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Sample records for case based review

  1. Intraosseous pneumatocysts: a case based review.

    PubMed

    Oehler, Erwan; Valour, Florent; Pascart, Tristan

    2013-01-01

    Intraosseous pneumatocysts are benign gaseous bone lesions, generally asymptomatic and incidentally discovered on X-ray. These characteristics explain why these lesions are unknown to most practitioners and their low representation in medical literature. The description of an incidentally discovered iliac pneumatocyst gives us the opportunity to provide a review of available medical literature on these frequent, but poorly known lesions.

  2. Learning based on patient case reviews: an interview study

    PubMed Central

    Andersen, Rikke Sand; Hansen, Rikke Pilegaard; Søndergaard, Jens; Bro, Flemming

    2008-01-01

    individual competence to personal capability. According to the physicians, they were not only able to identify needed changes, some reported that they were able to transform these ideas into action and do things more effectively. According to our data this transition takes place, because the learning processes initiated were based on real life experiences which equally initiated reflections on what to improve, as well as how to improve their work. Conclusion Patient case reviews initiate reflective processes providing feedback about performance in real life situations. Family physicians are in favour of patient case reviews as a learning method, because it embraces the complexities they encounter in their daily practice and is based on personal experiences. PMID:18775063

  3. Learning based on patient case reviews: an interview study.

    PubMed

    Andersen, Rikke Sand; Hansen, Rikke Pilegaard; Søndergaard, Jens; Bro, Flemming

    2008-09-05

    capability. According to the physicians, they were not only able to identify needed changes, some reported that they were able to transform these ideas into action and do things more effectively. According to our data this transition takes place, because the learning processes initiated were based on real life experiences which equally initiated reflections on what to improve, as well as how to improve their work. Patient case reviews initiate reflective processes providing feedback about performance in real life situations. Family physicians are in favour of patient case reviews as a learning method, because it embraces the complexities they encounter in their daily practice and is based on personal experiences.

  4. Pleomorphic adenoma of the tongue base: case report and review.

    PubMed

    Nascimento, Luiz Augusto; Vilela, Thais Gonçalves Pinheiro

    2014-07-01

    Introduction Pleomorphic adenoma, also known as mixed tumor, is the most common benign tumor of the major and minor salivary glands. The occurrence of pleomorphic adenoma of the tongue base is very rare, and very few cases have been reported in the literature. Objective The authors present a rare case of pleomorphic adenoma of the tongue base and a review of the literature. Case Report A 55-year-old woman had an extensive cervical mass, with little pain, from the submental level to the level below the hyoid bone. Fiberoptic endoscopic examination showed an extensive mass at the base of the tongue with considerable reduction in the airway. Magnetic resonance image scan revealed a contrast-enhancing mass of heterogeneous density over the base of the tongue of 8 × 8 × 7 cm and a reduction of the hypopharyngeal airway. Biopsy of the lesion was performed along with a tracheostomy due to the bulging tongue base and acute respiratory failure. Histologic examination with an immunohistochemistry study revealed a diagnosis of pleomorphic adenoma. The excision of the tumor was performed by a lateral pharyngotomy approach and the total mass was excised. Conclusion The authors consider the rarity of this case and show that this is the 11th and the largest pleomorphic adenoma reported in the English-language medical literature.

  5. Hypertriglyceridemia-induced pancreatitis: A case-based review

    PubMed Central

    Gan, S Ian; Edwards, Alun L; Symonds, Christopher J; Beck, Paul L

    2006-01-01

    Hypertriglyceridemia is an established cause of pancreatitis. In a case-based approach, we present a review of hypertriglyceridemia and how it can cause pancreatitis. We outline how to investigate and manage such patients. A 35 year old man presented to the emergency department with abdominal pain and biochemical evidence of acute pancreatitis. There was no history of alcohol consumption and biliary imaging was normal. The only relevant past medical history was that of mild hyperlipidemia, treated with diet alone. Physical exam revealed epigastric tenderness, right lateral rectus palsy, lipemia retinalis, bitemporal hemianopsia and a delay in the relaxation phase of his ankle reflexes. Subsequent laboratory investigation revealed marked hypertriglyceridemia and panhypopituarism. An enhanced CT scan of the head revealed a large suprasellar mass impinging on the optic chiasm and hypothalamus. The patient was treated supportively; thyroid replacement and lipid lowering agents were started. He underwent a successful resection of a craniopharyngioma. Post-operatively, the patient did well on hormone replacement therapy. He has had no further attacks of pancreatitis. This case highlights many of the factors involved in the regulation of triglyceride metabolism. We review the common causes of hypertriglyceridemia and the proposed mechanisms resulting in pancreatitis. The incidence and management of hypertriglyceridemia-induced pancreatitis are also discussed. PMID:17131487

  6. Paediatric acid-base disorders: A case-based review of procedures and pitfalls

    PubMed Central

    Carmody, J Bryan; Norwood, Victoria F

    2013-01-01

    Acid-base disorders occur frequently in paediatric patients. Despite the perception that their analysis is complex and difficult, a straightforward set of rules is sufficient to interpret even the most complex disorders – provided certain pitfalls are avoided. Using a case-based approach, the present article reviews the fundamental concepts of acid-base analysis and highlights common mistakes and oversights. Specific topics include the proper identification of the primary disorder; distinguishing compensatory changes from additional primary disorders; use of the albumin-corrected anion gap to generate a differential diagnosis for patients with metabolic acidosis; screening for mixed disorders with the delta-delta formula; recognizing the limits of compensation; use of the anion gap to identify ‘hidden’ acidosis; and the importance of using information from the history and physical examination to identify the specific cause of a patient’s acid-base disturbance. PMID:24381489

  7. Necrobiosis lipoidica diabeticorum: A case-based review of literature

    PubMed Central

    Kota, Sunil Kumar; Jammula, Sruti; Kota, Siva Krishna; Meher, Lalit Kumar; Modi, Kirtikumar D.

    2012-01-01

    Necrobiosis lipoidica diabeticorum (NLD) is a rare chronic and granulomatous skin disorder that affects 0.3% of diabetic patients. Although the etiology and pathogenesis of NLD is still controversial, it is thought that microangiopathy has an important role. The legs are the most common site for NLD, but involvement of other areas such as the abdomen, upper extremities and scalp has been reported. There is no rational therapy. However, benefit has been reported from different treatment regimens such as drugs acting on the hemostatic mechanisms, corticosteroid therapy (topical, intralesional and systemic), enhancers of wound healing, surgery and immunomodulating therapies (including photochemotherapy). We report a 59-year-old female, who was a diabetic patient with multiple, disseminated lesions on the legs, which tended to disappear as the glycemic control was achieved. Hereby, we also review the existing literature for the evolving aspects of etiopathogenesis and treatment. PMID:22837927

  8. Necrobiosis lipoidica diabeticorum: A case-based review of literature.

    PubMed

    Kota, Sunil Kumar; Jammula, Sruti; Kota, Siva Krishna; Meher, Lalit Kumar; Modi, Kirtikumar D

    2012-07-01

    Necrobiosis lipoidica diabeticorum (NLD) is a rare chronic and granulomatous skin disorder that affects 0.3% of diabetic patients. Although the etiology and pathogenesis of NLD is still controversial, it is thought that microangiopathy has an important role. The legs are the most common site for NLD, but involvement of other areas such as the abdomen, upper extremities and scalp has been reported. There is no rational therapy. However, benefit has been reported from different treatment regimens such as drugs acting on the hemostatic mechanisms, corticosteroid therapy (topical, intralesional and systemic), enhancers of wound healing, surgery and immunomodulating therapies (including photochemotherapy). We report a 59-year-old female, who was a diabetic patient with multiple, disseminated lesions on the legs, which tended to disappear as the glycemic control was achieved. Hereby, we also review the existing literature for the evolving aspects of etiopathogenesis and treatment.

  9. Radiologic Pearls for Internists: a Case-Based Review.

    PubMed

    McGettigan, Melissa J; Gatenby, Robert A

    2017-09-07

    Modern technologic advances in medical imaging and the increasing use of imaging across all disciplines in medicine have led to a striking rise in incidental findings unrelated to the original study indication. Often, these findings have no clinical relevance and will not impact the current or future health status of the patient. It is incumbent on radiologists to report these findings in a definitive and unambiguous manner. Similarly, it is essential for clinicians to restrain from further diagnostic investigation of incidental findings that are conclusive by imaging. A classic and common example is the finding of a cyst. This article presents several cases of incidentally found cysts for which a confident diagnosis can be made without any need for follow-up. Copyright © 2017. Published by Elsevier Inc.

  10. Clear cell carcinoma of the base of the tongue: case report and literature review.

    PubMed

    Watanabe, Kenichi; Okumura, Yuri; Hashimoto, Ken; Suzuki, Takashi

    2015-01-01

    Clear cell carcinoma (CCC) is a rare, low-grade malignant neoplasm of minor salivary glands. Clear cell carcinoma is composed of monomorphic clear cells that contain glycogen within a hyalinized stroma. The microscopic diagnosis can be challenging, and the treatment strategy has not been established. We report a case of a 56-year-old woman with CCC in the base of the tongue. A literature review, including 22 published cases and our case, was performed to clarify the clinical characteristics of CCC in the base of the tongue. The exophytic tumor showed no infiltration to the neighboring tissues. She underwent a local excision en bloc transorally and is free of the disease 15 months after surgery. In our review of 23 cases of CCC in the base of the tongue, 21 cases received surgical excision for the purpose of the primary treatment modality. The fact that the distinctive features of restricted site-related symptoms and the rare presentation of pain emerged was similar to previously reported cases of CCC. A relatively good prognosis was still indicated. We reveal the features of the unusual occurrence of CCC in the base of the tongue and consider the appropriate surgical approach for primary treatment. © The Author(s) 2014.

  11. Evaluation of an interactive, case-based review session in teaching medical microbiology

    PubMed Central

    Blewett, Earl L; Kisamore, Jennifer L

    2009-01-01

    Background Oklahoma State University-Center for Health Sciences (OSU-CHS) has replaced its microbiology wet laboratory with a variety of tutorials including a case-based interactive session called Microbial Jeopardy!. The question remains whether the time spent by students and faculty in the interactive case-based tutorial is worthwhile? This study was designed to address this question by analyzing both student performance data and assessing students' perceptions regarding the tutorial. Methods Both quantitative and qualitative data were used in the current study. Part One of the study involved assessing student performance using archival records of seven case-based exam questions used in the 2004, 2005, 2006, and 2007 OSU-CHS Medical Microbiology course. Two sample t-tests for proportions were used to test for significant differences related to tutorial usage. Part Two used both quantitative and qualitative means to assess student's perceptions of the Microbial Jeopardy! session. First, a retrospective survey was administered to students who were enrolled in Medical Microbiology in 2006 or 2007. Second, responses to open-ended items from the 2008 course evaluations were reviewed for comments regarding the Microbial Jeopardy! session. Results Both student performance and student perception data support continued use of the tutorials. Quantitative and qualitative data converge to suggest that students like and learn from the interactive, case-based session. Conclusion The case-based tutorial appears to improve student performance on case-based exam questions. Additionally, students perceived the tutorial as helpful in preparing for exam questions and reviewing the course material. The time commitment for use of the case-based tutorial appears to be justified. PMID:19712473

  12. A Review of Case-Based Learning Practices in an Online MBA Program: A Program-Level Case Study

    ERIC Educational Resources Information Center

    Lee, Seung-hee; Lee, Jieun; Liu, Xiaojing; Bonk, Curt J.; Magjuka, Richard J.

    2009-01-01

    This study examines how a case-based learning approach was used and facilitated in online business education. Perceptions of students and instructors regarding the practices of case-based learning in online environments are explored in terms of instructional design, facilitation, and technology support. This study finds case-based learning to be a…

  13. A Review of Case-Based Learning Practices in an Online MBA Program: A Program-Level Case Study

    ERIC Educational Resources Information Center

    Lee, Seung-hee; Lee, Jieun; Liu, Xiaojing; Bonk, Curt J.; Magjuka, Richard J.

    2009-01-01

    This study examines how a case-based learning approach was used and facilitated in online business education. Perceptions of students and instructors regarding the practices of case-based learning in online environments are explored in terms of instructional design, facilitation, and technology support. This study finds case-based learning to be a…

  14. Model-based performance monitoring: Review of diagnostic methods and chiller case study

    SciTech Connect

    Haves, Phil; Khalsa, Sat Kartar

    2000-05-01

    The paper commences by reviewing the variety of technical approaches to the problem of detecting and diagnosing faulty operation in order to improve the actual performance of buildings. The review covers manual and automated methods, active testing and passive monitoring, the different classes of models used in fault detection, and methods of diagnosis. The process of model-based fault detection is then illustrated by describing the use of relatively simple empirical models of chiller energy performance to monitor equipment degradation and control problems. The CoolTools(trademark) chiller model identification package is used to fit the DOE-2 chiller model to on-site measurements from a building instrumented with high quality sensors. The need for simple algorithms to reject transient data, detect power surges and identify control problems is discussed, as is the use of energy balance checks to detect sensor problems. The accuracy with which the chiller model can be expected! to predict performance is assessed from the goodness of fit obtained and the implications for fault detection sensitivity and sensor accuracy requirements are discussed. A case study is described in which the model was applied retroactively to high-quality data collected in a San Francisco office building as part of a related project (Piette et al. 1999).

  15. Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases

    PubMed Central

    DuBois, James M.; Carroll, Kelly; Gibb, Tyler; Kraus, Elena; Rubbelke, Timothy; Vasher, Meghan; Anderson, Emily E.

    2012-01-01

    In this paper we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. PMID:23226933

  16. Reviewing the development, evidence base, and application of the revised dengue case classification

    PubMed Central

    Horstick, O; Farrar, J; Lum, L; Martinez, E; San Martin, J L; Ehrenberg, J; Velayudhan, R; Kroeger, A

    2012-01-01

    With the example of dengue, an evidence-based approach to prospectively develop a case classification is described, gathering evidence for identifying strength and weaknesses of the existing model, collecting new data describing the disease as it occurs globally, further developing a new model that can be applied in practice and field testing the newly developed model in comparison to the previous model. For each step in this process, the highest available level of evidence has been applied. This process has been initiated by the World Health Organization’s (WHO) Special Programme for Research and Training in Tropical Diseases (TDR) and WHO’s Department for Control of Neglected Tropical Diseases (NTD), developing the following for dengue. Since the early 1970s, dengue has been classified into dengue fever, dengue haemorrhagic fever grades I and II and dengue shock syndrome grades III and IV (DF/DHF/DSS). However, in recent years, a growing number of dengue clinicians have questioned the shortcomings of this scheme. The issues have revolved around the complexity of confirming DHF in clinical practice, misclassifying severe cases as DF, and the emphasis on haemorrhage rather than plasma leakage as the underlying problem in most severe dengue cases. Step 1: A systematic literature review highlighted the shortcomings of the DF/DHF/DSS scheme: (1) difficulties in applying the criteria for DHF/DSS; (2) the tourniquet test has a low sensitivity for distinguishing between DHF and DF; and (3) most DHF criteria had a large variability in frequency of occurrence. Step 2: An analysis of regional and national dengue guidelines and their application in the clinical practice showed a need to re-evaluate and standardize guidelines as the actual ones showed a large variation of definitions, an inconsistent application by medical staff, and a lack of diagnostic facilities necessary for the DHF diagnosis in frontline services. Step 3: A prospective cohort study in seven countries

  17. A Case Review: Reframing School-Based Practices Using a Critical Perspective

    PubMed Central

    Phelan, Shanon K.; Ng, Stella L.

    2015-01-01

    It is well established in the literature that school-based practice is fraught with challenges such as acquisition of appropriate and sufficient resources, communication barriers among professionals, parental burden, and redundancies and gaps in services. The purpose of this perspective paper is to reframe potentially problematic school-based practices using a critical social science perspective, suggesting a vision and strategies for therapists working in school-based practice contexts. We illustrate our approach with a case example. To reframe school-based practices, we begin with Jill’s case, exploring it through a critical lens to identify potential issues and opportunities for change. We then trace these findings to our larger dataset from an ongoing program of research, to ensure relevance to the broader context of school-based practice. Reframing of three school-based practice issues are discussed, from: a) advocacy by proxy to collaborative dialogue, b) governing texts to guiding texts, and c) playing the “right” part to having a voice. Although this is a perspective paper based on a case exemplar, we posit how we may reframe and rethink school-based practices in pediatric rehabilitation. We suggest that only with a genuine shift in our professional values will we see the enactment of collaborative practice in school-based settings. PMID:25402329

  18. Complete androgen insensitivity syndrome or testicular feminization: review of literature based on a case report

    PubMed Central

    Souhail, Regragui; Amine, Slaoui; Nadia, Abounouh; Tarik, Karmouni; Khalid, El Khader; Abdellatif, Koutani; Ahmed, Ibn Attya

    2016-01-01

    Testicular feminization, or the androgen insensitivity syndrome, is a rare disease. Because of various abnormalities of the X chromosome, a male, genetically XY, has some physical characteristics of a woman or a full female phenotype. Indeed the androgen insensitivity syndrome occurs because of a resistance to the actions of the androgen hormones, which in turn switches the development towards the aspect of a woman. We report a case of complete androgen insensitivity syndrome in a 30 years old woman who presented primary amenorrhea. We aim to improve our knowledge of this illness from the data that provides us this study, and a review of the literature. PMID:28270903

  19. Organizing Pneumonia in Rheumatoid Arthritis Patients: A Case-Based Review

    PubMed Central

    Mori, Shunsuke; Koga, Yukinori; Sugimoto, Mineharu

    2015-01-01

    We treated 21 patients with organizing pneumonia (OP) associated with rheumatoid arthritis (RA) or related to biological disease-modifying antirheumatic drugs (DMARDs) at our institution between 2006 and 2014. Among these cases, 3 (14.3%) preceded articular symptoms of RA, 4 (19.0%) developed simultaneously with RA onset, and 14 (66.7%) occurred during follow-up periods for RA. In the case of OP preceding RA, increased levels of anti-cyclic citrullinated peptide antibodies and rheumatoid factor were observed at the OP onset. RA disease activity was related to the development of OP in the simultaneous cases. In the cases of OP developing after RA diagnosis, 10 of 14 patients had maintained low disease activity with biological DMARD therapy at the OP onset, and among them, 6 patients developed OP within the first year of this therapy. In the remaining four patients, RA activity was not controlled at the OP onset. All patients responded well to systemic steroid therapy, but two patients suffered from relapses of articular and pulmonary symptoms upon steroid tapering. In most of the RA patients, DMARD therapy was introduced or restarted during the steroid tapering. We successfully restarted a biological DMARD that had not been previously used for patients whose RA would otherwise have been difficult to control. In this study, we also perform a review of the literature on RA-associated or biological DMARD-related OP and discuss the pathogenesis and management of OP occurring in RA patients. PMID:26543387

  20. Organizing Pneumonia in Rheumatoid Arthritis Patients: A Case-Based Review.

    PubMed

    Mori, Shunsuke; Koga, Yukinori; Sugimoto, Mineharu

    2015-01-01

    We treated 21 patients with organizing pneumonia (OP) associated with rheumatoid arthritis (RA) or related to biological disease-modifying antirheumatic drugs (DMARDs) at our institution between 2006 and 2014. Among these cases, 3 (14.3%) preceded articular symptoms of RA, 4 (19.0%) developed simultaneously with RA onset, and 14 (66.7%) occurred during follow-up periods for RA. In the case of OP preceding RA, increased levels of anti-cyclic citrullinated peptide antibodies and rheumatoid factor were observed at the OP onset. RA disease activity was related to the development of OP in the simultaneous cases. In the cases of OP developing after RA diagnosis, 10 of 14 patients had maintained low disease activity with biological DMARD therapy at the OP onset, and among them, 6 patients developed OP within the first year of this therapy. In the remaining four patients, RA activity was not controlled at the OP onset. All patients responded well to systemic steroid therapy, but two patients suffered from relapses of articular and pulmonary symptoms upon steroid tapering. In most of the RA patients, DMARD therapy was introduced or restarted during the steroid tapering. We successfully restarted a biological DMARD that had not been previously used for patients whose RA would otherwise have been difficult to control. In this study, we also perform a review of the literature on RA-associated or biological DMARD-related OP and discuss the pathogenesis and management of OP occurring in RA patients.

  1. Osteosarcoma of the skull base: case report and review of literature.

    PubMed

    Chennupati, Sri Kiran; Norris, Robin; Dunham, Brian; Kazahaya, Ken

    2008-01-01

    Osteosarcoma is the most common primary malignancy of bone in children and adolescents. Osteosarcomas are an aggressive neoplasm composed of spindle cells producing osteoid. They primarily affect the long bones, particularly after radiation or chemotherapy for other neoplasms; however, 6-7% present in the head and neck. Primary head and neck osteosarcomas in children are rare. There are few case reports and limited-sized case series in the literature. A case report presentation of a skull base osteosarcoma in a teenage female. A 14-year-old African American female presented with dysphagia, voice changes, and neck pain. On examination, she had right-sided palsies in cranial nerves X, XI, and XII. Imaging revealed partial enhancement of the clivus without bony erosion and expansion of the hypoglossal canal. There were also findings consistent with chronic denervation of her right tongue and pharynx. During the evaluation process, she developed diplopia from a right cranial nerve VI palsy. Repeat imaging revealed progression of the skull base lesion with extension into the right sphenoid sinus. An endoscopic sphenoidotomy was performed to obtain tissue. The diagnosis of high-grade osteosarcoma was made by histologic morphology and immunohistochemistry. The child was treated primarily with chemotherapy. Other adjunctive therapies are being considered. Osteosarcoma of the skull base is a rare entity. We describe a case of a high-grade clival osteosarcoma presenting primarily with lower cranial nerve palsies and pain. The rapid progression, treatment options, and prognosis are discussed.

  2. Asthma in the workplace: a case-based discussion and review of current evidence.

    PubMed

    Fishwick, David; Barber, Chris; Walker, Samantha; Scott, Alister

    2013-06-01

    The relationship between asthma and the workplace is important to consider in all cases of adult asthma. Early identification of a cause in the workplace offers an opportunity to improve asthma control significantly and reduce the need for long-term medication if further exposures to the cause can be avoided. This typical but fictitious case is designed to give the reader clinical information in the order this would normally be received in clinical practice, with a real-time commentary about management decisions. Pertinent recent guidance is cited to stress the importance of evidence-based practice.

  3. Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

    PubMed

    Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

    2015-12-01

    To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

  4. Pheochromocytoma with renal artery stenosis: A case-based review of literature.

    PubMed

    Kota, Sunil K; Kota, Siva K; Meher, Lalit K; Tripathy, Prabhas R; Sruti, Jammula; Modi, Kirtikumar D

    2012-01-01

    Pheochromocytomas have been described to be associated with rare vascular abnormalities, most common of them being renal artery stenosis. A 45-year-old woman was admitted to our hospital with complaints of headache, sweating, anxiety, dizziness, nausea, vomiting and severe hypertension. Hypertension was confirmed to result from both excess catecholamine production and hyperreninemia of left kidney. The technical images (abdominal CT and renal arteriography) revealed the presence of a left adrenal pheochromocytoma and stenosis of the renal artery. Surgical removal of pheochromocytoma and correction of renal artery stenosis restored the postoperative plasma catecholamine, renin and blood pressure to normal. To our belief, this is the first such case report from India citing this rare association. We conclude that when the two diseases occur simultaneously, both must be diagnosed accurately and treated in a different manner. We also hereby review the existing literature.

  5. Epigastric hernia in pregnancy: a management plan based on a systematic review of literature and a case history.

    PubMed

    Debrah, Samuel A; Okpala, Amalachukwu M

    2013-06-01

    Symptomatic epigastric hernia is rare in pregnant women. A case history, management of which prompted a systematic review of the literature and proposed plan for treatment of such cases, is hereby presented. There is paucity of information on management of this condition in the standard literature as searches in Pubmed, Science Direct, Hinari, Medline, African Journal Online, Bioone as well as Cochrane library revealed. There are two schools of thought for the management of hernias in pregnancy-watchful waiting and herniorrhaphy in pregnancy. There is no consensus or definite guideline on the management of epigastric hernias in pregnancy. Based on the literature review, a management algorithm is proposed, which combines the two schools of thought.

  6. Infective endocarditis in Ethiopian children: a hospital based review of cases in Addis Ababa

    PubMed Central

    Moges, Tamirat; Gedlu, Etsegenet; Isaakidis, Petros; Kumar, Ajay; Van Den Berge, Rafael; Khogali, Mohammed; Mekasha, Amha; Hinderaker, Sven Gudmund

    2015-01-01

    Introduction Infective endocarditis is an infection of the endocardial lining of the heart mainly associated with congenital and rheumatic heart disease. Although it is a rare disease in children, it is associated with high morbidity and mortality; death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. Methods This was a retrospective review of routinely collected data from patient records. Results A total of 40 children (71% female) with 41 episodes of infective endocarditis admitted to a general paediatric ward in Addis Ababa, Ethiopia between 2008 and 2013. Age ranged from 7 months to 14 years, with a median of 9 years (Inter quartile Range: 7-12 years). Rheumatic and congenital heart diseases were underlying risk factors in 49% and 51% of cases respectively. Congestive heart failure, systemic embolization and death occurred in 66%, 12% and 7.3% respectively. Death was associated with the occurrence of systemic embolization (P-value = 0.03). Conclusion Rheumatic heart disease was an important predisposing factor for infective endocarditis in Ethiopian children. Late presentations of cases were evidenced by high proportion of complications such as congestive heart failure. A low rate of clinically evident systemic embolization in this study may be a reflection of the diagnostic challenges. High proportion of prior antibiotic intake might explain the cause of significant BCNE. Preventive measures like primary and secondary prophylaxis of rheumatic fever may decrease the associated morbidity and mortality. Early detection and referral of cases, awareness creation about indiscriminate use of antimicrobials, and proper history taking and documentation of information recommended. PMID:26090033

  7. Natural history of chondroid skull base lesions--case report and review.

    PubMed

    Schmidinger, A; Rosahl, S K; Vorkapic, P; Samii, M

    2002-03-01

    Long-term follow-up reports on chondroid lesions of the skull base are rarely presented in the literature. There are virtually no data on natural growth rates of these tumors based on MRI obtained over a period of 10 years or longer. We followed a patient who has had such a lesion for more than 12 years. A non-progressive, slight abducens palsy has been the only associated symptom so far. Even though the patient was operated on for an additional intracranial arterio-venous malformation, clinical features and chromosomal testing excluded Maffucci's syndrome. The MRI follow-up in this case provides an extraordinary perspective on the natural history of chondroid skull base tumors.

  8. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23.

    PubMed

    Thistlethwaite, Jill Elizabeth; Davies, David; Ekeocha, Samilia; Kidd, Jane M; MacDougall, Colin; Matthews, Paul; Purkis, Judith; Clay, Diane

    2012-01-01

    Case-based learning (CBL) is a long established pedagogical method, which is defined in a number of ways depending on the discipline and type of 'case' employed. In health professional education, learning activities are commonly based on patient cases. Basic, social and clinical sciences are studied in relation to the case, are integrated with clinical presentations and conditions (including health and ill-health) and student learning is, therefore, associated with real-life situations. Although many claims are made for CBL as an effective learning and teaching method, very little evidence is quoted or generated to support these claims. We frame this review from the perspective of CBL as a type of inquiry-based learning. To explore, analyse and synthesise the evidence relating to the effectiveness of CBL as a means of achieving defined learning outcomes in health professional prequalification training programmes. We focused the review on CBL for prequalification health professional programmes including medicine, dentistry, veterinary science, nursing and midwifery, social care and the allied health professions (physiotherapy, occupational therapy, etc.). Papers were required to have outcome data on effectiveness. The search covered the period from 1965 to week 4 September 2010 and the following databases: ASSIA, CINAHL, EMBASE, Education Research, Medline and Web of Knowledge (WoK). Two members of the topic review group (TRG) independently reviewed the 173 abstracts retrieved from Medline and compared findings. As there was good agreement on inclusion, one went onto review the WoK and ASSIA EndNote databases and the other the Embase, CINAHL and Education Research databases to decide on papers to submit for coding. Coding and data analysis: The TRG modified the standard best evidence medical education coding sheet to fit our research questions and assessed each paper for quality. After a preliminary reliability exercise, each full paper was read and graded by one

  9. Approaches to ascertaining comorbidity information: validation of routine hospital episode data with clinician-based case note review.

    PubMed

    Soo, Martin; Robertson, Lynn M; Ali, Tariq; Clark, Laura E; Fluck, Nicholas; Johnston, Marjorie; Marks, Angharad; Prescott, Gordon J; Smith, William Cairns S; Black, Corri

    2014-04-21

    In clinical practice, research, and increasingly health surveillance, planning and costing, there is a need for high quality information to determine comorbidity information about patients. Electronic, routinely collected healthcare data is capturing increasing amounts of clinical information as part of routine care. The aim of this study was to assess the validity of routine hospital administrative data to determine comorbidity, as compared with clinician-based case note review, in a large cohort of patients with chronic kidney disease. A validation study using record linkage. Routine hospital administrative data were compared with clinician-based case note review comorbidity data in a cohort of 3219 patients with chronic kidney disease. To assess agreement, we calculated prevalence, kappa statistic, sensitivity, specificity, positive predictive value and negative predictive value. Subgroup analyses were also performed. Median age at index date was 76.3 years, 44% were male, 67% had stage 3 chronic kidney disease and 31% had at least three comorbidities. For most comorbidities, we found a higher prevalence recorded from case notes compared with administrative data. The best agreement was found for cerebrovascular disease (κ = 0.80) ischaemic heart disease (κ = 0.63) and diabetes (κ = 0.65). Hypertension, peripheral vascular disease and dementia showed only fair agreement (κ = 0.28, 0.39, 0.38 respectively) and smoking status was found to be poorly recorded in administrative data. The patterns of prevalence across subgroups were as expected and for most comorbidities, agreement between case note and administrative data was similar. Agreement was less, however, in older ages and for those with three or more comorbidities for some conditions. This study demonstrates that hospital administrative comorbidity data compared moderately well with case note review data for cerebrovascular disease, ischaemic heart disease and diabetes, however there was

  10. Positive and Negative Predictive Value of PET-CT in Skull Base Lesions: Case Series and Systematic Literature Review.

    PubMed

    Hines, John Peyton; Howard, Brittany E; Hoxworth, Joseph M; Lal, Devyani

    2016-03-01

    Objectives To study positive (PPV) and negative predictive value (NPV) of positron emission tomography with computed tomography (PET-CT) scans in determining malignancy in skull base lesions and perform a systematic literature review for optimal PET-CT interpretation. Design Retrospective case series and systematic literature review of the current English literature. Setting Tertiary referral academic medical center. Participants All patients with skull base lesions that underwent PET-CT and tissue biopsy from 2010 to 2013. Main Outcome Measures PPV and NPV of radiologist's report and standardized uptake value (SUV) cutoff of 2.5 and 3, biopsy with pathologic interpretation, clinical follow-up. Results A total of 31 PET-CT scans of 16 patients were studied; 10 PET-CT were performed upfront for diagnostic purposes and 21 were post-treatment surveillance scans. The PPV of radiologist's interpretation, SUV cutoff of 2.5, and SUV cutoff of 3.0 was 80%, 60%, and 68.4%, with a NPV of 100%, 83.3%, and 75%, respectively. Literature search yielded 500 abstracts; 7 studies met inclusion criteria for detailed review. No consensus or guidelines for optimal SUV cutoff value was found. Conclusions PET-CT based on SUV cutoff criteria alone has high NPV but low PPV in determining malignancy in skull base lesions. Interpretation by a radiologist experienced in nuclear medicine and neuroradiology, synthesizing clinical, SUV, and radiologic data are of superior value.

  11. Fat necrosis in deep inferior epigastric perforator flaps: an ultrasound-based review of 202 cases.

    PubMed

    Peeters, Wouter J; Nanhekhan, Lloyd; Van Ongeval, Chantal; Fabré, Gerd; Vandevoort, Marc

    2009-12-01

    In autologous breast reconstruction after mastectomy, fat necrosis is a rather common complication that may lead to secondary corrective surgery. The understanding of fat necrosis until now has been limited because previous studies were based exclusively on physical examination and used diverse definitions. The authors retrospectively reviewed the incidence of fat necrosis and the correlation of several risk factors in 202 deep inferior epigastric perforator (DIEP) flaps for breast reconstruction. The incidence of fat necrosis was based on both physical examination and ultrasound imaging. The following risk factors were studied: age, smoking, body mass index, timing of reconstruction, and timing and extent of radiation therapy fields. Physical examination revealed a palpable mass or nodule in 14 percent of the DIEP flaps (28 of 202). Ultrasound examination added another 21 percent of DIEP flaps (42 of 202) with a firm area of scar tissue (diameter >or=5 mm). The overall ultrasound incidence of fat necrosis in this study was 35 percent (71 of 202). Although the overall ultrasound incidence of fat necrosis was very high, only 7 percent of the DIEP flaps (15 of 202) needed to undergo an extra surgical procedure for removal of this area. In contrast to previous studies, none of the risk factors studied was statistically significant for the occurrence of fat necrosis. These results suggest that there is no significant association between previously suspected risk factors and fat necrosis. The overall incidence of fat necrosis, however, is much higher than previously accepted, even though the need for corrective surgery is limited.

  12. "It's like Tuskegee in reverse": a case study of ethical tensions in institutional review board review of community-based participatory research.

    PubMed

    Malone, Ruth E; Yerger, Valerie B; McGruder, Carol; Froelicher, Erika

    2006-11-01

    Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.

  13. “It’s Like Tuskegee in Reverse”: A Case Study of Ethical Tensions in Institutional Review Board Review of Community-Based Participatory Research

    PubMed Central

    Malone, Ruth E.; Yerger, Valerie B.; McGruder, Carol; Froelicher, Erika

    2006-01-01

    Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment. PMID:17018816

  14. Human cowpox 1969-93: a review based on 54 cases.

    PubMed

    Baxby, D; Bennett, M; Getty, B

    1994-11-01

    This survey of the clinical and epidemiological features of human cowpox, a rare but relatively severe zoonotic infection, is based on 54 cases, many unpublished, which we have studied since 1969. Patients present with painful, haemorrhagic pustules or black eschars, usually on the hand or face, accompanied by oedema, erythema, lymphadenopathy, and systemic involvement. Severe, occasionally fatal, cases occur in eczematous and immunosuppressed individuals, although cowpox has not yet been reported in anyone infected with the human immunodeficiency virus. Variations in the clinical features are described, and the differential clinical diagnosis of cowpox, parapox, herpes virus, and anthrax infections is discussed. The role of the laboratory in diagnosis is described, and the value of electron microscopy in providing rapid confirmation is emphasized. Care in taking a detailed history will assist in the initial clinical diagnosis, and a history of contact with domestic cats, particularly during July-October, is important. The possible influence of smallpox vaccination on the incidence and severity is discussed and discounted.

  15. Managing inadequate responses to frontline treatment of chronic myeloid leukemia: a case-based review.

    PubMed

    Bixby, Dale L

    2013-05-01

    The tyrosine kinase inhibitors (TKIs) imatinib, nilotinib, and dasatinib are the standard of care for treating patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML). Compared with interferon-based treatment, the previous standard of care, imatinib is associated with significantly higher cytogenetic response rates and prolonged overall survival. Nilotinib and dasatinib, both newer and more potent TKIs, significantly improve cytogenetic and molecular response rates compared with imatinib. Despite significant advances in CML treatment enabled by the TKIs, a fraction of patients who receive frontline treatment with a TKI demonstrate inadequate response. The reasons for this vary, but in many cases, inadequate response can be attributed to non-adherence to the treatment regimen, intolerance to the drug, intrinsic or acquired resistance to the drug, or a combination of reasons. More often than not, strategies to improve response necessitate a change in treatment plan, either a dose adjustment or a switch to an alternate drug, particularly in the case of drug intolerance or drug resistance. Improved physician-patient communication and patient education are effective strategies to address issues relating to adherence and intolerance. Because inadequate response to TKI treatment correlates with poor long-term outcomes, it is imperative that patients who experience intolerance or who fail to achieve appropriate responses are carefully evaluated so that appropriate treatment modifications can be made to maximize the likelihood of positive long-term outcome. Copyright © 2012. Published by Elsevier Ltd.

  16. Donor organ shortage crisis: a case study review of a financial incentive-based system.

    PubMed

    Al Sebayel, M; Alenazi, A M; Sabbagh, R; Al Ageel, T; Al Enazi, M; Al Bahili, H; Elsiesy, H

    2014-01-01

    Current organ supply system depends on altruistic noncoercive donation, which has failed to meet the demand of organ transplantation. Providing financial incentives to donors is one of several approaches to address organ shortage. However, its feasibility is debatable as it relates to medical, ethical, and economic dimensions. An incentive-based procurement system (IBPS) applied by the Mobile Donor Action Team (MDAT) was instituted in Riyadh, Saudi Arabia, resulting in a 3-fold increase in donation rate. The goal of this study was to provide a qualitative review of a 7-year experience with IBPS. A qualitative approach was used. Documents were reviewed to create a chronological audit and shape interview questions. Sampling was purposeful and inclusive of MDAT members. Semi-structured interviews were conducted, and findings were subjected to thematic analysis. Documents reflected the evolution of MDAT. The essence of MDAT is field work and liberal use of financial incentives, which resulted in a 3-fold increase in the donation rate. MDAT members believed that IBPS is the main reason behind this increase. Moreover, IBPS is viewed as acceptable from a moral, ethical, and religious standpoint, with a high degree of professional satisfaction. Theoretical assumptions doubted the feasibility of IBPS. This real-life experience with IBPS proved the contrary. The findings may be applicable only to the setting in Riyadh, Saudi Arabia, however; further research is thus needed to explore its transferability to other settings. IBPS may be an alternative to altruistic noncoercive donation and should be piloted in different settings. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Case-based learning in education of Traditional Chinese Medicine: a systematic review.

    PubMed

    Chen, Ji; Li, Ying; Tang, Yong; Zeng, Fang; Wu, Xi; Liang, Fanrong

    2013-10-01

    To assess the effect of case-based learning (CBL) in the education of Traditional Chinese Medicine (TCM). The studies concerning TCM courses designed with CBL were included by searching the databases of EBSCO, Pubmed, Science Citation Index, China National Knowledge Infrastructure, Chongqing VIP database. The valid data was extracted in accordance with the included criteria. The quality of the studies was assessed with Gemma Flores-Masteo. A total of 22 articles were retrieved that met the selection criteria: one was of high quality; two were of low quality; the rest were categorized as moderate quality. The majority of the studies demonstrated the better effect produced by CBL, while a few studies showed no difference, compared with the didactic format. All included studies confirmed the favorable effect on learners' attitude, skills and ability. CBL showed the desirable results in achieving the goal of learning. Compared to didactic approach, it played a more active role in promoting students' competency. Since the quality of the articles on which the study was based was not so high, the findings still need further research to become substantiated.

  18. Acute hyperammonemic encephalopathy after fluoropyrimidine-based chemotherapy: A case series and review of the literature.

    PubMed

    Mitani, Seiichiro; Kadowaki, Shigenori; Komori, Azusa; Sugiyama, Keiji; Narita, Yukiya; Taniguchi, Hiroya; Ura, Takashi; Ando, Masashi; Sato, Yozo; Yamaura, Hidekazu; Inaba, Yoshitaka; Ishihara, Makoto; Tanaka, Tsutomu; Tajika, Masahiro; Muro, Kei

    2017-06-01

    Acute hyperammonemic encephalopathy induced by fluoropyrimidines (FPs) is a rare complication. Its pathophysiology remains unclear, especially given the currently used regimens, including intermediate-doses of 5-fluorouracil (5-FU) or oral FP agents. We aimed to characterize the clinical manifestations in cancer patients who developed hyperammonemic encephalopathy after receiving FP-based chemotherapy.We retrospectively reviewed 1786 patients with gastrointestinal or primary-unknown cancer who received FP-based regimens between 2007 and 2012. Eleven patients (0.6%) developed acute hyperammonemic encephalopathy. The incidence according to the administered anticancer drugs were as follows: 5-FU (8 of 1176, 0.7%), S-1 (1 of 679, 0.1%), capecitabine (2 of 225, 0.9%), and tegafur-uracil (UFT) (0 of 39, 0%). Ten patients (90.9%) had at least 1 aggravating factor, including infection, dehydration, constipation, renal dysfunction, and muscle loss. All the 10 patients met the definition of sarcopenia. Median time to the onset of hyperammonemic encephalopathy in the cycle was 3 days (range: 2-21). Three patients (27.3%) developed encephalopathy during the first cycle of the regimen and the remaining 8 patients during the second or more cycles. Seven patients (63.6%) had received at least 1 other FP-containing regimen before without episodes of encephalopathy.All patients recovered soon after immediate discontinuation of chemotherapy and supportive therapies, such as hydration, infusion of branched-chain amino acids, and oral lactulose intake, with a median time to recovery of 2 days (range: <1-7). Four patients (36.4%) received FP-based regimens after improvement of symptoms; 3 patients were successfully managed with dose reduction, and 1 patient, who had developed encephalopathy due to S-1 monotherapy, received modified FOLFOX-6 therapy without encephalopathy later.FP-associated acute hyperammonemic encephalopathy is extremely rare, but a possible event at any time and even

  19. Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model

    PubMed Central

    Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

    2014-01-01

    Background The purpose of this study was to examine factors associated with the implementation of case management (CM) interventions in primary health care (PHC) and to develop strategies to enhance its adoption by PHC practices. Methods This study was designed as a systematic mixed studies review (including quantitative and qualitative studies) with synthesis based on the diffusion of innovation model. A literature search was performed using MEDLINE, PsycInfo, EMBASE, and the Cochrane Database (1995 to August 2012) to identify quantitative (randomized controlled and nonrandomized) and qualitative studies describing the conditions limiting and facilitating successful CM implementation in PHC. The methodological quality of each included study was assessed using the validated Mixed Methods Appraisal Tool. Results Twenty-three studies (eleven quantitative and 12 qualitative) were included. The characteristics of CM that negatively influence implementation are low CM intensity (eg, infrequent follow-up), large caseload (more than 60 patients per full-time case manager), and approach, ie, reactive rather than proactive. Case managers need specific skills to perform their role (eg, good communication skills) and their responsibilities in PHC need to be clearly delineated. Conclusion Our systematic review supports a better understanding of factors that can explain inconsistent evidence with regard to the outcomes of dementia CM in PHC. Lastly, strategies are proposed to enhance implementation of dementia CM in PHC. PMID:24959072

  20. Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model.

