leg deformity after double level tibial osteotomy (DLTO). Materials and Methods: A case series of 10 patients of genu varum in addition to tibia vara (bow leg) deformity who were referred to orthopedic ward of an academic hospital of Isfahan- Iran during 2009–2011 were included in the study. The mean age was 17.3 ± 3.1 years and all of them underwent DLTO. The results of treatment have been assessed based on clinical and radiological parameters before and after surgery. Results: The mean pre- and post operative values for Tibia-Femoral Angle, Medial Proximal of Tibia Angle (MPTA), and Lateral Distal of Tibia Angle (LDTA) were 18.13 ± 3.05° vs. 3.93 ± 0.66°, 79.13 ± 3.4° vs. 89.7 ± 1.8° and 96.40 ± 1.8° vs. 88.73 ± 3.0° respectively (P < 0.05). Improvement of all radiological parameters was meaningful. Seventy three percent of patients had normal mechanical axis of limb after surgery. The remaining cases had varus deformity in distal femur that was corrected by valgus supracondylar osteotomy in an additional operation. Limited range of motion (ROM) near knee and ankle was not observed. Conclusion: DLTO correct bow leg deformity in the point of alignment of limb and paralleling of knee and ankle joint more effectively. This method can be used in metabolic and congenital bow leg which deformities are present in throughout of the lower limb. We described this technique for the first time. PMID:24523802

  1. Breast carcinoma and phyllodes tumour: a case series.

    PubMed

    Sin, Eliza I-Lin; Wong, Chow Yin; Yong, Wei Sean; Ong, Kong Wee; Madhukumar, Preetha; Tan, Veronique Kiak Mien; Thike, Aye Aye; Tan, Puay Hoon; Tan, Benita Kiat Tee

    2016-04-01

    Malignant transformation of the epithelial component of phyllodes tumours (PT) is rare and only reported in literature as sporadic cases of carcinoma associated with PTs. We report the clinicopathological characteristics of in situ and invasive carcinoma coexisting with PT in 10 patients treated in our institution over an 11-year period from 1992 to 2012. Ten patients with coexisting PT and in situ or invasive carcinoma were identified from our records. Six had carcinoma found within the PT. All were female with a median age of 47 (43-72) years. One patient had a history of PT in the same breast while another had a history of PT in the same breast as well as invasive ductal carcinoma in the contralateral breast. The rest did not have any risk factors of breast cancer. Five patients had a preoperative core needle biopsy performed with the report of a fibroepithelial lesion. The rest of the patients had surgery upfront for their breast masses. Two patients who had ER/PR positive invasive carcinoma received adjuvant hormonal therapy. Patients were followed up for a mean of 3.6 years (9 months-10 years) and all patients were alive and recurrence free. PT associated with carcinoma is rare, and we present a series of cases that add to the limited current literature. It is often difficult to detect the presence of the carcinomatous component preoperatively. Hence, close examination of resected PT specimens must be carried out to allow prompt detection of any associated carcinomas, however rare, such that adequate treatment can be given.

  2. Adverse clinical sequelae after skin branding: a case series

    PubMed Central

    2009-01-01

    Introduction Branding refers to a process whereby third degree burns are inflicted on the skin with a hot iron rod or metallic object. Branding employs the phenomenon of "counter irritation," and is widely used by faith healers in developing countries for therapeutic purposes. Some methods, which are very crude and inhuman, carry a large risk of complications. The purpose of this study is to present a series of complications and to familiarize clinicians with this dangerous method of treatment. Case presentation Four Pakistani patients, three male and one female, ranging from 25 to 60 years of age "branded" with a red hot iron rod for various medical reasons presented with severe medical complications to our tertiary care hospital. The mean duration between the procedure and presentation to the hospital was 6 days. At the time of admission, two patients had septic shock, one patient had cavernous sinus thrombosis and one patient had multiple splenic abscesses. All patients received standard care for wound management and systemic infections. Two patients eventually died during the course of treatment. Conclusion Severe complications from branding are troublesome and the potential risks of this treatment outweigh its benefits. Globally, there is a great need for heightened awareness about the dangers of branding among patients and physicians, as this will have an important effect on patients who seek branding for various medical conditions. PMID:19166615

  3. Agomelatine for Depression in Schizophrenia: A Case-Series

    PubMed Central

    Mutschler, Jochen; Rüsch, Nicolas; Schönfelder, Herdis; Herwig, Uwe; Brühl, Annette B.; Grosshans, Martin; Rössler, Wulf; Russmann, Heike

    2012-01-01

    Objectives Agomelatine, a melatonin (MT1/MT2) receptor agonist and 5-HT2C receptor antagonist, is a new antidepressant and a potential therapeutic option for major depressive episodes and negative symptoms in persons with schizophrenia. We investigated such treatment outcomes with respect to antidepressant efficacy, safety, and tolerability. Methods We report a consecutive case series of seven patients with schizophrenia and comorbid major depressive symptoms who received agomelatine for a period of at least six weeks in addition to stable doses of antipsychotic agents. General psychopathology, positive, negative and depressive symptoms were assessed with standardized interviews. Relevant blood parameters were assessed. Results Depressive symptoms improved significantly. Positive symptoms remained stable, while negative symptoms and global psychopathology improved significantly. Agomelatine was well tolerated in most patients. Conclusions Our findings provide initial evidence that agomelatine is safe and efficacious in treating depressive symptoms in patients with schizophrenia. Furthermore, agomelatine seems to be effective for the treatment of negative symptoms. Randomized controlled trials are necessary to confirm these first observations.

  4. Mycophenolate mofetil in juvenile dermatomyositis: a case series.

    PubMed

    Dagher, Rawane; Desjonquères, Marine; Duquesne, Agnès; Quartier, Pierre; Bader-Meunier, Brigitte; Fischbach, Michel; Guiguonis, Vincent; Picherot, Georges; Cimaz, Rolando

    2012-03-01

    The objective of this study was to report the use of Mycophenolate Mofetil (MMF) in Juvenile Dermatomyositis (JDM). A retrospective chart review of children diagnosed with JDM having received MMF was performed. Response was evaluated 3 months after the onset of MMF by comparing muscle strength and steroid dosage before and after treatment. A good response was defined by global improvement concerning weakness and fatigability as evaluated subjectively by the physician along with a gain of at least 4 points on each of 2 muscle testings (Manual Muscle Testing, MMT and Childhood Myositis Assessment Score, CMAS) and/or a decrease of >15% of the corticosteroid dosage. Eight patients were identified. Except for one, all had received MMF secondary to an initial therapy of conventional immunosuppressants. Six patients showed good response by our predefined criteria. Changes of muscle testing scores ranged between +0 to +21 points (mean = +10.6) for the MMT and between +3 and +11 (mean = +7) for the CMAS. Corticosteroid tapering varied from 0 to 50%, with a mean of 18%. In most cases, follow-up was available for many months (up to 26); overall, we observed only one complication: a transient neutropenia in a patient concurrently receiving another immunosuppressant. This small series is the first published report on the use of MMF in JDM and suggests it is safe. Prospective larger studies are required to further elucidate the use of MMF in JDM.

  5. Liver Damage Associated with Polygonum multiflorum Thunb.: A Systematic Review of Case Reports and Case Series.

    PubMed

    Lei, Xiang; Chen, Jing; Ren, Jingtian; Li, Yan; Zhai, Jingbo; Mu, Wei; Zhang, Li; Zheng, Wenke; Tian, Guihua; Shang, Hongcai

    2015-01-01

    Objective. To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with Polygonum multiflorum Thunb. (HSW), we provide a systematic review of case reports and case series about liver damage associated with HSW. Methods. An extensive search of 6 medical databases was performed up to June 2014. Case reports and case series involving liver damage associated with HSW were included. Results. This review covers a total of 450 cases in 76 articles. HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. Symptoms of liver damage occur mostly a month or so after taking the medicine, mainly including jaundice, fatigue, anorexia, and yellow or tawny urine. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care. Conclusion. HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Liver damage associated with HSW is reversible, and, after active treatment, the majority can be cured. People should be alert to liver damage when taking HSW preparations. PMID:25648693

  6. “Unwell while Aboriginal”: iatrogenesis in Australian medical education and clinical case management

    PubMed Central

    Ewen, Shaun C; Hollinsworth, David

    2016-01-01

    Introduction Attention to Aboriginal health has become mandatory in Australian medical education. In parallel, clinical management has increasingly used Aboriginality as an identifier in both decision making and reporting of morbidity and mortality. This focus is applauded in light of the gross inequalities in health outcomes between indigenous people and other Australians. Methods A purposive survey of relevant Australian and international literature was conducted to map the current state of play and identify concerns with efforts to teach cultural competence with Aboriginal people in medical schools and to provide “culturally appropriate” clinical care. The authors critically analyzed this literature in light of their experiences in teaching Aboriginal studies over six decades in many universities to generate examples of iatrogenic effects and possible responses. Results and discussion Understanding how to most effectively embed Aboriginal content and perspectives in curriculum and how to best teach and assess these remains contested. This review canvasses these debates, arguing that well-intentioned efforts in medical education and clinical management can have iatrogenic impacts. Given the long history of racialization of Aboriginal people in Australian medicine and the relatively low levels of routine contact with Aboriginal people among students and clinicians, the review urges caution in compounding these iatrogenic effects and proposes strategies to combat or reduce them. Conclusion Long overdue efforts to recognize gaps and inadequacies in medical education about Aboriginal people and their health and to provide equitable health services and improved health outcomes are needed and welcome. Such efforts need to be critically examined and rigorously evaluated to avoid the reproduction of pathologizing stereotypes and reductionist explanations for persistent poor outcomes for Aboriginal people. PMID:27313485

  7. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2007. A report of the Australian Mycobacterium Reference Laboratory Network.

    PubMed

    Lumb, Richard; Bastion, Ivan; Carter, Robyn; Jelfs, Peter; Keehner, Terillee; Sievers, Aina

    2009-09-01

    The Australian Mycobacterium Reference Laboratory Network collects and analyses laboratory data on new cases of disease caused by the Mycobacterium tuberculosis complex. In 2007, a total of 872 cases were identified by bacteriology; an annual reporting rate of 4.1 cases per 100,000 population. Isolates were identified as M. tuberculosis (n=867), M. africanum (n=4) and M. bovis (n=1). Fifteen children aged under 10 years had bacteriologically-confirmed tuberculosis. Results of in vitro drug susceptibility testing were available for 871 of 872 isolates for isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). A total of 98 (11.3%) isolates of M. tuberculosis were resistant to at least one of these anti-tuberculosis agents. Resistance to at least H and R (defined as multi-drug resistance, MDR) was detected in 24 (2.8%) isolates, all from overseas-born patients; 17 were from the respiratory tract (sputum n=16, endotracheal aspirate n=1). Thirteen patients with MDR-TB were from the Papua New Guinea-Torres Strait Islands zone. Of the 98 M. tuberculosis isolates resistant to at least one of the standard drugs, 54 (55.1%) were from new cases, 9 (9.2%) from previously treated cases, and no information was available on the remaining 35 cases. Seven were Australian-born, 90 were overseas- born, and the country of birth of 1 was unknown. Of the 90 overseas-born persons with drug resistant disease, 66 (73.3%) were from 5 countries: India (n=16); Papua New Guinea (n=15); the Philippines (n=12); Vietnam (n=12); and China (n=11). No XDR-TB was detected in 2007.

  8. Congenital Zika syndrome with arthrogryposis: retrospective case series study

    PubMed Central

    Filho, Epitacio Leite Rolim; Lins, Otavio Gomes; Aragão, Maria de Fátima Viana Vasco; Brainer-Lima, Alessandra Mertens; Cruz, Danielle Di Cavalcanti Sousa; Rocha, Maria Angela Wanderley; Sobral da Silva, Paula Fabiana; Carvalho, Maria Durce Costa Gomes; do Amaral, Fernando José; Gomes, Joelma Arruda; Ribeiro de Medeiros, Igor Colaço; Ventura, Camila V; Ramos, Regina Coeli

    2016-01-01

    Objective To describe the clinical, radiological, and electromyographic features in a series of children with joint contractures (arthrogryposis) associated with congenital infection presumably caused by Zika virus. Design Retrospective case series study. Setting Association for Assistance of Disabled Children, Pernambuco state, Brazil. Participants Seven children with arthrogryposis and a diagnosis of congenital infection presumably caused by Zika virus during the Brazilian microcephaly epidemic. Main outcome measures Main clinical, radiological, and electromyographic findings, and likely correlation between clinical and primary neurological abnormalities. Results The brain images of all seven children were characteristic of congenital infection and arthrogryposis. Two children tested positive for IgM to Zika virus in the cerebrospinal fluid. Arthrogryposis was present in the arms and legs of six children (86%) and the legs of one child (14%). Hip radiographs showed bilateral dislocation in seven children, subluxation of the knee associated with genu valgus in three children (43%), which was bilateral in two (29%). All the children underwent high definition ultrasonography of the joints, and there was no evidence of abnormalities. Moderate signs of remodeling of the motor units and a reduced recruitment pattern were found on needle electromyography (monopolar). Five of the children underwent brain computed tomography (CT) and magnetic resonance imaging (MRI) and the remaining two CT only. All presented malformations of cortical development, calcifications predominantly in the cortex and subcortical white matter (especially in the junction between the cortex and white matter), reduction in brain volume, ventriculomegaly, and hypoplasia of the brainstem and cerebellum. MRI of the spine in four children showed apparent thinning of the cord and reduced ventral roots. Conclusions Congenital Zika syndrome should be added to the differential diagnosis of congenital

  9. [Ultrasonographic diagnosis of the retroperitoneal space. A case history series and some selected clinical cases].

    PubMed

    Monaci, R; Rondine, P P; Morandini, M; Meoni, S; Cecchin, A

    1989-04-01

    A personal series and some clinical cases of pathology of the retroperitoneal space observed by ultrasonography during routine and emergency investigations are reported. Although the limitations of this diagnosis compared to the more recent image techniques (CT and NMR) are recognised, it is still considered an indispensable first level diagnosis in this extensive pathology (in terms of site, type and extent) of retroperitoneally located organs, tissues and systems.

  10. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2000: report of the Australian Mycobacterium Laboratory Reference Network.

    PubMed

    Lumb, Richard; Bastian, Ivan; Dawson, David; Gilpin, Chris; Havekort, Frank; Howard, Peter; Sievers, Aina

    2002-01-01

    The Australian Mycobacterium Reference Laboratory Network collected and analysed laboratory data on new diagnoses of disease caused by Mycobacterium tuberculosis complex in the year 2000. A total of 765 cases were identified, representing an annual reporting rate of 4.0 cases of laboratory-confirmed tuberculosis (TB) per 100,000 population. Pulmonary disease was diagnosed in 64.9 per cent of cases with a male:female ratio of 1.5:1. Smears were positive for 209/365 (57.3%) of sputum isolates and 39/117 (33.3%) bronchoscopy isolates. Sputum from males was more likely to be smear-positive (63.3%) than from females (47.5%). Isolates from lymph node accounted for 136 (17.7%) of all cases; only 28.7 per cent were smear-positive. Eighty-four (11.0%) isolates, comprising 82 M. tuberculosis and 2 M. bovis strains, demonstrated in vitro resistance to at least one of the standard anti-TB medications. Resistance to at least isoniazid and rifampicin (defined as multidrug-resistant TB) was observed for only 8 (1.0%) strains, a rate similar to previous years. Almost all (96.3%) of patients with drug resistant strains were classified as having initial resistance. The country of birth was known for 76 (92.7%) of 82 patients with a drug resistant strain of M. tuberculosis; 6 were Australian-born and 70 (92.1%) had migrated from a total of 17 countries. Of these 70 migrants with drug-resistant disease, 68.6 per cent had migrated from one of the following countries: Vietnam (n=15), China (n=11), Philippines (n=11), India (n=6), and Indonesia (n=5).

  11. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2000: report of the Australian Mycobacterium Laboratory Reference Network.

    PubMed

    Lumb, Richard; Bastian, Ivan; Dawson, David; Gilpin, Chris; Havekort, Frank; Howard, Peter; Sievers, Aina

    2002-01-01

    The Australian Mycobacterium Reference Laboratory Network collected and analysed laboratory data on new diagnoses of disease caused by Mycobacterium tuberculosis complex in the year 2000. A total of 765 cases were identified, representing an annual reporting rate of 4.0 cases of laboratory-confirmed tuberculosis (TB) per 100,000 population. Pulmonary disease was diagnosed in 64.9 per cent of cases with a male:female ratio of 1.5:1. Smears were positive for 209/365 (57.3%) of sputum isolates and 39/117 (33.3%) bronchoscopy isolates. Sputum from males was more likely to be smear-positive (63.3%) than from females (47.5%). Isolates from lymph node accounted for 136 (17.7%) of all cases; only 28.7 per cent were smear-positive. Eighty-four (11.0%) isolates, comprising 82 M. tuberculosis and 2 M. bovis strains, demonstrated in vitro resistance to at least one of the standard anti-TB medications. Resistance to at least isoniazid and rifampicin (defined as multidrug-resistant TB) was observed for only 8 (1.0%) strains, a rate similar to previous years. Almost all (96.3%) of patients with drug resistant strains were classified as having initial resistance. The country of birth was known for 76 (92.7%) of 82 patients with a drug resistant strain of M. tuberculosis; 6 were Australian-born and 70 (92.1%) had migrated from a total of 17 countries. Of these 70 migrants with drug-resistant disease, 68.6 per cent had migrated from one of the following countries: Vietnam (n=15), China (n=11), Philippines (n=11), India (n=6), and Indonesia (n=5). PMID:12206373

  12. Therapeutic plasma exchange in neuromyelitis optica: a case series.

    PubMed

    Morgan, Shanna M; Zantek, Nicole D; Carpenter, Adam F

    2014-06-01

    Neuromyelitis optica (NMO) is a relapsing inflammatory disease of the central nervous system that predominantly affects the spinal cord and optic nerves. The clinical hallmark of the disease is a step-wise deterioration of visual and spinal cord function. This study reviews patients with steroid resistant relapsing NMO presenting for therapeutic plasma exchange (TPE) at our institution from December 2005 to December 2012. A total of five patients were treated with single volume TPE. Both subjective and objective clinical response to TPE was estimated by three different sources (the patient, a Transfusion Medicine physician, and the treating Neurologist) with the patient and Transfusion Medicine physician's final assessment of response made at the time of the last TPE in the series and the treating neurologist's assessment of response made at the time of the next neurological exam after the last TPE. A total of 17 TPE series were performed with the average course of therapy being three series (ranged 1-5) with five TPE (ranged 3-7) per series. All patients demonstrated improvement with each series of TPE and all procedures were well tolerated with only transient and well-described reactions all of which were successfully resolved with minor or no sequelae. PMID:24136389

  13. Pure spinal epidural cavernous hemangioma: A case series of seven cases

    PubMed Central

    Esene, Ignatius Ngene; Ashour, Ahmed M; Marvin, Eric; Nosseir, Mohamed; Fayed, Zeiad Y; Seoud, Khaled; El Bahy, Khaled

    2016-01-01

    Introduction: Pure spinal epidural cavernous hemangiomas (PSECHs) are rare vascular lesions with about 100 cases reported. Herein, we present a case series of 7 PSECHs discussing their clinical presentation, radiological characteristics, surgical technique and intraoperative findings, pathological features, and functional outcome. Materials and Methods: We retrieved from the retrolective databases of the senior authors, patients with pathologically confirmed PSECH operated between January 2002 and November 2015. From their medical records, the patients’ sociodemographic, clinical, radiological, surgical, and histopathological data were retrieved and analyzed. Results: The mean age of the seven cases was 50.3 years. Four were females. All the five cases (71.4%) in the thoracic spine had myelopathy and the 2 (28.6%) lumbar cases had sciatica. Local pain was present in all the cases. All the lesions were isointense on T1-weighted images, hyperintense on T2-weighted images, and in five cases there was strong homogeneous enhancement. In six cases (85.7%), classical laminectomy was done; lesions resected in one piece in five cases. Total excision was achieved in all the cases. Lesions were thin-walled dilated blood vessels, lined with endothelium, and engorged with blood and with scanty loose fibrous stroma. The median follow-up was 12 months (range: 1–144 months). All patients gradually improved neurologically and achieved a good outcome with no recurrence at the last follow-up. Conclusion: PSECH although rare is increasing reported and ought to be included in the differential diagnosis of spinal epidural lesions. Early surgical treatment with total resection is recommended as would result in a good prognosis.

  14. Pure spinal epidural cavernous hemangioma: A case series of seven cases

    PubMed Central

    Esene, Ignatius Ngene; Ashour, Ahmed M; Marvin, Eric; Nosseir, Mohamed; Fayed, Zeiad Y; Seoud, Khaled; El Bahy, Khaled

    2016-01-01

    Introduction: Pure spinal epidural cavernous hemangiomas (PSECHs) are rare vascular lesions with about 100 cases reported. Herein, we present a case series of 7 PSECHs discussing their clinical presentation, radiological characteristics, surgical technique and intraoperative findings, pathological features, and functional outcome. Materials and Methods: We retrieved from the retrolective databases of the senior authors, patients with pathologically confirmed PSECH operated between January 2002 and November 2015. From their medical records, the patients’ sociodemographic, clinical, radiological, surgical, and histopathological data were retrieved and analyzed. Results: The mean age of the seven cases was 50.3 years. Four were females. All the five cases (71.4%) in the thoracic spine had myelopathy and the 2 (28.6%) lumbar cases had sciatica. Local pain was present in all the cases. All the lesions were isointense on T1-weighted images, hyperintense on T2-weighted images, and in five cases there was strong homogeneous enhancement. In six cases (85.7%), classical laminectomy was done; lesions resected in one piece in five cases. Total excision was achieved in all the cases. Lesions were thin-walled dilated blood vessels, lined with endothelium, and engorged with blood and with scanty loose fibrous stroma. The median follow-up was 12 months (range: 1–144 months). All patients gradually improved neurologically and achieved a good outcome with no recurrence at the last follow-up. Conclusion: PSECH although rare is increasing reported and ought to be included in the differential diagnosis of spinal epidural lesions. Early surgical treatment with total resection is recommended as would result in a good prognosis. PMID:27630480

  15. Concha bullosa mucocele and mucopyocele: a series of 4 cases.

    PubMed

    Al-Sebeih, Khalid H; Bu-Abbas, Mohd H

    2014-01-01

    Concha bullosa is an aerated turbinate in the nose. It is a common anatomic variant that can develop a mucocele if obstructed, which can further progress to become a mucopyocele if infected. A mucopyocele can expand and cause destruction of neighboring tissues. A review of the literature revealed only 10 cases previously reported. We describe 2 cases of mucocele and 2 cases of mucopyocele.

  16. Authors@UF Campus Conversation Series: A Case Study

    ERIC Educational Resources Information Center

    Silver, Isabel

    2014-01-01

    The Authors@UF program series emerged to showcase the scholarship and creativity of faculty, creating an intellectual forum within the academic library, and providing informal, extra-curriculum, academic engagement between students and faculty outside the classroom. This article identifies steps to launch an author program, and considerations in…

  17. Culture, history, and health in an Australian aboriginal community: the case of utopia.

    PubMed

    Anderson, Heather; Kowal, Emma

    2012-01-01

    The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia. PMID:22881383

  18. Responding to the Challenges of Providing Mental Health Services to Refugees: An Australian Case Report.

    PubMed

    Kaplan, Ida; Stow, Hardy David; Szwarc, Josef

    2016-01-01

    There has been a growing recognition of the mental health needs of refugees in countries of settlement, as many are survivors of torture and other traumatic events experienced in countries of origin, during flight, and in places of temporary refuge. The challenges in providing access to services and quality mental health care arise not only from the fact that refugees generally come from cultures very different to the societies in which they settle and are not proficient in the languages of their new homes. Other significant barriers relate to the impact of the trauma and psychosocial stressors they experience despite finding apparent security. In response to the challenges, specialist agencies have developed ways of providing services that are trauma-informed, culture-informed, and holistic. This paper describes an Australian example of a mental health clinic as part of a community-based service for refugees who are survivors of torture and other traumatic events. PMID:27524758

  19. Culture, history, and health in an Australian aboriginal community: the case of utopia.

    PubMed

    Anderson, Heather; Kowal, Emma

    2012-01-01

    The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia.

  20. Case-Control Study and Case Series of Pseudohyperphosphatemia during Exposure to Liposomal Amphotericin B

    PubMed Central

    Hoover, Katherine C.; Wahlquist, Amy E.; Zhu, Yusheng; Velez, Juan Carlos Q.

    2015-01-01

    Pseudohyperphosphatemia due to an interaction between liposomal amphotericin B and the Beckman Coulter PHOSm assay occurs sporadically and remains underrecognized in clinical practice. This retrospective case-control study compares the incidences of hyperphosphatemia in adult inpatients exposed to liposomal amphotericin B or a triazole. A case series of patients with confirmed pseudohyperphosphatemia is described. A total of 80 exposures to liposomal amphotericin B and 726 exposures to triazoles were identified. Among subjects without chronic kidney disease and no concomitant acute kidney injury, hyperphosphatemia occurred more often during liposomal amphotericin B therapy than during triazole therapy (40% [14/35 cases] versus 10% [47/475 cases] of cases; P < 0.01; adjusted odds ratio, 5.2 [95% confidence interval {CI}, 2.3 to 11.9]). Among individuals with chronic kidney disease and no concomitant acute kidney injury, hyperphosphatemia also occurred more often during liposomal amphotericin B exposure (59% [10/17 cases] versus 20% [34/172 cases] of cases; P < 0.01; adjusted odds ratio, 6.0 [95% CI, 2.0 to 18.0]). When acute kidney injury occurred during antifungal exposure, the frequencies of hyperphosphatemia were not different between treatments. Seven episodes of unexpected hyperphosphatemia during liposomal amphotericin B exposure prompted a confirmatory test using an endpoint-based assay that found lower serum phosphorus levels (median difference of 2.5 mg/dl [range, 0.6 to 3.6 mg/dl]). Liposomal amphotericin B exposure confers a higher likelihood of developing hyperphosphatemia than that with exposure to a triazole antifungal, which is likely attributable to pseudohyperphosphatemia. Elevated phosphorus levels in patients receiving liposomal amphotericin B at institutions using the Beckman Coulter PHOSm assay should be interpreted cautiously. PMID:26282423

  1. A case series of brain abscesses in Malawian children.

    PubMed

    Mankhambo, L; Phiri, A; Chiwaya, K; Waluza, J; Borgstein, Es; Graham, Sm

    2007-09-01

    We report three cases of brain abscess in children admitted to QECH in 2006. All children were HIV-uninfected. One case was associated with staphylococcal empyema, another with chronic suppurative otitis media and mastoiditis, and the third case had no identified extracranial focus of infection. These cases illustrate the difficulties of diagnosis and management of brain abscesses in the resource-poor setting where other causes of infection of the central nervous system are common. The typical clinical presentation of brain abscess of altered mental state and seizures is also characteristic of cerebral malaria and meningitis and it is likely that many cases of brain abscess in Malawian children are not diagnosed. The value of cranial CT scan, ideally with contrast, for diagnosis and management of brain abscess is highlighted by these cases.

  2. Non-gastric Gastrointestinal Xanthomas: Case Series and Literature Review.

    PubMed

    Díaz Del Arco, Cristina; Álvarez Sánchez, Ángel; Fernández Aceñero, M Jesús

    2016-09-01

    Gastrointestinal xanthomas are infrequent non-neoplastic lesions characterized by the accumulation of foam cells in the lamina propria. They are commonly seen in association with dyslipidemia, chemotherapy or radiotherapy, and infections in immunosuppressed patients. However, no clear connection to hyperlipidemia has been found. They occur more frequently in the stomach, and are very rare in the small bowel and esophagus. We identified all cases of non-gastric xanthoma or xanthomatosis reported in the English literature by searching the PubMed database and retrospectively reviewed the clinical, endoscopic, and histopathologic features of the 11 cases of non-gastric gastrointestinal xanthomas diagnosed in our hospital. Nine lesions were located in the large bowel, one in the duodenum and one in the esophagus. All xanthomas were small (<5 mm) sessile polyps except the esophageal xanthoma, which measured 13 mm. Two cases in the large bowel and the case in the small bowel were multiple. Most patients with large bowel xanthomas had hypercholesterolemia, unlike esophageal and small bowel cases. The esophageal lesion occurred in a patient with a history of partial fundoplication due to gastroesophageal reflux disease and the small bowel case was associated to chronic atrophic gastritis with intense activity. In our search of the English literature, we found 19 cases of xanthoma or xanthomatosis in the esophagus, 13 cases in the small bowel and 61 cases in the large bowel. In conclusion, gastrointestinal xanthomas, other than the gastric ones, are rare, and are usually incidental findings. PMID:27689205

  3. Difficult Cases of Pain and Nonpain Symptoms in Intractable Spinal Infections: A Case Series

    PubMed Central

    Olsen, Molly L.; Havyer, Rachel D. A.; Smith, Thomas J.; Swetz, Keith M.

    2014-01-01

    In the modern age of advanced surgical techniques and pharmacologic management, bacterial spinal infections (SIs) can be managed (either eradicated or suppressed) in many hosts. However, the optimal management of SIs may be limited by patient comorbidities, which do not allow for surgical management, or limited by antimicrobial options due to side effects, toxicities, or emerging drug resistance. In these settings, frank and honest discussion regarding risks and benefits of treatment should be pursued, including that the SI may be a terminal illness. In this case series, we present 3 patients who had bacterial SIs whose treatments were limited by the above-mentioned factors. Furthermore, each case presented challenges regarding optimal medical management of somatic and neuropathic pain associated with the SI. PMID:22144661

  4. Design considerations for case series models with exposure onset measurement error

    PubMed Central

    Mohammed, Sandra M.; Dalrymple, Lorien S.; Şentürk, Damla; Nguyen, Danh V.

    2014-01-01

    Summary The case series model allows for estimation of the relative incidence of events, such as cardiovascular events, within a pre-specified time window after an exposure, such as an infection. The method requires only cases (individuals with events) and controls for all fixed/time-invariant confounders. The measurement error case series model extends the original case series model to handle imperfect data, where the timing of an infection (exposure) is not known precisely. In this work, we propose a method for power/sample size determination for the measurement error case series model. Extensive simulation studies are used to assess the accuracy of the proposed sample size formulas. We also examine the magnitude of the relative loss of power due to exposure onset measurement error, compared to the ideal situation where the time of exposure is measured precisely. To facilitate the design of case series studies, we provide publicly available web-based tools for determining power/sample size for both the measurement error case series model as well as the standard case series model. PMID:22911898

  5. Methodology Series Module 2: Case-control Studies

    PubMed Central

    Setia, Maninder Singh

    2016-01-01

    Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same ‘study base’ as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive – particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases – selection bias and recall bias. PMID:27057012

  6. Case Series: Outbreak of Conversion Disorder among Amish Adolescent Girls.

    ERIC Educational Resources Information Center

    Cassady, Joslyn D.; Kirschke, David L.; Jones, Timothy F.; Craig, Allen S.; Bermudez, Ovidio B.; Schaffner, William

    2005-01-01

    Objective: Outbreak investigations are challenging in a cross-cultural context, and outbreaks of psychiatric disease are rare in any community. We investigated a cluster of unexplained debilitating illness among Amish girls. Method: We reviewed the medical records of cases, consulted with health care providers, performed active case finding,…

  7. Dyschromias: A Series of Five Interesting Cases from India

    PubMed Central

    Namitha, Prabhu; Sacchidanand, S

    2015-01-01

    Dyschromatosis is a pigmentary genodermatosis which presents with hyper and hypopigmented skin lesions giving a mottled appearance. It is a rare entity in India reported mainly in the East Asian population. Classically, two forms have been described; dyschromatosis universalis hereditaria (DUH) and dyschromatosis symmetrica hereditaria. Here we report four cases of DUH and one case of dyschromatosis symmetrica hereditaria from India. PMID:26677297

  8. Filicide-Suicide: Case Series and Review of the Literature.

    PubMed

    Shields, Lisa B E; Rolf, Cristin M; Goolsby, Mary E; Hunsaker, John C

    2015-09-01

    Homicide-suicides or "dyadic deaths" refer to a homicide followed by the suicide of the perpetrator within 1 week of the homicide. A unique subset is filicide-suicide: a parent kills his/her child before committing suicide. Shooting is the preferred method for both the homicide and suicide. The perpetrator has depression in most cases.We present 3 cases of filicide-suicide. In case 1, a divorced mother with schizophrenia and bipolar disorder shot her son and herself. In case 2, a father shot his son and himself while involved in a child-custody dispute. In case 3, a father, experiencing a divorce and financial difficulties, and his daughter with Angelman syndrome succumbed to carbon monoxide poisoning.The forensic pathologist should be aware of the psychosocial dynamics that interplay in filicide-suicide. Diligent attention to a parent's life stressors may aid in determining risk factors for filicide-suicide.

  9. Filicide-Suicide: Case Series and Review of the Literature.

    PubMed

    Shields, Lisa B E; Rolf, Cristin M; Goolsby, Mary E; Hunsaker, John C

    2015-09-01

    Homicide-suicides or "dyadic deaths" refer to a homicide followed by the suicide of the perpetrator within 1 week of the homicide. A unique subset is filicide-suicide: a parent kills his/her child before committing suicide. Shooting is the preferred method for both the homicide and suicide. The perpetrator has depression in most cases.We present 3 cases of filicide-suicide. In case 1, a divorced mother with schizophrenia and bipolar disorder shot her son and herself. In case 2, a father shot his son and himself while involved in a child-custody dispute. In case 3, a father, experiencing a divorce and financial difficulties, and his daughter with Angelman syndrome succumbed to carbon monoxide poisoning.The forensic pathologist should be aware of the psychosocial dynamics that interplay in filicide-suicide. Diligent attention to a parent's life stressors may aid in determining risk factors for filicide-suicide. PMID:26087315

  10. [Etiology of endocrine arterial hypertensions: about a series of cases].

    PubMed

    Bouznad, Naima; El Mghari, Ghizlane; El Ansari, Nawal

    2016-01-01

    Arterial hypertensions (HTA) of endocrine origin are a rare cause of hypertension; HTA overall prevalence don't exceed 4% of hypertensive patients. Research interest in endocrine HTA is due to the severity of some life-threatening, potentially curable and reversible forms of HTA. The aim of our study was to determine the clinical, paraclinical, etiological and therapeutic profile of secondary HTA of endocrine origin in patients treated in endocrinology department at the University Hospital Mohamed VI in Marrakech. We conducted a prospective, descriptive study spanned 4 years, enrolling 45 patients with endocrine HTA. The average age was 44.89 years, with a clear predominance of women (sex ratio 0.49). Etiology of endocrine HTA was dominated by pheochromocytoma (17 cases), hypercorticism (11 cases) and acromegaly (8 cases). HTA were paroxysmal in 24.4%. HTA were immediately classified as grade 3 severe in 40% of cases. HTA were complicated by heart disease in 24% of cases and by renal disease in 20% of cases. Curative treatment cleared up HTA in 60% of cases (27 cases). The diagnosis of secondary endocrine HTA is sometimes difficult because of the lack of clinical specificity. It is not unusual for HTA to be the only manifestation of the disease. In our study we noted the paroxysmal and severe nature of HTA. The potentially curable nature of HTA in more than two thirds of cases, demostrates the importance of early diagnosis of each severe HTA resistant to treatment or in the presence of suggestive clinical, biological or radiological signs. PMID:27303586

  11. Tooth resorption part II - external resorption: Case series

    PubMed Central

    Fernandes, Marina; de Ataide, Ida; Wagle, Rahul

    2013-01-01

    External tooth resorption usually follows trauma to the periodontal ligament. It can be classified into five categories based on its clinical and histological manifestations. Calcium hydroxide has long been used as an intracanal medicament to slow down the resorption process due to its alkaline pH. A combination of both external and internal resorptions can also occur on the same tooth, making the management more complex. Five case reports of external resorption have been presented in this article along with pertinent review of literature. Successful management was possible in two cases, while extractions had to be advised in 3 cases due to advanced nature of the lesions. PMID:23716975

  12. Nasolabial Flap in Maxillofacial Gunshot Trauma: A Case Series

    PubMed Central

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2016-01-01

    Introduction The nasolabial flap (NLF) has many advantages in oromaxillary reconstruction, but the majority of cases are reconstructions after pathologic resections. Its usage in trauma surgery, especially in the management of gunshot wounds, is rarely mentioned. Case Presentation Three cases involving gunshot injuries to the face are presented: one for reconstruction of the nasal ala, another for bone graft coverage in mandibular reconstruction, and the third for the repair of premaxillary hard and soft tissue avulsive defects. Conclusions The NLF is a thin, pliable flap and is useful for intraoral and facial reconstruction of trauma patients with small to moderate soft tissue loss. PMID:27148497

  13. Sentinel lymph node biopsy in paediatric melanoma. A case series.

    PubMed

    Sánchez Aguilar, M; Álvarez Pérez, R M; García Gómez, F J; Fernández Ortega, P; Borrego Dorado, I

    2015-01-01

    The incidence of melanoma in children is uncommon, being particularly rare in children under 10 years-old. However, this disease is increasing by a mean of 2% per year. As in adults, the lymph node status is the most important prognostic factor, crucial to performing the selective sentinel lymph node biopsy (SLNB). We report 3 cases of paediatric patients of 3, 4 and 8 years-old, in which SLNB was performed for malignant melanoma. Paediatric age implies greater technical difficulty to the scintigraphy scan due to poor patient cooperation, with mild sedation required in some cases, and only being able to acquire planar images in other cases. SPECT/CT was only performed in the oldest patient. In our cases, SLNB was useful for selecting the least invasive surgery in order to reduce morbidity.

  14. Breast Cancer in Transgender Veterans: A Ten-Case Series.

    PubMed

    Brown, George R

    2015-03-01

    All known cases of breast cancer in patients with a diagnosis consistent with transgender identification were identified in the Veterans Health Administration (1996-2013). Ten cases were confirmed: seven birth sex females and three birth sex males. Of the three birth sex males, two identified as gender dysphoric male-to-female and one identified as transgender with transvestic fetishism. The birth sex males all presented with late-stage disease that proved fatal, whereas most of the birth sex female transgender veterans presented with earlier stage disease that could be treated. These cases support the importance of screening for breast cancer using standard guidelines in birth sex males and females. Family history of breast cancer should be obtained from transgender people as part of routine care. This report expands the known cases of breast cancer in transgender persons from 5 to 12 (female-to-male) and from 10 to 13 (male-to-female).

  15. Cardiac pathological conditions in young soldiers: case series.

    PubMed

    Villacorta-Lyew, Rachel; Laselle, Brooks; Mazzoncini, Joseph P; Merchant, Emily; Buckley, Peter J

    2008-11-01

    We briefly review the disease processes for four young healthy soldiers who presented to our emergency department with serious cardiac pathological conditions. We present two unusual cases of myocardial infarction, a coronary artery aneurysm, and a case of smallpox vaccine-induced myocarditis/pericarditis. Our intent is to encourage others in military medicine to maintain a high index of suspicion for cardiac conditions even in a relatively young healthy population. PMID:19055189

  16. Proximal Interruption of the Pulmonary Artery: A Case Series.

    PubMed

    Anand, S H; Jasper, Anitha; Mani, Sunithi Elizabeth; Joseph, Elizabeth; Mathai, John

    2015-12-01

    We present a few cases of Proximal Interruption of the Pulmonary Artery, an uncommon developmental anomaly associated with congenital heart disease. The cases had varied clinical presentations. Chest radiograph showed a hypoplastic lung with an ipsilateral small hilum on the side of the interruption and hyperinflation of the contralateral lung. Contrast CT confirmed the diagnosis, demonstrating non-visualization of the left or right pulmonary artery, and other related findings. PMID:26816968

  17. Nazi medical experiments on Australian prisoners of war: Commentary on the testimony of an Australian soldier.

    PubMed

    Weisz, George M

    2015-12-01

    Archival research reveals that Australian prisoners of war were exposed to non-consensual medical experiments during World War II. This article discusses the first known case of an Australian soldier exposed to German medical experiments.

  18. Nazi medical experiments on Australian prisoners of war: Commentary on the testimony of an Australian soldier.

    PubMed

    Weisz, George M

    2015-12-01

    Archival research reveals that Australian prisoners of war were exposed to non-consensual medical experiments during World War II. This article discusses the first known case of an Australian soldier exposed to German medical experiments. PMID:26939510

  19. Re-Positioning as a Response to Government Higher Education Policy Development--An Australian Case Study

    ERIC Educational Resources Information Center

    Webber, Ruth; Jones, Kate

    2011-01-01

    Australian Catholic University (ACU) has had a long-standing commitment to social justice and to engaging with the rest of the community, arising from its Catholic intellectual tradition and its creation from Catholic teaching institutions. As a university created in 1991 as part of a radical re-structure of Australian higher education, ACU has…

  20. Penile cancer: a local case series and literature review

    PubMed Central

    Lau, Wei Da; Ong, Chin Hu; Lim, Tow Poh; Teo, Colin

    2015-01-01

    INTRODUCTION Penile cancer is an uncommon disease affecting only about one in 100,000 men worldwide in a year. The diagnosis of the condition is frequently delayed, and the disease and its treatment frequently result in significant morbidity in patients. METHODS We herein describe seven cases of penile tumours: six cases of squamous cell carcinomas and one case of B-cell lymphoma that presented to our hospital’s urology department between March 2011 and October 2012. We reviewed the literature to discuss the clinical presentation, natural history and current management of penile cancer. RESULTS The patients were followed up for 1–24 months. They were managed according to their disease stage and lymph node status. Four out of seven patients showed disease progression during the follow-up period. CONCLUSION The accurate staging of inguinal nodes in cases of low-risk disease is important to prescribe appropriate surgery for the inguinal nodes. Aggressive management of inguinal and pelvic lymph nodes remains the cornerstone in the treatment of high-risk disease cases. PMID:26668410

  1. Awake tracheal intubation using the Airtraq laryngoscope: a case series.

    PubMed

    Dimitriou, V K; Zogogiannis, I D; Liotiri, D G

    2009-08-01

    The Airtraq laryngoscope (AL) is a new single use indirect laryngoscope designed to facilitate tracheal intubation in anaesthetised patients either with normal or difficult airway anatomy. It is designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. We report four cases of successful awake tracheal intubation using the AL. The first case is a patient with severe ankylosing spondylitis and the other three cases with anticipated difficult airway. An awake intubation under sedation and topical airway anaesthesia was chosen. We consider that the AL can be used effectively to accomplish an awake intubation in patients with a suspected or known difficult airway and may be a useful alternative where other methods for awake intubation have failed or are not available.

  2. From the Billabong to the Mainstream? A Teachers' Guide to Australian Training & Literacy Policy Developments 1974-1998. Research into Practice Series Number 6.

    ERIC Educational Resources Information Center

    Kell, Peter

    This document traces Australian training and literacy policy developments from 1974 to 1998. The document begins with a brief discussion of the global political, educational, social, and economic trends that have affected Australia's training and literacy policies. Discussed next are major events of the four policy "epochs" in Australia's…

  3. Atypical forms of lupus vulgaris - a case series.

    PubMed

    Saritha, Mohanan; Parveen, Basheer Ahamed; Anandan, Venkatesan; Priyavathani, Malathy R; Tharini, Karuvelan G

    2009-02-01

    Atypical presentations of cutaneous tuberculosis are not so uncommon and are frequently overlooked in clinical practice, leading to late diagnosis and increased morbidity. We report three cases of lupus vulgaris with atypical presentations. The cases mimicked other chronic skin lesions like actinomycosis, mycetoma, and so on. Strong clinical suspicion, histopathology, and response to antituberculous treatment led to the diagnosis and all three had excellent response to treatment. Today, when tuberculosis threatens to burst into pandemics again, early diagnosis and treatment are more important than ever for control and prevention of morbidity.

  4. Neuroinfection as a Mask of Lung Cancer: A Case Series

    PubMed Central

    Kuklińska, Beata; Moniuszko-Malinowska, Anna; Mróz, Robert; Pancewicz, Sławomir; Zajkowska, Joanna

    2016-01-01

    Introduction. The diagnosis of lung cancer may still be difficult due to the fact that the first symptoms very often mimic symptoms of other diseases. Case Presentation. In this paper we present two cases, in which initial diagnosis of neuroinfection delayed proper diagnosis. Conclusion. Based on our experience we concluded that neurological symptoms in the area endemic for tick-borne diseases suggesting neuroinfection require careful differential diagnosis. Moreover, neurological symptoms in heavy smokers may be associated with metastases of lung cancer. PMID:27239354

  5. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study

    PubMed Central

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  6. Orthopedic Manifestations of Mobius Syndrome: Case Series and Survey Study.

    PubMed

    McClure, Philip; Booy, David; Katarincic, Julia; Eberson, Craig

    2016-01-01

    Background. Mobius Syndrome is a rare disease defined by bilateral congenital 7th nerve palsy. We focus on reporting the prevalence of orthopedic disease in this population. Methods. Twenty-three individuals with Mobius Syndrome underwent orthopedic physical examination, and additional 96 patients filled out a survey for self-reported orthopedic diagnoses. Results. Clubfoot was present in 60% of individuals in the physical exam series and 42% of those in the survey. Scoliosis was present in 26% and 28%, respectively. Poland's Syndrome was present in 17% and 30%. In addition to these findings, 27% of patients reported having difficulty with anesthesia, including difficulty in intubation and airway problems. Conclusion. An increased prevalence of scoliosis, clubfoot, transverse limb deficiencies, and Poland's Syndrome is identified in the setting of Mobius Syndrome. In the setting of several deformities often requiring surgical correction, a high incidence of anesthetic difficulty is noted and should be discussed with patients and other providers during surgical planning. PMID:26977161

  7. Diagnostic dilemma in ovarian pregnancy: a case series.

    PubMed

    Begum, Jasmina; Pallavee, P; Samal, Sunita

    2015-04-01

    Ovarian pregnancy is a rare form of ectopic pregnancy but it is the most common type of nontubal ectopic pregnancy. Many times it is operated with a misdiagnosis of ruptured tubal ectopic pregnancy or hemorrhagic corpus luteum. The high resolution transvaginal ultrasonography is a valuable tool for diagnosis of ectopic pregnancy but ovarian pregnancy still remains a diagnostic problem and a continuous challenge to the gynecologist. The correct diagnosis is made at the time of surgery and confirmation is by histopathological report. Here we report three cases of primary ovarian ectopic pregnancies, consistent with the Spiegelberg's criteria. Out of this, two cases have corroboration of ovarian ectopic pregnancy with use of intrauterine contraceptive device and one case by chance without any preexisting risk factors, probably due to interference in the release of ovum from the follicle. In all the three cases, emergency laparotomy was done for ruptured tubal ectopic pregnancy and the diagnosis of ruptured primary ovarian pregnancy was made at the time of surgery, this was subsequently confirmed by histopathology report. In the era where wider usage of intrauterine devices, ovulatory drugs and assisted reproductive techniques are rife, there is a possibility of an increase in the incidence of this rare entity, so ovarian ectopic pregnancy should be kept in mind as a possibility. Thereby early diagnosis by high resolution transvaginal ultrasound and laparoscopy can decrease the risk of complications like rupture, secondary implantation, hemorrhagic shock and maternal mortality. PMID:26023609

  8. Distance-Learning Programs. Case Studies in TESOL Practice Series.

    ERIC Educational Resources Information Center

    Henrichsen, Lynn E., Ed.