    PubMed

    Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

    2014-01-01

    The purpose of this study was to examine factors associated with the implementation of case management (CM) interventions in primary health care (PHC) and to develop strategies to enhance its adoption by PHC practices. This study was designed as a systematic mixed studies review (including quantitative and qualitative studies) with synthesis based on the diffusion of innovation model. A literature search was performed using MEDLINE, PsycInfo, EMBASE, and the Cochrane Database (1995 to August 2012) to identify quantitative (randomized controlled and nonrandomized) and qualitative studies describing the conditions limiting and facilitating successful CM implementation in PHC. The methodological quality of each included study was assessed using the validated Mixed Methods Appraisal Tool. Twenty-three studies (eleven quantitative and 12 qualitative) were included. The characteristics of CM that negatively influence implementation are low CM intensity (eg, infrequent follow-up), large caseload (more than 60 patients per full-time case manager), and approach, ie, reactive rather than proactive. Case managers need specific skills to perform their role (eg, good communication skills) and their responsibilities in PHC need to be clearly delineated. Our systematic review supports a better understanding of factors that can explain inconsistent evidence with regard to the outcomes of dementia CM in PHC. Lastly, strategies are proposed to enhance implementation of dementia CM in PHC.

  1. Ambulatory postoperative ward-based epidural analgesia: a retrospective review of 1,147 cases.

    PubMed

    Duff, P; Daly, C; McCrory, C

    2013-03-01

    A retrospective review of 1,147 patients who received epidural analgesia (EA) in surgical wards from January 2008 to December 2009 to determine the prevalence of early ambulation and assess the efficacy and safety of EA for postoperative pain management. Outcome measures were the prevalence of ambulation, pain scores at rest/movement and adverse events. Patients (N = 1,147) who received postoperative EA between January 2008 and December 2009 were included. Motor function was assessed using the Bromage scale. Ambulation was defined as: Day 1: mobilisation from bed to chair, walking on the spot, taking a few steps, thereafter walks of increasing duration and distance at least twice daily. Pain scores were measured using the verbal numerical rating scale (0-10), ≤4 signifying successful analgesia. Daily assessments and data recordings were performed by clinical nurse specialists (CNSs) using standardised charts. Data collected included patient demographics, surgical procedure, ambulation achieved, pain scores at rest/movement and adverse events. The data was analysed using Microsoft Excel(®). The prevalence of ambulation was 88% and this was maintained for the duration of EA. Ninety-eight percent of patients reported pain scores of ≤4 at rest and 88% reported pain scores of ≤4 on movement. Adverse events included motor block 12%, nausea 9%, hypotension 8%, catheter dislodgement 3.8%, leakage from insertion site 1.6%, decubitus ulcers 0.58% and infection 0.001%. Mean duration of EA was 4 days. Ward-based EA facilitates early ambulation, provides excellent postoperative pain relief and is associated with low prevalence of adverse events.

  2. Palliative Surgery for Advanced Cancer: Identifying Evidence-Based Criteria for Patient Selection: Case Report and Review of Literature.

    PubMed

    Foster, Deshka; Shaikh, Mohammad F; Gleeson, Elizabeth; Babcock, Blake D; Ringold, Daniel; Bowne, Wilbur B

    2016-01-01

    Criteria for selecting patients with advanced cancer for palliative surgery (PS) remains poorly defined. Decision making for PS requires realistic treatment goals with well-defined criteria. Here we discuss a 71-year-old Jehovah's Witness with advanced stage renal cell carcinoma (RCC) who presented with profound anemia due to intractable bleeding from gastric metastasis. After repeated attempts with endoscopic and angiographic management, she underwent surgical palliation. Through this case, we developed 10-item evidence-based criteria for selecting patients for PS. The study objective was to provide a review of pertinent literature for PS and identify evidence-based criteria for patient selection. These criteria were relevant for selecting this patient with metastatic RCC and may prove beneficial for selecting advanced cancer patients for PS. A MEDLINE search revealed 175 publications relevant to PS. Among these, 17 articles defining patient selection criteria (PSC) were reviewed. A frequency-based analysis of each criterion was performed. Another search returned 30 cases of RCC gastric metastases from 25 published reports. Outcome analysis was determined by the Kaplan-Meier actuarial method. Ten criteria were identified: symptom control, prognosis, preoperative performance status, quality of life (QoL), tumor burden amenable to palliation, procedure-related morbidity and mortality, feasibility of nonsurgical therapies, anticipated hospitalization, requirement for additional palliation, and cost. This patient met all inclusion criteria and underwent a successful gastrectomy. Median survival for patients with RCC gastric metastasis was 20 months. This report illustrates an example of implementation of evidence-based criteria for selecting advanced cancer patients for PS. Validation of these criteria is warranted.

  3. School-Based Peer-Related Social Competence Interventions for Children with Autism Spectrum Disorder: A Meta-Analysis and Descriptive Review of Single Case Research Design Studies

    ERIC Educational Resources Information Center

    Whalon, Kelly J.; Conroy, Maureen A.; Martinez, Jose R.; Werch, Brittany L.

    2015-01-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old…

  4. School-Based Peer-Related Social Competence Interventions for Children with Autism Spectrum Disorder: A Meta-Analysis and Descriptive Review of Single Case Research Design Studies

    ERIC Educational Resources Information Center

    Whalon, Kelly J.; Conroy, Maureen A.; Martinez, Jose R.; Werch, Brittany L.

    2015-01-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old…

  5. Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings.

    PubMed

    Kochar, Puneet S; Lath, Chinar O; Klein, Andrew P; Ulmer, John L

    2016-01-01

    We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT), magnetic resonance imaging (MRI), and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS) and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively.

  6. Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings

    PubMed Central

    Kochar, Puneet S; Lath, Chinar O; Klein, Andrew P; Ulmer, John L

    2016-01-01

    We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT), magnetic resonance imaging (MRI), and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS) and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively. PMID:27081235

  7. Achieving Research Impact Through Co-creation in Community-Based Health Services: Literature Review and Case Study.

    PubMed

    Greenhalgh, Trisha; Jackson, Claire; Shaw, Sara; Janamian, Tina

    2016-06-01

    Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-is an increasingly popular approach to aligning research and service development. It has potential for "moving beyond the ivory towers" to deliver significant societal impact via dynamic, locally adaptive community-academic partnerships. Principles of successful co-creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co-creation efforts may fail. Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-reflects a "Mode 2" relationship (knowledge production rather than knowledge translation) between universities and society. Co-creation is widely believed to increase research impact. We undertook a narrative review of different models of co-creation relevant to community-based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community-based research-service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary-Secondary Care at the University of Queensland, Australia. Co-creation emerged independently in several fields, including business studies ("value co-creation"), design science ("experience-based co-design"), computer science ("technology co-design"), and community development ("participatory research"). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of

  8. Achieving Research Impact Through Co‐creation in Community‐Based Health Services: Literature Review and Case Study

    PubMed Central

    JACKSON, CLAIRE; SHAW, SARA; JANAMIAN, TINA

    2016-01-01

    Policy Points: Co‐creation—collaborative knowledge generation by academics working alongside other stakeholders—is an increasingly popular approach to aligning research and service development.It has potential for “moving beyond the ivory towers” to deliver significant societal impact via dynamic, locally adaptive community‐academic partnerships.Principles of successful co‐creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process.If these principles are not followed, co‐creation efforts may fail. Context Co‐creation—collaborative knowledge generation by academics working alongside other stakeholders—reflects a “Mode 2” relationship (knowledge production rather than knowledge translation) between universities and society. Co‐creation is widely believed to increase research impact. Methods We undertook a narrative review of different models of co‐creation relevant to community‐based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community‐based research‐service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary‐Secondary Care at the University of Queensland, Australia. Findings Co‐creation emerged independently in several fields, including business studies (“value co‐creation”), design science (“experience‐based co‐design”), computer science (“technology co‐design”), and community development (“participatory research”). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human

  9. The role of thrombocytapheresis in the contemporary management of hyperthrombocytosis in myeloproliferative neoplasms: A case-based review.

    PubMed

    Boddu, Prajwal; Falchi, Lorenzo; Hosing, Chitra; Newberry, Kate; Bose, Prithviraj; Verstovsek, Srdan

    2017-03-22

    Extreme thrombocytosis induces an acquired thrombotic-hemorrhagic diathesis, and left uncontrolled is a harbinger of potentially fatal vascular complications. Currently, cytoreduction with medical therapy remains the mainstay of hyperthrombocytosis management. However, it offers a less-than-ideal option in situations where a rapid reduction in platelets is urgently needed, as in the presence of vital end-organ ischemia or to ameliorate of life-threatening hemorrhage. The role of thrombocytapheresis, or plateletpheresis, in hyperthrombocytosis has become increasingly obsolete given the proactive titration of cytoreductive therapies and early identification and correction of reversible causes of reactive thrombocytosis. Despite its narrowed indications, plateletpheresis continues to offer a valuable temporizing measure in platelet count reduction before cytoreductive agents exert their maximal effect. In this context, it is important for the treating physician to be aware of the symptoms and risks associated with hyperthrombocytosis to inform best clinical practices. In this review, we discuss the role of plateletpheresis in the modern-day management of hyperthrombocytosis in patients with myeloproliferative neoplasms through a case based review of the literature. It becomes apparent throughout the discussion that the decision to perform plateletpheresis should be individualized based upon the clinical scenario, degree of thrombocytosis, available infrastructure and every patient's risk profile.

  10. Internet-based crowdsourcing and research ethics: the case for IRB review.

    PubMed

    Graber, Mark A; Graber, Abraham

    2013-02-01

    The recent success of Foldit in determining the structure of the Mason-Pfizer monkey virus (M-PMV) retroviral protease is suggestive of the power-solving potential of internet-facilitated game-like crowdsourcing. This research model is highly novel, however, and thus, deserves careful consideration of potential ethical issues. In this paper, we will demonstrate that the crowdsourcing model of research has the potential to cause harm to participants, manipulates the participant into continued participation, and uses participants as experimental subjects. We conclude that protocols relying on this model require institutional review board (IRB) scrutiny.

  11. Community-based participatory research in Boston's neighborhoods: A review of asthma case examples.

    PubMed

    Brugge, Doug; Rivera-Carrasco, Edna; Zotter, Jean; Leung, Alice

    2010-01-01

    Three case examples of asthma studies that differ in terms of community and involvement are considered. The Boston Chinatown studies faced limited funding that restricted the level of community involvement, but resulted in some of the first published evidence about asthma in Asian American children. These studies led to an asthma education program grant to a local Asian clinic and elementary school. The public housing study was a well-funded multi-year study of asthma and pest management with city, university and community partners. Residents were trained to collect data and participated throughout the study. Follow up pest management and pesticide buy-back programs headed by the city and community partners have been funded. The Dorchester case had more limited funding, but had the greatest level of involvement of parents of asthmatic children in all phases of the research. This survey led to an interesting novel finding of lower asthma prevalence in foreign born black residents.

  12. Antiplatelet drug induced isolated profound thrombocytopenia in interventional cardiology: a review based on individual case reports.

    PubMed

    Höchtl, Thomas; Pachinger, Linda; Unger, Gerhard; Geppert, Alexander; Wojta, Johann; Harenberg, Job; Huber, Kurt

    2007-08-01

    A combination antithrombotic and antiplatelet therapy with clopidogrel, aspirin, glycoprotein IIb/IIIa receptor inhibitors and heparins is routinely used as adjunct therapy in patients undergoing percutaneous coronary intervention (PCI). As all substances inhibit platelet function, bleeding and thrombocytopenia may occur. We report on three patients who developed isolated profound thrombocytopenia (platelet count of < 20,000/mm(3)) within 24 h after initiation of combination antiplatelet and antithrombotic therapy during a 1 year observation period in 443 consecutive patients undergoing PCI and stent implantation. The data from our cardiology unit revealed an incidence of an isolated profound thrombocytopenia in 0.7% of all patients on combination antithrombotic therapy and in 1.5% of patients with GPIIb/IIIa-blockers. In all three cases with isolated profound thrombocytopenia GPIIb/IIIa-blockers were found to be the causative agents. Negative results of HIT-assays excluded heparin induced thrombocytopenia type II. Despite the extremely low platelet count no severe bleeding was observed and in all cases platelet counts normalized within 3-4 days without specific interventions except discontinuation of the responsible agent. These findings are discussed in conjunct with an overview of the recent literature.

  13. The case for home based telehealth in pediatric palliative care: a systematic review

    PubMed Central

    2013-01-01

    Background Over the last decade technology has rapidly changed the ability to provide home telehealth services. At the same time, pediatric palliative care has developed as a small, but distinct speciality. Understanding the experiences of providing home telehealth services in pediatric palliative care is therefore important. Methods A literature review was undertaken to identify and critically appraise published work relevant to the area. Studies were identified by searching the electronic databases Medline, CINAHL and Google Scholar. The reference list of each paper was also inspected to identify any further studies. Results There were 33 studies that met the inclusion criteria of which only six were pediatric focussed. Outcome measures included effects on quality of life and anxiety, substitution of home visits, economic factors, barriers, feasibility, acceptability, satisfaction and readiness for telehealth. While studies generally identified benefits of using home telehealth in palliative care, the utilisation of home telehealth programs was limited by numerous challenges. Conclusion Research in this area is challenging; ethical issues and logistical factors such as recruitment and attrition because of patient death make determining effectiveness of telehealth interventions difficult. Future research in home telehealth for the pediatric palliative care population should focus on the factors that influence acceptance of telehealth applications, including goals of care, access to alternative modes of care, perceived need for care, and comfort with using technology. PMID:23374676

  14. The case for home based telehealth in pediatric palliative care: a systematic review.

    PubMed

    Bradford, Natalie; Armfield, Nigel R; Young, Jeanine; Smith, Anthony C

    2013-02-01

    Over the last decade technology has rapidly changed the ability to provide home telehealth services. At the same time, pediatric palliative care has developed as a small, but distinct speciality. Understanding the experiences of providing home telehealth services in pediatric palliative care is therefore important. A literature review was undertaken to identify and critically appraise published work relevant to the area. Studies were identified by searching the electronic databases Medline, CINAHL and Google Scholar. The reference list of each paper was also inspected to identify any further studies. There were 33 studies that met the inclusion criteria of which only six were pediatric focussed. Outcome measures included effects on quality of life and anxiety, substitution of home visits, economic factors, barriers, feasibility, acceptability, satisfaction and readiness for telehealth. While studies generally identified benefits of using home telehealth in palliative care, the utilisation of home telehealth programs was limited by numerous challenges. Research in this area is challenging; ethical issues and logistical factors such as recruitment and attrition because of patient death make determining effectiveness of telehealth interventions difficult. Future research in home telehealth for the pediatric palliative care population should focus on the factors that influence acceptance of telehealth applications, including goals of care, access to alternative modes of care, perceived need for care, and comfort with using technology.

  15. Rheumatoid myositis leading to acute lower extremity compartment syndrome: a case-based review.

    PubMed

    Jo, Daniel; Pompa, Tiffany; Khalil, Ambreen; Kong, Frank; Wetz, Robert; Goldstein, Mark

    2015-10-01

    Muscle pain and weakness in a rheumatoid arthritis (RA) patient has a broad differential, and myositis should be considered early in the disease course as serious limb and life-threatening sequelae may occur. A 55-year-old woman with a past medical history of methotrexate-controlled RA presented with right leg pain for 4 days. The patient suffered sensory loss in the right foot and decreased strength in the toes. Lab tests revealed elevated creatine kinase, ESR, and anti-rheumatoid factor antibody titers. CT scan revealed myositis of posterior compartment muscles. Progressive edema, pain, and neuromuscular deficits persisted despite steroid and antibiotic therapy, so the patient was taken for urgent fasciotomy for acute compartment syndrome. The muscle biopsy showed diffuse mononuclear cell infiltration as well as perivascular and perineural involvement consistent with rheumatoid myositis (RM). The patient did well post-op on a prednisone taper. This case underlines the systemic nature of RA and exemplifies the severity of inflammation that may lead to grave consequences such as compartment syndrome. The histopathology is diagnostic when there is evidence of mononuclear cell infiltration; however, this is not entirely specific. Early, aggressive therapy with immunosuppressives is warranted in such patients. RM has not, to our knowledge, been recorded to cause acute compartment syndrome. Clinicians should be aware of this uncommon manifestation of RA keeping the various presentations of rheumatoid disease in mind when faced with these patients.

  16. Skull Base Clear Cell Carcinoma, Metastasis of Renal Primary Tumor: A Case Report and Literature Review

    PubMed Central

    Sepúlveda, Ilson; Platin, Enrique; Klaassen, Rodrigo; Spencer, M. Loreto; García, Cesar; Alarcón, Ricardo; Ulloa, David

    2013-01-01

    We report on a patient who presented with cranial nerve VI bilateral paresis, absence of pharyngeal reflex, dysarthria, right tongue deviation, and right facial paralysis. Imaging studies showed an expansive process in the cranial base with clivus and petrous apex osteolysis. A biopsy confirmed the presence of clear cell adenocarcinoma and suspicion of renal tumor metastases. Abdominal imaging studies revealed a mass in the right kidney. Consequently, radiotherapy was performed, and the patient was enrolled in a palliative care and pain control program. PMID:24019781

  17. Stereotactic radiosurgery planning based on time-resolved CTA for arteriovenous malformation: a case report and review of the literature.

    PubMed

    Turner, Ryan C; Lucke-Wold, Brandon P; Josiah, Darnell; Gonzalez, Javier; Schmidt, Matthew; Tarabishy, Abdul Rahman; Bhatia, Sanjay

    2016-08-01

    Stereotactic radiosurgery has long been recognized as the optimal form of management for high-grade arteriovenous malformations not amenable to surgical resection. Radiosurgical plans have generally relied upon the integration of stereotactic magnetic resonance angiography (MRA), standard contrast-enhanced magnetic resonance imaging (MRI), or computed tomography angiography (CTA) with biplane digital subtraction angiography (DSA). Current options are disadvantageous in that catheter-based biplane DSA is an invasive test associated with a small risk of complications and perhaps more importantly, the two-dimensional nature of DSA is an inherent limitation in creating radiosurgical contours. The necessity of multiple scans to create DSA contours for radiosurgical planning puts patients at increased risk. Furthermore, the inability to import two-dimensional plans into some radiosurgery programs, such as Cyberknife TPS, limits treatment options for patients. Defining the nidus itself is sometimes difficult in any of the traditional modalities as all draining veins and feeding arteries are included in the images. This sometimes necessitates targeting a larger volume, than strictly necessary, with stereotactic radiosurgery for treatment of the AVM. In this case report, we show the ability to use a less-invasive and three-dimensional form of angiography based on time-lapsed CTA (4D-CTA) rather than traditional DSA for radiosurgical planning. 4D-CTA may allow generation of a series of images, which can show the flow of contrast through the AVM. A review of these series may allow the surgeon to pick and use a volume set that best outlines the nidus with least interference from feeding arteries or draining veins. In addition, 4D-CTA scans can be uploaded into radiosurgery programs and allow three-dimensional targeting. This is the first reported case demonstrating the use of a 4D CTA and an MRI to delineate the AVM nidus for Gamma Knife radiosurgery, with complete

  18. Do Undergraduate Paramedic Students Embrace Case Based Learning Using a Blended Teaching Approach? A 3-Year Review

    ERIC Educational Resources Information Center

    Williams, Brett

    2009-01-01

    This paper presents the results of a descriptive longitudinal study which aimed to identify student paramedic perceptions of case based learning used in the clinical curriculum of the Bachelor of Emergency Health (BEH) degree at Monash University, Victoria, Australia. Case based learning and its integration within clinical curriculum is an…

  19. Fatal and near-fatal autoerotic asphyxial episodes in women. Characteristic features based on a review of nine cases.

    PubMed

    Byard, R W; Hucker, S J; Hazelwood, R R

    1993-03-01

    As asphyxial episodes during autoerotic activity are rarely reported in women, a review of eight fatal cases and one near-fatal case was conducted to delineate more clearly the characteristics of this syndrome in women. Six cases involved characteristic fatal autoerotic asphyxial activity. The remaining two fatal cases were atypical in that the apparatus that was used for sexual purposes was not intended to cause asphyxia in one case and did not directly cause asphyxial death in the second case. The final case was not fatal. Significantly, the majority of women did not use unusual clothing, props, or devices to augment their activity, for example, five were completely naked and only one was found with elaborate clothing and extra ligatures. Six of the fatal cases had objective evidence of sexual activity, three had used neck padding to prevent chafing, and eight had failed self-rescue mechanisms. Of note, the initial impression in four cases (44%) was homicide (two), attempted suicide (one), and accidental death during sexual activity with a partner (one). These results support the assertion that the manifestations of female autoerotic asphyxial activity reported to date may be initially misleading to investigators. Our purpose in presenting these findings, therefore, is to increase awareness of the more subtle features of this syndrome in women in an attempt to reduce the potential for underdiagnosis or confusion with nonaccidental death in future cases.

  20. Carbon Based Nanotechnology: Review

    NASA Technical Reports Server (NTRS)

    Srivastava, Deepak; Saini, Subhash (Technical Monitor)

    1999-01-01

    This presentation reviews publicly available information related to carbon based nanotechnology. Topics covered include nanomechanics, carbon based electronics, nanodevice/materials applications, nanotube motors, nano-lithography and H2O storage in nanotubes.

  1. 77 FR 56854 - Submission for OMB Review; Comment Request: A Multi-Center International Hospital-Based Case...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    ... International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) SUMMARY: Under the... Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) (OMB No. 0925-0654). Type of Information..., methodology, or burden of the study. The program staff submitted a response to the public comment. The...

  2. Endoscopic skull base reconstruction: a review and clinical case series of 152 vascularized flaps used for surgical skull base defects in the setting of intraoperative cerebrospinal fluid leak.

    PubMed

    Thorp, Brian D; Sreenath, Satyan B; Ebert, Charles S; Zanation, Adam M

    2014-01-01

    Endoscopic skull base surgery continues to rapidly evolve, requiring comparable advances in reconstructive techniques. While smaller skull base defects with low intraoperative CSF flow have been successfully managed with a variety of avascular and/or noncellular techniques, larger defects with high CSF flow require more robust repairs often in the form of vascularized flaps, which confer excellent success rates in this setting. Despite these successful outcomes, a paucity of data describing specific patient and operative characteristics and their effects on repair exist. Therefore, a retrospective, consecutive chart review was performed on patients who underwent endoscopic skull base reconstruction with a vascularized flap in the setting of intraoperative CSF leaks. In this series, 151 patients with a mean age of 51 years underwent 152 vascularized flap skull base reconstructions for an array of benign and malignant pathologies. These vascularized flaps included 144 nasoseptal flaps, 6 endoscopic-assisted pericranial flaps, 1 facial artery buccinator flap, and 1 inferior turbinate flap that were used throughout all regions of the skull base. Perioperative (< 3 months) and postoperative (> 3 months) flap complications were assessed and revealed 3 perioperative flap defects (2.0%) defined as a visualized defect within the substrate of the flap and a total of 5 perioperative CSF leaks (3.3%). No patient experienced flap death/complete flap loss in the cohort. Assessed postoperative flap complications included 1 case (0.7%) of mucocele formation, 8 cases (5.3%) of prolonged skull base crusting, and 2 cases (1.3%) of donor-site complication, specifically septal perforation secondary to nasoseptal flap harvest. Among the 152 cases identified, 37 patients received radiation therapy while 114 patients did not undergo radiation therapy as part of the treatment profile. No significant association was found between perioperative complication rates and radiation therapy (p = 0

  3. Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

    PubMed Central

    2010-01-01

    Background We report on the challenges of obtaining Institutional Review Board (IRB) coverage for a community-based participatory research (CBPR) environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities. PMID:20637068

  4. Erythromelalgia: a case report and literature review.

    PubMed

    Buttaci, Charles J

    2006-01-01

    Erythromelalgia is a rare condition, of uncertain etiology, characterized by episodic erythema, intense burning pain and warmth of the hands and/or feet, and when chronic, associated with significant disability. The diagnosis is based on a thorough history and physical exam during a painful episode along with diagnostic testing to exclude other causes. This paper describes the unique syndrome of erythromelalgia through a case report and literature review. Case presentation and literature review. A 44-year-old male with erythromelalgia. Despite multiple treatment options, erythromelalgia is a challenging disease to effectively manage. Early recognition and treatment may offer patients the best probability of achieving remission or significant improvement.

  5. Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature

    PubMed Central

    Johnson, Maxwell B.

    2016-01-01

    Background: Large complex scalp wounds that have traditionally required free vascularized tissue transfer have been successfully reconstructed with skin substitutes such as Integra. Although there are multiple reports of Integra-based reconstructions of scalp wounds, there has not been a comprehensive assessment of this body of literature that critically examines this method. Our goal was to conduct a systematic review to determine the effectiveness of Integra-based reconstructions of scalp wounds, with emphasis on large defects. Methods: A comprehensive systematic review was completed using key search terms, including Integra, dermal regeneration template, bovine collagen, skin substitute, forehead, and scalp. Selected articles reported characteristics of patients and their reconstructions. The primary outcome measures were wound complications and percent graft take. Results: Thirty-four articles were included in this systematic review. Wound sizes ranged from 5.7 to 610 cm2, with 35.3% of articles reporting a mean defect size >100 cm2. Thirty-two articles reported mean percent take of skin graft ≥90%. Sixteen articles reported a minor complication. There were no major complications associated with the reconstructions. Conclusions: There is a substantial evidence base for the use of Integra to reconstruct scalp wounds. To date, the dermal regeneration template is generally reserved for salvage procedures or when the patient cannot tolerate free tissue transfer. Based on the findings of this systematic review and the authors’ clinical experience, Integra can be used to achieve predictable results in large complex scalp defects. PMID:27826471

  6. Comparison of two expert-based assessments of diesel exhaust exposure in a case-control study: Programmable decision rules versus expert review of individual jobs

    PubMed Central

    Pronk, Anjoeka; Stewart, Patricia A.; Coble, Joseph B.; Katki, Hormuzd A.; Wheeler, David C.; Colt, Joanne S.; Baris, Dalsu; Schwenn, Molly; Karagas, Margaret R.; Johnson, Alison; Waddell, Richard; Verrill, Castine; Cherala, Sai; Silverman, Debra T.; Friesen, Melissa C.

    2012-01-01

    Objectives Professional judgment is necessary to assess occupational exposure in population-based case-control studies; however, the assessments lack transparency and are time-consuming to perform. To improve transparency and efficiency, we systematically applied decision rules to the questionnaire responses to assess diesel exhaust exposure in the New England Bladder Cancer Study, a population-based case-control study. Methods 2,631 participants reported 14,983 jobs; 2,749 jobs were administered questionnaires (‘modules’) with diesel-relevant questions. We applied decision rules to assign exposure metrics based solely on the occupational history responses (OH estimates) and based on the module responses (module estimates); we combined the separate OH and module estimates (OH/module estimates). Each job was also reviewed one at a time to assign exposure (one-by-one review estimates). We evaluated the agreement between the OH, OH/module, and one-by-one review estimates. Results The proportion of exposed jobs was 20–25% for all jobs, depending on approach, and 54–60% for jobs with diesel-relevant modules. The OH/module and one-by-one review had moderately high agreement for all jobs (κw=0.68–0.81) and for jobs with diesel-relevant modules (κw=0.62–0.78) for the probability, intensity, and frequency metrics. For exposed subjects, the Spearman correlation statistic was 0.72 between the cumulative OH/module and one-by-one review estimates. Conclusions The agreement seen here may represent an upper level of agreement because the algorithm and one-by-one review estimates were not fully independent. This study shows that applying decision-based rules can reproduce a one-by-one review, increase transparency and efficiency, and provide a mechanism to replicate exposure decisions in other studies. PMID:22843440

  7. Neuro-Behçet's disease, its mimickers and anti-TNF therapy: a case-based review.

    PubMed

    Neves, Fabricio S; Ferreira, Rafael M; Pereira, Ivanio A; Zimmermann, Adriana F; Lin, Katia

    2013-01-01

    When the central nervous system is the primary affected site in an initial attack of Behçet's disease (BD), the differential diagnosis is particularly challenging. Because the specificity of immunobiologic therapy is growing, the specific diagnosis may impact the chosen therapy. For instance, anti-tumour necrosis factor agents are efficacious in BD but may be harmful in multiple sclerosis or systemic lupus erythematosus. We present two cases with similar neurological features but different diagnosis (BD and systemic lupus erythematosus) as a starting point to review diagnostic and therapeutic approaches for neuro-BD and its differential diagnoses.

  8. [Intracranial aneurysm revealed by panhypopituitarism. Considerations on therapeutic management based on a case report and review of the literature].

    PubMed

    Métellus, Ph; Dicostanzo, V; Manera, L; Fuentes, S; Dufour, H; Grisoli, F

    2003-12-01

    We report a case of an unruptured intracranial aneurysm in paraclinoidal location which was a unmasked by severe panhypopituitarism. An ipsilateral internal carotid artery (ICA) clamp test was performed in the pretreatment stage. The test was well tolerated and the aneurysm could be embolized with GDC (Guglielmi detachable coils) without necessitating an occlusion of the ICA. The postoperative course was uneventful and the patient was discharged after 48 hours. At one year, cerebral angiograms confirmed complete obliteration of the aneurysm. Therapeutic management of this rare entity is discussed along with a careful and exhaustive review of the literature.

  9. Pulmonary embolism in burns, is there an evidence based prophylactic recommendation? Case report and review of literature.

    PubMed

    Sebastian, Raul; Ghanem, Omar; DiRoma, Frank; Milner, Stephen M; Price, Leigh A

    2015-03-01

    Burn patients exhibit an acquired hypercoagulable state with increased risk of venous thromboembolism. Currently, no randomized control study assessing the efficacy of chemical venous thromboembolism (VTE) prophylaxis in burn patients has been performed. We present a case of a morbidly (body mass index>54kg/m(2)) obese patient with 18% total body surface area (TBSA) burn who developed a VTE and a non-fatal submassive pulmonary embolus (PE). We will be reviewing the current consensus of venous thrombosis prophylaxis in burn patients and briefly discuss the treatment of PE in this population. Copyright © 2014. Published by Elsevier Ltd.

  10. Idiopathic cerebrospinal fluid overproduction: case-based review of the pathophysiological mechanism implied in the cerebrospinal fluid production.

    PubMed

    Trevisi, Gianluca; Frassanito, Paolo; Di Rocco, Concezio

    2014-08-28

    Cerebrospinal fluid (CSF) overproduction results from either CSF infection or choroid plexus hypertrophy or tumor, with only a single idiopathic case described so far. We report a unique case of a male infant with Crouzon syndrome who presented with intracranial hypertension, caused by up to 4-fold increase in CSF daily production. Conditions related to CSF overproduction, namely central nervous system infections and choroid plexus hypertrophy or tumor, were ruled out by repeated magnetic resonance imaging and CSF samples. Medical therapy failed to reduce CSF production and the patient underwent several shunting procedures, cranial expansion, and endoscopic coagulation of the choroid plexus. This article thoroughly reviews pertinent literature on CSF production mechanisms and possible therapeutic implications.

  11. Idiopathic cerebrospinal fluid overproduction: case-based review of the pathophysiological mechanism implied in the cerebrospinal fluid production

    PubMed Central

    Trevisi, Gianluca; Frassanito, Paolo; Di Rocco, Concezio

    2014-01-01

    Cerebrospinal fluid (CSF) overproduction results from either CSF infection or choroid plexus hypertrophy or tumor, with only a single idiopathic case described so far. We report a unique case of a male infant with Crouzon syndrome who presented with intracranial hypertension, caused by up to 4-fold increase in CSF daily production. Conditions related to CSF overproduction, namely central nervous system infections and choroid plexus hypertrophy or tumor, were ruled out by repeated magnetic resonance imaging and CSF samples. Medical therapy failed to reduce CSF production and the patient underwent several shunting procedures, cranial expansion, and endoscopic coagulation of the choroid plexus. This article thoroughly reviews pertinent literature on CSF production mechanisms and possible therapeutic implications. PMID:25165051

  12. Comparison of two expert-based assessments of diesel exhaust exposure in a case-control study: programmable decision rules versus expert review of individual jobs.

    PubMed

    Pronk, Anjoeka; Stewart, Patricia A; Coble, Joseph B; Katki, Hormuzd A; Wheeler, David C; Colt, Joanne S; Baris, Dalsu; Schwenn, Molly; Karagas, Margaret R; Johnson, Alison; Waddell, Richard; Verrill, Castine; Cherala, Sai; Silverman, Debra T; Friesen, Melissa C

    2012-10-01

    Professional judgment is necessary to assess occupational exposure in population-based case-control studies; however, the assessments lack transparency and are time-consuming to perform. To improve transparency and efficiency, we systematically applied decision rules to questionnaire responses to assess diesel exhaust exposure in the population-based case-control New England Bladder Cancer Study. 2631 participants reported 14 983 jobs; 2749 jobs were administered questionnaires ('modules') with diesel-relevant questions. We applied decision rules to assign exposure metrics based either on the occupational history (OH) responses (OH estimates) or on the module responses (module estimates); we then combined the separate OH and module estimates (OH/module estimates). Each job was also reviewed individually to assign exposure (one-by-one review estimates). We evaluated the agreement between the OH, OH/module and one-by-one review estimates. The proportion of exposed jobs was 20-25% for all jobs, depending on approach, and 54-60% for jobs with diesel-relevant modules. The OH/module and one-by-one review estimates had moderately high agreement for all jobs (κ(w)=0.68-0.81) and for jobs with diesel-relevant modules (κ(w)=0.62-0.78) for the probability, intensity and frequency metrics. For exposed subjects, the Spearman correlation statistic was 0.72 between the cumulative OH/module and one-by-one review estimates. The agreement seen here may represent an upper level of agreement because the algorithm and one-by-one review estimates were not fully independent. This study shows that applying decision-based rules can reproduce a one-by-one review, increase transparency and efficiency, and provide a mechanism to replicate exposure decisions in other studies.

  13. Hypertrophic Cranial Pachymeningitis and Skull Base Osteomyelitis by Pseudomonas Aeruginosa: Case Report and Review of the Literature

    PubMed Central

    Caldas, Ana Rita; Brandao, Mariana; Paula, Filipe Seguro; Castro, Elsa; Farinha, Fatima; Marinho, Antonio

    2012-01-01

    Hypertrophic cranial pachymeningitis (HCP) is an uncommon disorder characterized by localized or diffuse thickening of the dura mater, and it usually presents with multiple cranial neurophaties. It has been associated with a variety of inflammatory, infectious, traumatic, toxic and neoplasic diseases, when no specific cause is found the process is called idiopathic. The infectious cases occur in patients under systemic immunosuppression, which have an evident contiguous source or those who have undergone neurosurgical procedures. We describe a case of a 62-year-old immunosuppressed woman with diabetes and rheumatoid arthritis, which had HCP and osteomyelitis of the skull base caused by pseudomonas aeruginosa, presenting with headache and diplopia. We believe this is the second documented case of pachymeningitis secondary to this microorganism. As a multifactorial disease, it is essencial to determine the specific causative agent of HCP before making treatment decisions, and great care is needed with immunocompromised patients. Keywords Pseudomonas aeruginosa; Hypertrophic pachymeningitis; Ophtalmoplegia, optical neuropathy; Osteomyelitis; Skull base PMID:22505989

  14. School-based peer-related social competence interventions for children with autism spectrum disorder: a meta-analysis and descriptive review of single case research design studies.

    PubMed

    Whalon, Kelly J; Conroy, Maureen A; Martinez, Jose R; Werch, Brittany L

    2015-06-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to facilitate the peer-related social competence of children with autism spectrum disorder (ASD). Reviewed studies employed a single-case experimental design, targeted peer-related social competence, included children 3-12 years old with an ASD, and took place in school settings. Articles were analyzed descriptively and using the evaluative method to determine study quality. Additionally, effect size estimates were calculated using nonoverlap of all pairs method and Tau-U. A total of 37 studies including 105 children were reviewed. Overall, ES estimates ranged from weak to strong, but on average, the reviewed interventions produced a moderate to strong effect, and quality ratings were generally in the acceptable to high range. Findings suggest that children with ASD can benefit from social skill interventions implemented with peers in school settings.

  15. Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia

    PubMed Central

    Gebremariam, Solmon

    2016-01-01

    Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality. PMID:27974990

  16. Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia.

    PubMed

    Gebremariam, Solmon; Moges, Tamirat

    2016-01-01

    Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality.

  17. Symptomatic stroke complicating central skull base osteomyelitis following otitis media in a 2-year old boy: Case report and review of the literature.

    PubMed

    Kilich, Eliz; Dwivedi, Reena; Segal, Shelley; Jayawant, Sandeep; Sadarangani, Manish

    2016-10-01

    We describe the youngest case to date of a 2 year old child who developed central skull base osteomyelitis (SBO) initially presenting with a fever, vomiting and sore throat. An extremely rare complication of mastoiditis following otitis media in children is SBO which can present with non-specific symptoms. This report describes the first case of symptomatic ischaemic stroke secondary to SBO in an immunocompetent child. We review the literature of the management and the potential cerebrovascular complications of central SBO in children secondary to otolaryngological infection.

  18. Renal hemangiopericytoma: case report and literature review

    PubMed Central

    Vetorazzo, José Eduardo; Bahia, Leandro Augusto Costa; Esteves, Paulo Ebert; Maron, Paulo Eduardo Goulart; Vedovato, Bruno César; Fernandes, Roni de Carvalho; Perez, Marjo Deninson Cardenuto

    2015-01-01

    Hemangioperycytoma is a rare perivascular tumor that seldom involves the urogenital system. This tumor often appears with an unspecific clinical picture, and sometimes is associated with hematuria or hypertension. Diagnosis is based on a combination of histological and immunohistological findings. We report a case of a 52-year-old patient with renal hemangiopericytoma who underwent surgical treatment at our service. This report also includes a literature review on the subject. PMID:25946050

  19. Facial translocation approach to infratemporal fossa and cranial base in extensive angiofibroma: A review of 7 cases.

    PubMed

    Das, Udaya Chand; Stephen, A; Ross, Anitha; Chary, Geetha; Chand, Ashis K

    2005-01-01

    Angiofibroma extending to infratemporal fossa, orbit and middle cranial fossa is a difficult problem for a surgeon to tackle. Traditional extracranial excision with radiotherapy for the intracranial extension was practiced for a long time with variable results. Different approaches to remove such a tumour are described but most of them are not free from resultant morbidity in the form of facial asymmetry and incomplete tumour removal. Facial translocation approach facilitates complete tumour removal without cutting through the tumour thereby reducing per-operative blood loss. It also avoids facial asymmetry as the zygomatico-orbito-maxillary bony complex is replaced after the tumour removal. We present a review of seven cases with the results. The surgical steps, advantages, disadvantages and the complications are discussed.

  20. Simulated activity but real trauma: a systematic review on Nintendo Wii injuries based on a case report of an acute anterior cruciate ligament rupture.

    PubMed

    Müller, Sebastian A; Vavken, Patrick; Pagenstert, Geert

    2015-03-01

    Video gaming injuries are classically regarded as eccentric accidents and novelty diagnoses. A case of an anterior cruciate ligament (ACL) tear sustained during Wii boxing spurned us to review the literature for other Wii-related injuries and Wii-based posttraumatic rehabilitation. The English literature listed in PubMed was systematically reviewed by searching for "Wii (trauma or injury or fracture)." Full-text articles were included after duplicate, blinded review. The type and treatment of injury as well as the Wii-based rehabilitation programs found were analyzed. Additionally, a new case of an acute ACL tear-sustained playing, Wii boxing, is additionally presented. After exclusion of irrelevant articles, 13 articles describing Wii-related injuries were included reporting on 3 fractures, 6 nonosseous, 2 overuse injuries, and 2 rehabilitation programs using Wii for posttraumatic rehabilitation. Among the presented Wii-related injuries, only 12.5% were treated conservatively, whereas 87.5% underwent either surgical or interventional treatment. Because of the reported case, the literature search was limited to Wii-related injuries excluding other video games. Another limitation of this article lies in the fact that mainly case reports but no controlled trials exist on the topic. Assumingly, primarily the more severe injuries are reported in the literature with an unknown number of possibly minor injuries. Motion-controlled video games, such as Wii, are becoming increasingly popular as a recreational entertainment. Because of their wide acceptance and entertaining nature, they are also increasingly recognized as a tool in rehabilitation. However, although the activity is simulated, injuries are real. Our systematic review shows that Wii gaming can lead to severe injuries, sometimes with lasting limitations.

  1. Ictal swearing: a case series and review.

    PubMed

    Birca, Veronica; Tayah, Tania; Saint-Hilaire, Jean-Marc; Nguyen, Dang Khoa

    2013-12-01

    Seizures can manifest with ictal swearing but few studies have investigated the localising value of this epileptic manifestation. In this case series and review of the literature, we attempted to determine whether ictal swearing could help localise the epileptic focus. We review two previously published cases and report eight additional epileptic patients with ictal swearing for whom the epileptic focus was determined based on clinical, structural, electrophysiological, and surgical outcome data. Results indicated that ictal swearing occurs more commonly in male subjects and lateralises to the non-dominant hemisphere, but has poor localisation value, arising either from the frontal, parietal, temporal or occipital lobes in different patients. We discuss the significance of these findings. [Published with video sequences].

  2. Myocardial ischemia as presenting manifestation of IgG4-related disease: a case-based review.

    PubMed

    Delgado-García, Guillermo; Sánchez-Salazar, Sergio; Rendón-Ramírez, Erick; Castro-Medina, Mario; Sáenz-Ibarra, Bárbara; Barboza-Quintana, Álvaro; Loredo-Alanis, María Azalea; Hernández-Barajas, David; Galarza-Delgado, Dionicio

    2016-11-01

    Coronary involvement in IgG4-related disease (IgG4-RD) has been scarcely reported, and myocardial ischemia as its presenting feature is even rarer. Here, we describe an additional case with novel and relevant observations. The patient was a previously healthy, middle-aged woman who presented to the clinic with new-onset typical angina. One tumefactive lesion encasing the left anterior descending artery was found during her workup. The most common underlying malignancies with secondary cardiac involvement were rationally ruled out. Symptoms persisted despite medical treatment, and she was therefore referred to surgery. Tumor excision was successfully performed, and she received coronary bypass grafting. IgG4-related coronary arteritis with pseudotumor formation was subsequently diagnosed following the comprehensive diagnostic criteria. This condition was clinically classified as active and circulating plasmablasts were found to be increased (5480/mL), even when these were determined 38 days after surgery. A PET/CT revealed an additional hypermetabolic lymph node. She was therefore treated with rituximab as induction therapy (two 1000 mg doses, administered 15 days apart). Three months later, her disease remained clinically inactive. Circulating plasmablasts were repeated and these had dropped to 0/mL. We thereafter review the current and pertinent literature on the topic, emphasizing the previous cases with similar presenting features (n = 7). We lastly suggest that IgG4-RD should be part of the differential diagnosis of any patient with tumefactive lesions surrounding the coronary arteries, since it can initially presented as sudden cardiac death.