    The 14 cases in this book show how distance learning takes a variety of forms in teaching English to speakers of other languages (TESOL). The 15 chapters include the following: (1) "Beyond Adding Telecommunications to a Traditional Course: Insights into Human and Instructional Factors Affecting Distance Learning in TESOL" (Lynn E. Hendrichsen);…

  9. Looking for Childhood Schizophrenia: Case Series of False Positives.

    ERIC Educational Resources Information Center

    Stayer, Catherine; Sporn, Alexandra; Gogtay, Nitin; Tossell, Julia; Lenane, Marge; Gochman, Peter; Rapoport, Judith L.

    2004-01-01

    Extensive experience with the diagnosis of childhood-onset schizophrenia indicates a high rate of false positives. Most mislabeled patients have chronic disabling, affective, or behavioral disorders. The authors report the cases of three children who passed stringent initial childhood-onset schizophrenia "screens" but had no chronic psychotic…

  10. [Misuse of substances theoretically without abuse potential--case series].

    PubMed

    Anand, Jacek Sein; Habrat, Bogusław; Sut, Michał; Korolkiewicz, Roman

    2009-01-01

    The aim of our study was to present cases of misuse of different substances theoretically without abuse potential. In the last few years such behavior became an increasing problem in toxicological and emergency units. Lack of typical signs of intoxication with psychoactive substances, and negative results of standard toxicological tests may be a challenge for toxicologists and emergency medicine practitioners. PMID:19788132

  11. Bethanechol for buprenorphine-related urinary hesitancy: a case series.

    PubMed

    Varma, Anjali; Smigiel, Joseph; Eck, Nancy; Brooks, Stephanie

    2011-09-01

    Constipation is a well-known side effect of buprenorphine, but urinary hesitancy is less frequently discussed and may go unrecognized. Reported are the 2 cases of men older than 50 years who experienced disabling urinary hesitancy with buprenorphine and naloxone combination (suboxone) and were successfully treated with bethanechol, a cholinergic medication. PMID:21844838

  12. [Misuse of substances theoretically without abuse potential--case series].

    PubMed

    Anand, Jacek Sein; Habrat, Bogusław; Sut, Michał; Korolkiewicz, Roman

    2009-01-01

    The aim of our study was to present cases of misuse of different substances theoretically without abuse potential. In the last few years such behavior became an increasing problem in toxicological and emergency units. Lack of typical signs of intoxication with psychoactive substances, and negative results of standard toxicological tests may be a challenge for toxicologists and emergency medicine practitioners.

  13. Spontaneous coronary artery dissection: a case series and literature review

    PubMed Central

    Garcia, Nelson A. Telles; Khan, Abul N.; Boppana, Ratna C.; Smith, Hayden L.

    2014-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare and often lethal cause of acute coronary syndrome, which typically affects young women and otherwise healthy individuals. SCAD can be diagnosed in patients undergoing coronary angiography and can be underestimated. Special techniques such as optical coherence tomography (OCT) and intravascular ultrasound should be used when there is suspicion of the condition. In the majority of cases, the left anterior descending (LAD) artery is involved; however, a few cases of the right coronary artery (RCA) involvement have been reported. This article describes three cases of SCAD in women of different ages, all presenting with chest pain. Coronary angiography in conjunction with OCT was used for diagnosis in two of the cases. One of the patients had involvement of the proximal RCA and underwent percutaneous coronary intervention, whereas the other two patients had mid-LAD disease and were treated conservatively with medical therapy. Presently, there are no specific guidelines for the treatment of SCAD, and therapy is individualized according to extent and severity of the condition. PMID:25317273

  14. Simple resection of truncal desmoid tumors: A case series

    PubMed Central

    Nishida, Yoshihiro; Tsukushi, Satoshi; Urakawa, Hiroshi; Hamada, Shunsuke; Kozawa, Eiji; Ikuta, Kunihiro; Ishiguro, Naoki

    2016-01-01

    Desmoid tumors of the extra-abdominal and abdominal wall have been associated with morbidity due to the aggressive nature of the surgery and high recurrence rates. Surgery that does not cause functional impairment is desired for patients with desmoid tumors. In the present study, among patients with desmoid tumors who were prospectively and consecutively treated with identical conservative treatment with meloxicam, a selected patients of patients were treated with less invasive surgery than wide-resection. Out of 60 patients pathologically diagnosed with desmoid tumors, 9 patients with tumors refractory to conservative treatment and 4 patients who refused to receive this type of treatment were treated with planned simple resection. Subsequently, the clinical outcome of the patients and the mutational status of the catenin β-1 (CTNNB1) gene in the tumors were analyzed. The mean age of the 13 patients that underwent planned simple resection was 39 years, and the tumors were located in the abdominal wall in 6 cases, the chest wall in 4 cases and the neck in 3 cases. All excised specimens were evaluated and positive microscopic margins were identified; however, during the mean follow-up period of 30 months, 12/13 cases, 7 of which had T41A mutations and 5 of which had no mutations (wild-type), did not develop recurrence. Only 1 initial case with an S45F mutation in the CTNNB1 gene developed recurrence. The results of the present prospectively treated with simple resection and retrospectively analyzed study suggest that planned simple resection could serve as a therapeutic modality for extraperitoneal desmoid tumors, particularly truncal ones with a wild-type or T41A mutational status. PMID:27446472

  15. Cases Series of Malignant Lymphohematopoietic Disorder in Korean Semiconductor Industry

    PubMed Central

    Lee, Hye-Eun; Ryu, Hyung-Woo; Park, Seung-Hyun; Kang, Seong-Kyu

    2011-01-01

    Objectives Seven cases of malignant lymphohematopoietic (LHP) disorder were claimed to have developed from occupational exposure at two plants of a semiconductor company from 2007 to 2010. This study evaluated the possibility of exposure to carcinogenic agents for the cases. Methods Clinical courses were reviewed with assessing possible exposure to carcinogenic agents related to LHP cancers. Chemicals used at six major semiconductor companies in Korea were reviewed. Airborne monitoring for chemicals, including benzene, was conducted and the ionizing radiation dose was measured from 2008 to 2010. Results The latency of seven cases (five leukemiae, a Non-Hodgkin's lymphoma, and an aplastic anemia) ranged from 16 months to 15 years and 5 months. Most chemical measurements were at levels of less than 10% of the Korean Occupational Exposure Limit value. No carcinogens related to LHP cancers were used or detected. Complete-shielded radiation-generating devices were used, but the ionizing radiation doses were 0.20-0.22 uSv/hr (background level: 0.21 µSv/hr). Airborne benzene was detected at 0.31 ppb when the detection limit was lowered as low as possible. Ethylene oxide and formaldehyde were not found in the cases' processes, while these two were determined to be among the 263 chemicals in the list that was used at the six semiconductor companies at levels lower than 0.1%. Exposures occurring before 2002 could not be assessed because of the lack of information. Conclusion Considering the possibility of exposure to carcinogenic agents, we could not find any convincing evidence for occupational exposure in all investigated cases. However, further study is needed because the semiconductor industry is a newly developing one. PMID:22953195

  16. Quantifying Fish Assemblages in Large, Offshore Marine Protected Areas: An Australian Case Study

    PubMed Central

    Hill, Nicole A.; Barrett, Neville; Lawrence, Emma; Hulls, Justin; Dambacher, Jeffrey M.; Nichol, Scott; Williams, Alan; Hayes, Keith R.

    2014-01-01

    As the number of marine protected areas (MPAs) increases globally, so does the need to assess if MPAs are meeting their management goals. Integral to this assessment is usually a long-term biological monitoring program, which can be difficult to develop for large and remote areas that have little available fine-scale habitat and biological data. This is the situation for many MPAs within the newly declared Australian Commonwealth Marine Reserve (CMR) network which covers approximately 3.1 million km2 of continental shelf, slope, and abyssal habitat, much of which is remote and difficult to access. A detailed inventory of the species, types of assemblages present and their spatial distribution within individual MPAs is required prior to developing monitoring programs to measure the impact of management strategies. Here we use a spatially-balanced survey design and non-extractive baited video observations to quantitatively document the fish assemblages within the continental shelf area (a multiple use zone, IUCN VI) of the Flinders Marine Reserve, within the Southeast marine region. We identified distinct demersal fish assemblages, quantified assemblage relationships with environmental gradients (primarily depth and habitat type), and described their spatial distribution across a variety of reef and sediment habitats. Baited videos recorded a range of species from multiple trophic levels, including species of commercial and recreational interest. The majority of species, whilst found commonly along the southern or south-eastern coasts of Australia, are endemic to Australia, highlighting the global significance of this region. Species richness was greater on habitats containing some reef and declined with increasing depth. The trophic breath of species in assemblages was also greater in shallow waters. We discuss the utility of our approach for establishing inventories when little prior knowledge is available and how such an approach may inform future monitoring

  17. Chinese and Australian Year 3 Children's Conceptual Understanding of Science: A multiple comparative case study

    NASA Astrophysics Data System (ADS)

    Tao, Ying; Colette Oliver, Mary; Venville, Grady Jane

    2012-04-01

    Children have formal science instruction from kindergarten in Australia and from Year 3 in China. The purpose of this research was to explore the impact that different approaches to primary science curricula in China and Australia have on children's conceptual understanding of science. Participants were Year 3 children from three schools of high, medium and low socio-economic status in Hunan Province, central south China (n = 135) and three schools of similar socio-economic status in Western Australia (n = 120). The students' understanding was assessed by a science quiz, developed from past Trends in Mathematics and Science Study science released items for primary children. In-depth interviews were carried out to further explore children's conceptual understanding of living things, the Earth and floating and sinking. The results revealed that Year 3 children from schools of similar socio-economic status in the two countries had similar conceptual understandings of life science, earth science and physical science. Further, in both countries, the higher the socio-economic status of the school, the better the students performed on the science quiz and in interviews. Some idiosyncratic strengths and weaknesses were observed, for example, Chinese Year 3 children showed relative strength in classification of living things, and Australian Year 3 children demonstrated better understanding of floating and sinking, but children in both countries were weak in applying and reasoning with complex concepts in the domain of earth science. The results raise questions about the value of providing a science curriculum in early childhood if it does not make any difference to students' conceptual understanding of science.

  18. Comparison of several BHT correction methods: a case study on an Australian data set

    NASA Astrophysics Data System (ADS)

    Goutorbe, Bruno; Lucazeau, Francis; Bonneville, Alain

    2007-08-01

    Bottom-hole temperatures (BHT) from oil exploration provide useful constraints on the subsurface thermal regime, but they need to be corrected to obtain the equilibrium temperature. In this work, we introduce several BHT correction methods and compare them using a large Australian data set of more than 650 groups of multiple BHT measurements in about 300 oil exploration boreholes. Existing and suggested corrections are classified within a coherent framework, in which methods are divided into: line/cylinder source; instantaneous/continuous heat extraction; one/two component(s). Comparisons with reservoir test temperatures show that most of the corrections lead to reliable estimates of the formation equilibrium temperature within +/-10°C, but too few data exist to perform an intercomparison of the models based on this criterion. As expected, the Horner method diverges from its parent models for small elapsed times (or equivalently large radii). The mathematical expression of line source models suffers from an unphysical delay time that also restrains their domain of applicability. The model that takes into account the difference of thermal properties between circulating mud and surrounding rocks-that is the two-component model-is delicate to use because of its high complexity. For these reasons, our preferred correction methods are the cylindrical source models. We show that mud circulation time below 10 hr has a negligible effect. The cylindrical source models rely on one parameter depending on the thermal diffusivity and the borehole radius, which are poorly constrained, but the induced uncertainty on the extrapolations remains reasonably low.

  19. Quantifying fish assemblages in large, offshore marine protected areas: an Australian case study.

    PubMed

    Hill, Nicole A; Barrett, Neville; Lawrence, Emma; Hulls, Justin; Dambacher, Jeffrey M; Nichol, Scott; Williams, Alan; Hayes, Keith R

    2014-01-01

    As the number of marine protected areas (MPAs) increases globally, so does the need to assess if MPAs are meeting their management goals. Integral to this assessment is usually a long-term biological monitoring program, which can be difficult to develop for large and remote areas that have little available fine-scale habitat and biological data. This is the situation for many MPAs within the newly declared Australian Commonwealth Marine Reserve (CMR) network which covers approximately 3.1 million km2 of continental shelf, slope, and abyssal habitat, much of which is remote and difficult to access. A detailed inventory of the species, types of assemblages present and their spatial distribution within individual MPAs is required prior to developing monitoring programs to measure the impact of management strategies. Here we use a spatially-balanced survey design and non-extractive baited video observations to quantitatively document the fish assemblages within the continental shelf area (a multiple use zone, IUCN VI) of the Flinders Marine Reserve, within the Southeast marine region. We identified distinct demersal fish assemblages, quantified assemblage relationships with environmental gradients (primarily depth and habitat type), and described their spatial distribution across a variety of reef and sediment habitats. Baited videos recorded a range of species from multiple trophic levels, including species of commercial and recreational interest. The majority of species, whilst found commonly along the southern or south-eastern coasts of Australia, are endemic to Australia, highlighting the global significance of this region. Species richness was greater on habitats containing some reef and declined with increasing depth. The trophic breath of species in assemblages was also greater in shallow waters. We discuss the utility of our approach for establishing inventories when little prior knowledge is available and how such an approach may inform future monitoring

  20. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series

    PubMed Central

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  1. Probable Nootropicinduced Psychiatric Adverse Effects: A Series of Four Cases

    PubMed Central

    Ajaltouni, Jean

    2015-01-01

    The misuse of nootropics—any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters—may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects. We describe four cases of probable nootropic-induced psychiatric adverse effects to illustrate this theory. To the best of our knowledge this has not been previously reported in the formal medical literature. We briefly describe the most common classes of nootropics, including their postulated or proven methods of actions, their desired effects, and their adverse side effects, and provide a brief discussion of the cases. Our objective is to raise awareness among physicians in general and psychiatrists and addiction specialists in particular of the potentially dangerous phenomenon of unsupervised nootropic use among young adults who may be especially vulnerable to nootropics’ negative effects. PMID:27222762

  2. [Experience in thyroglossal duct pathology: clinical case series].

    PubMed

    Cieri, Patricio; Udaquiola, Julia E; Calello, Santiago E; Libero, Daniel H

    2016-10-01

    The thyroglossal duct cyst pathology represents the second cause of bening cervical anomalies in childhood. Diagnosis is mainly clinical. Sistrunk (1920) proposed a surgical technique that is still considered the gold standard for definitive treatment of this condition. A retrospective study was made including patients who underwent surgery for thyroglossal duct cyst pathology in our department between June 2008 and August 2015. In this period, we performed 54 procedures in 45 patients (39 primary cases). Median age was 4.7 years; 14/39 patients (31.1%) had pre-operative infection. All patients were studied with neck ultrasound. A Sistrunk's procedure was performed in all cases. The global recurrence rate was 17.8% (8/45).

  3. [Experience in thyroglossal duct pathology: clinical case series].

    PubMed

    Cieri, Patricio; Udaquiola, Julia E; Calello, Santiago E; Libero, Daniel H

    2016-10-01

    The thyroglossal duct cyst pathology represents the second cause of bening cervical anomalies in childhood. Diagnosis is mainly clinical. Sistrunk (1920) proposed a surgical technique that is still considered the gold standard for definitive treatment of this condition. A retrospective study was made including patients who underwent surgery for thyroglossal duct cyst pathology in our department between June 2008 and August 2015. In this period, we performed 54 procedures in 45 patients (39 primary cases). Median age was 4.7 years; 14/39 patients (31.1%) had pre-operative infection. All patients were studied with neck ultrasound. A Sistrunk's procedure was performed in all cases. The global recurrence rate was 17.8% (8/45). PMID:27606652

  4. Interdisciplinary Management of Gingivitis Artefacta Major: A Case Series.

    PubMed

    Pattnaik, Naina; Satpathy, Anurag; Mohanty, Rinkee; Nayak, Rashmita; Sahoo, Surjeet

    2015-01-01

    Cases described here discuss interdisciplinary (periodontal and behavioral) approach in the management of rare and difficult to diagnose self-inflicted injuries of gingiva such as gingivitis artefacta major. Self-inflicted injuries to the gingiva are rare and their management by periodontal therapy alone is inadequate. Proper management of this condition requires early detection and effective psychological treatment through behavioral therapy in addition to the treatment of dental lesion. Three male patients in their twenties presented with traumatic injuries of gingiva with history of self-injury and underlying emotional disturbances. Following basic periodontal intervention, their self-inflicting behavior was confirmed on psychiatric consultation. All of them underwent cognitive behavior therapy and were able to successfully curb their self-inflicting behavior prior to any definitive dental procedures. These cases illustrate the essentiality of behavioral intervention in addition to periodontal procedures in the management of such lesions. PMID:26664762

  5. Benign paroxysmal positional vertigo after nonotologic surgery: case series.

    PubMed

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2015-03-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe three cases of benign paroxysmal positional vertigo attacks after non-otologic surgery (one patient after a nasal septoplasty and two patients after dental endodontic treatment) and discuss the pathophysiological mechanism of benign paroxysmal positional vertigo seen after non-otologic surgery, its diagnosis and treatment.

  6. Clinical Use of Laser-Microtextured Abutments: A Case Series.

    PubMed

    Shapoff, Cary A; Babushkin, Jeffrey A; Wohl, David J

    2016-01-01

    This article discusses the clinical use of laser-microtextured abutments on dental implant restorations. Four cases are presented, each using one of the four commercially available laser-microtextured abutment styles. Numerous preclinical and clinical studies have shown the positive effects of laser microtexturing on the implant platform in limiting crestal bone loss and benefiting soft tissue stability. Other histologic studies of laser microtexturing on the implant abutment have demonstrated the ability of this specific feature to block epithelial downgrowth and provide a functional connective tissue attachment to the abutment surface. Other abutment designs, styles, and materials have only demonstrated a soft tissue seal with epithelial adhesion and a circular ring of connective tissue fibers around the abutment without direct contact. This article presents clinical and radiographic case examples from a private practice perspective on the longterm successful use of microtextured abutments with respect to crestal bone levels, exceptional soft tissue health, and stability with minimal sulcular depth. PMID:27560683

  7. Paroxetine Treatment of Problematic Pornography Use: A Case Series.

    PubMed

    Gola, Mateusz; Potenza, Marc N

    2016-09-01

    Background How best to conceptualize problematic pornography use (PPU) and intervene most effectively remain debated, with obsessive-compulsive disorder (OCD) and addiction frameworks. We investigated the efficacy of the serotonin-reuptake inhibitor paroxetine in combination with cognitive-behavioral therapy in the treatment of problematic pornography use (PPU). Case presentation Three heterosexual males with PPU were treated with cognitive-behavioral therapy and paroxetine. Frequency of pornography use, other sexual behaviors, and anxiety were assessed during treatment. Discussion Paroxetine treatment, although seemingly initially effective in reducing pornography use and anxiety, appeared related to new compulsive sexual behaviors after 3 months. Conclusions Paroxetine may hold promise for short-term reduction of PPU and related anxiety, but new potentially distressing sexual behaviors may emerge. The cases suggest that PPU may arise from multiple domains. We propose an explanation of the effects based on recent neuroscientific research on sexual behaviors and alcohol use.

  8. Diagnosis of filariasis on cytology: a series of 24 cases.

    PubMed

    Handa, Uma; Kundu, Reetu; Singhal, Niti; Mohan, Harsh

    2014-04-01

    Filariasis has a worldwide distribution, with a special predilection for tropical and subtropical areas. The microfilaria wanders in lymphatics and can be accidentally trapped in the needle during fine-needle aspiration cytology, thus leading to its incidental detection. This is a retrospective study of 24 cases of microfilarial infestation diagnosed on cytology. Accurate recognition and detection of the parasite leads to the institution of specific treatment and prevents chronic manifestations of the disease.

  9. Dyke-Davidoff-Masson Syndrome: Time to Revisit Case Series.

    PubMed

    Shubhakaran; Bhushan, Bharat

    2015-09-01

    We read a case report by Manghera et al (JAPI, Vol 62 page No. 76-67), which was in response to an earlier case report by Ola et al.1 Here we would like to share our experience and views as under- The authors in the correspondence have said that crossed cerebellar atrophy is an unusual and rare finding. We in our study of 28 patients of DDMS, have found cerebellar atrophy in nine patients along with cerebral atrophy.2 Out of nine patients with cerebellar atrophy three patients had diffuse bilateral atrophy, only one patient had unilateral cerebellar atrophy which was controlateral to left cerebral hemiatrophy (CHA). This is similar to the findings of the authors and the patho-physiology quoted by authors is worth appreciation. Other parenchymal changes observed in our study were cerebral peduncle atrophy in three patients, and thalamic atrophy with lentiform nucleus hypoplasia in 11 patients. Seven cases of CHA were associated with ipsilateral large schizencephalic cleft with absence of the septum pellucidum whereas two had porencephaly. Five patients had left-sided hippocampal sclerosis (HS), four were concordant and one was discordant. PMID:27608884

  10. Kissing molars extraction: Case series and review of the literature

    PubMed Central

    Arjona-Amo, Manuel; Torres-Carranza, Eusebio; Batista-Cruzado, Antonio; Serrera-Figallo, Maria-Angeles; Crespo-Torres, Santos; Belmonte-Caro, Rodolfo; Albisu-Andrade, Claudio; Gutiérrez-Pérez, José-Luis

    2016-01-01

    Kissing molars are a very rare form of inclusion defined as molars included in the same quadrant, with occlusal surfaces contacting each other within a single dental follicle. We present four cases of this pathology: a 35 year-old male, referred to the Oral and Maxillofacial Surgery Department of the Hospital Virgen del Rocio in Seville, and three females of 24, 26, and 31 years, all of which had kissing molars that were treated by tooth extraction. We have found only 10 cases published in the medical literature in which this type of inclusion is briefly described, none of which elaborate on the surgical technique employed. In these cases, the indication for surgery is established when there is a history of recurring infections or cystic lesions associated with dental inclusions. The extraction of kissing molars requires an exhaustive comprehension of the anatomy of the region involved, sufficiently developed surgical abilities, and an extensive planning process. Key words:Impacted molar, kissing molar, surgical extraction. PMID:26855716

  11. Rhabdoid papillary meningioma: a clinicopathologic case series study.

    PubMed

    Wu, You-Ting; Ho, Jih-Tsun; Lin, Yu-Jun; Lin, Jui-Wei

    2011-12-01

    World Health Organization (WHO) grade III meningiomas are subclassified on the basis of their architectural pattern into papillary and rhabdoid subtypes. Some meningiomas even combine papillary architecture with rhabdoid cytology. Additionally, they always show malignant histological features, follow an aggressive clinical course and tend to spread through the CSF after frequent local recurrence. We render the first series of rhabdoid papillary meningioma with review of the literature to further elucidate its biological behavior. From six patients (three male, three female), nine specimens of rhabdoid papillary meningioma were obtained between 1994 and 2010. Correlations of histologic parameters, immunohistochemical study, and clinical features were assessed. The mean age of patients was 44.7 years at their first operation. The mean postoperative follow-up period was 63.2 months. Five patients experienced tumor recurrence, and one of them died from the disease after diffuse leptomeningeal dissemination. The mean time to first recurrence was 28 months. Only one patient was free of tumoral recurrence after an 8-year follow-up. Immunohistochemically, all tumors were positive for vimentin and epithelial membrane antigen. MIB-1 labeling indices were higher following tumor recurrence. The present study expands the clinicopathologic horizon of rhabdoid papillary meningioma and suggests that it will behave aggressively based on its histology and concomitant features of atypia or malignancy or high MIB-1 labeling indices. Close follow-up and aggressive treatments of these tumors are warranted.

  12. Crisponi/CISS1 syndrome: A case series.

    PubMed

    Alhashem, Amal M; Majeed-Saidan, Muhammad Ali; Ammari, Amer N; Alrakaf, Maha S; Nojoom, Maha; Maddirevula, Sateesh; Faqeih, Eissa; Alkuraya, Fowzan S; Garne, Ester; Kurdi, Ahmad M

    2016-05-01

    Crisponi/CISS1 syndrome (MIM#272430) is a rare autosomal recessive disease characterized by major feeding difficulties, camptodactyly, and anhidrosis in early childhood; and the subsequent development of paradoxical cold-induced sweating and scoliosis later in life. The syndrome is caused by biallelic mutations in CRLF1 or, much less commonly, CLCF1. Although genotype/phenotype correlation has been elusive, it has been suggested that the level of the mutant protein may correlate with the phenotypic severity. However, we show in this series of 12 patients from four families, all previously unpublished, that the homogeneity of the recently described c.983dupG (p.Ser328Argfs∗2) mutation in CRLF1 was associated with a highly variable degree of severity, and that the phenotype significantly overlaps with the recently described COG6-related anhidrosis syndrome (MIM#615328). Another fifth previously unpublished family is also described with a novel mutation in CRLF1, c.605delC (p.Ala202Valfs*32). In Saudi Arabia the prevalence of the syndrome is probably underestimated due to the difficulty in making the diagnosis considering the complex phenotype with typical neonatal and evolutive features. PMID:26804344

  13. Bisphosphonates in Langerhans Cell Histiocytosis: An International Retrospective Case Series

    PubMed Central

    Chellapandian, Deepak; Makras, Polyzois; Kaltsas, Gregory; van den Bos, Cor; Naccache, Lamia; Rampal, Raajit; Carret, Anne-Sophie; Weitzman, Sheila; Egeler, R. Maarten; Abla, Oussama

    2016-01-01

    Background Bone is the most common organ of involvement in patients with Langerhans cell histiocytosis (LCH), which is often painful and associated with significant morbidity from pathological fractures. Current first-line treatments include chemotherapy and steroids that are effective but often associated with adverse effects, whereas the disease may reactivate despite an initial response to first-line agents. Bisphosphonates are osteoclast inhibitors that have shown to be helpful in treating bone lesions of LCH. To date, there are no large international studies to describe their role in treating bone lesions of LCH. Method We conducted a multicenter retrospective review of 13 patients with histologically proven LCH, who had received bisphosphonates either at diagnosis or at disease reactivation. Results Ten patients (77%) had a single system bone disease, and 3 (23%) had bone lesions as part of multisystem disease. Median follow-up time post-bisphosphonate therapy was 4.6 years (range, 0.8 to 8.2 years). Treatment with bisphosphonates was associated with significant pain relief in almost all patients. Twelve (92%) achieved resolution of active bone lesions, and 10 out of them had no active disease for a median of 3.5 years (range, 0.8 to 5 years). One patient did not respond. No major adverse effects were reported in this series. Conclusion Bisphosphonates are well-tolerated drugs that can significantly improve bone pain and induce remission in active bone LCH. Future prospective studies evaluating the role of bisphosphonates in LCH are warranted. PMID:27413525

  14. [Migraine with prolonged eyelid edema: a series of 10 cases].

    PubMed

    Toribio-Díaz, M E; Cuadrado-Pérez, M L; Peláez, A; Aledo-Serrano, Angel; Pedraza, M Isabel; Porta-Etessam, Jesús; Guerrero-Peral, Angel L

    2014-05-01

    Introduccion. La migraña puede cursar con sintomas autonomicos craneales propios de las cefaleas trigeminoautonomicas, lo que plantea dificultades en el diagnostico. Objetivo. Describir una serie de diez pacientes con edema palpebral asociado a la migraña. Pacientes y metodos. Diez pacientes atendidos en la consulta de cefaleas de tres hospitales (nueve mujeres, un varon; edad: 26-53 años), con edema palpebral recurrente asociado a la migraña. Resultados. Segun los criterios diagnosticos de la Clasificacion Internacional de las Cefaleas (ICHD-III, version beta), ocho pacientes presentaban migraña sin aura, una tenia migraña con aura y otra, migraña cronica. El edema palpebral aparecia durante las crisis de migraña mas intensas, y tenia mayor duracion que la cefalea. Se descartaron causas farmacologicas o sistemicas del edema en todos los casos. Otros sintomas autonomicos asociados fueron la inyeccion conjuntival (n = 3), el lagrimeo (n = 2) y la rinorrea (n = 1). Tanto el dolor como el edema asociado respondieron a los tratamientos sintomaticos y preventivos de la migraña. Conclusiones. El edema palpebral es un posible acompañante de la migraña. Aparece en algunos pacientes con los episodios de mayor intensidad, y responde al tratamiento sintomatico y preventivo de la migraña.

  15. Hypophosphatemic rickets and craniosynostosis: a multicenter case series.

    PubMed

    Vega, Rafael A; Opalak, Charles; Harshbarger, Raymond J; Fearon, Jeffrey A; Ritter, Ann M; Collins, John J; Rhodes, Jennifer L

    2016-06-01

    OBJECTIVE This study examines a series of patients with hypophosphatemic rickets and craniosynostosis to characterize the clinical course and associated craniofacial anomalies. METHODS A 20-year retrospective review identified patients with hypophosphatemic rickets and secondary craniosynostosis at 3 major craniofacial centers. Parameters examined included sex, age at diagnosis of head shape anomaly, affected sutures, etiology of rickets, presenting symptoms, number and type of surgical interventions, and associated diagnoses. A review of the literature was performed to optimize treatment recommendations. RESULTS Ten patients were identified (8 males, 2 females). Age at presentation ranged from 1 to 9 years. The most commonly affected suture was the sagittal (6/10 patients). Etiologies included antacid-induced rickets, autosomal dominant hypophosphatemic rickets, and X-linked hypophosphatemic (XLH) rickets. Nine patients had undergone at least 1 cranial vault remodeling (CVR) surgery. Three patients underwent subsequent surgeries in later years. Four patients underwent formal intracranial pressure (ICP) monitoring, 3 of which revealed elevated ICP. Three patients were diagnosed with a Chiari Type I malformation. CONCLUSIONS Secondary craniosynostosis develops postnatally due to metabolic or mechanical factors. The most common metabolic cause is hypophosphatemic rickets, which has a variety of etiologies. Head shape changes occur later and with a more heterogeneous presentation compared with that of primary craniosynostosis. CVR may be required to prevent or relieve elevated ICP and abnormalities of the cranial vault. Children with hypophosphatemic rickets who develop head shape abnormalities should be promptly referred to a craniofacial specialist. PMID:26824597

  16. Benign paroxysmal positional vertigo after radiologic scanning: a case series

    PubMed Central

    Aydin, Erdinc; Akman, Kubra; Yerli, Hasan; Ozluoglu, Levent N

    2008-01-01

    Introduction Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo. It is frequently seen in elderly patients, and the course of the attack may easily mimic cerebrovascular disease. A BPPV attack after a radiologic examination has not been reported previously. We report the cases of two patients who had BPPV attacks after radiologic imaging. Case presentation The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT) imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients. Conclusion Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur. PMID:18371218

  17. Bleeding events associated with novel anticoagulants: a case series.

    PubMed

    Mirzaee, Sam; Tran, Tara Thi Thien; Amerena, John

    2013-12-01

    Until lately warfarin was the only valuable oral anticoagulant in stroke reduction in high risk cases with non valvular atrial fibrillation (NVAF). Although with warfarin the rate of stroke reduced notably, the major concern is the risk of serious bleeding and difficulty of establishing and maintaining the international normalised ratio (INR) within the therapeutic range. With the development of the novel anticoagulants we now have for the first time since the innovation of Warfarin feasible alternatives to it to decrease stroke rates in high risk patients with NVAF. To diminish adverse bleeding events with the novel anticoagulant proper selection of patients prior starting treatment is essential.

  18. Superhero‐related injuries in paediatrics: a case series

    PubMed Central

    Davies, Patrick; Surridge, Julia; Hole, Laura; Munro‐Davies, Lisa

    2007-01-01

    Five cases of serious injuries to children wearing superhero costumes, involving extreme risk‐taking behaviour, are presented here. Although children have always displayed behaviour seemingly unwise to the adult eye, the advent of superhero role models can give unrealistic expectations to the child, which may lead to serious injury. The children we saw have all had to contemplate on their way to hospital that they do not in fact possess superpowers. The inbuilt injury protection which some costumes possess is also discussed. PMID:17337680

  19. Case series: Pregnancy Outcome in Patients with Uterine Fibroids.

    PubMed

    Radhika, B H; Naik, Kusuma; Shreelatha, S; Vana, Harshini

    2015-10-01

    Fibroids in pregnancy is a commonly encountered clinical entity. Objective of this study was to evaluate the maternal and fetal outcome in women having pregnancy with uterine fibroids. We present the clinical, obstetric data, perinatal outcomes of 15 patients from a prospective study. Fifteen pregnant women with fibroid >3cm were prospectively included in study. Major proportion of patient with fibroids were in younger age group of 25-30 years when compared to older age group of 31-35 years (66% vs 33%). Fibroids were more frequent in multi-gravidae, compared to primigravidae. In almost half of patients, (53.3%) fibroids were diagnosed before pregnancy. Common complications encountered during pregnancy in decreasing order of frequency were pain abdomen (46.6%), followed by threatened preterm labour (26.6%) and anaemia (26.6%). Out of 15, three (20%) women had abortion. In remaining, 11/12 patients attained term pregnancy between 37 to 40 weeks. Two patients required antenatal myomectomy. Caesarean section was done in 75% of women who attained term pregnancy and one patient had technical difficulty during caesarean section. Post partum heamorrhage was seen in 5/15 (33.3%) of patients. Out of 12, five babies were low birth weight. Four babies required NICU admission. There was no perinatal mortality. In our small patient series high incidence of caesarean section rates and increased incidence of threatened preterm labour, anaemia, and postpartum haemorrhage, was observed in pregnant patients with fibroids and hence, the pregnancy with fibroids should be considered as high risk pregnancy. PMID:26557577

  20. Case series: Pregnancy Outcome in Patients with Uterine Fibroids

    PubMed Central

    Naik, Kusuma; Shreelatha, S.; Vana, Harshini

    2015-01-01

    Fibroids in pregnancy is a commonly encountered clinical entity. Objective of this study was to evaluate the maternal and fetal outcome in women having pregnancy with uterine fibroids. We present the clinical, obstetric data, perinatal outcomes of 15 patients from a prospective study. Fifteen pregnant women with fibroid >3cm were prospectively included in study. Major proportion of patient with fibroids were in younger age group of 25-30 years when compared to older age group of 31-35 years (66% vs 33%). Fibroids were more frequent in multi-gravidae, compared to primigravidae. In almost half of patients, (53.3%) fibroids were diagnosed before pregnancy. Common complications encountered during pregnancy in decreasing order of frequency were pain abdomen (46.6%), followed by threatened preterm labour (26.6%) and anaemia (26.6%). Out of 15, three (20%) women had abortion. In remaining, 11/12 patients attained term pregnancy between 37 to 40 weeks. Two patients required antenatal myomectomy. Caesarean section was done in 75% of women who attained term pregnancy and one patient had technical difficulty during caesarean section. Post partum heamorrhage was seen in 5/15 (33.3%) of patients. Out of 12, five babies were low birth weight. Four babies required NICU admission. There was no perinatal mortality. In our small patient series high incidence of caesarean section rates and increased incidence of threatened preterm labour, anaemia, and postpartum haemorrhage, was observed in pregnant patients with fibroids and hence, the pregnancy with fibroids should be considered as high risk pregnancy. PMID:26557577

  1. Fasting and cancer treatment in humans: A case series report

    PubMed Central

    Safdie, Fernando M.; Dorff, Tanya; Quinn, David; Fontana, Luigi; Wei, Min; Lee, Changhan; Cohen, Pinchas; Longo, Valter D.

    2009-01-01

    Short-term fasting (48 hours) was shown to be effective in protecting normal cells and mice but not cancer cells against high dose chemotherapy, termed Differential Stress Resistance (DSR), but the feasibility and effect of fasting in cancer patients undergoing chemotherapy is unknown. Here we describe 10 cases in which patients diagnosed with a variety of malignancies had voluntarily fasted prior to (48-140 hours) and/or following (5-56 hours) chemotherapy. None of these patients, who received an average of 4 cycles of various chemotherapy drugs in combination with fasting, reported significant side effects caused by the fasting itself other than hunger and lightheadedness. Chemotherapy associated toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) of the National Cancer Institute (NCI). The six patients who underwent chemotherapy with or without fasting reported a reduction in fatigue, weakness, and gastrointestinal side effects while fasting. In those patients whose cancer progression could be assessed, fasting did not prevent the chemotherapy-induced reduction of tumor volume or tumor markers. Although the 10 cases presented here suggest that fasting in combination with chemotherapy is feasible, safe, and has the potential to ameliorate side effects caused by chemotherapies, they are not meant to establish practice guidelines for patients undergoing chemotherapy. Only controlled-randomized clinical trials will determine the effect of fasting on clinical outcomes including quality of life and therapeutic index. PMID:20157582

  2. Efficient nitrogen recycling through sustainable use of organic wastes in agriculture - an Australian case study

    NASA Astrophysics Data System (ADS)

    Rigby, Hannah; Landman, Michael; Collins, David; Walton, Katrina; Penney, Nancy; Pritchard, Deborah

    2014-05-01

    The effective recycling of nutrients in treated sewage sludge (biosolids) domestic (e.g. source separated food waste), agricultural, and commercial and industrial (C&I) biowastes (e.g. food industry wastes, papermill sludge) for use on land, generally following treatment (e.g. composting, anaerobic digestion or thermal conversion technologies) as alternatives to conventional mineral fertilisers in Australia can have economic benefits, ensure food security, and close the nutrient loop. In excess of 75% of Australian agricultural soils have less than 1% organic matter (OM), and, with 40 million tonnes of solid waste per year potentially available as a source of OM, biowastes also build soil carbon (C) stocks that improve soil structure, fertility and productivity, and enhance soil ecosystem services. In recent years, the increasing cost of conventional mineral fertilisers, combined with changing weather patterns have placed additional pressure on regional and rural communities. Nitrogen (N) is generally the most limiting nutrient to crop production, and the high-energy required and GHGs associated with its manufacture mean that, additionally, it is critical to use N efficiently and recycle N resources where possible. Biosolids and biowastes have highly variable organic matter (OM) and nutrient contents, with N often present in a variety of forms only some of which are plant-available. The N value is further influenced by treatment process, storage and fundamental soil processes. The correct management of N in biowastes is essential to reduce environmental losses through leaching or runoff and negative impacts on drinking water sources and aquatic ecosystems. Gaseous N emissions also impact upon atmospheric quality and climate change. Despite the body of work to investigate N supply from biosolids, recent findings indicate that historic and current management of agricultural applications of N from biosolids and biowastes in Australia may still be inefficient leading

  3. Histopathologic classification of parapharyngeal space tumors: a case series and review of the literature.

    PubMed

    Locketz, Garrett D; Horowitz, Gilad; Abu-Ghanem, Sara; Wasserzug, Oshri; Abergel, Abraham; Yehuda, Moshe; Fliss, Dan M

    2016-03-01

    The objective of the study is to present a large case series of parapharyngeal space tumors (PPST) and the most comprehensive literature review of tumor histopathologic distribution. The study was designed as internal case series and full Pubmed/MEDLINE electronic database review in a tertiary academic medical center. Tumor histopathology and patient demographics were obtained from a comprehensive Pubmed/MEDLINE database review, as well from an internal case series of 117 patients referred to our center between 1993 and 2013. Main outcome and measures of the study were to define the age, gender, and histopathology of PPST within a large internal case series and among the current body of published literature, and to propose a diagnostic and treatment algorithm for these tumors. Our cohort included 117 cases, 58 females and 59 males, with benign tumors comprising 85 % (n = 99) and malignant tumors 15 % (n = 18). A systematic review of published literature from 1963 to the present revealed 37 case series, and when combined with our present series, yielded a total of 2160 cases. Benign tumors are most common (78.8 %), with tumors of salivary gland (44.4 %), neural (34.4 %), and vascular (2.64 %) origin representing the largest subtypes. Pleomorphic adenomas (30.9 %), paragangliomas (13.1 %), and schwannomas (12.3 %) comprised the majority of all cases. Due to their rarity, data regarding the histopathologic distribution of PPST is scarce. We provide one of the largest case series and the most comprehensive review of these tumors in the literature to date, and offer our algorithm for evaluation and treatment.

  4. [Foreign bodies in esophagus in children: case series].

    PubMed

    Rodríguez, Hugo; Cuestas, Giselle; Botto, Hugo; Nieto, Mary; Cocciaglia, Alejandro; Gregori, Dario

    2013-06-01

    Ingestion of foreign bodies is an avoidable accident that is seen mainly in children under 3 years-old. Most of them pass through the digestive tract without causing clinical manifestations or complications, but a significant percentage is impacted in the esophagus causing vomiting, sore throat, dysphagia and drooling. The most common foreign bodies are coins. Complications usually occur when there is a delay in diagnosis or with large, sharp or potentially toxic objects, as the button battery. It is essential to make differential diagnosis between coin and button battery, since the latter requires urgent removal due to the earliness of the injury caused. We report 115 cases of foreign bodies in the esophagus, and we alert the pediatrician in recognizing and preventing this problem.

  5. Purpura fulminans secondary to rickettsial infections: A case series

    PubMed Central

    Katoch, Saloni; Kallappa, Ravindra; Shamanur, Murugesh B.; Gandhi, Sneha

    2016-01-01

    Purpura fulminans (PF) is a descriptive term used to describe a heterogeneous group of disorders characterized by rapidly progressive purpuric lesions that may develop into extensive areas of skin necrosis, and peripheral gangrene. This rare disorder is associated with laboratory evidence of consumptive coagulopathy and is often fatal. PF is usually associated with many infections, most notably with meningococcal, staphylococcal, and streptococcal infections. However, there are very few reports of this entity with spotted fever and scrub typhus from India. Rickettsial infections are an underdiagnosed group of diseases presenting as acute febrile illness, with high mortality in untreated cases. Of the available tests, Weil–Felix is a handy and economical tool for early diagnosis of this fatal disease especially in resource poor settings. We present four infants with PF secondary to rickettsial fever diagnosed by the Weil–Felix test. PMID:26955583

  6. [Foreign bodies in esophagus in children: case series].

    PubMed

    Rodríguez, Hugo; Cuestas, Giselle; Botto, Hugo; Nieto, Mary; Cocciaglia, Alejandro; Gregori, Dario

    2013-06-01

    Ingestion of foreign bodies is an avoidable accident that is seen mainly in children under 3 years-old. Most of them pass through the digestive tract without causing clinical manifestations or complications, but a significant percentage is impacted in the esophagus causing vomiting, sore throat, dysphagia and drooling. The most common foreign bodies are coins. Complications usually occur when there is a delay in diagnosis or with large, sharp or potentially toxic objects, as the button battery. It is essential to make differential diagnosis between coin and button battery, since the latter requires urgent removal due to the earliness of the injury caused. We report 115 cases of foreign bodies in the esophagus, and we alert the pediatrician in recognizing and preventing this problem. PMID:23732356

  7. Metronidazole Toxicity in Cockayne Syndrome: A Case Series.

    PubMed

    Wilson, Brian T; Strong, Andrew; O'Kelly, Sean; Munkley, Jennifer; Stark, Zornitza

    2015-09-01

    Cockayne syndrome (CS) is a rare genetic disorder characterized by small stature, intellectual disability, and accelerated pathologic aging. Through the Cockayne Syndrome Natural History Study, we have identified 8 cases of acute hepatic failure after metronidazole administration (8% of our cohort), 3 of which were fatal. The interval between initial administration and death was 6 to 11 days. Two of these patients also experienced acute neurologic deficit. Both hepatotoxicity and acute neurologic deficit have been reported previously as extremely rare adverse events after metronidazole administration. However, we have not identified any patients with CS who have received metronidazole without serious adverse effects. We recommend that a diagnosis of CS be considered an absolute contraindication to the use of metronidazole. PMID:26304821

  8. Connecting Hospitalized Patients with Their Families: Case Series and Commentary

    PubMed Central

    Parsapour, Kourosh; Kon, Alexander A.; Dharmar, Madan; McCarthy, Amy K.; Yang, Hsuan-Hui; Smith, Anthony C.; Carpenter, Janice; Sadorra, Candace K.; Farbstein, Aron D.; Hojman, Nayla M.; Wold, Gary L.; Marcin, James P.

    2011-01-01

    The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010). The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital—principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction. PMID:22121359

  9. Soft tissue development around pontic site: A case series.

    PubMed

    Narayan, Sarita Joshi; Singh, Pranav Kumar; Devarhubli, Achut R; Keerthi, R

    2016-01-01

    An ideal emergence profile is vital for maintaining gingival health and developing esthetics. The ovate pontic which mimics a natural tooth gives the most appropriate emergence profile. For a successful ovate pontic restoration, an alveolar ridge of sufficient height and width is necessary to enhance the deficient ridge and to achieve an esthetic emergence profile. Interpositional graft was carried out along with ovate pontic to achieve an ideal esthetic restoration. After three months of the postoperative period, there was an increased horizontal dimension in the deficient ridge and an esthetic emergence profile. Interpositional graft technique is a simpler and predictable technique for pontic site development in moderate cases of bucco-lingual ridge deficiency. PMID:27621552

  10. Facial Blanching After Cosmetic Botulinum Toxin Injection: Case Series.

    PubMed

    Warren, Donald; Woody, Meghan; Vickers, Jennifer

    2016-01-01

    Case 1 A 32-year-old woman was treated for the first time with onabotulinumtoxinA (BoNT), receiving 10 units in her forehead and 20 units in her glabella. She reported no history of skin disease and had a very active lifestyle. She first noticed blanching while doing a group workout and a friend inquired if she had "hives" on her forehead (Figure 1). She continued to note the blanching during workouts 5 months after injection. Each episode lasted 30 minutes to 2 hours. There were no associated symptoms with the blanching other than minor embarrassment. Given her active lifestyle and frequent blanching, she has elected not to receive further injections.

  11. Filiform polyposis in the sigmoid colon: A case series

    PubMed Central

    Lee, Chang Geun; Lim, Yun Jeong; Choi, Jong Sun; Lee, Jin Ho

    2010-01-01

    Filiform polyposis is a rare condition of uncertain pathogenesis that is usually found in association with Crohn’s disease, ulcerative colitis, intestinal tuberculosis or histiocytosis X. We report seven interesting cases of polyposis with various pathologic components, mainly located in the left side of the colon with no associated inflammatory bowel disease, intestinal tuberculosis or histiocytosis X. Multiple finger-like polypoid lesions with the appearance of stalactites were noted on the left side of the colon, especially in the sigmoid area, at the time of colonoscopy. The polyps had a variety of sizes and shapes and were shown to have various histopathologic components among the different patients. Although filiform polyposis localized in the sigmoid colon appears not to have high oncogenic potential, periodic follow-up seems to be needed. PMID:20480534

  12. Filiform polyposis in the sigmoid colon: a case series.

    PubMed

    Lee, Chang-Geun; Lim, Yun-Jeong; Choi, Jong-Sun; Lee, Jin-Ho

    2010-05-21

    Filiform polyposis is a rare condition of uncertain pathogenesis that is usually found in association with Crohn's disease, ulcerative colitis, intestinal tuberculosis or histiocytosis X. We report seven interesting cases of polyposis with various pathologic components, mainly located in the left side of the colon with no associated inflammatory bowel disease, intestinal tuberculosis or histiocytosis X. Multiple finger-like polypoid lesions with the appearance of stalactites were noted on the left side of the colon, especially in the sigmoid area, at the time of colonoscopy. The polyps had a variety of sizes and shapes and were shown to have various histopathologic components among the different patients. Although filiform polyposis localized in the sigmoid colon appears not to have high oncogenic potential, periodic follow-up seems to be needed.

  13. Pediatric non-Helicobacter pylori atrophic gastritis: a case series.

    PubMed

    Pogoriler, Jennifer; Kamin, Daniel; Goldsmith, Jeffrey D

    2015-06-01

    Although autoimmune atrophic gastritis is classically a disease of elderly adults, recent studies have described the disease in younger adults, particularly in those with other autoimmune diseases and iron-deficiency anemia. Atrophic gastritis in pediatrics is a rare and possibly underdiagnosed entity that has been primarily reported as single-case reports. This retrospective study of atrophic gastritis not associated with Helicobacter pylori infection was performed to further expand the knowledge of clinical presentation, pathologic findings, and natural history of this disease in the pediatric population. Twelve patients with a histologic diagnosis of atrophic gastritis were identified, with an age range of 8 months to 18 years. Seven had other autoimmune diseases and/or immunodeficiency. Atrophy was confined to the oxyntic mucosa in 10 patients, with intramucosal inflammation in a diffuse or basal-predominant pattern. Active inflammation was present in 7 patients. Pseudopyloric, intestinal, or squamous/mucinous metaplasia was seen at initial biopsy or on follow-up in 8 patients, and enterochromaffin-like cell hyperplasia was seen in 5. One patient developed an adenocarcinoma during the follow-up period of 10 years. Two false-negative diagnoses were retrospectively identified. In the majority of cases, the possibility of atrophic gastritis was not raised by the submitting physician, and the endoscopic findings were not specific. Therefore, accurate diagnosis requires a high degree of suspicion on the part of the pathologist, and the diagnosis should be considered particularly in patients with a clinical history of other autoimmune diseases or iron-deficiency anemia.

  14. Squamous neoplasia of the scrotum: a series of 29 cases.

    PubMed

    Matoso, Andres; Ross, Hillary M; Chen, Sonja; Allbritton, Jill; Epstein, Jonathan I

    2014-07-01

    The current epidemiology and clinicopathologic features of squamous cell carcinoma (SCC) of the scrotum are largely unknown because of its low incidence. We describe the histopathologic features, immunohistochemistry, and human papillomavirus (HPV) status of 29 patients with scrotal SCC. The mean age at presentation was 55 years (range, 30 to 74 y). White to black ratio was 1.9:1. There was no predominant occupation, with the majority being white-collar professionals. Clinical history of condylomas was present in 5 patients, and 7 patients had a history of multiple skin cancers including melanoma, basal cell carcinoma, and other SCCs. Other comorbidities included human immunodeficiency virus infection (n=2), kidney transplant (n=1), leukemia/lymphoma (n=2), hidradenitis suppurativa (n=1), chronic scrotal infections with abscess (n=1), inflamed epidermal inclusion cyst (n=1), and lichen planus (n=1). One patient had a history of regular tanning bed use. Morphologically, the majority was usual type (n=17), followed by basaloid (n=7) and warty (n=5). Nineteen cases were in situ, and 10 were invasive. Three patients had inguinal lymphadenopathy; in 1, metastasis was confirmed. Suprabasal nuclear staining for Ki67 was considered positive. For p16, a continuous band of nuclear and cytoplasmic staining was considered positive, and a noncontinuous or absence of staining was considered negative. p16 was positive in 10 cases; high-risk HPV was confirmed in 7 cases. Ki67 was positive in 8/17 (47%) usual, 6/7 (85.7%) basaloid, and 3/5 (60%) warty type. p53 was positive in 5/17 (29.4%) usual, 2/7 (28.6%) basaloid, and 1/5 (20%) warty type. All patients were treated with local excision only; 13 had positive margins. Three patients were treated with imiquimod after local excision. The median follow-up was 30 months. Three patients recurred and were treated with re-excision; 1 patient received radiotherapy. Overall, the morphologic, immunohistochemical, and HPV studies show that

  15. Meeting Indigenous peoples' objectives in environmental flow assessments: Case studies from an Australian multi-jurisdictional water sharing initiative

    NASA Astrophysics Data System (ADS)

    Jackson, Sue; Pollino, Carmel; Maclean, Kirsten; Bark, Rosalind; Moggridge, Bradley

    2015-03-01

    The multi-dimensional relationships that Indigenous peoples have with water are only recently gaining recognition in water policy and management activities. Although Australian water policy stipulates that the native title interests of Indigenous peoples and their social, cultural and spiritual objectives be included in water plans, improved rates of Indigenous access to water have been slow to eventuate, particularly in those regions where the water resource is fully developed or allocated. Experimentation in techniques and approaches to both identify and determine Indigenous water requirements will be needed if environmental assessment processes and water sharing plans are to explicitly account for Indigenous water values. Drawing on two multidisciplinary case studies conducted in Australia's Murray-Darling Basin, we engage Indigenous communities to (i) understand their values and explore the application of methods to derive water requirements to meet those values; (ii) assess the impact of alternative water planning scenarios designed to address over-allocation to irrigation; and (iii) define additional volumes of water and potential works needed to meet identified Indigenous requirements. We provide a framework where Indigenous values can be identified and certain water needs quantified and advance a methodology to integrate Indigenous social, cultural and environmental objectives into environmental flow assessments.

  16. A review of Computer Science resources for learning and teaching with K-12 computing curricula: an Australian case study

    NASA Astrophysics Data System (ADS)

    Falkner, Katrina; Vivian, Rebecca

    2015-10-01

    To support teachers to implement Computer Science curricula into classrooms from the very first year of school, teachers, schools and organisations seek quality curriculum resources to support implementation and teacher professional development. Until now, many Computer Science resources and outreach initiatives have targeted K-12 school-age children, with the intention to engage children and increase interest, rather than to formally teach concepts and skills. What is the educational quality of existing Computer Science resources and to what extent are they suitable for classroom learning and teaching? In this paper, an assessment framework is presented to evaluate the quality of online Computer Science resources. Further, a semi-systematic review of available online Computer Science resources was conducted to evaluate resources available for classroom learning and teaching and to identify gaps in resource availability, using the Australian curriculum as a case study analysis. The findings reveal a predominance of quality resources, however, a number of critical gaps were identified. This paper provides recommendations and guidance for the development of new and supplementary resources and future research.

  17. An empirical case study examining effectiveness of environmental enrichment in two captive Australian Sea Lions (Neophoca cinerea).

    PubMed

    Smith, Bradley P; Litchfield, Carla A

    2010-01-01

    This case study examined the effect of environmental enrichment on the activity budgets of a male and female Australian Sea Lion (Neophoca cinerea) housed together at Adelaide Zoo. Using non-food-related (intrinsic) and food-related (extrinsic) enrichment objects, the study conducted an ABABA (withdrawal) experimental design over a 30-day period (180 hr). The study expected extrinsically reinforcing objects to be more effective than intrinsically reinforcing objects in reducing pattern swimming. The male sea lion spent more than 45% of scans engaged in pattern swimming during the initial baseline, which was reduced by at least 25% when enrichment items were present. However, there was no evidence of stereotypic behavior in the female sea lion, indicating that individual differences may exist. When enrichment was present, the study observed more active behaviors in both nonhuman animals. They spent more time interacting with the non-food-related objects overall. Therefore, introducing simple enrichment devices offers a cheap, practical, and effective method of adding complexity to the environment, which is likely to benefit the animals' welfare and enhance the zoo-visitor experience.

  18. Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians

    PubMed Central

    Perales, Francisco

    2015-01-01

    Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus . This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation. PMID:26091283

  19. Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians.

    PubMed

    Perales, Francisco; Baffour, Bernard; Mitrou, Francis

    2015-01-01

    Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus. This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation. PMID:26091283

  20. Fatal Cerebral Air Embolism: A Case Series and Literature Review.

    PubMed

    Mishra, Rashmi; Reddy, Pavithra; Khaja, Misbahuddin

    2016-01-01

    Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful. Retrograde rise of venous air to the cerebral circulation was the likely mechanism for venous CAE. The second patient was a 46-year-old female presenting with fever, shortness of breath, and hematemesis. She was febrile, tachypneic, and tachycardic and required intubation and mechanical ventilation. An orogastric tube inserted drained 2500 mL of bright red blood. Flexible laryngoscopy and esophagogastroduodenoscopy were performed. She also underwent central venous catheter placement. CT scan of head performed the next day due to absent brain stem reflexes revealed intravascular air within cerebral arteries. A transthoracic echocardiogram with bubble study ruled out patent foramen ovale. The patient had a paradoxical CAE in the absence of a patent foramen ovale. PMID:27635266

  1. Gastroparesis secondary to a demyelinating disease: a case series

    PubMed Central

    Reddymasu, Savio C; Bonino, John; McCallum, Richard W

    2007-01-01

    Background Gastroparesis has a number of etiologies. The main ones are secondary to a complication from diabetes mellitus, related to post vagotomy or post gastric surgical resections, or idiopathic when the etiology is unclear. Gastroparesis secondary to a demyelinating disease of the brain is unusual. Case presentation A 22-year-old woman was referred for acute onset of intractable nausea and vomiting. She also had cerebellar deficits, dysphagia and paresthesias. Magnetic resonance imaging (MRI) of the brain revealed an isolated area of demyelination in the medullary region. Another 24-year-old woman had a similar presentation with right hemiplegia and MRI of the brain revealed a distal medullary region. Both these patients had an abnormal gastric emptying test. Gastroparesis and neurological deficits improved with intravenous corticosteroids. While the former patient has had no further recurrences, the latter patient developed multiple sclerosis within three months of presentation. Conclusion A demyelinating disease is a rare cause gastropareis, but should be suspected when symptoms of gastroparesis are associated with neurological deficits. MRI might help in the diagnosis and intravenous coriticosteroids can address the underlying disease process and improve gastric emptying, especially when used early during the course of the disease. PMID:17266755

  2. AUTOLOGOUS CHONDROCYTE TRANSPLANTATION-SERIES OF 3 CASES

    PubMed Central

    Gobbi, Riccardo Gomes; Demange, Marco Kawamura; Barreto, Ronald Bispo; Pécora, José Ricardo; Rezende, Múrcia Uchõa de; Filho, Tarcisio E.P Barros; Lombello, Christiane Bertachini

    2015-01-01

    Hyaline cartilage covers joint surfaces and plays an important role in reducing friction and mechanical loading on synovial joints such as the knee. This tissue is not supplied with blood vessels, nerves or lymphatic circulation, which may be one of the reasons why joint cartilage has such poor capacity for healing. Chondral lesions that reach the subchondral bone (osteochondral lesions) do not heal and may progress to arthrosis with the passage of time. In young patients, treatment of chondral defects of the knee is still a challenge, especially in lesions larger than 4 cm. One option for treating these patients is autologous chondrocyte transplantation/implantation. Because this treatment does not violate the subchondral bone and repairs the defect with tissue similar to hyaline cartilage, it has the theoretical advantage of being more biological, and mechanically superior, compared with other techniques. In this paper, we describe our experience with autologous chondrocyte transplantation/implantation at the Institute of Orthopedics and Traumatology, Hospital das Clínicas, University of Sâo Paulo, through a report on three cases. PMID:27022579

  3. Khat chewing and cirrhosis in Somaliland: Case series

    PubMed Central

    Mahamoud, Hawa D.; Muse, Sabah Mohammed; Roberts, Lewis R.; Torbenson, Michael S.; Fader, Tim

    2016-01-01

    Background Khat chewing is common especially among men in East Africa and Yemen. It is generally viewed by the populace as a benign social custom. Several studies of ethnic Somali immigrants to Western countries suggest an association between khat chewing and hepatotoxicity, but the risk of hepatotoxicity related to khat chewing within African settings is not documented. Aim To identify and describe liver disease without evidence of alcohol exposure or infectious etiology in khat chewers. Settings A university-affiliated teaching hospital in Somaliland. Methods Cases of cirrhosis of unknown cause were identified from the clinical practice of Al Hayatt Hospital in Borama, Somaliland, during 14 months beginning December 2012. Results Eight Somali men aged 27–70 years living in Somaliland were identified with cirrhosis of otherwise unknown cause. All chewed khat habitually for many years (15–128 bundles per day times years of use). A liver biopsy of one man was consistent with khat hepatotoxicity. Four of the eight men died during the study period. Conclusion Khat chewing may be associated with health consequences including severe hepatotoxicity with cirrhosis. PMID:27543281

  4. Fatal Cerebral Air Embolism: A Case Series and Literature Review

    PubMed Central

    Reddy, Pavithra; Khaja, Misbahuddin

    2016-01-01

    Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful. Retrograde rise of venous air to the cerebral circulation was the likely mechanism for venous CAE. The second patient was a 46-year-old female presenting with fever, shortness of breath, and hematemesis. She was febrile, tachypneic, and tachycardic and required intubation and mechanical ventilation. An orogastric tube inserted drained 2500 mL of bright red blood. Flexible laryngoscopy and esophagogastroduodenoscopy were performed. She also underwent central venous catheter placement. CT scan of head performed the next day due to absent brain stem reflexes revealed intravascular air within cerebral arteries. A transthoracic echocardiogram with bubble study ruled out patent foramen ovale. The patient had a paradoxical CAE in the absence of a patent foramen ovale.

  5. Fatal Cerebral Air Embolism: A Case Series and Literature Review

    PubMed Central

    Reddy, Pavithra; Khaja, Misbahuddin

    2016-01-01

    Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful. Retrograde rise of venous air to the cerebral circulation was the likely mechanism for venous CAE. The second patient was a 46-year-old female presenting with fever, shortness of breath, and hematemesis. She was febrile, tachypneic, and tachycardic and required intubation and mechanical ventilation. An orogastric tube inserted drained 2500 mL of bright red blood. Flexible laryngoscopy and esophagogastroduodenoscopy were performed. She also underwent central venous catheter placement. CT scan of head performed the next day due to absent brain stem reflexes revealed intravascular air within cerebral arteries. A transthoracic echocardiogram with bubble study ruled out patent foramen ovale. The patient had a paradoxical CAE in the absence of a patent foramen ovale. PMID:27635266

  6. Osteoradionecrosis of the Temporal Bone: A Case Series

    PubMed Central

    Sharon, Jeffrey D; Khwaja, Shariq S.; Drescher, Andrew; Gay, Hiram; Chole, Richard A

    2014-01-01

    Objective To study osteoradionecrosis (ORN) of the temporal bone Study Design Retrospective case review Setting Academic medical center Patients Patients were included who had previously undergone radiation to the head and neck and then developed exposed necrotic bone within the ear canal that persisted at least three months Intervention(s) Patients were treated with a variety of modalities, including conservative therapy with antibiotic ear drops and in-office debridements, hyperbaric oxygen therapy and surgery. Main Outcome Measure(s) To describe the presentation and management of patients with temporal bone osteoradionecrosis. Results 33 patients with temporal bone osteoradionecrosis were included. The most common site of primary tumor was the parotid gland (n=11), followed by the nasopharynx (n=7). The time to development of ORN varied between 1 and 22 years, with mean 7.9 years. The mean radiation dose was 62.6 Gy to the primary tumor, 53.1 Gy to the affected temporal bone, and 65.2 Gy to the affected tympanic bone. The most common symptoms of ORN were otorrhea (n=15), hearing loss (n=13), and otalgia (n=12). 15 patients had bacterial superinfection, most commonly S. aureus (n=9). Conservative therapy was successful at managing symptoms but not in eradicating exposed bone in most patients. Surgery was used for recalcitrant pain, infection, cholesteatoma, cranial neuropathies, and intracranial complications. Conclusions Osteoradionecrosis is a rare complication of radiation to the temporal bone. Management should be aimed at relief of symptoms, eradication of superinfection, and treatment of other commonly present radiation effects like cholesteatoma and hearing loss. PMID:24914789

  7. Intestinal Infarction Through Arterial Vascular Obstruction - Case Series from 1st and 3rd Surgery Clinics Cluj-Napoca.

    PubMed

    Jeican, Ionuţ Isaia; Mocan, Mihaela; Gheban, Dan

    2016-01-01

    This article presents a case series of intestinal infarction through obstruction of superior mesenteric artery - two cases of acute mesenteric artery embolism, two cases of acute mesenteric artery thrombosis and a case of volvulus.

  8. Morgellons disease, illuminating an undefined illness: a case series

    PubMed Central

    2009-01-01

    Introduction This review of 25 consecutive patients with Morgellons disease (MD) was undertaken for two primary and extremely fundamental reasons. For semantic accuracy, there is only one "proven" MD patient: the child first given that label. The remainder of inclusive individuals adopted the label based on related descriptions from 1544 through 1884, an internet description quoted from Sir Thomas Browne (1674), or was given the label by practitioners using similar sources. Until now, there has been no formal characterization of MD from detailed examination of all body systems. Our second purpose was to differentiate MD from Delusions of Parasitosis (DP), another "informal" label that fit most of our MD patients. How we defined and how we treated these patients depended literally on factual data that would determine outcome. How they were labeled in one sense was irrelevant, except for the confusing conflict rampant in the medical community, possibly significantly skewing treatment outcomes. Case presentation Clinical information was collected from 25 of 30 consecutive self-defined patients with Morgellons disease consisting of laboratory data, medical history and physical examination findings. Abnormalities were quantified and grouped by system, then compared and summarized, but the numbers were too small for more complex mathematical analysis. The quantification of physical and laboratory abnormalities allowed at least the creation of a practical clinical boundary, separating probable Morgellons from non-Morgellons patients. All the 25 patients studied meet the most commonly used DP definitions. Conclusions These data suggest Morgellons disease can be characterized as a physical human illness with an often-related delusional component in adults. All medical histories support that behavioral aberrancies onset only after physical symptoms. The identified abnormalities include both immune deficiency and chronic inflammatory markers that correlate strongly with

  9. A systematic review protocol for reporting deficiencies within surgical case series

    PubMed Central

    Agha, Riaz; Fowler, Alexander J; Lee, Seon-Young; Gundogan, Buket; Whitehurst, Katharine; Sagoo, Hakiran; Jeong, Kyung Jin Lee; Altman, Douglas G; Orgill, Dennis P

    2015-01-01

    Introduction Case series are an important and common study type in surgical literature. There is evidence that key data are excluded from published case series, and currently no reporting guideline exists for case series. There is, therefore, the potential to change practices and improve the reporting of case series. Reporting guidelines have been shown to be efficacious in raising the bar for reporting quality. We present our protocol for the first stage of guideline development—a systematic review of previously identified deficiencies in how surgical case series are reported. Methods and analysis Electronic searches will be conducted on MEDLINE, EMBASE, Cochrane Methods Register, Science Citation Index and Conference Proceedings Citation Index, from the start of indexing until 5 November 2014. The electronic search strategy was developed with an information specialist. Two independent researchers will identify articles for inclusion, specifically those that describe reporting deficiencies within surgical case series. Data will be extracted to specifically focus on the deficiencies of reporting. These will be categorised according to their type, and other identified issues will also be presented. Data will be presented with descriptive statistics to determine frequently missing types of data, and the commonest reporting issues tabulated. Ethics and dissemination The authors hope to disseminate the findings as widely as possible, irrespective of results, as these will add to the wider corpora of information on this subject. The systematic review will be published in a peer-reviewed journal and will be presented at a wide range of national and international conferences. Ultimately, this will inform a Delphi process for the development of a surgical case series reporting guideline. Protocol registration CRD42015016145. PMID:26438134

  10. Obsessive Compulsive Disorder Treatment in Patients with Down Syndrome: A Case Series

    ERIC Educational Resources Information Center

    Sutor, Bruce; Hansen, Mark R.; Black, John L.

    2006-01-01

    In this case series we report four cases of patients with Down syndrome with symptoms consistent with obsessive compulsive disorder. Each patient experienced substantial reduction in compulsive behaviors with pharmacotherapy of an SSRI alone or with the addition of risperidone to SSRI therapy. None of the patients experienced significant side…

  11. Aortic complications following pediatric heart transplantation: A case series and review

    PubMed Central

    Lang, Sean M; Frazier, Elizabeth A; Collins, R Thomas

    2016-01-01

    Aortic complications occur rarely after pediatric orthotopic heart transplantation, but are typically accompanied by catastrophic events. We describe the three cases of major aortic complications in our experience of 329 pediatric heart transplants. This case series and review highlight the important risk factors for aortic complications after heart transplantation. PMID:27011691

  12. Teamwork--Teach Me, Teach Me Not: A Case Study of Three Australian Preservice Teachers

    ERIC Educational Resources Information Center

    Main, Katherine

    2010-01-01

    Explicit training in teaming skills (both preservice and inservice) has been identified as a key means of facilitating the effective functioning of teaching teams (Main, 2007). This case study explored how groupwork tasks within university coursework can prepare preservice education students to work effectively in teaching teams. Three students in…

  13. Generic Skills Requirement for Stakeholders: An Australian Case Study. AIR 1994 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Heskin, Ken; And Others

    This case study examined which outcomes stakeholders desire for Bachelor of Information Technology (BIT) degree graduates at Swinburne University of Technology (SUT) in Australia and whether they find these outcomes among graduates. The four stakeholder groups were current BIT undergraduates, BIT graduates, academic staff of SUT involved with the…

  14. Piano Pedagogy with a Student Who Is Blind: An Australian Case

    ERIC Educational Resources Information Center

    Power, Anne; McCormack, Dorothy

    2012-01-01

    Teaching and learning piano poses challenges when the student is clinically blind. This article addresses the following question: What can be learned from a case study of teaching piano successfully to a student who is blind? The article has three purposes. The first is to document the achievements of a young student who met these challenges. The…

  15. Using a Client Survey to Support Continuous Improvement: An Australian Case Study in Managing Change

    ERIC Educational Resources Information Center

    Besch, Janice

    2014-01-01

    With the arrival of online survey tools that are low-cost, readily available and easy to administer, all organizations have access to one of the most effective mechanisms for determining quality improvement priorities and measuring progress towards achieving those priorities over time. This case study outlines the use made of this simple tool by a…

  16. Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

    ERIC Educational Resources Information Center

    Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

    2014-01-01

    With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages,…

  17. First Reported Australian Case of Cladophilophora arxii: Features Consistent with Possible Primary Pulmonary Chromoblastomycosis

    PubMed Central

    Brischetto, Anna; Kidd, Sarah; Baird, Rob

    2015-01-01

    We describe the first case of possible pulmonary chromoblastomycosis in the absence of any identified cutaneous lesions in a relatively immunosuppressed man. The causative organism was Cladophialophora arxii, which is a rare pathogen that has only been described as causing human disease two times previously. PMID:25624408

  18. Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series.

    PubMed

    Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M

    2016-01-01

    Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals' mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (MAPP

  19. Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series.

    PubMed

    Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M

    2016-01-26

    Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals' mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (MAPP).

  20. Applications of time-series analysis to mood fluctuations in bipolar disorder to promote treatment innovation: a case series

    PubMed Central

    Holmes, E A; Bonsall, M B; Hales, S A; Mitchell, H; Renner, F; Blackwell, S E; Watson, P; Goodwin, G M; Di Simplicio, M

    2016-01-01

    Treatment innovation for bipolar disorder has been hampered by a lack of techniques to capture a hallmark symptom: ongoing mood instability. Mood swings persist during remission from acute mood episodes and impair daily functioning. The last significant treatment advance remains Lithium (in the 1970s), which aids only the minority of patients. There is no accepted way to establish proof of concept for a new mood-stabilizing treatment. We suggest that combining insights from mood measurement with applied mathematics may provide a step change: repeated daily mood measurement (depression) over a short time frame (1 month) can create individual bipolar mood instability profiles. A time-series approach allows comparison of mood instability pre- and post-treatment. We test a new imagery-focused cognitive therapy treatment approach (MAPP; Mood Action Psychology Programme) targeting a driver of mood instability, and apply these measurement methods in a non-concurrent multiple baseline design case series of 14 patients with bipolar disorder. Weekly mood monitoring and treatment target data improved for the whole sample combined. Time-series analyses of daily mood data, sampled remotely (mobile phone/Internet) for 28 days pre- and post-treatment, demonstrated improvements in individuals' mood stability for 11 of 14 patients. Thus the findings offer preliminary support for a new imagery-focused treatment approach. They also indicate a step in treatment innovation without the requirement for trials in illness episodes or relapse prevention. Importantly, daily measurement offers a description of mood instability at the individual patient level in a clinically meaningful time frame. This costly, chronic and disabling mental illness demands innovation in both treatment approaches (whether pharmacological or psychological) and measurement tool: this work indicates that daily measurements can be used to detect improvement in individual mood stability for treatment innovation (MAPP

  1. What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital.

    PubMed

    McDougall, Rosalind J; Notini, Lauren

    2016-09-01

    Clinical ethics has been developing in paediatric healthcare for several decades. However, information about how paediatricians use clinical ethics case consultation services is extremely limited. In this project, we analysed a large set of case records from the clinical ethics service of one paediatric hospital in Australia. We applied a paediatric-specific typology to the case referrals, based on the triadic doctor-patient-parent relationship. We reviewed the 184 cases referred to the service in the period 2005-2014, noting features including the type of case, the referring department(s) and the patient's age at referral. The two most common types of referral involved clinician uncertainty about the appropriate care pathway for the child (26% of total referrals) and situations where the child's parents disagreed with the doctors' recommendations for the child's care (22% of total referrals). Referrals came from 28 different departments. Cancer, cardiology/cardiac surgery and general medicine referred the highest numbers of cases. The most common patient age groups were children under 1, and 14-15 years old. For three controversial areas of paediatric healthcare, clinicians had initiated processes of routine review of cases by the clinical ethics service. These insights into the way in which one very active paediatric clinical ethics service is used further our understanding of the work of paediatric clinical ethics, particularly the kinds of ethically challenging cases that paediatricians view as appropriate to refer for clinical ethics support. PMID:27317508

  2. What kinds of cases do paediatricians refer to clinical ethics? Insights from 184 case referrals at an Australian paediatric hospital.

    PubMed

    McDougall, Rosalind J; Notini, Lauren

    2016-09-01

    Clinical ethics has been developing in paediatric healthcare for several decades. However, information about how paediatricians use clinical ethics case consultation services is extremely limited. In this project, we analysed a large set of case records from the clinical ethics service of one paediatric hospital in Australia. We applied a paediatric-specific typology to the case referrals, based on the triadic doctor-patient-parent relationship. We reviewed the 184 cases referred to the service in the period 2005-2014, noting features including the type of case, the referring department(s) and the patient's age at referral. The two most common types of referral involved clinician uncertainty about the appropriate care pathway for the child (26% of total referrals) and situations where the child's parents disagreed with the doctors' recommendations for the child's care (22% of total referrals). Referrals came from 28 different departments. Cancer, cardiology/cardiac surgery and general medicine referred the highest numbers of cases. The most common patient age groups were children under 1, and 14-15 years old. For three controversial areas of paediatric healthcare, clinicians had initiated processes of routine review of cases by the clinical ethics service. These insights into the way in which one very active paediatric clinical ethics service is used further our understanding of the work of paediatric clinical ethics, particularly the kinds of ethically challenging cases that paediatricians view as appropriate to refer for clinical ethics support.

  3. Total thyroidectomy without the use of drainage - case series of 66 patients

    PubMed Central

    SAPALIDIS, K.; STRATI, T.; ANASTASIADIS, I.; PANTELI, N.; LIAVAS, L.; KESISOGLOU, I.; KANELLOS, I.

    2014-01-01

    Aim: The aim of this series is to study the need of drainage use after total thyreoidectomy. Material and Methods: Retrospective study of a series of patients who underwent total thyroidectomy from 2005 up to 2013. The presence or not of hematomas, seromas and hemorrhage were recorded. Results: Out of the 66 patients included in this series, only one case of post-operative hematoma was recorded. Neither a hemorrhage nor a seroma were identified despite the volume, the underlying pathology and the co-morbidity of the patients involved. Conclusion: In our experience a thyroidectomy with adequate hemostasis does not require the use of drains. PMID:24791207

  4. Successful use of right unilateral ECT for catatonia: a case series.

    PubMed

    Cristancho, Pilar; Jewkes, Delaina; Mon, Thetsu; Conway, Charles

    2014-03-01

    Catatonia is a neuropsychiatric syndrome involving motor signs in association with disorders of mood, behavior, or thought. Bitemporal electrode placement electroconvulsive therapy (ECT) is a proven effective treatment for catatonia, and this mode of ECT delivery is the preferred method of treatment in this condition. Studies in major depressive disorder have demonstrated that suprathreshold, nondominant (right) hemisphere, unilateral electrode placement ECT has fewer adverse effects, especially cognitive adverse effects, than bitemporal ECT. This case series describes the use of right unilateral (RUL) ECT in 5 patients with catatonia. Before ECT, all 5 patients in this series initially failed therapy with benzodiazepines and psychotropic medications. Each catatonic patient received a series of 8 to 12 RUL ECT in an every-other-day series. After ECT, 4 of the 5 patients had a full recovery from catatonia. One patient achieved only partial response to RUL ECT, and no additional benefit was obtained with bitemporal ECT. All patients in this case series tolerated RUL ECT without major adverse effects. This case series illustrates successful use of RUL ECT in patients with catatonia and adds to the early literature demonstrating its effective use in treating this complex condition.

  5. EPIDEMIOLOGY AND TREATMENT OF MONTEGGIA LESION IN ADULTS: SERIES OF 44 CASES

    PubMed Central

    Suarez, Roberto; Barquet, Antonio; Fresco, Rodrigo

    2016-01-01

    ABSTRACT Objective: To analyze the epidemiology, treatment and outcome of a series of adult patients with Monteggia lesion treated in Uruguayan institutions. Methods: This is a retrospective article, we retrospectively identified from two Uruguayan institutions 44 adult patients with Monteggia lesion and analyzed their characteristics including Bado classification, associated injuries, treatment modality and outcome (Morrey score). Results: Using Bado classification, 23 cases (52%) were type II, 12 (27%) type I, seven (16%) type IV and two cases (5%) type III. Associated lesions were radial head fractures, found in 15 patients, coronoid ipsilateral fractures in seven patients, and neurological injuries in four. Radial head dislocation was reduced in 93% of the cases with closed maneuvers. Ulna fractures underwent open reduction and internal fixation in all 30 cases using 3.5 mm DCP plates. Complications after surgery occurred in 21 cases. Revision surgery was done in 15 cases. Outcomes after primary and revision surgery were good or excellent in 37 cases. Conclusions: In our series we observed that Monteggia lesion in adults is a serious injury with a high number of complications that often require revision surgeries. Level of Evidence IV, Retrospective Study, Case Series. PMID:26997915

  6. Source rock potential analysis using rock physics approach and 2D seismic data inversion: case study of Great Australian Bight

    NASA Astrophysics Data System (ADS)

    Shulakova, V.

    2015-12-01

    The quantity of total organic carbon (TOC) and its type determine the ability of source rocks to generate hydrocarbons. Thus, the quantification of TOC content is an essential part of any reservoir characterisation project. Traditionally TOC is estimated from geochemical analysis of core samples. In this case the results are limited spatially by a well location as well as vertically by a number of tested samples. At the same time TOC vertical variability might be very high, changing every 1-3 m. The several methods have been deployed to estimate TOC from well-log data which provides continuous vertical profile estimations. The basin wide information might be provided by the utilization of seismic surveys. The methodology of mapping source rocks based on seismic data has been lately reported to be successful for the thick source rocks (>20 m) with relatively high TOC values up to 3-4% (Løseth et al., 2011). We employ the described approach and demonstrate our findings for a case study from Ceduna Basin (Great Australian Bight, Australia). The reported TOC values estimated from the cores go up to only 1.3%. The organic matter is contained in thin layers of claystones interlayered with sandstones. The workflow included TOC estimation from the well-log data and then seismic data inversion performed in JasonTM software. The inverted acoustic impedance decreases nonlinearly with increasing TOC content. The obtained results comprises 2D section of TOC distribution. The calculated TOC values are in a good agreement with the results of laboratory measurements. The results of this study show that TOC can be successfully estimated from seismic data inversion even in the case of low organic matter values. Further work has to be done to understand whether this approach works for different types of organic matter and stages of its maturation. Løseth H., Wensaas L., Gading M., Duffaut K., Springer M. 2001. Can hydrocarbon source rocks be identified on seismic data? Geology 39/12.

  7. Virtual reality hypnosis pain control in the treatment of multiple fractures: a case series.

    PubMed

    Teeley, Aubriana M; Soltani, Maryam; Wiechman, Shelley A; Jensen, Mark P; Sharar, Sam R; Patterson, David R

    2012-01-01

    This case series evaluated the use of virtual reality hypnosis (VRH) for the treatment of pain associated with multiple fractures from traumatic injuries. VRH treatment was administered on 2 consecutive days, and pain and anxiety were assessed each day before and after VRH treatment as well as on Day 3, which was 24 hours after the second treatment session. Pain reduction from baseline to Day 3 was from 70% to 30%, despite opioid analgesic use remaining stable. The subjective pain reduction reported by patients was encouraging, and the results of this case series suggest the importance of further study of VRH with larger samples using randomized controlled trials. PMID:22443021

  8. Australian Extinctions

    ERIC Educational Resources Information Center

    Science Teacher, 2005

    2005-01-01

    Massive extinctions of animals and the arrival of the first humans in ancient Australia--which occurred 45,000 to 55,000 years ago--may be linked. Researchers at the Carnegie Institution, University of Colorado, Australian National University, and Bates College believe that massive fires set by the first humans may have altered the ecosystem of…

  9. Recovery as a model of care? Insights from an Australian case study.

    PubMed

    Hungerford, Catherine

    2014-03-01

    The terms "model of health care," "service model." and "nursing model of practice" are often used interchangeably in practice, policy, and research, despite differences in definitions. This article considers these terms in the context of consumer-centred recovery and its implementation into a publicly-funded health service organization in Australia. Findings of a case study analysis are used to inform the discussion, which considers the diverse models of health care employed by health professionals; together with the implications for organizations worldwide that are responsible for operationalizing recovery approaches to health care. As part of the discussion, it is suggested that the advent of recovery-oriented services, rather than recovery models of health care, presents challenges for the evaluation of the outcomes of these services. At the same time, this situation provides opportunities for mental health nurses to lead the way, by developing rigorous models of practice that support consumers who have acute, chronic, or severe mental illness on their recovery journey; and generate positive, measureable outcomes.

  10. The case for a southeastern Australian Dust Bowl, 1895-1945

    NASA Astrophysics Data System (ADS)

    Cattle, Stephen R.

    2016-06-01

    Australia has an anecdotal history of severe wind erosion and dust storm activity, but there has been no lasting public perception of periods of extreme dust storm activity in this country, such as that developed in the USA following the Dust Bowl of the 1930s. Newspaper accounts of droughts and dust storms in southeastern (SE) Australia between 1895 and 1945 suggest that, at various times, the scale of these events was comparable to those experienced in the USA Dust Bowl. During this 50-year period, average annual rainfall values in this region were substantially below long-term averages, air temperatures were distinctly warmer, marginal lands were actively cropped and grazed, and rabbits were a burgeoning grazing pest. From the beginning of the Federation Drought of 1895-1902, dust storm activity increased markedly, with the downwind coastal cities of Sydney and Melbourne experiencing dust hazes, dust storms and falls of red rain relatively regularly. Between 1935 and 1945, Sydney and Melbourne received ten and nine long-distance dust events, respectively, with the years of 1938 and 1944/45 being the most intensely dusty. Entire topsoil horizons were blown away, sand drift was extreme, and crops and sheep flocks were destroyed. Although these periods of extreme dust storm activity were not as sustained as those experienced in the USA in the mid-1930s, there is a strong case to support the contention that SE Australia experienced its own extended, somewhat episodic version of a Dust Bowl, with a similar combination of causal factors and landscape effects.

  11. Complications of emergency refeeding in anorexia nervosa: case series and review.

    PubMed

    Webb, G J; Smith, K; Thursby-Pelham, F; Smith, T; Stroud, M A; Da Silva, A N

    2011-01-01

    The refeeding syndrome is common among patients with anorexia nervosa. It may be lethal and has many manifestations. We report a case series of 14 anorexic patients admitted for feeding to a single British centre. There was a high prevalence of the refeeding syndrome, with three cases requiring higher dependency unit support and one death. We present a review of the refeeding syndrome in anorectics and highlight our impression that infection among such patients may be serious and under-recognised.

  12. Eosinophilic meningitis: a case series and review of literature of Angiostrongylus cantonensis and Gnathostoma spinigerum.

    PubMed

    Shah, I; Barot, S; Madvariya, M

    2015-01-01

    Eosinophilic meningitis is defined as the presence of >10 eosinophils/μL in cerebrospinal fluid (CSF) or at least 10% eosinophils in the total CSF leukocyte count. Eosinophilic meningitis has been reported in two case series and two case reports in India till date and has not been reported in children below 15 years of age. We present two children with eosinophilic meningitis with peripheral eosinophilia and the proposed etiologic agents based on the clinical setting and their response to antihelminthic agents.

  13. African Students from Refugee Backgrounds in Australian TAFE Institutes: A Case for Transformative Learning Goals and Processes

    ERIC Educational Resources Information Center

    Onsando, Gerald; Billett, Stephen

    2009-01-01

    Australian Technical and Further Education (TAFE) institutes are perhaps the most heterogeneous of the nation's educational sectors. However, TAFE institutes' capacity to provide inclusive education is constrained by their curriculum focus and pedagogical practices and culturally premised assumptions that may inhibit learning for students from…

  14. Variation in Student Selection within the Australian Unified National System: A Case Study in Undergraduate Business Studies from Western Australia.

    ERIC Educational Resources Information Center

    Stanley, Gordon; Oliver, Jeff

    1994-01-01

    Data on admission criteria for four undergraduate business administration programs in Western Australian universities were used to investigate variation in student characteristics across schools. Results indicated large differences in student characteristics among schools, which could affect student progress and outcomes. Implications for such…

  15. Engaging or Training Sessional Staff: Evidence from an Australian Case of Enhanced Engagement and Motivation in Teaching Delivery

    ERIC Educational Resources Information Center

    Byers, Philippa; Tni, Massimiliano

    2014-01-01

    This paper examines the effectiveness of a programme of weekly meetings between sessional staff and the unit coordinator of a large first-year class at an Australian university. Interviews with sessional staff indicate that, in addition to training and targeted professional development initiatives, management initiatives that promote engagement…

  16. Intervention for Infants at Risk of Developing Autism: A Case Series

    ERIC Educational Resources Information Center

    Green, Jonathan; Wan, Ming Wai; Guiraud, Jeanne; Holsgrove, Samina; McNally, Janet; Slonims, Vicky; Elsabbagh, Mayada; Charman, Tony; Pickles, Andrew; Johnson, Mark

    2013-01-01

    Theory and evidence suggest the potential value of prodromal intervention for infants at risk of developing autism. We report an initial case series (n = 8) of a parent-mediated, video-aided and interaction-focused intervention with infant siblings of autistic probands, beginning at 8-10 months of age. We outline the theory and evidence base…

  17. Outcomes of laparoscopic removal of the Essure sterilization device for pelvic pain: a case series.

    PubMed

    Casey, James; Aguirre, Francisco; Yunker, Amanda

    2016-08-01

    The following presents a case series of 29 referral patients who underwent laparoscopic Essure removal for the indication of suspected Essure-related pelvic pain and to describe patient characteristics, intraoperative findings and postoperative pain outcomes. Laparoscopic removal for Essure-associated pelvic pain is a safe and effective treatment. PMID:27063056

  18. The Understanding Words Reading Intervention: Evidence from a Case Series Design

    ERIC Educational Resources Information Center

    Wright, Craig; Conlon, Elizabeth G.; Wright, Michalle

    2012-01-01

    Using a case-series design with double baseline and 10-week maintenance phase, 5 struggling readers from middle- to high-income families (age range 6.4-7.9 years) completed a 5-times-weekly intervention (96 sessions) administered by a parent. All participants completed the intervention with phonological decoding, text-reading accuracy and reading…

  19. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    ERIC Educational Resources Information Center

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  20. Brief Report: Retrospective Case Series of Oxcarbazepine for Irritability/Agitation Symptoms in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Douglas, Jessica F.; Sanders, Kevin B.; Benneyworth, M. Hannah; Smith, Jessica L.; DeJean, Virginia M.; McGrew, Susan G.; Veenstra-VanderWeele, Jeremy

    2013-01-01

    We examined response to oxcarbazepine prescribed for irritability/agitation symptoms in a retrospective case series of 30 patients with Autism Spectrum Disorder (ASD). The average patient was 12.0 years old (range 5-21) and taking two other psychotropic medications (range 0-4). Fourteen patients (47 %) had a clinical global impression of…

  1. REHABILITATION OF SUBACROMIAL PAIN SYNDROME EMPHASIZING SCAPULAR DYSKINESIS IN AMATEUR ATHLETES: A CASE SERIES

    PubMed Central

    Moura, Katherinne F.; Monteiro, Renan L.; Lucareli, Paulo R.G.

    2016-01-01

    ABSTRACT Study design Case series Background and Purpose Scapular dyskinesis has been associated with several shoulder injuries. Recent literature has suggested that a greater activation of the scapular muscles can play an important role in reducing subacromial impingement in patients with shoulder pain. Thus, the purpose of this case series was to describe a rehabilitation program that emphasizes scapular dyskinesis correction for those with clinical evidence of subacromial pain syndrome. Case Descriptions The four amateur athletes in this series showed clinical evidence of subacromial pain syndrome and scapular dyskinesis and each underwent a treatment protocol consisting of three phases. Phase 1 emphasized pain relief, scapular control, and recovery of normal range of motion (ROM), Phase 2 focused on muscular strengthening, and Phase 3 emphasized sensory motor training. Outcomes All subjects demonstrated decreased pain, improved sports performance and function, increased muscular strength for shoulder elevation and external rotation, and increased ROM for internal rotation. Improvement in serratus anterior (SA) activation was also noted. Discussion The results of this case series suggest that subjects with clinical tests positive for subacromial pain syndrome can show significant improvement with an intervention focused on scapular dyskinesis correction. SA activation can play an important role in this process given that all subjects presented with better recruitment after rehabilitation, as measured by electromyography. Levels of Evidence Level 4 PMID:27525180

  2. Assessing Outcome in Cognitive Behavior Therapy for Child Depression: An Illustrative Case Series

    ERIC Educational Resources Information Center

    Eckshtain, Dikla; Gaynor, Scott T.

    2009-01-01

    Recent meta-analytic data suggest a need for ongoing evaluation of treatments for youth depression. The present article calls attention to a number of issues relevant to the empirical evaluation of if and how cognitive behavior therapy for child depression works. A case series of 6 children and a primary caregiver received treatment--individual…

  3. Dialectical Behavior Therapy of Anorexia and Bulimia Nervosa among Adolescents: A Case Series

    ERIC Educational Resources Information Center

    Salbach-Andrae, Harriet; Bohnekamp, Inga; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Miller, Alec L.

    2008-01-01

    The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behavior therapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…

  4. Neurosis Meets Psychosis: Case Series from a Tertiary Care Center in South India

    PubMed Central

    Dholakia, Saumil Y.; Susmita, Chandramouleeswaran; Ranjit, Krishna Das; Singh, Yogendra; Braganza, Deepa

    2015-01-01

    The utility of the terms psychosis and neurosis in psychiatry have maintained their dichotomous stance since ages. Clinical observations and etiological hypothesis of psychiatric disorders have kept this polarity intact since the times of Freud and Jung. This case series attempts to revisit this perennial psychiatric controversy. PMID:26664092

  5. Is Family Therapy Useful for Treating Children with Anorexia Nervosa? Results of a Case Series

    ERIC Educational Resources Information Center

    Lock, James; le Grange, Daniel; Forsberg, Sarah; Hewell, Kristen

    2006-01-01

    Objective: Research suggests that family-based treatment (FBT) is an effective treatment for adolescents with anorexia nervosa (AN). This retrospective case series was designed to examine its usefulness with younger children. Method: Data were abstracted from medical records of 32 children with a mean age of 11.9 years (range 9.0-12.9) meeting…

  6. Manualized Family-Based Treatment for Anorexia Nervosa: A Case Series.

    ERIC Educational Resources Information Center

    Le Grange, Daniel; Binford, Roslyn; Loeb, Katharine L.