  3. Bortezomib-based chemotherapy to treat refractory angioimmunoblastic T-cell lymphoma: A case report and review of the literature

    PubMed Central

    DU, HUA-PING; YANG, QIAN-QIAN; ZHANG, YE

    2016-01-01

    The peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive neoplasms that account for <15% of all non-Hodgkin's lymphoma cases in adults. Angioimmunoblastic T-cell lymphoma (AITL) is a specific subtype of PTCL. The tumor is frequently aggressive and there is currently no general consensus regarding an effective treatment strategy. The present study reports a case in which bortezomib combined with dexamethasone was used to treat refractory AITL. A 63-year-old woman was admitted to Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (Zhejiang, China) on August 17, 2013. The patient had been diagnosed with AITL for 4 months and had experienced a relapse of symptoms for the 4 days prior to admission. The patient demonstrated fever and dyspnea, accompanied by severe edema in the face and lower limbs, which later spread to the right upper limb. The patient was treated with bortezomib plus dexamethasone, which rapidly relieved the symptoms. The patient was subsequently administered an additional 2 cycles of bortezomib-based chemotherapy and survived for an additional 4 months, prior to succumbing to the disease. Only a small number of studies have reported the use of bortezomib in the treatment of T-cell lymphoma. The present study suggested that bortezomib-based treatment may be a reliable, safe and effective alternative for the treatment of relapsed/refractory PTCL. The efficacy of bortezomib as a treatment for PTCL requires additional evaluation in future studies. PMID:26998168

  4. Successful treatment of fractures of the base of the acromion after reverse shoulder arthroplasty: Case report and review of the literature

    PubMed Central

    Rouleau, Dominique M.; Gaudelli, Cinzia

    2013-01-01

    Fractures of the acromion and scapula are known to occur after reverse shoulder arthroplasty. We present a case of a fracture at the base of the acromion 5 months after arthroplasty treated successfully with dual plating of the acromion. Eighteen months after fracture fixation, the patient had 160 degrees of active forward flexion, a QuickDASH of 29.5, a Constant score of 69 and she was satisfied with the result. A concomitant review of the literature produced, in addition to our patient, 56 cases. These were used to produce a classification system, based on bony and functional anatomy as follows. Tip fractures are of the most lateral or anterior portion of the acromion, those of the body of the acromion are medial to the tip but lateral to the beginning of the scapular base. Fractures at the scapular base are termed fractures of the base of the acromion and those more medial to that, fractures of the scapular spine. The functional results of these case series demonstrated poorer functional outcomes for more medial fractures. As future research in this domain increases, clarity on the nomenclature of these fractures will allow for prognostication and treatment based on fracture location as well as comparison between studies. PMID:24403763

  5. Applying systematic review search methods to the grey literature: a case study examining guidelines for school-based breakfast programs in Canada.

    PubMed

    Godin, Katelyn; Stapleton, Jackie; Kirkpatrick, Sharon I; Hanning, Rhona M; Leatherdale, Scott T

    2015-10-22

    Grey literature is an important source of information for large-scale review syntheses. However, there are many characteristics of grey literature that make it difficult to search systematically. Further, there is no 'gold standard' for rigorous systematic grey literature search methods and few resources on how to conduct this type of search. This paper describes systematic review search methods that were developed and applied to complete a case study systematic review of grey literature that examined guidelines for school-based breakfast programs in Canada. A grey literature search plan was developed to incorporate four different searching strategies: (1) grey literature databases, (2) customized Google search engines, (3) targeted websites, and (4) consultation with contact experts. These complementary strategies were used to minimize the risk of omitting relevant sources. Since abstracts are often unavailable in grey literature documents, items' abstracts, executive summaries, or table of contents (whichever was available) were screened. Screening of publications' full-text followed. Data were extracted on the organization, year published, who they were developed by, intended audience, goal/objectives of document, sources of evidence/resources cited, meals mentioned in the guidelines, and recommendations for program delivery. The search strategies for identifying and screening publications for inclusion in the case study review was found to be manageable, comprehensive, and intuitive when applied in practice. The four search strategies of the grey literature search plan yielded 302 potentially relevant items for screening. Following the screening process, 15 publications that met all eligibility criteria remained and were included in the case study systematic review. The high-level findings of the case study systematic review are briefly described. This article demonstrated a feasible and seemingly robust method for applying systematic search strategies to

  6. A case of bilateral lower cranial nerve palsies after base of skull trauma with complex management issues: case report and review of the literature.

    PubMed

    Lehn, Alexander Christoph; Lettieri, Jennie; Grimley, Rohan

    2012-05-01

    Fractures of the skull base can cause lower cranial nerve palsies because of involvement of the nerves as they traverse the skull. A variety of syndromes have been described, often involving multiple nerves. These are most commonly unilateral, and only a handful of cases of bilateral cranial nerve involvement have been reported. We describe a 64-year-old man with occipital condylar fracture complicated by bilateral palsies of IX and X nerves associated with dramatic physiological derangement causing severe management challenges. Apart from debilitating postural hypotension, he developed dysphagia, severe gastrointestinal dysmotility, issues with airway protection as well as airway obstruction, increased oropharyngeal secretions and variable respiratory control. This is the first report of a patient with traumatic bilateral cranial nerve IX and X nerve palsies. This detailed report and the summary of all 6 previous case reports of traumatic bilateral lower cranial nerve palsies illustrate clinical features, treatment strategies, and outcomes of these rare events.

  7. Is Performance Feedback for Educators an Evidence-Based Practice? A Systematic Review and Evaluation Based on Single-Case Research

    ERIC Educational Resources Information Center

    Fallon, Lindsay M.; Collier-Meek, Melissa A.; Maggin, Daniel M.; Sanetti, Lisa M. H.; Johnson, Austin H.

    2015-01-01

    Optimal levels of treatment fidelity, a critical moderator of intervention effectiveness, are often difficult to sustain in applied settings. It is unknown whether performance feedback, a widely researched method for increasing educators' treatment fidelity, is an evidence-based practice. The purpose of this review was to evaluate the current…

  8. Is Performance Feedback for Educators an Evidence-Based Practice? A Systematic Review and Evaluation Based on Single-Case Research

    ERIC Educational Resources Information Center

    Fallon, Lindsay M.; Collier-Meek, Melissa A.; Maggin, Daniel M.; Sanetti, Lisa M. H.; Johnson, Austin H.

    2015-01-01

    Optimal levels of treatment fidelity, a critical moderator of intervention effectiveness, are often difficult to sustain in applied settings. It is unknown whether performance feedback, a widely researched method for increasing educators' treatment fidelity, is an evidence-based practice. The purpose of this review was to evaluate the current…

  9. Non-Dural-Based Spinal Meningioma : The First Case Report of a Fibrous Subtype and a Review of the Literature

    PubMed Central

    Lee, Ji Hye; Moon, Hong Joo; Kim, Joo Han

    2014-01-01

    Spinal meningiomas typically adhere to the dura matter. Non-dural based spinal meningiomas are rare and most are clear cell meningiomas. We report here the first case of a fibrous meningioma with non-dural attachment. The patient was a 49-year-old female, who complained of numbness in the legs and a gait disturbance. Magnetic resonance imaging revealed a 1.7×1.4-cm mass in the C7-T1 intra-dural extramedullary space, showing peripheral gadolinium enhancement without a "dural tail sign". A complete microsurgical resection was performed. The mass was covered with a white membrane but was not adhered to the dura, and its appearance was consistent with a neurilemmoma. The histopathological diagnosis was fibrous-type meningioma. The recovery of the patient was uneventful. No surgical complications and no recurrence of the tumor had occurred at the 6-month follow-up. PMID:25289128

  10. Valproic acid and fatalities in children: a review of individual case safety reports in VigiBase.

    PubMed

    Star, Kristina; Edwards, I Ralph; Choonara, Imti

    2014-01-01

    Valproic acid is an effective first line drug for the treatment of epilepsy. Hepatotoxicity is a rare and potentially fatal adverse reaction for this medicine. Firstly to characterise valproic acid reports on children with fatal outcome and secondly to determine reporting over time of hepatotoxicity with fatal outcome. Individual case safety reports (ICSRs) for children ≤ 17 years with valproic acid and fatal outcome were retrieved from the WHO Global ICSR database, VigiBase, in June 2013. Reports were classified into hepatotoxic reactions or other reactions. Shrinkage observed-to-expected ratios were used to explore the relative reporting trend over time and for patient age. The frequency of polytherapy, i.e. reports with more than one antiepileptic medicine, was investigated. There have been 268 ICSRs with valproic acid and fatal outcome in children, reported from 25 countries since 1977. A total of 156 fatalities were reported with hepatotoxicity, which has been continuously and disproportionally reported over time. There were 31 fatalities with pancreatitis. Other frequently reported events were coma/encephalopathy, seizures, respiratory disorders and coagulopathy. Hepatotoxicity was disproportionally and most commonly reported in children aged 6 years and under (104/156 reports) but affected children of all ages. Polytherapy was significantly more frequently reported for valproic acid with fatal outcome (58%) compared with non-fatal outcome (34%). Hepatotoxicity remains a considerable problem. The risk appears to be greatest in young children (6 years and below) but can occur at any age. Polytherapy is commonly reported and seems to be a risk factor for hepatotoxicity, pancreatitis and other serious adverse drug reactions with valproic acid.

  11. Valproic Acid and Fatalities in Children: A Review of Individual Case Safety Reports in VigiBase

    PubMed Central

    Star, Kristina; Edwards, I. Ralph; Choonara, Imti

    2014-01-01

    Introduction Valproic acid is an effective first line drug for the treatment of epilepsy. Hepatotoxicity is a rare and potentially fatal adverse reaction for this medicine. Objective Firstly to characterise valproic acid reports on children with fatal outcome and secondly to determine reporting over time of hepatotoxicity with fatal outcome. Methods Individual case safety reports (ICSRs) for children ≤17 years with valproic acid and fatal outcome were retrieved from the WHO Global ICSR database, VigiBase, in June 2013. Reports were classified into hepatotoxic reactions or other reactions. Shrinkage observed-to-expected ratios were used to explore the relative reporting trend over time and for patient age. The frequency of polytherapy, i.e. reports with more than one antiepileptic medicine, was investigated. Results There have been 268 ICSRs with valproic acid and fatal outcome in children, reported from 25 countries since 1977. A total of 156 fatalities were reported with hepatotoxicity, which has been continuously and disproportionally reported over time. There were 31 fatalities with pancreatitis. Other frequently reported events were coma/encephalopathy, seizures, respiratory disorders and coagulopathy. Hepatotoxicity was disproportionally and most commonly reported in children aged 6 years and under (104/156 reports) but affected children of all ages. Polytherapy was significantly more frequently reported for valproic acid with fatal outcome (58%) compared with non-fatal outcome (34%). Conclusion Hepatotoxicity remains a considerable problem. The risk appears to be greatest in young children (6 years and below) but can occur at any age. Polytherapy is commonly reported and seems to be a risk factor for hepatotoxicity, pancreatitis and other serious adverse drug reactions with valproic acid. PMID:25302991

  12. A Multiple Case Study of a Baldrige-Based Peer Review Process in an Urban School District

    ERIC Educational Resources Information Center

    Ray, Janet L.

    2012-01-01

    Distinct purposes were identified for this phenomenological multiple-case study. The first purpose of the study was to determine in what ways the BbPRP influenced (a) leadership, (b) strategic planning, and (c) process management among the five selected schools within AISD. The second purpose of this study was to examine administrators'…

  13. Button Osteoma: A Review of Ten Cases.

    PubMed

    Chae, Soo Yuhl; Sim, Hyun Bo; Kim, Min Ji; Jang, Yong Hyun; Lee, Seok-Jong; Kim, Do Won; Lee, Weon Ju

    2015-08-01

    Button osteoma presents as small circumscribed ivory-like lumps on the skull vault. Although not rare, its diagnosis can be challenging for dermatologists. To clarify the clinical characteristics of button osteoma by reviewing 10 cases. Ten patients diagnosed with button osteoma at the Department of Dermatology, Kyungpook National University Hospital, between January 2011 and August 2014 were enrolled. We retrospectively reviewed medical records and analyzed demographic and clinical characteristics including sex, age, sites, number of lesions, symptoms, duration, histopathological finding, radiological findings, and treatment. All patients presented with an asymptomatic small circumscribed hard lump fixed to a bony structure. There were 9 female and 1 male patient, and the mean age was 54 years (range, 28~61 years). The most common site was the forehead, and disease duration ranged from 2 weeks to more than 20 years. The differential diagnosis included cranial exostosis, ballooned osteoma, epidermal cyst, and lipoma. Simple radiography, ultrasonography, and computed tomography (CT) were used to make a confirmative diagnosis. Histopathological findings showed lamellated bony structures with poor vascularization. Ostectomy was performed for 5 patients, and no recurrence was detected within an average of 13.4 months after treatment. This review characterized button osteoma. Surgical excision is a useful therapeutic modality after CT-based diagnosis. Further studies with more patients are required to confirm the findings.

  14. Review of ORD Nanomaterial Case Studies Workshop

    EPA Pesticide Factsheets

    The following is a letter report from the Executive Committee of the BOSC concerning the review of the ORD Nanomaterial Case Studies Workshop: Developing a Comprehensive Environmental Assessment Research Strategy for Nanoscale Titanium Dioxide.

  15. Dysgerminoma in a female with turner syndrome and Y chromosome material: A case-based review of literature.

    PubMed

    Kota, Sunil Kumar; Gayatri, Kotni; Pani, Jaya Prakash; Kota, Siva Krishna; Meher, Lalit Kumar; Modi, Kirtikumar D

    2012-05-01

    We report a 17-year-old girl evaluated for primary amenorrhea. Cytogenetic analysis of the peripheral blood lymphocytes revealed normal autosomes with 46X inv (Y) confirming the diagnosis of Turner's syndrome with Y cell line. Treatment was initiated with conjugated estrogen while recommending bilateral prophylactic oophorectomy to the patient. One year later the patient presented with abdominal mass, biopsy of the specimen following resection confirmed dysgerminoma originating from right ovary with no invasion or metastasis. The literature is reviewed with regard to the various pathogenetic mechanisms proposed for the development of germ cell tumors in ovary, the cytogenetic findings and recommendations to handle such scenario.

  16. Review Article: A Review of Melioidosis Cases in the Americas

    PubMed Central

    Benoit, Tina J.; Blaney, David D.; Doker, Thomas J.; Gee, Jay E.; Elrod, Mindy G.; Rolim, Dionne B.; Inglis, Timothy J. J.; Hoffmaster, Alex R.; Bower, William A.; Walke, Henry T.

    2015-01-01

    Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, a gram-negative saprophytic bacillus. Cases occur sporadically in the Americas with an increasing number of cases observed among people with no travel history to endemic countries. To better understand the incidence of the disease in the Americas, we reviewed the literature, including unpublished cases reported to the Centers for Disease Control and Prevention. Of 120 identified human cases, occurring between 1947 and June 2015, 95 cases (79%) were likely acquired in the Americas; the mortality rate was 39%. Burkholderia pseudomallei appears to be widespread in South, Central, and North America. PMID:26458779

  17. Atrial Myxoma: A Case Presentation and Review

    PubMed Central

    Cohen, Ronny; Singh, Gagandeep; Mena, Derrick; Garcia, Christine A.; Loarte, Pablo; Mirrer, Brooks

    2012-01-01

    Myxomas are the most common primary cardiac tumors, most frequently found in the left atrium. We present a case of an atrial myxoma. An in-depth review of atrial myxoma is presented, examining the important clinical symptoms and diagnostic indicators. The treatment of atrial myxoma is then discussed, with an emphasis on current therapies. An extensive literature review has been performed to present a comprehensive review of the causes, pathophysiology of atrial myxoma.

  18. Citrus waste as feedstock for bio-based products recovery: Review on limonene case study and energy valorization.

    PubMed

    Negro, Viviana; Mancini, Giuseppe; Ruggeri, Bernardo; Fino, Debora

    2016-08-01

    The citrus peels and residue of fruit juices production are rich in d-limonene, a cyclic terpene characterized by antimicrobial activity, which could hamper energy valorization bioprocess. Considering that limonene is used in nutritional, pharmaceutical and cosmetic fields, citrus by-products processing appear to be a suitable feedstock either for high value product recovery or energy bio-processes. This waste stream, more than 10MTon at 2013 in European Union (AIJN, 2014), can be considered appealing, from the view point of conducting a key study on limonene recovery, as its content of about 1%w/w of high value-added molecule. Different processes are currently being studied to recover or remove limonene from citrus peel to both prevent pollution and energy resources recovery. The present review is aimed to highlight pros and contras of different approaches suggesting an energy sustainability criterion to select the most effective one for materials and energy valorization.

  19. Case report and literature review

    PubMed Central

    Flahault, Adrien; Vignon, Marguerite; Rabant, Marion; Hummel, Aurélie; Noël, Laure-Hélène; Canioni, Danielle; Knebelmann, Bertrand; Suarez, Felipe; El Karoui, Khalil

    2016-01-01

    Abstract Introduction: We report the case of a multicentric Castleman disease (MCD) with initial renal involvement. Although the renal involvement in this case was typical of MCD, it constitutes a rare presentation of the disease, and in our case the renal manifestations led to the haematological diagnosis. Clinical Findings/Patient Concerns: The patient was admitted for fever, diarrhea, anasarca, lymphadenopathies and acute renal failure. Despite intravenous rehydration using saline and albumin, renal function worsened and the patient required dialysis. While diagnostic investigations were performed, right hemiplegia occurred. There was no anemia or thrombocytopenia. Diagnoses: Kidney biopsy was consistent with glomerular thrombotic microangiopathy (TMA). Lymph node histology was consistent with hyalin-vascular variant of Castleman disease. Outcomes: Given the renal and neurological manifestations of this MCD-associated TMA, the patient was treated with plasma exchange during one month, and six courses of rituximab, cyclophosphamide and dexamethasone. The evolution was favorable. Conclusion: Although rare, this diagnosis is worth knowing, as specific treatment has to be started as soon as possible and proved to be efficient in our case as well as in other reports in the literature. PMID:27741115

  20. A case and review of congenital leukonychia.

    PubMed

    Pathipati, Akhilesh S; Ko, Justin M; Yost, John M

    2016-10-15

    Leukonychia refers to a white discoloration of the nails. Although several conditions may cause white nails, a rare, isolated, congenital form of the disease is hypothesized to stem from disordered keratinization of the nail plate. Herein, we report a case of a 41-year-old woman with congenital leukonychia and review prior cases.

  1. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing... purposes of the case reviews, States, the District of Columbia and Puerto Rico shall select a random sample...

  2. [Retinoblastoma: review of 19 cases].

    PubMed

    Martínez y Arroyo, M M; Díaz Vela, J F; Martín Valverde, J A; Llanes Menéndez, F; de Paz Garnelo, J A

    1991-02-01

    A retrospective study of retinoblastoma was done during 1978-1987, analysing the clinics aspects of the entity. We found nineteen children during this period, from them eight were girls (42%) and eleven were boys (58%). Ages of diagnostic ranged between three months and four years, with and average of 17.53 months. Nine children (47%) were bilaterally affected. Leocokoria was the most common initial sign, followed by strabismus. Ophthalmoscopy was the diagnostic procedure used, and surgery the recommended therapeutic, using radiotherapy as a palliative method in the cases which surgery has no indications.

  3. Intraoperative monitoring of lower cranial nerves in skull base surgery: technical report and review of 123 monitored cases.

    PubMed

    Topsakal, Cahide; Al-Mefty, Ossama; Bulsara, Ketan R; Williford, Veronica S

    2008-01-01

    The fundamental goal of skull base surgery is tumor removal with preservation of neurological function. Injury to the lower cranial nerves (LCN; CN 9-12) profoundly affects a patient's quality of life. Although intraoperative cranial nerve monitoring (IOM) is widely practiced for other cranial nerves, literature addressing the LCN is scant. We examined the utility of IOM of the LCN in a large patient series. One hundred twelve patients underwent 123 skull base operations with IOM between January 1994 to December 1999. The vagus nerve (n=37), spinal accessory nerve (n=118), and the hypoglossal nerve (n=83) were monitored intraoperatively. Electromyography (EMG) and compound muscle action potentials (CMAP) were recorded from the relevant muscles after electrical stimulation. This data was evaluated retrospectively. Patients who underwent IOM tended to have larger tumors with more intricate involvement of the lower cranial nerves. Worsening of preoperative lower cranial nerve function was seen in the monitored and unmonitored groups. With the use of IOM in the high risk group, LCN injury was reduced to a rate equivalent to that of the lower risk group (p>0.05). The immediate feedback obtained with IOM may prevent injury to the LCN due to surgical manipulation. It can also help identify the course of a nerve in patients with severely distorted anatomy. These factors may facilitate gross total tumor resection with cranial nerve preservation. The incidence of high false positive and negative CMAP and the variability in CMAP amplitude and threshold can vary depending on individual and technical factors.

  4. Duodenal gossypiboma: a case report and literature review.

    PubMed

    Velasco-Mata, Stephany; Díaz-Gómez, Marialy; Cova-Bianco, Tamarys; Hopp-Mora, Evelyn; Rodriguez-Rojas, Roselin; Chirinos-Malave, Yeirama; Carreiro-Rodriguez, Manuel

    2015-09-01

    Gossypiboma is a retained surgical cotton matrix material in the body after a surgical procedure. Cases are rarely reported due to medico-legal concerns. Although infrequent, it causes serious morbidity and even mortality if left undiagnosed. We present the case of a trans-mural migration of gossypiboma and a review of the literature. Gossypiboma's trans-duodenal migration is a rare complication of retained gauzes. Cases reported in the literature were easy to diagnose based on clinical grounds and endoscopic studies.

  5. Management of Mallet Fracture by Closed Extension-Block Pinning – A case based review of a novel technique

    PubMed Central

    Agarwal, Sharat; Akhtar, Mohammad Nasim

    2013-01-01

    Close reduction by extension-block K-wire fixation for acute mallet fracture is a relatively novel mode of treatment which is based on two sound orthopedic principles – stable arc splinting and early protected motion. Distal interphalangeal joint splinting is still the technique commonly used for mallet fractures with significant morbidity and only moderate functional outcome. We have demonstrated here Ishiguro’s technique in a partially treated 2 weeks old mallet fracture with the flexion deformity at distal interphalangeal (DIP) joint after proper preoperative assessment. Peroperatively, proper anatomical localization of mallet fragment was done under fluoroscopy. Reduction of the avulsion fracture was done by extension block K-wire and intra-articular K-wire was inserted subsequently to hold the reduction in place and DIP joint in extension. Later on K-wires were removed at the end of 6 weeks follow up. Patient was subjected to the physiotherapy during the course of the treatment. Excellent functional outcome was noted at the end of three months. PMID:26120399

  6. Regenerative endodontics--biologically-based treatment for immature permanent teeth: a case report and review of the literature.

    PubMed

    Thomson, A; Kahler, B

    2010-12-01

    A paradigm shift in the treatment of immature, necrotic teeth has occurred with biologically-based principles and regenerative endodontic protocols replacing traditional 'apexification' procedures. Preliminary research suggests that stem and progenitor cells from the pulp and/or periodontium contribute to continued root development when regenerative procedures are followed. A mandibular premolar tooth with a chronic periapical abscess was irrigated with sodium hypochlorite with minimal instrumentation and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was evoked in the canal by irritating periapical tissues and the canal sealed with mineral trioxide aggregate, glass ionomer cement and composite resin. Resolution of apical periodontitis and the draining sinus, continued root maturation and apical closure occurred over an 18-month period. The tooth became responsive to pulp sensibility testing. It is important that dentists recognize the potential of regenerative endodontics in the treatment of necrotic, immature teeth. Initial management should involve irrigation with sodium hypochlorite only. Intra-canal medicaments, such as calcium hydroxide, are contraindicated as they inhibit further root growth. This report uses a variation of the tri-antibiotic paste currently recommended for regenerative procedures that avoided the discolouration of the crown associated with current protocols. Regenerative endodontics with continued root growth may reduce the risk of fracture and premature tooth loss associated with traditional 'apexification' procedures where the root remains thin and weak. © 2010 Australian Dental Association.

  7. Management of Mallet Fracture by Closed Extension-Block Pinning - A case based review of a novel technique.

    PubMed

    Agarwal, Sharat; Akhtar, Mohammad Nasim

    2013-01-01

    Close reduction by extension-block K-wire fixation for acute mallet fracture is a relatively novel mode of treatment which is based on two sound orthopedic principles - stable arc splinting and early protected motion. Distal interphalangeal joint splinting is still the technique commonly used for mallet fractures with significant morbidity and only moderate functional outcome. We have demonstrated here Ishiguro's technique in a partially treated 2 weeks old mallet fracture with the flexion deformity at distal interphalangeal (DIP) joint after proper preoperative assessment. Peroperatively, proper anatomical localization of mallet fragment was done under fluoroscopy. Reduction of the avulsion fracture was done by extension block K-wire and intra-articular K-wire was inserted subsequently to hold the reduction in place and DIP joint in extension. Later on K-wires were removed at the end of 6 weeks follow up. Patient was subjected to the physiotherapy during the course of the treatment. Excellent functional outcome was noted at the end of three months.

  8. Neuropathological review of 138 cases genetically tested for X-linked hydrocephalus: evidence for closely related clinical entities of unknown molecular bases.

    PubMed

    Adle-Biassette, Homa; Saugier-Veber, Pascale; Fallet-Bianco, Catherine; Delezoide, Anne-Lise; Razavi, Férecheté; Drouot, Nathalie; Bazin, Anne; Beaufrère, Anne-Marie; Bessières, Bettina; Blesson, Sophie; Bucourt, Martine; Carles, Dominique; Devisme, Louise; Dijoud, Frédérique; Fabre, Blandine; Fernandez, Carla; Gaillard, Dominique; Gonzales, Marie; Jossic, Frédérique; Joubert, Madeleine; Laurent, Nicole; Leroy, Brigitte; Loeuillet, Laurence; Loget, Philippe; Marcorelles, Pascale; Martinovic, Jelena; Perez, Marie-José; Satge, Daniel; Sinico, Martine; Tosi, Mario; Benichou, Jacques; Gressens, Pierre; Frebourg, Thierry; Laquerrière, Annie

    2013-09-01

    L1 syndrome results from mutations in the L1CAM gene located at Xq28. It encompasses a wide spectrum of diseases, X-linked hydrocephalus being the most severe phenotype detected in utero, and whose pathophysiology is incompletely understood. The aim of this study was to report detailed neuropathological data from patients with mutations, to delineate the neuropathological criteria required for L1CAM gene screening in foetuses by characterizing the sensitivity, specificity and positive predictive value of the cardinal signs, and to discuss the main differential diagnoses in non-mutated foetuses in order to delineate closely related conditions without L1CAM mutations. Neuropathological data from 138 cases referred to our genetic laboratory for screening of the L1CAM gene were retrospectively reviewed. Fifty-seven cases had deleterious L1CAM mutations. Of these, 100 % had hydrocephalus, 88 % adducted thumbs, 98 % pyramidal tract agenesis/hypoplasia, 90 % stenosis of the aqueduct of Sylvius and 68 % agenesis/hypoplasia of the corpus callosum. Two foetuses had L1CAM mutations of unknown significance. Seventy-nine cases had no L1CAM mutations; these were subdivided into four groups: (1) hydrocephalus sometimes associated with corpus callosum agenesis (44 %); (2) atresia/forking of the aqueduct of Sylvius/rhombencephalosynapsis spectrum (27 %); (3) syndromic hydrocephalus (9 %), and (4) phenocopies with no mutations in the L1CAM gene (20 %) and in whom family history strongly suggested an autosomal recessive mode of transmission. These data underline the existence of closely related clinical entities whose molecular bases are currently unknown. The identification of the causative genes would greatly improve our knowledge of the defective pathways involved in these cerebral malformations.

  9. Multiple perpetrator rape among girls evaluated at a hospital-based Child Advocacy Center: Seven years of reviewed cases

    PubMed Central

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B.; Saewyc, Elizabeth

    2015-01-01

    The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n = 32) and to compare these findings to a group of single perpetrator sexual assaults (n = 534). This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M = 14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims. PMID:24933707

  10. Multiple perpetrator rape among girls evaluated at a hospital-based child advocacy center: seven years of reviewed cases.

    PubMed

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B; Saewyc, Elizabeth

    2014-09-01

    The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n=32) and to compare these findings to a group of single perpetrator sexual assaults (n=534). This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M=14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. [Melorheostosis: a case review and review of literature].

    PubMed

    Radło, W; Michno, P

    2000-01-01

    The authors present a review of the literature and the diagnostic difficulties in a case of melorheostosis in a 6 year old boy. Melorheostosis is characterized by longitudinal foci of subcutaneous sclerosis, limitation of motion in the joints and swelling of the knee and ankle joints. Radiologically numerous foci of hyperostosis similar to wax flowing down a burning candle have been noted.

  12. Osteoinvasive subungual melanoma: a case and review.

    PubMed

    Kleinerman, Rebecca; Kriegel, David; Amir, Imran; Emanuel, Patrick O; Markinson, Bryan C

    2010-02-01

    Subungual melanoma is a relatively rare variant of melanoma, accounting for 0.7-3.5% of all melanoma cases in the Caucasian population. Curiously, it occurs in 8-33% of cases in black, Asian, Native American and Hispanic populations, which generally face a substantially lower risk of melanoma. Herein the authors report the case of a 69-year-old Hispanic female with a subungual melanoma of the acral lentiginous type that directly invaded the periosteum, cortex and medulla of the distal phalanx. In addition, we review published reports of acral lentiginous melanoma with osseous invasion and discuss the evidence, on a molecular level, for this entity's aggressive pattern of invasion. The review of cases is limited to those found through the PubMed search engine.

  13. [Anaphylactic shock associated with ceftriaxone, case report and literature review].

    PubMed

    Del Carpio-Orantes, Luis; Azuara-Trujillo, Hugo Alberto

    2015-01-01

    This study presents a case of anaphylactic shock in a senile patient, who had a biphasic event associated with the administration of a beta-lactam cephalosporin (ceftriaxone), needing stay in the intensive care unit and support with vasoactive amines, which it is rare to see in this issue, already being in itself a difficult diagnosis and often undervalued by rejecting causes of shock in a senile patient other than cardiogenic or septic. Also, a case review is made based on epidemiological issues, clinical and paraclinical diagnosis, and current treatment implications based on current international guidelines and a review of the topic.

  14. Does case management for patients with heart failure based in the community reduce unplanned hospital admissions? A systematic review and meta-analysis

    PubMed Central

    Huntley, A L; Johnson, R; King, A; Morris, R W; Purdy, S

    2016-01-01

    Objectives The aim of this systematic review of randomised controlled trials (RCTs) and controlled trials (non-RCTs, NRCTs) is to investigate the effectiveness and related costs of case management (CM) for patients with heart failure (HF) predominantly based in the community in reducing unplanned readmissions and length of stay (LOS). Setting CM initiated either while as an inpatient, or on discharge from acute care hospitals, or in the community and then continuing on in the community. Participants Adults with a diagnosis of HF and resident in Organisation for Economic Co-operation and Development countries. Intervention CM based on nurse coordinated multicomponent care which is applicable to the primary care-based health systems. Primary and secondary outcomes Primary outcomes of interest were unplanned (re)admissions, LOS and any related cost data. Secondary outcomes were primary healthcare resources. Results 22 studies were included: 17 RCTs and 5 NRCTs. 17 studies described hospital-initiated CM (n=4794) and 5 described community-initiated CM of HF (n=3832). Hospital-initiated CM reduced readmissions (rate ratio 0.74 (95% CI 0.60 to 0.92), p=0.008) and LOS (mean difference −1.28 days (95% CI −2.04 to −0.52), p=0.001) in favour of CM compared with usual care. 9 trials described cost data of which 6 reported no difference between CM and usual care. There were 4 studies of community-initiated CM versus usual care (2 RCTs and 2 NRCTs) with only the 2 NRCTs showing a reduction in admissions. Conclusions Hospital-initiated CM can be successful in reducing unplanned hospital readmissions for HF and length of hospital stay for people with HF. 9 trials described cost data; no clear difference emerged between CM and usual care. There was limited evidence for community-initiated CM which suggested it does not reduce admission. PMID:27165648

  15. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Case Review Methodology. 98.101 Section 98.101... FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing... conduct comprehensive reviews of case records using a methodology established by the Secretary....

  16. Chondromyxoid fibroma of the anterior skull base invading the orbit in a pediatric patient: case report and review of the literature.

    PubMed

    Khalatbari, Mahmoud Reza; Hamidi, Mehrdokht; Moharamzad, Yashar

    2012-06-01

    Chondromyxoid fibroma (CMF) is a rare bone tumor of cartilaginous derivation representing less than 1% of all benign bone neoplasms. It is a slow-growing, locally destructive tumor that usually affects the metaphyseal region of long bones of patients in their second or third decade of life. Involvement of the skull base and orbit is extremely rare. We present the first case of histopathology-proven CMF originating in the greater sphenoid wing and extending into the orbit in a 14-year-old boy. He complained of pain and swelling of his left lateral orbit for 4 months and had 3-mm nonaxial proptosis. Magnetic resonance imaging of the orbit revealed a well-defined lesion in the lateral wall of the left orbit, hypointense on T1-weighted images, and heterogenous hyperintense on T2-weighted images and enhanced after contrast media injection. Through a left semicoronal skin incision, the mass was removed totally and the lateral orbital wall was reconstructed. The clinical manifestations, imaging findings, and surgical treatment of the lesion are discussed with a review of the literature.

  17. Automated Developmental Disabilities Out-Patient Treatment Review System (ADDOPTRS)—Development and Automation of a Microcomputer Based Case Management System

    PubMed Central

    Fisch, Clifford B.; Fisch, Martin L.

    1979-01-01

    The Stanley S. Lamm Institute for Developmental Disabilities of The Long Island College Hospital, in conjunction with Micro-Med Systems has developed a low cost micro-computer based information system (ADDOP TRS) which monitors quality of care in outpatient settings rendering services to the developmentally disabled population. The process of conversion from paper record keeping systems to direct key-to-disk data capture at the point of service delivery is described. Data elements of the information system including identifying patient information, coded and English-grammar entry procedures for tracking elements of service as well as their delivery status are described. Project evaluation criteria are defined including improved quality of care, improved productivity for clerical and professional staff and enhanced decision making capability. These criteria are achieved in a cost effective manner as a function of more efficient information flow. Administrative applications including staff/budgeting procedures, submissions for third party reimbursement and case reporting to utilization review committees are considered.

  18. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    SciTech Connect

    Kelly, Paul J.; Alexander, Brian M.; Hacker, Fred; Marcus, Karen J.; Weiss, Stephanie E.

    2012-01-01

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women's Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1-3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15-18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41-1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective studies.

  19. Melorheostosis: a case report and literature review.

    PubMed

    Perlman, M D

    1990-01-01

    Melorheostosis is a rare form of cortical hyperostosis that resembles wax dripping down the side of a candle. This disease usually affects the long and short bones of an extremity. Literature review and a case report will be discussed with respect to incidence, clinical presentation, radiographic appearance, and treatment.

  20. Cutaneous malakoplakia: case report and review*

    PubMed Central

    Afonso, João Paulo Junqueira Magalhães; Ando, Patricia Naomi; Padilha, Maria Helena Valle de Queiroz; Michalany, Nilceo Schwery; Porro, Adriana Maria

    2013-01-01

    Malakoplakia is a rare acquired disease that can affect many systems but is more common in the urogenital tract. Cutaneous malakoplakia is even rarer. It is far more frequent in immunodeficient patients. We report a case of cutaneous malakoplakia in a kidney transplant patient who had recently stopped receiving immunosuppressive therapy to illustrate a review of the relevant recent literature. PMID:23793204

  1. Bullosis diabeticorum: case report and review.

    PubMed

    Zhang, Angela J; Garret, Michele; Miller, Steven

    2013-03-15

    Assessment of the foot is an essential component of clinical examination of the patient with diabetes. As the prevalence of diabetes in New Zealand is increasing rapidly, a growing number of clinical encounters will involve individuals with diabetes. We present a case of bullosis diabeticorum, review the important clinical features and propose a management strategy for this rare dermatological complication of longstanding diabetes.

  2. Three Exemplary Models of Case-Based Teaching.

    ERIC Educational Resources Information Center

    Irby, David M.

    1994-01-01

    Three effective strategies for case-based teaching in clinical medicine are described: case-bedside teaching involving case discussion and bedside demonstration; a combination of quick case reviews with more formal presentations on relevant topics; and discovery learning using complex cases. Five general principles of experiential learning in…

  3. Three Exemplary Models of Case-Based Teaching.

    ERIC Educational Resources Information Center

    Irby, David M.

    1994-01-01

    Three effective strategies for case-based teaching in clinical medicine are described: case-bedside teaching involving case discussion and bedside demonstration; a combination of quick case reviews with more formal presentations on relevant topics; and discovery learning using complex cases. Five general principles of experiential learning in…

  4. Female serial killing: review and case report.

    PubMed

    Frei, Andreas; Völlm, Birgit; Graf, Marc; Dittmann, Volker

    2006-01-01

    Single homicide committed by women is rare. Serial killing is very infrequent, and the perpetrators are usually white, intelligent males with sadistic tendencies. Serial killing by women has, however, also been described. To conduct a review of published literature on female serial killers and consider its usefulness in assessing a presenting case. A literature review was conducted, after searching EMBASE, MEDLINE and PsycINFO. The presenting clinical case is described in detail in the context of the literature findings. Results The literature search revealed few relevant publications. Attempts to categorize the phenomenon of female serial killing according to patterns of and motives for the homicides have been made by some authors. The most common motive identified was material gain or similar extrinsic gratification while the 'hedonistic' sadistic or sexual serial killer seems to be extremely rare in women. There is no consistent theory of serial killing by women, but psychopathic personality traits and abusive childhood experiences have consistently been observed. The authors' case did not fit the description of a 'typical' female serial killer. In such unusual circumstances as serial killing by a woman, detailed individual case formulation is required to make sense of the psychopathology in each case. Publication of cases in scientific journals should be encouraged to advance our understanding of this phenomenon. Copyright (c) 2006 John Wiley & Sons, Ltd.

  5. Nocardia Arthritis: 3 Cases and Literature Review

    PubMed Central

    Chaussade, Hélène; Lebeaux, David; Gras, Guillaume; Catherinot, Emilie; Rammaert, Blandine; Poiree, Sylvain; Lecuyer, Hervé; Zeller, Valérie; Bernard, Louis; Lortholary, Olivier

    2015-01-01

    Abstract Nocardia are Gram-positive filamentous bacteria responsible for infections ranging from opportunistic life-threatening disseminated diseases to chronic skin and soft-tissue infections. Even if virtually all organs can be infected, articular involvement is rare. Therefore, we report 3 recent cases and performed a literature review of cases of Nocardia arthritis in order to describe clinical features, therapeutic challenges, and outcome of these patients. Among 34 patients (31 in the literature plus our 3 cases), 21 (62%) were due to hematogenous dissemination, 9 (26%) were due to direct bacterial inoculation through the skin, and in 4 cases, the mechanism of infection was unknown. Four out of these 34 cases occurred on prosthetic joints. Whereas hematogenous infections mostly occurred in immunocompromised hosts (17 of 21, 81%), direct inoculation was mostly seen in immunocompetent patients. Eighty-two percent of patients (28 out of 34) received trimethoprim-sulfamethoxazole-containing regimens and median antibiotic treatment duration was 24 weeks (range, 12–120) for hematogenous infections and 12 weeks (range, 6–24) for direct inoculations. Outcome was favorable in 27 cases despite unsystematic surgical management (17 cases) without sequelae in 70% of the cases. Nocardia arthritis is rare but its management is complex and should rely on a combined approach with rheumatologist, infectious diseases expert, and surgeon. PMID:26496274

  6. Consideration of food wastage along the supply chain in lifecycle assessments: A mini-review based on the case of tomatoes.

    PubMed

    Bernstad, Anna Karin; Cánovas, Alba; Valle, Rogerio

    2017-01-01

    In recent years, increased light has been shed on the large amounts of food wasted along the food supply chain (FSC). As lifecycle assessments (LCAs) are commonly used for estimations of environmental impacts from food production, it is relevant to investigate and discuss how such wastage is reflected in foodstuff LCAs. The objective of the present paper is to review a larger set of LCAs of foodstuff in order to (1) investigate if and how wastage along the FSC is addressed and (2) explore the importance of including wastage accumulated along the FSC in terms of environmental impacts. Twenty-eight LCA case studies and two review papers, focusing on tomatoes, were reviewed and greenhouse gas (GHG) emissions chosen as indicator for the second objective. Only one third of the studies consider wastage at some part of the supply chain, in many cases in an inconsistent manner, and only in nine cases were GHG emissions from wastage included in overall systems GHG emissions. In these, wastage accounts for between 2 and 33% of total contribution to climate change. Omitting wastage when conducting LCA of foodstuff could result in underestimations of environmental impacts. Occurrence of wastage along all phases of the supply chain should be acknowledged in order to estimate environmental benefits from prevention and to identify areas where strategies with the aim of reducing wastage could be most efficient.