    2005-01-01

    Objective: The purpose of this study was to describe a case series of children and adolescents (mean age = 14.5 years, SD = 2.3; range 9-18) with anorexia nervosa who received manualized family-based treatment for their eating disorder. Method: Forty-five patients with anorexia nervosa were compared pre- and post-treatment on weight and menstrual…

  7. Applying data mining techniques to medical time series: an empirical case study in electroencephalography and stabilometry.

    PubMed

    Anguera, A; Barreiro, J M; Lara, J A; Lizcano, D

    2016-01-01

    One of the major challenges in the medical domain today is how to exploit the huge amount of data that this field generates. To do this, approaches are required that are capable of discovering knowledge that is useful for decision making in the medical field. Time series are data types that are common in the medical domain and require specialized analysis techniques and tools, especially if the information of interest to specialists is concentrated within particular time series regions, known as events. This research followed the steps specified by the so-called knowledge discovery in databases (KDD) process to discover knowledge from medical time series derived from stabilometric (396 series) and electroencephalographic (200) patient electronic health records (EHR). The view offered in the paper is based on the experience gathered as part of the VIIP project. Knowledge discovery in medical time series has a number of difficulties and implications that are highlighted by illustrating the application of several techniques that cover the entire KDD process through two case studies. This paper illustrates the application of different knowledge discovery techniques for the purposes of classification within the above domains. The accuracy of this application for the two classes considered in each case is 99.86% and 98.11% for epilepsy diagnosis in the electroencephalography (EEG) domain and 99.4% and 99.1% for early-age sports talent classification in the stabilometry domain. The KDD techniques achieve better results than other traditional neural network-based classification techniques.

  8. Validation of the Extend Suite of MOD09 and SMAC Processed Reflectance Products for Australian Terrestrial Supersites: A Case Study

    NASA Astrophysics Data System (ADS)

    Broomhall, M. A.; Chedzey, H. C.; McAtee, B.; Fearns, P.; Lynch, M. J.

    2014-12-01

    The Australian Terrestrial Ecosystem Research Network (TERN) brings together ecosystem scientists allowing them to collect, contribute, store, integrate data and collaborate across numerous disciplines. The TERN AusCover Facility comprises a national expert network that provides remote sensing data such as satellite-derive biophysical products, advanced remote sensing products and ground-validation information free and online to the research community. TERN and AusCover have collected in situ data for a number of 5 km x 5 km supersites from nearly every state and territory in Australia. These data include spectrophotometer data, sun photometer and ozonometer data, airborne and terrestrial LIDAR data and airborne hyperspectral data. As part of the AusCover facility and in conjunction with Landgate, Western Australia, Curtin University has modified the atmospheric correction and surface reflectance processing scheme from Landgate to process 12 extra MODIS bands to surface reflectance, thus providing 19 bands. This processing scheme uses the Simple Method for Atmospheric Correction (SMAC) to produce reflectance data. Until recently, only the first 7 MODIS bands were available with the MODIS institutional algorithm for surface reflectance, MOD09, but this has altered to now also provide 9 extra bands. MOD09 is based around 6S to produce reflectance data. This case study makes use of hyperspectral airborne data captured over the Credo TERN supersite to compare the surface reflectance products from MOD09 and the SMAC-based 19-band reflectance process. This work required validating the airborne data against a set in situ reflectance measurements of large calibration targets. The validated airborne data were resampled spatially and spectrally to MODIS bands and both the airborne and MODIS data were mapped to the same spatial grid. Direct pixel comparisons have been made between the airborne data and the two algorithms, and between the algorithms themselves. The algorithms

  9. Global trade in ornamental fish from an Australian perspective: the case for revised import risk analysis and management strategies.

    PubMed

    Whittington, R J; Chong, R

    2007-09-14

    Over 1 billion ornamental fish comprising more than 4000 freshwater and 1400 marine species are traded internationally each year, with 8-10 million imported into Australia alone. Compared to other commodities, the pathogens and disease translocation risks associated with this pattern of trade have been poorly documented. The aim of this study was to conduct an appraisal of the effectiveness of risk analysis and quarantine controls as they are applied according to the Sanitary and Phytosanitary (SPS) agreement in Australia. Ornamental fish originate from about 100 countries and hazards are mostly unknown; since 2000 there have been 16-fold fewer scientific publications on ornamental fish disease compared to farmed fish disease, and 470 fewer compared to disease in terrestrial species (cattle). The import quarantine policies of a range of countries were reviewed and classified as stringent or non-stringent based on the levels of pre-border and border controls. Australia has a stringent policy which includes pre-border health certification and a mandatory quarantine period at border of 1-3 weeks in registered quarantine premises supervised by government quarantine staff. Despite these measures there have been many disease incursions as well as establishment of significant exotic viral, bacterial, fungal, protozoal and metazoan pathogens from ornamental fish in farmed native Australian fish and free-living introduced species. Recent examples include Megalocytivirus and Aeromonas salmonicida atypical strain. In 2006, there were 22 species of alien ornamental fish with established breeding populations in waterways in Australia and freshwater plants and molluscs have also been introduced, proving a direct transmission pathway for establishment of pathogens in native fish species. Australia's stringent quarantine policies for imported ornamental fish are based on import risk analysis under the SPS agreement but have not provided an acceptable level of protection (ALOP

  10. Modern Spirometry Supports Anesthetic Management in Small Animal Clinical Practice: A Case Series.

    PubMed

    Calice, Ivana; Moens, Yves

    2016-01-01

    Modern spirometry, like no other monitoring technique, allows insight into breath-to-breath respiratory mechanics. Spirometers continuously measure volume, airway pressure, and flow while calculating and continuously displaying respiratory system compliance and resistance in the form of loops. The aim of this case series is to show how observation of spirometric loops, similar to electrocardiogram or CO2 curve monitoring, can improve safety of anesthetic management in small animals. Spirometric monitoring cases described in this case series are based on use of the anaesthesia monitor Capnomac Ultima with a side stream spirometry sensor. The cases illustrate how recognition and understanding of spirometric loops allows for easy diagnosis of iatrogenic pneumothorax, incorrect ventilator settings, leaks in the system, kinked or partially obstructed endotracheal tube, and spontaneous breathing interfering with intermittent positive-pressure ventilation. The case series demonstrates the potential of spirometry to improve the quality and safety of anesthetic management, and, hence, its use can be recommended during intermittent positive-pressure ventilation and procedures in which interference with ventilation can be expected. PMID:27487353

  11. Use of the Australian Childhood Immunisation Register for vaccine safety data linkage.

    PubMed

    Gold, Michael; Dugdale, Sarah; Woodman, Richard J; McCaul, Kieran A

    2010-06-11

    We linked the Australian Childhood Immunisation Register (ACIR) to South Australian (SA) hospital outcome data in order to evaluate the association between Measles Mumps and Rubella (MMR) and Diphtheria Tetanus Pertussis (DTP) vaccines and convulsions. Linkage occurred using probabilistic matching and data was analysed using the self-controlled case series methodology. An increase in febrile convulsions 6-11 days post-MMR vaccination was demonstrated which equates to a vaccine-attributable risk of 1 convulsion per 6753 vaccines. This study confirms the known association between MMR vaccination and febrile convulsions and in doing so demonstrates the feasibility of using the ACIR for data linkage and vaccine safety surveillance.

  12. Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report

    PubMed Central

    Cuthbert, Scott C.; Rosner, Anthony L.

    2012-01-01

    Objective The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI). Clinical Features Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI. Intervention and Outcome Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable. Conclusion The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time. PMID:22942842

  13. Tubercular Uveitis with Ocular Manifestation as the First Presentation of Tuberculosis: A Case Series.

    PubMed

    Shah, Jayashree S; Shetty, Niharika; Shah, Sharath Kumar D; Shah, Neelesh Kumar S

    2016-03-01

    Tuberculosis is very common disease in India. It is one of the most common causes of Granulomatous Uveitis in our Country even today. So the strongest suspicion in our mind when we are treating a case of Uveitis, should be TB. We reviewed all the cases of clinically suspected ocular tuberculosis attending the Ophthalmology OPD of Sri Siddhartha Medical College between December 2012 and December 2014 who were refractory to routine uveitis management and later on responded to anti-Tubercular treatment. History of TB contact, Ocular manifestation, Demographic Profile of the patients, Diagnostic test, Treatment regime were looked into. Here by we present a case series of 15 cases of refractory uveitis that later were detected to be of tuberculous origin. We studied the characteristic features, complications and correlation of mantoux test, ESR and Koch's contact with these cases.

  14. Tubercular Uveitis with Ocular Manifestation as the First Presentation of Tuberculosis: A Case Series.

    PubMed

    Shah, Jayashree S; Shetty, Niharika; Shah, Sharath Kumar D; Shah, Neelesh Kumar S

    2016-03-01

    Tuberculosis is very common disease in India. It is one of the most common causes of Granulomatous Uveitis in our Country even today. So the strongest suspicion in our mind when we are treating a case of Uveitis, should be TB. We reviewed all the cases of clinically suspected ocular tuberculosis attending the Ophthalmology OPD of Sri Siddhartha Medical College between December 2012 and December 2014 who were refractory to routine uveitis management and later on responded to anti-Tubercular treatment. History of TB contact, Ocular manifestation, Demographic Profile of the patients, Diagnostic test, Treatment regime were looked into. Here by we present a case series of 15 cases of refractory uveitis that later were detected to be of tuberculous origin. We studied the characteristic features, complications and correlation of mantoux test, ESR and Koch's contact with these cases. PMID:27134908

  15. Late-life homicide-suicide: a national case series in New Zealand.

    PubMed

    Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

    2016-01-01

    Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy.

  16. Late-life homicide-suicide: a national case series in New Zealand.

    PubMed

    Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

    2016-01-01

    Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy. PMID:25735608

  17. Thumb reconstruction without formal pollicization in mirror hand deformity: a series of four cases.

    PubMed

    Al-Qattan, M M; Al-Kahtani, A R; Al-Sharif, E M; Al-Otaibi, N J

    2013-11-01

    Thumb reconstruction in mirror hands is usually done by pollicization. However, objective pinch strength and power grip data in mirror hands following pollicization are lacking. Alternative thumb reconstruction techniques include doing nothing, rotation osteotomy or syndactylization of the radial digits. In this article, we report a series of four cases of mirror hand deformity where the thumb was not reconstructed by formal pollicization. Two cases had non-classic mirror hand deformity (the forearm contained a radius and an ulna) and the other two had classic ulnar dimelia. In all cases, thumb reconstruction was done by keeping one of the radial fingers in place (without pollicization) as the new thumb; and then (if required) performing a secondary osteotomy procedure to rotate the new thumb into pronation. The four cases were recalled back to the clinic for functional assessment at ages 20 years, 5 years, 4 years and 2 years, respectively. The overall hand function was considered 'fair' in the case with concurrent unique features, and was considered 'excellent' in the other three cases. It was concluded that the technique of thumb reconstruction used in the current series is an acceptable option. However, objective measurements, especially with regards to pinch strength and power grip, need to be compared with the pollicization technique.

  18. Complications associated with negative pressure reaming for harvesting autologous bone graft: a case series.

    PubMed

    Lowe, Jason A; Della Rocca, Gregory J; Murtha, Yvonne; Liporace, Frank A; Stover, Michael D; Nork, Sean E; Crist, Brett D

    2010-01-01

    A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered.

  19. Buprenorphine/naloxone therapy for opioid refractory neuropathic pain following traumatic amputation: a case series.

    PubMed

    Licina, Lauren; Hamsher, Carlyle; Lautenschager, Karl; Dhanjal, Sandeep; Williams, Necia; Spevak, Christopher

    2013-07-01

    Phantom limb pain is a common consequence of limb amputation and is prevalent among the service members sustaining traumatic battlefield limb injuries during the conflicts in Iraq and Afghanistan. Current treatment to relieve phantom limb pain consists of physical, behavioral, and medical modalities including opioids and adjunct medications. Treatment failure resulting in persistent pain and disability may result. This case series describes four previously healthy service members who developed phantom limb pain following traumatic amputation successfully treated with buprenorphine/naloxone after failing traditional treatment. This is the first reported case series of patients expressing improved pain control with decreased frequency of phantom limb pain with the use of buprenorphine/naloxone instead of traditional opioid agonists. PMID:23820366

  20. Law enforcement-applied tourniquets: a case series of life-saving interventions.

    PubMed

    Callaway, David W; Robertson, Joshua; Sztajnkrycer, Matthew D

    2015-01-01

    Although the epidemiology of civilian trauma is distinct from that encountered in combat, in both settings, extremity hemorrhage remains a major preventable cause of potential mortality. The current paper describes the largest case series in the literature in which police officers arriving prior to emergency medical services applied commercially available field tourniquets to civilian victims of violent trauma. Although all 3 patients with vascular injury arrived at the receiving emergency department in extremis, they were successfully resuscitated and survived to discharge without major morbidity. While this outcome is likely multifactorial and highlights the exceptional care delivered by the modern trauma system, tourniquet application appears to have kept critically injured patients alive long enough to reach definitive trauma care. No patient had a tourniquet-related complication. This case series suggests that law enforcement officers can effectively identify indications for tourniquets and rapidly apply such life-saving interventions.

  1. Ethnomedicine and dominant medicine in multicultural Australia: a critical realist reflection on the case of Korean-Australian immigrants in Sydney

    PubMed Central

    Han, Gil-Soo; Ballis, Harry

    2007-01-01

    Background Viewed through the micro focus of an interpretive lens, medical anthropology remains mystified because interpretivist explanations seriously downplay the given context in which individual health seeking-behaviours occur. This paper draws upon both the interpretivist and political economy perspectives to reflect on the ethno medical practices within the Korean-Australian community in Sydney. Methods We draw on research data collected between 1995 and 1997 for an earlier study of the use of biomedical and traditional medicine by Korean-Australians in Sydney. A total of 120 interviews were conducted with a range of participants, including biomedical doctors, traditional health professionals, Korean community leaders and Korean migrants representing a range of socio-economic backgrounds and migration patterns. Results and Discussion First, the paper highlights the extent to which the social location of migrants in a host society alters or restructures their initial cultural practices they bring with them. Second, taking hanbang medicine in the Korean-Australian community as an illustrative case, the paper explores the transformation of the dominant biomedicine in Australia as a result of the influx of ethnomedicine in the era of global capitalism and global movement. Conclusion In seeking to explain the popularity and supply of alternative health care, it is important to go beyond the culture of each kind of health care itself and to take into consideration the changes occurring at societal, national and global levels as well as consequential individual response to the changes. New social conditions influence the choice of health care methods, including herbal/alternative medicine, health foods and what are often called New Age therapies. PMID:17201916

  2. Treatment of rosacea with topical ivermectin cream: a series of 34 cases.

    PubMed

    Mendieta Eckert, Marta; Landa Gundin, Nerea

    2016-01-01

    Rosacea is a highly prevalent, chronic inflammatory disease. The use of topical ivermectin cream has recently been described in the treatment of rosacea in three clinical trials. We report our experience in a series of 34 patients treated with topical ivermectin cream. The results are a reflection of the reality of clinical practice and the perception of patients of the treatment. We also evaluate the efficacy in cases of mild rosacea and erythematotelangiectatic rosacea which have not been studied in trials. PMID:27617938

  3. Resolution of choroidal neovascularization secondary to punctate inner choroidopathy (PIC) with intravitreal anti-VEGF agents: a case series.

    PubMed

    Mangat, Simran S; Ramasamy, B; Prasad, Som; Walters, Gavin; Mohammed, Moin; Mckibbin, Martin

    2011-01-01

    Case series of four patients with CNVM secondary to PIC treated solely with anti VEGF in three cases and in combination with PDT in the other. This series reveals long term follow up (3 months to 28 months) which is currently not described in the literature.

  4. Evaluation of Streptococcus pneumoniae in bile samples: A case series review.

    PubMed

    Itoh, Naoya; Kawamura, Ichiro; Tsukahara, Mika; Mori, Keita; Kurai, Hanako

    2016-06-01

    Although Streptococcus pneumoniae is an important pathogen of humans, pneumococcal cholangitis is rare because of the rapid autolysis of S. pneumoniae. The aim of this case series was to review patients with bile cultures positive for S. pneumoniae. This study was a single center retrospective case series review of patients with S. pneumoniae in their bile at a tertiary-care cancer center between September 2002 and August 2015. Subjects consisted of all patients in whom S. pneumoniae was isolated in their bile during the study period. Bile specimens for culture were obtained from biliary drainage procedures such as endoscopic retrograde biliary drainage, endoscopic nasobiliary drainage, and percutaneous transhepatic biliary drainage. There were 20 patients with bile cultures positive for S. pneumoniae during the study period. All patients presented with extrahepatic obstructive jaundice due to hepatopancreatobiliary tumors. Nineteen of 20 patients underwent the placement of plastic intrabiliary tubes. The mean time between the first-time drainage and the positive culture was 26 days (range 0-313 days). Although 12 of 20 patients met our definition of cholangitis, 5 were clinically treated with antibiotics based on a physician's assessment of whether there was a true infection. The present study is the largest case series of patients with S. pneumoniae in their bile. Based on our findings, the isolation of S. pneumoniae from bile may be attributed to the placement of biliary drainage devices. PMID:27025902

  5. Forecasting malaria cases using climatic factors in delhi, India: a time series analysis.

    PubMed

    Kumar, Varun; Mangal, Abha; Panesar, Sanjeet; Yadav, Geeta; Talwar, Richa; Raut, Deepak; Singh, Saudan

    2014-01-01

    Background. Malaria still remains a public health problem in developing countries and changing environmental and climatic factors pose the biggest challenge in fighting against the scourge of malaria. Therefore, the study was designed to forecast malaria cases using climatic factors as predictors in Delhi, India. Methods. The total number of monthly cases of malaria slide positives occurring from January 2006 to December 2013 was taken from the register maintained at the malaria clinic at Rural Health Training Centre (RHTC), Najafgarh, Delhi. Climatic data of monthly mean rainfall, relative humidity, and mean maximum temperature were taken from Regional Meteorological Centre, Delhi. Expert modeler of SPSS ver. 21 was used for analyzing the time series data. Results. Autoregressive integrated moving average, ARIMA (0,1,1) (0,1,0)(12), was the best fit model and it could explain 72.5% variability in the time series data. Rainfall (P value = 0.004) and relative humidity (P value = 0.001) were found to be significant predictors for malaria transmission in the study area. Seasonal adjusted factor (SAF) for malaria cases shows peak during the months of August and September. Conclusion. ARIMA models of time series analysis is a simple and reliable tool for producing reliable forecasts for malaria in Delhi, India. PMID:25147750

  6. Life threatening hyperkalemia chronic kidney diseases patients treated with trimethoprim-sulfamethoxazole: a case series.

    PubMed

    Calderón-Ortiz, Ricardo; Colton-Verge, Pedro; Muñiz-Ortega, Myrna; Lespier, Laura; Córdova, Héctor

    2011-01-01

    We report a case series of patients that develop severe life threatening hyperkalemia after use of a commonly prescribe oral antibiotic, Trimethoprim-Sulfamethoxazole. The three patients required acute hemodialysis to normalize serum potassium levels after development of hypotension and heart block due to hyperkalemia. All had preexisting chronic kidney disease. Some of them were on medications that interfere with the effects of aldosterone. Patients with chronic kidney disease, particularly those receiving other medications that may also contribute to the development of hyperkalemia, should be closely monitored for this complication when Trimethoprim-containing antibiotic is needed. In these cases, other antibiotic therapy alternatives should be considered.

  7. Grape Cells (Multinucleated Keratinocytes) in Noninfectious Dermatoses: Case Series and Review of the Literature.

    PubMed

    Sweeney, Sarah A; Sulit, Daryl J; Adams, Erin G; Shvartsman, Katerina R; Rapini, Ronald P

    2015-12-01

    Multinucleated keratinocytes (also known as multinucleated epidermal giant cells) are a frequently overlooked histological finding in noninfectious inflammatory dermatoses. They are sometimes found in conditions characterized by chronic rubbing and pruritus, such as lichen simplex chronicus or prurigo nodularis, and may be a helpful clue in making the clinical diagnosis. This finding must be differentiated from other conditions characterized by multinucleated keratinocytes on histopathology, specifically herpes simplex, varicella zoster, or measles viral infections. The authors present a case series of 2 patients with unique clinical noninfectious diagnoses but similar histopathologic findings on biopsy. The histopathologic findings on both cases demonstrated multinucleated keratinocytes, which were related to manipulation of the epidermis.

  8. Diagnosis and management of focal reactive overgrowths of gingiva--a case series.

    PubMed

    Parwani, Simran; Parwani, Rajkumar N

    2014-07-01

    Localized overgrowths of gingiva such as peripheral fibroma, peripheral ossifying/cementifying fibroma, pyogenic granuloma and peripheral giant cell granuloma belong to a common group of lesions designated as focal reactive overgrowths (FROG). These growths are reactive in nature. They occur in response to chronic, low grade irritation caused by plaque or any other irritant. Etiology, clinical features and treatment modes of these lesions are the same with slight variations. The present case series describes five different cases of FROG where the lesions were treated by surgical excision under local anesthesia followed by a three month re-evaluation where no recurrences were observed.

  9. Grape Cells (Multinucleated Keratinocytes) in Noninfectious Dermatoses: Case Series and Review of the Literature

    PubMed Central

    Sulit, Daryl J.; Adams, Erin G.; Shvartsman, Katerina R.; Rapini, Ronald P.

    2015-01-01

    Abstract: Multinucleated keratinocytes (also known as multinucleated epidermal giant cells) are a frequently overlooked histological finding in noninfectious inflammatory dermatoses. They are sometimes found in conditions characterized by chronic rubbing and pruritus, such as lichen simplex chronicus or prurigo nodularis, and may be a helpful clue in making the clinical diagnosis. This finding must be differentiated from other conditions characterized by multinucleated keratinocytes on histopathology, specifically herpes simplex, varicella zoster, or measles viral infections. The authors present a case series of 2 patients with unique clinical noninfectious diagnoses but similar histopathologic findings on biopsy. The histopathologic findings on both cases demonstrated multinucleated keratinocytes, which were related to manipulation of the epidermis. PMID:26588345

  10. Regression of advanced melanoma upon withdrawal of immunosuppression: case series and literature review

    PubMed Central

    Thomas, N.; Sharpless, N.; Collichio, F.

    2013-01-01

    We report two cases of stage IV malignant melanoma arising in patients treated with azathioprine for myasthenia gravis. In both cases, the melanoma metastases regressed upon withdrawal of immunosuppression. One patient remains melanoma free at 10 years, and the second patient experienced an 18-month disease free period. There is one prior case report in the medical literature to support full immune reconstitution for treatment in advanced immunosuppression-related melanoma, and one case series suggesting that transplant patients developing melanoma may benefit from a switch to sirolimus. Virtually, no data exist for the medical management of early stage melanoma in the immunosuppressed patients. We review the limited preclinical data in support of immune reconstitution and the data on immunosuppression as a risk factor for melanoma. We conclude that reduction or withdrawal of immunosuppression may be beneficial in patients with advanced stage melanoma and warrants further consideration in patients with early stage melanoma. PMID:19890737

  11. Management of cervical cancer and surgical-pathological staging (SPS). Report of our clinical case series.

    PubMed

    Onnis, A; Marchetti, M; Maggino, T; Cascio, A; Cerri, G; Dipasquale, C; Meneghello, E; Romagnolo, C; Rozzo, M L

    1988-01-01

    FIGO staging is imprecise in a relevant number of cases of cervical cancer, especially in advanced stages, when the prognosis and the choice of the therapy are most delicate. The Authors examine their case series about the index of correction of FIGO staging after Surgical Pathological Staging (SPS). Surgical Pathological Staging was applied systematically in 788 cases and revealed errors in FIGO staging in 16% of cases at stage I; 77% at stage II; and 96% at stage III. SPS allows a more precise knowledge of neoplastic diffusion and consequently to the elimination of many false advanced stages and to adequate the treatment. Furthermore 5 year survival rate confirms the role of SPS and Surgical therapy alone or combined with Radiotherapy and Chemotherapy in every stages of diffusion of cervical cancer. PMID:3383889

  12. Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy.

    PubMed

    Gauffin, Helena; Landtblom, Anne-Marie

    2014-01-01

    Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs). Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures. Children can also be affected by PNESs. It is essential to notice especially those children of parents with epilepsy who live under difficult psychosocial circumstances and offer extra support when necessary. PMID:25484586

  13. Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy

    PubMed Central

    Gauffin, Helena; Landtblom, Anne-Marie

    2014-01-01

    Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs). Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures. Children can also be affected by PNESs. It is essential to notice especially those children of parents with epilepsy who live under difficult psychosocial circumstances and offer extra support when necessary. PMID:25484586

  14. Palliative stenting of the digestive tract: a case series of a single centre

    PubMed Central

    Dekkers, Pascale E.P.

    2013-01-01

    Background and aim Obstruction of the gastrointestinal tract due to cancer can be treated with stenting. The aim was to review the local experience with endoscopic stenting. All patients treated with stenting in a ten years period from 2001-2010 were studied. Results Fifty one patients received 57 stents because of oesophageal cancer. Mean survival after stent placement was 141 days. No case of perforation occurred. In nine cases (17%) clogging with food occurred. Tumour overgrowth was noted in four cases. Twenty four patients received 28 stents in their colon or rectum. The stents were placed in the rectum (n=6), the sigmoid (n=14), the descending colon (n=1), and the transverse colon (n=3). Mean survival was 276 days. Perforation did not occur. Tumour ingrowth was seen in two patients. One patient received a second stent. Dislocation occurred in two cases. There were two cases of clogging (8%) by stool. Fourteen patients received a total of 18 stents because of obstructing stomach cancer. Mean survival after placement was 121 days. There was no perforation, one case of clogging, and four cases of tumour ingrowth. Eight patients had stent placement in their duodenum. Mean survival after stent placement was 84 days. No perforation or clogging occurred. But three cases of tumour ingrowth were seen. Conclusions The present series shows that placement of expandable stents in the digestive tract in normal daily practice is feasible, safe, with a low number of complications, and provides good palliation for their remaining life. PMID:23450097

  15. Ornamental Stones and Gemstones: The limits of heritage stone designation: The case for and against Australian Precious Opal

    NASA Astrophysics Data System (ADS)

    Cooper, Barry

    2015-04-01

    When the international designation of natural stone types was first mooted in 2007, stones that were utilised in building and construction were the primary focus of attention. However following public discussion it soon became apparent that sculptural stones, stone used for utilitarian purposes such as millstones, as well as archaeological materials including stones used by early man could all be positively assessed as a potential Global Heritage Stone Resource (GHSR). Over the past 2 years it has been realised there is also a range of ornamental and semi-precious stones that may also be considered in the same international context. Examples in this respect include Imperial Porphyry sourced from Egypt that was much prized in the ancient world and "Derbyshire Blue John" a variety of fluorspar from central England that was used for vases, chalices, urns, candle sticks, jars, bowls door, jewellery and fire-place surrounds, especially in the 18th and 19th centuries. It is at this point that rock materials, sometimes used as gemstones, impinge on the domain of typical heritage stones. In Australia, the gemstone most identifiable with the country is precious opal formed by sedimentary processes in the Great Artesian Basin. In this paper the question is asked whether "Australian Precious Opal" could be or should be considered as a heritage stone of international significance. Immediately Australian Precious Opal satisfies several GHSR criteria including historic use for more than 50 years and wide-ranging utilisation for prestige jewellery around the world. It is also recognised as a cultural icon including association with national identity in Australia as it is legally defined as Australia's "National Gemstone" as well as being the "Gemstone Emblem" for the State of South Australia. Opal continues to be mined. Designation of Australian Precious Opal as a Global Heritage Stone Resource would likely involve formal international recognition of Australian opal in the

  16. Time Constraints on Soil Evolution from Uranium-series Isotopes in the South-eastern Australian Highlands: Evidences for a Coupling Between Soil Erosion and Production

    NASA Astrophysics Data System (ADS)

    Puthiyaveetil Othayoth, S.; Dosseto, A.; Hesse, P. P.; Handley, H. K.

    2011-12-01

    The evolution of soil resources (steady-state, aggradation or degradation) is determined by the balance between soil production and denudation rates. The uranium-series isotopic composition of four soil profiles from Frogs Hollow, a location in the upper catchment area of the Murrumbidgee River in southeastern Australia, has been determined to constrain the soil production rate in this region. The results are compared with previous estimates of soil residence time at this site, estimated from cosmogenic radionuclides and soil elemental chemistry data. Soil is increasingly weathered from bottom to top, which is evident from the decrease in (234U/238U) ratios and increase in relative quartz content with decreasing soil depth. The observed variations in mineralogy and geochemistry between the four soil profiles reflect differences in the degree of weathering. Sequential leaching was conducted to assess how uranium-series isotopes are distributed between primary and secondary minerals. Leached and unleached aliquots show similar mineralogy with minor variation in the relative mineral abundances whereas the elemental and isotopic compositions of uranium and thorium show notable differences. The unleached samples show more systematic variations in uranium-series isotopic compositions with depth when compared to leached samples. Soil residence times are calculated by modeling soil uranium-series isotopic composition using the model from (Dosseto et al., 2008). Inferred values vary from 3 to 30 kyr for profiles F1 (unleached aliquots) and F2. A negative correlation is observed between muscovite abundance and calculated soil residence times. The slope of this correlation is similar for different soil profiles and for both leached and unleached aliquots. Thus, we were able to apply this relationship to profiles where the residence time could not be calculated due to scatter in U-series isotope compositions. The inferred soil residence times range from 3 to 33 kyr for leached

  17. Mantle cell lymphoma of the oral cavity. Case Series and Comprehensive Review of the Literature

    PubMed Central

    Guggisberg, Kelly; Jordan, Richard C.K.

    2009-01-01

    Objective Mantle cell lymphoma (MCL) is a rare B cell neoplasm that has only recently been defined as a distinct entity. Because of its rarity and histological similarities with other small cell lymphomas, the microscopic diagnosis of MCL may be challenging. This is particularly true within the oral cavity where other lymphomas are more frequent. To date, few cases of MCL presenting within the oral cavity have been reported. Study Design We present 2 new cases of MCL presenting within the oral cavity and systematically reviewed 7 other cases of MCL reported in the English language literature. Historical cases were reviewed and available data regarding morphology, special stains, demographics, clinical presentation, radiographic findings, management and outcome were extracted. Data from our current series was then compared with the earlier published literature. Results To the best of our knowledge, this is the largest reviewed series of MCL within the oral cavity totaling 9 cases. The features of our cases, including histology, clinical presentation and outcome, are consistent with the 7 previously reported cases. The majority of oral MCLs occur in an older male population and a high proportion occur on the palate. Conclusion We conclude that MCL of the oral cavity is an uncommon diagnosis. Most oral MCLs occur in an elderly male population and have a possible predilection for the palate. The microscopic diagnosis can be challenging given its similar appearance to other small cell lymphomas requiring a comprehensive immunohistochemical panel for the accurate diagnosis. Like MCL occurring in other sites in the body, the prognosis and outcome of oral MCL appears to be poor. PMID:19880332

  18. Paracetamol serum concentrations in preterm infants treated with paracetamol intravenously: a case series

    PubMed Central

    2012-01-01

    Introduction Until now, studies on paracetamol given intravenously have mainly been performed with the pro-drug propacetamol or with paracetamol in preterm babies above 32 weeks of gestation. Studies in these babies indicate that intravenous paracetamol is tolerated well, however studies on the efficacy of intravenous paracetamol are lacking. There are no pharmacokinetic data on the administration of multiple doses of paracetamol in preterm babies with a gestational age below 32 weeks. Case presentation We present a case series of nine Caucasian preterm babies, six boys and three girls, with a mean gestational age of 28.6 weeks (range 25.9 to 31.6 weeks). Case one, a girl with a gestational age of 25 weeks and six days, presented with necrotizing enterocolitis. In the second case, a female baby with a gestational age of 26 weeks and two days presented with hematoma. In case three, a female baby with a gestation of 26 weeks and one day developed intraventricular hemorrhage. In case four, a male baby with a gestational age of 31 weeks and four days presented with pain after vacuum delivery. Case five, a female baby born after a gestation of 29 weeks and six days presented with hematoma. In case six, a male baby with a gestation of 30 weeks and six days presented with hematoma. In case seven, a male baby, born with a gestational age of 30 weeks and six days, presented with caput succedaneum and hematoma. In case eight, a male baby, born after a gestation of 28 weeks and four days, developed abdominal distention. Case nine, a female baby, born with a gestational age of 27 weeks and three days presented with hematoma. These babies were treated with intravenous paracetamol 15 mg/kg every six hours. Serum concentrations and aspartate transaminase were determined after prolonged administration. Pain scores were assessed using the Premature Infant Pain Profile. Conclusion Paracetamol serum concentrations ranged from 8 to 64 mg/L after eight to 12 doses of intravenous

  19. Contribution of arthroscopy in case of septic appearance arthritis of the wrist: a nine cases series.

    PubMed

    Hariri, A; Lebailly, F; Zemirline, A; Hendriks, S; Facca, S; Liverneaux, P

    2013-09-01

    Septic arthritis of the wrist is a diagnostic and therapeutic emergency. Synovectomy and lavage by arthrotomy is often followed by stiffness. The purpose of this study was to evaluate the diagnostic and therapeutic contribution of emergency arthroscopic synovectomy with intraarticular lavage. Nine patients were operated on for wrist pathology with septic appearance. All had signs of local inflammation, three showed locoregional inflammation, three were febrile. In one patient several joints were involved. Seven patients presented with inflammatory or degenerative arthritis. All patients underwent emergency surgery using radiocarpal joint puncture, arthroscopic exploration, intraarticular lavage and synovectomy at both the radiocarpal and midcarpal joints. The results were evaluated by pain, Quick DASH, grip strength, and wrist range of motion. In three cases, joint fluid appeared clear, in three it was turbid, and in three purulent. Gram stain and culture revealed bacteria in four cases. Synovitis was radiocarpal four times, radiocarpal and midcarpal once. In one case, there was radiocarpal and midcarpal chondritis. Average pain was 5.3/10 preoperatively and 2/10 at the last clinical follow-up visit. Mean grip strength was 23.3 kg on the involved side vs. 33.5 kg on the opposite one. Mean flexion was 55° for the involved wrist vs. 68°; mean extension was 52° for the affected wrist vs. 59°. No patient was reoperated on. In all cases, there was no sign of local inflammation, regional lymphadenopathy or systemic infection at the last follow-up. One patient died of colon metastatic cancer. Another patient developed a severe Complex Regional Pain Syndrome type I (CRPS1). Our results suggest three principles of management of wrist arthritis with septic appearance: extended surgical indication, emergency operation and arthroscopic procedure.

  20. Direct Cranial Nerve Involvement by Gliomas: Case Series and Review of the Literature.

    PubMed

    Mabray, M C; Glastonbury, C M; Mamlouk, M D; Punch, G E; Solomon, D A; Cha, S

    2015-07-01

    Malignant gliomas are characterized by infiltrative growth of tumor cells, including along white matter tracts. This may result in clinical cranial neuropathy due to direct involvement of a cranial nerve rather than by leptomeningeal spread along cranial nerves. Gliomas directly involving cranial nerves III-XII are rare, with only 11 cases reported in the literature before 2014, including 8 with imaging. We present 8 additional cases demonstrating direct infiltration of a cranial nerve by a glioma. Asymmetric cisternal nerve expansion compared with the contralateral nerve was noted with a mean length of involvement of 9.4 mm. Based on our case series, the key imaging feature for recognizing direct cranial nerve involvement by a glioma is the detection of an intra-axial mass in the pons or midbrain that is directly associated with expansion, signal abnormality, and/or enhancement of the adjacent cranial nerves.

  1. Perioperative Respiratory Compromise in Patients Undergoing PCNL-A Case Series.

    PubMed

    Namasivayam S, Ponnambala; Gayathri; Indu

    2013-10-01

    Percutaneous Nephrolithotomy (PCNL) is a surgical procedure which is used to extract renal pelvic stones. An optimum access tract, without traumatizing the surrounding structures, is essential for the surgery. Trauma to the surrounding structures and extra-vasation of the irrigating fluid may result in complications like hydrothorax, pneumothorax, hydro pneumothorax etc. These complications may produce intra- operative respiratory compromise leading on to arterial hypoxemia and its sequelae. A series of three case reports with review is presented here. First case is accumulation of irrigating fluid in the pleura causing hydrothorax and oxygen desaturation. Second case is extra-vasation of fluid in the abdominal wall and the patient was ventilated artificially for 24 hours. Third patient developed pneumothorax and he needed chest drainage.PCNL is done under general anaesthesia in prone position. The anaesthesiologist should be vigil enough to identify the situation and take appropriate measures to correct it.

  2. Perioperative Respiratory Compromise in Patients Undergoing PCNL-A Case Series

    PubMed Central

    Namasivayam S., Ponnambala; Gayathri; Indu

    2013-01-01

    Percutaneous Nephrolithotomy (PCNL) is a surgical procedure which is used to extract renal pelvic stones. An optimum access tract, without traumatizing the surrounding structures, is essential for the surgery. Trauma to the surrounding structures and extra–vasation of the irrigating fluid may result in complications like hydrothorax, pneumothorax, hydro pneumothorax etc. These complications may produce intra– operative respiratory compromise leading on to arterial hypoxemia and its sequelae. A series of three case reports with review is presented here. First case is accumulation of irrigating fluid in the pleura causing hydrothorax and oxygen desaturation. Second case is extra–vasation of fluid in the abdominal wall and the patient was ventilated artificially for 24 hours. Third patient developed pneumothorax and he needed chest drainage.PCNL is done under general anaesthesia in prone position. The anaesthesiologist should be vigil enough to identify the situation and take appropriate measures to correct it. PMID:24298514

  3. Treatment of Catatonia With Ultrabrief Right Unilateral Electroconvulsive Therapy: A Case Series.

    PubMed

    Kugler, Joseph L; Hauptman, Aaron J; Collier, Samuel J; Walton, Amy E; Murthy, Smitha; Funderburg, Linda G; Garcia, Keith S

    2015-09-01

    Catatonia is a syndrome heterogeneous with regard to presentation and etiology. Electroconvulsive therapy (ECT) remains the first-line treatment for catatonia. Literature review reveals only a few published case reports on the use of right unilateral (RUL) ECT in catatonia, 1 case report on ultrabrief RUL ECT, and an absence of evidence on the relative effectiveness and tolerability of RUL versus bilateral ECT in treating catatonia. In contrast, there are multiple reports in the literature of robustly dosed bilateral ECT, often administered on consecutive days. Reasons for choosing this intervention over the better-tolerated RUL treatment include assumptions about its relative speed and/or breadth of efficacy. Here we present a case series of 13 catatonic patients treated in an academic center over the course of the last 3 years. Our experience suggests that ultrabrief RUL ECT can rapidly and effectively treat catatonia from diverse etiologies.

  4. Greenhouse gas network design using backward Lagrangian particle dispersion modelling - Part 1: Methodology and Australian test case

    NASA Astrophysics Data System (ADS)

    Ziehn, T.; Nickless, A.; Rayner, P. J.; Law, R. M.; Roff, G.; Fraser, P.

    2014-03-01

    This paper describes the generation of optimal atmospheric measurement networks for determining carbon dioxide fluxes over Australia using inverse methods. A Lagrangian particle dispersion model is used in reverse mode together with a Bayesian inverse modelling framework to calculate the relationship between weekly surface fluxes and hourly concentration observations for the Australian continent. Meteorological driving fields are provided by the regional version of the Australian Community Climate and Earth System Simulator (ACCESS) at 12 km resolution at an hourly time scale. Prior uncertainties are derived on a weekly time scale for biosphere fluxes and fossil fuel emissions from high resolution BIOS2 model runs and from the Fossil Fuel Data Assimilation System (FFDAS), respectively. The influence from outside the modelled domain is investigated, but proves to be negligible for the network design. Existing ground based measurement stations in Australia are assessed in terms of their ability to constrain local flux estimates from the land. We find that the six stations that are currently operational are already able to reduce the uncertainties on surface flux estimates by about 30%. A candidate list of 59 stations is generated based on logistic constraints and an incremental optimization scheme is used to extend the network of existing stations. In order to achieve an uncertainty reduction of about 50% we need to double the number of measurement stations in Australia. Assuming equal data uncertainties for all sites, new stations would be mainly located in the northern and eastern part of the continent.

  5. Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series

    PubMed Central

    Kotzalidis, Georgios D.; Panaccione, Isabella; Simonetti, Alessio; De Chiara, Lavinia; Del Casale, Antonio; Ambrosi, Elisa; Napoletano, Flavia; Janiri, Delfina; Danese, Emanuela; Girardi, Nicoletta; Rapinesi, Chiara; Serata, Daniele; Manfredi, Giovanni; Koukopoulos, Alexia E.; Angeletti, Gloria; Nicoletti, Ferdinando; Girardi, Paolo

    2014-01-01

    The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do not respond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergic transmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder and one with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125 mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergic mechanisms may be involved in counteracting PMDD symptoms. PMID:24605130

  6. Inadvertent Stent Retriever Detachment: A Multicenter Case Series and Review of Device Experience FDA Reports

    PubMed Central

    Masoud, Hesham; Nguyen, Thanh N.; Martin, Coleman O.; Holloway, William E.; Ambekar, Sudheer; Yavagal, Dileep R.; Haussen, Diogo C.; Nogueira, Raul; Lozano, Diego J.; Puri, Ajit; Quateen, Ayman; Iancu, Daniela; Abraham, Michael G.; Chen, Michael; Mehta, Sonal; Malisch, Tim; Marden, Franklin; Novakovic, Robin; Roy, Daniel; Weill, Alain; Norbash, Alexander M.

    2016-01-01

    Mechanical thrombectomy using retrievable stents or stent retriever devices has become the mainstay of intra-arterial therapy for acute ischemic stroke. The recent publication of a series of positive trials supporting intra-arterial therapy as standard of care for the treatment of large vessel occlusion will likely further increase stent retriever use. Rarely, premature stent detachment during thrombectomy may be encountered. In our multicenter case series, we found a rate of detachment of less than 1% (n = 7/1,067), and all were first-generation Solitaire FR devices. A review of the US Food and Drug Administration database of device experience yielded 90 individual adverse reports of detachment. There were 82, 1 and 7 detachments of Solitaire FR (first generation), Solitaire FR2 (second generation) and Trevo devices, respectively. We conclude with a brief overview of the technical and procedural considerations which may be helpful in avoiding this rare complication. PMID:27051402

  7. Hypnosis delivered through immersive virtual reality for burn pain: A clinical case series.

    PubMed

    Patterson, David R; Wiechman, Shelley A; Jensen, Mark; Sharar, Sam R

    2006-04-01

    This study is the first to use virtual-reality technology on a series of clinical patients to make hypnotic analgesia less effortful for patients and to increase the efficiency of hypnosis by eliminating the need for the presence of a trained clinician. This technologically based hypnotic induction was used to deliver hypnotic analgesia to burn-injury patients undergoing painful wound-care procedures. Pre- and postprocedure measures were collected on 13 patients with burn injuries across 3 days. In an uncontrolled series of cases, there was a decrease in reported pain and anxiety, and the need for opioid medication was cut in half. The results support additional research on the utility and efficacy of hypnotic analgesia provided by virtual reality hypnosis. PMID:16581687

  8. Inadvertent Stent Retriever Detachment: A Multicenter Case Series and Review of Device Experience FDA Reports.

    PubMed

    Masoud, Hesham; Nguyen, Thanh N; Martin, Coleman O; Holloway, William E; Ambekar, Sudheer; Yavagal, Dileep R; Haussen, Diogo C; Nogueira, Raul; Lozano, Diego J; Puri, Ajit; Quateen, Ayman; Iancu, Daniela; Abraham, Michael G; Chen, Michael; Mehta, Sonal; Malisch, Tim; Marden, Franklin; Novakovic, Robin; Roy, Daniel; Weill, Alain; Norbash, Alexander M

    2016-03-01

    Mechanical thrombectomy using retrievable stents or stent retriever devices has become the mainstay of intra-arterial therapy for acute ischemic stroke. The recent publication of a series of positive trials supporting intra-arterial therapy as standard of care for the treatment of large vessel occlusion will likely further increase stent retriever use. Rarely, premature stent detachment during thrombectomy may be encountered. In our multicenter case series, we found a rate of detachment of less than 1% (n = 7/1,067), and all were first-generation Solitaire FR devices. A review of the US Food and Drug Administration database of device experience yielded 90 individual adverse reports of detachment. There were 82, 1 and 7 detachments of Solitaire FR (first generation), Solitaire FR2 (second generation) and Trevo devices, respectively. We conclude with a brief overview of the technical and procedural considerations which may be helpful in avoiding this rare complication. PMID:27051402

  9. Schema therapy for patients with borderline personality disorder: a single case series.

    PubMed

    Nordahl, Hans M; Nysaeter, Tor E

    2005-09-01

    The effectiveness of schema therapy for patients with borderline personality disorder (BPD) developed by Young was investigated using a single case series trial of six patients who all had primarily a DSM-IV BPD diagnosis. The treatment approach comprised the core elements of schema therapy with an emphasis on schema mode work and limited re-parenting. An A-B direct replication series with follow-up assessments at 12 months was implemented. From baseline to follow-up improvement was large, as indicated by large effect sizes, and improvement was clinically meaningful for five of the six patients included. Three of the six patients did not any longer fulfill the criteria for BPD by the end of the treatment.