  7. Cemento-osseous dysplasia in Jamaica: review of six cases.

    PubMed

    Ogunsalu, C; Miles, D

    2005-09-01

    Six cases of cemento-osseous dysplasia (COD) of the jaw bone in Jamaicans are reviewed. Five were documented over a 15-year period (1980-1995). These include a case of florid cemento-osseous dysplasia (previously called gigantiform cementoma). Three of the initial cases were histologically diagnosed as gigantiform cementoma. There was no indication in the patient's case file whether these were familial or non-familial. The other two cases were diagnosed histologically as periapical cemento-osseous dysplasia and cementoblastoma respectively. Based on the current understanding of the nature of florid-cemento-osseous dysplasia (FLCOD), a new case was diagnosed as such solely on radiological findings. This single case of FLCOD is reported and discussed against the background of other cemento-osseous lesions. Special emphasis is placed on the radiology of COD in this paper. The confirmative role of radiology without the need for histophathology and treatment for asymptomatic FLCOD is emphasized.

  8. Reexpansion pulmonary edema: review of pediatric cases.

    PubMed

    Kira, Shinichiro

    2014-03-01

    Reexpansion pulmonary edema (RPE) is an increased permeability pulmonary edema that usually occurs in the reexpanded lung after several days of lung collapse. This condition is recognized to occur more frequently in patients under the age of 40 years, but there has been no detailed analysis of reported pediatric cases of RPE to date. For this review, PubMed literature searches were performed using the following terms: 're(-)expansion pulmonary (o)edema' AND ('child' OR 'children' OR 'infant' OR 'boy' OR 'girl' OR 'adolescent'). The 22 pediatric cases of RPE identified were included in this review. RPE was reported in almost the entire pediatric age range, and as in adult cases, the severity ranged from subclinical to lethal. No specific treatment for RPE was identified, and treatment was administered according to the clinical features of each patient. Of the 22 reported cases, 10 occurred during the perioperative period, but were not related to any specific surgical procedures or anesthetic techniques, or to the duration of lung collapse. Pediatric anesthesiologists should be aware that pediatric RPE can occur after reexpansion of any collapsed lung and that some invasive therapies can be useful in severe cases. © 2013 John Wiley & Sons Ltd.

  9. Vaginal Enterobius vermicularis diagnosed on liquid-based cytology during papanicolaou test cervical cancer screening: A report of two cases and a review of the literature.

    PubMed

    Tsai, Chun-Yi; Junod, Rachel; Jacot-Guillarmod, Martine; Beniere, Charles; Ziadi, Sonia; Bongiovanni, Massimo

    2017-09-14

    Enterobiasis is one of the most common human parasitic infections. It is considered an intestinal parasite, but cases of extra-intestinal affections exist, notably infections of the female genital tract. Enterobius vermicularis (EV) eggs (or ova) have been found in the cervical smears of two patients in our institute during the last 16 years. No gynaecological or gastrointestinal symptoms were reported, and there was no known intestinal infection in these two cases. A review of the available literature revealed rare cases of vaginal enterobiasis, with a wide range of clinical presentations, many patients being asymptomatic. The diagnosis may sometimes be difficult, mainly because of the lack of clinical suspicion. However, cytological identification of EV in cervico-vaginal smears is important, especially when considering the risk of ascending infections of the genital tract associated with severe complications. © 2017 Wiley Periodicals, Inc.

  10. Assessing the Quality of a Radiation Oncology Case-Based, Peer-Review Program in an Integrated Academic and Community Cancer Center Network.

    PubMed

    Thaker, Nikhil G; Sturdevant, Laurie; Jhingran, Anuja; Das, Prajnan; Delclos, Marc E; Gunn, Gary B; McAleer, Mary Frances; Tereffe, Welela; Choi, Seungtaek L; Frank, Steven J; Simeone, William J; Martinez, Wendi; Hahn, Stephen M; Famiglietti, Robin; Kuban, Deborah A

    2016-04-01

    Academic centers increasingly find a need to define a comprehensive peer-review program that can translate high-quality radiation therapy (RT) to community network sites. In this study, we describe the initial results of a quarterly quality audit program that aims to improve RT peer-review and provider educational processes across community sites. An electronic tool was used by community-based certified member (CM) sites to enter clinical treatment information about patients undergoing peer review. At least 10% of the patient load for each CM physician was selected for audit on a quarterly basis by expert academic faculty. Quality metrics included the review of the management plan, technical plan, and other indicators. RT was scored as being concordant or nonconcordant with institutional guidelines, national standards, or expert judgment. A total of 719 patients were entered into the peer-review database by the first four CM sites. Of 14% of patients audited, 17% (18 of 104) were deemed nonconcordant. Nonconcordance rates were lowest in prevalent disease sites, such as breast (16%), colorectal (14%), and lung (12%), whereas rates were highest in lymphoma (50%), brain (44%), and gynecology (27%). Deficiencies included incomplete staging work-up, incorrect target and normal tissue delineation, and nonadherence to accepted dose-volume constraints. Given the high rate of nonconcordance, we recommend prospective, pre-RT peer review of all patients, and, in particular, expert review of patients that are from low-volume or complex disease sites. An integrated approach to peer review holds a promise of improving the quality, safety, and value of cancer therapy in the community setting. Copyright © 2016 by American Society of Clinical Oncology.

  11. Familial hypocalciuric hypercalcemia: review of three cases.

    PubMed

    Olivar Roldán, Juana; Pavón de Paz, Isabel; Iglesias Bolaños, Paloma; Montoya Álvarez, Teresa; Fernández Martínez, Alberto; Monereo Megías, Susana

    2008-06-01

    Familial hypocalciuric hypercalcemia, also denominated familial benign hypercalcemia, is an uncommon cause of hypercalcemia. It is caused by mutations of the calcium-sensing receptor, which are inherited in an autosomal dominant high-penetrance fashion. Generally, patients are asymptomatic, and heterozygote cases are diagnosed in childhood or adulthood, when diagnostic work-up of an incidentally discovered hypercalcemia ensues. This disorder is characterized by moderate hypercalcemia, with normal parathormone levels and low urine calcium excretion. It is very important to diagnose this condition, as it does not require surgical procedures, unlike primary hyperparathyroidism, which needs parathyroidectomy in 50% of cases. We present 3 cases of familial hypocalciuric hypercalcemia belonging to the same family, and provide an updated review on the topic.

  12. Implementation of a Software Application for Presurgical Case History Review of Frozen Section Pathology Cases.

    PubMed

    Norgan, Andrew P; Okeson, Mathew L; Juskewitch, Justin E; Shah, Kabeer K; Sukov, William R

    2017-01-01

    The frozen section pathology practice at Mayo Clinic in Rochester performs ~20,000 intraoperative consultations a year (~70-80/weekday). To prepare for intraoperative consultations, surgical pathology fellows and residents review the case history, previous pathology, and relevant imaging the day before surgery. Before the work described herein, review of pending surgical pathology cases was a paper-based process requiring handwritten transcription from the electronic health record, a laborious and potentially error prone process. To facilitate more efficient case review, a modular extension of an existing surgical listing software application (Surgical and Procedure Scheduling [SPS]) was developed. The module (SPS-pathology-specific module [PM]) added pathology-specific functionality including recording case notes, prefetching of radiology, pathology, and operative reports from the medical record, flagging infectious cases, and real-time tracking of cases in the operating room. After implementation, users were surveyed about its impact on the surgical pathology practice. There were 16 survey respondents (five staff pathologists and eleven residents or fellows). All trainees (11/11) responded that the application improved an aspect of surgical list review including abstraction from medical records (10/11), identification of possibly infectious cases (7/11), and speed of list preparation (10/11). The average reported time savings in list preparation was 1.4 h/day. Respondents indicated the application improved the speed (11/16), clarity (13/16), and accuracy (10/16) of morning report. During the workday, respondents reported the application improved real-time case review (14/16) and situational awareness of ongoing cases (13/16). A majority of respondents found the SPS-PM improved all preparatory and logistical aspects of the Mayo Clinic frozen section surgical pathology practice. In addition, use of the SPS-PM saved an average of 1.4 h/day for residents and fellows

  13. Implementation of a Software Application for Presurgical Case History Review of Frozen Section Pathology Cases

    PubMed Central

    Norgan, Andrew P.; Okeson, Mathew L.; Juskewitch, Justin E.; Shah, Kabeer K.; Sukov, William R.

    2017-01-01

    Background: The frozen section pathology practice at Mayo Clinic in Rochester performs ~20,000 intraoperative consultations a year (~70–80/weekday). To prepare for intraoperative consultations, surgical pathology fellows and residents review the case history, previous pathology, and relevant imaging the day before surgery. Before the work described herein, review of pending surgical pathology cases was a paper-based process requiring handwritten transcription from the electronic health record, a laborious and potentially error prone process. Methods: To facilitate more efficient case review, a modular extension of an existing surgical listing software application (Surgical and Procedure Scheduling [SPS]) was developed. The module (SPS-pathology-specific module [PM]) added pathology-specific functionality including recording case notes, prefetching of radiology, pathology, and operative reports from the medical record, flagging infectious cases, and real-time tracking of cases in the operating room. After implementation, users were surveyed about its impact on the surgical pathology practice. Results: There were 16 survey respondents (five staff pathologists and eleven residents or fellows). All trainees (11/11) responded that the application improved an aspect of surgical list review including abstraction from medical records (10/11), identification of possibly infectious cases (7/11), and speed of list preparation (10/11). The average reported time savings in list preparation was 1.4 h/day. Respondents indicated the application improved the speed (11/16), clarity (13/16), and accuracy (10/16) of morning report. During the workday, respondents reported the application improved real-time case review (14/16) and situational awareness of ongoing cases (13/16). Conclusions: A majority of respondents found the SPS-PM improved all preparatory and logistical aspects of the Mayo Clinic frozen section surgical pathology practice. In addition, use of the SPS-PM saved an

  14. 75 FR 12746 - Difenzoquat; Registration Review Case Closure; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... each pesticide's registration is based on current scientific and other knowledge, including its effects... registration review case closure for the pesticide difenzoquat, case 0223. Registration review is EPA's periodic review of pesticide registrations to ensure that each pesticide continues to satisfy the...

  15. 75 FR 57782 - Clofencet; Registration Review Case Closure; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-22

    ... each pesticide's registration is based on current scientific and other knowledge, including its effects... registration review case closure for the pesticide clofencet, case 7015. Registration review is EPA's periodic review of pesticide registrations to ensure that each pesticide continues to satisfy the...

  16. Symptomatic cluster headache: a review of 63 cases.

    PubMed

    Edvardsson, Bengt

    2014-01-01

    Cluster headache is a primary headache by definition not caused by any known underlying structural pathology. Symptomatic cases have been described, for example tumours, dissections and infections, but a causal relationship between the underlying lesion and the headache is difficult to determine in many cases. The proper diagnostic evaluation of cluster headache is an issue unresolved. The literature has been reviewed for symptomatic cluster headache or cluster headache-like cases in which causality was likely. The review also attempted to identify clinical predictors of underlying lesions in order to formulate guidelines for neuroimaging. Sixty-three cluster headache or "cluster headache-like"/"cluster-like headache" cases in the literature were identified which were associated with an underlying lesion. A majority of the cases had a non-typical presentation that is atypical symptomatology and abnormal examination (including Horner's syndrome). A striking finding in this appraisal was that a significant proportion of CH cases were secondary to diseases of the pituitary gland or pituitary region. Another notable finding was that a proportion of cluster headache cases were associated with arterial dissection. Even typical cluster headaches can be caused by structural lesions and the response to typical cluster headache treatments does not exclude a secondary form. It is difficult to draw definitive conclusions from this retrospective review of case reports especially considering the size of the material. However, based on this review, I suggest that neuroimaging, preferably contrast-enhanced magnetic resonance imaging/magnetic resonance angiography should be undertaken in patients with atypical symptomatology, late onset, abnormal examination (including Horner's syndrome), or those resistant to the appropriate medical treatment. The decision to perform magnetic resonance imaging in cases of typical cluster headache remains a matter of medical art.

  17. Revisiting cruciate paralysis: A case report and systematic review

    PubMed Central

    Hopkins, Benjamin; Khanna, Ryan; Dahdaleh, Nader S

    2016-01-01

    Objective: Cruciate paralysis is a rare, poorly understood condition of the upper craniovertebral junction that allows for selective paralysis of the upper extremities while sparing the lower extremities. Reported cases are few and best treatment practices remain up for debate. The purpose of this study was to conduct a systemic literature review in an attempt to identify prognostic predictors and outcome trends associated with cases previously reported in the literature. Materials and Methods: We conducted a systematic literature review for all cases using the term “Cruciate Paralysis,” reviewing a total of 37 reported cases. All outcomes were assigned a numerical value based on examination at the last follow-up. These numerical values were further analyzed and tested for statistical significance. Results: Of the 37 cases, 78.4% were of traumatic causes. Of these, there were considerably worse outcomes associated with patients over the age of 65 years (P < 0.001). Those patients undergoing surgical treatment showed potentially worse outcomes, with a P value approaching significance at P = 0.08. Conclusion: Numerous cases of trauma-associated cruciate paralysis have been reported in the literature; however, there remains a strong need for further study of the condition. While certain risk factors can be elicited from currently reported studies, insignificant data exist to make any sound conclusion concerning whether surgical intervention is always the best method of treatment. PMID:27891037

  18. Lucio's phenomenon: exuberant case report and review of Brazilian cases*

    PubMed Central

    Rocha, Rafael Henrique; Emerich, Paulo Sergio; Diniz, Lucia Martins; de Oliveira, Marcela Bahia Barretto; Cabral, Aline Neves Freitas; do Amaral, Ana Cristina Vervloet

    2016-01-01

    Lucio’s phenomenon is an uncommon reaction characterized by severe necrotizing cutaneous lesions that occurs in patients with Lucio’s leprosy and lepromatous leprosy. It is considered by some authors as a variant of type 2 or 3 reaction. Death can occur because of blood dyscrasia or sepsis. Precipitating factors include infections, drugs and pregnancy. We report a 31-year-old female patient exhibiting both clinical and histopathological features of lepromatous leprosy and Lucio’s phenomenon presenting favorable response to treatment. We complement our report with a literature review of the Brazilian cases of Lucio’s phenomenon published in Portuguese and English. PMID:28300896

  19. Combined Fascia Iliaca and Sciatic Nerve Block for Hip Surgery in the Presence of Severe Ankylosing Spondylitis: A Case-Based Literature Review.

    PubMed

    Chen, Lingmin; Liu, Jin; Yang, Jing; Zhang, Yanzi; Liu, Yue

    2016-01-01

    Selecting an appropriate anesthetic technique for patients with ankylosing spondylitis undergoing hip surgery is challenging because of a potentially difficult airway, the risk of cardiovascular and respiratory complications, and the technical difficulty of performing central neuraxial blocks in patients with ankylosing spondylitis. Our objective was to report a case in which combination neural blockade was used successfully in an elderly patient with ankylosing spondylitis undergoing hip fracture surgery. In addition, a literature review of the anesthetic techniques reported for these patients was conducted. A 70-year-old man with severe ankylosing spondylitis and respiratory dysfunction was scheduled for a closed intertrochanteric fracture reduction and internal fixation. Combined fascia iliaca block and parasacral sciatic nerve block were used successfully for the surgery. Postoperative analgesia was accomplished by continuous fascia iliaca block. According to the literature review, general anesthesia is the most commonly performed anesthetic technique for patients with ankylosing spondylitis undergoing hip surgeries. Special intubation techniques and cautious airway management were very important for these patients. Although both general anesthesia and central neuraxial blockade pose considerable risks to the patients, this case report suggests that combined fascia iliaca block and sciatic nerve block might be a promising option.

  20. [Cold urticaria: case series and literature review].

    PubMed

    Sánchez, Jorge Mario; Ramírez, Ruth Helena; Tamayo, Liliana María; Chinchilla, Carlos Fernando; Cardona, Ricardo

    2011-06-01

    Cold urticaria is one of the five most common causes of chronic urticaria and is grouped as a physical urticaria. It can occur after exposure to cold, either through solid objects, air or liquids. Patients may have symptoms of urticaria, angioedema, respiratory distress and even anaphylaxis when the skin is exposed to a cold environment, such as handling refrigerated objects, swimming in cold water or entering an air-conditioned room. Five cases of cold urticaria are presented, followed by a brief literature review.

  1. Orbital cysticercosis, case report and review.

    PubMed

    Ziaei, Mohammed; Elgohary, Mostafa; Bremner, Fion D

    2011-10-01

    Orbital cysticercosis is secondary to an infestation by cysticercus cellulosae, the larval form of Taenia solium.Orbital cysticercosis may present with a wide spectrum of clinical findings and result in significant ocular morbidity. Although traditionally thought to be only prevalent in endemic regions with poor sanitation, immigration requires even ophthalmologists practicing in industrialised counties to be aware of this masquerading condition's presentation and treatment.We report the clinical manifestation of a case of orbital cysticersosis that presented with recurrent orbital inflammation for almost a year. We also present a literature review of the different ocular manifestations, diagnostic and treatment modalities.

  2. 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. PMID:27721722

  3. [Review of 15 cases of hypervitaminosis D].

    PubMed

    Castelló, F; Callís, L; Vilaplana, E; Fortuny, G

    1977-01-01

    In our experience, hypervitaminosis D, which at present should only be a historic remembrance in pediatrics, is still a frequent cause of hipercalcemia in childhood. It is easy understand that its appearance should turn out to be a complication in the treatment of hypoparathyroidisms or in vitamin D resistant rickets, but its persistance as a purely iatrogenic diseases is at present inexplicable. The frequency with which we have seen it has led us to review 15 cases where erroneous administration of high doses of vitamin D has resulted in serious clinical, biological and anatomical problems.

  4. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In...

  5. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In...

  6. 45 CFR 98.101 - Case Review Methodology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Case Review Methodology. 98.101 Section 98.101 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Error Rate Reporting § 98.101 Case Review Methodology. (a) Case Reviews and Sampling—In preparing...

  7. Acromegaly: A Review of 100 Cases

    PubMed Central

    Gordon, Duncan A.; Hill, F. Marguerite; Ezrin, Calvin

    1962-01-01

    Clinical and pathological findings in 100 cases of acromegaly were reviewed. Great individual variation in manifestations of the disease was apparent. The chronic course was evidenced by 30 patients presenting symptoms unrelated to acromegaly. Headache, visual disturbances, arthritis and elevated blood pressure were common. The incidence of diabetes mellitus, thyroid and adrenal dysfunction was similar to that reported in other series. Gonadal disturbances were frequent. Two patients had galactorrhea and two had hyperparathyroidism. Radiologically, pituitary fossae were normal in 24. Pituitary histology in 29 cases revealed four eosinophilic adenomas, but most were mixed eosinophilic-chromophobic. Fifty-two patients received radiation therapy. Rhinorrhea and optic nerve fibrosis were seen in this group. Twenty-four patients were operated upon, with no operative deaths since 1945 and no morbidity since 1952. Visual failure was the clearest indication for surgery. Treatment will be difficult to evaluate until an index of growth hormone secretion is generally available. PMID:13949186

  8. Goldenhar Syndrome: A Case Report with Review

    PubMed Central

    Goswami, Mridula; Jangra, Babita

    2016-01-01

    Goldenhar syndrome is a rare condition which is characterized by a multitude of anomalies involving craniofacial structures, vertebrae, internal organs and usually occurs unilaterally. The etiology of this syndrome is unclear since it varies genetically and is linked to a plethora of reasons. Herein, we report a case of Goldenhar syndrome with hemifacial microsomia and microtia along with systemic involvement which was clinically and radio-graphically assessed. Many classical signs of the syndrome were present in the patient along with few rare ones. The various aspects of this rare disease have been discussed with emphasis on timely diagnosis and multidisciplinary approach to manage it. How to cite this article Goswami M, Bhushan U, Jangra B. Goldenhar Syndrome: A Case Report with Review. Int J Clin Pediatr Dent 2016;9(3):278-280. PMID:27843263

  9. Acute paediatric paraplegia: a case series review.

    PubMed

    Sharpe, Abigail N; Forsyth, Rob

    2013-11-01

    Paediatric paraplegia resulting from spinal cord pathology of any cause is rare; hence prognostic information for children less than 16 years is limited. This case series review aims to ascertain all cases of paediatric paraplegia from 1997 to 2012 in the former Northern Region of England. Children presenting with sudden paraplegia before the age of 16 years were multiply ascertained from databases in the regional paediatric neurology, neuroradiology, neuro-oncology and adult spinal injuries units. Data were obtained from retrospective case note review. A total of 44 cases (24 female) were identified. The incidence is estimated at 0.49 per 100,000 children under 16/year (95% confidence interval 0.41-0.57). Mean age of onset was 8.8 years and the most common aetiology was inflammatory. Twelve months post presentation, mortality was zero and a good outcome (defined as Gross Motor Function Classification System grades I or II) was seen in 66.6%. Motor outcome at 12 months was associated with the presence of bladder/bowel signs at presentation, previous viral illness and initial severity of paraplegia. Bladder signs at presentation were the strongest predictor of prognosis (OR for poor motor outcome 10.3). We were unable to demonstrate a relationship between aetiology and late outcome. Paediatric paraplegia is rare. Mortality rates are low and 66.6% have a good outcome with fully or nearly independent walking. Bladder signs are the strongest predictor of prognosis. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  10. Temafloxacin syndrome: review of 95 cases.

    PubMed

    Blum, M D; Graham, D J; McCloskey, C A

    1994-06-01

    Four months after its approval in the United States, temafloxacin was withdrawn from the market worldwide because of frequent reports of serious hemolysis with or without other organ system dysfunction. We describe this "temafloxacin syndrome" on the basis of a review of 95 spontaneous reports of hemolysis sent to the Food and Drug Administration. Patients typically presented with fever, chills, and jaundice a mean of 6.4 days after starting therapy. A moderate degree of hemolysis was reflected by the mean drop in hemoglobin level (by 42 g/L) and by the mean lowest concentration of hemoglobin (97 g/L). New-onset renal dysfunction was noted in 54 cases (57%), and dialysis was required in 34 cases (63%). Coagulopathy was noted in 33 cases (35%), and 48 cases (51%) met the criteria for hepatic dysfunction. Four patients developed central nervous system complications, and two patients died. Prior quinolone use was more common among patients who developed hemolysis after only one dose as opposed to two or more doses (P < .001). These data suggest that temafloxacin causes immune hemolytic anemia, most likely secondary to immune complex formation.

  11. Chronic Sleep Disruption and the Reexperiencing Cluster of Posttraumatic Stress Disorder Symptoms Are Improved by Olanzapine: Brief Review of the Literature and a Case-Based Series.

    PubMed

    States, James H.; St Dennis, Clarke D.

    2003-04-01

    BACKGROUND: Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric disorders in young adults. Early diagnosis and treatment of PTSD are essential to avoid possible long-term neuropsychiatric changes in brain physiology and function. A cardinal symptom of PTSD is chronic sleep disruption, often with recurring nightmares. If untreated, PTSD symptoms often contribute to substance abuse and the development of other comorbid psychiatric disorders. Once PTSD is diagnosed, drug treatment should begin with antidepressant therapy. If antidepressants do not correct the sleep disruption, adjunctive treatment with the atypical antipsychotic olanzapine or other agents should be considered. METHOD: This case series reviews 7 cases of patients with PTSD (DSM-IV criteria) seen in primary care clinics who were successfully treated with olanzapine. In most cases, olanzapine therapy was adjunctive and followed failed treatment with antidepressant monotherapy for sleep disturbances. RESULTS: All patients reported improved sleep with decreased or absent nightmares, as well as improvements in other PTSD symptom clusters. CONCLUSION: Further controlled studies are needed to better characterize and validate this therapeutic indication.

  12. Myxedema Ascites: Case Report and Literature Review

    PubMed Central

    Ji, Jeong-Seon; Cho, Young-Seok; Kim, Hyung-Keun; Kim, Sung-Soo; Kim, Chang-Wook; Lee, Chang-Don; Lee, Bo-In; Choi, Hwang; Lee, Kang-Moon; Lee, Hye-Kyung; Choi, Kyu-Yong

    2006-01-01

    Myxedema ascites caused by hypothyroidism is rare, so its diagnosis is often delayed and patients frequently receive unnecessary procedures such as liver biopsies and exploratory laparotomies. We report a 71-yr-old man with clinical ascites that was the first manifestation of hypothyroidism, and which resolved completely in response to thyroid hormone replacement therapy. To our knowledge, this is the first report of myxedema ascites in Korea. A review of the literature revealed 51 well-documented cases of myxedema ascites. Analyses of ascites from patients in this condition usually show high protein (>2.5 g/dL) and low white blood cell counts, with a high proportion of lymphocytes. A consistent feature is the good response to thyroid hormone replacement therapy, which has always led to resolution of the ascites. Myxedema ascites is thus rare but easy to treat; it should be borne in mind, especially if the ascites fluid has a high protein content. PMID:16891828

  13. Case-based medical informatics.

    PubMed

    Pantazi, Stefan V; Arocha, José F; Moehr, Jochen R

    2004-11-08

    The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning) and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and powerful case matching

  14. Case-based medical informatics

    PubMed Central

    Pantazi, Stefan V; Arocha, José F; Moehr, Jochen R

    2004-01-01

    Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning) and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and

  15. Spinal gout: A review with case illustration

    PubMed Central

    Elgafy, Hossein; Liu, Xiaochen; Herron, Joseph

    2016-01-01

    AIM To summarize clinical presentations and treatment options of spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation. METHODS The authors reviewed 68 published cases of spinal gout, which were collected by searching “spinal gout” on PubMed from 2000 to 2014. The data were analyzed for clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, and treatment choices. RESULTS Of the 68 patients reviewed, the most common clinical presentation was back or neck pain in 69.1% of patients. The most common laboratory study was elevated uric acid levels in 66.2% of patients. The most common diagnostic image finding was hypointense lesion of the gout tophi on the T1-weighted magnetic resonance imaging scan. The most common surgical treatment performed was a laminectomy in 51.5% and non-surgical treatment was performed in 29.4% of patients. CONCLUSION Spinal gout most commonly present as back or neck pain with majority of reported patients with elevated uric acid. The diagnosis of spinal gout is confirmed with the presence of negatively birefringent monosodium urate crystals in tissue. Treatment for spinal gout involves medication for the reduction of uric acid level and surgery if patient symptoms failed to respond to medical treatment. PMID:27900275

  16. Melorheostosis: a review of 23 cases.

    PubMed

    Freyschmidt, J

    2001-01-01

    The aim of this study was to review clinical and radiological signs of melorheostosis in a large series of cases. Family history, patient history, clinical data and radiological features of 23 consecutive cases of melorheostosis were investigated. Criteria for establishing the diagnosis "melorheostosis" were defined. Sixteen patients (mean age 34 years, equal ratio between genders) had chronic pain in the affected limb(s) and/or subcutaneous fibrosis and/or various skin lesions. Number of involved bones: one bone (n = 10); two bones (n = 4); three or more bones (n = 9). Anatomic distribution: upper extremity (n = 5); lower extremity (n = 16); upper and lower extremity (n = 1); sacrum (n = 1). Radiologic pattern: osteoma-like (n = 7); classic candle wax appearance (n = 5); myositis ossificans-like (n = 1); osteopathia striata-like (n = 6); mixed pattern (n = 4). Patterns different from the appearance formerly judged to be "classic" prevail. The standard concept of disease manifestation has to be adjusted. Pathogenesis remains unclear. The classic theory claims the presence of an early embryonic infection of a sensory nerve inducing changes in the respective sclerotome, but we propose the concept of mosaicism as a better explanation for the sporadic occurrence, the asymmetric "segmental" pattern with variable extent of involvement and equal gender ratio of the disease.

  17. Chylothorax: a review of 18 cases.

    PubMed Central

    Fairfax, A J; McNabb, W R; Spiro, S G

    1986-01-01

    Eighteen patients who had developed a chylothorax during a 25 year period, 1955-80, were reviewed. The chylothoraces occurred as a complication of cardiothoracic surgery in 11 patients, of whom eight were children in the first decade of life. Five cases followed operations for coarctation of the aorta and two occurred as a complication of a Blalock shunt for Fallot's tetralogy. The chylothorax was evident within 48 hours of the operation in all but two patients. In seven cases a second operation was performed to prevent further chylous leakage and in two infants the thoracic duct was ligated. The remainder of the postsurgical chylothoraces responded to either continuous drainage or repeated aspiration and a low fat diet. There were no late sequelae of chylothorax following surgery. Spontaneous chylothorax was identified in seven patients and in five of these it was bilateral. Patients with spontaneous chylothorax were all adults and, despite treatment, had a poor prognosis. Three with malignant disease and two with pulmonary lymphangioleiomyomatosis had died within two years of the appearance of the chylothorax. Two patients with chronic idiopathic chylothoraces survived for more than two years and one of these developed a secondary fibrothorax. PMID:3824274

  18. Djenkolism: case report and literature review.

    PubMed

    Bunawan, Nur C; Rastegar, Asghar; White, Kathleen P; Wang, Nancy E

    2014-01-01

    Djenkolism is an uncommon but important cause of acute kidney injury. It sporadically occurs after an ingestion of the djenkol bean (Archidendron pauciflorum), which is native to Southeast Asia. The clinical features defining djenkolism include: spasmodic suprapubic and/or flank pain; urinary obstruction; and acute kidney injury. The precise pathogenesis of acute kidney injury following djenkol ingestion remains unknown. However, it is proposed that an interaction between the characteristics of the ingested beans and the host factors causes hypersaturation of djenkolic acid crystals within the urinary system, resulting in subsequent obstructive nephropathy with sludge, stones, or possible spasms. We report a case of djenkolism from our rural clinic in Borneo, Indonesia. Our systematic literature review identified 96 reported cases of djenkolism. The majority of patients recovered with hydration, bicarbonate therapy, and pain medication. Three patients required surgical intervention; one patient required ureteral stenting for the obstructing djenkolic acid stones. Four of the 96 reported patients died from acute kidney failure. We stress the importance of awareness of djenkolism to guide medical practitioners in the treatment of this rare disease in resource-poor areas in Southeast Asia.

  19. Infantile botulism: a case report and review.

    PubMed

    Brown, Nicole; Desai, Sameer

    2013-12-01

    Infantile botulism is the result of ingestion of Clostridium botulinum spores, and is the most common form of infection with botulism in the United States. Ninety percent of cases occur in infants <6 months old. The infants typically present with vague symptoms such as hypotonia and poor feeding. This article reports an infant with confirmed infantile botulism that presented to the Emergency Department (ED) with complaints of decreased feeding and absence of bowel movements for >1 week. Review a case of infantile botulism, its diagnosis, and treatment. A 4-month-old healthy Caucasian male presented to the ED with a 6-day history of decreased feeding after referral from the pediatrician. He had not had a bowel movement for 9 days, and his parents were also concerned about increasing weakness, as he was no longer able to hold his head up on his own. In the ED, he was minimally interactive. His vital signs were within normal limits, and he had hypoactive bowel sounds and decreased tone throughout. He was admitted to the Children's Hospital and eventually transferred to the Pediatric Intensive Care Unit requiring intubation and mechanical ventilation. The botulism immunoglobulin was administered, and a diagnosis was confirmed with positive botulinum toxin in the stool samples. Full recovery was made by the infant. Awareness of the symptoms of botulism and a high degree of clinical suspicion is needed to make a prompt diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Avulsion Fractures at the Base of the 2nd Metacarpal Due to the Extensor Carpi Radialis Longus Tendon: A Case Report and Review of the Literature

    PubMed Central

    Najefi, Ali; Jeyaseelan, Lucksmana; Patel, Anand; Kapoor, Akhil; Auplish, Sunil

    2016-01-01

    Introduction: Simultaneous contraction of the extensor carpi radialis longus (ECRL) with forced hyperflexion of the wrist can result in avulsion of the tendon and its bony attachment at its insertion at the dorsum of the base of the second metacarpal. This is a rare and often unreported fracture pattern. Case Presentation: We present a 31- year- old male who sustained a hyperflexion injury. He was managed surgically and had good post-operative outcomes. A literature search revealed 16 papers covering 18 cases of similar injuries. 12 were initially managed surgically and 6 were managed conservatively. Conclusions: Of the open reductions and internal fixations, 11 (92%) were successful and patients made a full recovery. Conservative management was unsuccessful in 4 cases; one patient required surgery for metacarpal boss, one patient had retraction of the tendon at one week follow up and another had weak flexion of the wrist. We recommend open reduction and internal fixation for these injuries. It may allow a faster recovery and therefore allow an earlier return to work and activity. PMID:27148501

  1. Intermuscular pterygoid-temporal abscess following inferior alveolar nerve block anesthesia–A computer tomography based navigated surgical intervention: Case report and review

    PubMed Central

    Wallner, Jürgen; Reinbacher, Knut Ernst; Pau, Mauro; Feichtinger, Matthias

    2014-01-01

    Inferior alveolar nerve block (IANB) anesthesia is a common local anesthetic procedure. Although IANB anesthesia is known for its safety, complications can still occur. Today immediately or delayed occurring disorders following IANB anesthesia and their treatment are well-recognized. We present a case of a patient who developed a symptomatic abscess in the pterygoid region as a result of several inferior alveolar nerve injections. Clinical symptoms included diffuse pain, reduced mouth opening and jaw's hypomobility and were persistent under a first step conservative treatment. Since image-based navigated interventions have gained in importance and are used for various procedures a navigated surgical intervention was initiated as a second step therapy. Thus precise, atraumatic surgical intervention was performed by an optical tracking system in a difficult anatomical region. A symptomatic abscess was treated by a computed tomography-based navigated surgical intervention at our department. Advantages and disadvantages of this treatment strategy are evaluated. PMID:24987612

  2. Retroperitoneal Angiomyolipoma: A Case Report and Review of the Literature

    PubMed Central

    King, Jonathan; McClintock, Scott

    2013-01-01

    Retroperitoneal angiomyolipoma is a rare tumour that is difficult to diagnose preoperatively. We present a case of retroperitoneal angiomyolipoma that highlights its diagnostic dilemma. We also performed a literature review and present a review of retroperitoneal angiomyolipoma. PMID:24303222

  3. Medical attention seeking dance injuries: systematic review of case reports.

    PubMed

    Anand Prakash, Akilesh

    2017-02-01

    The objective of this study was to conduct a systematic review of case reports documenting the epidemiology of unique and rare musculoskeletal injuries in dancers. A systematic review was conducted online using PubMed and Google Scholar, as per PRISMA guidelines up to July 30, 2016. Predefined eligibility criteria were applied, and the data thus compiled was analysed. Study quality was assessed based on CARE guidelines. 72 studies reporting 92 dance injuries were included in the review. The average age of dancers was 23 years (SD = 10 years) with majority being females (65%). Chronic injuries were the most common presentation with lower extremity injuries being the commonest. Foot and knee injuries were the top two articulations involved across injuries and groups. Overall bony injuries were most frequently reported, with stress injury being the most common type. Conservative approach was the most commonly reported treatment approach across case reports. The methodological quality of case reports included in the study varied considerably and lacked uniformity. The evidence provided, though not sufficient for any recommendation, it should alert the physicians and those concerned with the primary care of the dancers to be vigilant of the eccentricity and severity of the injuries, their atypical presentation, mode, mechanism and trend, thereby being prepared for the unexpected.

  4. Prognostic factors for long-term outcome of patients with surgical resection of skull base chordomas-106 cases review in one institution.

    PubMed

    Wu, Zhen; Zhang, Junting; Zhang, Liwei; Jia, Guijun; Tang, Jie; Wang, Liang; Wang, Zhongcheng

    2010-10-01

    Skull base chordoma are still challenging. Between May 1993 and June 2005, 106 consecutive patients with skull base chordoma underwent surgical removal at Skull Base Division of Neurosurgery, Beijing Tiantan Hospital, China. Retrospective analysis included medical charts and images. The age of the patients ranged from 7 to 65 years old, with an average age of 35.6 years. Sixty patients were male; the other 46 were female (1.3:1). Follow up data were available in 79 cases ranging from 10 to 158 months (average 63.9 months) after operation. The prognostic factors for recurrence and survival were analyzed with Kaplan-Meier, Cox regression and t-test. Overall, 1, 3, 5 and 10 years survival rates were 87.2%, 79.4%, 67.6%and 59.5% respectively. One, 3, 5 and 10 year recurrent rates were 19.1%, 34.7%, 52.9% and 88.3%, respectively. The long term outcome of the skull base chordomas is poor. The previous radiotherapy or surgery, dedifferentiated pathology, and less tumor resection are risk factors for longterm survival and recurrence (p < 0.05). Although there is no statistic significant role of tumor adherent to vital structure for outcome (p = 0.051), it can not exclude its importance for favorable outcome. Gender, age, tumor size and staging are not independent risk factors for outcome. Surgical technique leading to radical tumor resection with less morbidity is advocatory and beneficial for patients with skull base chordoma with long term outcome, if the tumor could be exposed and resected completely, the recurrence rate was very low for most benign chordomas.

  5. NASA Case Sensitive Review and Audit Approach

    NASA Astrophysics Data System (ADS)

    Lee, Arthur R.; Bacus, Thomas H.; Bowersox, Alexandra M.; Newman, J. Steven

    2005-12-01

    As an Agency involved in high-risk endeavors NASA continually reassesses its commitment to engineering excellence and compliance to requirements. As a component of NASA's continual process improvement, the Office of Safety and Mission Assurance (OSMA) established the Review and Assessment Division (RAD) [1] to conduct independent audits to verify compliance with Agency requirements that impact safe and reliable operations. In implementing its responsibilities, RAD benchmarked various approaches for conducting audits, focusing on organizations that, like NASA, operate in high-risk environments - where seemingly inconsequential departures from safety, reliability, and quality requirements can have catastrophic impact to the public, NASA personnel, high-value equipment, and the environment. The approach used by the U.S. Navy Submarine Program [2] was considered the most fruitful framework for the invigorated OSMA audit processes. Additionally, the results of benchmarking activity revealed that not all audits are conducted using just one approach or even with the same objectives. This led to the concept of discrete, unique "audit cases."

  6. [Spontaneous pneumothorax in cats: two case reports and literature review].

    PubMed

    Manchi, George; Jarolmasjed, Seyedhosein; Brunnberg, Mathias; Shahid, Muhammad; Rehbein, Sina; Stein, Silke; Gruber, Achim D; Brunnberg, Leo

    2017-08-10

    Spontaneous pneumothorax (SP) is a non-traumatic accumulation of air in the pleural cavity. This case report describes a cat with SP as a result of primary pulmonary adenocarcinoma. A second cat was diagnosed with primary pulmonary adenocarcinoma and asthma. A thoracostomy tube was inserted in the first cat while in the second cat a thoracostomy tube was placed and lobectomy of the right cranial and middle lung lobes was performed. Both cats died following treatment. The current literature reviewed here covers the comparative etiologies of SP as well as clinical presentation, diagnostic work-up, therapy and prognosis in cats. A total of 64 cases of cats with secondary spontaneous pneumothorax reported in nine articles are discussed. To our knowledge, there has been no previous description in the literature regarding primary SP in cats. Based on prior case reports, surgery was performed in 16% (10 cats) of SP cases. The current review demonstrates that depending on the underlying lung disease, cats with SP have a careful short-term prognosis because 39 of 64 cats (60%) were discharged.

  7. Arsenic exposures in Mississippi: A review of cases

    SciTech Connect

    Park, M.J.; Currier, M. )

    1991-04-01

    Arsenic poisonings occur in Mississippi despite public education campaigns to prevent poisonings in the home. We reviewed 44 Mississippi cases of arsenic exposures occurring from January 1986 to May 1990. We compared the epidemiologic differences between unintentional and intentional poisonings. Cases were found and characterized through the two toxicology laboratories and hospital records. Arsenic-based rodenticides were the arsenic source in 23 of the 44 exposures. Other sources were monosodium methylarsenate (4 cases), dodecyl ammonium methane arsonate (5 cases), and other compounds (12 cases). Of the 44 exposures, 27 were unintentional, 7 were suicide attempts, 6 were homicide attempts, and 4 were of unknown intent. Of the 27 unintentionally exposed patients, 19 were black and 14 were male; their median age was 3 years. Of the 13 intentionally poisoned persons, 9 were male and 10 were black, with a median age of 28 years. Six of the seven patients who attempted suicide were white; four of the six victims of attempted homicide were black. We recommend removal of remaining bottles of arsenic-based rodenticides from store shelves, and we urge practicing physicians to warn patients of the dangers of using such rodenticides.

  8. 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

  9. Takotsubo syndrome. Case report and literature review.

    PubMed

    Pacheco Bouthillier, Alex Daniel; Maza Juárez, Gerardo; Vargas Guzmán, Rosa María; Santiago Hernández, Jaime; Almeida Gutiérrez, Eduardo; Borrayo Sánchez, Gabriela

    2010-01-01

    Takotsubo syndrome is a cardiopathy characterized by a dyskinesia or left ventricular apical ballooning and subsequent recovery of ventricular function. We undertook this study to present a case of Takotsubo syndrome. We present the case of a 60-year-old female with a 26-year history of systemic arterial hypertension treated with 40 mg of termisartan daily. She started with headache after an emotional event (witness to an aggression of her son) associated with elevation of blood pressure that was suddenly accompanied by intense oppressive chest pain and neurovegetative symptoms. Electrocardiogram showed ST-segment elevation in anteroseptal and lateral derivations. Catheterization showed a 50% obstruction in the anterior descending artery and apical dyskinesia with hypercontractile base and 35% left ventricular ejection fraction. We performed stent angioplasty in the responsible artery. Nuclear medicine study showed extensive apical infarction, and echocardiogram agreed with transient apical dyskinesia and basal hypercontractility. After a 1-month evolution, echocardiogram mobility was completely recovered and myocardial perfusion study was normal 4 months later. We show a transitory apical ballooning secondary to acute myocardial infarction associated with a significantly stressful event that resulted in complete improvement of ventricular function with percutaneous coronary intervention during the following 4 months.