  10. Zolpidem Ingestion, Automatisms, and Sleep Driving: A Clinical and Legal Case Series

    PubMed Central

    Poceta, J. Steven

    2011-01-01

    Study Objectives: To describe zolpidem-associated complex behaviors, including both daytime automatisms and sleep-related parasomnias. Methods: A case series of eight clinical patients and six legal defendants is presented. Patients presented to the author after an episode of confusion, amnesia, or somnambulism. Legal defendants were being prosecuted for driving under the influence, and the author reviewed the cases as expert witness for the defense. Potential predisposing factors including comorbidities, social situation, physician instruction, concomitant medications, and patterns of medication management were considered. Results: Patients and defendants exhibited abnormal behavior characterized by poor motor control and confusion. Although remaining apparently interactive with the environment, all reported amnesia for 3 to 5 hours. In some cases, the episodes began during daytime wakefulness because of accidental or purposeful ingestion of the zolpidem and are considered automatisms. Other cases began after ingestion of zolpidem at the time of going to bed and are considered parasomnias. Risk factors for both wake and sleep-related automatic complex behaviors include the concomitant ingestion of other sedating drugs, a higher dose of zolpidem, a history of parasomnia, ingestion at times other than bedtime or when sleep is unlikely, poor management of pill bottles, and living alone. In addition, similar size and shape of two medications contributed to accidental ingestion in at least one case. Conclusions: Sleep driving and other complex behaviors can occur after zolpidem ingestion. Physicians should assess patients for potential risk factors and inquire about parasomnias. Serious legal and medical complications can occur as a result of these forms of automatic complex behaviors. Citation: Poceta JS. Zolpidem ingestion, automatisms, and sleep driving: a clinical and legal case series. J Clin Sleep Med 2011;7(6):632-638. PMID:22171202

  11. Severe tissue necrosis following intra-arterial injection of endodontic calcium hydroxide: a case series.

    PubMed

    Sharma, Sanjay; Hackett, Robert; Webb, Roger; Macpherson, David; Wilson, Alan

    2008-05-01

    We present 2 cases of intra-arterial injection of endodontic calcium hydroxide via the root canal system of molar teeth. Nonsetting calcium hydroxide paste was used as a temporary dressing during endodontic treatment and in both cases delivered via an injectable syringe technique. Retrograde flow of the calcium hydroxide occurred along the artery until its origin where orthograde flow continued to the capillary bed. Case 1 demonstrates calcium hydroxide injected into the distal root canal of a lower second molar resulting in its distribution to the external carotid bed and case 2 demonstrates calcium hydroxide injected into the palatal root of an upper second molar with flow into the infraorbital artery. In both cases this resulted in severe clinical signs and symptoms ending in tissue necrosis. Long-term sequelae included scarring, deformity, and chronic pain. This case series illustrates the high toxicity of calcium hydroxide when displaced into vessels and soft tissues. Caution should be exercised when using injectable systems for endodontic calcium hydroxide. PMID:18442746

  12. Acquired Factor XIII Inhibitor in Hospitalized and Perioperative Patients: A Systematic Review of Case Reports and Case Series.

    PubMed

    Tone, Kira J; James, Tyler E; Fergusson, Dean A; Tinmouth, Alan; Tay, Jason; Avey, Marc T; Kilty, Shaun; Lalu, Manoj M

    2016-07-01

    Factor XIII (FXIII) cross-links fibrin monomers to support clot stabilization and wound healing. Acquired FXIII deficiency is caused by autoantibodies that inhibit FXIII and can result in bleeding despite normal routine coagulation test results. Given the rarity of this disease, large clinical studies are not feasible. We therefore conducted a systematic review of case reports and case series of acquired FXIII inhibitor to evaluate potential management and treatment strategies for acquired FXIII inhibitor in hospitalized and/or perioperative patients. A systematic search of MEDLINE, Embase, and Web of Science identified reports of hospitalized and perioperative patients with acquired FXIII deficiency. No restrictions were placed on language or publication type. Article screening and data extraction were performed independently by 2 abstractors. Completeness of reporting was evaluated according to modified elements from the CAse REport (CARE) guidelines. A total of 1028 citations were reviewed, with 36 case reports and 3 case series meeting eligibility criteria (63 patients total). The mean age was 60 (range, 9-87) years with balanced sex representation. At presentation, 48 patients (76%) had intramuscular or subcutaneous bleeding, and 34 patients (54%) had external or surgical bleeding. All cases were diagnosed by initially detecting a FXIII deficiency and then identifying the inhibitor. Clinical improvement in bleeding was seen in patients receiving FXIII concentrate (13/17 patients), cryoprecipitate (5/8), and plasma (10/18). Inhibitor reduction was seen in patients who received rituximab (6/6 patients), plasma exchange (2/2), intravenous immunoglobulin (4/5), steroid (15/20), and cyclophosphamide (10/15). Concurrent initiation of multiple therapies and obvious lack of control comparisons made direct association to outcomes difficult to establish. Outcomes were reported for 55 patients, with 25 patients (45%) having complete inhibitor eradication and 15 patients

  13. Endoscopic ear surgery: A case series and first United Kingdom experience

    PubMed Central

    Kanona, Hala; Virk, Jagdeep Singh; Owa, Anthony

    2015-01-01

    AIM: To present the United Kingdom’s first case series of 70 otological cases of endoscopic and non-endoscopic ear surgeries. METHODS: Prospective case series incorporating a range of endoscopic procedures performed using a 4 mm, 18 cm rigid endoscope, performed by a single surgeon at a single centre. Primary outcome measures included mean average pre and post-operative air-bone gap hearing thresholds and duration of surgery. RESULTS: Thirty-eight patients underwent endoscopic assisted ear surgery and 32 underwent non-endoscopic assisted ear surgery. In both surgical groups, there was a significant difference between pre and post-operative mean air-bone gaps (P = 0.02). Mean operating time was comparable between both groups. Eight patients developed post-operative complications. CONCLUSION: Endoscopic ear surgery can be performed safely in a range of otological procedures. This has the potential to become a well-established surgical option for middle ear surgery in the near future. Advantages and limitations are discussed. PMID:25789304

  14. Arthroscopic management of proximal tibial fractures: technical note and case series presentation

    PubMed Central

    BENEA, HOREA; TOMOAIA, GHEORGHE; MARTIN, ARTUR; BARDAS, CIPRIAN

    2015-01-01

    Background and aims The purpose of this article is to describe a new surgical method of arthroscopy assisted treatment of intraarticular proximal tibial fractures (ARIF – arthroscopic reduction and internal fixation), analyzing its efficiency and safety on a series of patients. Tibial plateau fractures affect the proximal tibial metaphyseal and articular surface, representing 1.2% of all fractures and up to 8% of all fractures in elderly. Patients and method Our case series consists of 6 patients with Schatzker types I-III tibial plateau fractures, treated in the Orthopedic and Traumatology Clinic of Cluj-Napoca from July 2012 to August 2014. Patients included in the study presented Schatzker type I-III tibial plateau fracture. Results The results obtained with the arthroscopic method were excellent in 5 cases (mean Rasmussen score 27.60 points) and good in 1 case (mean score 23.75). The radiological consolidation appeared after a mean of 12 weeks. No major complication was noted. Conclusions Diagnosis and treatment of associated lesions, shortening of hospitalization length and postoperative rehabilitation, but also the lower rate of complications, can make arthroscopic reduction and internal fixation the method of choice for the operative treatment of selected Schatzker I-III types of proximal tibial fractures. PMID:26528076

  15. Immediate Effect of Therapeutic Massage on Pain Sensation and Unpleasantness: A Consecutive Case Series

    PubMed Central

    2015-01-01

    Background: Musculoskeletal pain is a common condition that poses a significant burden to its sufferers and costs the US economy billions of dollars each year in lost productivity. Individuals complaining of musculoskeletal pain make up a large proportion of clients treated by massage therapists in community practices, yet few studies have examined the immediate effect of therapeutic massage on this type of pain in the practice setting. Purpose: To assess the immediate effect of therapeutic massage on musculoskeletal pain sensation and unpleasantness in a community setting. Setting: Solo private practice in central Virginia, United States. Participants: One hundred sixteen first-time clients who complained of musculoskeletal pain as a presenting symptom. Research design: Prospective, consecutive practice-based case series. Intervention: A single 60-minute session of individualized therapeutic massage; techniques used included Swedish massage employing effleurage, petrissage, and friction,;deep tissue; myofascial; positional release; passive and resisted joint mobilization; and biofield modalities. Main Outcome Measures: Visual Analog Scales for pain sensation and unpleasantness. Results: Both pain sensation and unpleasantness were significantly reduced by a single session of therapeutic massage. Mean pain sensation decreased from 3.76 (SD=1.87) prior to massage to .89 (SD=1.35) following massage, with t=18.87, P<.001. Mean pain unpleasantness decreased from 5.21 (SD=2.48) prior to massage to .64 (SD=1.23) following massage, with t =20.45, P<.001. Effect sizes were 1.76 and 1.90, respectively. Conclusions: In this case series, therapeutic massage appeared to be an effective intervention for common musculoskeletal pain that influenced both the physical and affective dimension of the pain experience. Although care was taken to reduce potential bias through limiting eligibility to first time clients and use of a standardized script, practice-based case series have

  16. Four cases of echogenic breast lesions: a case series and review

    PubMed Central

    Goh, Lin Wah; Wong, Su Lin Jill; Tan, Puay Hoon

    2016-01-01

    Echogenic breast lesions are generally thought to be benign. We herein report four cases of echogenic breast lesions that were seen at our centre over 38 months. One patient had a prior history of wide excision and radiotherapy for breast cancer and was imaged as part of routine cancer surveillance, while the other three were recalled for further assessment following an abnormal screening mammogram. All four patients were assessed on ultrasonography, which demonstrated an echogenic lesion in each patient. All four lesions underwent ultrasonography-guided core biopsy, followed by excision biopsy. The indications for biopsy were interval increase in the size of lesion or indeterminate features demonstrated in the lesion. Three lesions were benign, while the lesion from the patient who had received previous radiotherapy was angiosarcoma. Not all echogenic lesions are benign and lesions with suspicious features on ultrasonography should undergo biopsy. PMID:26891743

  17. Collaborative case conferences in rectal cancer: case series in a tertiary care centre

    PubMed Central

    Eskicioglu, C.; Forbes, S.; Tsai, S.; Francescutti, V.; Coates, A.; Grubac, V.; Sonnadara, R.; Simunovic, M.

    2016-01-01

    Background In many hospitals, resource barriers preclude the use of preoperative multidisciplinary cancer conferences (mccs) for consecutive patients with cancer. Collaborative cancer conferences (cccs) are modified mccs that might overcome such barriers. Methods We established a ccc at an academic tertiary care centre to review preoperative plans for patients with rectal cancer. Attendees included only surgeons who perform colorectal cancer procedures and a radiologist with expertise in cross-sectional imaging. Individual reviews began with the primary surgeon presenting the case information and initial treatment recommendations. Cross-sectional images were then reviewed, the case was discussed, and consensus on ccc-treatment recommendations was achieved. Outcomes for the present study were changes in treatment recommendations defined as “major” (that is, redirection of patient to preoperative radiation from straight-to-surgery or uncertain plan, or redirection of the patient to straight-to-surgery from preoperative radiation or plan uncertain) or as “minor” (that is, referral to a multidisciplinary cancer clinic, request additional tests, change type of neoadjuvant therapy, change type of surgery). Chart reviews provided relevant patient, tumour, and treatment information. Results Between September 2011 and September 2012, 101 rectal cancer patients were discussed at a ccc. Of the 35 management plans (34.7%) that were changed as a result, 8 had major changes, and 27 had minor changes. Available patient and tumour factors did not predict for a change in treatment recommendation. Conclusions Preoperative cccs at a tertiary-care centre changed treatment recommendations for one third of patients with rectal cancer. Given that no specific factor predicted for a treatment plan change, it is likely prudent that all rectal cancer patients undergo some form of collaborative review. PMID:27122982

  18. Analysis of time series of cattle rabies cases in Minas Gerais, Brazil, 2006-2013.

    PubMed

    Lopes, Edna; Sáfadi, Thelma; Da Rocha, Christiane Maria Barcellos Magalhaes; Cardoso, Denis Lucio

    2015-04-01

    Vampire bats are potential transmitters of rabies in rural areas. Cattle rabies is relevant in the state of Minas Gerais due to the increasing cattle herds and geographical features of the area, which are favorable to bat populations. This study evaluated the occurrence of rabies in state cattle by analyzing the time series of monthly values, 2006-2012, describing some aspects of the areas and species affected. The study also pointed out the disease prediction for January-December 2013. We used monthly data of cases reported to the Continental Epidemiological Surveillance System (SIVCONT) of the Ministry of Agriculture, Livestock, and Supply (MAPA), January 2006-March 2013. We also collected data on municipalities and other animal species affected by rabies for a descriptive analysis of the disease. The results indicate that cattle rabies is endemic in the State, with different intensities in different regions. The variables frequency of notifications and bat shelters had a positive and regular correlation (P = 0.035; r = 0.567) between them. With respect to data series, there was a fluctuation of the number of cases (5 to 29 cases per month) over 2006 and 2013, without trend or seasonality, although there would visually appear to be a downward trend. The results also suggest that the forecasting method is suitable for predicting future cases. Bovine species had the highest number of reporting, with 1007 cases (88.88 %), followed by equine species with 112 (9.89 %). The information provided by this study may help understand disease occurrence and find the most effective measures for rabies control in endemic areas. PMID:25698529

  19. Case Series of First Metatarsophalangeal Joint Injuries in Division 1 College Athletes

    PubMed Central

    Faltus, John; Mullenix, Kerry; Moorman, Claude T.; Beatty, Kyle; Easley, Mark E.

    2014-01-01

    Context: Injuries of the first metatarsophalangeal (hallux MP) joint can be debilitating in the athletic population. Turf toe and plantar plate injuries are typically diagnosed similarly. However, variance in injury mechanism as well as compromised integrity of soft tissue and ligamentous structures make it difficult to accurately diagnose specific hallux MP injuries. Recent literature has supported the use of both radiographic imaging and the Lachman test as reliable indicators of joint instability in the presence of hallux MP injuries. To date, research supporting specific rehabilitation interventions and return-to-play decision making for hallux MP injuries has been limited to case studies and suggested guidelines from literature reviews. There is limited evidence suggesting specific criteria for surgical and nonsurgical decision making in conjunction with rehabilitation progressions to return an athlete to sport when managing hallux MP injuries. Evidence Acquisition: A literature search was performed using Medline, PubMed, and Google Scholar to find and review articles from 1970 to 2013 that addressed the basic anatomy of the plantar plate, injuries to this anatomical structure, and the evaluation, diagnosis, surgical and nonsurgical management, and rehabilitation of these injuries, specifically in the athletic population. Medical information for each case was gathered from electronic medical records from the individual athletes cited in this case series, which included imaging reports, rehabilitation documentation, and both evaluation and surgical reports. No statistical analysis was used. Study Design: Case series. Level of Evidence: Level 4. Results: Treatment plans for each case varied depending on surgical and nonsurgical intervention and rehabilitation outcomes. However, each athlete was able to return to sports-specific activities. Conclusion: Successful outcomes for hallux MP injuries are contingent on thorough evaluation, appropriate clinical decision

  20. All that looks like "Brugada" is not "Brugada": Case series of Brugada phenocopy caused by hyponatremia.

    PubMed

    Agrawal, Yashwant; Aggarwal, Sourabh; Kalavakunta, Jagadeesh K; Gupta, Vishal

    2016-10-01

    Brugada syndrome (BS), a life-threatening channelopathy associated with reduced inward sodium current due to dysfunctional sodium channels, is characterized by ST-segment elevation with downsloping "coved type" (type 1) or "saddle back" (type 2) pattern in V1-V3 precordial chest leads (1, 2). Brugada phenocopy, a term describing conditions inducing Brugada-like pattern of electrocardiogram (EKG) manifestations in patients without true BS, is an emerging condition (3). We describe a case series of Brugada phenocopy with hyponatremia. PMID:27688678

  1. The versatility of intraosseous vascular access in perioperative medicine: a case series.

    PubMed

    Anson, Jonathan A; Sinz, Elizabeth H; Swick, John T

    2015-02-01

    Intraosseous vascular access is a time-tested procedure that is reemerging in popularity. This is primarily a result of the emphasis on intraosseous access in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Advanced Cardiac Life Support. Modern intraosseous insertion devices are easy to learn and use, suggesting the possibility of use beyond the resuscitation setting. We present a case series of recent intraosseous insertions for a variety of indications by anesthesiologists at our institution to demonstrate the potential utility of this alternative access technique. PMID:25547826

  2. Oncoplastic breast surgery for centrally located breast cancer: a case series

    PubMed Central

    Yoshinaka, Heiji; Shinden, Yoshiaki; Hirata, Munetsugu; Nakajo, Akihiro; Arima, Hideo; Okumura, Hiroshi; Kurahara, Hiroshi; Ishigami, Sumiya; Natsugoe, Shoji

    2014-01-01

    Oncoplastic breast surgery (OBS), which combines the concepts of oncologic and plastic surgery, is becoming more common worldwide. We herein report the results of OBS in Japanese patients with centrally located breast cancer (CLBC) and Paget’s disease. We performed OBS combining partial mastectomy and immediate volume replacement on patients with non-ptotic and/or small breasts, and volume reduction surgery for patients with ptotic breasts, as reported in Western countries. Japanese encounters are described in this report as a case series. PMID:25083497

  3. A Unique Incidental Finding in Two Young Dancers: A Case Series.

    PubMed

    Miller, Marshal N; Close, Jeremy D

    2015-01-01

    Dancers frequently present to the sports medicine clinic with a variety of lower extremity complaints ranging from acute and traumatic injuries to more chronic, overuse injuries. This case series depicts a similar and unique incidental radiographic finding found in 2 young dancers seen at the same sports medicine clinic. While the findings are likely benign and unrelated to both patients' initial presentation, the finding of acroosteolysis can be found in more serious systemic and genetic processes as well an early finding in repetitive trauma. PMID:26502417

  4. Publication Ethics: A Case Series with Recommendations According to Committee on Publication Ethics (COPE)

    PubMed Central

    Fazly Bazzaz, Bibi Seddigheh; Sadeghi, Ramin

    2012-01-01

    Ethical misconduct is not a new issue in the history of science and literature. However, ethical misconducts in science have grown considerably in the modern era which is due to emphasis on the scientific proliferation in research institutes and gauging scientists according to their publications. In the current case series, several misconducts occurring over the previous years in Mashhad University of Medical Sciences (Mashhad, Iran) either for Journals or Faculty members were gathered and specific recommendations were provided to avoid similar events in the future. All recommendations are according to Committee on Publication Ethics (COPE). PMID:23493618

  5. Case series on anesthesia for video-assisted thoracoscopic surgery for congenital diaphragmatic hernia in children

    PubMed Central

    Aggarwal, Anurag; Lohani, Rohit; Suresh, Varun

    2016-01-01

    Video-assisted thoracoscopic surgery (VATS) in the pediatric population is a challenging task for any anesthesiologist, moreover considering the high incidence of associated congenital anomalies which are individual predictors of poor prognosis. A thorough preoperative evaluation, knowledge of the physiology of one lung ventilation - pertaining to various methods of lung isolation, individualized meticulous planning, and continuous vigilance to detect any untoward event at the earliest with good communication between the anesthesiology and surgical teams contributes to a safe and successful surgery. We present a case series of anesthetic management of congenital diaphragmatic hernia with VATS. PMID:26957707

  6. Spinal cord ependymoma: a review of the literature and case series of ten patients.

    PubMed

    Celano, Emma; Salehani, Arsalaan; Malcolm, James G; Reinertsen, Erik; Hadjipanayis, Constantinos G

    2016-07-01

    Spinal cord ependymoma (SCE) is a rare tumor that is most commonly low-grade. Complete surgical resection has been established as first-line treatment and can be curative. However, SCEs tend to recur when complete tumor resection is not possible. Evidence supporting the use of adjuvant radiation and chemotherapy is not definitive. We review the most recent literature on SCE covering a comprehensive range of topics spanning the biology, presentation, clinical management, and outcomes. In addition, we present a case series of ten SCE patients with the goal of contributing to existing knowledge of this rare disease. PMID:27154165

  7. Treatment outcome with guiding flange prosthesis in hemimandibulectomy patients: Case series of three patients

    PubMed Central

    Kar, Sushil; Tripathi, Arvind; Madhok, Riti

    2015-01-01

    There are various indications that may necessitate partial or complete resection of the mandible, from trauma to congenital deformities. However, the most prevalent indication that requires surgical resection of the mandible along with the involved adjacent oral structures is the presence of a locally aggressive neoplastic growth. The resultant continuity defect leads to an alteration in the range and direction of mandibular movement, impedes clear articulation of syllables and cosmetic disfigurement. The role of a prosthodontist is paramount in bringing about the restoration of the esthetic and functional dysfunction. This article discusses a series of hemimandibulectomy cases wherein mandibular deviation was successfully corrected using guide-flange prosthesis. PMID:26981486

  8. Occupational asthma in the commercial fishing industry: a case series and review of the literature.

    PubMed

    Lucas, David; Lucas, Raymond; Boniface, Keith; Jegaden, Dominique; Lodde, Brice; Dewitte, Jean-Ariel

    2010-01-01

    We present a case series of snow crab-induced occupational asthma (OA) from a fishing and processing vessel, followed by a review of OA in the commercial fishing industry. OA is typically caused from an IgE-mediated hypersensitivity reaction after respiratory exposure to aerosolized fish and shellfish proteins. It more commonly occurs due to crustaceans, but molluscs and fin fish are implicated as well. Standard medical therapy for asthma may be used acutely; however, steps to reduce atmospheric allergen concentrations in the workplace have proven to be preventive for this disease.

  9. Congenital familial subglottic stenosis: a case series and review of literature.

    PubMed

    Manickavasagam, J; Yapa, S; Bateman, N D; Thevasagayam, M S

    2014-02-01

    Subglottic stenosis is a narrowing of the endolarynx and maybe classified as congenital (primary) or acquired (secondary). Congenital stenosis maybe caused by a small cricoid cartilage, thick submucosa or other laryngeal abnormalities and remains a well-known cause of stridor in infancy. It occurs sporadically and familial occurrence is rare. Our case series identifies three children with congenital subglottic stenosis born to consanguineous parents. Congenital subglottic stenosis in siblings of unrelated parents has been previously reported, but not in consanguineous parents indicating a strong genetic link. We recommend further genetic research to assess the mode of possible heritage in this disease.

  10. Hypnobehavioral approaches for school-age children with dysphagia and food aversion: a case series.

    PubMed

    Culbert, T P; Kajander, R L; Kohen, D P; Reaney, J B

    1996-10-01

    The purpose of this article is to describe hypnobehavioral treatment of five school-age children with maladaptive eating behaviors, including functional dysphagia, food aversion, globus hystericus, and conditioned fear of eating (phagophobia). The unique treatment approach described emphasizes the successful use of self-management techniques, particularly hypnosis, by all five children. Common etiological factors, treatment strategies, and proposed mechanisms of change are discussed. To the authors' knowledge, this is the first such case series in the mainstream pediatric literature describing the use of a hypnobehavioral approach for children with these maladaptive eating problems.

  11. Motion-related vascular abnormalities at the craniocervical junction: illustrative case series and literature review.

    PubMed

    Ravindra, Vijay M; Neil, Jayson A; Mazur, Marcus D; Park, Min S; Couldwell, William T; Taussky, Philipp

    2015-04-01

    The craniocervical junction (CCJ) functions within a complicated regional anatomy necessary to protect and support vital neurovascular structures. In select instances, vascular pathology can be attributed to this complicated interplay of motion and structure found within this narrow space. The authors report 3 cases of complex vascular pathology related to motion at the CCJ and detail the management of these cases. Two cases involved posterior circulation vascular compression syndromes, and one case involved a vascular anomaly and its relation to aneurysm formation and rupture. The patient in Case 1 was a 66-year-old man with a history of syncopal episodes resulting from the bilateral vertebral artery becoming occluded when he rotated his head. Successful microsurgical decompression at the skull base resulted in patent bilateral vertebral artery V3 segments upon head movement in all directions. The patient in Case 2 was a 53-year-old woman who underwent elective resection of a right temporal meningioma and who experienced postoperative drowsiness, dysphagia, and mild right-arm ataxia. Subsequent MRI demonstrated bilateral posterior inferior cerebel-lar artery (PICA) strokes. Cerebral angiography showed a single PICA, of extradural origin, supplying both cerebellar hemispheres. The PICA exhibited dynamic extradural compression when the patient rotated her head; the bilateral PICA strokes were due to head rotation during surgical positioning. In Case 3, a 37-year-old woman found unconscious in her home had diffuse subarachnoid hemorrhage and evidence of a right PICA aneurysm. A right far-lateral craniectomy was performed for aneurysm clipping, and she was found to have a dissecting aneurysm with an associated PICA originating extradurally. There was a shearing phenomenon of the extradural PICA along the dura of the foramen magnum, and this microtraumatic stress imposed on the vessel resulted in a dissecting aneurysm. This series of complex and unusual cases

  12. Inter-regional variability in environmental availability of fungicide derived copper in vineyard soils: an Australian case study.

    PubMed

    Wightwick, Adam M; Salzman, Scott A; Reichman, Suzanne M; Allinson, Graeme; Menzies, Neal W

    2010-01-13

    This study determined the environmental availability of copper (Cu) in Australian vineyard soils contaminated with fungicide derived Cu residues, and investigated the soil characteristics correlated with differences in Cu availability between regions. Concentrations of 0.01 M calcium chloride extractable Cu, measured in surface soils collected from 98 vineyards in 10 different grape-growing regions of Australia, ranged from <0.1 to 0.94 mg/kg and accounted for 0.10-1.03% of the total Cu concentrations in the soils. Differences in the calcium chloride extractable Cu concentrations were related to the total Cu concentration and soil properties, including pH, clay, exchangeable K, silt, and calcium carbonate. The information generated from this study may prove useful in devising strategies to reduce the availability and toxicity of Cu in agricultural soils.

  13. Drivers and annual estimates of marine wildlife entanglement rates: A long-term case study with Australian fur seals.

    PubMed

    McIntosh, Rebecca R; Kirkwood, Roger; Sutherland, Duncan R; Dann, Peter

    2015-12-30

    Methods of calculating wildlife entanglement rates are not standardised between studies and often ignore the influence of observer effort, confounding comparisons. From 1997-2013 we identified 359 entangled Australian fur seals at Seal Rocks, south-eastern Australia. Most entanglement materials originated from commercial fisheries; most frequently entangling pups and juveniles. Using Generalized Additive Mixed Models, which incorporated observer effort and survey frequency, we identified that entanglements were observed more frequently amongst pups from July to October as they approached weaning. Neither the decline in regional fishing intensity nor changing seal population size influenced the incidence of entanglements. Using the models, we estimated that 302 (95% CI=182-510) entangled seals were at Seal Rocks each year, equivalent to 1.0% (CI=0.6-1.7%) of the site population. This study highlights the influence of observer effort and the value of long-term datasets for determining the drivers of marine debris entanglements. PMID:26475026

  14. Drivers and annual estimates of marine wildlife entanglement rates: A long-term case study with Australian fur seals.

    PubMed

    McIntosh, Rebecca R; Kirkwood, Roger; Sutherland, Duncan R; Dann, Peter

    2015-12-30

    Methods of calculating wildlife entanglement rates are not standardised between studies and often ignore the influence of observer effort, confounding comparisons. From 1997-2013 we identified 359 entangled Australian fur seals at Seal Rocks, south-eastern Australia. Most entanglement materials originated from commercial fisheries; most frequently entangling pups and juveniles. Using Generalized Additive Mixed Models, which incorporated observer effort and survey frequency, we identified that entanglements were observed more frequently amongst pups from July to October as they approached weaning. Neither the decline in regional fishing intensity nor changing seal population size influenced the incidence of entanglements. Using the models, we estimated that 302 (95% CI=182-510) entangled seals were at Seal Rocks each year, equivalent to 1.0% (CI=0.6-1.7%) of the site population. This study highlights the influence of observer effort and the value of long-term datasets for determining the drivers of marine debris entanglements.

  15. Catheter Ablation of Arrhythmias Exclusively Using Electroanatomic Mapping: A Series of Cases

    PubMed Central

    Pires, Leonardo Martins; Leiria, Tiago Luiz Luz; Kruse, Marcelo Lapa; Ronsoni, Rafael; Gensas, Caroline Saltz; de Lima, Gustavo Glotz

    2013-01-01

    Background Catheter ablation is a treatment that can cure various cardiac arrhythmias. Fluoroscopy is used to locate and direct catheters to areas that cause arrhythmias. However, fluoroscopy has several risks. Electroanatomic mapping (EAM) facilitates three-dimensional imaging without X-rays, which reduces risks associated with fluoroscopy. Objective We describe a series of patient cases wherein cardiac arrhythmia ablation was exclusively performed using EAM. Methods Patients who presented with cardiac arrhythmias that were unresponsive to pharmacological therapy were prospectively selected between March 2011 and March 2012 for arrhythmia ablation exclusively through EAM. Patients with indications for a diagnostic electrophysiology study and ablation of atrial fibrillation, left atrial tachyarrhythmias as well as hemodynamically unstable ventricular arrhythmia were excluded. We documented the procedure time, success rate and complications as well as whether fluoroscopy was necessary during the procedure. Results In total, 11 patients were enrolled in the study, including seven female patients (63%). The mean age of the patients was 50 years (SD ±16.5). Indications for the investigated procedures included four cases (35%) of atrial flutter, three cases (27%) of pre-excitation syndrome, two cases (19%) of paroxysmal supraventricular tachycardia and two cases (19%) of ventricular extrasystoles. The mean procedure duration was 86.6 min (SD ± 26 min). Immediate success (at discharge) of the procedure was evident for nine patients (81%). There were no complications during the procedures. Conclusion This study demonstrates the feasibility of performing an arrhythmia ablation exclusively using EAM with satisfactory results. PMID:23877742

  16. Small-cell lung cancer in never-smokers: A case series.

    PubMed

    Tavares e Castro, Ana; Clemente, Joana; Carvalho, L; Freitas, Sara; Cemlyn-Jones, Jessica

    2016-03-01

    Small-cell lung cancer (SCLC) is closely correlated with smoking and only sporadic cases have been reported in non-smoking patients. Environmental tobacco smoke and/or occupational risk factors have been suggested as possible causes of lung cancer in this subset of patients. However, particularly in relation to SCLC there is not enough reliable information. All patients with lung cancer in follow-up for a period of three-months at the Pulmonology Unit of Coimbra University Hospital were retrospectively assessed. From a total of 303 patients, 35 had SCLC, 4 of which were never-smokers and their clinical cases are hereby presented. A detailed questionnaire was given to all patients, which excluded second-hand smoking or occupational hazards. They were all female with a mean age of 63.0 ± 15.7 years. The most frequent complaints were cough, dyspnoea, anorexia and significant weight loss. Diagnosis was obtained by transbronchial biopsies in all cases. Two patients had locally advanced disease and the other two had extensive-disease due to distant metastases. Treatment approaches included first-line chemotherapy with platin and etoposide duplet and partial remission was achieved in half the cases. All patients died; mean survival was 15.8 ± 3.8 months. Further studies are needed for a better understanding of the pathogenicity of non-smoking related SCLC and we hope that this case series with its meticulous exclusion of potential risk factors will be a useful contribution. PMID:26898619

  17. Predicting the Incidence of Smear Positive Tuberculosis Cases in Iran Using Time Series Analysis

    PubMed Central

    MOOSAZADEH, Mahmood; KHANJANI, Narges; NASEHI, Mahshid; BAHRAMPOUR, Abbas

    2015-01-01

    Background: Determining the temporal variation and forecasting the incidence of smear positive tuberculosis (TB) can play an important role in promoting the TB control program. Its results may be used as a decision-supportive tool for planning and allocating resources. The present study forecasts the incidence of smear positive TB in Iran. Methods: This a longitudinal study using monthly tuberculosis incidence data recorded in the Iranian National Tuberculosis Control Program. The sum of registered cases in each month created 84 time points. Time series methods were used for analysis. Based on the residual chart of ACF, PACF, Ljung-Box tests and the lowest levels of AIC and BIC, the most suitable model was selected. Results: From April 2005 until March 2012, 34012 smear positive TB cases were recorded. The mean of TB monthly incidence was 404.9 (SD=54.7). The highest number of cases was registered in May and the difference in monthly incidence of smear positive TB was significant (P<0.001). SARIMA (0,1,1)(0,1,1)12 was selected as the most adequate model for prediction. It was predicted that the incidence of smear positive TB for 2015 will be about 9.8 per 100,000 people. Conclusion: Based on the seasonal pattern of smear positive TB recorded cases, seasonal ARIMA model was suitable for predicting its incidence. Meanwhile, prediction results show an increasing trend of smear positive TB cases in Iran. PMID:26744711

  18. Greenhouse gas network design using backward Lagrangian particle dispersion modelling - Part 1: Methodology and Australian test case

    NASA Astrophysics Data System (ADS)

    Ziehn, T.; Nickless, A.; Rayner, P. J.; Law, R. M.; Roff, G.; Fraser, P.

    2014-09-01

    This paper describes the generation of optimal atmospheric measurement networks for determining carbon dioxide fluxes over Australia using inverse methods. A Lagrangian particle dispersion model is used in reverse mode together with a Bayesian inverse modelling framework to calculate the relationship between weekly surface fluxes, comprising contributions from the biosphere and fossil fuel combustion, and hourly concentration observations for the Australian continent. Meteorological driving fields are provided by the regional version of the Australian Community Climate and Earth System Simulator (ACCESS) at 12 km resolution at an hourly timescale. Prior uncertainties are derived on a weekly timescale for biosphere fluxes and fossil fuel emissions from high-resolution model runs using the Community Atmosphere Biosphere Land Exchange (CABLE) model and the Fossil Fuel Data Assimilation System (FFDAS) respectively. The influence from outside the modelled domain is investigated, but proves to be negligible for the network design. Existing ground-based measurement stations in Australia are assessed in terms of their ability to constrain local flux estimates from the land. We find that the six stations that are currently operational are already able to reduce the uncertainties on surface flux estimates by about 30%. A candidate list of 59 stations is generated based on logistic constraints and an incremental optimisation scheme is used to extend the network of existing stations. In order to achieve an uncertainty reduction of about 50%, we need to double the number of measurement stations in Australia. Assuming equal data uncertainties for all sites, new stations would be mainly located in the northern and eastern part of the continent.

  19. The Emergence of Zoonotic Onchocerca lupi Infection in the United States--A Case-Series.

    PubMed

    Cantey, Paul T; Weeks, Jessica; Edwards, Morven; Rao, Suchitra; Ostovar, G Amin; Dehority, Walter; Alzona, Maria; Swoboda, Sara; Christiaens, Brooke; Ballan, Wassim; Hartley, John; Terranella, Andrew; Weatherhead, Jill; Dunn, James J; Marx, Douglas P; Hicks, M John; Rauch, Ronald A; Smith, Christiana; Dishop, Megan K; Handler, Michael H; Dudley, Roy W R; Chundu, Kote; Hobohm, Dan; Feiz-Erfan, Iman; Hakes, Joseph; Berry, Ryan S; Stepensaski, Shelly; Greenfield, Benjamin; Shroeder, Laura; Bishop, Henry; de Almeida, Marcos; Mathison, Blaine; Eberhard, Mark

    2016-03-15

    This case-series describes the 6 human infections with Onchocerca lupi, a parasite known to infect cats and dogs, that have been identified in the United States since 2013. Unlike cases reported outside the country, the American patients have not had subconjunctival nodules but have manifested more invasive disease (eg, spinal, orbital, and subdermal nodules). Diagnosis remains challenging in the absence of a serologic test. Treatment should be guided by what is done for Onchocerca volvulus as there are no data for O. lupi. Available evidence suggests that there may be transmission in southwestern United States, but the risk of transmission to humans is not known. Research is needed to better define the burden of disease in the United States and develop appropriately-targeted prevention strategies. PMID:26611778

  20. Tinea genitalis: a new entity of sexually transmitted infection? Case series and review of the literature

    PubMed Central

    Luchsinger, Isabelle; Bosshard, Philipp Peter; Kasper, Romano Silvio; Reinhardt, Dominic; Lautenschlager, Stephan

    2015-01-01

    Objective Investigation on recent cases of tinea genitalis after travelling to South East Asia. Methods Patients with tinea in the genital region, which emerged after sex in South East Asia, underwent further assessment including microscopy, cultures and DNA analyses. Results The case series includes seven patients. In six patients, Trichophyton interdigitale (former Trichophyton mentagrophytes) was detected. Three patients suffered from a severe inflammatory reaction of the soft tissue and two of them needed hospitalisation due to severe pain. In four patients, cicatrising healing was noticed. Five patients were declared incapacitated for work. Conclusions Sexual activity should be considered as a potentially important and previously underappreciated means of transmission of T. interdigitale. To avoid irreversible scarring alopecia, prompt initiation of antifungal treatment is essential and adequate isolation and identification of the pathogen is mandatory. PMID:26071391

  1. Cranial nerve injuries with supraglottic airway devices: a systematic review of published case reports and series.

    PubMed

    Thiruvenkatarajan, V; Van Wijk, R M; Rajbhoj, A

    2015-03-01

    Cranial nerve injuries are unusual complications of supraglottic airway use. Branches of the trigeminal, glossopharyngeal, vagus and the hypoglossal nerve may all be injured. We performed a systematic review of published case reports and case series of cranial nerve injury from the use of supraglottic airway devices. Lingual nerve injury was the most commonly reported (22 patients), followed by recurrent laryngeal (17 patients), hypoglossal (11 patients), glossopharyngeal (three patients), inferior alveolar (two patients) and infra-orbital (one patient). Injury is generally thought to result from pressure neuropraxia. Contributing factors may include: an inappropriate size or misplacement of the device; patient position; overinflation of the device cuff; and poor technique. Injuries other than to the recurrent laryngeal nerve are usually mild and self-limiting. Understanding the diverse presentation of cranial nerve injuries helps to distinguish them from other complications and assists in their management. PMID:25376257

  2. Nd:YAG laser photocoagulation of benign oral vascular lesions: a case series.

    PubMed

    Medeiros, Rui; Silva, Igor Henrique; Carvalho, Alessandra Tavares; Leão, Jair Carneiro; Gueiros, Luiz Alcino

    2015-11-01

    Vascular anomalies of the head and neck are common lesions usually associated with functional and/or aesthetic limitations. The aim of the present paper was to report a case series of oral vascular malformations treated with Nd:YAG laser photocoagulation, highlighting the clinical evolution and post-surgical complications. Fifteen patients diagnosed with oral vascular malformations were treated with Nd:YAG laser followed by three sessions of biostimulation. None of the patients presented post-surgical pain, but 6 of 15 patients (40%) experienced minimal post-surgical complications. All cases presented complete resolution of the lesions after laser treatment. More importantly, 12 out of 15 (80%) resolved after a single session. Low morbidity, minimal patient discomfort, and satisfactory aesthetic results point Nd:YAG laser photocoagulation as a promising option for the management of benign oral vascular lesions.

  3. Multidisciplinary management of Paget-Schroetter syndrome. A case series of eight patients.

    PubMed

    Rosa Salazar, Vladimir; Otálora Valderrama, Sonia Del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés Del Amor; García Méndez, María Del Mar

    2015-08-01

    Paget-Schroetter syndrome (PSS) in the context of upper extremity deep venous thrombosis (DVT) is an uncommon but potentially very serious condition affecting young, healthy adults, in which secondary post-thrombotic syndrome (PTS) can be a complication with major implications. The best treatment option remains controversial, with current guidelines recommending anticoagulation for at least 3 months. However, an incidence of PTS of approximately 50% after 6 months, 30% after 1 year and 25% after 2 years has been found using this therapeutic approach. Consequently, specialized units recommend local thrombolysis and early decompressive surgery. We describe a series of eight cases treated in this way. None of the patients showed signs of complications, and an early return to regular activities with no PTS was observed in 90% of cases.

  4. Imaging in the diagnosis of cemento-ossifying fibroma: a case series.

    PubMed

    Mithra, R; Baskaran, Pavitra; Sathyakumar, M

    2012-01-01

    Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.

  5. Treatment of Myositis Ossificans with acetic acid phonophoresis: a case series

    PubMed Central

    Bagnulo, Angela; Gringmuth, Robert

    2014-01-01

    Objective To create awareness of myositis ossificans (MO) as a potential complication of muscle contusion by presenting its clinical presentation and diagnostic features. An effective method of treatment is offered for those patients who develop traumatic MO. Management: Patients in this case series developed traumatic MO, confirmed on diagnostic ultrasound. Patients participated in a treatment regimen consisting of phonophoresis of acetic acid with ultrasound. Outcome: In all cases, a trial of phonophoresis therapy significantly decreased patient signs, symptoms and the size of the calcification on diagnostic ultrasound in most at a 4-week post diagnosis mark. Discussion: Due to the potential damage to the muscle and its function, that surgical excision carries; safe effective methods of conservative treatment for MO are crucial. MO deserves more attention in the literature due to its common presentation in athletes. PMID:25550659

  6. SNAKE BITE: CASE SERIES OF PATIENTS PRESENTED TO GONDAR UNIVERSITY HOSPITAL, NORTH WEST ETHIOPIA.

    PubMed

    Mekonnen, Desalew; Mitiku, Tadesse; Tamir, Yenesew; Azazh, Aklilu

    2016-04-01

    Snakebite is an important public health challenge. Venomous snake bites cause significant morbidity and mortality if treatment measures, especially antivenom therapy, are delayed. We did a case series of 27 adult patients admitted after snakebite to the medical wards of Gondar University Hospital (GUH) from September 2013 to August 2014. The age range was from 15 to 74 years. The male to female ratio was 8:1. The majority (25) of patients presented after 12 hours of being bitten. Most of the bites occurred on the legs. Hematologic complications, including prolonged bedside whole blood clotting test, bleeding complications and Disseminated Intravascular Coagulation, were the common complications detected. The case fatality rate was 4/27 (14.8%). Availability of affordable snake specific antivenom is recommended. A large population study is needed to address the burden in Ethiopia. PMID:27476228

  7. Photodynamic Therapy as Novel Treatment for Halitosis in Adolescents: A Case Series Study

    PubMed Central

    Lopes, Rubia Garcia; de Santi, Maria Eugenia Simões Onofre; Franco, Bruno Edin; Deana, Alessandro Melo; Prates, Renato Araujo; França, Cristiane Miranda; Fernandes, Kristianne Porta Santos; Ferrari, Raquel Agnelli Mesquita; Bussadori, Sandra Kalil

    2014-01-01

    Introduction: Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% of cases and systemic in 10% of cases. The foul odor is caused mainly by volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H2S) in the presence of amino acids, such as cysteine. Light with and without the combination of chemical agents has been used to induce therapeutic and antimicrobial effects. In photodynamic therapy, the antimicrobial effect is confined to areas covered by the photosensitizing dye. The aim of the present case series study was to evaluate the antimicrobial effect of photodynamic therapy on halitosis in adolescents through the analysis of volatile sulfur compounds measured using a sulfide meter (Halimeter®). Methods: Five adolescents aged 14 to 16 years were evaluated using a sulfide meter before and one hour after photodynamic therapy, which involved the use of methylene blue 0.005% on the middle third and posterior thirds of the dorsum of the tongue and nine points of laser irradiation in the red band (660 nm) with an energy dose of 9 J, power output of 100 mW and 90-seconds exposure time. Results: A 31.8% reduction in the concentration of volatile sulfur compounds was found in the comparison of the initial and final readings. The statistically significant reduction (p = 0.0091) led to an absence of halitosis following treatment (mean: 58.2 ppb). Conclusion: Photodynamic therapy seems to be effective on reduction the concentration of volatile sulfur compounds.Considering the positive effects of photodynamic therapy in this case series, further studies involving microbiological analyses should be conducted to allow comparisons of the results. PMID:25653814

  8. Clinical and radiological observations in a case series of 26 patients with fibrous dysplasia.

    PubMed

    Thomsen, Malissa Dawn; Rejnmark, Lars

    2014-04-01

    Fibrous dysplasia (FD) is a rare disease caused by a sporadic postzygotic missense mutation that leads to abnormal fibroblast proliferation, defective osteoblast differentiation, and increased bone resorption. It may affect one or several bones. Both the mono-ostotic and polyostotic types may be associated with hyperfunctional endocrinopathies and hyperpigmentation of the skin (café-au-lait spots) in the so-called McCune-Albright syndrome (MAS). Due to its rarity, only a few case series are available, making it difficult for most clinicians to judge the severity of the disease. To improve our knowledge of FD, we reviewed all cases of FD treated at our department of endocrinology. Among 26 patients, 17 (65 %) had polyostotic FD, with four being diagnosed with MAS. Patients with polyostotic FD were diagnosed at an earlier age (median 13, range 0.5-64 years) than patients with the mono-ostotic form (median 21, 1-70 years). Craniofacial bones were affected in 80 % of cases, and 66 % complained of bone pain at the affected site, with no difference between patients with mono- and polyostotic FD. Two patients with mono-ostotic and three with polyostotic FD had cranial nerve impairments. Fourteen underwent, at least, one surgery, six (67 %) with mono-ostotic and eight (47 %) with polyostotic FD. Most received treatment with bisphosphonates, but therapy did not result in any clear relief of symptoms or radiological improvements. In conclusion, bone pain is common in patients with FD. The severity of the disease depends on affected bones as mono-ostotic may be as debilitating as polyostotic FD. In our case series, bisphosphonate treatment did not show clear beneficial effects.

  9. Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

    PubMed Central

    Nakamura, Yoshiaki; Kusukawa, Jingo; Tubbs, R. Shane

    2016-01-01

    Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients.