  10. Cockayne's syndrome: a case report. Literature review.

    PubMed

    Arenas-Sordo, María de la Luz; Hernández-Zamora, Edgar; Montoya-Pérez, Luis Alberto; Aldape-Barrios, Beatriz Catalina

    2006-05-01

    Cockayne s syndrome is a genetic disorder with a recessive autosomal inheritance, described first by Cockayne in 1936. Patients with this syndrome present failure to thrive, short stature, premature aging, neurological alterations, photosensitivity, delayed eruption of the primary teeth, congenitally absent of some permanent teeth, partial macrodontia, atrophy of the alveolar process and caries. It could be caused by two gene mutations, CNK1 (ERCC8) and ERCC6, located on the 5 and 10 chromosomes respectively, causing two variations of Cockayne s syndrome, CS-A, secondary to a ERCC8 mutation and CS-B with ERCC6 mutation, the last one causes hypersensitivity to the ultraviolet light secondary to a DNA repair defect. The syndrome is also associated with mutations of the XPB, XPD and XPG genes. In this report we present a 9 year and 4 month old patient. He had a height of 94 cm, weight of 8.6 Kg, head circumference of 42 cm. and blood pressure of 120/80. Cachectic habitus, kyphosis, microcephaly, oval face, sunken eyes, a thin and beaklike nose, lack of subcutaneous facial fat (especially in the middle of the face), and large ears give the patient a birdlike appearance. It is notorious the photosensitivity in all the sun-exposed skin. The patient also displays delayed psychomotor skills and mental retardation. In the oral cavity we found deficient hygiene, gingivitis, cervical caries, enamel hipoplasia, abnormal position of the upper and inferior lateral incisors, macrodontia of the upper central teeth, the left one presented a caries. In the x-ray we observed congenital absence of 14, 23 and 24 teeth and mandibular hipoplasia. The aim of this review is to show the dentistry community the characteristics of the Cockayne s syndrome by means of a clinical case.

  11. 5 CFR 1501.9 - Cases reviewable by the Board.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Cases reviewable by the Board. 1501.9 Section 1501.9 Administrative Personnel THE INTERNATIONAL ORGANIZATIONS EMPLOYEES LOYALTY BOARD OPERATIONS OF THE INTERNATIONAL ORGANIZATIONS EMPLOYEES LOYALTY BOARD § 1501.9 Cases reviewable by the...

  12. 20 CFR 260.8 - Pre-hearing case review.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Pre-hearing case review. 260.8 Section 260.8 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT REQUESTS FOR RECONSIDERATION AND APPEALS WITHIN THE BOARD § 260.8 Pre-hearing case review. (a) General. The hearings...

  13. 20 CFR 260.8 - Pre-hearing case review.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Pre-hearing case review. 260.8 Section 260.8 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT REQUESTS FOR RECONSIDERATION AND APPEALS WITHIN THE BOARD § 260.8 Pre-hearing case review. (a) General. The hearings...

  14. 20 CFR 260.8 - Pre-hearing case review.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Pre-hearing case review. 260.8 Section 260.8 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT REQUESTS FOR RECONSIDERATION AND APPEALS WITHIN THE BOARD § 260.8 Pre-hearing case review. (a) General. The hearings...

  15. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls

    PubMed Central

    Hackshaw, Allan; Rodeck, Charles; Boniface, Sadie

    2011-01-01

    BACKGROUND There is uncertainty over whether maternal smoking is associated with birth defects. We conducted the first ever comprehensive systematic review to establish which specific malformations are associated with smoking. METHODS Observational studies published 1959–2010 were identified (Medline), and included if they reported the odds ratio (OR) for having a non-chromosomal birth defect among women who smoked during pregnancy compared with non-smokers. ORs adjusted for potential confounders were extracted (e.g. maternal age and alcohol), otherwise unadjusted estimates were used. One hundred and seventy-two articles were used in the meta-analyses: a total of 173 687 malformed cases and 11 674 332 unaffected controls. RESULTS Significant positive associations with maternal smoking were found for: cardiovascular/heart defects [OR 1.09, 95% confidence interval (CI) 1.02–1.17]; musculoskeletal defects (OR 1.16, 95% CI 1.05–1.27); limb reduction defects (OR 1.26, 95% CI 1.15–1.39); missing/extra digits (OR 1.18, 95% CI 0.99–1.41); clubfoot (OR 1.28, 95% CI 1.10–1.47); craniosynostosis (OR 1.33, 95% CI 1.03–1.73); facial defects (OR 1.19, 95% CI 1.06–1.35); eye defects (OR 1.25, 95% CI 1.11–1.40); orofacial clefts (OR 1.28, 95% CI 1.20–1.36); gastrointestinal defects (OR 1.27, 95% CI 1.18–1.36); gastroschisis (OR 1.50, 95% CI 1.28–1.76); anal atresia (OR 1.20, 95% CI 1.06–1.36); hernia (OR 1.40, 95% CI 1.23–1.59); and undescended testes (OR 1.13, 95% CI 1.02–1.25). There was a reduced risk for hypospadias (OR 0.90, 95% CI 0.85–0.95) and skin defects (OR 0.82, 0.75–0.89). For all defects combined the OR was 1.01 (0.96–1.07), due to including defects with a reduced risk and those with no association (including chromosomal defects). CONCLUSIONS Birth defects that are positively associated with maternal smoking should now be included in public health educational materials to encourage more women to quit before or during pregnancy

  16. Immediate Loading of Tantalum-Based Implants in Fresh Extraction Sockets in Patient With Sjogren Syndrome: A Case Report and Literature Review.

    PubMed

    Peron, Cristian; Javed, Fawad; Romanos, Georgios E

    2017-08-01

    The objective of this article is to demonstrate treatment of a clinical case using implants in conjunction with immediate loading in a patient with Sjogren syndrome (SS) and to present the current status of knowledge about this type of patients with dental implants. This article describes a 62-year-old woman patient with SS and partially edentulous maxilla who was rehabilitated with 5 immediately loaded tantalum-based dental implants (TBDIs) placed in fresh extraction sockets. Six nonrestorable teeth were atraumatically extracted and immediate TBDI were placed in the fresh extraction sites. Space between the implants and socket walls were filled with particulate bone graft. After implant placement, a prefabricated screw-retained provisional restoration was placed and adapted in centric occlusion. The provisional restoration was removed after 2 months and replaced with a full metal/ceramic restoration. Minimal invasive surgical procedures and temporary immediate restorations are steps particularly important in patients with SS to guide the healing of periimplant tissues and avoid discomfort and complications from removable prostheses.

  17. IconiCase: A visual System for Rapid Case Review.

    ERIC Educational Resources Information Center

    Kaltenbach, M.; Preiss, B.

    A computer system, IconiCase, is currently being developed to assist users in the task of classifying and memorizing medical cases. The system uses assemblies of icons, called Concept Graphics (CG), as pointers to medical cases, leading to a form of electronic document delivery in which information is accessed at various levels, with a gradual…

  18. Institutional review board consideration of chart reviews, case reports, and observational studies.

    PubMed

    Neff, Margaret J

    2008-10-01

    Though the need for human-subjects review is readily apparent to investigators when conducting a randomized clinical trial, that same requirement is often less obvious when considering activities such as chart reviews, observational studies, or even case reports. In some cases all that is needed is notification of the institutional review board, which might then exempt the research. In other cases, waiver of consent and Health Insurance Portability and Accountability Act authorization may be granted, whereas in some situations risk to privacy may be considered too great and approval denied. In all cases, including case reviews, quality-improvement projects, and chart reviews, the most cautious approach for the investigator is to discuss regulatory requirements with the institutional review board official to ensure compliance. I will review what constitutes human-subjects research and how investigators may access protected health information, and consider some examples of observational research.

  19. Hypothenar hammer syndrome: a case and brief review.

    PubMed

    Swanson, Keith E; Bartholomew, John R; Paulson, Rolf

    2012-04-01

    Hypothenar hammer syndrome is an uncommon cause of upper-extremity ischemia that is often overlooked in the absence of a thorough occupational and recreational history. Importantly, it is a reversible cause of hand ischemia that, if missed, can lead to significant morbidity and even amputation. The occupational ramifications and quality of life of those affected can be significant. Its relative rarity, set against the ubiquitous use of the hand as a 'hammer' is noteworthy. Several other causes of hand ischemia can present similarly; therefore, consideration of other etiologies must be thoroughly investigated. Key distinguishing clinical features, in addition to a detailed occupational and recreational history, may include characteristic sparing of the thumb, the absence of a hyperemic phase in 'Raynaud's phenomenon', and a positive Allen's sign. Both non-invasive and invasive diagnostic studies, including bilateral upper-limb segmental pulse volume recordings (PVR), arterial duplex examination, and upper-extremity angiography, are complementary to a thorough history and physical examination. Optimal management strategies are not well defined because of its rarity and resultant lack of quality, evidence-based data. Though most cases can be successfully managed non-operatively, micrographic arterial reconstruction may be limb saving in severe or recalcitrant cases. Newer, experimental strategies including selective sympathetic blockage using botulinum toxin A have been reported in a few recalcitrant cases. The brief case description illustrates the typical presentation and potential treatment strategies employed in a difficult case. A review of relevant literature is also presented.

  20. [Rib cage ostheosynthesis. Literature review and case reports].

    PubMed

    Jiménez-Quijano, Andrés; Varón-Cotés, Juan Carlos; García-Herreros-Hellal, Luis Gerardo; Espinosa-Moya, Beatriz; Rivero-Rapalino, Oscar; Salazar-Marulanda, Michelle

    2015-01-01

    Fractures of the chest wall include sternum and rib fractures. Traditionally they are managed conservatively due to the anatomy of the rib cage that allows most of them to remain stable and to form a callus that unites the fractured segments. In spite of this management, some patients present with chronic pain or instability of the wall which makes them require some type of fixation. The present article performs a literature review based on 4 cases. The first case was a 61 year-old man with blunt chest trauma, with a great deformity of the chest wall associated with subcutaneous emphysema, and pneumothorax. The second case was a 51 year-old man with blunt chest trauma, initially managed at another institution, who despite treatment, had persistent pain and dyspnoea. The third case was a 30 year-old man that suffered a motor vehicle accident, with resulting pain and crepitation of the rib cage and with diagnostic images showing multiple rib fractures. The last case is a 62 year-old man that fell down the stairs, with blunt chest trauma with high intensity pain, dyspnoea and basal ipsilateral hypoventilation. Rib fracture fixation offers a good alternative in selected patients to decrease associated morbidity, leading to a patient's fast return to his or her working life. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  1. [Castleman's disease. Review of five cases].

    PubMed

    Rodríguez Silva, H; Buchaca Faxas, E; Machado Puerto, I; Pérez Román, G; Pérez Caballero, D

    2005-01-01

    It has been reported five cases of Castleman s disease. They were admitted at Hermanos Ameijeiras Surgical-Clinic Hospital. In four out of the five cases belonged to hyaline-vascular histological variety and one case to plasmacellular variety. All the cases which belonged hyaline-vascular variety were located and one of them was complicated with sarcoma of dendritic follicular cells. The plasmacellular variety was of the multicentric type. Of the four located cases two of them were retroperitoneals and they received surgical treatment only; the case of cervical location was treated with radiotherapy and steroids and the forth one of axillary location was treated with surgical removal followed of radiotherapy. The last one case, of plasma-cell and multicentric type, was only treated with prednisone. All the patients are still alive and only the one with plasmacellular variety has symptoms yet.

  2. Review of extended producer responsibility: A case study approach.

    PubMed

    Gupt, Yamini; Sahay, Samraj

    2015-07-01

    Principles of extended producer responsibility have been the core of most of the recent policies and legislation dealing with the end-of-life management of recyclable goods. This article makes an exploratory review of 27 cases of extended producer responsibility from developed and developing economies with and without informal recycling, to ascertain the most important aspect of extended producer responsibility. A comparative analysis of the cases with respect to role of stakeholders in the upstream and downstream stages of the extended producer responsibility has been carried out. Further, the study uses exploratory factor analysis to determine the important aspects of the extended producer responsibility in practice using 13 variables identified from the review. Findings of the comparative analysis reveal that financial responsibility of the producers and separate collecting and recycling agencies contributed significantly to the success of the extended producer responsibility-based environmental policies. Regulatory provisions, take-back responsibility and financial flow come out to be the three most important aspects of the extended producer responsibility. Presence of informal sector had a negative impact on the regulatory provisions. The outcomes of this study could serve as a guideline for designing of effective extended producer responsibility-based policies.

  3. A Classification-based Review Recommender

    NASA Astrophysics Data System (ADS)

    O'Mahony, Michael P.; Smyth, Barry

    Many online stores encourage their users to submit product/service reviews in order to guide future purchasing decisions. These reviews are often listed alongside product recommendations but, to date, limited attention has been paid as to how best to present these reviews to the end-user. In this paper, we describe a supervised classification approach that is designed to identify and recommend the most helpful product reviews. Using the TripAdvisor service as a case study, we compare the performance of several classification techniques using a range of features derived from hotel reviews. We then describe how these classifiers can be used as the basis for a practical recommender that automatically suggests the mosthelpful contrasting reviews to end-users. We present an empirical evaluation which shows that our approach achieves a statistically significant improvement over alternative review ranking schemes.

  4. Oculogyric Crisis with Clozapine: A Case Report and Review of Similar Case Reports in the Literature

    PubMed Central

    Nebhinani, Naresh; Avasthi, Ajit; Modi, Manish

    2015-01-01

    Oculogyric crisis (OGC) is a dystonic reaction and commonly caused by typical antipsychotics and rarely occurs with clozapine. Here, we are presenting a case of OGC with clozapine therapy and reviewing the similar cases reported in the literature. PMID:26664086

  5. Sinonasal phosphaturic mesenchymal tumor: Case report and systematic review

    PubMed Central

    Cain, Rachel B.; McCullough, Ann E.; Hoxworth, Joseph M.; Lal, Devyani

    2014-01-01

    We report a case of sinonasal phosphaturic mesenchymal tumor (PMT) and conduct a systematic review of the literature to highlight a unique paraneoplastic syndrome associated with PMT. We used English language publications from Medline and Cochrane databases (1970–2013) as data sources. A systematic review of the literature was conducted. All reported cases of head and neck PMTs were included. The presence or absence of the associated paraneoplastic syndrome was noted. We found 33 cases of PMT in the head and neck reported in the literature, 17 of which occurred in the sinonasal area. Approximately 5% of all PMTs are located in the head and neck. Just greater than half are concentrated in the sinonasal area, and the remaining involve various bony and soft tissue structures of the head and neck. PMT is sometimes associated with a paraneoplastic syndrome of tumor-induced (oncogenic) osteomalacia (TIO) causing bone pain, muscle weakness, and pathologic fractures. We present the 18th reported case of sinonasal PMT. A smooth mucosa-covered midline intraseptal mass filling the posterior nasal cavity with destruction and erosion of the skull base was found in an adult male. The patient underwent successful endoscopic resection with wide negative margins and is without recurrence at 24-month follow-up. PMT is a benign, locally aggressive tumor with rare malignant transformation. Knowledge of the bony invasion and destruction caused by this tumor is essential in planning surgical resection with wide negative margins. Familiarity with the associated TIO is essential to investigate for and manage any associated bony morbidity. PMID:25565053

  6. Epidemic decompression sickness: case report, literature review, and clinical commentary.

    PubMed

    Butler, William P

    2002-08-01

    Decompression sickness (DCS) is a syndrome of symptoms caused by bubbles of inert gas. These bubbles are produced by a significant ambient pressure drop. Although cases are usually solitary there have been several episodes of DCS clusters. This paper reports an episode of epidemic decompression sickness and reviews the literature. The case reported describes six aircrewmen with DCS following an unpressurized AC-130 flight (maximum altitude 17,000 ft). Two obvious concerns-the low altitude at which DCS was encountered and the potential for epidemic hysteria-are discussed and discounted. In addition, factors contributing to this case are recounted in depth. Moreover, the literature was examined for similar cases of epidemic decompression sickness. Four other instances were discovered. Detailed qualitative analysis of these five reports was performed. With this information epidemic decompression sickness is defined and classified. Two types are described-individual-based (Epi-I) and population-based (Epi-P). Epi-I is a cluster of DCS following a solitary exposure; whereas, Epi-P is a cluster of DCS following multiple exposures over time. Investigation of Epi-P follows the classical rules of outbreak investigation (time, place, person, and environment); whereas, Epi-I does not. In fact, the focus in Epi-I is almost entirely the environment. Following this outline should produce an etiology that control measures can be directed against. However, it is prudent to look beyond the etiology. Enter the Haddon Matrix, a classic public health tool that considers counter-measures before, during, and after the event. These many concepts are illustrated with the presented case. Following this template, both the expert and the novice flight surgeon have a systematic and reproducible approach to these difficult puzzles.

  7. Identification and classification of tibioperoneal diaphyseal toxopachyosteosis (Weismann-Netter-Stuhl syndrome): based on two new cases and a review of the literature.

    PubMed

    Nor 3es, J M; Monsegu, M H; de Masfrand, V; Oberlin, F; Denormandie, P; Rémy, J M

    1997-01-01

    Using two new cases and 70 case reports in the literature as a starting point, the authors focus on the Weismann-Netter-Stuhl syndrome. Weismann-Netter and Stuhl reported the first cases of tibioperoneal diaphyseal toxopachyosteosis in 1954. This syndrome is defined as an anomaly of the diaphyseal part of both tibiae and fibulae with posterior cortical thickening and anterior-posterior bowing. This anomaly is usually bilateral and symmetrical and patients are short. The thickening of the fibula is true tibialisation and is the main feature and the only feature confirming diagnosis. Routine laboratory investigations showed no abnormalities. The authors specify the limits encountered in classifying this anomaly and discuss the degree to which this anomaly is an entity unto itself when compared with rickets sequelae.

  8. Clonorchiasis/opisthorchiasis in Malaysians case reports and review.

    PubMed

    Shekhar, K C; Nazarina, A R; Lee, S H; Pathmanathan, R

    1995-06-01

    Clonorchiasis and opisthorchiasis are snail-transmitted trematode infections. The disease is endemic in many parts of Asia. Local case reports have been predominantly in Chinese with a history of travel to endemic countries. Thus far, 20 cases of liver fluke infestation have been reported in this country. This report presents another two cases of clonorchiasis and a case of opisthorchiasis. We also briefly review pertinent aspects of the disease.

  9. [Utero-cutaneous fistula: a case report and literature review].

    PubMed

    Ruiz Arteaga, José Daniel; Valdez Murillo, Ana Nallely; Hernández Trejo, Matilde Cecilia

    2012-02-01

    Utero-cutaneous fistula is a rare clinical entity with less than 15 cases reported worldwide in the last 20 years and this is the first case reported in our country. In this article we review the worldwide literature addressing this condition and present the first case reported in México and the first case reported worldwide in which the fistula is demonstrated using a combination of fistulogram and CT.

  10. [Xanthogranulomatous pyelonephritis: Review of 10 cases].

    PubMed

    Leoni, Francisco Alberto; Kinleiner, Pablo; Revol, Martín; Zaya, Alejandro; Odicio, Alejandro

    2009-05-01

    To report our experience with clinical presentation, appearance, diagnosis and treatment of Xanthogranulomaous pyelonephritis (XP). Multicenter, observational, descriptive and retrosprospective study carried out during six years. We studied 10 patients, 8 women and 2 males, with an average age of 50 years. All cases presented with lumbar and abdominal pain, loss of weight, conjuntival pallor, renal lithiasis and chronic evolution Fever and palpable abdominal mass, were present in 80% of cases and 60% presented history of urinary tract infection. Initial diagnosis, in most cases, was pyonephrosis. Two cases (20 %). were associated with cancer and other 2 (20 %)with Psoriasis. Mortality was of (10 %).Laboratory hallmark were anemia, high SGV rate and leukocytosis. Urinary sediment showed pyuria. Urine culture was positive in the 50 % of the patients. On the other hand urine cultures obtained from nephrostomy tube were always positive. The onset was unilateral and diffuse in all cases without predominance in the location. Direct abdominal x-ray showed lithiasis, ultrasound showed increased renal size, with a pattern of hydronephrosis and/or intraparenchymatous abscesses. CT scan was useful to demonstrate disease extension. Xanthogranulomatous pyelonephritis (XP) is a chronic and unusual inflammatory-infectious disease with acute episodes involving renal parenchyma. Most cases appear in medium aged women. Histopathologic study offers the accurate diagnosis. Antibiotic therapy avoids septic complications. Total or partial nephrectomy is the definitive treatment. We propose nephrostomy because it facilitates the microbiological diagnosis and surgery (nephrectomy).

  11. Pineal Gland Agenesis: Review and Case Illustration

    PubMed Central

    Cox, Marcus A; Voin, Vlad; Shoja, Mohammadali; Oskouian, Rod J; Loukas, Marios; Tubbs, R. Shane

    2017-01-01

    Agenesis of the pineal gland has rarely been reported in the medical literature. Herein, we report a cadaveric specimen found to have agenesis of the pineal gland. The remaining gross examination of the brain was normal. A review of the literature was performed on this unusual finding. PMID:28690948

  12. Intermediate probability lung scans (IPLS): retrospective review of 82 cases.

    PubMed

    Wong, W Y; Ng, D C; Ang, E S; Goh, A S; Sundram, F X

    2001-10-01

    In the light of a reported 30-40% prevalence of pulmonary embolism (PE) in intermediate probability lung scans (IPLS) based on results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study, we examined the frequency of documented PE in 82 patients with IPLS, the management strategy employed in these patients with regards to additional imaging (e.g. further evaluation with venous sonography or spiral computed tomographic angiography (CTA)), anticoagulation therapy, and subsequent follow-up outcomes. Retrospective review of the medical records of 82 patients with intermediate probability ventilation-perfusion (V/Q) lung scans from January 1998 to July 1999. 14.1% of V/Q scans were reported as having an intermediate probability of PE. 72% of IPLS were subject to further evaluation with venous Doppler ultrasound and/or CTA, and 39% of these patients had evidence of thrombo-embolic disease. All patients with imaging evidence of thromboembolic disease were started on anticoagulation therapy. In addition, 19 patients were treated based on clinical judgement. Amongst the 35 patients who were not treated, 17 (49%) were based on clinical findings without further imaging. There was no mortality on follow-up of 28 cases of untreated IPLS. The majority of IPLS will have further imaging, out of which over one-third will have thrombo-embolic disease. Approximately half of IPLS cases will receive anticoagulation therapy. No mortality or PE was found on follow-up of patients who were not treated.

  13. Penetrating Neck Trauma: Review of 192 Cases

    PubMed Central

    Mahmoodie, Mohsen; Sanei, Behnam; Moazeni-Bistgani, Mohammad; Namgar, Mohammad

    2012-01-01

    Background The neck region contains a high density of vital organ structures within a relatively small and unprotected anatomic region, making it one of the most vulnerable areas of the body for all types of injuries. Objectives In this article, we studied penetrating neck trauma cases in Alzahra Hospital over a 10-year period. Patients and Methods In this retrospective, descriptive, analytical study, penetrating neck trauma cases admitted to Alzahra Hospital between April 2000 and April 2010 were analyzed for epidemiology, mechanism of trauma, zone of trauma, therapeutic method, injuries to other organs, complications, and mortality. Results Among 192 penetrating neck injuries, the mean age at the time of injury was 25.08 ± 15.02 years. Of these cases, 96.4% occurred in men. The most common mechanisms of trauma was stab wounds (85.93%). In 56.3% of penetrating neck injuries, zone 2 was involved. Neck exploration was positive in 84.4% of cases, and 52.1% of patients underwent surgery. Vascular exploration was the most common cause of surgery (67.2% of patients). The most common surgical intervention was vein ligation (50.8% of cases). In 11.98% of cases, another organ injury occurred simultaneously, and chest injury was the most common coexisting problem (65.2%). Complications were reported in 9.3% of patients, and the need for intubation was the most common complication (5.2% of patients). Mortality rate was 1.5%. Conclusions According to the findings of this study, the most common cause of penetrating neck injuries was stab wounds, and the majority of patients were young men, therefore, preventive measures should be implemented. Because of fatal complications associated with neck injuries, we recommend early neck exploration in unstable cases or when injuries are deeper than the platysma. PMID:24719835

  14. Polymicrogyria, Large Corpus Callosum and Psychomotor Retardation in Four-Year-Old Girl: Potential Association Based on MR Findings. A Case Report and Literature Review.

    PubMed

    Budai, Caterina; Moscato, Giulia; Patruno, Francesco; Leonardi, Marco; Maffei, Monica

    2014-10-01

    SUMMARY - We describe a child from consanguineous parents presenting mega corpus callosum (MegaCC), polymicrogyria, psychomotor retardation with swallowing difficulties and language impairment perhaps linked to the syndrome of megalencephaly-polymicrogyria-mega corpus callosum (MEG-PMG-MegaCC). Reviewing the literature, we speculate that MegaCC, psychomotor retardation and anomalies in cortical migration are the three pathognomonic features. The presence of additional possibly associated anomalies such as megalencephaly, indicates that the spectrum of linked malformations with this rare syndrome is broad and yet to be defined.

  15. Spindle cell/sclerosing rhabdomyosarcoma with intracranial invasion without destroying the bone of the skull base: a case report and literature review

    PubMed Central

    Togao, Osamu; Hiwatashi, Akio; Yamashita, Koji; Yoshimoto, Koji; Mori, Megumu; Honda, Hiroshi

    2017-01-01

    Spindle cell/sclerosing rhabdomyosarcoma (ssRMS) is a new subtype of rhabdomyosarcoma included in the World Health Organization soft tissue and bone tumor classification in 2013. Despite the increasing number of reported cases of ssRMS, the imaging characteristics of ssRMS are not established. Herein, we present the case of an elderly Japanese woman with ssRMS of the masticator space with intracranial invasion without destruction of the adjacent bone. Attention should be paid to the presence of intracranial infiltration that may indicate a worse prognosis. Tumor growth without bone destruction could be a key finding to differentiate ssRMSs from conventional subtypes of rhabdomyosarcoma. PMID:28839951

  16. [General practitioners' experience from systematic review of patient cases as a learning vehicle in general practice].

    PubMed

    Andersen, Rikke Sand; Søndergaard, Jens; Hansen, Rikke Pilegaard; Bro, Flemming

    2009-01-19

    The study shows that GPs perceive systematic reviews of patient cases as potential learning vehicles. This is in line with adult learning theories, which argue that professional capability is best enhanced by situating learning in real-life contexts. This paper argues that we should think pragmatically when developing learning methods, and strengthen future efforts to develop methods that ensure reliable learning based on reviews of patient cases.

  17. Iliopsoas bursopathies. A review of twelve cases.

    PubMed

    Ginesty, E; Dromer, C; Galy-Fourcade, D; Bénazet, J F; Marc, V; Zabraniecki, L; Railhac, J J; Fournié, B

    1998-03-01

    Synovial cysts are far less common at the hip than at the knee and usually occur in patients whose hip cavity communicates with the iliopsoas bursa. We report 12 cases of enlargement of the iliopsoas bursa, nine men and three women, with a mean age of 48 years. The six patients with septic bursitis had severe symptoms similar to those seen in septic arthritis of the hip. Chronic pain with or without a palpable inguinal swelling was the main symptom in the six remaining patients, some of whom had compression of neighboring structures making the diagnosis more difficult. Ultrasonography is the best first-line investigation in patients with an inguinal swelling. Computed arthrotomography with examination of the synovial fluid or magnetic resonance imaging should be performed as a confirmatory diagnostic test. Our series provides evidence of the efficacy of appropriate antimicrobial therapy in septic cases and of corticosteroid injections into the bursa or hip cavity in nonseptic cases.

  18. Academic Integrity--A Review and Case Study.

    ERIC Educational Resources Information Center

    Dowd, Steven B.

    Focusing on the role of the community college in promoting academic integrity, this paper provides a review of the literature and a case study describing the development of a relevant college-wide policy. First, a general overview of the role of colleges in promoting values is presented. Next, the literature review on cheating and plagiarism in…

  19. 7 CFR 275.13 - Review of negative cases.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Quality Control (QC) Reviews § 275.13 Review of negative cases. (a) General. A sample of households whose applications for food...

  20. Linear porokeratosis: a case report and review of the literature.

    PubMed

    Lorenz, Giovanni E; Ritter, Steven E

    2008-06-01

    Linear porokeratosis refers to 1 of 5 variants of porokeratosis. Porokeratosis is a keratinization disorder of multiple etiologies including genetic aberrancy, trauma, and infection. We review a case of a 35-year-old man with a chronic history of linear porokeratosis and conduct a review of porokeratosis subtypes, etiology, histology, pathology, differential diagnosis, and treatment.

  1. Academic Integrity--A Review and Case Study.

    ERIC Educational Resources Information Center

    Dowd, Steven B.

    Focusing on the role of the community college in promoting academic integrity, this paper provides a review of the literature and a case study describing the development of a relevant college-wide policy. First, a general overview of the role of colleges in promoting values is presented. Next, the literature review on cheating and plagiarism in…

  2. A Case of Peri-Anal Varicella and Review of the Literature

    ERIC Educational Resources Information Center

    Barrett, Sabrina; Burgess, Scott

    2011-01-01

    Grouped vesicle on an erythematous base suggests a herpes virus infection and located within the anogenital region raises the possibility of sexual assault. The following case and review highlight the need to consider infection by varicella zoster virus in such cases and emphasises the importance of a prompt and accurate diagnosis.

  3. A Case of Peri-Anal Varicella and Review of the Literature

    ERIC Educational Resources Information Center

    Barrett, Sabrina; Burgess, Scott

    2011-01-01

    Grouped vesicle on an erythematous base suggests a herpes virus infection and located within the anogenital region raises the possibility of sexual assault. The following case and review highlight the need to consider infection by varicella zoster virus in such cases and emphasises the importance of a prompt and accurate diagnosis.

  4. Delayed spontaneous pneumocephalus in ventriculoperitoneal shunting: two case reports and literature review.

    PubMed

    Najera Aguilar, Edinson; Castle Ramirez, Maria; Bollar Zabala, Alicia; Urculo Bareño, Enrique

    2014-01-01

    Spontaneous pneumocephalus following cerebrospinal fluid shunt is a rare complication. In most cases, the air enters in the intracranial cavity via a skull base defect. We report 2 cases of delayed tension pneumocephalus, secondary to ventriculoperitoneal shunt, and review the etiopathogenesis, prevention and treatment of this condition.

  5. Tufted hemangioma: clinical case and literature review

    PubMed Central

    Kazlouskaya, Viktoryia; Lytvynenko, Bohdan; Blochin, Elen

    2014-01-01

    Tufted hemangiomas are relatively rare benign vascular proliferations that are congenital or appear during the first years of life. Herein we present an additional case of tufted hemangioma that appeared one year after birth and discuss its histopathological criteria and differential diagnosis with malignant vascular proliferations including sarcoma Kaposi, angiosarcoma and kaposiform hemangioendothelioma. PMID:24855571

  6. Suicide pacts: six cases and literature review.

    PubMed

    Prat, Sebastien; Rérolle, Camille; Saint-Martin, Pauline

    2013-07-01

    A suicide pact is the decision of two or more people to die together. This event is rare. The majority of suicide pacts victims are married, socially isolated, with a serious physical illness in one or both partners. We performed a retrospective study of all cases of suicide pacts leading to death between January 1, 2003 and December 31, 2010 referred to the Forensic Medicine Department of Tours (France). Six cases were recorded as suicide pacts. Firearms were the preferred means of death. Five suicide notes were discovered. For some cases, it was difficult to establish whether death was the result of a suicide pact or of a homicide-suicide without the consent of the victim. An objective element, such as a suicide note and motive, is required to prove that a suicide pact is involved. The prevalence of mental disorders is hard to assess. In France, psychological autopsies are not performed in such cases, as the investigation is usually very sparse after the death of both individuals.

  7. Emphysematous pyelonephritis: a review of six cases.

    PubMed

    Ali, Sohrab Naushad; Ahmed, Niqad; Naushad, Aymon; Naushad, Mian

    2014-01-01

    Emphysematous pyelonephritis is a severe life threatening necrotising infection of the renal parenchyma. The infection most commonly occurs in the diabetic population, often associated with the organism E. coli Emphysematous pyelonephritis differs from standard pyelonephritis by the bacterial liberation and accumulation of gas in the surrounding tissues. The condition is rarely encountered in clinical practice and since the first description by Kelly et al in 1898, approximately 200 cases have been reported in the literature. The case series examines our experience with six diagnosed cases of emphysematous pyelonephritis over a one year period. All patients were female, the mean age of presentation being 53 years. Of the six patients, five were diabetics with hypertension, the one exception being a non-diabetic patient who had undergone renal exploration in the past. Computed tomography confirmed the diagnosis in all patients except one which was confirmed during renal exploration. Urine culture was positive for E. coli in two patients. Emphysematous pyelonephritis which used to be a rare disease is now being more readily diagnosed. The cases were diagnosed at a late stage making its conservative management not feasible

  8. Hyperlipidemic myeloma: review of 53 cases.

    PubMed

    Misselwitz, Benjamin; Goede, Jeroen S; Pestalozzi, Bernhard C; Schanz, Urs; Seebach, Jörg D

    2010-06-01

    Hyperlipidemic myeloma is a rare and poorly understood variant of multiple myeloma. We report the case of a 53-year-old woman with hyperlipidemic myeloma, skin xanthomas and hyperviscosity syndrome who underwent allogeneic bone marrow transplantation. A comprehensive literature search identified 52 additional cases with plasma cell disease and hyperlipidemia. A detailed analysis revealed several characteristics of these patients as compared to multiple myeloma with normal lipid status: (1) IgA paraprotein was present in the majority (53% vs. 21% in classical multiple myeloma). (2) Skin xanthomas, especially in the palmar creases, elbows, and knees were common (70%). (3) Hyperviscosity syndrome occurred more often (26% vs. 2-6%). While conventional lipid-lowering therapy had only marginal effects, successful anti-myeloma therapy also reduced hyperlipidemia. Analyses of the mechanisms leading to hyperlipidemia documented complexes of paraprotein and lipoprotein in 75% of the 32 cases tested, suggesting an inhibitory role of the paraprotein on lipid degradation. In conclusion, the clinical characteristics, the therapeutic options, and the pathophysiologic mechanisms of hyperlipidemic myeloma are comprehensively reported using the available data from all 53 published cases in the literature.

  9. [Erythromelalgia: two case reports and literature review].

    PubMed

    Nurowska-Wrzosek, Barbara; Tołodziecka, Lucja; Gaciong, Zbigniew

    2007-07-01

    Erythromelalgia is a rare disease of unclear etiology characterized by recurrent erythema, burning pain and warmth of the affected extremities. In this paper we reported 2 cases of primary familial erythromelalgia and difficulties with achieving a significant improvement with the currently available treatment. Moreover, this paper provides a brief update on pathophysiology, prognosis and treatment of erythromelalgia.

  10. Inferior vena cava filter migration: updated review and case presentation.

    PubMed

    Janjua, Muhammad; Omran, Fatema M; Kastoon, Tony; Alshami, Mahmood; Abbas, Amr E

    2009-11-01

    We report a case of inferior vena cava filter migration to the right ventricle resulting in ventricular tachycardia and elevated troponin. The patient was taken to the cardiac catheterization laboratory and under fluoroscopy the filter was found to be in the right ventricle. Later in the day the filter was removed surgically with the aid of cardiopulmonary bypass. This case, as well as the other 27 reported cases of filter migration, were reviewed. It was noticed that newer retrievable filters made of nitinol, phynox and elgioly have a significantly higher percentage of filter migration into the right ventricle as compared to the old stainless steel and titanium-based Greenfield filters. Similarly, there were also higher percentages of complications and mortality associated with the newer retrievable filters migrating to the right ventricle. Filter migration to the right ventricle as opposed to the right atrium increased over the past 10 years, which has resulted in more serious symptoms, ventricular arrhythmias, deaths and higher rates of surgical removal.

  11. Swallowed dentures: Two cases and a review

    PubMed Central

    Gachabayov, Mahir; Isaev, Mubariz; Orujova, Lala; Isaev, Emin; Yaskin, Evgeniy; Neronov, Dmitriy

    2015-01-01

    Introduction Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction. Presentation of cases First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools. Discussion Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer. Conclusion Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible. PMID:26635957

  12. Development of the major trauma case review tool.

    PubMed

    Curtis, Kate; Mitchell, Rebecca; McCarthy, Amy; Wilson, Kellie; Van, Connie; Kennedy, Belinda; Tall, Gary; Holland, Andrew; Foster, Kim; Dickinson, Stuart; Stelfox, Henry T

    2017-02-28

    As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. Development of the trauma case review tool was multi-faceted, beginning with a review of the trauma audit tool literature. Data were extracted from the literature to inform iterative tool development using a consensus approach. Inter-rater agreement was assessed for both the pilot and finalised versions of the tool. The final trauma case review tool contained ten sections, including patient factors (such as pre-existing conditions), presenting problem, a timeline of events, factors contributing to the care delivery problem (including equipment, work environment, staff action, organizational factors), positive aspects of care and the outcome of panel discussion. After refinement, the inter-rater reliability of the human factors and outcome components of the tool improved with an average 86% agreement between raters. This research developed an evidence-informed tool for use in paediatric trauma case review that considers both system safety and human factors to facilitate clinical review of trauma patient care. This tool can be used to identify opportunities for improvement in trauma care and guide quality assurance activities. Validation is required in the adult population.

  13. Autoscopic phenomena: case report and review of literature

    PubMed Central

    2011-01-01

    Background Autoscopic phenomena are psychic illusory visual experiences consisting of the perception of the image of one's own body or face within space, either from an internal point of view, as in a mirror or from an external point of view. Descriptions based on phenomenological criteria distinguish six types of autoscopic experiences: autoscopic hallucination, he-autoscopy or heautoscopic proper, feeling of a presence, out of body experience, negative and inner forms of autoscopy. Methods and results We report a case of a patient with he-autoscopic seizures. EEG recordings during the autoscopic experience showed a right parietal epileptic focus. This finding confirms the involvement of the temporo-parietal junction in the abnormal body perception during autoscopic phenomena. We discuss and review previous literature on the topic, as different localization of cortical areas are reported suggesting that out of body experience is generated in the right hemisphere while he-autoscopy involves left hemisphere structures. PMID:21219608

  14. Nasolacrimal Duct Mucocele: Case Report and Literature Review

    PubMed Central

    Britto, Fernanda Carneiro Corujeira de; Rosier, Vitor Veloso; Luz, Tovar Vicente; Verde, Raquel Crisóstomo Lima; Lima, Clara Mônica Figueiredo de; Lessa, Marcus Miranda

    2014-01-01

    Introduction Mucoceles are benign expansive cystic formations, composed of a mucus-secreting epithelium (respiratory or pseudostratified epithelium). Nasolacrimal mucocele occurs in a small proportion of children with nasolacrimal duct obstruction and is characterized by a cystic mass in the medial canthus with dilation of the nasolacrimal duct; although dacryocystoceles are rare in adults, they have been reported in patients with trachoma. Objective Discuss clinical aspects, diagnosis, and therapeutic management of mucocele of nasolacrimal duct based on literature review. Resumed Report The authors report a case of bilateral congenital nasolacrimal duct cysts in a 30-year-old man, identified as a tumor in the topography of both lacrimal sacs since birth without associated symptoms. The patient underwent successive surgical treatments, leading to recurrence of the tumor at the right side and recurrent local infections. Conclusion Endoscopic dacryocystorhinostomy has been increasingly used with good results and success rates similar to the external access. PMID:25992160

  15. Nasolacrimal duct mucocele: case report and literature review.

    PubMed

    Britto, Fernanda Carneiro Corujeira de; Rosier, Vitor Veloso; Luz, Tovar Vicente; Verde, Raquel Crisóstomo Lima; Lima, Clara Mônica Figueiredo de; Lessa, Marcus Miranda

    2015-01-01

    Introduction Mucoceles are benign expansive cystic formations, composed of a mucus-secreting epithelium (respiratory or pseudostratified epithelium). Nasolacrimal mucocele occurs in a small proportion of children with nasolacrimal duct obstruction and is characterized by a cystic mass in the medial canthus with dilation of the nasolacrimal duct; although dacryocystoceles are rare in adults, they have been reported in patients with trachoma. Objective Discuss clinical aspects, diagnosis, and therapeutic management of mucocele of nasolacrimal duct based on literature review. Resumed Report The authors report a case of bilateral congenital nasolacrimal duct cysts in a 30-year-old man, identified as a tumor in the topography of both lacrimal sacs since birth without associated symptoms. The patient underwent successive surgical treatments, leading to recurrence of the tumor at the right side and recurrent local infections. Conclusion Endoscopic dacryocystorhinostomy has been increasingly used with good results and success rates similar to the external access.

  16. Hypersensitivity to laminaria: a case report and review of literature.

    PubMed

    Sierra, Tania; Figueroa, Melissa M; Chen, Katherine T; Lunde, Britt; Jacobs, Adam

    2015-04-01

    We report a case of laminaria hypersensitivity treated with diphenhydramine and corticosteroids. A literature review identified 10 previously reported cases, with 8 recognized as anaphylaxis, and good outcomes with corticosteroids and antihistamines despite limited epinephrine utilization. Laminaria hypersensitivity is likely IgE mediated with an increased anaphylaxis risk with prior exposure. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. [Intrasellar arachnoid cysts. Two case reports and literature review].

    PubMed

    Lorente-Muñoz, Asís; Lisbona-Alquézar, María Pilar; Alberdi-Viñas, Juan; Orduna-Martinez, Javier; González-Martínez, Luis; Fernández-Liesa, Rafael

    2013-01-01

    Intrasellar arachnoid cysts are an uncommon pathology, with only a few cases reported in scientific literature. Their physiopathology is still unknown, with different hypothesis about their development. Differential diagnosis with other cystic sellar lesions is difficult. We report two cases of two intrasellar arachnoid cysts that were treated surgically using transsphenoidal approach and present a review of the literature.

  18. Pancreatic liposarcoma: case report with review of retroperitoneal liposarcomas.

    PubMed

    Elliott, T E; Albertazzi, V J; Danto, L A

    1980-04-01

    A case report of a large pancreatic liposarcoma is presented showing a five-year survival with aggressive surgical excision as the only treatment. The medical literature of the subject is reviewed. This is the only reported case of retroperitoneal liposarcoma which is limited to the pancreas. A discussion of the current types of treatment for retroperitoneal liposarcomas is included.

  19. Loiasis: Report of Three Cases and Literature Review

    PubMed Central

    Gibbs, Rose Delores

    1979-01-01

    Loiasis is a tropical infection caused by the microfilarial nematode Loa loa. Increased numbers of cases of loiasis have been diagnosed outside of the endemic areas in Western and Central Africa because of widespread international travel. The author presents three cases of loiasis discovered at Howard University followed by a review of the literature. PMID:291735

  20. Gorlin-Goltz Syndrome: Case report and literature review

    PubMed Central

    Ramesh, Maya; Krishnan, Ramesh; Chalakkal, Paul; Paul, George

    2015-01-01

    Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities. PMID:26604511

  1. Gorlin-Goltz Syndrome: Case report and literature review.

    PubMed

    Ramesh, Maya; Krishnan, Ramesh; Chalakkal, Paul; Paul, George

    2015-01-01

    Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities.

  2. Infective Endocarditis by Aggregatibacter paraphrophilus: Case Report and Literature Review

    PubMed Central

    Sood, Smita

    2013-01-01

    Aggregatibacter paraphrophilus (former name, Haemophilus paraphrophilus) is a normal inhabitant of the naso- and oropharynx and has been rarely reported as a cause of human infections. A case of infective endocarditis by this organism is being reported and literature of endocarditis cases caused by Aggregatibacter paraphrophilus is being reviewed. PMID:24392406

  3. Hereditary xerocytosis. A case history and review of the literature.

    PubMed

    Nolan, G R

    1984-04-01

    A case of hereditary xerocytosis, a rare hemolytic anemia with dehydrated erythrocytes resulting from excess potassium efflux through the red cell membrane, is presented and the literature on the subject reviewed. This is one of the first cases reported from Australia.

  4. [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.

  5. MURCS association: case report and review.

    PubMed Central

    Braun-Quentin, C; Billes, C; Böwing, B; Kotzot, D

    1996-01-01

    We report on a 25 year old woman with aplasia of the Müllerian duct, unilateral renal agenesis, and anomalies of the cervicothoracic somites (MURCS association). Growth retardation and facial asymmetry were also present. A review of published reports allows MURCS association to be distinguished from related associations, sequences, and syndromes. Moreover, sporadic occurrence, the broad spectrum of associated anomalies, and the involvement of different organ systems closely related in early embryogenesis are arguments for considering MURCS association as the consequence of a developmental field defect. Images PMID:8818954

  6. Biperiden dependence: case report and literature review.

    PubMed

    Espi Martinez, Fernando; Espi Forcen, Fernando; Shapov, Arlenne; Martinez Moya, Amparo

    2012-01-01

    Anticholinergic drugs are frequently used in psychiatry for the prophylaxis and treatment of extrapiramidal symptoms caused by neuroleptics. Abuse of anticholinergic agents has been reported in patients with psychotic disorders, on treatment with neuroleptics, and polysubstance use disorders. We are reporting the case of a patient who presented with hypoactive delirium as a consequence of biperiden dependence. The clinician must pay special attention to detect anticholinergic misuse in patients presenting with delirium of unknown cause.

  7. Pylephlebitis: case report and literature review.

    PubMed

    Flores-Anaya, Lizeth; León-Lozada, Cinthia; Torres-Damas, William

    2015-09-08

    We present the case of a 50-year-old man who comes to the emergency department of Dos de Mayo Hospital, Lima, Peru, with fever, abdominal pain, diarrhea and jaundice. An intestinal infection arises as initial diagnosis. He is referred to the area of Internal Medicine where various laboratory tests and imaging studies were conducted, including an abdominal computerized tomography scan. The scan confirmed the diagnosis of pylephlebitis; treatment with antibiotics and anticoagulant therapy was immediately established. Response and evolution were favorable.

  8. Biperiden Dependence: Case Report and Literature Review

    PubMed Central

    Espi Martinez, Fernando; Espi Forcen, Fernando; Shapov, Arlenne; Martinez Moya, Amparo

    2012-01-01

    Anticholinergic drugs are frequently used in psychiatry for the prophylaxis and treatment of extrapiramidal symptoms caused by neuroleptics. Abuse of anticholinergic agents has been reported in patients with psychotic disorders, on treatment with neuroleptics, and polysubstance use disorders. We are reporting the case of a patient who presented with hypoactive delirium as a consequence of biperiden dependence. The clinician must pay special attention to detect anticholinergic misuse in patients presenting with delirium of unknown cause. PMID:22937420

  9. [Sheehan's syndrome - case report and review].

    PubMed

    Kristjánsdóttir, Hallgerdur Lind; Bödvarsdóttir, Sigrún Perla; Sigurjónsdóttir, Helga Agústa

    2010-05-01

    Sheehan's syndrome (SS) is a pituitary failure after delivery. Symptoms depend on which hormonal axis are affected, failure to lactate and resume menstruation is most frequent but cortisol deficiency is most dangerous and may lead to death if undiagnosed. We present a 38 year old female that was diagnosed with SS after repeated visits to health care professionals with typical symptoms of SS. The purpose of this case report is to draw attention to SS and the symptoms of cortisol deficiency.

  10. Chorangiocarcinoma: a case report and clinical review

    PubMed Central

    Huang, Bin; Zhang, Yan-Ping; Yuan, Dan-Fang; Yang, Rui; Wang, Chun; Wu, Rui-Fang

    2015-01-01

    Objective: We describe a case of chorangiocarcinoma, a chorangioma covered by an abnormal trophoblastic proliferation, presenting in a term placenta and in an asymptomatic pregnancy. Evidence of metastasis was found on follow-up of the mother. Materials and methods: The lesion Was diagnosed by pathologic examination after cesarian section at term for fetal macrosomia, performed because of the abnormal gross findings in the placenta. After uncomplicated delivery, a thealthy child was born and the placent was expelled completely. There was follow-up in the mother and the child, up to 19 months after delivery. Results: Gross examination of the placenta showed a well-demarcated and grayish yellow-white mass, bulging paracentrally from the fetal surface. Histology revealed a trophoblastic proliferation inside a chorangioma, consisting of extensive central necrosis and high mitotic activity. Immunohistochemical staining showed strong intensity for hCG, PLAP, CK, CD31 (+) and CD34 (+); Ki67 showed a high proliferation index. Follow-up revealed metastasis in the mother and chemotherapy were performed at 3 months postpartum. Conclusion: This is only the sixth reported case of chorangiocarcinoma of the placenta in the literature. However, no metastasis were discovered in the reported case, which was not identical to ours. Follow-up revealed metastasis at lung in the mother. Chorangiocarcinoma should be carefully examined and followed-up. PMID:26629223

  11. [Infective endocarditis: review of 36 cases].

    PubMed

    Lupis, Francesco; Giordano, Salvatore; Pampinella, Diego; Scarlata, Francesco; Romano, Amelia

    2009-09-01

    In a retrospective study of cases of infective endocarditis (IE) observed in adult patients, the data of patients hospitalized for definite IE in the Cardiosurgery Unit of ARNAS-Civico in Palermo (Italy) from March 2003 to September 2006 were analysed. All cases were classified according to the modified Duke criteria. In all, 36 immunocompetent patients with "definite" IE were included (20 males and 16 females with a median age of 54 years). The aortic valve (23/36, 64%) was the most commonly involved, followed by the mitral (19/36, 52.7%) and tricuspid valve (4/36, 11%). In 10 patients (27.7%), a double localization was observed. Blood culture yielded a positive result in 15 cases. Staphylococci and enterococci were the pathogens most commonly identified. Valvular diseases and previous cardiosurgical procedures were the risk factors most commonly noted. Four patients developed complications during the course of the disease, one of whom died. In patients with positive blood culture, antibiotics were prescribed on the basis of susceptibility test results. In patients with negative blood culture, empiric therapy was directed against Gram+ bacteria (glycopeptides, aminoglycosides and betalactams). Surgical therapy was necessary in 25 patients (69.4%). The patients were subsequently enrolled in a cardiological and infectivological follow-up. Our results showed that rapid diagnosis, correct antibiotic therapy and early surgical treatment improve the outcome in patients with infective endocarditis.

  12. A Review of Melioidosis Cases in the Americas.

    PubMed

    Benoit, Tina J; Blaney, David D; Doker, Thomas J; Gee, Jay E; Elrod, Mindy G; Rolim, Dionne B; Inglis, Timothy J J; Hoffmaster, Alex R; Bower, William A; Walke, Henry T

    2015-12-01

    Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, a gram-negative saprophytic bacillus. Cases occur sporadically in the Americas with an increasing number of cases observed among people with no travel history to endemic countries. To better understand the incidence of the disease in the Americas, we reviewed the literature, including unpublished cases reported to the Centers for Disease Control and Prevention. Of 120 identified human cases, occurring between 1947 and June 2015, 95 cases (79%) were likely acquired in the Americas; the mortality rate was 39%. Burkholderia pseudomallei appears to be widespread in South, Central, and North America. © The American Society of Tropical Medicine and Hygiene.

  13. Perianal pseudolymphoma: A case report and review of the literature.

    PubMed

    Cuda, Tahleesa; Prinsloo, Pieter

    2017-08-17

    Perianal pseudolymphoma is a rare lymphoproliferative disorder that can mimic cutaneous lymphoma. The condition can present acutely with concerns of perianal sepsis. The purpose of this case review is to review the current literature on perianal pseudolymphoma and emphasise to the surgical community its presentation, suggested aetiology and management. In this case report, we detail the case of a 28-year-old female who presented with perianal pseudolymphoma. Malignant lymphoproliferative diseases required exclusion. Conservative management of this rare condition was successful. We highlight the differential diagnoses, investigations and treatment options for a rare condition. A review of the literature on the limited published data on perianal pseudolymphoma is briefly discussed. The aim of this case report is to highlight the existence of such a rare condition that can imitate an acute surgical presentation and its successful conservative management. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Qualitative case study methodology in nursing research: an integrative review.

    PubMed

    Anthony, Susan; Jack, Susan

    2009-06-01

    This paper is a report of an integrative review conducted to critically analyse the contemporary use of qualitative case study methodology in nursing research. Increasing complexity in health care and increasing use of case study in nursing research support the need for current examination of this methodology. In 2007, a search for case study research (published 2005-2007) indexed in the CINAHL, MEDLINE, EMBASE, PsychINFO, Sociological Abstracts and SCOPUS databases was conducted. A sample of 42 case study research papers met the inclusion criteria. Whittemore and Knafl's integrative review method guided the analysis. Confusion exists about the name, nature and use of case study. This methodology, including terminology and concepts, is often invisible in qualitative study titles and abstracts. Case study is an exclusive methodology and an adjunct to exploring particular aspects of phenomena under investigation in larger or mixed-methods studies. A high quality of case study exists in nursing research. Judicious selection and diligent application of literature review methods promote the development of nursing science. Case study is becoming entrenched in the nursing research lexicon as a well-accepted methodology for studying phenomena in health and social care, and its growing use warrants continued appraisal to promote nursing knowledge development. Attention to all case study elements, process and publication is important in promoting authenticity, methodological quality and visibility.

  15. Case reviews in the family physician's office.

    PubMed

    Kates, N; Craven, M; Webb, S; Low, J; Perry, K

    1992-02-01

    The majority of patients with emotional or psychiatric disorders are treated in the primary care setting without psychiatric input. Psychiatrists need to find ways of helping family physicians manage these patients without necessarily taking over their care. One way of achieving this is for a psychiatric consultant to visit the family physician's office on a regular basis to discuss the physician's problem cases. This paper describes such a pilot project, outlines the kinds of problems family physicians discussed and recommendations that were made, and discusses the benefits of this collaborative approach.

  16. Learning from experience: constructing critical case reviews for a leadership programme.

    PubMed

    Crofts, Linda

    2006-10-01

    A previous paper described the development of a leadership programme for critical care and highlighted that one of the strengths of the programme was the critical case review. This paper sets out in some depth the major theoretical influences in the construction of the case review. Case reviews have been used in education for some time but often have predetermined outcomes. The education approach favoured here was based on action learning, which in itself belongs to the broad church of reflective practice. While reflective practice has been advocated in nursing since 1986 together with the introduction of clinical supervision neither have met with unqualified success in their own right. This paper concludes that while the concept and construction of the critical case review may be new it is in essence no more than a jigsaw of already well-established practices of reflection, clinical supervision and action learning woven into the foundations of clinical risk management and whole systems working.

  17. Contact lens hygiene compliance and lens case contamination: A review.

    PubMed

    Wu, Yvonne Tzu-Ying; Willcox, Mark; Zhu, Hua; Stapleton, Fiona

    2015-10-01

    A contaminated contact lens case can act as a reservoir for microorganisms that could potentially compromise contact lens wear and lead to sight threatening adverse events. The rate, level and profile of microbial contamination in lens cases, compliance and other risk factors associated with lens case contamination, and the challenges currently faced in this field are discussed. The rate of lens case contamination is commonly over 50%. Coagulase-negative Staphylococcus, Bacillus spp., Pseudomonas aeruginosa and Serratia marcescens are frequently recovered from lens cases. In addition, we provide suggestions regarding how to clean contact lens cases and improve lens wearers' compliance as well as future lens case design for reducing lens case contamination. This review highlights the challenges in reducing the level of microbial contamination which require an industry wide approach. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  18. [Cardiopathia fantastica: case report and literature review].

    PubMed

    Zahner, J; Muehlenberg, K

    2001-01-01

    We describe the case of a 71-year old medical technician, who was treated for instable angina pectoris in 29 different hospitals 38 times over 9 years. Dramatically presented retrosternal pain regularly started in crowded places, such as bus or railway stations or directly in front of the hospital. Ultrasound and ECG gave evidence of an old inferior myocardial infarction. Invasive diagnostic procedures were rejected by the patient because of an alleged allergy for contrast media. The single, retired patient never admitted former cardiac hospitalizations and restrained the physicians from contacting his local doctor. The patient mostly left the hospital against medical advice and achieved hospitalization in another clinic sometimes the same day. Because of his personality structure, the dramatic presentation of his complaints and the numerous hospitalizations in various hospitals with self-discharge, we made the diagnosis of a cardiac Munchausen syndrome, a so-called cardiopathia fantastica, in the presence of an accompanying coronary heart disease. In the literature we found 52 cases of cardiopathia fantastica since the first description of this phenomenon in the year 1953. Interestingly enough, mostly men were identified. Angina pectoris is by far the most frequent symptom of cardiopathia fantastica. In 8 of 53 patients (15%) an additional cardiac manifestation was present in addition to cardiopathia fantastica. Cardiopathia fantastica on the one hand is an important differential diagnosis of coronary heart disease; on the other hand it may develop in the presence of an underlying cardiac disease.

  19. Grynfelt hernia: case report and literature review.

    PubMed

    Cesar, D; Valadão, M; Murrahe, R J

    2012-02-01

    Back lumbar hernia is a rare abdominal wall defect that usually presents spontaneously after trauma or lumbar surgery or, less frequently, during infancy (congenital). Few reports have been published in the literature describing primary lumbar hernia. A general surgeon will have the opportunity to repair only one or a few lumbar hernia cases in his/her lifetime. We report a case of a healthy 50-year-old man, with no previous surgeries or history of trauma, who presented to the outpatient department with abdominal discomfort, pain, and a sensation of a growing mass on his lower left back for 4 years. CT scan of the abdomen showed a mass in the left posterolateral abdominal wall. Specifically, a herniation of retroperitoneal fat between the erector spinae muscle group and internal oblique muscles through aponeurosis of the transversalis muscle (Grynfeltt hernia). The patient underwent a small lumbotomy, polypropylene mesh was placed and he recovered well. Although many techniques have been described for the surgical management of such hernias, none of them can be recommended as the preferred method. Our impression, however, is that the open approach, with a small lumbotomy, seems to be easy, safe and presents good postoperative recovery.

  20. Gallstone ileus: case report and literature review.

    PubMed

    Dai, Xin-Zheng; Li, Guo-Qiang; Zhang, Feng; Wang, Xue-Hao; Zhang, Chuan-Yong

    2013-09-07

    Gallstone ileus (GI) is characterized by occlusion of the intestinal lumen as a result of one or more gallstones. GI is a rare complication of gallstones that occurs in 1%-4% of all cases of bowel obstruction. The mortality associated with GI ranges between 12% and 27%. Classical findings on plain abdominal radiography include: (1) pneumobilia; (2) intestinal obstruction; (3) an aberrantly located gallstone; and (4) change of location of a previously observed stone. The optimal management of acute GI is controversial and can be: (1) enterotomy with stone extraction alone; (2) enterotomy, stone extraction, cholecystectomy and fistula closure; (3) bowel resection alone; and (4) bowel resection with fistula closure. We describe a case to highlight some of the pertinent issues involved in GI management, and propose a scheme to minimize recurrent disease and postoperative complications. We conclude that GI is a rare condition affecting mainly the older population with a female predominance. The advent of computed tomography and magnetic resonance imaging has made it easier to diagnose GI. Enterotomy with stone extraction alone remains the most common surgical method because of its low incidence of complications.

  1. [Chronic pancreatitis: Retrospective review of 121 cases].

    PubMed

    Berger F, Zoltán; Mancilla A, Carla

    2016-12-01

    Chronic pancreatitis (CP) is a rare disease in Chile, without a clear explanation for this low prevalence. To analyze the characteristics of our patients with pancreatitis. Retrospective analysis of a database of patients with pancreatitis of a clinical hospital. Morphological proof of diagnosis (calcifications/calculi, alterations of ducts, local complication or histology) was obtained for every patient. History of acute pancreatitis was recorded and exocrine-endocrine function was assessed. We retrieved information of 121 patients with pancreatitis (86 males) in a period of 20 years. The number of cases increased markedly every five years. The calculated incidence and prevalence was 0.8/100,000/year and 6/100,000, respectively. Pancreatic calcifications were initially observed in 93 patients and became evident during the follow-up in another six patients. Severe pain or local complications occurred in 27 patients, requiring surgery in 10 or endoscopic treatment in 15. During the years of follow-up, 55 patients were free of symptoms. Exocrine and endocrine insufficiency was demonstrated and treated in 81 and 67 patients, respectively. Alcoholic etiology was evident in 40% of patients. In 29% no etiology was identified. Mapuche origin was exceptional. Late diagnosis of CP is common, since most of our patients presented with advanced stages. Even though CP is increasingly diagnosed in our hospitals, the number of cases is still far fewer when compared to other countries. Underdiagnosis alone cannot explain this difference and genetic factors might be of importance.

  2. Immunoblastic lymphadenopathy: case report and literature review.

    PubMed Central

    Cooperberg, A. A.; de Champlain, M. B.; Siminovitch, J.; Rosenberg, A.; Schwartz, J. P.

    1977-01-01

    A patient with immunoblastic lymphadenopathy (IL) had an unusual course of illness, with frequent episodes, over a 20-month period, of chills, fever, abdominal pain, hepatosplenomegaly and weight loss. The episodes were short-lived and many resolved spontaneously. Eventually generalized lymphadenopathy and profound monoclonal IgG gammopathy developed, with atypical mononuclear cells in the peripheral blood and increased numbers of plasmacytoid cells in the bone marrow. Lymph node biopsy revealed the morphologic triad typical of IL: proliferation immunoblasts, proliferation of small blood vessels and the deposit of an amorphous acidophillic material in the vascular walls and the interstitium. Up to October 1976 110 cases had been reported of this disorder, first described 3 years ago, which indicates that IL is not rare. Remissions have occurred spontaneously and after steroid therapy or chemotherapy or both. However, death has been reported in almost 50% of the cases, and the best approach to therapy remains to be determined. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 PMID:861911

  3. [Forestier disease. Case report and literature review].

    PubMed

    Zárate-Kalfópulos, Barón; Jerez-Saldaña, Omar; Romero-Vargas, Samuel; Juárez Jiménez, Héctor Gerardo; Rosales-Olivarez, Luis Miguel

    2012-01-01

    Forestier disease is a systemic disorder characterized by ossification of the anterior spinal longitudinal ligament (ALL) in at least three adjacent vertebrae, and diffuse spinal enthesopathy. Indication for surgical treatment is rare and limited to cases of related myelopathy, fracture or significant dysphagia. Few cases of surgical treatment are reported in the medical literature. Surgical treatment depends on the particular symptoms or complications, and usually involves osteophytectomy through the standard anterior approach. Surgery may bring about complications, such as pharyngeal paralysis, thrombosis, infections and respiratory obstruction. 79-year old male with dysphagia of 10 years of evolution, and hoarseness and respiratory distress since 8 years ago. Screening studies showed a diffuse calcification of anterior longitudinal ligament along with large cervical osteophytes. Forestier disease and secondary dysphagia were diagnosed. Surgical treatment consisted of resection of bone exostoses in C4 and C5 vertebral bodies. Six months after surgery, the patient reported improvement of esophageal and respiratory symptoms without evidence of recurrence on imaging studies. Data on Forestier disease's epidemiological nature and impact on life quality in Mexico is unknown. An increase in its occurrence is projected as the Mexican population ages. An observational study is required to identify the characteristics of this disease in Mexico.

  4. Investment case concepts in leprosy elimination: A systematic review.

    PubMed

    Tiwari, Anuj; Richardus, Jan Hendrik

    2016-03-01

    Leprosy continues to be a global public health problem, but draws less attention because 'prevalence based elimination' has been misinterpreted as eradication. The ongoing transmission of M. leprae has renewed interest in complete elimination. The aim of our study is to review systematically the literature regarding the elimination of leprosy, and to assess this information on its applicability for defining a Leprosy Elimination Investment Case (LEIC) based on Eradication Investment Case guidelines. A literature search was conducted using the MeSH subheadings and synonyms of leprosy. A total of 1007 articles were considered and 112 were included in the final selection. The search focused on the literature covering leprosy elimination and its public health aspects. The LEIC framework was adapted from an existing "Guide to Preparing an Eradication Investment Case". The LEIC framework provided 11 topics under which information was synthesized from the literature. The fields were categorised under sections: 1) Proposed investment; 2) Rationale for investing; 3) Issues to consider when moving from control to eradication; 4) Management and governance. Scanty quantitative data are available for developing a LEIC, particularly regarding disease burden, and new interventions that could contribute to elimination are not yet applied routinely. For monitoring global elimination, it is necessary to measure disease burden comprehensively, and contact centered preventive interventions should be part of a global elimination strategy. The biological and technical feasibility of elimination is not certain and advanced microbiological and operational research is necessary to understand transmission better. The current WHO road map for leprosy elimination is too vague and needs further structuring through a thoroughly prepared LEIC.

  5. Malouf Syndrome with Hypergonadotropic Hypogonadism and Cardiomyopathy: Two-Case Report and Literature Review

    PubMed Central

    Şilfeler, Dilek Benk; Karateke, Atilla; Keskin Kurt, Raziye; Aldemir, Özgür; Buğra Nacar, Alper; Baloğlu, Ali

    2014-01-01

    Malouf syndrome is a very rarely encountered syndrome which was first diagnosed in 1985 upon the examination of two sisters, with findings of hypergonadotropic hypogonadism, dilated cardiomyopathy, blepharoptosis, and broad nasal base. Later on, Narahara diagnosed another sporadic case with the same findings. A survey of relevant literature leads us to three women cases in total. Here we present two cases of Malouf syndrome and literature review. PMID:25544917

  6. [Infant botulism: case report and review].

    PubMed

    Arriagada S, Daniela; Wilhelm B, Jan; Donoso F, Alejandro

    2009-04-01

    Botulism is a rare disease in Chile and of the known clinical presentation, infant botulism is the most common. We report the case of a previously healthy seven month old male infant with a two weeks history of rinorrea, cough, fatigue, constipation and progressive weakness after the consumption of honey. Stool cultures were positive for Clostridium botulinum group 1 type A and electromyography was compatible with the diagnosis. The patient evolved with arterial hypertension, interpreted as secondary to autonomic dysfunction, which responded to calcium channel blockers. Muscle tone improved progressively during the following four weeks. Infant botulism is a potentially fatal disease; diagnosis can be difficult given the broad clinical manifestations. Prevention should focus on education of parents of infants as well as medical personnel.

  7. Treacher Collins syndrome: a case review.

    PubMed

    Jensen-Steed, Ginger

    2011-12-01

    Treacher Collins syndrome is named after the English surgeon Edward Treacher Collins, who initially described the syndrome's traits in 1900. This rare autosomal dominant disorder affects approximately 1:50 000 live births. It primarily affects the development of facial structures through a mutation in the TCOF1 gene found at the 5q32-33.1 loci. While common facies and phenotype can be described with this syndrome, the gene has a wide variation of expressivity, thus making the diagnosis of mild cases challenging. This study involves a term female diagnosed with Treacher Collins syndrome, who was also diagnosed with Tracheal Esophageal Fistula. She is expected to be of normal intelligence but, as is typical for Treacher Collins syndrome, has conductive hearing loss and therefore is at risk for developmental delay. This article describes her hospital course and outcomes thus far and is intended to guide the bedside practitioner in recognition and guidance of families in the future.

  8. 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

  9. Botfly myiasis: case report and brief review.

    PubMed

    Sampson, C E; MaGuire, J; Eriksson, E

    2001-02-01

    The painful, boil-like lesion of furuncular myiasis is a result of the invasion of subcutaneous tissues by larvae of Dermatobia hominis, the human botfly. This arthropod is indigenous to Mexico, and Central and South America, and imported cases to the United States are increasing as travel to these regions continues to rise. There are several dozen reports of furuncular myiasis in the United States and Canadian literature since the initial description of this disease in 1920. None of the reports are in the surgical literature, which is surprising because the treatment of choice is surgical excision. Surgical removal sometimes results in damage to the larva with retention of larval fragments in the wound. The authors describe a patient and a novel approach that ensures removal of the intact larva and its surrounding burrow.

  10. [Protein contact dermatitis: review of 27 cases].

    PubMed

    Hernández-Bel, P; de la Cuadra, J; García, R; Alegre, V

    2011-06-01

    Protein contact dermatitis (PCD) is a rare and underdiagnosed condition that many dermatologists fail to recognize. Nevertheless, increasing awareness of the condition and the substances responsible has led to a rise in the number of published cases in recent years. To determine the clinical characteristics and allergens implicated in PCD in our setting. A retrospective observational study of all patients diagnosed with PCD in the last 10 years was undertaken in the Skin Allergies Unit of the Department of Dermatology at Hospital General Universitario in Valencia, Spain. All patients were assessed by skin-prick test with the standard GEIDAC allergen panel and by prick-by-prick test with foods or other products that were linked to immediate skin symptoms following handling. Twenty-seven patients (8 men and 19 women) were diagnosed with PCD, and 26 of the cases were occupational in origin. The mean age of the patients was 32.3 years and 51.8% had a history of atopy. The latency period varied from 2 months to 27 years. The most commonly affected areas were the backs of the hands and the forearms. Four patients had an oral allergy syndrome. In order of frequency, the substances responsible for PCD were fish (9 patients, 33.3%), latex (8 patients, 29.6%), potato (4 patients, 14.8%), chicken (3 patients, 11.1%), flour (3 patients, 11.1%), alpha amylase (2 patients, 7.4%), aubergine (2 patients, 7.4%), pork (1 patient, 3.7%), garlic (1 patient, 3.7%), and Anisakis (1 patient, 3.7%). PCD is a clinically relevant condition that dermatologists should include in the differential diagnosis of chronic dermatitis affecting the hands or forearms in patients at high occupational risk, particular those in the food preparation industry. 2010 Elsevier España, S.L. y AEDV. All rights reserved.

  11. Rhabdomyolysis case based on hypothyroidism

    PubMed Central

    Katipoglu, Bilal; Acehan, Fatih; Meteris, Ayşenur; Yılmaz, Nisbet

    2016-01-01

    Summary Hypothyroidism is a wide clinical spectrum disorder and only a few cases in literature show this. Rhabdomyolysis and acute renal impairment can be seen concurrently in a hypothyroid state. We report a case of severe hypothyroidism with poor drug compliance leading to rhabdomyolysis and acute kidney injury. Learning points: Hypothyroidism is a rare cause of acute kidney injury. In this case report, we studied a rare occurrence of acute renal impairment due to hypothyroidism with poor drug compliance, which induced rhabdomyolysis. Our report emphasized that thyroid status should be evaluated in patients with unexplained acute renal impairment or presenting with the symptoms of muscle involvement. PMID:27855234

  12. Abetalipoproteinemia: two case reports and literature review.

    PubMed

    Zamel, Rola; Khan, Razi; Pollex, Rebecca L; Hegele, Robert A

    2008-07-08

    Abetalipoproteinemia (ABL, OMIM 200100) is a rare, autosomal recessive disorder, characterized by fat malabsorption, acanthocytosis and hypocholesterolemia in infancy. Later in life, deficiency of fat-soluble vitamins is associated with development of atypical retinitis pigmentosa, coagulopathy, posterior column neuropathy and myopathy. ABL results from mutations in the gene encoding the large subunit of microsomal triglyceride transfer protein (MTP; OMIM 157147). To date at least 33 MTP mutations have been identified in 43 ABL patients. We describe the clinical progress of two patients, both currently in the fifth decade of life, who were diagnosed with ABL as children and were treated with high oral doses of fat soluble vitamins, including vitamin E over the last three decades. Treatment appears to have been associated with arrest of the neuropathy and other complications in both patients. Because pharmacologic inhibition of MTP is being developed as a novel approach to reduce plasma cholesterol for prevention of cardiovascular disease, defining the long-term clinical features of patients with a natural deficiency in MTP might provide some insight into the possible effects of such treatments. We review the range of clinical, biochemical and molecular perturbations in ABL.

  13. Congenital psoriasis: case report and literature review.

    PubMed

    Lehman, Julia S; Rahil, Anudeep K

    2008-01-01

    While childhood psoriasis is fairly common, congenital psoriasis appears to be rare and has not been well characterized. We present a patient with histologically confirmed congenital psoriasis. By reviewing the literature, we aim to both define this disease and compare it to infantile and childhood psoriasis. Electronic searches found articles reporting patients with biopsy-proven congenital psoriasis. We recorded clinical features, such as family history, anatomic involvement, and disease severity. We compared these data with previous descriptions of infantile and childhood psoriasis. We included nine patients with congenital psoriasis in our analysis. No patient had a first-degree family history of psoriasis. While the face, scalp, chest, and trunk were frequently involved, the buttocks generally were spared. Several patients had persistent disease despite therapy. In this series, congenital psoriasis differed from infantile and childhood psoriasis in several respects. Specifically, congenital psoriasis was associated with a lower prevalence of relevant family history, which could increase over time, and a different pattern of anatomic involvement, which may reflect exposure to age-associated environmental factors. Although several patients with congenital psoriasis had severe disease, this likely represents publication bias. Additional reports of congenital psoriasis with extended follow-up are needed to better characterize this condition.

  14. Perianal Paget's disease: presentation of six cases and literature review.

    PubMed

    Minicozzi, Annamaria; Borzellino, Giuseppe; Momo, Rostand; Steccanella, Francesca; Pitoni, Federica; de Manzoni, Giovanni

    2010-01-01

    Extramammary Paget's disease (EMPD) is frequently associated with adnexal or visceral synchronous or metachronous malignancies. Our purpose was to evaluate, retrospectively, the results obtained in six cases of EMPD and to review the literature. Six patients with the perianal Paget's disease had been treated in our division between March 1996 and December 2006. In three cases, the disease was confined in the epidermis; in one case, there was a microinvasion of the dermis, while in another one the dermis was infiltrated. The last case was associated to a low rectal adenocarcinoma. All patients underwent wide perianal excision and reconstruction with skin graft. We performed a transanal resection of the rectal adenocarcinoma. A review of the literature from 1990 to 2008 revealed 193 cases of perianal EMPD, 112 were intraepithelial/intradermal while 81 were associated with malignancies. Anorectal adenocarcinoma was already existing in two cases, synchronous in 48, and subsequent to diagnosis in 11. In three cases, the disease recurred locally, but no patient developed metastatic spread. Five patients survived and are free of disease. The review of the literature allows a clear identification of the primitive EMPD and the form associated to anorectal adenocarcinoma and little information about cases associated with synchronous adnexal adenocarcinoma. The Paget's disease can relapse after radical surgery and has a capacity of metastatic spread. Up to now, no clear guidelines have been established for the diagnosis of EMPD. The association with synchronous or metachronous carcinomas imposes a long-term follow-up with frequent clinical, radiological, and endoscopical controls.

  15. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study.

    PubMed

    Rengit, Ashy C; McKowen, James W; O'Brien, Julie; Howe, Yamini J; McDougle, Christopher J

    2016-07-01

    There is limited literature available on the comorbidity between autism spectrum disorder (ASD) and substance use disorder (SUD). This paper reviews existing literature and exemplifies the challenges of treating this population with a case report of an adult male with ASD and DSM-5 alcohol use disorder. This review and case study seeks to illustrate risk factors which predispose individuals with ASD to developing SUD and discuss the obstacles to and modifications of evidence-based treatments for SUD. A review of the therapeutic interventions implemented in the treatment of this young male are described to highlight potential recommendations for the general management of SUD in those with ASD.

  16. Case definitions for chronic rhinosinusitis in administrative data: A systematic review.

    PubMed

    Lui, Justin T; Rudmik, Luke

    2015-01-01

    The use of administrative data for pharmacoepidemiologic research on chronic rhinosinusitis (CRS) has become increasingly popular. Although large sample sizes and ease of accessibility have made electronic health data an attractive data option, the risk of inaccurate cohort identification can lead to biased outcomes. The objectives of this systematic review were to (1) report current case definitions for CRS used in administrative data base research, and (2) define the various administrative data bases used for CRS research. Medical literature data bases were searched from the date of their inception to February 1, 2015. Included studies were publications that obtained CRS-specific data from a health records data base. Studies were excluded if they evaluated a non-CRS cohort, failed to use or report an international classification of disease (ICD) code in the case definition, or published in a non-peer-reviewed journal. Of the 27 studies that met inclusion criteria, 8 different CRS case definitions were identified and 13 administrative data bases were evaluated. Of the 8 different CRS case definitions identified, only one was validated. The most commonly used CRS case definition was the ICD-9 473.x code alone. To optimize the accuracy of pharmacoepidemiologic research for CRS that used administrative data, it is important to apply appropriate case definitions for CRS. Various nonvalidated CRS case definitions are currently being used in administrative data base research. There is a need to develop a generalizable and validated ICD-based CRS case definition to increase the accuracy of future pharmacoepidemiologic research.

  17. Clinical review: Reunification of acid–base physiology

    PubMed Central

    Kellum, John A

    2005-01-01

    Recent advances in acid–base physiology and in the epidemiology of acid–base disorders have refined our understanding of the basic control mechanisms that determine blood pH in health and disease. These refinements have also brought parity between the newer, quantitative and older, descriptive approaches to acid–base physiology. This review explores how the new and older approaches to acid–base physiology can be reconciled and combined to result in a powerful bedside tool. A case based tutorial is also provided. PMID:16277739

  18. [Lazy bladder syndrome: review of 126 cases].

    PubMed

    Falcou, L; Mauruc, E; Guinet-Lacoste, A; Jousse, M; Le Breton, F; Vérollet, D; Amarenco, G

    2014-09-01

    The lazy bladder syndrome (LBS) is characterized by an infrequent voiding, a large bladder capacity without neurological or urological disorders. In spite of being relatively common, there is little literature about it. The aim of our study was to compare the clinical features and urodynamic findings in asymptomatic or symptomatic patients with lazy bladder syndrome. We reviewed the charts of 126 adult patients diagnosed with lazy bladder syndrome. Clinical and radiological features, urodynamic findings and therapeutic management were evaluated. With these data, we divided patients into 2 groups: asymptomatic and symptomatic patients. After, we performed a comparative analysis of the data. The incident of LBS was significantly higher in women (81%). Twenty-one patients were asymptomatic (17%), 105 patients were symptomatic (83%). The patients with symptomatic LBS were significantly older (54.3 years ± 14.7). Voiding dysfunction (53%) and urinary retention (27%) were the most common symptoms in symptomatic group. In the uroflowmetry test, maximum and mean uroflow were significantly higher in asymptomatic group (P=0.0074). Reduced bladder sensation revealed no difference in the 2 groups, but in the symptomatic group, detrusor has also a poor contractility (P=0.0001). Nineteen patients (18%) had uro-nephrological complications. LBS is certainly underestimated. Voiding dysfunction, urinary retention in infrequent voiders or uro-nephrological complication (urinary tract infection with fever, ureteral reflux…) should recall LBS diagnosis. The hypothesis of bladder structural failure or autonomic nervous system dysfunction may be discussed (suggested). 5. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Shwachman's syndrome. A review of 21 cases.

    PubMed Central

    Aggett, P J; Cavanagh, N P; Matthew, D J; Pincott, J R; Sutcliffe, J; Harries, J T

    1980-01-01

    21 patients (10 male, 11 female) aged between 11 months and 29 years with Shwachman's syndrome are reviewed. All patients had exocrine pancreatic insufficiency. Haematological features included neutropenia in 19 (95%), anaemia in 10 (50%), and thrombocytopenia in 14 (70%); one patient developed erythroleukaemia. Severe infections occurred in 17 (85%) from which 3 (15%) died. Only one child exceeded the 3rd centile for height, and growth retardation was particularly evident in the older patients. All had skeletal abnormalities or delayed skeletal maturation, or both. Metaphyseal dyschondroplasia affected 13 of the older patients and was associated with skeletal deformities. Eight of 9 children under 2 1/2 years had rib abnormalities. Respiratory function tests in children under 2 years demonstrated reduced thoracic gas volume and chest wall compliance. Older patients had reduced forced expiratory volume and forced vital capacity. Neurological assessment showed developmental retardation or reduced IQ assessments, or both, in 85% of patients studied. Other neurological abnormalities included hypotonia, deafness, and retinitis pigmentosa. Neonatal problems had been present in 16 (80%) of the patients and 5 were of low birthweights. Hepatomegaly with biochemical evidence of liver involvement occurred in the younger patients and resolved with age. Other associated features included dental abnormalities, renal dysfunction, an icthyotic maculopapular rash in 13 (65%), delayed puberty, diabetes mellitus, and various dysmorphic features. These findings stress the diverse manifestations of the syndrome and extend knowledge on a number of aspects. Sibship segregation ratios support an autosomal mode of inheritance and an hypothesis for the pathophysiological basis of this syndrome is advanced. Images Fig. 2 Fig. 4(a) Fig. 4(b) Fig. 5 PMID:7436469

  20. Applying Quality Indicators to Single-Case Research Designs Used in Special Education: A Systematic Review

    ERIC Educational Resources Information Center

    Moeller, Jeremy D.; Dattilo, John; Rusch, Frank

    2015-01-01

    This study examined how specific guidelines and heuristics have been used to identify methodological rigor associated with single-case research designs based on quality indicators developed by Horner et al. Specifically, this article describes how literature reviews have applied Horner et al.'s quality indicators and evidence-based criteria.…

  1. Applying Quality Indicators to Single-Case Research Designs Used in Special Education: A Systematic Review

    ERIC Educational Resources Information Center

    Moeller, Jeremy D.; Dattilo, John; Rusch, Frank

    2015-01-01

    This study examined how specific guidelines and heuristics have been used to identify methodological rigor associated with single-case research designs based on quality indicators developed by Horner et al. Specifically, this article describes how literature reviews have applied Horner et al.'s quality indicators and evidence-based criteria.…

  2. [Primary intramedullary melanoma: Case report and literature review].

    PubMed

    Narváez-Martínez, Yislenz; de la Ossa, Napoleón; López-Martos, Raquel; Cohn-Reinoso, Carlos; Castellví-Juan, Marina; Martin-Ferrer, Secundino

    A dark pigmented intramedullary mass is very rarely encountered in daily practice, and poses a diagnostic challenge. Several entities have to be considered, including melanin-containing tumours (melanotic ependymoma and melanotic schwannoma) and melanocyte-containing tumours (melanocytoma, primary melanoma and melanoma metastases). The case is presented of a 47 year-old male with a pigmented intramedullary tumour located at T7-T8 level. Magnetic resonance images (MRI) revealed a tumour with hyperintensity on T1 and hypointensity on T2. The tumour was resected partially and treated with adjuvant radiotherapy. The diagnosis of primary intramedullary melanoma (PIM) was established based on histology and the absence of other lesions outside of the CNS. A literature review is presented on the other 26 PIM cases reported. PIM are extremely rare tumours, but are the most frequent cause of pigmented intramedullary tumour. Complete surgical resection is the treatment of choice whenever possible, followed by radiotherapy. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. 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.

  4. Exercise-Induced Vasculitis: A Review with Illustrated Cases.

    PubMed

    Espitia, Olivier; Dréno, Brigitte; Cassagnau, Elisabeth; Didier, Quentin; Quillard, Thibaut; Nicol, Christelle; Le Bouch, Yann; Planchon, Bernard; Pistorius, Marc-Antoine

    2016-12-01

    Although exercise-induced vasculitis (EIV) is usually misdiagnosed, it is not uncommon. Occurring mostly after prolonged exercise, especially in hot weather, EIV is an isolated cutaneous vasculitis with stereotypical presentation. This article reviews the clinical characteristics, treatments, and outcomes of EIV based on the published literature. We report 99 patients who developed EIV after walking, dancing, swimming, or hiking especially during hot weather, including the records of 16 patients with EIV treated at our hospital from 2007 to 2015. Erythematous or purpuric plaques arise on the lower legs, without the involvement of compression socks or stockings. Symptoms include itch, pain, and a burning sensation. EIV is an isolated cutaneous vasculitis. Lesions resolve spontaneously after 10 days. When triggering conditions persist, relapses are frequent (77.5 %). Histopathology demonstrates leukocytoclastic vasculitis in 95 % of cases with C3 or immunoglobulin M deposits in 88 and 46 % of cases, respectively. Blood investigations are negative. EIV appears to be a consequence of venous stasis induced by an acute failure of the muscle pump of the calf and thermoregulation decompensation. Both appear after prolonged and unusual exercise in hot weather. Treatment is not codified; topical corticosteroids may reduce symptoms and wearing light clothes might limit lesion occurrence.

  5. Vascular hemichorea: case report and review.

    PubMed

    Martínez Alfonzo, Bárbara; Blanco, Andrés Enrique; Rojano, Jairo; Calleja, José Luis

    2014-04-09

    Chorea rarely complicates ischemic or hemorrhagic cerebral vascular lesions. Clinical symptoms usually involve one side of the body while the injury is situated on the contralateral cerebral hemisphere. Spontaneous remission is the norm, but sometimes symptomatic treatment is required. A 58-year-old male patient who suffers from untreated high blood pressure, type II obesity, smokes 6 packs of cigarettes per year and has a moderate intake of alcohol is presented. The patient’'s recent history began three days before he appeared at the Emergency Department. His symptoms were ceaseless, involuntary movements in his left arm and foot during day and night with no restriction of voluntary movements. Physical examination and laboratory tests revealed no other findings. Magnetic resonance imaging of the brain showed hyperintensity in the right posterolateral thalamic region consistent with ischemic cerebrovascular disease. Symptomatic therapy was indicated and his underlying conditions were addressed. The importance of this case lies on the low prevalence as well as the scarcity of publications regarding vascular causes of hemichorea, including diagnosis, therapy and prognosis.