  10. No apparent mineralocorticoid receptor defect in a series of sporadic cases of pseudohypoaldosteronism.

    PubMed

    Arai, K; Tsigos, C; Suzuki, Y; Listwak, S; Zachman, K; Zangeneh, F; Rapaport, R; Chanoine, J P; Chrousos, G P

    1995-03-01

    Pseudohypoaldosteronism (PHA) is characterized by congenital resistance of the kidney and/or other mineralocorticoid target tissues to aldosterone, resulting in excessive salt wasting. Although the mineralocorticoid receptor (MR) was suggested as a potential locus of the defect in this disease, no such abnormality was found in 3 recently reported cases, one of whom belongs to this series of 5 patients. Molecular studies of the MR complementary DNA and gene in this series of sporadic cases of pseudohypoaldosteronism are reported. Four of these patients had multiple mineralocorticoid target tissue resistance, whereas 1 had transient isolated resistance in the kidney. A nonconservative homozygous mutation (C944-->T944, Ala241-->Val241) was identified in the complementary DNA of 4 of the patients but was also found in 62 of 100 normal alleles. One of these 4 patients had an additional conservative heterozygous mutation (A760-->G760, Ileu180-->Val180), which was also present in 11 of 100 normal alleles. None of the patients had any abnormalities in the first untranslated exon and 0.9 kilobases of the 5'-regulatory region of the MR gene, which were fully sequenced and compared with the normal sequence. It is concluded that the mutations identified in 4 of these 5 patients with PHA are polymorphisms, which on their own have no apparent pathophysiological significance. It is hypothesized that the defect causing PHA might be in a post-MR step of aldosterone action or in an unsuspected nonclassic receptor for this hormone. PMID:7883835

  11. Volatile anesthetics for status asthmaticus in pediatric patients: a comprehensive review and case series.

    PubMed

    Carrié, Sabrina; Anderson, Thomas Anthony

    2015-05-01

    Status asthmaticus is an acute, intractable asthma attack refractory to standard interventions that can lead to progressive respiratory failure. Successful management requires a fundamental understanding of the disease process, its clinical presentation, and proper evaluation. Treatment must be instituted early and is aimed at reversing the airway inflammation, bronchoconstriction, and hyper-reactivity that often lead to lower airway obstruction, impaired ventilation, and oxygenation. Most patients are effectively treated with standard therapy including beta2-adrenergic agonists and corticosteroids. Others necessitate adjunctive therapies and escalation to noninvasive ventilation or intubation. We will review the pathophysiology, evaluation, and treatment options for pediatric patients presenting with status asthmaticus with a particular focus on refractory status asthmaticus treated with volatile anesthetics. In addition, we include a proven approach to the management of these patients in the critical care setting, which requires close coordination between critical care and anesthesia providers. We present a case series of three patients, two of which have the longest reported cases of continuous isoflurane use in status asthmaticus. This series was obtained from a retrospective chart review and highlights the efficacy of the volatile anesthetic, isoflurane, in three pediatric patients with refractory life-threatening status asthmaticus. PMID:25580870

  12. Complications associated with negative pressure reaming for harvesting autologous bone graft: a case series.

    PubMed

    Lowe, Jason A; Della Rocca, Gregory J; Murtha, Yvonne; Liporace, Frank A; Stover, Michael D; Nork, Sean E; Crist, Brett D

    2010-01-01

    A technical benefit of the reamer-irrigator-aspirator (RIA) system (Synthes, Paoli, PA) is the ability to harvest large volumes (40-90 cm3) of autogenous bone graft. Early evaluations of this technique have reported few problems, all of which were attributed to technical error. This case series reviews 6 RIA-associated complications including 4 fractures and their contributing risk factors. Cases were collected from 4 independent orthopaedic centers, and all patients underwent RIA bone graft harvesting in a lower extremity long bone injuries. In this population, 2 patients experienced acute RIA-associated events, necessitating an additional procedure or altered postoperative rehabilitation, whereas 4 patients fractured through their donor site in the early postoperative period. This series suggests that surgeons should (1) preoperatively assess cortical diameters at long bone harvest sites, (2) carefully monitor intraoperative reaming, and (3) avoid RIA bone graft harvesting in patients with a history of osteoporosis or osteopenia unless postharvest intramedullary stabilization is considered. PMID:20035178

  13. Cognitive-behavioral therapy for subthreshold bulimia nervosa: A case series.

    PubMed

    Peterson, C B; Miller, K B; Willer, M G; Ziesmer, J; Durkin, N; Arikian, A; Crow, S J

    2011-09-01

    The extent to which cognitive-behavioral therapy (CBT) is helpful in treating individuals with bulimic symptoms who do not meet full criteria for bulimia nervosa is unclear. The purpose of this investigation was to examine the potential efficacy of CBT for eating disorder individuals with bulimic symptoms who do not meet full criteria for bulimia nervosa. Twelve participants with subthreshold bulimia nervosa were treated in a case series with 20 sessions of CBT. Ten of the 12 participants (83.3%) completed treatment. Intent-to-treat abstinent percentages were 75.0% for objectively large episodes of binge eating (OBEs), 33.3% for subjectively large episodes of binge eating (SBEs), and 50% for purging at end of treatment. At one year follow-up, 66.7% were abstinent for OBEs, 41.7% for SBEs, and 50.0% for purging. The majority also reported improvements in associated symptoms. This case series provides support for the use of CBT with individuals with subthreshold bulimia nervosa.

  14. Sedative Dosing of Propofol for Treatment of Migraine Headache in the Emergency Department: A Case Series

    PubMed Central

    Mosier, Jarrod; Roper, Grant; Hays, Daniel; Guisto, John

    2013-01-01

    Introduction: Migraine headaches requiring an emergency department visit due to failed outpatient rescue therapy present a significant challenge in terms of length of stay (LOS) and financial costs. Propofol therapy may be effective at pain reduction and reduce that length of stay given its pharmacokinetic properties as a short acting intravenous sedative anesthetic and pharmacodynamics on GABA mediated chloride flux. Methods: Case series of 4 patients presenting to an urban academic medical center with migraine headache failing outpatient therapy. Each patient was given a sedation dose (1 mg/kg) of propofol under standard procedural sedation precautions. Results: Each of the 4 patients experienced dramatic reductions or complete resolution of headache severity. LOS for 3 of the 4 patients was 50% less than the average LOS for patients with similar chief complaints to our emergency department. 1 patient required further treatment with standard therapy but had a significant reduction in pain and a shorter LOS. There were no episodes of hypotension, hypoxia, or apnea during the sedations. Conclusion: In this small case series, sedation dose propofol appears to be effective and safe for the treatment of refractory migraines, and may result in a reduced LOS. PMID:24381692

  15. Successful treatment of rare-earth magnet ingestion via minimally invasive techniques: a case series.

    PubMed

    Kosut, Jessica S; Johnson, Sidney M; King, Jeremy L; Garnett, Gwendolyn; Woo, Russell K

    2013-04-01

    Cases of rare-earth magnet ingestions have been increasingly reported in the literature. However, these descriptions have focused on the severity of the injuries, rather than the clinical presentation and/or therapeutic approach. We report a series of eight children, ranging in age from 2 to 10 years, who ingested powerful rare-earth magnets. The rare-earth magnets were marketed in 2009 under the trade name Buckyballs(®) (Maxfield & Oberton, New York, NY). They are about 5 mm in size, spherical, and brightly colored, making them appealing for young children to play with and place in their mouths. Three children presented within hours of ingestion, and the magnets were successfully removed via endoscopy in two, whereas the third child required laparoscopy. No fistulas were found in these children. A fourth child presented 2 days after ingestion with evidence of bowel wall erosion, but without fistula formation; the magnets were removed via laparoscopy. A fifth child ingested nine magnets in a ring formation, which were removed via colonoscopy without evidence of injury or fistula formation. The three remaining children presented late (5-8 days after ingestion) and were found to have associated fistulas. They were treated successfully with a combination of endoscopy and laparoscopy with fluoroscopy. None of the children in our series required an open surgical procedure. All children were discharged home without complications. This case series highlights the potential dangers of rare-earth magnet ingestion in children. Our experience suggests that prompt intervention using minimally invasive approaches can lead to successful outcomes.

  16. Five-Year Antimicrobial Resistance Patterns of Urinary Escherichia coli at an Australian Tertiary Hospital: Time Series Analyses of Prevalence Data

    PubMed Central

    Fasugba, Oyebola; Mitchell, Brett G.; Mnatzaganian, George; Das, Anindita; Collignon, Peter; Gardner, Anne

    2016-01-01

    This study describes the antimicrobial resistance temporal trends and seasonal variation of Escherichia coli (E. coli) urinary tract infections (UTIs) over five years, from 2009 to 2013, and compares prevalence of resistance in hospital- and community-acquired E. coli UTI. A cross sectional study of E. coli UTIs from patients attending a tertiary referral hospital in Canberra, Australia was undertaken. Time series analysis was performed to illustrate resistance trends. Only the first positive E. coli UTI per patient per year was included in the analysis. A total of 15,022 positive cultures from 8724 patients were identified. Results are based on 5333 first E. coli UTIs, from 4732 patients, of which 84.2% were community-acquired. Five-year hospital and community resistance rates were highest for ampicillin (41.9%) and trimethoprim (20.7%). Resistance was lowest for meropenem (0.0%), nitrofurantoin (2.7%), piperacillin-tazobactam (2.9%) and ciprofloxacin (6.5%). Resistance to amoxycillin-clavulanate, cefazolin, gentamicin and piperacillin-tazobactam were significantly higher in hospital- compared to community-acquired UTIs (9.3% versus 6.2%; 15.4% versus 9.7%; 5.2% versus 3.7% and 5.2% versus 2.5%, respectively). Trend analysis showed significant increases in resistance over five years for amoxycillin-clavulanate, trimethoprim, ciprofloxacin, nitrofurantoin, trimethoprim-sulphamethoxazole, cefazolin, ceftriaxone and gentamicin (P<0.05, for all) with seasonal pattern observed for trimethoprim resistance (augmented Dickey-Fuller statistic = 4.136; P = 0.006). An association between ciprofloxacin resistance, cefazolin resistance and ceftriaxone resistance with older age was noted. Given the relatively high resistance rates for ampicillin and trimethoprim, these antimicrobials should be reconsidered for empirical treatment of UTIs in this patient population. Our findings have important implications for UTI treatment based on setting of acquisition. PMID:27711250

  17. Sonography of Occult Rib and Costal Cartilage Fractures: A Case Series

    PubMed Central

    Mattox, Ross; Reckelhoff, Kenneth E.; Welk, Aaron B.; Kettner, Norman W.

    2014-01-01

    Objective The purpose of this case series is to describe the use of diagnostic ultrasound (US) in the detection of occult rib and costal cartilage fractures presenting as chest wall pain to a chiropractic clinic. Clinical features Three patients presented with chest wall pain and tenderness. Two of the patients presented with acute chest wall injury and 1 carried a previous diagnosis of rib fracture after trivial trauma 2 months earlier. Intervention and outcomes Diagnostic US was selected as a non-ionizing imaging tool for these patients after negative digital radiography studies. All fractures were considered isolated as there was no associated injury, such as pneumothorax. Both of the acute cases were followed up to complete healing (evidence of osseous union) using US. All patients eventually achieved pain-free status. Conclusion In these cases, US was more sensitive than radiography for diagnosing these cases of acute rib and costal cartilage fractures. Early recognition of rib injury could avoid potential complications from local manipulative therapy. PMID:25685124

  18. Symptomatic retention of the patency capsule: a multicenter real life case series

    PubMed Central

    Kopylov, Uri; Nemeth, Artur; Cebrian, Alba; Wurm Johansson, Gabriele; Thorlacius, Henrik; Fernandez-Urien Sainz, Ignacio; Koulaouzidis, Anastasios; Eliakim, Rami; Toth, Ervin

    2016-01-01

    Background and aims: The patency capsule is designed to evaluate the patency of the small bowel before administration of small-bowel capsule endoscopy (SBCE) in patients at high risk of retention. The utilization of a patency capsule may be associated with a risk of symptomatic retention, but very few cases have been reported to date. The aim of our study was to describe our experience with this rare complication of a patency capsule. Methods: This was a multicenter retrospective case series. The medical records of patients who underwent a patency capsule test were scanned and all cases of symptomatic retention were collected. Results: In total, 20 symptomatic cases of retention out of 1615 (1.2 %) patency capsule tests were identified; in one patient, the patency capsule was retained in the esophagus, in the rest, the capsule was detected in the small bowel resulting in abdominal pain or small-bowel obstruction. One patient (5 %) required surgery; all other patients resolved spontaneously or after corticosteroid therapy. Conclusions: Symptomatic patency capsule retention is a very rare complication with a favorable prognosis. It should be recognized but its use in patients with suspected small-bowel stenosis should not be discouraged.

  19. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series

    PubMed Central

    Jaeger, Marie; Harats, Moti; Kornhaber, Rachel; Aviv, Uri; Zerach, Amir; Haik, Josef

    2016-01-01

    Hypergranulation tissue (or also known as overgranulation) may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal®. All five cases underwent surgical debridement and split-skin grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3–41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds. PMID:27570466

  20. Symptomatic retention of the patency capsule: a multicenter real life case series

    PubMed Central

    Kopylov, Uri; Nemeth, Artur; Cebrian, Alba; Wurm Johansson, Gabriele; Thorlacius, Henrik; Fernandez-Urien Sainz, Ignacio; Koulaouzidis, Anastasios; Eliakim, Rami; Toth, Ervin

    2016-01-01

    Background and aims: The patency capsule is designed to evaluate the patency of the small bowel before administration of small-bowel capsule endoscopy (SBCE) in patients at high risk of retention. The utilization of a patency capsule may be associated with a risk of symptomatic retention, but very few cases have been reported to date. The aim of our study was to describe our experience with this rare complication of a patency capsule. Methods: This was a multicenter retrospective case series. The medical records of patients who underwent a patency capsule test were scanned and all cases of symptomatic retention were collected. Results: In total, 20 symptomatic cases of retention out of 1615 (1.2 %) patency capsule tests were identified; in one patient, the patency capsule was retained in the esophagus, in the rest, the capsule was detected in the small bowel resulting in abdominal pain or small-bowel obstruction. One patient (5 %) required surgery; all other patients resolved spontaneously or after corticosteroid therapy. Conclusions: Symptomatic patency capsule retention is a very rare complication with a favorable prognosis. It should be recognized but its use in patients with suspected small-bowel stenosis should not be discouraged. PMID:27652302

  1. Case Series of an Intraoral Balancing Appliance Therapy on Subjective Symptom Severity and Cervical Spine Alignment

    PubMed Central

    Lee, Young Jun; Lee, Joo Kang; Jung, Soo Chang; Lee, Hwang-woo; Yin, Chang Shik; Lee, Young Jin

    2013-01-01

    Objective. The objective of this study was to investigate the effect of a holistic intraoral appliance (OA) on cervical spine alignment and subjective symptom severity. Design. An observational study on case series with holistic OA therapy. Setting. An outpatient clinic for holistic temporomandibular joint (TMJ) therapy under the supervision of the Pain Center, CHA Biomedical center, CHA University. Subjects. Ambulatory patients presenting with diverse chief complaints in the holistic TMJ clinic. Main Measures. Any immediate change in the curvature of cervical spine and the degree of atlantoaxial rotation was investigated in the images of simple X-ray and computed tomography of cervical spine with or without OA. Changes of subjective symptom severity were also analyzed for the holistic OA therapy cases. Results. A total of 59 cases were reviewed. Alignment of upper cervical spine rotation showed an immediate improvement (P < 0.001). Changes of subjective symptom severity also showed significant improvement (P < 0.05). Conclusion. These cases revealed rudimentary clinical evidence that holistic OA therapy may be related to an alleviated symptom severity and an improved cervical spinal alignment. These results show that further researches may warrant for the holistic TMJ therapy. PMID:23935655

  2. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series.

    PubMed

    Jaeger, Marie; Harats, Moti; Kornhaber, Rachel; Aviv, Uri; Zerach, Amir; Haik, Josef

    2016-01-01

    Hypergranulation tissue (or also known as overgranulation) may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal(®). All five cases underwent surgical debridement and split-skin grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3-41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds. PMID:27570466

  3. Determining Financial Capability of SSI/SSDI Beneficiaries with Psychiatric Disabilities: A Case Series

    PubMed Central

    Lazar, Christina M.; Black, Anne C.; McMahon, Thomas J; O’Shea, Kevin; Rosen, Marc I.

    2015-01-01

    Objective Social Security beneficiaries’ liberty is constrained if they are judged incapable of managing their disability payments and are assigned a fiduciary to manage benefit payments on their behalf. Conversely, beneficiaries’ well-being may be compromised if they misspend money that they need to survive. Several studies have shown that determinations of financial capability are made inconsistently and capability guidelines appear to be applied inconsistently in practice. This case series describes the ambiguities remaining for a small number of individuals even after published criteria for capability— failing to meet basic needs and/or harmful spending on drugs— are applied. Methods Trained, experienced assessors rated the financial capability of 119 individuals in intensive outpatient or inpatient psychiatric facilities who received SSI or SSDI payments. Ten individuals’ cases were determined difficult to judge. Results Six sources of ambiguity were identified by case review: distinguishing incapability from the challenges of navigating poverty, the amount of nonessential spending needed to be considered incapable, the amount of spending on harmful things needed to be considered incapable, how intermittent periods of capability and incapability should be considered, the relative weighting of past behavior and future plans to change, and discrepancies between different sources of information. Conclusion The cases raise fundamental questions about what financial incapability is, but also illustrate how detailed consideration of beneficiaries’ living situations and decision making can inform the difficult dichotomous decision about capability. PMID:25727116

  4. Manual Therapy and Exercise to Improve Outcomes in Patients With Muscle Tension Dysphonia: A Case Series

    PubMed Central

    Archer, Kristin R.

    2015-01-01

    Background and Purpose Muscle tension dysphonia (MTD), a common voice disorder that is not commonly referred for physical therapy intervention, is characterized by excessive muscle recruitment, resulting in incorrect vibratory patterns of vocal folds and an alteration in voice production. This case series was conducted to determine whether physical therapy including manual therapy, exercise, and stress management education would be beneficial to this population by reducing excess muscle tension. Case Description Nine patients with MTD completed a minimum of 9 sessions of the intervention. Patient-reported outcomes of pain, function, and quality of life were assessed at baseline and the conclusion of treatment. The outcome measures were the numeric rating scale (NRS), Patient-Specific Functional Scale (PSFS), and Voice Handicap Index (VHI). Cervical and jaw range of motion also were assessed at baseline and postintervention using standard goniometric measurements. Outcomes Eight of the patients had no pain after treatment. All 9 of the patients demonstrated an improvement in PSFS score, with 7 patients exceeding a clinically meaningful improvement at the conclusion of the intervention. Three of the patients also had a clinically meaningful change in VHI scores. All 9 of the patients demonstrated improvement in cervical flexion and lateral flexion and jaw opening, whereas 8 patients improved in cervical extension and rotation postintervention. Discussion The findings suggest that physical therapists can feasibly implement an intervention to improve outcomes in patients with MTD. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the intervention. A clinical implication is the expansion of physical therapy to include referrals from voice centers for the treatment of MTD. PMID:25256740

  5. Ophthalmologic manifestations of focal dermal hypoplasia (Goltz syndrome): A case series of 18 patients.

    PubMed

    Gisseman, Jordan D; Herce, Honey H

    2016-03-01

    Focal Dermal Hypoplasia (FDH) or Goltz syndrome is a rare multi-system disorder with cutaneous, ocular, dental, and skeletal anomalies due to dysplasia of mesoectodermal derived tissues. It is an X-linked inheritance syndrome caused by mutations in the PORCN gene. This study is aimed to investigate the ocular findings in patients with Goltz syndrome. To date, there have been a limited number of case reports on the ocular manifestations of FDH. This is a prospective, non-consecutive, observational case series. Prospective ophthalmologic evaluation was performed on 18 patients with confirmed genetic testing for FDH, Goltz Syndrome, as a component of a larger multi-subspecialty study to better characterize the findings of this condition. Special attention was placed on evaluating the incidence of anophthalmia, microphthalmia, colobomas (iris, optic nerve, and/or retinal), cataracts, nystagmus, and strabismus. A complete ophthalmologic exam was done on all the patients. The mean patient age was 12.8 years (1-55 years). Eighty-nine percent were female and 77% (14/18) of patients had some form of an ophthalmologic manifestation of the condition. Ophthalmological findings included chorioretinal colobomas (61%), iris colobomas (50%), microphthalmia (44%), anophthalmia (11%), cataracts (11%), and conjunctival and eyelid papillomas (5%). Nystagmus was present in 33% and strabismus in 22% of the patients. Visual acuity ranged from 20/20 to no light perception. This study demonstrates a higher incidence of ophthalmologic manifestations as previously reported (77% vs. 40%). To our knowledge, this is the largest case series reported in the literature with 18 patients. PMID:27001926

  6. Complications and subsequent removal of retained shunt hardware after endoscopic third ventriculostomy: case series.

    PubMed

    Pindrik, Jonathan; Jallo, George I; Ahn, Edward S

    2013-06-01

    This case series highlights multiple complications and subsequent removal of retained shunt hardware in pediatric patients after successful endoscopic third ventriculostomy (ETV). Removal or retention of existing shunt hardware following ETV represents an important dilemma. Prior studies have reported infections and organ perforation related to nonfunctioning shunts but none in the context of successful ETV. Data obtained in 3 children with hydrocephalus treated at the authors' institution were retrospectively reviewed after the patients experienced complications due to retained shunt hardware following ETV. Etiologies of hydrocephalus included tectal glioma and intraventricular hemorrhage. All 3 patients had a history of multiple shunt revisions and underwent urgent ETV in the setting of a shunt malfunction. In each case, the entire shunt system was left in situ, but it became the source of subsequent complications. Two of the 3 patients presented with the shunt infected by gram-negative bacilli 10 days and 4.5 months postoperatively, respectively. The remaining patient experienced wound dehiscence over the shunt valve 4.5 months after ETV. In all patients, the complications were managed successfully by removing the shunt hardware. None of the patients required repeat shunt insertion from the time of removal throughout the follow-up period (mean 24 months, range 9-36 months). During the study period, a total of 6 patients with indwelling shunt hardware underwent ETV with the expectation of being shunt independent. Among these 6 patients, 3 experienced no complications from the retained hardware whereas 3 patients (50%) ultimately experienced adverse consequences related to retained hardware. This case series illustrates complications involving retained shunt hardware after successful ETV. These examples support consideration of shunt removal at the time of ETV in the appropriate context.

  7. Diagnostic criteria and follow-up in neuroendocrine cell hyperplasia of infancy: a case series*

    PubMed Central

    Gomes, Vivianne Calheiros Chaves; Silva, Mara Cristina Coelho; Maia, José Holanda; Daltro, Pedro; Ramos, Simone Gusmão; Brody, Alan S.; Marchiori, Edson

    2013-01-01

    OBJECTIVE: Neuroendocrine cell hyperplasia of infancy (NEHI) is a form of childhood interstitial lung disease characterized by tachypnea, retractions, crackles, and hypoxia. The aim of this study was to report and discuss the clinical, imaging, and histopathological findings in a series of NEHI cases at a tertiary pediatric hospital, with an emphasis on diagnostic criteria and clinical outcomes. METHODS: Between 2003 and 2011, 12 full-term infants were diagnosed with NEHI, based on clinical and tomographic findings. Those infants were followed for 1-91 months. Four infants were biopsied, and the histopathological specimens were stained with bombesin antibody. RESULTS: In this case series, symptoms appeared at birth in 6 infants and by 3 months of age in the remaining 6. In all of the cases, NEHI was associated with acute respiratory infection. The most common initial chest HRCT findings were ground-glass opacities that were in the middle lobe/lingula in 12 patients and in other medullary areas in 10. Air trapping was the second most common finding, being observed in 7 patients. Follow-up HRCT scans (performed in 10 patients) revealed normal results in 1 patient and improvement in 9. The biopsy findings were nonspecific, and the staining was positive for bombesin in all samples. Confirmation of NEHI was primarily based on clinical and tomographic findings. Symptoms improved during the follow-up period (mean, 41 months). A clinical cure was achieved in 4 patients. CONCLUSIONS: In this sample of patients, the diagnosis of NEHI was made on the basis of the clinical and tomographic findings, independent of the lung biopsy results. Most of the patients showed clinical improvement and persistent tomographic changes during the follow-up period, regardless of the initial severity of the disease or type of treatment. PMID:24310630

  8. Unit: The Australian Scene, Inspection Pack, National Trial Print.

    ERIC Educational Resources Information Center

    Australian Science Education Project, Toorak, Victoria.

    As a part of the interim unit materials in the series produced by the Australian Science Education Project, this teachers' guide is composed of five sections: an introduction to nature in the balance, tests, excursion activities, options, and research activities. Options are under the headings: The Changing Face, Australian Soils, Distribution of…

  9. Sclerosing Mesenteritis and Disturbance of Glucose Metabolism: A New Relationship? A Case Series

    PubMed Central

    Pereira, João Pedro Tavares; Romão, Vera; Eulálio, Margarida; Jorge, Rita; Breda, Filipe; Calretas, Suzana; Leitão, Sara; Eugénio, Gisela; Santos, Rui; Carvalho, Armando

    2016-01-01

    Case series Patient: Male, 51 • Male, 70 • Male, 63 • Male, 67 • Female, 76 Final Diagnosis: Sclerosing mesenteritis Symptoms: Abdominal pain Medication: — Clinical Procedure: Colcicine Specialty: Metabolic Disorders and Diabetics Objective: Rare co-existance of disease or pathology Background: Sclerosing mesenteritis is an idiopathic inflammatory and fibrotic disease that affects the mesentery. It is a rare disease, with the total number of reported cases in the literature ranging from 122 to 300. It mainly affects men in the sixth decade of life, and its etiology remains unknown. Clinical presentation is variable, but it is frequently asymptomatic. Diagnosis is often made by computed tomography (CT) scan, although biopsy may be needed for confirmation. An association between other diseases (e.g., neoplasms) and sclerosing mesenteritis has been described, but the relationship between the latter and glucose changes is not disclosed in the currently available literature. Case Report: Five cases of sclerosing mesenteritis and glucose metabolism disorders (impaired fasting glucose and type 2 diabetes mellitus) were retrospectively collected and analyzed. The mean age was 65±9.3 years, 80% were male, and all patients were white. Three patients were asymptomatic and the other 2 (40%) had non-specific chronic abdominal pain. Blood tests revealed normal inflammatory parameters (mean HbA1c was 6.4% and fasting blood glucose was 140 mg/dL). The diagnosis was made by abdominal CT scan. The 2 symptomatic patients underwent therapy with colchicine 1 mg/day, with clinical improvement. During the mean 43-month follow-up period, there was no symptomatic progression, thereby maintaining the usual benign course of this condition. Conclusions: Sclerosing mesenteritis has only been described in small series and isolated cases, but its diagnosis is becoming more common due to greater access to diagnostic methods and higher awareness of the disease in the medical community

  10. Three explanations for biodiversity hotspots: small range size, geographical overlap and time for species accumulation. An Australian case study.

    PubMed

    Cook, Lyn G; Hardy, Nate B; Crisp, Michael D

    2015-07-01

    To understand the generation and maintenance of biodiversity hotspots, we tested three major hypotheses: rates of diversification, ecological limits to diversity, and time for species accumulation. Using dated molecular phylogenies, measures of species' range size and geographical clade overlap, niche modelling, and lineages-through-time plots of Australian Fabaceae, we compared the southwest Australia Floristic Region (SWAFR; a global biodiversity hotspot) with a latitudinally equivalent non-hotspot, southeast Australia (SEA). Ranges of species (real and simulated) were smaller in the SWAFR than in SEA. Geographical overlap of clades was significantly greater for Daviesia in the SWAFR than in SEA, but the inverse for Bossiaea. Lineage diversification rates over the past 10 Myr did not differ between the SWAFR and SEA in either genus. Interaction of multiple factors probably explains the differences in measured diversity between the two regions. Steeper climatic gradients in the SWAFR probably explain the smaller geographical ranges of both genera there. Greater geographical overlap of clades in the SWAFR, combined with a longer time in the region, can explain why Daviesia is far more species-rich there than in SEA. Our results indicate that the time for speciation and ecological limits hypotheses, in concert, can explain the differences in biodiversity.

  11. Potential Impact of Dietary Choices on Phosphorus Recycling and Global Phosphorus Footprints: The Case of the Average Australian City

    PubMed Central

    Metson, Geneviève S.; Cordell, Dana; Ridoutt, Brad

    2016-01-01

    Changes in human diets, population increases, farming practices, and globalized food chains have led to dramatic increases in the demand for phosphorus fertilizers. Long-term food security and water quality are, however, threatened by such increased phosphorus consumption, because the world’s main source, phosphate rock, is an increasingly scarce resource. At the same time, losses of phosphorus from farms and cities have caused widespread water pollution. As one of the major factors contributing to increased phosphorus demand, dietary choices can play a key role in changing our resource consumption pathway. Importantly, the effects of dietary choices on phosphorus management are twofold: First, dietary choices affect a person or region’s “phosphorus footprint” – the magnitude of mined phosphate required to meet food demand. Second, dietary choices affect the magnitude of phosphorus content in human excreta and hence the recycling- and pollution-potential of phosphorus in sanitation systems. When considering options and impacts of interventions at the city scale (e.g., potential for recycling), dietary changes may be undervalued as a solution toward phosphorus sustainability. For example, in an average Australian city, a vegetable-based diet could marginally increase phosphorus in human excreta (an 8% increase). However, such a shift could simultaneously dramatically decrease the mined phosphate required to meet the city resident’s annual food demand by 72%. Taking a multi-scalar perspective is therefore key to fully exploring dietary choices as one of the tools for sustainable phosphorus management.

  12. Potential Impact of Dietary Choices on Phosphorus Recycling and Global Phosphorus Footprints: The Case of the Average Australian City

    PubMed Central

    Metson, Geneviève S.; Cordell, Dana; Ridoutt, Brad

    2016-01-01

    Changes in human diets, population increases, farming practices, and globalized food chains have led to dramatic increases in the demand for phosphorus fertilizers. Long-term food security and water quality are, however, threatened by such increased phosphorus consumption, because the world’s main source, phosphate rock, is an increasingly scarce resource. At the same time, losses of phosphorus from farms and cities have caused widespread water pollution. As one of the major factors contributing to increased phosphorus demand, dietary choices can play a key role in changing our resource consumption pathway. Importantly, the effects of dietary choices on phosphorus management are twofold: First, dietary choices affect a person or region’s “phosphorus footprint” – the magnitude of mined phosphate required to meet food demand. Second, dietary choices affect the magnitude of phosphorus content in human excreta and hence the recycling- and pollution-potential of phosphorus in sanitation systems. When considering options and impacts of interventions at the city scale (e.g., potential for recycling), dietary changes may be undervalued as a solution toward phosphorus sustainability. For example, in an average Australian city, a vegetable-based diet could marginally increase phosphorus in human excreta (an 8% increase). However, such a shift could simultaneously dramatically decrease the mined phosphate required to meet the city resident’s annual food demand by 72%. Taking a multi-scalar perspective is therefore key to fully exploring dietary choices as one of the tools for sustainable phosphorus management. PMID:27617261

  13. Potential Impact of Dietary Choices on Phosphorus Recycling and Global Phosphorus Footprints: The Case of the Average Australian City.

    PubMed

    Metson, Geneviève S; Cordell, Dana; Ridoutt, Brad

    2016-01-01

    Changes in human diets, population increases, farming practices, and globalized food chains have led to dramatic increases in the demand for phosphorus fertilizers. Long-term food security and water quality are, however, threatened by such increased phosphorus consumption, because the world's main source, phosphate rock, is an increasingly scarce resource. At the same time, losses of phosphorus from farms and cities have caused widespread water pollution. As one of the major factors contributing to increased phosphorus demand, dietary choices can play a key role in changing our resource consumption pathway. Importantly, the effects of dietary choices on phosphorus management are twofold: First, dietary choices affect a person or region's "phosphorus footprint" - the magnitude of mined phosphate required to meet food demand. Second, dietary choices affect the magnitude of phosphorus content in human excreta and hence the recycling- and pollution-potential of phosphorus in sanitation systems. When considering options and impacts of interventions at the city scale (e.g., potential for recycling), dietary changes may be undervalued as a solution toward phosphorus sustainability. For example, in an average Australian city, a vegetable-based diet could marginally increase phosphorus in human excreta (an 8% increase). However, such a shift could simultaneously dramatically decrease the mined phosphate required to meet the city resident's annual food demand by 72%. Taking a multi-scalar perspective is therefore key to fully exploring dietary choices as one of the tools for sustainable phosphorus management. PMID:27617261

  14. Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory.

    PubMed

    Baum, Fran; Freeman, Toby; Jolley, Gwyn; Lawless, Angela; Bentley, Michael; Värttö, Kaisu; Boffa, John; Labonte, Ronald; Sanders, David

    2014-12-01

    This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance. The study is based on an audit of activities and on 68 interviews conducted with staff. All the sites undertake health promotion and recognize its importance but all report that this activity is under constant pressure resulting from the need to provide services to people who have health problems. We also found an increased focus on chronic disease management and prevention which prioritized individuals and behavioural change strategies rather than addressing social determinants affecting whole communities. There was little health promotion work that reflected a salutogenic approach to the creation of health. Most activity falls under three types: parenting and child development, chronic disease prevention and mental health. Only the non-government organizations reported advocacy on broader policy issues. Health reform and consequent reorganizations were seen to reduce the ability of some services to undertake health promotion. The paper concludes that PHC in Australia plays an important role in disease prevention, but that there is considerable scope to increase the amount of community-based health promotion which focuses on a salutogenic view of health and which engages in community partnerships. PMID:23656732

  15. Potential Impact of Dietary Choices on Phosphorus Recycling and Global Phosphorus Footprints: The Case of the Average Australian City.

    PubMed

    Metson, Geneviève S; Cordell, Dana; Ridoutt, Brad

    2016-01-01

    Changes in human diets, population increases, farming practices, and globalized food chains have led to dramatic increases in the demand for phosphorus fertilizers. Long-term food security and water quality are, however, threatened by such increased phosphorus consumption, because the world's main source, phosphate rock, is an increasingly scarce resource. At the same time, losses of phosphorus from farms and cities have caused widespread water pollution. As one of the major factors contributing to increased phosphorus demand, dietary choices can play a key role in changing our resource consumption pathway. Importantly, the effects of dietary choices on phosphorus management are twofold: First, dietary choices affect a person or region's "phosphorus footprint" - the magnitude of mined phosphate required to meet food demand. Second, dietary choices affect the magnitude of phosphorus content in human excreta and hence the recycling- and pollution-potential of phosphorus in sanitation systems. When considering options and impacts of interventions at the city scale (e.g., potential for recycling), dietary changes may be undervalued as a solution toward phosphorus sustainability. For example, in an average Australian city, a vegetable-based diet could marginally increase phosphorus in human excreta (an 8% increase). However, such a shift could simultaneously dramatically decrease the mined phosphate required to meet the city resident's annual food demand by 72%. Taking a multi-scalar perspective is therefore key to fully exploring dietary choices as one of the tools for sustainable phosphorus management.

  16. Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory.

    PubMed

    Baum, Fran; Freeman, Toby; Jolley, Gwyn; Lawless, Angela; Bentley, Michael; Värttö, Kaisu; Boffa, John; Labonte, Ronald; Sanders, David

    2014-12-01

    This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance. The study is based on an audit of activities and on 68 interviews conducted with staff. All the sites undertake health promotion and recognize its importance but all report that this activity is under constant pressure resulting from the need to provide services to people who have health problems. We also found an increased focus on chronic disease management and prevention which prioritized individuals and behavioural change strategies rather than addressing social determinants affecting whole communities. There was little health promotion work that reflected a salutogenic approach to the creation of health. Most activity falls under three types: parenting and child development, chronic disease prevention and mental health. Only the non-government organizations reported advocacy on broader policy issues. Health reform and consequent reorganizations were seen to reduce the ability of some services to undertake health promotion. The paper concludes that PHC in Australia plays an important role in disease prevention, but that there is considerable scope to increase the amount of community-based health promotion which focuses on a salutogenic view of health and which engages in community partnerships.

  17. "The Sacred Spark of Wonder": Local Museums, Australian Curriculum History, and Pre-Service Primary Teacher Education: A Tasmanian Case Study

    ERIC Educational Resources Information Center

    Brett, Peter

    2014-01-01

    This article explores the intersections between museum learning in a distinctive Tasmanian setting, the possibilities of a new national History curriculum, and the evolving views and professional practices of pre-service primary teachers at one Australian university. Following a brief overview of the framework for local and Australian history that…

  18. Sporadic nocturnal frontal lobe epilepsy: A consecutive series of 8 cases

    PubMed Central

    Yeh, Shih-Bin; Schenck, Carlos H.

    2014-01-01

    Objective To present findings on a series of cases of sporadic nocturnal frontal lobe epilepsy (NFLE), a form of NFLE that is infrequently reported, in contrast to familial (autosomal dominant) NFLE. Both forms of NFLE need to be distinguished from parasomnias, nocturnal temporal lobe epilepsy, and other nocturnal disorders. Methods Eight consecutive cases of sporadic NFLE were evaluated at a sleep clinic in Taiwan. All patients had clinical evaluations, daytime waking and sleeping EEGs, brain MRIs, and overnight video-polysomnography (vPSG) with seizure montage. Results Gender was equal (four males, four females); mean age was 18.4 yrs (range, 7–41 yrs). Age of NFLE onset was by puberty. Premorbid history was negative for any neurologic, medical or psychiatric disorder. NFLE subtypes: nocturnal paroxysmal dystonia, n=6; paroxysmal arousals, n=2. MRI brain scan abnormalities with clinical correlates were found in one patient. Daytime awake EEGs were negative for ictal/interictal activity in all patients, but two patients had daytime sleep EEGs with interictal epileptiform EEG activity. During vPSG studies, three of eight patients with NFLE seizure events had concurrent epileptiform EEG activity, and two patients had interictal epileptiform EEG activity during their vPSG studies. No case had a spontaneous remission. Anticonvulsant therapy was highly effective in all eight cases (>75% reduction in seizure frequency). Discussion These cases confirm that sporadic NFLE closely resembles familial NFLE, and comprises a set of distinct clinical manifestations, with variable intensity, and variable scalp EEG epileptiform abnormalities across sleep and wakefulness, which have previously been identified in Caucasian patients from Europe and North America. PMID:26483923

  19. 68Ga-DOTATATE uptake in pineal gland, a rare physiological variant: case series.

    PubMed

    Riaz, Saima; Syed, Rizwan; Skoura, Evangelia; Alshammari, Alshaima; Gaze, Mark; Sajjan, Rakesh; Halsey, Richard; Bomanji, Jamshed

    2015-11-01

    (68)Ga-DOTATATE PET-CT is widely used for the evaluation of neuroendocrine tumours. Knowledge of the physiological distribution of the radiotracer is of critical importance in characterizing focal areas of uptake. In this case series, we report three paediatric cases (average age 4.7 years ± 0.6 SD) with diagnosed advanced stage IV Neuroblastoma. Two had (68)Ga-DOTATATE PET-CT scans and one underwent (68)Ga-DOTATATE PET-MRI scan to assess for suitability of molecular therapy. Focal increased tracer uptake in the pineal gland was noted in all cases with no morphological abnormality on the corresponding CT and MRI scans. The uptake within the gland was thought to be a physiological variant rather than metastases owing to the heterogeneity of somatostatin receptors expression. The pineal gland has been reported to express somatostatin receptors. The physiological distribution of (68)Ga-DOTATATE uptake in the pineal gland is not routinely seen. Furthermore, the possibility of pineal meningioma is very unlikely as pineal meningiomas are very rare and there was no convincing morphological evidence of meningiomas on CT/MRI scan.

  20. Sodium oxybate plus nalmefene for the treatment of alcohol use disorder: A case series.

    PubMed

    Caputo, Fabio; Maremmani, Angelo G I; Addolorato, Giovanni; Domenicali, Marco; Zoli, Giorgio; D'Amore, Antonio; Maremmani, Icro; Bernardi, Mauro

    2016-04-01

    The treatment of alcohol use disorder still remains a challenge. The efficacy of the combined pharmacological treatment for alcohol use disorder has been widely investigated with controversial results. The aim of our case series was to investigate the effect of nalmefene in patients not responding to sodium oxybate therapy. We describe seven cases of consecutive patients affected by alcohol use disorder, and treated with sodium oxybate (50 mg/kg per day) who did not achieve complete alcohol abstinence after at least one month of pharmacological treatment. Then, in partial- and non-responder patients to sodium oxybate treatment, administration of nalmefene, 18 mg as needed, was commenced. Our data show that, during the first month of the combined treatment of sodium oxybate plus nalmefene, patients were able to achieve alcohol abstinence (two patients), to suppress (five cases) or reduce (two patients) episodes of heavy drinking days, and to suppress the onset of craving for sodium oxybate (one patient). Likely, nalmefene may act in modulating the excessive reward effect of sodium oxybate, which may be responsible for the persistence of alcohol intake and for the onset of craving for sodium oxybate. However, controlled clinical trials to confirm the safety and efficacy of sodium oxybate plus nalmefene in treating alcohol use disorder are warranted.

  1. Rare Adrenal Gland Emergencies: A Case Series of Giant Myelolipoma Presenting With Massive Hemorrhage and Abscess

    PubMed Central

    Kumar, Santosh; Jayant, Kumar; Prasad, Seema; Agrawal, Swati; Parma, Kalpesh Mahesh; Roat, Rajesh; Kumar, Kushal

    2015-01-01

    Introduction: Adrenal Myelolipoma is a rare benign neoplasm, which contains mature adipose tissue and variable amounts of haematopoietic elements. Most lesions are small and asymptomatic, discovered incidentally during autopsy or imaging studies performed for other reasons. Case Presentation: Here we reported a series of two cases of giant myelolipomas of the adrenal gland; first one the largest tumor reported so far presented with massive hemorrhage and the second case introduced with its rare unreported presentation of adrenal myelolipomas i.e. a large abscess. Discussion: Adrenal myelolipoma is a rare and asymptomatic tumor usually discovered incidentally in less than 1% of population on autopsy or imaging performed for other reasons. There is an increasing incidence of large adrenal myelolipoma (> 10 cm) presenting with life threatening and recurrent retroperitoneal hemorrhage along with other complications as abscess. To avoid such a life-threatening situation, authors recommend close monitoring and consideration of urgent surgical intervention for tumors larger than 4 cm at presentation or increase in size or change in appearance during follow-up. PMID:25738127

  2. An Alternative Approach to Atopic Dermatitis: Part I—Case-Series Presentation

    PubMed Central

    2004-01-01

    Atopic dermatitis (AD) is a complex disease of obscure pathogenesis. A substantial portion of AD patients treated with conventional therapy become intractable after several cycles of recurrence. Over the last 20 years we have developed an alternative approach to treat many of these patients by diet and Kampo herbal medicine. However, as our approach is highly individualized and the Kampo formulae sometimes complicated, it is not easy to provide evidence to establish usefulness of this approach. In this Review, to demonstrate the effectiveness of the method of individualized Kampo therapy, results are presented for a series of patients who had failed with conventional therapy but were treated afterwards in our institution. Based on these data, we contend that there exist a definite subgroup of AD patients in whom conventional therapy fails, but the ‘Diet and Kampo’ approach succeeds, to heal. Therefore, this approach should be considered seriously as a second-line treatment for AD patients. In the Discussion, we review the evidential status of the current conventional strategies for AD treatment in general, and then specifically discuss the possibility of integrating Kampo regimens into it, taking our case-series presented here as evidential basis. We emphasize that Kampo therapy for AD is more ‘art’ than technology, for which expertise is an essential pre-requisite. PMID:15257326

  3. Gluteal tendon repair augmented with a synthetic ligament: surgical technique and a case series.

    PubMed

    Bucher, Thomas A; Darcy, Peter; Ebert, Jay R; Smith, Anne; Janes, Greg

    2014-01-01

    We describe an augmented surgical repair technique for gluteus minimus and medius tears, along with a supportive case series. A consecutive series of 22 patients presenting with clinical and radiological findings consistent with hip abductor tears, who had undergone failed prior conservative treatments, were prospectively recruited. Patients underwent open bursectomy, Y-iliotibial release, debridement of the diseased tendon, decortication of the trochanteric foot-plate and reattachment augmented with a LARS ligament through a trans-osseous tunnel, together with suture anchors. All patients were assessed pre- and postoperatively to 12 months with the Oxford Hip Score (OHS), the Short-Form Health Survey (SF-36) and a Visual Analogue Pain Scale (VAS), while a satisfaction scale was employed at 12 months. A statistically significant improvement (p<0.05) was observed for all patient reported outcome measures, while all patients were at least 'satisfied' with the procedure at 12 months. One patient reported some lateral hip discomfort at 10 months, and removal of the LARS interference screw provided immediate relief. One patient had a urological catheter-related complication. With no other complications and no clinical failures of the repair, we believe the technique to be safe and reliable, whilst reducing the incidence of re-tears as reported in the existing literature. PMID:24186680

  4. Intervention for infants at risk of developing autism: a case series.

    PubMed

    Green, Jonathan; Wan, Ming Wai; Guiraud, Jeanne; Holsgrove, Samina; McNally, Janet; Slonims, Vicky; Elsabbagh, Mayada; Charman, Tony; Pickles, Andrew; Johnson, Mark

    2013-11-01

    Theory and evidence suggest the potential value of prodromal intervention for infants at risk of developing autism. We report an initial case series (n = 8) of a parent-mediated, video-aided and interaction-focused intervention with infant siblings of autistic probands, beginning at 8-10 months of age. We outline the theory and evidence base behind this model and present data on feasibility, acceptability and measures ranging from parent-infant social interaction, to infant atypical behaviors, attention and cognition. The intervention proves to be both feasible and acceptable to families. Measurement across domains was successful and on larger samples promise to be an effective test of whether such an intervention in infancy will modify emergent atypical developmental trajectories in infants at risk for autism.