  6. Duodenal Somatostatinoma: A Case Report and Review

    PubMed Central

    Kim, Jung A; Choi, Won-Ho; Kim, Chul Nam; Moon, Young Soo; Chang, Sun Hee

    2011-01-01

    Somatostatinomas are rare functioning carcinoid tumors that usually arise in the pancreas and duodenum. They are seldom associated with typical clinical symptoms; their diagnosis is confirmed only by histological and immunohistochemical studies and the presence of specific hormones. Two distinct clinicopathological forms of somatostatinoma exist: duodenal and pancreatic somatostatinomas. Clinically, compared to pancreatic somatostatinomas, duodenal somatostatinomas are more often associated with nonspecific symptoms and neurofibromatosis, but less often with somatostatinoma syndrome or metastasis. Histologically, duodenal somatostatinomas frequently have psammoma bodies in the tumor cells. We report a case of duodenal somatostatinoma in 58-year-old man with vague epigastric pain and nausea. He did not have diabetes, steatorrhea, or cholelithiasis. Abdominal computed tomography showed a 25-mm mass in the duodenum and 25-mm nodule in the liver. Endoscopic retrograde cholangiopancreatography showed a duodenal submucosal tumor. Although the endoscopic biopsies were free of malignancy, the patient subsequently underwent Whipple's operation for the duodenal mass. Examination revealed as a somatostatinoma using a special stain for somatostatin. PMID:21437171

  7. Emphysematous osteomyelitis: a case report and review of the literature.

    PubMed

    Luey, Christopher; Tooley, Debbie; Briggs, Simon

    2012-03-01

    We report the case of a 15-year-old girl with pelvic and sacral emphysematous osteomyelitis caused by Fusobacterium necrophorum. This infection was cured following four surgical procedures and 4 weeks of intravenous then 4 weeks of oral antibiotics. We review our case alongside the 24 previously reported cases of emphysematous osteomyelitis in the literature. The 25 cases include 15 monomicrobial and 10 polymicrobial infections. The causative organism(s) in all but three cases included an anaerobe or a member of the Enterobacteriaceae family. A significant underlying comorbidity was reported in 18 cases. At least 15 cases required one or more surgical procedures. There was a significant associated mortality with eight (32%) patients dying in hospital at 7 to 56 days after the diagnosis of emphysematous osteomyelitis.

  8. Cloacal Prolapse in Raptors: Review of 16 Cases.

    PubMed

    Dutton, Thomas A G; Forbes, Neil A; Carrasco, Daniel Calvo

    2016-06-01

    Sixteen cases of cloacal prolapse in raptors were reviewed in this study. Colonic prolapse was the most common presentation (56% of cases). Red-tailed hawks ( Buteo jamaicensis ) were overrepresented, comprising 66% of colonic prolapse cases. In cases of colonic prolapse, postsurgical stricture formation was a commonly identified complication after resection and anastomosis of the colon. A novel technique was used in 2 cases of colonic prolapse, in which sterile, semirigid rubber tubing was placed in the distal colon and removed per-cloaca at the end of the procedure; this facilitated a secure, fluid-tight anastomosis while maintaining sufficient intestinal lumen. Oviductal prolapse (31% of cases) was associated with the most guarded prognosis (40% treatment success). Cloacoliths were treated successfully in 2 birds (13% of cases) by minimally invasive per-cloacal manual removal.

  9. Clinical considerations for the surgical treatment of pectoralis major muscle ruptures based on 60 cases: a prospective study and literature review.

    PubMed

    de Castro Pochini, Alberto; Andreoli, Carlos Vicente; Belangero, Paulo Santoro; Figueiredo, Eduardo Antonio; Terra, Bernardo Barcellos; Cohen, Carina; Andrade, Marilia dos Santos; Cohen, Moises; Ejnisman, Benno

    2014-01-01

    Early recognition of the clinical signs of ruptures of the pectoralis major muscle (PMM) in athletes by orthopaedic surgeons, physical therapists, and physical trainers may prove to be critical for patient access to surgical treatment while the injury is still in the acute phase. Total ruptures of the PMM may yield a better outcome with surgical treatment than with nonoperative treatment in athletes. Cohort study; Level of evidence, 2. A prospective study was performed on 60 patients with total ruptures of the PMM. The patients were followed from 1997 to 2012, with a physical examination every 6 months for the first 2 years and every 12 months thereafter. The patients' mean age was 31.21 years, and the mean length of follow-up was 48.25 months. The surgical treatment methods included reinsertion of the tendon in 51% of the patients and nonoperative treatment in 49% of the patients. All of the patients were evaluated using the Bak criteria. The bench-press exercise was associated with 80% of the PMM ruptures (48 patients). Forty-one of the patients with chronic ruptures were seen after 3 months (80%). The outcomes were poor in 9 patients from the nonoperative group (31%) and in 3 patients from the surgical group (9.7%); the outcomes were fair in 12 patients from the nonoperative group and in no patients from the surgical group. Excellent results were not observed in any patient from the nonoperative group and were observed in 21 patients from the surgical group (67.7%). The isokinetic evaluation at 60 deg/s showed a decrease in strength of 41.7% in the nonsurgical group and 14.3% for the surgical group, which was significant at P < .05. Total ruptures of the PMM exhibit better outcomes with surgical treatment than with nonoperative treatment based on the Bak criteria in athletes.

  10. The history of the case report: a selective review

    PubMed Central

    Nissen, Trygve

    2014-01-01

    The clinical case report is a popular genre in medical writing. While authors and editors have debated the justification for the clinical case report, few have attempted to examine the long history of this genre in medical literature. By reviewing selected literature and presenting and discussing excerpts of clinical case reports from Egyptian antiquity to the 20th century, we illustrate the presence of the genre in medical science and how its form developed. Central features of the clinical case report in different time periods are discussed, including its main components, structure, style and author presence. PMID:25057387

  11. Tuberculous parotitis: a review of seven cases.

    PubMed

    Oktay, Mehmet Faruk; Aşkar, Ibrahim; Yildirim, Müzeyyen; Topçu, Ismail; Meriç, Faruk

    2007-01-01

    Tuberculous parotitis is rare even in countries where tuberculosis is widespread. We evaluated seven patients with tuberculous parotitis together with clinical and histopathologic findings, and management. In a period of 13 years, seven patients (5 males, 2 females; mean age 32 years; range 23 to 47 years) were diagnosed and treated for tuberculous parotitis. All the patients had a clinical suspicion of a parotid gland tumor. The lesions were localized on the left in four patients, and on the right in three patients. The duration of disease varied from seven months to three years. The masses were localized, mobile, and measured 3 to 6 cm in diameter; one was fistulized. There was no evidence for active pulmonary tuberculosis. Chest radiograms showed old tuberculous lesions in two patients. The PPD skin test results were positive (>12 mm induration) in five patients (71%). Computed tomography or magnetic resonance imaging obtained in five patients showed mass formation suggesting a benign parotid gland tumor. Fine-needle aspiration cytology performed in three patients and cultivation performed in the fistulized case were all non-diagnostic. Superficial parotidectomy was performed in six patients and enucleation was performed in one patient. Histopathologic examination showed tubercles composed of macrophages, epithelioid cells and Langhans giant cells, and central caseous necrosis. Following diagnosis, all patients were treated with a four-drug chemotherapy regimen. There was no evidence for recurrence within a mean of 15-month follow-up. Tuberculosis of the parotid gland should be considered in the differential diagnosis of patients presenting with a solitary tumor in the parotid gland.

  12. Evaluation of a case-based urology learning program.

    PubMed

    Mishra, Kirtishri; Snow-Lisy, Devon C; Ross, Jonathan; Goldfarb, David A; Goldman, Howard; Campbell, Steven C

    2013-12-01

    To address the challenges that today's trainees encounter, such as information overload and reduced immersion in the field, and recognizing their preference for novel educational resources, an electronic case-based urology learning program was developed. Each case was designed to illustrate the basic principles of the disease process and the fundamentals of evaluation and management using the Socratic method, recapitulating a prototypical patient encounter. A 21-question survey was developed after review of published reports of classroom and clinical learning environment surveys. The target group was 2 pilot urology training programs (the Cleveland Clinic and University Hospitals-Case Medical Center). The responses were entirely anonymous. A total of 32 trainees participated (8 fellows and 24 residents), representing a 53% response rate. Most trainees (79%) were able to process cases within an average of ≤ 10 minutes. Of the trainees, 91% reported referring back to particular cases for patient care, to review for examinations, or for studying. Most trainees believed a case-based urology learning program would be a potentially important resource for clinical practice (69%) and for preparing for the in-service (63%) or board (69%) examinations. Most trainees believed the program met its goals of illustrating the basics principles of the disease process (88%), outlining the fundamentals of evaluation and management (94%), and improving the trainees' knowledge base (91%). An electronic case-based urology learning program is feasible and useful and stimulates learning at all trainee levels. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Detection of medical examiner cases from review of cremation requests.

    PubMed

    Nelson, Craig L; Winston, David C

    2006-06-01

    Title 9, Chapter 19, Article 3 of the Arizona Administrative Code requires all bodies that are to be cremated must have the death certificate reviewed by a county medical examiner. In Tucson, AZ, and surrounding Pima County, all cremation requests are submitted to the Forensic Science Center, where the death certificates are reviewed by one of 5 board-certified forensic pathologists. In 2002, there were 5557 cremation requests, and in 2003 there were 5662 cremation requests. Of these requests, 670 (12.1%) and 447 (7.9%) death certificates were flagged for further investigation in 2002 and 2003, respectively. Eventually, 47 cases (0.8% of total, 7.0% of flagged cases) were accepted as medical examiner cases in 2002, and 43 cases (0.8% of total, 9.6% of flagged cases) were accepted as medical examiner cases in 2003. In 2002, the majority of cases were handled as a records review; however, 4 cases were brought in for autopsy and 1 was certified after an external examination only. In 2003, all cases were certified via a records review. The manner of death in all but 3 of these deaths was certified as accident, with complications of remote trauma being the most common proximate cause of death. The 3 most common injuries were complications of fractured pelvis or femur (15 in 2002, 22 in 2003), head injury due to fall (18 in 2002, 8 in 2003), and complications of remote motor vehicle accident (3 in 2002, 6 in 2003). The other 3 deaths included 2 homicides, 1 in each year, and 1 suicide in 2003.

  14. Elastofibroma dorsi: review of 4 cases.

    PubMed

    Cavallasca, Javier A; Sohn, Debora I; Borgia, Ariel R; Maliandi, María Del Rosario; Musuruana, Jorge L

    2012-01-01

    Elastofibroma dorsi is a benign, uncommon fibroelastic tissue condition, more common in women after the fifth decade of life. It is usually located in the subscapular region, and can sometimes be bilateral. We present 4 patients, between 53 and 73 years of age, with this disease. It is often an asymptomatic lesion that can manifest, even at its apex, with mild pain when moving the scapula. All our patients had pain.The diagnosis is based on clinical findings and imaging studies, especially ultrasound, computed tomography, and nuclear magnetic resonance. The biopsy is reserved for patients who have no characteristic signs on imaging. In our series, surgical excision was necessary in one of the patients, and in the others, clinical and imaging studies allowed us to arrive at a definitive diagnosis.

  15. Paediatric lymphoedema: A retrospective chart review of 86 cases.

    PubMed

    Watt, Hilary; Singh-Grewal, Davinder; Wargon, Orli; Adams, Susan

    2017-01-01

    To define the clinical characteristics, investigations, management and outcomes of lymphoedema in a paediatric cohort. A retrospective chart review of children with lymphoedema seen at two tertiary paediatric hospitals since 1998. Telephone interviews with parents were performed when information was missing. Information recorded included demographic data, features of diagnosis and clinical presentation, symptoms, complications and treatment. A total of 86 patients with lymphoedema were identified. Eighty cases (93%) were primary and six cases (7%) were secondary. Most were female (60%). Location of swelling was most commonly the lower limbs (94%). There were 13 cases (15%) of genital involvement. Swelling presented in the first 12 months of life in 60% of primary lymphoedema patients. Complications of lymphoedema occurred in 73% of patients. Lymphoscintigraphy was the most common investigation used (65%), followed by ultrasound (57%) and magnetic resonance imaging (MRI) (35%). Eight of the 48 (17%) lymphoscintigraphs produced a false negative result or were inconclusive with a correct diagnosis subsequently made clinically and using MRI. Average time to diagnosis was 9 months. Lymphoedema was managed with compression garments (99%), manual lymph drainage (97%) and multilayered bandaging (68%). Eight patients had an operative procedure as a part of management. Primary lymphoedema is more common than secondary lymphoedema in children. Onset tends to be during infancy for both males and females, and the lower limb is typically involved. Causes of secondary lymphoedema are diverse and rare. Diagnosis in children is often delayed but is possible based on history and physical examination alone and when further investigation is necessary MRI is effective. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  16. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    PubMed Central

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  17. Effectiveness of case management for homeless persons: a systematic review.

    PubMed

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness.

  18. Meningitis caused by Abiotrophia defectiva: case report and literature review.

    PubMed

    Tena, D; Solís, S; Lainez, S; Torralba, M; Chacón, P; Valdezate, S; Sáez-Nieto, J A; Bisquert, J

    2013-04-01

    The genus Abiotrophia comprises fastidious Gram-positive bacteria previously classified as nutritionally variant streptococci (NVS). The isolation of NVS from the central nervous system (CNS) is very rare. We describe a case of meningitis due to Abiotrophia defectiva in a patient who underwent a total hip arthroplasty 4 days previously. It is possible that the organism could be introduced through the spinal anesthesia. We also review all cases of CNS infections caused by NVS.

  19. Intramural ectopic pregnancy: a case and review of the literature.

    PubMed

    Kirk, Emma; McDonald, Katie; Rees, Julia; Govind, Abha

    2013-06-01

    An intramural ectopic is a rare type of ectopic pregnancy in which the gestational sac is implanted within the myometrium, separate from the endometrial cavity and Fallopian tubes. There are only 53 cases in the published literature. We report a case of intramural ectopic pregnancy treated surgically and review the published data on this rare type of ectopic pregnancy, with respect to aetiology, diagnosis and management. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. [Lethal achondrogenesis: a review of 56 cases (author's transl)].

    PubMed

    Schulte, M J; Lenz, W; Vogel, M

    1978-07-01

    54 cases with lethal achondrogenesis from the literature as well as two own cases are reviewed and analyzed with regard to the following characteristics: sex, hydramnios, breech presentation, duration of pregnancy, length and weight at birth, head circumference, length of upper and lower extremities, clinical and radiological data, age of mother and father at time of birth, familial occurrence and consanguinity of parents, histological, histochemical and electronmicroscopic tissue examination.

  1. Unilateral Maxillary Canine Agenesis: A Case Report and Literature Review

    PubMed Central

    Koç, Nagihan; Çağırankaya, L. Berna; Akkaya, Nursel

    2014-01-01

    Congenital absence of maxillary permanent canines is an extremely rare condition, which may appear as part of a syndrome or as a nonsyndromic form. Nonsyndromic canine agenesis combined with other types of tooth agenesis has occasionally been described in the literature but isolated cases are rarely observed. This report presents an isolated case of maxillary permanent canine agenesis in a healthy 18-year-old female patient and a literature review on the prevalence, etiology, and differential diagnosis of the condition. PMID:25177502

  2. A case report of recurrent anencephaly and literature review.

    PubMed

    Koukoura, O; Sifakis, S; Stratoudakis, G; Mantas, N; Kaminopetros, P; Koumantakis, E

    2006-01-01

    Anencephaly is a rare congenital anomaly in which the forebrain, meninges, vault of the skull, and scalp all fail to form. We report a case of a 32-year-old gravida 2 woman with an anencephalic fetus detected at the 21st gestational week. She had a history of an intrauterine fetal death of an anencephalic fetus at the 20th gestational week two years before. We present the case and briefly review the literature.

  3. Benign mesothelial mesenteric cyst: case report and literature review.

    PubMed

    Prudnick, Colton; Turnbull, Jacob; Jarosz, Susan; Hofeldt, Matthew; Richmond, Bryan

    2015-01-01

    A rare case of a benign mesothelial cyst arising from the mesentery of the descending colon is presented. A 73 year old female presented with an asymptomatic mesenteric cyst on CT scan. Colonoscopy revealed extrinsic compression of the descending colon. Surgical resection of the cyst necessitated partial colon resection due to the adherent nature of the cyst to the colon and its mesentery. The details of the case are presented as well as a brief review of the relevant literature.

  4. Hunting for tularaemia - a review of cases in North Carolina.

    PubMed

    Rimawi, R H; Shah, K B; Chowdhary, R A; Cook, P P

    2015-05-01

    Human infections with Francisella tularensis can be acquired via numerous routes, including ingestion, inhalation, arthropod bite or direct contact with infected animals. Since 1991, there have been 25 reported cases of tularaemia in North Carolina, most of which were associated with rabbit hunting or cat bites. We present two adults cases of pulmonary and oropharyngeal tularaemia and review the reported cases since 1991-2013. We also present the fifth case of pulmonary empyema. While cavitary pneumonias are primarily treated with drainage, we illustrate a case of cavitary pneumonia associated with tularaemia successfully treated with oral ciprofloxacin after drainage. Tularaemia should be considered in patients with a perplexing radiographic image, animal exposure and lack of response to conventional empiric broad-spectrum antibiotics. Even in serious cases of pneumonic tularaemia, fluoroquinolones may provide a suitable alternative to aminoglycosides. © 2014 Blackwell Verlag GmbH.

  5. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    PubMed

    Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  6. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series

    PubMed Central

    Patil, Shankargouda; Sarode, Gargi S.; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Background Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. Method A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of ‘Oral submucous fibrosis’, ‘prosthesis’, ‘dentures’ and/or ‘restricted mouth opening’. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. Results A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Conclusion Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results. PMID:28877246

  7. Internet-based Science Learning: A review of journal publications

    NASA Astrophysics Data System (ADS)

    Wen-Yu Lee, Silvia; Tsai, Chin-Chung; Wu, Ying-Tien; Tsai, Meng-Jung; Liu, Tzu-Chien; Hwang, Fu-Kwun; Lai, Chih-Hung; Liang, Jyh-Chong; Wu, Huang-Ching; Chang, Chun-Yen

    2011-09-01

    Internet-based science learning has been advocated by many science educators for more than a decade. This review examines relevant research on this topic. Sixty-five papers are included in the review. The review consists of the following two major categories: (1) the role of demographics and learners' characteristics in Internet-based science learning, such as demographic background, prior knowledge, and self-efficacy; and (2) the learning outcomes derived from Internet-based science learning, such as attitude, motivation, conceptual understanding, and conceptual change. Some important conclusions are drawn from the review. For example, Internet-based science learning is equally favorable, or in some cases more so, to learning for female students compared to male students. The learner's control is essential for enhancing students' attitudes and motivation toward learning in Internet-based science learning environments. Nevertheless, appropriate guidance from teachers, moderators, or the Internet-based learning environment itself is still quite crucial in Internet-based science learning. Recommendations for future research related to the effects of Internet-based science learning on students' metacognitive reflections, epistemological development, and worldviews are suggested.

  8. Case-Only Designs in Pharmacoepidemiology: A Systematic Review

    PubMed Central

    Ravaud, Philippe; Esposito-Farèse, Marina; Tubach, Florence

    2012-01-01

    Background Case-only designs have been used since late 1980’s. In these, as opposed to case-control or cohort studies for instance, only cases are required and are self-controlled, eliminating selection biases and confounding related to control subjects, and time-invariant characteristics. The objectives of this systematic review were to analyze how the two main case-only designs – case-crossover (CC) and self-controlled case series (SCCS) – have been applied and reported in pharmacoepidemiology literature, in terms of applicability assumptions and specificities of these designs. Methodology/Principal Findings We systematically selected all reports in this field involving case-only designs from MEDLINE and EMBASE up to September 15, 2010. Data were extracted using a standardized form. The analysis included 93 reports 50 (54%) of CC and 45 (48%) SCCS, 2 reports combined both designs. In 12 (24%) CC and 18 (40%) SCCS articles, all applicable validity assumptions of the designs were fulfilled, respectively. Fifty (54%) articles (15 CC (30%) and 35 (78%) SCCS) adequately addressed the specificities of the case-only analyses in the way they reported results. Conclusions/Significance Our systematic review underlines that implementation of CC and SCCS designs needs to be more rigorous with regard to validity assumptions, as well as improvement in results reporting. PMID:23166668

  9. Neutrophilic Dermatosis of the Hands: A Review of 17 Cases.

    PubMed

    Cheng, Anthony M Y; Cheng, Harriet S; Smith, Belinda J; Stewart, David A

    2017-09-21

    Neutrophilic dermatosis of the hands is an inflammatory skin condition related to Sweet syndrome that responds to corticosteroids. It commonly affects the dorsum of the hand and often mimics infection, with violaceous inflammatory papules and plaques that may ulcerate. The aim of this study was to review the clinical presentation of neutrophilic dermatosis of the hands. A retrospective review was undertaken of all cases of neutrophilic dermatosis of the hands seen at a tertiary hospital in New South Wales, Australia, over a 5-year period. Seventeen cases were identified. The mean time to diagnosis was 9 days after lesion onset. Most cases were older adults (mean age, 71 years). The most common referral diagnoses were infection or a nonhealing wound and 65% of cases reported a history of trauma. The dorsal index finger was the site of involvement in 41% of cases. One case involved the palm. Histopathology reports were available for skin punch biopsy for 14 of 17 cases, which showed dermal neutrophilic infiltrate (93%) and epidermal involvement with necrosis, ulceration, or pustulation (64%). Six cases were treated surgically prior to the correct diagnosis and management being introduced. Neutrophilic dermatosis of the hands was often misdiagnosed as infection. A history of trauma is common and may be misleading. Dermatological consultation and skin punch biopsy are useful in confirming the diagnosis, ideally prior to surgical management. Diagnostic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  10. Hospital case management and the Utilization Review Committee.

    PubMed

    Orland, Richard A

    2011-01-01

    This article describes the overall regulatory mandate governing the Utilization Review Committee (URC) in the hospital setting. General structure, function, and meeting format of the URC are important considerations. Furthermore, the URC can serve as a vital platform for medical staff leadership and case management practice to use pertinent risk-adjusted data to drive needed change at the organizational, departmental, service line, and physician level. A case history illustrates the importance of these issues. Acute care hospitals. Case management staff, medical advisors, and physician leaders play important roles in driving changes. The URC will become ever-more important in the rapidly accelerating changes, driving heightened accountability on the part of hospitals.

  11. Adverse Events of Acupuncture: A Systematic Review of Case Reports

    PubMed Central

    Xu, Shifen; Wang, Lizhen; Cooper, Emily; Zhang, Ming; Manheimer, Eric; Berman, Brian; Shen, Xueyong; Lao, Lixing

    2013-01-01

    Acupuncture, moxibustion, and cupping, important in traditional Eastern medicine, are increasingly used in the West. Their widening acceptance demands continual safety assessment. This review, a sequel to one our team published 10 years ago, is an evaluation of the frequency and severity of adverse events (AEs) reported for acupuncture, moxibustion, and cupping between 2000 and 2011. Relevant English-language reports in six databases were identified and assessed by two reviewers. During this 12-year period, 117 reports of 308 AEs from 25 countries and regions were associated with acupuncture (294 cases), moxibustion (4 cases), or cupping (10 cases). Country of occurrence, patient's sex and age, and outcome were extracted. Infections, mycobacterial, staphylococcal, and others, were the main complication of acupuncture. In the previous review, we found the main source of infection to be hepatitis, caused by reusable needles. In this review, we found the majority of infections to be bacterial, caused by skin contact at acupoint sites; we found no cases of hepatitis. Although the route of infection had changed, infections were still the major complication of acupuncture. Clearly, guidelines such as Clean Needle Technique must be followed in order to minimize acupuncture AEs. PMID:23573135

  12. Oral Myiasis: A Rare Case Report and Literature Review.

    PubMed

    Shikha, Singh; Prasad Guru, R; Ashutoshdutt, Pathak; Meenakshi, Sood

    2015-06-01

    Myiasis is a rare disease caused by infestation of tissue by larvae of flies. Oral myiasis is still "rare" and "unique" owing to the fact that oral cavity rarely provides the necessary habitat for a larval lifecycle. Herein, we present a case of extensive gingival myiasis in a 12-year-old mentally retarded, epileptic child as well as a literature review.

  13. Mucinous eccrine nevus: a case report and literature review.

    PubMed

    Chen, Jia; Sun, Jian-fang; Zeng, Xue-si; Liu, Yi; Jiang, Yi-qun; Li, A-mei; Song, Ya-li

    2009-06-01

    Mucinous eccrine nevus (MEN) is a rare variant of eccrine nevus, characterized by a proliferation of normal eccrine structure surrounded by mucin deposits. We report herein the eighth case of mucinous eccrine nevus in the literature, with abundant mucin deposits not only in the stroma surrounding the eccrine glands but also in the superficial dermis. The literature is reviewed.

  14. Takotsubo Cardiomyopathy: A Case Series and Review of the Literature

    PubMed Central

    Merchant, Emily E.; Johnson, Sara W.; Nguyen, Phu; Kang, Christopher; Mallon, William K.

    2008-01-01

    Takotsubo cardiomyopathy (TCM) is an unusual form of acute cardiomyopathy showing left ventricular apical ballooning. It is often triggered by intense physical or emotional distress. We report here four cases of TCM and a review of the literature on the topic. PMID:19561716

  15. Contact-lens-related microbial keratitis: case report and review

    PubMed Central

    Eltis, Mark

    2012-01-01

    Bacterial keratitis is a serious, potentially blinding, complication most often involving overnight contact lens wear. This case report reviews the management of a patient with bacterial keratitis and discusses the etiology, differential diagnosis, classification and risk factors associated with the condition.

  16. Intrascrotal lipoblastoma: a case report and review of the literature.

    PubMed

    Del Sordo, Rachele; Cavaliere, Antonio; Sidoni, Angelo; Colella, Renato; Bellezza, Guido

    2007-03-01

    Lipoblastomas are rare benign soft tissue tumors that occur primarily in young children. Most lipoblastomas occur in the extremities, trunk, head, and neck. An intrascrotal location is unusual. We describe the case of a 4-year-old boy with an intrascrotal lipoblastoma and discuss the differential diagnosis in reviewing the literature.

  17. Sporotrichosis arthritis. A case presentation and review of the literature.

    PubMed

    Khan, M I; Goss, G; Gotsman, A; Asvat, M S

    1983-12-31

    Mimicry by fungal infection of other chronic bone and joint diseases may easily result in a tardy diagnosis with subsequent needless surgery or permanent damage to the joint and its function. A case of sporotrichosis arthritis involving both wrists and knee joints is described. Diagnostic pitfalls and therapeutic dilemmas are outlined. The literature on this apparently 'rare' form of arthritis is reviewed.

  18. Double mesiodens: a review and report of 2 cases.

    PubMed

    Sujlana, Amrita; Pannu, Parampreet; Bhangu, Japneet

    2017-01-01

    Mesiodentes are the most frequently encountered supernumerary teeth. Recently, reports of double mesiodens have increased, which may be due to the availability of better diagnostic methods. This article discusses 2 cases of double mesiodens with varying clinical presentations. In addition, the literature related to the etiology, clinical presentation, diagnosis, and management of mesiodentes is reviewed.

  19. [Portal venous system calcifications. Study of 3 cases and review of the literature].

    PubMed

    Delamarre, J; Fabre, V; Remond, A; Sevenet, F; Tossou, H; Capron, J P

    1991-01-01

    Three cases of calcifications of the portal system are reported in men aged 42, 53 and 40 years old. Two patients had alcoholic cirrhosis, and one had familial congenital hepatic fibrosis, respectively. Calcifications were discovered fortuitously on plain abdominal films. Ultrasound and computed tomography studies, and in two cases, angiography, confirmed that calcifications were located within the vein walls. The veins involved were the portal vein in 3 cases, the splenic vein in 2 cases, and the superior mesenteric and left gastric veins in one case each. Investigations demonstrated splenoportal and splenic thrombosis in 2 cases, whereas the portal vein system was patent in the other. In two cases, the splenic artery was aneurysmal, associated with several intrasplenic arterial aneurysms in one. Based on these three cases, combined with a review of the literature of 123 previous reports, the features of this rare entity are described with emphasis placed on the value of computed tomography studies.

  20. Analytical review of 664 cases of penetrating buttock trauma

    PubMed Central

    2011-01-01

    A comprehensive review of data has not yet been provided as penetrating injury to the buttock is not a common condition accounting for 2-3% of all penetrating injuries. The aim of the study is to provide the as yet lacking analytical review of the literature on penetrating trauma to the buttock, with appraisal of characteristics, features, outcomes, and patterns of major injuries. Based on these results we will provide an algorithm. Using a set of terms we searched the databases Pub Med, EMBASE, Cochran, and CINAHL for articles published in English between 1970 and 2010. We analysed cumulative data from prospective and retrospective studies, and case reports. The literature search revealed 36 relevant articles containing data on 664 patients. There was no grade A evidence found. The injury population mostly consists of young males (95.4%) with a high proportion missile injury (75.9%). Bleeding was found to be the key problem which mostly occurs from internal injury and results in shock in 10%. Overall mortality is 2.9% with significant adverse impact of visceral or vascular injury and shock (P < 0.001). The major injury pattern significantly varies between shot and stab injury with small bowel, colon, or rectum injuries leading in shot wounds, whilst vascular injury leads in stab wounds (P < 0.01). Laparotomy was required in 26.9% of patients. Wound infection, sepsis or multiorgan failure, small bowel fistula, ileus, rebleeding, focal neurologic deficit, and urinary tract infection were the most common complications. Sharp differences in injury pattern endorse an algorithm for differential therapy of penetrating buttock trauma. In conclusion, penetrating buttock trauma should be regarded as a life-threatening injury with impact beyond the pelvis until proven otherwise. PMID:21995834

  1. Postoperative intussusception in children: a review of 14 cases.

    PubMed

    Niu, Zhi-bin; Hou, Ying; Wang, Chang-lin

    2005-12-01

    To search the etiologic factor, clinical diagnosis points and treatment of postoperative intussusception (PI). To retrospectively review the clinical materials of 14 cases with PI including the cause of disease and treatment. PI occurred within 10 days (average 4 days) after the primary operation. Bowel obstructive symptoms gradually emerged. One case was diagnosed with intussusception by sonography and received enema reduction of intussusception by hydrostatic pressure. Thirteen cases were performed secondary operation. Small intestine was main site of intussusception. Manual reduction of the lesion was performed in 12 cases and bowel resection and anastomosis was done in 1 case with bowel necrosis. PI should be suspected if child presents with the symptoms of ileus in early postoperative period. Abdominal sonography may have some value on diagnosis of PI. Operation is the first choice for the treatment of PI.

  2. [Superfetation: case report and review of the literature].

    PubMed

    Pape, O; Winer, N; Paumier, A; Philippe, H-J; Flatrès, B; Boog, G

    2008-12-01

    We report the case of a dichorionic-diamniotic pregnancy in which a discordance in the size of the fetuses was observed as early as the first trimester. This discordance in size was maintained over time and the two fetuses continued their respective growths. We suggest the very rare phenomenon of superfetation as a diagnosis because less than 10 cases are described in the literature. Even though a formal proof of the diagnosis is difficult to obtain, the elements described in this article rally in favor of this hypothesis. Superfetation is defined by the fertilization and the implantation of a second oocyte in a uterus already containing the product of a previous conception. After a description of the case, a review of the literature enables us to describe the frequency, the possible risk factors and the existing case reports on the subject. The rarity of this case justifies its publication for the information of clinicians.

  3. Optic Nerve Aplasia: Case Report and Literature Review

    PubMed Central

    Ghassemi, Fariba; Bazvand, Fatemeh; Hosseini, Seyedeh Simindokht; Karkhaneh, Reza; Ebrahimiadib, Nazanin; Shekarchi, Babak

    2015-01-01

    Purpose: To report three cases of optic nerve aplasia (ONA). Case Report: Herein three subjects with ONA are described, two subjects had unilateral involvement. In one of these cases, the fellow eye had an associated persistent hyperplastic primary vitreous (PHPV). The third patient had bilateral ONA with multiple intracranial anomalies. Previous reports are reviewed and reported findings are summarized. Orbital and brain magnetic resonance imaging (MRI) were normal in two of our cases and loss of corpus callosum in the third case. Narrow optic nerve was observed on the right side and normal appearance in other two patients. Conclusion: The diagnosis of optic nerve abnormalities in children requires a thorough ophthalmic examination and proper ancillary testing. Although MRI is valuable in the diagnosis of associated central nervous system anomalies, the optic nerve may appear in normal size and course on MRI images and thus one may not be able to diagnose ONA in eyes with opaque media. PMID:26425324

  4. Lateral Periodontal Cyst: a Case Report and Literature Review

    PubMed Central

    de Carvalho, Luis Felipe das Chagas e Silva; Lima, Celina Faig; Cabral, Luiz Antonio Guimarães; Brandão, Adriana Aigotti Haberbeck

    2010-01-01

    ABSTRACT Background The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts. Methods A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp. Results A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was "lateral periodontal cyst of developmental origin". There was no recurrence or complications for 24 months follow-up. Conclusions The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent. PMID:24421982

  5. Macro-thyrotropin: a case report and review of literature.

    PubMed

    Loh, Tze Ping; Kao, Shih Ling; Halsall, David J; Toh, Sue-Anne Ee Shiow; Chan, Edmund; Ho, Su Chin; Tai, E Shyong; Khoo, Chin Meng

    2012-06-01

    Isolated elevation of TSH in the absence of thyroid symptoms can be very rarely caused by a macromolecule formed between TSH and Ig (macro-TSH), confounding the interpretation of thyroid function test results. We described the use of several commonly available laboratory-based approaches to investigate an isolated TSH elevation [232 mIU/liter; free T(4), 10 pmol/liter (reference interval, 10.0-23.0 pmol/liter), Vitros platform] in a clinically euthyroid elderly gentleman, which led to the diagnosis of macro-TSH. TSH concentration of the patient was significantly lower (122 mIU/liter) when measured on the Advia Centaur platform. Serial dilution of the patient's sample showed a nonlinear increase in TSH recovery at increasing dilution (nonlinearity). Polyethylene glycol precipitation and mixing the patient's sample with a hypothyroid patient sample showed reduced TSH recovery, suggesting the presence of a high molecular weight interfering substance and excess TSH binding capacity, respectively. Heterophile blocking tube studies and rheumatoid factors were negative. Gel filtration chromatography demonstrated a TSH peak fraction that approximated the molecular size of IgG; together with the excess TSH binding capacity, this indicated the presence of TSH-IgG macro-TSH. A review of 12 macro-TSH case reports showed that samples with macro-TSH produce over-recovery with dilution, return negative results on anti-animal and anti-heterophile blocking studies, and commonly have recovery of less than 20% when subjected to polyethylene glycol precipitation. Macro-TSH is an underrecognized laboratory interference. Routine laboratory techniques described above can help diagnose this rare entity. A close dialogue between the physician and the laboratory is important in approaching such cases.

  6. [Autoimmune lymphoproliferative syndrome: a case report and literature review].

    PubMed

    Sun, Jia-peng; Lu, Xin-tian; Zhao, Wei-hong; Hua, Ying

    2015-12-18

    We described 1 case of autoimmune lymphoproliferative syndrome (ALPS), first diagnosed in our hospital, and reviewed the recent literature. The 11-month old male patient presented with a history of splenomegaly and hepatomegaly since 1 month after birth. He suffered recurrent infectious diseases including cytomegalovirus infection, parvovirus B19 infection and chronic diarrhea disease. Besides, his symptoms included hemolytic anemia and thrombocytopenia. The laboratory abnormality indicated an expanded population of alpha/beta double-negative T cells (DNTs) (27.18% of lymphocytes, 35.16% of CD3+ T lymphocytes) in peripheral blood, and autoantibodies including antinuclear antibody, double-stranded DNA and rheumatic factor were positive. Hyper gamma globulinemia and positive direct Coombs tests were seen in the patient. His parents were both healthy and denied autoimmune diseases. We identified a heterozygous point mutation in exon 3 of the FAS gene carrying c.309 A>C, resulting in a single base pair substitution in exon 3 of FAS gene which changed the codon of Arg103 to Ser103. Unfortunately, we were unable to obtain the gene results of the child's parents. The patient was treated with glucocorticoids in our hospital and with mycophenolatemofetil in other hospital. And we were informed that his anemia condition relieved through the telephone follow-up, but he still suffered recurrent infections, hepatomegaly and splenomegaly still existed. As we all know ALPS is characterized by defective lymphocyte apoptosis, and thus cause lymphoproliferative disease and autoimmune disease, and increase the risk of lymphoma. It is more likely to be misdiagnosed as other diseases. ALPS should be suspected in the case of chronic lymphadenopathy, splenomegaly and autoimmune features. Flow cytometry approach is helpful for the diagnosis. Immunosuppressive drugs are the necessary treatment.

  7. What physicians reason about during admission case review.

    PubMed

    Juma, Salina; Goldszmidt, Mark

    2016-07-28

    Research suggests that physicians perform multiple reasoning tasks beyond diagnosis during patient review. However, these remain largely theoretical. The purpose of this study was to explore reasoning tasks in clinical practice during patient admission review. The authors used a constant comparative approach-an iterative and inductive process of coding and recoding-to analyze transcripts from 38 audio-recorded case reviews between junior trainees and their senior residents or attendings. Using a previous list of reasoning tasks, analysis focused on what tasks were performed, when they occurred, and how they related to the other tasks. All 24 tasks were observed in at least one review with a mean of 17.9 (Min = 15, Max = 22) distinct tasks per review. Two new tasks-assess illness severity and patient decision-making capacity-were identified, thus 26 tasks were examined. Three overarching tasks were identified-assess priorities, determine and refine the most likely diagnosis and establish and refine management plans-that occurred throughout all stages of the case review starting from patient identification and continuing through to assessment and plan. A fourth possible overarching task-reflection-was also identified but only observed in four instances across three cases. The other 22 tasks appeared to be context dependent serving to support, expand, and refine one or more overarching tasks. Tasks were non-sequential and the same supporting task could serve more than one overarching task. The authors conclude that these findings provide insight into the 'what' and 'when' of physician reasoning during case review that can be used to support professional development, clinical training and patient care. In particular, they draw attention to the iterative way in which each task is addressed during a case review and how this finding may challenge conventional ways of teaching and assessing clinical communication and reasoning. They also suggest that further research

  8. Esophageal granular cell tumors: Case report and literature review

    PubMed Central

    Wang, Hong-Qun; Liu, Ai-Jun

    2015-01-01

    We reported 5 cases of granular cell tumors (GCTs) of esophagus and reviewed the literature. There were 4 females and 1 male with a median age of 43 years and an average age of 44 years. All of the cases had solitary tumors. Tumor size was 0.4-2.5 cm in diameter. Gastroscopy revealed that 2 cases were located in the middle esophagus, 1 case in the upper esophagus, and 2 cases in the distal one. Five cases displayed gray-white, pink, yellow mucosal uplifts of esophagus, 3 cases had smooth surface, 1 case was slightly concave, and the biggest tumor had erosion. Tumor cells were large and polygonal with rich granular and eosinophilic cytoplasm, and small oval nuclei. Cells were arranged in nest or aciniform. Immunohistochemistry and histochemistry staining showed S-100+, neuron specific enolase+, Vim+, CD68+, smooth muscle actin-, Des-, CK-, CD117-, CD34-, Ki67-or ≤ 5%+. Periodic acid-Schiff reaction and epithelial membrane antigen were both weakly positive. GCTs of esophagus are rare and most of the cases have good prognosis. PMID:26306145

  9. Multiple myeloma and pregnancy: a case report and literature review.

    PubMed

    Borja de Mozota, Daphné; Kadhel, Philippe; Dermeche, Slimane; Multigner, Luc; Janky, Eustase

    2011-10-01

    Multiple myeloma, a hematological malignancy generally affecting elderly people, was diagnosed at the beginning of the pregnancy of a 33-year-old woman. We carried out a literature review in order to evaluate the consequences of this cancer on pregnancy and of pregnancy on multiple myeloma, as to determine the specific follow-up required. A systematic search for articles of interest published between 1949 and 16 November 2010 was performed in MEDLINE, SCOPUS and EMBASE, using the words "multiple myeloma" and "pregnancy". We identified 398 publications of potential interest, 20 of which were selected and included in the analysis. The selected articles included 26 cases. No specific risk factors were identified in pregnant women. The most common presentations were bone pain and/or anemia, as in the general population. Pregnancy seemed to have no effect on multiple myeloma progression. Most pregnancies went to term, with only two medical terminations and six cesareans performed before term, due to the severity of the cancer. No effect of the cancer or its treatment by chemotherapy during pregnancy was found in the children. Pregnancy does not seem to be contraindicated in women with multiple myeloma. Nevertheless, the management of pregnant patients with multiple myeloma is a diagnostic, therapeutic and social challenge, requiring a multidisciplinary approach and regular follow-up. Decisions should be taken based on the severity of the disease, its prognosis and maternal choice.