  5. Clinical and histologic evaluation of calcium carbonate in sinus augmentation: a case series.

    PubMed

    Mangano, Carlo; Iaculli, Flavia; Piattelli, Adriano; Mangano, Francesco; Shibli, Jamil Awad; Perrotti, Vittoria; Iezzi, Giovanna

    2014-01-01

    The aim of this case series was a clinical, histologic, and histomorphometric evaluation of calcium carbonate in sinus elevation procedures. Sinus augmentation was performed in the atrophic maxillae of 24 subjects using calcium carbonate. Six months after the regeneration procedures, 68 implants were placed and clinically followed for 1 to 5 years, depending on the placement timing. At the last implant placement procedure, 8 bone cores were harvested and processed for histology. After a 6-month healing period, sinuses grafted with calcium carbonate showed a mean vertical bone gain of 6.93 ± 0.23 mm. The histomorphometric analysis revealed 15% ± 3% residual grafted biomaterial, 28% ± 2% newly formed bone, and 57% ± 2% marrow spaces. The implant survival rate was 98.5%. It can be concluded that calcium carbonate was shown to be clinically suitable for sinus elevation procedures after 1 to 5 years of follow-up and histologically biocompatible and osteoconductive.

  6. Lymphatic Mapping in the Treatment of Chronic Seroma: A Case Series

    PubMed Central

    Aliano, Kristen; Stavrides, Steven; Davenport, Thomas

    2015-01-01

    Objective: Seromas or lymphoceles are common postoperative complications. This series presents 3 patients with lower extremity seromas refractory to treatment that required lymphatic mapping and lymphatic ligation for closure, and in 1 case, diagnosis. Methods: Lymphatic mapping procedure consisted of intraoperative injection of subcutaneous tissue with methylene blue distal to the seroma with observation of dye effluence from transected or injured lymphatics draining into area of seroma. Results: In 2 patients, methylene blue dye absorption into lymphatic vessels allowed for optimized visual identification of lymphatic leak and contrast against surrounding tissues. In the third patient, where no lymphocele leak was found, the study was diagnostic and helped to find an alternate etiology for the recurrent seroma. Conclusion: Lymphatic mapping with methylene blue dye is an effective tool in the evaluation and diagnosis of chronic seroma. PMID:25848444

  7. Case series of cerebral infarction with Trousseau's syndrome associated with malignant gynecological tumors

    PubMed Central

    ISHIKAWA, MASAKO; NAKAYAMA, KENTARO; ISHIBASHI, TOMOKA; SATO, EMI; NAKAMURA, KOHEI; KATAGIRI, HIROSHI; KYO, SATORU

    2016-01-01

    The association between neoplastic disease and thromboembolic disorders was first recognized by Trousseau in 1865. Blood coagulation abnormalities have been reported in the majority of patients with cancer, including those with ovarian carcinoma. However, Trousseau's syndrome (TS) has rarely been reported in women with ovarian carcinoma. We herein report a case series of TS, notably in the brain, in association with gynecological malignant disease, and emphasize the difficulties associated with the management of these thromboembolic effects. The aim of this study was to present our experience with 5 TS patients whose condition was effectively controlled through treatment of the primary malignant disease. Therefore, we suggest that patients with TS may be cured by tumor resection, even if they have severe thromboembolic disease, such as cerebral or pulmonary infarction. PMID:27330786

  8. Surgical techniques for the treatment of ankyloglossia in children: a case series.

    PubMed

    Junqueira, Marina Azevedo; Cunha, Nayara Nery Oliveira; Costa e Silva, Lidiane Lucas; Araújo, Leandro Borges; Moretti, Ana Beatriz Silveira; Couto Filho, Carlos Eduardo Gomes; Sakai, Vivien Thiemy

    2014-06-01

    This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort. PMID:25025566

  9. The use of hemospray in portal hypertensive bleeding; a case series.

    PubMed

    Smith, L A; Morris, A J; Stanley, A J

    2014-02-01

    Hemospray is a haemostatic agent licensed for endoscopic haemostasis of non-variceal upper gastrointestinal bleeding (NVUGIB) in Europe and Canada. Hemospray has been shown to be safe and effective in achieving haemostasis in bleeding peptic ulcers in a prospective clinical study and several further case series have described the use of hemospray in other non-variceal causes of gastrointestinal bleeding. Portal hypertensive gastropathy and colopathy are common in patients with portal hypertension. As hemospray is an easy to apply, non-contact method, which can cover large areas of mucosa, it may be of benefit in acute non-variceal portal hypertensive bleeding. We present data from the first four consecutive patients presenting to our institution with acute haemorrhage secondary to non-variceal diffuse portal hypertensive bleeding treated with hemospray.

  10. Improvements in chronic diseases with a comprehensive natural medicine approach: a review and case series.

    PubMed

    Nader, T; Rothenberg, S; Averbach, R; Charles, B; Fields, J Z; Schneider, R H

    2000-01-01

    Approximately 40% of the US population report using complementary and alternative medicine, including Maharishi Vedic Medicine (MVM), a traditional, comprehensive system of natural medicine, for relief from chronic and other disorders. Although many reports suggest health benefits from individual MVM techniques, reports on integrated holistic approaches are rare. This case series, designed to investigate the effectiveness of an integrated, multimodality MVM program in an ideal clinical setting, describes the outcomes in four patients: one with sarcoidosis; one with Parkinson's disease; a third with renal hypertension; and a fourth with diabetes/essential hypertension/anxiety disorder. Standard symptom reports and objective markers of disease were evaluated before, during, and after the treatment period. Results suggested substantial improvements as indicated by reductions in major signs, symptoms, and use of conventional medications in the four patients during the 3-week in-residence treatment phase and continuing through the home follow-up program.

  11. Case Series: Evaluation of Behavioral Sleep Intervention for Medicated Children With ADHD.

    PubMed

    Vetrayan, Jayachandran; Othman, Suhana; Victor Paulraj, Smily Jesu Priya

    2013-03-25

    Objective: To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD. Method: Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children's sleep. Results: For all six children, significant decrease was found in the severity of children's sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful. Conclusion: Based on the initial data, this intervention shows promise as an effective and feasible treatment. (J. of Att. Dis. 2013; XX(X) 1-XX).

  12. Chondroblastoma of the Temporal Bone: A Case Series, Review, and Suggested Management Strategy

    PubMed Central

    Reid, Luke B.; Wong, David S.; Lyons, Bernard

    2011-01-01

    Chondroblastoma of the temporal bone is a rare condition. Chondroblastomas account for less than 1% of primary bone tumors, and those involving the temporal bone represent a tiny fraction of these tumors with most arising from the knee, rib, and pelvis. We present a case series of two patients who presented with chondroblastomas of the temporal bone over a period of 8 years to the St. Vincent's Hospital in Melbourne, Victoria, Australia. In particular, we outline the presenting complaint, diagnostic imaging undertaken, and the importance of preoperative histopathology in coming to the diagnosis and subsequent resection undertaken. A review of the current literature is presented with a suggested management strategy for these tumors. PMID:23984206

  13. Vertical Ridge Augmentation and Soft Tissue Reconstruction of the Anterior Atrophic Maxillae: A Case Series.

    PubMed

    Urban, Istvan A; Monje, Alberto; Wang, Hom-Lay

    2015-01-01

    Severe vertical ridge deficiency in the anterior maxilla represents one of the most challenging clinical scenarios in the bone regeneration arena. As such, a combination of vertical bone augmentation using various biomaterials and soft tissue manipulation is needed to obtain successful outcomes. The present case series describes a novel approach to overcome vertical deficiencies in the anterior atrophied maxillae by using a mixture of autologous and anorganic bovine bone. Soft tissue manipulation including, but not limited to, free soft tissue graft was used to overcome the drawbacks of vertical bone augmentation (eg, loss of vestibular depth and keratinized mucosa). By combining soft and hard tissue grafts, optimum esthetic and long-term implant prosthesis stability can be achieved and sustained.

  14. Surgical techniques for the treatment of ankyloglossia in children: a case series.

    PubMed

    Junqueira, Marina Azevedo; Cunha, Nayara Nery Oliveira; Costa e Silva, Lidiane Lucas; Araújo, Leandro Borges; Moretti, Ana Beatriz Silveira; Couto Filho, Carlos Eduardo Gomes; Sakai, Vivien Thiemy

    2014-06-01

    This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

  15. Demodex treatment in external ocular disease: the outcomes of a Tasmanian case series.

    PubMed

    Nicholls, Stephen G; Oakley, Carmen L; Tan, Andrea; Vote, Brendan J

    2016-10-01

    Demodex species (spp.) have previously been implicated in the pathogenesis of blepharitis. This study aims to correlate improvement in symptoms of external ocular disease with treatment of underlying Demodex spp. This is a prospective, observational case series of patients with chronic external ocular disease. Demodicosis was confirmed by microscopic examination of epilated eyelashes. The main outcome measure was response to the treatment (5 % tee tree oil) in regard to change in subjective symptoms utilising a symptom-based patient questionnaire assessment. Overall patients had a good response to the treatment in terms of improvement or resolution of symptoms, with 91 % of patients reporting at least some improvement in symptoms. The treatment of underlying Demodex spp. appears to result in improvement of symptoms in patients with long standing external ocular disease and underlying Demodex spp. infestation. PMID:26843091

  16. Ulnar Impaction Syndrome: A case series investigating the appropriate diagnosis, management, and post-operative considerations.

    PubMed

    Woitzik, Erin; deGraauw, Chris; Easter, Brock

    2014-12-01

    Ulnar sided wrist pain is a common site for upper extremity disability. Ulnar impaction syndrome results in a spectrum of triangular fibrocartilage complex (TFCC) injuries and associated lunate, triquetrum, and ligamentous damage. Patients commonly present with insidious ulnar sided wrist pain and clicking, and a history of trauma or repetitive axial loading and rotation. In this case series, three patients presented to a sports chiropractor for evaluation and were subsequently diagnosed with ulnar impaction syndrome. Treatment strategies consist of conservative management, arthroscopic debridement or repair, arthroscopic wafer procedure, or ulnar shortening osteotomy. For the athlete, intervention should be individualized and sport-specific, considering athletic priorities, healing potential, return to play, and long-term health concerns.

  17. Eosinophilic esophagitis that develops during therapy with proton pump inhibitors : case series and possible mechanisms.

    PubMed

    Orel, R; Murch, S; Amil Dias, J; Vandenplas, Y; Homan, M

    2016-01-01

    Therapy with proton-pump inhibitors (PPIs) results in remission in at least one third of patients with esophageal eosinophilia, presumably because of both their acid-related and anti-inflammatory mechanisms of action. However, eosinophilic esophagitis (EoE) may also develop during therapy with PPIs. We present a case series of four children who were initially diagnosed with infectious esophagitis, gastroesophageal reflux disease or gastric ulcer, who had no eosinophilic infiltration of the esophagus, but subsequently developed symptoms, endoscopic features and histological picture of typical EoE. We discuss mechanisms of action of PPIs of likely relevance to an increased risk of development of EoE in some patients, such as their influence on mucosal barrier function, interference with pH-related protein digestion by pepsin, and antigen processing by immune cells. PMID:27382946

  18. Bilateral Vocal Cord Palsy with Arnold Chiari Malformation: A Rare Case Series

    PubMed Central

    Arora, Nikhil; Meher, Ravi; Bhargava, Eishaan K.

    2016-01-01

    Stridor in paediatric age group is not an uncommon presentation to the ENT emergency. The range of differential diagnosis is vast. The presentation may vary from noisy breathing to severe respiratory distress and apnea. Early and meticulous diagnosis is crucial for the management as the condition may be life threatening. We report a rare case series of 3 infants with Arnold Chiari Malformation who presented to the hospital with stridor and were diagnosed with bilateral vocal cord palsy. These 3 infants had similar underlying neurological condition with hydrocephalus and raised intracranial pressure. Chiari malformation is the one of the most common congenital central nervous system anomaly associated with bilateral vocal cord paralysis. However, the presentation is rare. This article, thus, emphasizes the significance of early diagnosis and immediate management of this condition. PMID:27790480

  19. Internet-delivered, family-based treatment for early-onset OCD: a preliminary case series.

    PubMed

    Comer, Jonathan S; Furr, Jami M; Cooper-Vince, Christine E; Kerns, Caroline E; Chan, Priscilla T; Edson, Aubrey L; Khanna, Muniya; Franklin, Martin E; Garcia, Abbe M; Freeman, Jennifer B

    2014-01-01

    Given the burdens of early-onset obsessive-compulsive disorder (OCD), limitations in the broad availability and accessibility of evidence-based care for affected youth present serious public health concerns. The growing potential for technological innovations to transform care for the most traditionally remote and underserved families holds enormous promise. This article presents the rationale, key considerations, and a preliminary case series for a promising behavioral telehealth innovation in the evidence-based treatment of early-onset OCD. We developed an Internet-based format for the delivery of family-based treatment for early-onset OCD directly to families in their homes, regardless of their geographic proximity to a mental health facility. Videoteleconferencing (VTC) methods were used to deliver real-time cognitive-behavioral therapy centering on exposure and response prevention to affected families. Participants in the preliminary case series included 5 children between the ages of 4 and 8 (M Age = 6.5) who received the Internet-delivered treatment format. All youth completed a full treatment course, all showed OCD symptom improvements and global severity improvements from pre- to posttreatment, all showed at least partial diagnostic response, and 60% no longer met diagnostic criteria for OCD at posttreatment. No participants got worse, and all mothers characterized the quality of services received as "excellent." The present work adds to a growing literature supporting the potential of VTC and related computer technology for meaningfully expanding the reach of supported treatments for OCD and lays the foundation for subsequent controlled evaluations to evaluate matters of efficacy and engagement relative to standard in-office evidence-based care. PMID:24295036

  20. Internet-Delivered, Family-Based Treatment for Early-Onset OCD: A Preliminary Case Series

    PubMed Central

    Comer, Jonathan S.; Furr, Jami M.; Cooper-Vince, Christine E.; Kerns, Caroline E.; Chan, Priscilla T.; Edson, Aubrey L.; Khanna, Muniya; Franklin, Martin E.; Garcia, Abbe M.; Freeman, Jennifer B.

    2014-01-01

    Given the burdens of early-onset obsessive-compulsive disorder (OCD), limitations in the broad availability and accessibility of evidence-based care for affected youth present serious public health concerns. The growing potential for technological innovations to transform care for the most traditionally remote and underserved families holds enormous promise. This article presents the rationale, key considerations, and a preliminary case series for a promising behavioral telehealth innovation in the evidence-based treatment of early-onset OCD. We developed an Internet-based format for the delivery of family-based treatment for early-onset OCD directly to families in their homes, regardless of their geographic proximity to a mental health facility. Videoteleconferencing (VTC) methods were used to deliver real-time cognitive-behavioral therapy centering on exposure and response prevention to affected families. Participants in the preliminary case series included 5 children between the ages of 4 and 8 (MAge = 6.5) who received the Internet-delivered treatment format. All youth completed a full treatment course, all showed OCD symptom improvements and global severity improvements from pre- to posttreatment, all showed at least partial diagnostic response, and 60% no longer met diagnostic criteria for OCD at posttreatment. No participants got worse, and all mothers characterized the quality of services received as “excellent.” The present work adds to a growing literature supporting the potential of VTC and related computer technology for meaningfully expanding the reach of supported treatments for OCD and lays the foundation for subsequent controlled evaluations to evaluate matters of efficacy and engagement relative to standard in-office evidence-based care. PMID:24295036

  1. Internet-delivered, family-based treatment for early-onset OCD: a preliminary case series.

    PubMed

    Comer, Jonathan S; Furr, Jami M; Cooper-Vince, Christine E; Kerns, Caroline E; Chan, Priscilla T; Edson, Aubrey L; Khanna, Muniya; Franklin, Martin E; Garcia, Abbe M; Freeman, Jennifer B

    2014-01-01

    Given the burdens of early-onset obsessive-compulsive disorder (OCD), limitations in the broad availability and accessibility of evidence-based care for affected youth present serious public health concerns. The growing potential for technological innovations to transform care for the most traditionally remote and underserved families holds enormous promise. This article presents the rationale, key considerations, and a preliminary case series for a promising behavioral telehealth innovation in the evidence-based treatment of early-onset OCD. We developed an Internet-based format for the delivery of family-based treatment for early-onset OCD directly to families in their homes, regardless of their geographic proximity to a mental health facility. Videoteleconferencing (VTC) methods were used to deliver real-time cognitive-behavioral therapy centering on exposure and response prevention to affected families. Participants in the preliminary case series included 5 children between the ages of 4 and 8 (M Age = 6.5) who received the Internet-delivered treatment format. All youth completed a full treatment course, all showed OCD symptom improvements and global severity improvements from pre- to posttreatment, all showed at least partial diagnostic response, and 60% no longer met diagnostic criteria for OCD at posttreatment. No participants got worse, and all mothers characterized the quality of services received as "excellent." The present work adds to a growing literature supporting the potential of VTC and related computer technology for meaningfully expanding the reach of supported treatments for OCD and lays the foundation for subsequent controlled evaluations to evaluate matters of efficacy and engagement relative to standard in-office evidence-based care.

  2. Miltefosine for Mucosal and Complicated Cutaneous Old World Leishmaniasis: A Case Series and Review of the Literature.

    PubMed

    Mosimann, Vincent; Blazek, Claudia; Grob, Heini; Chaney, Matthew; Neumayr, Andreas; Blum, Johannes

    2016-01-01

    Complicated Old World cutaneous leishmaniasis (OWCL) and Old World mucosal leishmaniasis (OWML) constitute an indication for systemic treatment. To date, there no controlled clinical studies that compare treatment options for these diseases. We compiled a case series of 24 cases successfully treated with miltefosine. We conclude that oral miltefosine is an effective treatment option for both OWCL and OWML.

  3. Climate change, water security and the need for integrated policy development: the case of on-farm infrastructure investment in the Australian irrigation sector

    NASA Astrophysics Data System (ADS)

    Maraseni, T. N.; Mushtaq, S.; Reardon-Smith, K.

    2012-09-01

    The Australian Government is currently addressing the challenge of increasing water scarcity through significant on-farm infrastructure investment to facilitate the adoption of new water-efficient pressurized irrigation systems. However, it is highly likely that conversion to these systems will increase on-farm energy consumption and greenhouse gas (GHG) emissions, suggesting potential conflicts in terms of mitigation and adaptation policies. This study explored the trade-offs associated with the adoption of more water efficient but energy-intensive irrigation technologies by developing an integrated assessment framework. Integrated analysis of five case studies revealed trade-offs between water security and environmental security when conversion to pressurized irrigation systems was evaluated in terms of fuel and energy-related emissions, except in cases where older hand-shift sprinkler irrigation systems were replaced. These results suggest that priority should be given, in implementing on-farm infrastructure investment policy, to replacing inefficient and energy-intensive sprinkler irrigation systems such as hand-shift and roll-line. The results indicated that associated changes in the use of agricultural machinery and agrochemicals may also be important. The findings of this study support the use of an integrated approach to avoid possible conflicts in designing national climate change mitigation and adaptation policies, both of which are being developed in Australia.

  4. Shrinking lung syndrome in systemic lupus erythematosus: A case series and review of the literature.

    PubMed

    Borrell, Helena; Narváez, Javier; Alegre, Juan José; Castellví, Ivan; Mitjavila, Francesca; Aparicio, María; Armengol, Eulàlia; Molina-Molina, María; Nolla, Joan M

    2016-08-01

    Shrinking lung syndrome (SLS) is a rare and less known complication mainly associated with systemic lupus erythematosus (SLE). In this study, we analyze the clinical features, investigation findings, approaches to management, and outcome in a case series of 9 adult patients with SLE and SLS diagnosed during a 35-year period in 3 referral tertiary care hospitals in Spain. Additionally, we reviewed 80 additional cases previously reported (PubMed 1965-2015). These 80 cases, together with our 9 patients, form the basis of the present analysis.The overall SLS prevalence in our SLE population was 1.1% (9/829). SLS may complicate SLE at any time over its course, and it usually occurs in patients without previous or concomitant major organ involvement. More than half of the patients had inactive lupus according to SELENA-systemic lupus erythematosus disease activity index (SLEDAI) scores. Typically, it presents with progressive exertional dyspnea of variable severity, accompanied by pleuritic chest pain in 76% of the cases.An important diagnostic delay is common. The diagnostic tools that showed better yield for SLS detection are the imaging techniques (chest x-ray and high-resolution computed tomography) along with pulmonary and diaphragmatic function tests. Evaluation of diaphragm dome motion by M-mode ultrasonography and phrenic nerve conduction studies are less useful.There are no standardized guidelines for the treatment of SLS in SLE. The majority of patients were treated with medium or high doses of glucocorticoids. Several immunosuppressive agents have been used in conjunction with steroids either if the patient fails to improve or since the beginning of the treatment. Theophylline and beta-agonists, alone or in combination with glucocorticoids, have been suggested with the intent to increase diaphragmatic strength.The overall long-term prognosis was good. The great majority of patients had significant clinical improvement and stabilization, or mild to moderate

  5. Shrinking lung syndrome in systemic lupus erythematosus: A case series and review of the literature.

    PubMed

    Borrell, Helena; Narváez, Javier; Alegre, Juan José; Castellví, Ivan; Mitjavila, Francesca; Aparicio, María; Armengol, Eulàlia; Molina-Molina, María; Nolla, Joan M

    2016-08-01

    Shrinking lung syndrome (SLS) is a rare and less known complication mainly associated with systemic lupus erythematosus (SLE). In this study, we analyze the clinical features, investigation findings, approaches to management, and outcome in a case series of 9 adult patients with SLE and SLS diagnosed during a 35-year period in 3 referral tertiary care hospitals in Spain. Additionally, we reviewed 80 additional cases previously reported (PubMed 1965-2015). These 80 cases, together with our 9 patients, form the basis of the present analysis.The overall SLS prevalence in our SLE population was 1.1% (9/829). SLS may complicate SLE at any time over its course, and it usually occurs in patients without previous or concomitant major organ involvement. More than half of the patients had inactive lupus according to SELENA-systemic lupus erythematosus disease activity index (SLEDAI) scores. Typically, it presents with progressive exertional dyspnea of variable severity, accompanied by pleuritic chest pain in 76% of the cases.An important diagnostic delay is common. The diagnostic tools that showed better yield for SLS detection are the imaging techniques (chest x-ray and high-resolution computed tomography) along with pulmonary and diaphragmatic function tests. Evaluation of diaphragm dome motion by M-mode ultrasonography and phrenic nerve conduction studies are less useful.There are no standardized guidelines for the treatment of SLS in SLE. The majority of patients were treated with medium or high doses of glucocorticoids. Several immunosuppressive agents have been used in conjunction with steroids either if the patient fails to improve or since the beginning of the treatment. Theophylline and beta-agonists, alone or in combination with glucocorticoids, have been suggested with the intent to increase diaphragmatic strength.The overall long-term prognosis was good. The great majority of patients had significant clinical improvement and stabilization, or mild to moderate

  6. Clinical Spectrum and Management of Caustic Ingestion: A Case Series Presenting Three Opposing Outcomes

    PubMed Central

    Vezakis, Antonios I.; Pantiora, Eirini V.; Kontis, Elissaios A.; Sakellariou, Vasileios; Theodorou, Dimitrios; Gkiokas, Georgios; Polydorou, Andreas A.; Fragulidis, Georgios P.

    2016-01-01

    Case series Patient: Fenale, 77 • Female, 46 • Female, 33 Final Diagnosis: Caustic injury Symptoms: — Medication: — Clinical Procedure: Surgery Specialty: Surgery Objective: Unusual clinical course Background: Ingestion of caustic substances is a medical emergency in both the adult and pediatric population and is associated with high morbidity and mortality. The extent of injuries after ingestion of caustic substances depends on the nature, amount, and concentration of the agent and on the exposure time. Acutely, caustic substances may cause massive hemorrhage and gastrointestinal tract perforation; the most markedly affected cases require urgent surgical treatment. Patients surviving the initial event may present with aorto-enteric or gastrocolic fistulae, esophageal strictures, dysphagia, and increased risk of esophageal cancer as long term sequelae. Case Report: The features of three cases of caustic ingestion are reported to demonstrate significantly different complaints presented at the emergency department. Two patients had free gastric perforation, one at presentation, and one delayed. The third patient presented with late severe strictures of the esophagus and pylorus. The outcomes of the three patients are discussed in detail along with the most current management strategies. Conclusions: Among adults, ingestion of caustic substances is usually associated with more severe lesions due to the increased amount of ingested substance, as compared with pediatric patients. The most serious presentation is that of visceral perforation, most commonly of the stomach and rarely of the esophagus. Management involves urgent resuscitation with correction of fluid and electrolyte and acid-base abnormalities and immediate surgical exploration in those patients with signs of perforation. Once the perioperative period is managed successfully, the long-term results can be satisfactory. Managing of strictures or else reconstructive procedures must be well timed to

  7. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    PubMed

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery. PMID:27064368

  8. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    PubMed

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery.

  9. Microvascular decompression for glossopharyngeal neuralgia through a microasterional approach: A case series

    PubMed Central

    Revuelta-Gutiérrez, Rogelio; Morales-Martínez, Andres Humberto; Mejías-Soto, Carolina; Martínez-Anda, Jaime Jesús; Ortega-Porcayo, Luis Alberto

    2016-01-01

    Background: Glossopharyngeal neuralgia (GPN) is an uncommon craniofacial pain syndrome. It is characterized by a sudden onset lancinating pain usually localized in the sensory distribution of the IX cranial nerve associated with excessive vagal outflow, which leads to bradycardia, hypotension, syncope, or cardiac arrest. This study aims to review our surgical experience performing microvascular decompression (MVD) in patients with GPN. Methods: Over the last 20 years, 14 consecutive cases were diagnosed with GPN. MVD using a microasterional approach was performed in all patients. Demographic data, clinical presentation, surgical findings, clinical outcome, complications, and long-term follow-up were reviewed. Results: The median age of onset was 58.7 years. The mean time from onset of symptoms to treatment was 8.8 years. Glossopharyngeal and vagus nerve compression was from the posterior inferior cerebellar artery in eleven cases (78.5%), vertebral artery in two cases (14.2%), and choroid plexus in one case (7.1%). Postoperative mean follow-up was 26 months (3–180 months). Pain analysis demonstrated long-term pain improvement of 114 ± 27.1 months and pain remission in 13 patients (92.9%) (P = 0.0001) two complications were documented, one patient had a cerebrospinal fluid leak, and another had bacterial meningitis. There was no surgical mortality. Conclusions: GPN is a rare entity, and secondary causes should be discarded. MVD through a retractorless microasterional approach is a safe and effective technique. Our series demonstrated an excellent clinical outcome with pain remission in 92.9%. PMID:27213105

  10. A Genuine Career or Impossible Heroism? Experiencing the Role of the Head of School: An Australian Case Study

    ERIC Educational Resources Information Center

    Stratford, Elaine

    2012-01-01

    Studies since the mid-1980s suggest that university heads of schools experience the role as a series of tensions between enlightenment and enterprise-building agendas. It is apparent that the headship requires skills in management and capacities in leadership not necessarily furnished via typical academic pathways. In such light, the present…

  11. Potential utility of precision medicine for older adults with polypharmacy: a case series study

    PubMed Central

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as “CYP3A4/CYP3A5 poor metabolizer”, which affected metabolism of eleven prescribed drugs. The second case had “CYP2D6 rapid metabolizer” status affecting three prescribed medications, two of which were key drugs for managing this patient’s chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug–drug interactions. Both patients with significant drug–gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides

  12. Potential utility of precision medicine for older adults with polypharmacy: a case series study.

    PubMed

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as "CYP3A4/CYP3A5 poor metabolizer", which affected metabolism of eleven prescribed drugs. The second case had "CYP2D6 rapid metabolizer" status affecting three prescribed medications, two of which were key drugs for managing this patient's chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug-drug interactions. Both patients with significant drug-gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides providing

  13. Potential utility of precision medicine for older adults with polypharmacy: a case series study.

    PubMed

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    Pharmacogenomic (PGx) testing has been increasingly used to optimize drug regimens; however, its potential in older adults with polypharmacy has not been systematically studied. In this hypothesis-generating study, we employed a case series design to explore potential utility of PGx testing in older adults with polypharmacy and to highlight barriers in implementing this methodology in routine clinical practice. Three patients with concurrent chronic heart and lung disease aged 74, 78, and 83 years and whose medication regimen comprised 26, 17, and 18 drugs, correspondingly, served as cases for this study. PGx testing identified major genetic polymorphisms in the first two cases. The first case was identified as "CYP3A4/CYP3A5 poor metabolizer", which affected metabolism of eleven prescribed drugs. The second case had "CYP2D6 rapid metabolizer" status affecting three prescribed medications, two of which were key drugs for managing this patient's chronic conditions. Both these patients also had VKORC1 allele *A, resulting in higher sensitivity to warfarin. All cases demonstrated a significant number of potential drug-drug interactions. Both patients with significant drug-gene interactions had a history of frequent hospitalizations (six and 23, respectively), whereas the person without impaired cytochrome P450 enzyme activity had only two acute episodes in the last 5 years, although he was older and had multiple comorbidities. Since all patients received guideline-concordant therapy from the same providers and were adherent to their drug regimen, we hypothesized that genetic polymorphism may represent an additional risk factor for higher hospitalization rates in older adults with polypharmacy. However, evidence to support or reject this hypothesis is yet to be established. Studies evaluating clinical impact of PGx testing in older adults with polypharmacy are warranted. For practical implementation of pharmacogenomics in routine clinical care, besides providing

  14. Cryptococcosis in non-HIV/non-transplant patients: A Brazilian case series.

    PubMed

    Lomes, Naiane Ribeiro; Melhem, Marcia Souza de Carvalho; Szeszs, Maria Walderez; Martins, Marilena Dos Anjos; Buccheri, Renata

    2016-10-01

    Cryptococcosis is a classical systemic opportunistic mycosis, primarily occurring among patients with significant immunologic impairment. However, this disease could also affect patients without any recognized immunologic defects, that is, phenotypically normal patients. The medical records of 29 non-HIV/nontransplant patients with cryptococcal disease during the period 2007-2014 were retrospectively reviewed. The most common site of infection was the central nervous system (n = 25, 86.2%), followed by the pulmonary system (n = 11, 37.9%) and blood (n = 2, 6.8%). Thoracic- and brain-computed tomography demonstrated abnormalities of 81.2% (n = 13) and 62.5% (n = 15), respectively. In sum, 22% (n = 6) of the patients experienced a significant underlying condition. More than one therapeutic regimen was used in 77.8% (n = 21) of the patients. The isolates were identified as being Cryptococcus neoformans species complex (n = 4, 36.4%) and Cryptococcus gattii species complex (n = 7, 63.6%). The overall mortality was 20.7% (n = 6). Herein, we presented the first case series of cryptococcosis in this specific population in São Paulo City, Brazil. The incidence of cryptococcosis in our hospital has not increased in recent years, and 77.8% (n = 21) of cases had no obvious predisposing factor. However, this disease remains associated with high mortality. PMID:27118805

  15. A multi-modal treatment approach for the shoulder: A 4 patient case series

    PubMed Central

    Pribicevic, Mario; Pollard, Henry

    2005-01-01

    Background This paper describes the clinical management of four cases of shoulder impingement syndrome using a conservative multimodal treatment approach. Clinical Features Four patients presented to a chiropractic clinic with chronic shoulder pain, tenderness in the shoulder region and a limited range of motion with pain and catching. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was reached. The four patients were admitted to a multi-modal treatment protocol including soft tissue therapy (ischaemic pressure and cross-friction massage), 7 minutes of phonophoresis (driving of medication into tissue with ultrasound) with 1% cortisone cream, diversified spinal and peripheral joint manipulation and rotator cuff and shoulder girdle muscle exercises. The outcome measures for the study were subjective/objective visual analogue pain scales (VAS), range of motion (goniometer) and return to normal daily, work and sporting activities. All four subjects at the end of the treatment protocol were symptom free with all outcome measures being normal. At 1 month follow up all patients continued to be symptom free with full range of motion and complete return to normal daily activities. Conclusion This case series demonstrates the potential benefit of a multimodal chiropractic protocol in resolving symptoms associated with a suspected clinical diagnosis of shoulder impingement syndrome. PMID:16168053

  16. Sperm parameters and male fertility after bariatric surgery: three case series.

    PubMed

    Sermondade, Nathalie; Massin, Nathalie; Boitrelle, Florence; Pfeffer, Jérôme; Eustache, Florence; Sifer, Christophe; Czernichow, Sébastien; Lévy, Rachel

    2012-02-01

    Recent studies have underlined the impact of obesity on sperm parameters, but very few data are available on the effect of weight loss on male fertility. This article reports the case series of three male patients who underwent rapid and major weight loss following bariatric surgery and the consequences of this surgery on semen parameters and fertility. A severe worsening of semen parameters was observed during the months after bariatric surgery, including extreme oligoasthenoteratozoospermia, but azoospermia was not observed. This effect may hypothetically be the result of two opposite mechanisms: (i) the suppression of the deleterious effects of obesity; and (ii) the negative impact of both nutritional deficiencies and the release of toxic substances. Information about potential reproductive consequences of bariatric surgery should be given to patients and sperm cryopreservation before surgery proposed. However, for one case, the alterations of spermatogenesis were reversible 2 years after the surgical procedure. Finally, intracytoplasmic sperm injection with fresh spermatozoa after male bariatric surgery can be successful, as demonstrated here, where clinical pregnancies were obtained for two out of the three couples.

  17. Cardiac myxoma in Iceland: a case series with an estimation of population incidence.

    PubMed

    Sigurjonsson, Hannes; Andersen, Karl; Gardarsdottir, Marianna; Petursdottir, Vigdis; Klemenzson, Gudmundur; Gunnarsson, Gunnar; Danielsen, Ragnar; Gudbjartsson, Tomas

    2011-09-01

    Cardiac myxoma (CM) is the most common primary benign tumor of the heart, but the true age-standardized incidence rate (ASR) has remained unknown. We therefore used nationwide registries in Iceland to study CM and establish its incidence rate. This was a retrospective study involving all patients diagnosed with CM in Iceland between 1986 and 2010. Cases were identified through three different registries, and hospital charts and histology results reviewed. An ASR was estimated based on a world standard population (w). Nine cases of CM (six women) were identified with a mean age of 62.8 years (range: 37-85), giving an ASR of 0.11 (95% CI: 0.05-0.22) per 100,000. The mean tumor size was 4.4 cm (range: 1.5-8.0) with all the tumors located in the left atrium. Dyspnea (n = 6) and ischemic stroke (n = 2) were the most common symptoms. All patients underwent complete resection of the tumor and there were no postoperative deaths or CM-related deaths at follow-up (mean 85 months). The ASR of CM in Iceland was 0.11 per 100,000. To our knowledge, this is the first study to determine the incidence of CM in an entire population. In Iceland, the presenting symptoms and mode of detection of CM are similar to those in other series.

  18. Steroid-responsive Encephalopathy Subsequently Associated with Alzheimer Disease Pathology: A Case Series

    PubMed Central

    Mateen, Farrah J.; Josephs, Keith A.; Parisi, Joseph E.; Drubach, Daniel A.; Caselli, Richard J.; Kantarci, Kejal; Lennon, Vanda; Jack, Clifford; Boeve, Bradley F.

    2011-01-01

    Background Steroid-responsive encephalopathies can considered vasculitic or nonvasculitic. Clinicopathological studies of nonvasculitic steroid-responsive encephalopathy are unusual, but can explain the range of diagnoses consistent with a steroid responsive presentation in life. Objective To extend the range of clinical features and pathological findings consistent with steroid-responsive encephalopathy. Design, Methods, and Patients A clinicopathological case series of four patients (ages 54–71 years, 2 women) with steroid-responsive encephalopathy followed at this institution until the time of death. Results Clinical features were suggestive of Creutzfeld-Jakob disease, dementia with Lewy Bodies, and parkinsonism, but pathological examination revealed only Alzheimer’s Disease-related findings without evidence of Lewy bodies or prion disease in all cases. All patients demonstrated marked, sustained improvement following steroid treatment, based on clinical, magnetic resonance imaging, and/or electroencephalogram studiesAlzheimer’s Disease was not diagnosed in life due to a lack of hippocampal atrophy on brain imaging and a dramatic symptomatic response to steroids. Conclusions Steroid-responsive encephalopathy is the clinical presentation of some patients with Alzheimer’s Disease related pathology at autopsy, and can be consistent with the clinical diagnoses of parkisonism, dementia with Lewy Bodies, or Creutzfeld-Jakob Disease in life. PMID:21714739

  19. Composite vertical bite reconstructions in eroded dentitions after 5·5 years: a case series.

    PubMed

    Attin, T; Filli, T; Imfeld, C; Schmidlin, P R

    2012-01-01

    In the following case series, we report on six cases of erosive worn dentitions (75 posterior teeth), which have been reconstructed using a template-based technique with direct composite resin restorations and already examined after 3 years in service. In all patients either one or both tooth arches were completely restored using direct resin composite restorations. A wax-up-based template was used to avoid freehand build-up techniques and to ensure optimal anatomy and function. All patients were re-assessed after a mean service time of 5·5 years (mean 67 ± 4 months) using United States Public Health Service criteria. The overall quality of the restorations was good with predominantly 'alpha' and 'bravo' scores, respectively. However, the restorations showed some deterioration with respect to marginal quality, marginal discoloration, surface texture and anatomy as compared to the 3-year investigation. The marginal impairments could be resolved by polishing. It is concluded that this non-invasive technique provides a possible treatment option at least for the displayed observation period of 5·5 years.

  20. Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study

    PubMed Central

    Tarocchi, Anna; Aschieri, Filippo; Fantini, Francesca; Smith, Justin D.

    2013-01-01

    The cumulative effect of repeated traumatic experiences in early childhood incrementally increases the risk of adjustment problems later in life. Surviving traumatic environments can lead to the development of an interrelated constellation of emotional and interpersonal symptoms termed complex posttraumatic stress disorder (CPTSD). Effective treatment of trauma begins with a multimethod psychological assessment and requires the use of several evidence-based therapeutic processes, including establishing a safe therapeutic environment, reprocessing the trauma, constructing a new narrative, and managing emotional dysregulation. Therapeutic Assessment (TA) is a semistructured, brief intervention that uses psychological testing to promote positive change. The case study of Kelly, a middle-aged woman with a history of repeated interpersonal trauma, illustrates delivery of the TA model for CPTSD. Results of this single-case time-series experiment indicate statistically significant symptom improvement as a result of participating in TA. We discuss the implications of these findings for assessing and treating trauma-related concerns, such as CPTSD. PMID:24159267

  1. Paroxysmal sympathetic hyperactivity in pediatric traumatic brain injury: A case series of four patients.

    PubMed

    Deepika, Akhil; Mathew, Manish Joseph; Kumar, S Arun; Devi, Bhagavatula Indira; Shukla, Dhaval

    2015-12-01

    Paroxysmal sympathetic hyperactivity (PSH) is a condition in which there is extreme autonomic dysregulation leading to multiple episodes of sympathetic hyperactivity. Its occurrence after traumatic brain injury (TBI) in pediatric population is a neglected scenario. In our series, all pediatric patients with moderate and severe head injuries were studied and those patients who developed PSH were monitored for the PSH episodes. Four children out of 36 cases of pediatric severe traumatic brain injury developed features of PSH. Admission GCS of 3 children were 4/15 and 1 child was 6/15 and each of them had an ICU stay of more than 2 weeks and a poor DRS score at discharge. The presence of PSH is known to produce poorer outcome in terms of overall mortality, time needed for recovery, chances of developing infections, etc. which was also seen in these cases presented here. Though some studies have provided guidelines for the management of PSH like symptomatic management and use of drugs like clonidine, bromocriptine, benzodiazepines, and gabapentin, strict management guidelines are not established and exact incidence in pediatric population is not determined. PMID:26277041

  2. Labour exploitation and health: a case series of men and women seeking post-trafficking services.

    PubMed

    Turner-Moss, Eleanor; Zimmerman, Cathy; Howard, Louise M; Oram, Siân

    2014-06-01

    Research on the health of trafficked men and on the health problems associated with trafficking for labor exploitation are extremely limited. This study analysed data from a case series of anonymised case records of a consecutive sample of 35 men and women who had been trafficked for labor exploitation in the UK and who were receiving support from a non-governmental service between June 2009 and July 2010. Over three-quarters of our sample was male (77 %) and two-thirds aged between 18 and 35 years (mean 32.9 years, SD 10.2). Forty percent reported experiencing physical violence while they were trafficked. Eighty-one percent (25/31) reported one or more physical health symptoms. Fifty-seven percent (17/30) reported one or more post-traumatic stress symptoms. A substantial proportion of men and women who are trafficked for labor exploitation may experience violence and abuse, and have physical and mental health symptoms. People who have been trafficked for forced labor need access to medical assessment and treatment.

  3. Effectiveness of Lifestyle Measures in the Treatment of Gastroesophageal Reflux Disease — A Case Series

    PubMed Central

    Nowak, Madeleine; Büttner, Petra; Harrison, Simone; Daniell, Kym; Raasch, Beverly; Speare, Rick

    2006-01-01

    Aim To assess the effectiveness of lifestyle measures in the treatment of gastroesophageal reflux disease (GERD) among adults attending a dietetic practice. Methods A retrospective case series of adult patients presenting with GERD to a dietetic practice over a three year period. The routine lifestyle counselling for treatment of symptoms of GERD included: not reclining within two to three hours of eating; a diet low in fat; small frequent meals; avoiding dietary components considered to relax the lower esophageal sphincter; and avoiding local irritants. Results Twenty three cases were included (12 male). Eighteen, (9 female) were referred by their doctor, 7 (6 female) presented for GERD alone, 7 (4 female) presented for GERD together with comorbidities, and 9 (1 female) incidentally mentioned GERD during a dietary consultation for another disorder. Thirteen participants (9 female) had previously undergone endoscopies, 18 (11 female) were taking medication for GERD, and 19 (7 female) had comorbidities. Twenty two (10 female) reported an improvement in symptoms with 11/18 taking GERD medication at presentation reducing their medication following treatment. Conclusions These results suggest that a more thorough investigation of lifestyle modification in the treatment of GERD is warranted. PMID:18360609

  4. Flexible modelling of vaccine effect in self-controlled case series models.

    PubMed

    Ghebremichael-Weldeselassie, Yonas; Whitaker, Heather J; Farrington, C Paddy

    2016-05-01

    The self-controlled case series (SCCS) method, commonly used to investigate the safety of vaccines, requires information on cases only and automatically controls all age-independent multiplicative confounders, while allowing for an age-dependent baseline incidence. Currently, the SCCS method represents the time-varying exposures using step functions with pre-determined cut points. A less prescriptive approach may be beneficial when the shape of the relative risk function associated with exposure is not known a priori, especially when exposure effects can be long-lasting. We therefore propose to model exposure effects using flexible smooth functions. Specifically, we used a linear combination of cubic M-splines which, in addition to giving plausible shapes, avoids the integral in the log-likelihood function of the SCCS model. The methods, though developed specifically for vaccines, are applicable more widely. Simulations showed that the new approach generally performs better than the step function method. We applied the new method to two data sets, on febrile convulsion and exposure to MMR vaccine, and on fractures and thiazolidinedione use. PMID:26494534

  5. The Reasons of Renal Transplant Recipients’ Admission to the Emergency Department; a Case Series Study

    PubMed Central

    Uysal, Erdal; Dokur, Mehmet; Bakir, Hasan; Ikidag, Mehmet Ali; Kirdak, Turkay; Kazimoglu, Hatem

    2016-01-01

    Introduction: Renal transplantation are admitted to emergency department (ED) more than normal population. The present brief report aimed to determine the reasons of renal transplant patients’ ED visits. Methods: This retrospective case series study analyzed the reasons of renal transplant recipients’ admission to one ED between 2011 and 2014. The patient data were collected via a checklist and presented using descriptive statistics tools. Results: 41 patients with the mean age of 40.63 ± 10.95 years were studied (60.9% male). The most common ED presenting complaints were fever (36.6%) and abdominal pain (26.8%). Infections were the most common final diagnosis (68.3%). Among non-infectious causes, the most common was acute renal failure (9.7 %). 73.2% of the patients were hospitalized and no cases of graft loss and mortality were seen. Conclusion: The most common reason for ED admission was fever, and infections were the most common diagnosis. Acute gastroenteritis being the most frequent infection and among non-infectious problems, acute renal failure was the most frequent one. PMID:27800542

  6. Clinical Effect of Acupotomy Combined with Korean Medicine: A Case Series of a Herniated Intervertebral Disc.

    PubMed

    Kim, Hyun-ji; Jeon, Ju-hyun; Kim, Young-il

    2016-02-01

    The aim of this study is to evaluate the effect of acupotomy for treating patients with a herniated intervertebral disc (HIVD). This case series includes five HIVD patients who were treated at the Department of Acupuncture and Moxibustion, Daejeon University Dunsan Korean Hospital, Daejeon, Korea, from January 2015 to April 2015. Acupotomy was performed three times over a 2-week period, along with Korean medical treatment. The outcomes were evaluated by using a numeric rating scale (NRS), physical examination, the Oswestry Low Back Pain Disability Index (ODI), the Short-Form 36-Item Health Survey (SF-36), and the Surgical Safety Checklist. The NRS and physical examination results, as well as the ODI scores, were improved in all cases. No significant differences were noted on the SF-36. No patients had any adverse effects. This study, with its findings of encouraging responses in reducing low back pain and radiating pain and in recovering the kinetic state of soft tissue, supports the potential use of acupotomy for the treatment of patients suffering from HIVD. PMID:26896075

  7. Renal involvement in MELAS syndrome - a series of 5 cases and review of the literature.

    PubMed

    Seidowsky, Alexandre; Hoffmann, Maxime; Glowacki, François; Dhaenens, Claire-Marie; Devaux, Jean-Philippe; de Sainte Foy, Celia Lessore; Provot, François; Gheerbrant, Jean-Dominique; Hummel, Aurelie; Hazzan, Marc; Dracon, Michel; Dieux-Coeslier, Anne; Copin, Marie-Christine; Noël, Christian; Buob, David

    2013-12-01

    Renal dysfunction is increasingly recognized as a potential clinical feature of mitochondrial cytopathies such as mitochondrial encephalomyopathy, lacticacidosis and stroke-like episodes (MELAS) syndrome. Five cases of MELAS syndrome with renal involvement from 4 unrelated families are presented in this case series. Three of the 5 patients had a history of maternally-inherited diabetes and/or deafness. Focal and segmental glomerulosclerosis and arteriolar hyaline thickening were the most striking findings on renal biopsy. In addition to clinical presentation with the typical symptoms of MELAS syndrome, genetic testing in these patients identified the A3243G point mutation in the tRNALeu gene of the mitochondrial DNA (mtDNA). The diagnosis of MELAS syndrome was thus considered to be unequivocal. The incidence of kidney disease in MELAS syndrome may be underestimated although a study is required to investigate this hypothesis. As the A3243G mtDNA mutation leads to a progressive adult-onset form of focal segmental glomerulosclerosis (FSGS), screening for the MELAS A3243G mtDNA mutation should therefore be performed especially in patients with maternally-inherited diabetes or hearing loss presenting with FSGS.

  8. Subcutaneous Fungal Cyst Masquerading as Benign Lesions – A Series of Eight Cases

    PubMed Central

    Varghese, Renu G’Boy; Phansalkar, Manjiri; Ramdas, Anita; K, Authy; G, Thangiah

    2015-01-01

    Background Subcutaneous fungal infections are caused by penetration of the causative fungi into the subcutaneous layer and are usually localised. We present a series of eight cases with subcutaneous fungal cystic lesions masquerading as benign lesions. Materials and Methods A retrospective study was conducted on subcutaneous fungal infections seen between January 2007 to July 2014 in the Department of Pathology. Eight patients with biopsy proven subcutaneous fungal infection were included. We collected and analysed their demographic, clinical and histopathological details. Results Among eight patients, six were male and two were female. The mean age was 47 years (Range: 21-70). All the eight patients presented with non-tender cystic swelling. The size of the swellings varied from a minimum of 3x3 cm to maximum of 10x4 cm. Out of eight, hand was involved in three, forearm in one, elbow in two, leg in one and foot in one. On H&E staining, all the cases showed fibro collagenous cyst wall, lined by histiocytes, granulomatous reaction, foreign body type of giant cells with acute and chronic inflammatory infiltrate containing fungal elements. Six were identified as hyalohyphomycosis and two were identified as phaeohyphomycotic cysts based on pigmentation of hyphae. Conclusion Fungal infection should be suspected in all subcutaneous cystic lesions. Excised tissue should always be sent for culture and histopathology. PMID:26557537

  9. Composite vertical bite reconstructions in eroded dentitions after 5·5 years: a case series.

    PubMed

    Attin, T; Filli, T; Imfeld, C; Schmidlin, P R

    2012-01-01

    In the following case series, we report on six cases of erosive worn dentitions (75 posterior teeth), which have been reconstructed using a template-based technique with direct composite resin restorations and already examined after 3 years in service. In all patients either one or both tooth arches were completely restored using direct resin composite restorations. A wax-up-based template was used to avoid freehand build-up techniques and to ensure optimal anatomy and function. All patients were re-assessed after a mean service time of 5·5 years (mean 67 ± 4 months) using United States Public Health Service criteria. The overall quality of the restorations was good with predominantly 'alpha' and 'bravo' scores, respectively. However, the restorations showed some deterioration with respect to marginal quality, marginal discoloration, surface texture and anatomy as compared to the 3-year investigation. The marginal impairments could be resolved by polishing. It is concluded that this non-invasive technique provides a possible treatment option at least for the displayed observation period of 5·5 years. PMID:21827523

  10. Mucoepidermoid carcinoma of the parotid presenting as periauricular cystic nodules: a series of four cases.

    PubMed

    Lehmer, Larisa M; Ragsdale, Bruce D; Crawford, Richard I; Bukachevsky, Roman; Hannah, Lauren A

    2012-07-01

    Mucoepidermoid carcinoma is a relatively common neoplasm of the major and minor salivary glands that can secondarily involve skin. In the vicinity of the ear lobe, mimicry of a benign cyst, both clinically and histopathologically is a diagnostic pitfall to avoid. The clinical manifestations, diagnostic histopathology, and clinical course of mucoepidermoid carcinoma of the parotid gland presenting as a clinically benign periauricular cystic nodule in four patients ranging in age from 11 to 63 years, are analyzed in the present report. Illustrating the challenge of accurate diagnosis, three of the four cases were initially misinterpreted on biopsy as benign cystic lesions. Multiple biopsies displayed foamy histiocytes around mucinous extravasations into dermis that mimicked ruptured epithelial cysts in two cases before malignancy was ascertained. This series demonstrates the need to include parotid tumor in the differential diagnosis of odd periauricular cyst-like expansions and adenosquamous proliferations. Mucoepidermoid carcinoma in particular can explain indolent, infra-auricular 'mucinous cysts'. Familiarity with this syndrome should arouse suspicion of parotid carcinoma when a 'cyst' or nodule is located near the earlobe. Delay in diagnosis results in larger surgical procedures than are otherwise necessary.

  11. New activity-based funding model for Australian private sector overnight rehabilitation cases: the rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model.

    PubMed

    Hanning, Brian; Predl, Nicolle

    2015-09-01

    Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally. PMID:25725655

  12. New activity-based funding model for Australian private sector overnight rehabilitation cases: the rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model.

    PubMed

    Hanning, Brian; Predl, Nicolle

    2015-09-01

    Traditional overnight rehabilitation payment models in the private sector are not based on a rigorous classification system and vary greatly between contracts with no consideration of patient complexity. The payment rates are not based on relative cost and the length-of-stay (LOS) point at which a reduced rate applies (step downs) varies markedly. The rehabilitation Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) model (RAM), which has been in place for over 2 years in some private hospitals, bases payment on a rigorous classification system, relative cost and industry LOS. RAM is in the process of being rolled out more widely. This paper compares and contrasts RAM with traditional overnight rehabilitation payment models. It considers the advantages of RAM for hospitals and Australian Health Service Alliance. It also considers payment model changes in the context of maintaining industry consistency with Electronic Claims Lodgement and Information Processing System Environment (ECLIPSE) and health reform generally.

  13. Huntington disease and Huntington disease-like in a case series from Brazil.

    PubMed

    Castilhos, R M; Souza, A F D; Furtado, G V; Gheno, T C; Silva, A L; Vargas, F R; Lima, M-A F D; Barsottini, O; Pedroso, J L; Godeiro, C; Salarini, D; Pereira, E T; Lin, K; Toralles, M-B; Saute, J A M; Rieder, C R; Quintas, M; Sequeiros, J; Alonso, I; Saraiva-Pereira, M L; Jardim, L B

    2014-10-01

    The aim of this study was to identify the relative frequency of Huntington's disease (HD) and HD-like (HDL) disorders HDL1, HDL2, spinocerebellar ataxia type 2 (SCA2), SCA17, dentatorubral-pallidoluysian degeneration (DRPLA), benign hereditary chorea, neuroferritinopathy and chorea-acanthocytosis (CHAC), in a series of Brazilian families. Patients were recruited in seven centers if they or their relatives presented at least chorea, besides other findings. Molecular studies of HTT, ATXN2, TBP, ATN1, JPH3, FTL, NKX2-1/TITF1 and VPS13A genes were performed. A total of 104 families were ascertained from 2001 to 2012: 71 families from South, 25 from Southeast and 8 from Northeast Brazil. There were 93 HD, 4 HDL2 and 1 SCA2 families. Eleven of 104 index cases did not have a family history: 10 with HD. Clinical characteristics were similar between HD and non-HD cases. In HD, the median expanded (CAG)n (range) was 44 (40-81) units; R(2) between expanded HTT and age-at-onset (AO) was 0.55 (p=0.0001, Pearson). HDL2 was found in Rio de Janeiro (2 of 9 families) and Rio Grande do Sul states (2 of 68 families). We detected HD in 89.4%, HDL2 in 3.8% and SCA2 in 1% of 104 Brazilian families. There were no cases of HDL1, SCA17, DRPLA, neuroferritinopathy, benign hereditary chorea or CHAC. Only six families (5.8%) remained without diagnosis.

  14. Neglected dislocation in sub-axial cervical spine: Case series and a suggested treatment protocol

    PubMed Central

    Srivastava, Sudhir Kumar; Aggarwal, Rishi Anil; Bhosale, Sunil Krishna; Nemade, Pradip Sharad

    2016-01-01

    Context: Approaches suggested for treatment of neglected dislocations in the subaxial cervical spine (SACS) include only anterior approach (a), only posterior approach (b), posterior-anterior approach, posterior-anterior-posterior approach, and anterior-posterior-anterior-posterior approach. No protocol is suggested in literature to guide surgeons treating neglected dislocations. Aim: To describe a protocol for the treatment of neglected dislocation in the SACS. Settings and Designs: Retrospective case series and review of literature. Materials and Methods: Six consecutive patients of neglected dislocation (presenting to us more than 3 weeks following trauma) of the SACS were operated as per the protocol suggested in this paper. A retrospective review of the occupational therapy reports, patient records, and radiographs was performed. Only cases with time lapse of more than 3 weeks between the time of injury and initial management have been included in the review. Results: Closed reduction (CR) was achieved in three patients following cervical traction and these were managed by anterior cervical discectomy and fusion (ACDF). Open reduction via posterior approach and soft tissue release was required to achieve reduction in two patients. Following reduction posterior instrumented fusion was done in them. One patient with preoperative neurological deficit needed a facetectomy to achieve reduction. Following short-segment fixation, ACDF was also performed in this patient. None of the patients deteriorated neurologically following surgery. Fusion was achieved in all patients. Conclusions: Preoperative and intraoperative traction have a role in the management of neglected dislocations in the cervical spine. If CR is achieved the patient may be managed by ACDF. If CR is not achieved, posterior soft tissue release may be done to achieve reduction and partial facetectomy must be reserved for cases in which reduction is not achieved after soft tissue release. A treatment

  15. Transient congenital hypothyroidism due to thyroid-stimulating hormone receptor blocking antibodies: a case series.

    PubMed

    Evans, Carol; Gregory, John W; Barton, John; Bidder, Christopher; Gibbs, John; Pryce, Rebekah; Al-Muzaffar, Iyad; Ludgate, Marian; Warner, Justin; John, Rhys; Moat, Stuart J

    2011-07-01

    We describe seven infants with transient congenital hypothyroidism (CH) due to maternal thyroid-stimulating hormone receptor (TSH-R) blocking antibodies (TRAb) identified over three decades of newborn screening for CH in Wales, UK that represents a minimum incidence of 1.6% of CH cases. Infants with transient CH due to maternal TRAb presented with a spectrum of clinical and biochemical hypothyroidism. Blood spot TSH concentrations ranged 60.5-332 mIU/L. CH was confirmed by plasma thyroid function tests in all cases (plasma TSH ranged 21-752 mIU/L). The seven infants belonged to five different families. On examination, four infants were clinically hypothyroid. Five infants had a thyroid ultrasound, of which three were abnormal. All infants were treated with thyroxine, which was subsequently withdrawn from three. Following thyroxine withdrawal, one infant resumed normal thyroid function and two developed compensated hypothyroidism. Of the five mothers, two had undiagnosed hypothyroidism and three were receiving thyroxine for longstanding hypothyroidism. Thyroid peroxidase antibody (aTPO) was measured in four and was negative in two, borderline positive in one and strongly positive in another. TRAb was measured in all five women and was strongly positive in all of them. This case series highlights the importance of identifying CH due to TRAb by investigating both the infant and the mother following a raised TSH found on newborn screening. The identification of those infants with transient CH caused by maternal transfer of TRAb is essential for optimizing management during childhood (including potential withdrawal of thyroxine replacement in the longer term) and in any subsequent pregnancy.

  16. Pituitary hyperplasia: case series and literature review of an under-recognised and heterogeneous condition

    PubMed Central

    Earls, Peter; McCormack, Ann I

    2015-01-01

    Summary Pituitary hyperplasia (PH) occurs in heterogeneous settings and remains under-recognised. Increased awareness of this condition and its natural history should circumvent unnecessary trans-sphenoidal surgery. We performed an observational case series of patients referred to a single endocrinologist over a 3-year period. Four young women were identified with PH manifesting as diffuse, symmetrical pituitary enlargement near or touching the optic apparatus on MRI. The first woman presented with primary hypothyroidism and likely had thyrotroph hyperplasia given prompt resolution with thyroxine. The second and third women were diagnosed with pathological gonadotroph hyperplasia due to primary gonadal insufficiency, with histopathological confirmation including gonadal-deficiency cells in the third case where surgery could have been avoided. The fourth woman likely had idiopathic PH, though she had concomitant polycystic ovary syndrome which is a debated cause of PH. Patients suspected of PH should undergo comprehensive hormonal, radiological and sometimes ophthalmological evaluation. This is best conducted by a specialised multidisciplinary team with preference for treatment of underlying conditions and close monitoring over surgical intervention. Learning points Normal pituitary dimensions are influenced by age and gender with the greatest pituitary heights seen in young adults and perimenopausal women.Pituitary enlargement may be seen in the settings of pregnancy, end-organ insufficiency with loss of negative feedback, and excess trophic hormone from the hypothalamus or neuroendocrine tumours.PH may be caused or exacerbated by medications including oestrogen, GNRH analogues and antipsychotics.Management involves identification of cases of idiopathic PH suitable for simple surveillance and reversal of pathological or iatrogenic causes where they exist.Surgery should be avoided in PH as it rarely progresses. PMID:26124954

  17. Diaphragmatic hernia after liver transplantation in children: case series and review of the literature.

    PubMed

    Cortes, Miriam; Tapuria, Niteen; Khorsandi, Shirin Elizabeth; Ibars, Eugenia Pareja; Vilca-Melendez, Hector; Rela, Mohamed; Heaton, Nigel D

    2014-12-01

    A diaphragmatic hernia (DH) is a rare complication of pediatric liver transplantation (LT), with multiple factors implicated in the pathophysiology. It is a potentially life-threatening condition in the absence of early recognition and surgical treatment. A DH after LT has been reported in 16 patients in 7 case series. We report 10 cases from our institution and review the published literature to understand the underlying pathophysiology. The study sample included all children (<18 years of age) who underwent LT from October 1989 to August 2013 at our center and subsequently presented with a DH. Among 4433 LT procedures performed in this time period, 1032 were for children. Ten DH cases were recognized, and risk factors were assessed. The mean age at diagnosis was 4.9 years, all patients with a DH received left lateral segment split grafts, and the mean graft weight was 248 ± 41 g with a mean graft-to-recipient body weight ratio (GBWR) of 3% ± 1.22% (range = 1.7%-5.0%). The mean cold ischemia time was 510.7 ± 307.6 minutes (range = 60-900 minutes). Six patients had a primary abdominal muscle closure, 3 had a temporary Silastic mesh closure, and 1 had a skin closure only. Postoperative ascites and pleural effusion did not appear to be significant risk factors. All 10 children presented with a right posterolateral DH, with 1 also having a left DH. The small bowel was herniated in the majority. All patients underwent prompt surgical intervention without complications. An early age, a split graft, and a high GBWR may be risk factors for a DH. A high index of suspicion and prompt surgical intervention minimize complications. PMID:25124299

  18. Pitfalls in Fractal Time Series Analysis: fMRI BOLD as an Exemplary Case.

    PubMed

    Eke, Andras; Herman, Peter; Sanganahalli, Basavaraju G; Hyder, Fahmeed; Mukli, Peter; Nagy, Zoltan

    2012-01-01

    This article will be positioned on our previous work demonstrating the importance of adhering to a carefully selected set of criteria when choosing the suitable method from those available ensuring its adequate performance when applied to real temporal signals, such as fMRI BOLD, to evaluate one important facet of their behavior, fractality. Earlier, we have reviewed on a range of monofractal tools and evaluated their performance. Given the advance in the fractal field, in this article we will discuss the most widely used implementations of multifractal analyses, too. Our recommended flowchart for the fractal characterization of spontaneous, low frequency fluctuations in fMRI BOLD will be used as the framework for this article to make certain that it will provide a hands-on experience for the reader in handling the perplexed issues of fractal analysis. The reason why this particular signal modality and its fractal analysis has been chosen was due to its high impact on today's neuroscience given it had powerfully emerged as a new way of interpreting the complex functioning of the brain (see "intrinsic activity"). The reader will first be presented with the basic concepts of mono and multifractal time series analyses, followed by some of the most relevant implementations, characterization by numerical approaches. The notion of the dichotomy of fractional Gaussian noise and fractional Brownian motion signal classes and their impact on fractal time series analyses will be thoroughly discussed as the central theme of our application strategy. Sources of pitfalls and way how to avoid them will be identified followed by a demonstration on fractal studies of fMRI BOLD taken from the literature and that of our own in an attempt to consolidate the best practice in fractal analysis of empirical fMRI BOLD signals mapped throughout the brain as an exemplary case of potentially wide interest. PMID:23227008

  19. Pitfalls in Fractal Time Series Analysis: fMRI BOLD as an Exemplary Case

    PubMed Central

    Eke, Andras; Herman, Peter; Sanganahalli, Basavaraju G.; Hyder, Fahmeed; Mukli, Peter; Nagy, Zoltan

    2012-01-01

    This article will be positioned on our previous work demonstrating the importance of adhering to a carefully selected set of criteria when choosing the suitable method from those available ensuring its adequate performance when applied to real temporal signals, such as fMRI BOLD, to evaluate one important facet of their behavior, fractality. Earlier, we have reviewed on a range of monofractal tools and evaluated their performance. Given the advance in the fractal field, in this article we will discuss the most widely used implementations of multifractal analyses, too. Our recommended flowchart for the fractal characterization of spontaneous, low frequency fluctuations in fMRI BOLD will be used as the framework for this article to make certain that it will provide a hands-on experience for the reader in handling the perplexed issues of fractal analysis. The reason why this particular signal modality and its fractal analysis has been chosen was due to its high impact on today’s neuroscience given it had powerfully emerged as a new way of interpreting the complex functioning of the brain (see “intrinsic activity”). The reader will first be presented with the basic concepts of mono and multifractal time series analyses, followed by some of the most relevant implementations, characterization by numerical approaches. The notion of the dichotomy of fractional Gaussian noise and fractional Brownian motion signal classes and their impact on fractal time series analyses will be thoroughly discussed as the central theme of our application strategy. Sources of pitfalls and way how to avoid them will be identified followed by a demonstration on fractal studies of fMRI BOLD taken from the literature and that of our own in an attempt to consolidate the best practice in fractal analysis of empirical fMRI BOLD signals mapped throughout the brain as an exemplary case of potentially wide interest. PMID:23227008

  20. Brachial Plexus Block for Cancer-Related Pain: A Case Series.

    PubMed

    Zinboonyahgoon, Nantthasorn; Vlassakov, Kamen; Abrecht, Christ R; Srinivasan, Suresh; Narang, Sanjeet

    2015-01-01

    Neoplastic brachial plexopathy (NBP) is caused by a cancerous infiltration into the brachial plexus, presenting often as severe pain in the affected upper extremity. Such pain can be resistant to medical treatment. Invasive interventions such as brachial plexus neurolysis with phenol or cordotomy may result in severe complications including permanent neurological damage and death. Continuous brachial plexus and paravertebral block with local anesthetic have been reported to successfully control pain from NBP, but these techniques are logistically challenging and frequently have catheter-related complications. We report a series of patients who received single-shot brachial plexus blocks with a mixture of local anesthetic and corticosteroid (bupivacaine 0.25% with methyl-prednisolone 20-120 mg) for the treatment of refractory cancer-related pain in the brachial plexus territory, mostly from NBP. Theoretically, such blocks could provide immediate analgesia from the local anesthetic and a longer-lasting analgesia from the slow-release steroids. Responders reported a sustained decrease in their pain (lasting from 2 weeks to 10 months), a significant decrease in their opioid and non-opioid (ketamine, gabapentin) consumption, overall satisfaction with the block, and unchanged or improved function of their limb. The ideal candidate for this procedure is a patient who has pain that is predominantly neuropathic from a lesion within the brachial plexus and with anatomy amenable to ultrasound-guided nerve block. Our case series suggests that, in the appropriately selected patient, this technique can safely and effectively alleviate pain from NBP. The procedure is simple, spares limb function, and can be diagnostic, predicting response to more complex procedures. To the best of our knowledge, this is the first report using this technique for NBP.

  1. Ovulation induction with minimal dose of follitropin alfa: a case series study

    PubMed Central

    2011-01-01

    Background Gonadotropins are used in ovulation induction (OI) for patients with anovulatory infertility. Pharmacologic OI is associated with risks of ovarian hyperstimulation syndrome and multiple pregnancy. Treatment protocols that minimize these risks by promoting monofollicular development are required. A starting dose of 37.5 IU/day follitropin alfa has been used in OI, particularly among women at high risk of multifollicular development and multiple pregnancy. A retrospective case series study was performed to evaluate rates of monofollicular development and singleton pregnancy following standard treatment with 37.5 IU/day follitropin alfa. Methods Spanish centers that had performed at least five OI cycles during 2008 using 37.5 IU/day follitropin alfa as a starting dose were invited to participate. Data could be provided from any cycle performed in 2008 (up to a maximum of 12 consecutive cycles per site). Case report forms were collected during April-November 2009 and reviewed centrally. Descriptive statistics were obtained from all cases, and follicular development and clinical pregnancy rates assessed. Potential associations of age and body mass index with follicular development and clinical pregnancy were assessed using univariate correlation analyses. Results Thirty centers provided data on 316 cycles of OI using a starting dose of 37.5 IU/day follitropin alfa. Polycystic ovary syndrome was the cause of anovulatory infertility in 217 (68.7%) cases. Follitropin alfa at 37.5 IU/day was sufficient to achieve ovarian stimulation in 230 (72.8%) cycles. A single follicle ≥16 mm in diameter developed in 193 cycles (61.1%; 95% confidence interval [CI] 55.7-66.4%). Seventy-eight women (24.7%; 95% CI 19.9-29.5%) became pregnant: 94.9% singleton and 5.1% twin pregnancies. Fourteen started cycles (4.4%) were cancelled, mainly due to poor response. Univariate correlation analyses detected weak associations. Conclusions Monofollicular growth rate was comparable with

  2. Convergence in spectral forward modelling: Binominal series solutions vs. direct integral solutions at high degrees - spherical and ellipsoidal case

    NASA Astrophysics Data System (ADS)

    Rexer, Moritz; Claessens, Sten; Hirt, Christian

    2016-04-01

    The number of relevant terms of binominal series expansions used in spectral forward modelling of the gravitational potential is known to rise substantially as the resolution of the models increases. Here, we investigate and compare the binominal series expansions in forward modelling w.r.t. a sphere and w.r.t. an ellipsoid (Claessens and Hirt, 2013) in view of high degree forward modelling (d/o 10800). The series in each case depend on different parameters - such as elevation of the topographic function or ellipsoidal radius/co-latitude - and reveal different maximum orders of truncation for a 1% convergence level (=relative error). The results are verified in a real data scenario up to d/o 5400 by spot-checks using direct integral solutions that do not depend on binomial series expansions. As a conclusion, our study demonstrates that for d/o 10800 modelling up to 30 terms of the binominal series accounting for the radial integral are needed within the spherical and the ellipsoidal case, while up to 60 terms are needed for the binominal series accounting for the oblateness of Earth in the ellipsoidal case for a convergence at the 1% level. References: Claessens, S.J.; Hirt, C.: Ellipsoidal topographic potential - new solutions for spectral forward gravity modelling of topography with respect to a reference ellipsoid; Journal of Geophysical Research (JGR) - Solid Earth, Vol. 118, DOI: 10.1002/2013JB010457, 2013.

  3. Reproductive and other factors and risk of epithelial ovarian cancer: an Australian case-control study. Survey of Women's Health Study Group.

    PubMed

    Purdie, D; Green, A; Bain, C; Siskind, V; Ward, B; Hacker, N; Quinn, M; Wright, G; Russell, P; Susil, B

    1995-09-15

    Of the few factors known to be associated with epithelial ovarian cancer, the most consistently observed relate to women's reproductive function, although even here uncertainties remain. We have undertaken a case-control study involving personal interviews with over 1,600 women, the largest of its kind to date, to investigate further the associations between women's reproductive histories and other factors and the development of ovarian cancer. Cases were drawn from women diagnosed with epithelial ovarian cancer in 3 Australian states, Queensland, New South Wales and Victoria, between August 1990 and December 1993, and controls were drawn at random from the electoral roll, stratified by age and geographic region. Trained interviewers administered standard questionnaires to obtain detailed information about women's reproductive and contraceptive histories and other factors of interest, such as smoking and family history of ovarian or other cancer. Findings were based on data from 824 cases and 860 controls and confirmed the reduced risk of ovarian cancer associated with increasing parity and duration of use of the oral contraceptive pill (OCP), hysterectomy and tubal ligation. The strongest association of all was seen with use of the OCP for 10 years or more. An inverse association between ovarian cancer and age at first birth was observed, but this was not statistically significant. There were no associations between development of ovarian cancer and number of incomplete pregnancies, use of hormone replacement therapy or menstrual history. Among other factors considered, education after leaving school was negatively associated and high body mass index, family history of ovarian cancer, use of talc in the abdominal or perineal region and smoking were positively associated with occurrence of ovarian cancer.

  4. Young Australians: Their Health and Wellbeing 2011

    ERIC Educational Resources Information Center

    Milnes, Annette; Pegrum, Karen; Nebe, Brett; Topfer, Alex; Gaal, Lisa; Zhang, Jessica; Hunter, Nicole

    2011-01-01

    This paper is the fourth in a series of national statistical reports on young people aged 12-24 years produced by the Australian Institute of Health and Welfare (AIHW). This report provides the latest available information on how Australia's young people are faring according to national indicators of health and wellbeing. Many young Australians…

  5. Citizen Child: Australian Law and Children's Rights.

    ERIC Educational Resources Information Center

    Funder, Kathleen, Ed.

    Ratification by Australia of the United Nations Convention on the Rights of the Child in 1990 acted as a potent stimulus for a series of debates and controversies concerning the place of children in Australian society. The debate has largely taken place in relatively specialized forums involving lawyers, members of the judiciary, social…

  6. CASE/A - COMPUTER AIDED SYSTEM ENGINEERING AND ANALYSIS, ECLSS/ATCS SERIES

    NASA Technical Reports Server (NTRS)

    Bacskay, A.

    1994-01-01

    , specific heat, density, and viscosity) is generated at user-selected output intervals and stored for reference. The Integrated Plot Utility (IPU) provides plotting capability for all data output. System utility commands are provided to enable the user to operate more efficiently in the CASE/A environment. The user is able to customize a simulation through optional operations FORTRAN logic. This user-developed code is compiled and linked with a CASE/A model and enables the user to control and timeline component operating parameters during various phases of the iterative solution process. CASE/A provides for transient tracking of the flow stream constituents and determination of their thermodynamic state throughout an ECLSS/ATCS simulation, performing heat transfer, chemical reaction, mass/energy balance, and system pressure drop analysis based on user-specified operating conditions. The program tracks each constituent through all combination and decomposition states while maintaining a mass and energy balance on the overall system. This allows rapid assessment of ECLSS designs, the impact of alternate technologies, and impacts due to changes in metabolic forcing functions, consumables usage, and system control considerations. CASE/A is written in FORTRAN 77 for the DEC VAX/VMS computer series, and requires 12Mb of disk storage and a minimum paging file quota of 20,000 pages. The program operates on the Tektronix 4014 graphics standard and VT100 text standard. The program requires a Tektronix 4014 or later graphics terminal, third party composite graphics/text terminal, or personal computer loaded with appropriate VT100/TEK 4014 emulator software. The use of composite terminals or personal computers with popular emulation software is recommended for enhanced CASE/A operations and general ease of use. The program is available on an unlabeled 9-track 6250 BPI DEC VAX BACKUP format magnetic tape. CASE/A development began in 1985 under contract to NASA/Marshall Space Flight

  7. Osteoradionecrosis of the mandible: a case series at a single institution

    PubMed Central

    2013-01-01

    Background Osteoradionecrosis (ORN) defines exposed irradiated bone, which fails to heal over a period of 3–6 months without evidence of residual or recurrent tumor. In the previous decades, a staging and treatment protocol suggested by Marx, has dominated the approach to ORN. However, recently this paradigm is shifting. The purpose of this study was to evaluate our institutional experience in managing ORN through a retrospective review of case series from a large urban academic cancer centre. Methods A retrospective chart review was conducted to include all ORN cases from 2003 to 2009 diagnosed at the Department of Otolaryngology – Head and Neck Surgery and the Department of Dentistry. The staging of ORN was assessed as affected by tumor site, tumor stage, radiotherapy modality and dose, chemotherapy, dental work, and time to diagnosis. The effectiveness of hyperbaric oxygen therapy (HBO) and surgery in the management of ORN was evaluated. Results Fourteen cases of ORN were documented (incidence 0.84%). Primary subsites included tonsils, tongue, retromolar trigone, parotid gland, soft palate and buccal mucosa. There were 5 (35.7%) stage 1, 3 (21.4%) stage 2, and 6 (42.9%) stage 3 cases. ORN severity was not significantly associated with gender, smoking, alcohol use, tumor site, T stage, N stage, AJCC stage, or treatment modality (radiation alone, surgery with adjuvant radiation or adjuvant chemoradiation). Patients treated with intensity-modulated radiotherapy developed less severe ORN compared to those treated with conventional radiotherapy (p < 0.015). ORN stage did not correlate with radiation dose. In one patient only dental procedures were performed following radiation and could be implicated as the cause of ORN. HBO therapy failed to prevent ORN progression. Surgical treatment was required for most stage 2 (partial resections and free tissue transfers) and stage 3 patients (mandibulectomies and free tissue transfers, including two flaps in one

  8. Long ureteric stricture replacement by buccal mucosa graft: an Armenian experience case series report

    PubMed Central

    Akopyan, Kristina; Levonyan, Arthur; Tsaturyan, Ashot

    2016-01-01

    Introduction The aim of this study is to demonstrate the results of a case series concerning the replacement of long ureteric strictures using buccal mucosa grafts. Material and methods Five patients (3 men, 2 women), with a mean age of 35 years old, underwent reconstructive ureteral surgery using buccal mucosa graft with omental wrapping during the period of 2010–2013. In all cases, the location of strictures was in the proximal ureters with the length of strictures varying from 2.5 to 5.0 cm. Results We did not observe any major complications postoperatively. Two patients complained of constipation, which was resolved on the second day without any special treatment. Only one patient experienced fever (39°C) on the seventh day after the surgery due to inadequate drainage of the nephrostomic tube. Mean follow-up time was 39.6 months (range 26–52 months), mean hospital stay length was 10.6 days. Intravenous and antegrade urography were performed after removing JJ stents. Results were favorable without any signs of stricture. Repetitive ultrasound and radiologic imaging was performed at month 3, 6, 12 in the first year and every half-year thereafter. Intravenous urography showed no signs of strictures. Hydronephrosis was resolved in all patients by the sixth month following the surgery. Conclusions Postoperatively, we observed favorable results in all patients in terms of absence of short term-surgical complications. This technique could be considered for patients with long ureteric strictures in whom ureteral replacement with bowel interposition or kidney auto-transplantation is contraindicated. PMID:27551561

  9. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    PubMed Central

    Dautovic, Elmedina; de Roos, Carlijn; van Rood, Yanda; Dommerholt, Agnes; Rodenburg, Roos

    2016-01-01

    Purpose To examine the potential effects of eye movement desensitization and reprocessing (EMDR) in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods Five children (aged 8–18) with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED) pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results Before EMDR, overall or subscale scores indicated that all children had (sub)clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session). Conclusions In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy. Highlights of the article The first study to examine the potential effects of EMDR to reduce clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms in children with epilepsy. After 1–3 EMDR (45 min) sessions, positive treatment effects were found on a range of seizure-related PTSD symptoms and/or anxiety symptoms. During treatment, no seizures, absences, or any other adverse events were observed; the seizure diaries showed that none of the children experienced more seizures (or an unusual pattern) after treatment. At the reevaluation of EMDR, all children and parents

  10. Ascending aortitis: a clinicopathological study of 21 cases in a series of 300 aortic repairs.

    PubMed

    Xu, Lauren; Heath, Jonathon; Burke, Allen

    2014-06-01

    There are few single-institution clinicopathological series of aortitis. In this study, all ascending aneurysms were prospectively evaluated pathologically with ≥6 aortic sections over a 6-year period.Of 300 ascending aortic resections, there were 21 cases of aortitis (7%), in 11 women and 10 men (mean 67, range 41-88 years). There were 19 patients with aneurysms, and two patients with sclerosing periaortitis, clinically suspected to have intramural haematoma. Of the 19 patients with aneurysms (11 women), two had prior temporal arteritis, one ankylosing spondylitis, one IgA nephropathy, one undifferentiated autoimmune disease, one Lyme disease, and one fibromyalgia. In only two patients was aortitis suspected before surgery as the cause of aneurysm. Four patients developed distal aortic aneurysm requiring repeat surgery. Valve replacement or repair was necessary in nine patients, and two patients died after surgery. There were no significant differences between patients with and without autoimmune disease. The histological features were necrotising aortitis in 18 of 19 patients with aneurysmal aortitis, and there was one case of non-necrotising aortitis. One valve showed autoimmune valvulitis, congenitally bicuspid associated with ankylosing spondylitis. Necrotising aortitis was classified as acute (n = 5), healing (n = 9), and healed (n = 4). Acute necrotising aortitis was associated with need for valve replacement (p = 0.01) and younger age (p = 0.01). The healed phase had subtle histological features, sparse medial inflammation, marked medial attenuation, and chronic adventitial inflammation. Two patients with periaortitis demonstrated marked fibroinflammatory thickening of the adventitia with histological features typical of IgG4-related disease; neither had systemic symptoms. Ascending aortitis is histologically diverse, most frequently of the medial necrotising type, and is usually not suspected pre-operatively. Awareness of the

  11. Validation of a home safety questionnaire used in a series of case-control studies

    PubMed Central

    Watson, Michael; Benford, Penny; Coupland, Carol; Clacy, Rose; Hindmarch, Paul; Majsak-Newman, Gosia; Deave, Toity; Kendrick, Denise

    2014-01-01

    Objective To measure the validity of safety behaviours, safety equipment use and hazards reported on a questionnaire by parents/carers with children aged under 5 years participating in a series of home safety case-control studies. Methods The questionnaire measured safety behaviours, safety equipment use and hazards being used as exposures in five case-control studies. Responses to questions were compared with observations made during a home visit. The researchers making observations were blind to questionnaire responses. Results In total, 162 families participated in the study. Overall agreement between reported and observed values of the safety practices ranged from 48.5% to 97.3%. Only 3 safety practices (stair gate at the top of stairs, stair gate at the bottom of stairs, stairs are carpeted) had substantial agreement based on the κ statistic (k=0.65, 0.72, 0.74, respectively). Sensitivity was high (≥70%) for 19 of the 30 safety practices, and specificity was high (≥70%) for 20 of the 30 practices. Overall for 24 safety practices, a higher proportion of respondents over-reported than under-reported safe practice (negative predictive value>positive predictive value). For six safety practices, a higher proportion of respondents under-reported than over-reported safe practice (negative predictive value

  12. Amniotic membrane - A Novel material for the root coverage: A case series

    PubMed Central

    Sharma, Anamika; Yadav, Komal

    2015-01-01

    Background: Periodontal plastic surgical procedures aimed at coverage of exposed root surface. Owing to the second surgical donor site and difficulty in procuring a sufficient graft for the treatment of root coverage procedures, various alternative additive membranes have been used. A recent resorbable amniotic membrane, not only maintains the structural and anatomical configuration of regenerated tissues, but also enhances gingival wound healing, provides a rich source of stem cells. Therefore, amniotic membrane is choice of material these days in augmenting the better results in various periodontal procedures. Aim: The aim of this observational case series was to evaluate the effectiveness, predictability and the use of a novel material, amniotic membrane in the treatment of shallow-to-moderate isolated recession defects. Materials and Methods: A total of three cases, showing Miller's Class I or Class II gingival recession, participated in this study. Recession depth, recession width, keratinized gingiva (KG) tissue width, clinical attachment level (CAL) were recorded at baseline, 3 and 6 months postoperatively. Results: Six months following root coverage procedures, the mean root coverage was found to be 70.2 ± 6.8%. CAL significantly decreased from 6.4 ± 0.54 mm preoperatively to 3.5 ± 0.9 mm postoperatively at 6 months while KG showed significant improvement from 3.2 ± 0.28 mm preoperatively to 5.9 ± 0.74 mm postoperatively at 6 months. Conclusion: Autogenous graft tissue procurement significantly increases patient morbidity while also lengthening the duration of surgery in placing the graft, while self-adherent nature of amniotic membrane significantly reduces surgical time and made the procedure easier to perform, making it membrane of choice. PMID:26392696

  13. Treatment of post-cardiopulmonary bypass SIRS by hemoadsorption: a case series.

    PubMed

    Träger, Karl; Fritzler, Daniel; Fischer, Guenther; Schröder, Janpeter; Skrabal, Christian; Liebold, Andreas; Reinelt, Helmut

    2016-05-16

    The use of cardiopulmonary bypass (CPB) in cardiothoracic surgery results in a well-known activation of the immunologic response. In some cases, however, this triggered immunologic response may be excessive, leading to a severe systemic inflammatory response syndrome (SIRS) and induced organ dysfunction. For example, patients frequently develop hemodynamic instability with hypotension and low systemic vascular resistance. To date, different therapeutic approaches, such as steroids, have been tried to control this maladaptive postoperative SIRS response, yet definitive proof of clinical efficacy is missing. A new cytokine adsorber device (CytoSorb; CytoSorbents) may be a useful approach to control hyperinflammatory systemic reactions by reducing a broad range of proinflammatory cytokines and other inflammatory mediators. This may, in turn, help to reestablish a physiologic immune response and help to restore deranged clinical parameters in these patients. In this retrospective case series study, we describe 16 cardiac surgery patients following prolonged CPB with post-CPB SIRS and subsequent acute kidney injury, who were then treated with hemoadsorption using CytoSorb in combination with continuous renal replacement therapy (CRRT). Treatment of patients with CytoSorb who presented with severe post-CPB SIRS resulted in a reduction of elevated cytokine levels, which was associated with a clear stabilization of deranged hemodynamic, metabolic, and organ function parameters. Treatment was well tolerated and safe, with no device-related adverse events occurring. CytoSorb therapy combined with CRRT is a potentially promising new treatment approach to achieve hemodynamic stability, cytokine reduction, and improved organ function in cardiac surgery patients who develop post-CPB SIRS. PMID:27140295

  14. Testicular resistive index determined by Doppler ultrasonography in men with spinal cord injury - a case series.

    PubMed

    Krebs, J; Göcking, K; Pannek, J

    2015-09-01

    In this case series, the testicular resistive index was determined in men with spinal cord injury. In ten men participating in our fertility programme, the peak systolic and end-diastolic velocity of centripetal testicular arteries was measured in triplicates by Doppler ultrasonography to calculate the testicular resistive index. Furthermore, the right and left testicular volume was determined by ultrasonography, blood samples were obtained for hormonal evaluation, and sperm analysis was performed according to the WHO guidelines. The median testicular resistive index measured 0.69 and was significantly (P < 0.001) greater than the reported cut-off value of 0.6. The spermiograms were characterised by normal sperm count but decreased sperm motility and plasma membrane integrity. The median right and left testicular volume was significantly (P < 0.01) smaller compared to the volumes measured in able-bodied adult males without scrotal pathology and measured 8.4 ml and 7.2 ml respectively. There was a significant (P = 0.005) correlation (rs  = 0.81) between testicular resistive index and sperm concentration. However, no correlations were observed between testicular resistive index and other variables. The testicular resistive index in men with spinal cord injury was significantly greater than 0.6. Measuring the testicular resistive index may represent a useful additional parameter in the assessment of infertility in spinal cord-injured men. PMID:25228165

  15. Time-series microarray data simulation modeled with a case-control label.

    PubMed

    Liu, Y J; Zhang, J Y

    2016-05-12

    With advances in molecular biology, microarray data have become an important resource in the exploration of complex human diseases. Although gene chip technology continues to grow, there are still many barriers to overcome, such as high costs, small sample sizes, complex procedures, poor repeatability, and the dependence on data analysis methods. To avoid these problems, simulation data have a vital role in the study of complex diseases. A simulation method of microarray data is introduced in this study to model the occurrence and development of general diseases. Using classic statistics and control theory, five risk models are proposed. One or more models can be introduced into the baseline simulation dataset with a case-control label. In addition, time-series gene expression data can be generated to model the dynamic evolutionary process of a disease. The prevalence of each model is estimated and disease-associated genes are tested by significance analysis of microarrays. The source code, written in MATLAB, is freely and publicly available at http://sourceforge.net/projects/genesimulation/files/.

  16. Clinical Advantages and Limitations of Monolithic Zirconia Restorations Full Arch Implant Supported Reconstruction: Case Series

    PubMed Central

    Carames, Joao; Yu, Yung Cheng Paul; Pérez, Alejandro; Kang, Mary

    2015-01-01

    Purpose. The purpose of this retrospective case series is to evaluate the clinical advantages and limitations of monolithic zirconia restorations for full arch implant supported restorations and report the rate of complications up to 2 years after insertion. Materials and Methods. Fourteen patients received implant placement for monolithic zirconia full arch reconstructions. Four implants were placed in seven arches, eleven arches received six implants, two arches received seven implants, two arches received eight implants, and one arch received nine implants. Results. No implant failures or complications were reported for an implant survival rate of 100% with follow-up ranging from 3 to 24 months. Conclusions. Monolithic zirconia CAD-/CAM-milled framework restorations are a treatment option for full arch restorations over implants, showing a 96% success rate in the present study. Some of the benefits are accuracy, reduced veneering porcelain, and minimal occlusal adjustments. The outcome of the present study showed high success in function, aesthetics, phonetics, and high patient satisfaction. PMID:26124835

  17. Time-series microarray data simulation modeled with a case-control label.

    PubMed

    Liu, Y J; Zhang, J Y

    2016-01-01

    With advances in molecular biology, microarray data have become an important resource in the exploration of complex human diseases. Although gene chip technology continues to grow, there are still many barriers to overcome, such as high costs, small sample sizes, complex procedures, poor repeatability, and the dependence on data analysis methods. To avoid these problems, simulation data have a vital role in the study of complex diseases. A simulation method of microarray data is introduced in this study to model the occurrence and development of general diseases. Using classic statistics and control theory, five risk models are proposed. One or more models can be introduced into the baseline simulation dataset with a case-control label. In addition, time-series gene expression data can be generated to model the dynamic evolutionary process of a disease. The prevalence of each model is estimated and disease-associated genes are tested by significance analysis of microarrays. The source code, written in MATLAB, is freely and publicly available at http://sourceforge.net/projects/genesimulation/files/. PMID:27323009

  18. Traumatic Rupture of the Distal Triceps Tendon (A Series of 7 Cases)

    PubMed Central

    Neumann, H.; Schulz, A.-P.; Breer, S.; Faschingbauer, M.; Kienast, B.

    2015-01-01

    Even non-traumatic ruptures of the triceps tendon are rare, surgical therapy should be recommended in all cases, because of poor results after non-operative treatment. A golden standard for the surgical procedure is not established. A small series of traumatic distal tendon ruptures was treated surgical in our hospital and was followed up after 12 months concerning their function. Very good and good results could be found with a strong reintegration of the tendon by using transosseus sutures with non resorbable suture material. The refixation with suture anchors showed disappointing results with early pull-outs of the anchor. Revision with screw augmentation with a washer had to be performed. Concerning the biomechanical forces, which show up on the olecranon (up to 40 NM), the refixation of the triceps tendon has proved to be extremely resistant against pull out forces. The good results by using non absorbable transosseus sutures led to a standardized procedure in our trauma center, even the rupture is not traumatic. PMID:26664499

  19. Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series

    PubMed Central

    Robinson, Cassandra L.

    2015-01-01

    Psychopharmacological treatment has been the mainstay in long-term maintenance of bipolar disorder (BD) patients for the last 60 years. Conventionally accepted treatment options are primarily based on expert opinion rather than on well-executed, independently funded research. Investigation of maintaining patients without medications using treatment alternatives has been neglected. This clinical case series examines the outcomes of 7 BD patients who experienced a poor response or significant side effects with conventional treatment modalities. Patients were gradually and safely withdrawn from all medications. Treatment strategies were based on an individualized holistic approach using herbs, nutritional supplements, vitamins, amino acids, acupuncture, dietary recommendations, and behavioral modifications. Multiple treatment modalities were combined addressing the etiological causes for BD symptoms. Upon withdrawal from psychotropic medications, patients were free of medication-induced side effects and obtained psychiatric stability for at least 10 months. Further research is needed to investigate the long-term outcomes of BD treatment modalities based on well-defined successful outcome criteria, such as reduction in symptoms, improvement in quality of life, overall health outcomes, and cost effectiveness. PMID:25984407

  20. Nonoperative Korean Medicine Combination Therapy for Lumbar Spinal Stenosis: A Retrospective Case-Series Study.

    PubMed

    Kim, Kiok; Jeong, Yongjae; Youn, Yousuk; Choi, Jeongcheol; Kim, Jaehong; Chung, Wonseok; Kim, Tae-Hun

    2015-01-01

    This is a retrospective case series exploring the therapeutic benefits and harm of nonoperative Korean medicine combination therapy for lumbar spinal stenosis (LSS). The medical records of a total of 33 LSS patients, who were treated as inpatients at Mokhuri Neck and Back Hospital, Republic of Korea, from November 2010 to January 2012, were reviewed first and telephone survey on these patients was conducted after one year. Body acupuncture, pharmacoacupuncture, Chuna, and oral administration of herbal medicines were offered to all patients. A Visual analogue scale (VAS) of pain and the walking duration without pain were used to assess the patients during the approximately 1-month treatment period. The average VAS score of pain and the walking duration improved significantly; the VAS score decreased from 9 (SD, 1.15) to 2.75 (2.22) (p < 0.01), and the walking duration increased from 5.5 (6.66) to 16.75 (13.00) minutes (p < 0.01). No adverse event was reported during the treatment. In addition, the decreased pain level and improved function continued for over one year. Although we did not find definitive evidence, the study results suggest that KM combination therapy may be beneficial for decreasing pain and improving function in LSS patients and may produce comparatively few adverse events. PMID:26543486