  10. Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review

    PubMed Central

    Díaz Angulo, Sara; Szram, Joanna; Welch, Jenny; Cannon, Julie; Cullinan, Paul

    2011-01-01

    Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5–8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required. PMID:21603168

  11. Orofacial pain of cardiac origin: Review literature and clinical cases

    PubMed Central

    Garcia-Vicente, Laia; Jané-Salas, Enric; Estrugo-Devesa, Albert; Chimenos-Küstner, Eduardo; Roca-Elias, Josep

    2012-01-01

    The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments. Key words:Orofacial pain, ischemic heart disease, heterotopic pain, odontalgia. PMID:22322488

  12. Consequences of clinical case management for caregivers: a systematic review.

    PubMed

    Corvol, Aline; Dreier, Adina; Prudhomm, Joachim; Thyrian, Jochen René; Hoffmann, Wolfgang; Somme, Dominique

    2017-05-01

    Informal caregivers are deeply involved in the case management process. However, little is known about the consequences of such programs for informal caregivers. This systematic literature review, reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, addressed the consequences of clinical case management programs, whether positive or negative, for caregivers of frail older persons or persons with dementia. We systematically identified and analyzed published randomized trials and quasi-experimental studies comparing case management programs to usual care, which discussed outcomes concerning caregivers. Sixteen studies were identified, and 12 were included after quality assessment. Seven identified at least one positive result for caregivers, and no negative effect of case management has been found. Characteristics associated with positive results for caregivers were a high intensity of case management and programs specifically addressed to dementia patients. Despite the numerous methodological challenges in the assessment of such complex social interventions, our results show that case management programs can be beneficial for caregivers of dementia patients and that positive results for patients are achieved without increasing caregivers' burden. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Unusual Foreign Body of Parotid Gland Presenting as Sialolithiasis: Case Report and Literature Review

    PubMed Central

    Sreetharan, Sivapatha Sundaram; Philip, Rajan

    2012-01-01

    This case report highlights an unusual case where a foreign body in the parotid gland was initially thought to be sialolithiasis based on CT scans. The foreign body was safely retrieved from the parotid gland without formal superficial parotidectomy using methylene blue and an image intensifier to localize the lesion. Diagnosis and management of foreign bodies in the parotid gland are reviewed, and surgical options in removal of such lesions are discussed. PMID:23320231

  14. Primary CNS hemangiopericytoma presenting as an intraparenchymal mass--case report and review of literature.

    PubMed

    Shetty, Prakash M; Moiyadi, Aliasgar V; Sridhar, Epari

    2010-04-01

    Hemangiopericytomas (HPC) are rare, aggressive tumours that mostly involve the musculoskeletal system. They account for less than 1% of intracranial tumours. Intracranially, they are predominantly meningeal based and are thought to arise from the spindle cells (pericytes) in the vicinity of the blood vessels. We present a case of a 69-year-old male with a hemangiopericytoma in the left perisylvian region which was subcortically located. This is an uncommon location. We discuss the case and review the literature.

  15. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

    ERIC Educational Resources Information Center

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily

    2012-01-01

    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  16. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

    ERIC Educational Resources Information Center

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily

    2012-01-01

    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  17. Autochthonous cases of mycetoma in Europe: report of two cases and review of literature.

    PubMed

    Buonfrate, Dora; Gobbi, Federico; Angheben, Andrea; Marocco, Stefania; Farina, Claudio; Van Den Ende, Jef; Bisoffi, Zeno

    2014-01-01

    Mycetoma is a chronic granulomatous infection involving cutaneous and subcutaneous tissues. It is endemic in tropical and subtropical areas, but sporadic cases have been reported also in countries of temperate climate. The purpose of this paper is to review the cases of mycetoma in European subjects (and presumably acquired in Europe), to give an insight in the main factors associated with this condition, and to describe two previously unpublished cases observed at our Centre. PubMed was systematically searched for case reports and case series of mycetoma in Europeans reported between 1980 and 2014, using specific search strategies. Two further cases diagnosed by the authors are described. Forty-two cases were collected. Eleven cases were caused by Scedosporium apiospermium, mainly in immunosuppressed patients from Bulgaria, Germany, the Netherlands, Portugal, Slovenia, Spain and the United Kingdom. Excluding all patients with immunosuppression, 29 cases remain. Most of them were reported from Bulgaria and in Albanian patients (all diagnosed outside Albania). In the Bulgarian case series many different micro-organisms, both bacteria and fungi, were isolated, while all the 5 cases from Albania were caused by Actinomadura spp. Other countries reporting cases were Greece, Italy and Turkey. In general, Actinomadura spp is the most frequent causative agent isolated, followed by Nocardia spp and Madurella mycetomatis. The foot was the most reported site involved. Most patients were medically treated, but unfortunately a long-term follow up (at least one year) was available only in a few cases. Our review and our own cases suggest that Europeans without travel history can be affected by Madura foot. The lack of a surveillance system is likely to cause an underreporting of cases. Moreover, the unfamiliarity of Western doctors with this peculiar infection may cause a mismanagement, including unnecessary amputations.

  18. Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature

    PubMed Central

    Buonfrate, Dora; Gobbi, Federico; Angheben, Andrea; Marocco, Stefania; Farina, Claudio; Van Den Ende, Jef; Bisoffi, Zeno

    2014-01-01

    Background Mycetoma is a chronic granulomatous infection involving cutaneous and subcutaneous tissues. It is endemic in tropical and subtropical areas, but sporadic cases have been reported also in countries of temperate climate. The purpose of this paper is to review the cases of mycetoma in European subjects (and presumably acquired in Europe), to give an insight in the main factors associated with this condition, and to describe two previously unpublished cases observed at our Centre. Methods and Findings PubMed was systematically searched for case reports and case series of mycetoma in Europeans reported between 1980 and 2014, using specific search strategies. Two further cases diagnosed by the authors are described. Forty-two cases were collected. Eleven cases were caused by Scedosporium apiospermium, mainly in immunosuppressed patients from Bulgaria, Germany, the Netherlands, Portugal, Slovenia, Spain and the United Kingdom. Excluding all patients with immunosuppression, 29 cases remain. Most of them were reported from Bulgaria and in Albanian patients (all diagnosed outside Albania). In the Bulgarian case series many different micro-organisms, both bacteria and fungi, were isolated, while all the 5 cases from Albania were caused by Actinomadura spp. Other countries reporting cases were Greece, Italy and Turkey. In general, Actinomadura spp is the most frequent causative agent isolated, followed by Nocardia spp and Madurella mycetomatis. The foot was the most reported site involved. Most patients were medically treated, but unfortunately a long-term follow up (at least one year) was available only in a few cases. Conclusions Our review and our own cases suggest that Europeans without travel history can be affected by Madura foot. The lack of a surveillance system is likely to cause an underreporting of cases. Moreover, the unfamiliarity of Western doctors with this peculiar infection may cause a mismanagement, including unnecessary amputations. PMID:24963778

  19. CaseWorld™: Interactive, media rich, multidisciplinary case based learning.

    PubMed

    Gillham, David; Tucker, Katie; Parker, Steve; Wright, Victoria; Kargillis, Christina

    2015-11-01

    Nurse educators are challenged to keep up with highly specialised clinical practice, emerging research evidence, regulation requirements and rapidly changing information technology while teaching very large numbers of diverse students in a resource constrained environment. This complex setting provides the context for the CaseWorld project, which aims to simulate those aspects of clinical practice that can be represented by e-learning. This paper describes the development, implementation and evaluation of CaseWorld, a simulated learning environment that supports case based learning. CaseWorld provides nursing students with the opportunity to view unfolding authentic cases presented in a rich multimedia context. The first round of comprehensive summative evaluation of CaseWorld is discussed in the context of earlier formative evaluation, reference group input and strategies for integration of CaseWorld with subject content. This discussion highlights the unique approach taken in this project that involved simultaneous prototype development and large scale implementation, thereby necessitating strong emphasis on staff development, uptake and engagement. The lessons learned provide an interesting basis for further discussion of broad content sharing across disciplines and universities, and the contribution that local innovations can make to global education advancement. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  20. Pulmonary toxocariasis: a case report and literature review.

    PubMed

    Ranasuriya, G; Mian, A; Boujaoude, Z; Tsigrelis, C

    2014-06-01

    Toxocariasis is a parasitic disease caused by Toxocara canis or T. cati. We report a patient with toxocariasis who presented with dyspnea, high-grade eosinophilia, and bilateral pulmonary nodules. To further characterize the pulmonary manifestations of toxocariasis, we have reviewed 11 previously published pulmonary toxocariasis cases. The most common pulmonary symptoms in our review were cough and dyspnea, and the most common finding on chest imaging was bilateral pulmonary nodules. Risk factors for Toxocara infection primarily included exposure to dogs. Most patients received albendazole and responded well. A high index of suspicion is needed to diagnose this otherwise preventable parasitic disease.

  1. CABINS: Case-based interactive scheduler

    NASA Technical Reports Server (NTRS)

    Miyashita, Kazuo; Sycara, Katia

    1992-01-01

    In this paper we discuss the need for interactive factory schedule repair and improvement, and we identify case-based reasoning (CBR) as an appropriate methodology. Case-based reasoning is the problem solving paradigm that relies on a memory for past problem solving experiences (cases) to guide current problem solving. Cases similar to the current case are retrieved from the case memory, and similarities and differences of the current case to past cases are identified. Then a best case is selected, and its repair plan is adapted to fit the current problem description. If a repair solution fails, an explanation for the failure is stored along with the case in memory, so that the user can avoid repeating similar failures in the future. So far we have identified a number of repair strategies and tactics for factory scheduling and have implemented a part of our approach in a prototype system, called CABINS. As a future work, we are going to scale up CABINS to evaluate its usefulness in a real manufacturing environment.

  2. Hospital financing reform and case-mix measurement: An international review

    PubMed Central

    Wiley, Miriam M.

    1992-01-01

    A review of reforms in the financing of hospital services in eight European countries and Australia reveals a commitment to a common objective of relating resource use to hospital workload by means of a standardized case-mix framework in the pursuit of greater efficiency. While this objective is also shared with the U.S. prospective payment system (PPS), it is noteworthy that the majority of countries reviewed favor a global budgeting approach to financing hospital services. Ongoing evaluation of these reforms should facilitate an assessment of the merits of case-mix adjusted global budgeting relative to the patient-based alternative. PMID:10122001

  3. Erysipelothrix rhusiopathiae-induced aortic valve endocarditis: case report and literature review

    PubMed Central

    Hua, Ping; Liu, Jialiang; Tao, Jun; Liu, Jianyang; Yang, Yanqi; Yang, Songran

    2015-01-01

    Erysipelothrix rhusiopathiae is a pathogen of zoonosis often associated with occupational exposure. Although Erysipelothrix rhusiopathiae infection has high mortality, the heart valves in humans are rarely involved. The clinical data of a case of a 65-year-old male with Erysipelothrix rhusiopathiae-induced aortic valve endocarditis was summarized retrospectively and analyzed with a literature review. Based on a literature review and our experience, cases of E. rhusiopathiae-induced aortic valve endocarditis are extremely rare and surgical treatment for this condition is useful and recommended. PMID:25785050

  4. Erysipelothrix rhusiopathiae-induced aortic valve endocarditis: case report and literature review.

    PubMed

    Hua, Ping; Liu, Jialiang; Tao, Jun; Liu, Jianyang; Yang, Yanqi; Yang, Songran

    2015-01-01

    Erysipelothrix rhusiopathiae is a pathogen of zoonosis often associated with occupational exposure. Although Erysipelothrix rhusiopathiae infection has high mortality, the heart valves in humans are rarely involved. The clinical data of a case of a 65-year-old male with Erysipelothrix rhusiopathiae-induced aortic valve endocarditis was summarized retrospectively and analyzed with a literature review. Based on a literature review and our experience, cases of E. rhusiopathiae-induced aortic valve endocarditis are extremely rare and surgical treatment for this condition is useful and recommended.

  5. Cerebral salt wasting in tuberculous meningitis: Two cases and review of the literature. Case Report.

    PubMed

    Celik, Umit; Celik, Tamer; Tolunay, Orkun; Başpınar, Hüseyin; Kömür, Mustafa; Levent, Fatma

    2015-01-01

    Cerebral salt wasting syndrome (CSWS) is characterized by severe natriuresis and volume depletion in the presence of cerebral pathology. In literature, there are few reports about tuberculous meningitis and cerebral CSWS. In this article, we report two tuberculous meningitis cases with CSWS and present a review of the literature on this topic. Cerebral salt wasting diagnosis was based on hyponatraemia associated with high urinary sodium excretion and inappropriately high urine output in the presence of dehydration. Treatment was made with sodium-fluid replacement plus fludrocortisone therapy in both cases. In agreement with the literature we argue that cerebral salt wasting syndrome might be more common than the syndromes of inappropriate antidiuretic hormone secretion (SIADH) in cerebral disorders. Differentiating the cerebral salt wasting syndrome from the SIADH is very important because unrecognized cerebral salt wasting syndrome can lead to inadequate management and result in unnecessary hyponatremia-related morbidity. The electrolyte and hydration status of patients should be monitored closely in patients with tuberculous meningitis.

  6. Adult intussusception: case reports and review of literature

    PubMed Central

    Yalamarthi, S; Smith, R

    2005-01-01

    Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, aetiology, and treatment. Diagnosis can be delayed because of its longstanding, intermittent, and non-specific symptoms and most cases are diagnosed at emergency laparotomy. With more frequent use of computed tomography in the evaluation of patients with abdominal pain, the condition can be diagnosed more reliably. Treatment entails simple bowel resection in most cases. Reduction of the intussusception before resection is controversial, but there is a shift against this, especially in colonic cases. Surgical treatment can be difficult in gastroduodenal and coloanal intussusceptions, sometimes requiring innovative techniques. This paper presents the diagnosis and management of four cases of adult intussusception, followed by review of the literature. PMID:15749793

  7. [Proliferative verrucous leukoplakia: Three cases and literature review].

    PubMed

    Ottavioli, A; Campana, F; Catherine, J-H; Massereau, E; Del Grande, J; Ordioni, U

    2016-03-01

    The aim of this study was to collect epidemiological, aetiopathogenic, clinical, histological and therapeutic data concerning proliferative verrucous leucoplakia (PVL) and to report three new cases. A literature review performed using the Medline database enabled us to collate 39 studies involving 607 cases. Three new cases were added. PVL is a rare disease characterized by extensive and multifocal oral leucoplakic lesions. Its histological pattern depends on the stage of the disease: hyperkeratosis, verrucous hyperplasia, verrucous carcinoma and squamous cell carcinoma. The aetiopathogenesis of PVL is poorly understood and there is no clear consensus concerning therapy. Malignant transformation occurs in over 50 % of cases. Diagnosis of PVL is difficult because of the presenting signs, which can be mistaken for those of other diseases. Management may be complicated and long-term follow-up is essential. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Autoimmune pancreatitis: case series and review of the literature.

    PubMed

    Shakov, Rada; DePasquale, Joseph R; Elfarra, Hossam; Spira, Robert S

    2009-01-01

    Autoimmune pancreatitis (AuP) is a chronic pancreatic inflammation secondary to an underlying autoimmune mechanism. After early reports of a particular type of pancreatitis associated with hypergammaglobulinemia, others asserted that there is an autoimmune mechanism involved in some patients with chronic pancreatitis. In 1995 AuP was first described as a distinct clinical entity. Since then, there have been many documented cases of AuP in Japan, and now, perhaps due to increased awareness, more cases are being reported in Europe and the United States. Herein we present our experience with 3 cases of AuP and we review the relevant literature. These 3 cases demonstrate the difficulties that exist in making the diagnosis of AuP and the impact that the diagnosis can have on patient management.

  9. Case mix planning in hospitals: a review and future agenda.

    PubMed

    Hof, Sebastian; Fügener, Andreas; Schoenfelder, Jan; Brunner, Jens O

    2017-06-01

    The case mix planning problem deals with choosing the ideal composition and volume of patients in a hospital. With many countries having recently changed to systems where hospitals are reimbursed for patients according to their diagnosis, case mix planning has become an important tool in strategic and tactical hospital planning. Selecting patients in such a payment system can have a significant impact on a hospital's revenue. The contribution of this article is to provide the first literature review focusing on the case mix planning problem. We describe the problem, distinguish it from similar planning problems, and evaluate the existing literature with regard to problem structure and managerial impact. Further, we identify gaps in the literature. We hope to foster research in the field of case mix planning, which only lately has received growing attention despite its fundamental economic impact on hospitals.

  10. Antisynthetase Syndrome: two case report and literature review.

    PubMed

    Theilacker, Lívia Regina; Brandão, Fabíola Sampaio; Goulart, Fernanda Velloso; Vaz, João Luiz Pereira; D'Almeida, Luiz Octávio Dias; da Fonseca Salgado, Maria Cecília

    2015-01-01

    Antissintetase Syndrome (ASS) is characterized by myositis, Raunaud's phenomenon, fever, intertitial lung disease, mechanic's hands and arthropathy associated with the presence of antibodies against tRNA synthetase, especially anti-Jo-1. This article aims to review the literature on ASS and report two cases where the first is a patient with polymyositis who developed subluxation on the proximal interphalangeal joint of bilateral first right finger after a few years of the disease, associated with pulmonary manifestations and positive anti-JO-1. In the second case, we present a patient with dermatomyositis, who developed a subluxation of the two first fingers, anti-Jo1 positive and chest CT changes, but without clinical evidence of pulmonary involvement. These cases reveal the importance of performing early diagnosis. The authors describe two cases of this rare syndrome, emphasizing the severity of interstitial lung disease and arthritis.

  11. Duodenoduodenal intussusception: Report of three challenging cases with literature review.

    PubMed

    Pradhan, Dinesh; Kaur, Neeraj; Nagi, Birinder

    2015-01-01

    Small bowel intussusception is an uncommon condition with cases of duodenoduodenal intussusception (DDI) being exceptionally rare. Adult intussusception occurs infrequently and differs from childhood intussusception in its presentation, etiology, and treatment. DDI is very unusual due to the fixed position of the duodenum within the retroperitoneum. The lead point usually is hamartomatous polyp, adenoma, or adenocarcinoma. Only few cases of DDI in adults have been reported in the literature. We herein report a series of three cases of DDI encountered in a tertiary level research institute. All cases had underlying abnormality acting as lead point with different etiologies. DDI is a challenging condition due to its rarity and nonspecific presentation and should be considered in the differential diagnosis of gastric outlet obstruction, pancreatitis, and obstructive jaundice. We elaborate this condition with a detailed review of the literature to gain a better understanding of its clinical features and enable early diagnosis.

  12. Memantine and catatonia: a case report and literature review.

    PubMed

    Obregon, Demian F; Velasco, Regina M; Wuerz, Timothy P; Catalano, Maria C; Catalano, Glenn; Kahn, David

    2011-07-01

    Catatonia is a movement disorder with various possible etiologies. The majority of cases are associated with an underlying mood or psychotic disorder, while others are caused by medical conditions. Currently, benzodiazepines are the first-line psychopharmacologic agents in the treatment of catatonia. However, several cases have been reported in which treatment with memantine proved to be effective. We present the case of a 92-year-old female with major depressive disorder and associated catatonic symptoms. In this case, the patient's symptoms remitted quickly after the initiation of memantine. We review the possible causes of catatonia and pharmacologic treatments for the condition and highlight the possible benefits of N-methylD-aspartic acid receptor antagonists such as memantine in the treatment of catatonia.

  13. Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan

    PubMed Central

    Hoshimoto, Sojun; Matsui, Junichi; Miyata, Ryohei; Takigawa, Yutaka; Miyauchi, Jun

    2016-01-01

    We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas (ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia (hemoglobin level < 10.0 g/dL) and elevated leucocyte counts (> 12000/mm3), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels. PMID:27784976

  14. Population-based case-control association studies.

    PubMed

    Hancock, Dana B; Scott, William K

    2012-07-01

    This unit provides an overview of the design and analysis of population-based case-control studies of genetic risk factors for complex disease. Considerations specific to genetic studies are emphasized. The unit reviews basic study designs differentiating case-control studies from others, presents different genetic association strategies (candidate gene, genome-wide association, and high-throughput sequencing), introduces basic methods of statistical analysis for case-control data and approaches to combining case-control studies, and discusses measures of association and impact. Admixed populations, controlling for confounding (including population stratification), consideration of multiple loci and environmental risk factors, and complementary analyses of haplotypes, genes, and pathways are briefly discussed. Readers are referred to basic texts on epidemiology for more details on general conduct of case-control studies.

  15. The use of rapid review methods in health technology assessments: 3 case studies.

    PubMed

    Kaltenthaler, Eva; Cooper, Katy; Pandor, Abdullah; Martyn-St James, Marrissa; Chatters, Robin; Wong, Ruth

    2016-08-26

    Rapid reviews are of increasing importance within health technology assessment due to time and resource constraints. There are many rapid review methods available although there is little guidance as to the most suitable methods. We present three case studies employing differing methods to suit the evidence base for each review and outline some issues to consider when selecting an appropriate method. Three recently completed systematic review short reports produced for the UK National Institute for Health Research were examined. Different approaches to rapid review methods were used in the three reports which were undertaken to inform the commissioning of services within the NHS and to inform future trial design. We describe the methods used, the reasoning behind the choice of methods and explore the strengths and weaknesses of each method. Rapid review methods were chosen to meet the needs of the review and each review had distinctly different challenges such as heterogeneity in terms of populations, interventions, comparators and outcome measures (PICO) and/or large numbers of relevant trials. All reviews included at least 10 randomised controlled trials (RCTs), each with numerous included outcomes. For the first case study (sexual health interventions), very diverse studies in terms of PICO were included. P-values and summary information only were presented due to substantial heterogeneity between studies and outcomes measured. For the second case study (premature ejaculation treatments), there were over 100 RCTs but also several existing systematic reviews. Data for meta-analyses were extracted directly from existing systematic reviews with new RCT data added where available. For the final case study (cannabis cessation therapies), studies included a wide range of interventions and considerable variation in study populations and outcomes. A brief summary of the key findings for each study was presented and narrative synthesis used to summarise results for each

  16. Case-mix adjustment for diabetes indicators: a systematic review.

    PubMed

    Calsbeek, Hiske; Markhorst, Joekle G M; Voerman, Gerlienke E; Braspenning, Jozé C C

    2016-02-01

    Case-mix adjustment is generally considered indispensable for fair comparison of healthcare performance. Inaccurate results are also unfair to patients as they are ineffective for improving quality. However, little is known about what factors should be adjusted for. We reviewed case-mix factors included in adjustment models for key diabetes indicators, the rationale for their inclusion, and their impact on performance. Systematic review. This systematic review included studies published up to June 2013 addressing case-mix factors for 6 key diabetes indicators: 2 outcomes and 2 process indicators for glycated hemoglobin (A1C), low-density lipoprotein cholesterol, and blood pressure. Factors were categorized as demographic, diabetes-related, comorbidity, generic health, geographic, or care-seeking, and were evaluated on the rationale for inclusion in the adjustment models, as well as their impact on indicator scores and ranking. Thirteen studies were included, mainly addressing A1C value and measurement. Twenty-three different case-mix factors, mostly demographic and diabetes-related, were identified, and varied from 1 to 14 per adjustment model. Six studies provided selection motives for the inclusion of case-mix factors. Marital status and body mass index showed a significant impact on A1C value. For the other factors, either no or conflicting associations were reported, or too few studies (n ≤ 2) investigated this association. Scientific knowledge about the relative importance of case-mix factors for diabetes indicators is emerging, especially for demographic and diabetes-related factors and indicators on A1C, but is still limited. Because arbitrary adjustment potentially results in inaccurate quality information, meaningful stratification that demonstrates inequity in care might be a better guide, as it can be a driver for quality improvement.

  17. Severe strongyloidiasis: a systematic review of case reports

    PubMed Central

    2013-01-01

    Background Strongyloidiasis is commonly a clinically unapparent, chronic infection, but immuno suppressed subjects can develop fatal disease. We carried out a review of literature on hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), in order to describe the most challenging aspects of severe strongyloidiasis. Methods We conducted a structured search using PubMed to collect case reports and short case series on HS/DS published from 1991 to 2011. We restricted search to papers in English, Spanish, Italian and French. Case reports were classified as HS/DS according to given definitions. Results Records screened were 821, and 311 were excluded through titles and abstract evaluation. Of 510 full-text articles assessed for eligibility, 213 were included in qualitative analysis. As some of them were short case series, eventually the number of cases analyzed was 244. Steroids represented the main trigger predisposing to HS and DS (67% cases): they were mostly administered to treat underlying conditions (e.g. lymphomas, rheumatic diseases). However, sometimes steroids were empirically prescribed to treat signs and symptoms caused by unsuspected/unrecognized strongyloidiasis. Diagnosis was obtained by microscopy examination in 100% cases, while serology was done in a few cases (6.5%). Only in 3/29 cases of solid organ/bone marrow transplantation there is mention of pre-transplant serological screening. Therapeutic regimens were different in terms of drugs selection and combination, administration route and duration. Similar fatality rate was observed between patients with DS (68.5%) and HS (60%). Conclusions Proper screening (which must include serology) is mandatory in high - risk patients, for instance candidates to immunosuppressive medications, currently or previously living in endemic countries. In some cases, presumptive treatment might be justified. Ivermectin is the gold standard for treatment, although the optimal dosage is not clearly defined in

  18. Invasive Aspergillosis Caused by Aspergillus ustus: Case Report and Review

    PubMed Central

    Verweij, Paul E.; van den Bergh, Marjolein F. Q.; Rath, Peter M.; de Pauw, Ben E.; Voss, Andreas; Meis, Jacques F. G. M.

    1999-01-01

    A case of invasive pulmonary aspergillosis in an allogeneic bone marrow transplant recipient caused by Aspergillus ustus is presented. A. ustus was also recovered from the hospital environment, which may indicate that the infection was nosocomially acquired. A literature review revealed seven cases of invasive infections caused by A. ustus, and three of these were primarily cutaneous infections. In vitro susceptibility testing of 12 A. ustus isolates showed that amphotericin B and terbinafine had fungicidal activity and that itraconazole and voriconazole had fungistatic activity. PMID:10203536

  19. Eagle syndrome: case report and review of the literature.

    PubMed

    Kim, Esther; Hansen, Karla; Frizzi, James

    2008-11-01

    Eagle syndrome, which is an uncommon sequela of elongation of the styloid process, can manifest as pain in the anterolateral neck, often with referred pain to the ear. In most cases, the elongation is an acquired condition, often occurring as a result of a traumatic incident, including tonsillectomy. We describe the case of a 57-year-old man who experienced unremitting right neck pain for several years following an accidental fall. A multidisciplinary investigation identified an elongated styloid process. Surgical shortening of the structure provided definitive relief of the patient's symptoms. We review the anatomy of the peristyloid structures and discuss the etiology, diagnosis, and treatment of Eagle syndrome.

  20. Epidermolysis Bullosa Pruriginosa: Case Series and Review of the Literature.

    PubMed

    Kim, Whan B; Alavi, Afsaneh; Pope, Elena; Walsh, Scott

    2015-06-01

    Epidermolysis bullosa (EB) pruriginosa is a rare clinical subtype of dystrophic epidermolysis bullosa (DEB) that is characterized by intense pruritus resulting in hypertrophic, lichenified, prurigo-like plaques and nodules secondary to scratching. The variability in the age of onset, rarity of intact bullae, histologic ambiguities, and close resemblance to other conditions such as acquired inflammatory dermatoses may make diagnosis difficult for this unusual condition, for which fewer than 100 cases have been documented. In this report, we describe 3 cases of EB pruriginosa and review the current literature. © The Author(s) 2015.

  1. Blastomycosis in China: a case report and literature review.

    PubMed

    Zhao, Tie-Mei; Gao, Jie; She, Dan-Yang; Chen, Liang-An

    2011-12-01

    Blastomycosis is a fungal disease that is endemic in parts of North America. It is very rare in China and also commonly misdiagnosed, often as cancer or other infectious diseases. The clinical profile of a case of disseminated blastomycosis with pulmonary changes and skin ulcers was described. He had been misdiagnosed with tuberculosis, after adequate therapy with a lipid formulation of amphotericin B, followed by itraconazole, the lung and skin lesions improved. Then the five cases reported in China and literatures were reviewed. The aim of this report was to improve the knowledge regarding blastomycosis for physicians in China to avoid delaying adequate therapy.

  2. Understanding Cerebellar Liponeurocytomas: Case Report and Literature Review

    PubMed Central

    Oudrhiri, M. Y.; Raouzi, N.; El Kacemi, I.; El Fatemi, N.; Gana, R.; Maaqili, M. R.; Bellakhdar, F.

    2014-01-01

    Cerebellar liponeurocytomas were recognized in the 2000 WHO 3rd edition of CNS tumors as a distinct grade I pathological entity, a tumor with a more favorable prognosis than medulloblastoma. But reports of long-term recurrences and some possible aggressive behavior led to an upgrade on the latest WHO 4th edition of CNS tumors. The case of a 64-year-old female patient is reported in this paper. More than 30 cases of this lately recognized pathological entity have been reported to date. The diagnostic, radiological, and pathological features associated with this tumor are discussed through a literature review. PMID:24716015

  3. Feline Hyperthyroidism: A Case Report and Review of the Literature

    PubMed Central

    Joffe, Daniel J.

    1986-01-01

    A sixteen year old cat was examined because of polyphagia and weight loss. On the basis of elevated thyroxine levels and the clinical presentation a diagnosis of hyperthyroidism was made. The cat was treated presurgically with propylthiouracil and propranolol. Surgical excision of the grossly affected thyroid lobe, and partial excision of the apparently normal contralateral lobe was carried out. The cat improved clinically after the surgery but elevated thyroxine levels persisted. This case and the literature review, which is presented also, stress the necessity to either demonstrate unilateral involvement via extensive presurgical work-up, or to do bilateral, or staged bilateral thyroidectomies in cases of feline hyperthyroidism. ImagesFigure 1.

  4. Ischemic nephropathy in South Dakota: case reports and review.

    PubMed

    Natarajan, Malarvizhi; Larson, Christopher; Zawada, Edward T

    2004-09-01

    Ischemic nephropathy, a relatively new term coined to describe renal insufficiency due to renal artery disease, is neither a new subject for medicine throughout the country, nor a new problem here in South Dakota. It is an important and overlooked cause of renal insufficiency and is almost certainly under-diagnosed. Five case reports and a review of the entity are described to illustrate the diversity of this clinical presentation. Intervention in such cases was thought to preserve, or even improve renal function, delaying the onset of end stage renal disease (ERSD).

  5. Paediatric Geographic Tongue: A Case Report, Review and Recent Updates

    PubMed Central

    Bhavana, Shivanand Bagalad; Deepak, Byathnal Suryakanth; Ashwini, Ramakrishna

    2016-01-01

    Geographic tongue is a benign recurrent condition of uncertain aetiology affecting the tongue characterized by loss of epithelium especially filiform papillae giving a characteristic appearance. The clinical presentation may vary from asymptomatic to painful and burning ulceration. The condition is commonly seen in adults but few cases are reported in children. A case of asymptomatic geographic tongue in three-year-old male child and literature review with new insight in aetiology is presented here. Management depends on the clinical condition and underlying aetiology. PMID:27042597

  6. Meningeal melanocytoma: case report and review of the literature.

    PubMed

    Ibáñez, J; Weil, B; Ayala, A; Jimenez, A; Acedo, C; Rodrigo, I

    1997-06-01

    We report a case of meningeal melanocytoma in the thoracic spinal cord of a 44-year-old woman and review previously documented cases. Our patient experienced numbness and tingling in her left leg for 8 years, and low back pains with intermittent claudication for the previous 2 months. A histologically benign 20-mm tumour was totally resected. Radiation therapy was not given. The tumour showed the histological, immunohistochemical and ultrastructural features of a meningeal melanocytoma. The patient is alive without recurrence 4.5 years after surgery.

  7. A case of true tubal hydatidiform mole and literature review.

    PubMed

    Siozos, A; Sriemevan, A

    2010-08-09

    Tubal hydatidiform mole is an uncommon condition with about 40 confirmed cases in the accessible literature. The patient usually presents with symptoms and signs of a classical ectopic pregnancy and it is only after histological examination and DNA ploidy analysis of the conceptus that a hydatidiform mole is diagnosed. Management requires complete removal of the conceptus and follow-up needs to be arranged with an appropriate supraregional centre. The authors present a case of complete molar tubal pregnancy and a review of the literature.

  8. Juvenile idiopathic arthritis: review of the literature and case report.

    PubMed

    Beena, J P

    2013-01-01

    Juvenile idiopathic arthritis (JIA), previously known as juvenile chronic arthritis or juvenile rheumatoid arthritis, is a chronic disease of childhood with a spectrum of joint involvement and associated systemic involvement. The cause of JIA is poorly understood, and no drugs can cure the disease currently. Pediatric dentists should be familiar with the symptoms, complications, and oral manifestations of JIA to help manage the disease and provide quality care to these patients. The purpose of this case report is to review the condition and to describe the case of an adolescent with polyarticular juvenile rheumatoid arthritis, focusing on specific recommendations for dental management.

  9. Clear cell meningioma: case report and review of the literature.

    PubMed

    Oviedo, Angelica; Pang, Dachling; Zovickian, John; Smith, Matthew

    2005-01-01

    Clear cell meningioma (CCM) is a rare variant of meningioma. Only 17 cases have been previously reported in children. Although it has bland cytologic features, it has a higher rate of recurrence than does conventional meningioma. This variant has been reported in sites such as spinal/intradural (lumbar and thoracic), cerebellopontine angle, and supratentorial. The differential diagnosis of CCM includes microcystic meningioma, hemangioblastoma, and clear cell ependymoma. The characteristic histology and immunohistochemistry leads to the diagnosis. We present a case of a 7-year-old boy with a CCM of the cauda equina and a review of pediatric CCM.

  10. Pituitary apoplexy in pregnancy: A case series and literature review

    PubMed Central

    Grand'Maison, Sophie; Weber, Florence; Bédard, Marie-Josée; Mahone, Michele

    2015-01-01

    Background Severe headache during pregnancy is a challenging condition that may rarely imply endocrine disturbances. Rapid recognition of pituitary apoplexy is needed to improve pregnancy outcome. Objective To review and compare maternal and fetal outcomes after pituitary apoplexy. Methods Four cases of pituitary apoplexy during pregnancy in our centre are reported and literature review covering the past 54 years was performed. Results In the four cases presented and the 33 reported in the literature, most women presented with severe headaches and systemic symptoms. Overall, 42% were treated surgically, 31% received bromocriptine or cabergoline and 61% were given hormone replacement. No major obstetrical complication was reported and all babies were healthy. Conclusion Pituitary apoplexy is a rare cause of sudden and severe headache during pregnancy. Rapid identification of this condition with potentially associated endocrine disturbances is important to ensure maternal and fetal well-being. A multidisciplinary team approach seems to reduce morbidity and mortality. PMID:27512477

  11. Review of the literature on necrotizing sialometaplasia and case presentation.

    PubMed

    Ledesma-Montes, Constantino; Garcés-Ortíz, Maricela; Salcido-García, Juan Francisco; Hernández-Flores, Florentino

    2015-01-01

    The aim of this article is to report a case of necrotizing sialometaplasia with long-term follow-up. A case of necrotizing sialometaplasia in a 37-year-old man with clinical documentation on the progress during a 2-year follow-up is presented. Data from an extensive review of the literature including clinical, imagenologic, and microscopic features are provided. Information on diagnostic and prognostic factors is offered and comprehensibly discussed. The importance of identification and diagnosis of this entity during the review of the slides from the first biopsy is stressed and the exclusive performance of an incisional biopsy is debated. The presented clinical photographs reveal the clinical changes of the lesion from the beginning of the lesions up to 2 years follow-up, documenting the complete long-term clinical course and the healing process of this entity.

  12. [Plant-based diets: a review].

    PubMed

    Szabó, Zoltán; Erdélyi, Attila; Gubicskóné Kisbenedek, Andrea; Ungár, Tamás; Lászlóné Polyák, Éva; Szekeresné Szabó, Szilvia; Kovács, Réka Erika; Raposa, László Bence; Figler, Mária

    2016-11-01

    Plant-based diet is an old-new trend in nutrition. In this review based on a historical context, we wish to introduce this popular nutritional trend. Our aim is to present plant-based diet as a primary measure for prevention. We intend to critically analyse some past stereotypes related to plant-based diet - whose main components include fruits, vegetables, whole grains, legumes, nuts and seeds - according to the literature (e.g. protein, vitamin B12, folic acid, and iron intake) by doing so we wish to create an adequate conceptual basis for its interpretation. We discuss positive physiological effects of plant-based diet and its possible role in diseases risk reduction. Cardiovascular and metabolic diseases developing due to obesity could be prevented by a properly compiled plant-based diet. For patients with cancer minimizing the intake of foods of animal origin - as opposed to plant-based ones - has proved to have positive effects. Our review suggests this diet can be used in a number of diseases and it also provides long-term sustainable solutions for the health care challenges of the newest era. Orv. Hetil., 2016, 157(47), 1859-1865.

  13. Systematic review and case report: Intracranial complications of pediatric sinusitis.

    PubMed

    Patel, Neha A; Garber, David; Hu, Shirley; Kamat, Ameet

    2016-07-01

    Intracranial complications of rhinosinusitis are rare in the post-antibiotic era. However, due to potentially devastating outcomes, prompt recognition and management are essential. This study aims to perform the first systematic review of the intracranial complications of rhinosinusitis in order to better characterize their clinical presentation, diagnosis, and treatment, and report a case of frontal lobe empyema secondary to pediatric frontoethmoid sinusitis. Ovid MEDLINE, Cochrane Library, and Google Scholar. Full-text, peer-reviewed journal publications from 1947 to January 1, 2015 in English; focus on intracranial complications of sinusitis; pediatric patients (<18 years of age); studies including data on diagnostic workup and treatment. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixteen studies involving 180 patients were included. An overwhelming majority of patients were young adolescent males (70%). The most common intracranial complications were subdural empyema (49%), epidural abscess (36%), cerebral abscess (21%), and meningitis (10%). Patients most often presented with nonspecific symptoms such as headache, fever, nausea and vomiting. Computed tomography with contrast or magnetic resonance imaging confirmed the diagnosis when intracranial complications were suspected. Typical treatment included surgical incision and drainage, often involving joint neurosurgical and otolaryngological procedures, combined with a long course of antibiotics. The morbidity rate was 27%, and the mortality rate was 3.3%. All studies were retrospective chart reviews, case series or case reports. A review of the currently available literature shows that with a high degree of suspicion, multidisciplinary cooperation and aggressive treatment, favorable outcomes are attainable. The most effective surgical treatment for intracranial complications remains unclear and should be investigated further. Copyright © 2016 Elsevier Ireland Ltd. All rights

  14. Amputee fetishism and genital mutilation: case report and literature review.

    PubMed

    Wise, T N; Kalyanam, R C

    2000-01-01

    A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the Internet. The patient had a long-standing amputee fetish, which evolved into eroticized genital mutilation. The transformation of the preferred fetish occurred in a setting of depression due to environmental stressors. The literature about amputee fetishism, also called "apotemnophilia," is reviewed, and possible connections with the genital mutilation are discussed.

  15. [Somnambulism and pavor nocturnus--review and case report].

    PubMed

    Staedt, J; Stoppe, G; Müller-Struck, A; Kunert, H J; Hajak, G; Rüther, E

    1992-11-01

    A case of night terror with sleepwalking in an adult patient is described. Sleep polygraphic data are presented. The literature related to sleepwalking, night terror and its treatment is reviewed. The psychopathologic patterns of sleepwalking and night terror are illustrated and the differentiations of parasomnias and epileptic seizures discussed. The clinical applications of these findings are described and practical recommendations made for the management of NON-REM parasomnia.

  16. Unilateral condylar hyperplasia: A case report and review of literature.

    PubMed

    Bharathi, Saravana C; Senthilnathan, S; Kumar, Lokesh D; Mohan, Anand C S; Taranath, M

    2014-01-01

    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle 'differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature.

  17. Multifocal and metastatic hepatic hemangioendothelioma: case report and literature review.

    PubMed

    Torres, Lucas Rios; Timbó, Luciana Sátiro; Ribeiro, Cristiane Maria de Freitas; Galvão Filho, Mario Melo; Verrastro, Carlos Gustavo Yuji; D'Ippolito, Giuseppe

    2014-01-01

    Epithelioid hemangioendothelioma is a rare neoplasm of vascular origin whose involvement of organs such as lung, spleen, bone, breast and liver has already been reported. The clinical signs and the prognosis of this tumor are quite variable. From the present case report, the authors have sought to contribute with literature data, by reviewing clinical and radiological features which may be useful to include such a condition in the differential diagnosis of liver lesions.

  18. [Bickerstaff brain encephalitis: case report and literature review].

    PubMed

    Guerra, Carolina; Uribe, Carlos Santiago; Guerra, Alejandro; Hernández, Olga H

    2013-01-01

    We describe the case of a 34-year-old male patient, who was referred to the Instituto Neurológico de Colombia with probable Guillain-Barré syndrome, requiring intensive care management. The presence of cognitive alterations during his evolution, lead the team to reconsider the initial diagnosis for the Bickerstaff's brainstem encephalitis diagnosis. We aim to describe the patient's treatment and evolution, as well as a brief review and discussion.

  19. Verrucous carcinoma-an enigma: Case report and review

    PubMed Central

    Rao, Dhanya S.; Kalappanavar, Anupama N.; Ali, I. M.; Annigeri, Rajeshwari G.

    2016-01-01

    Verrucous hyperplasia, verrucous keratosis, and VC may not be distinguished clinically or may coexist. Though it appears remarkably harmless, the histopathological diagnosis of VC should be accompanied with careful identification of tumors with a greater chance to become frank cancers. Here, we report two cases of OVC, referring all the diagnostic intricacy occurring in the clinicopathological examination along with a review of the scientific literature. PMID:27630507

  20. Verrucous carcinoma-an enigma: Case report and review.

    PubMed

    Rao, Dhanya S; Kalappanavar, Anupama N; Ali, I M; Annigeri, Rajeshwari G

    2016-01-01

    Verrucous hyperplasia, verrucous keratosis, and VC may not be distinguished clinically or may coexist. Though it appears remarkably harmless, the histopathological diagnosis of VC should be accompanied with careful identification of tumors with a greater chance to become frank cancers. Here, we report two cases of OVC, referring all the diagnostic intricacy occurring in the clinicopathological examination along with a review of the scientific literature.

  1. Extraskeletal Osteosarcoma: A case report and review of the literature

    PubMed Central

    Hoch, Michael; Ali, Sayed; Agrawal, Shefali; Wang, Congli; Khurana, Jasvir S.

    2013-01-01

    We report an instructive case of extraskeletal osteosarcoma in a 63-year-old African American male who presented after an episode of recent trauma, with clinical and radiological features characteristic of this neoplasm. Osteosarcoma is the most common primary malignant tumor of bone in young adults, but the extraskeletal variety is very uncommon. The radiological and pathological features of this neoplasm will be discussed, along with a review of the literature. PMID:24421944

  2. Oral Myiasis: A Rare Case Report and Literature Review

    PubMed Central

    Prasad Guru, R; Ashutoshdutt, Pathak; Meenakshi, Sood

    2015-01-01

    Myiasis is a rare disease caused by infestation of tissue by larvae of flies. Oral myiasis is still “rare” and “unique” owing to the fact that oral cavity rarely provides the necessary habitat for a larval lifecycle. Herein, we present a case of extensive gingival myiasis in a 12-year-old mentally retarded, epileptic child as well as a literature review. PMID:26884780

  3. Choledochal cysts--report of three cases and review.

    PubMed Central

    Waldron, R.; Drumm, J.; McCarthy, C. F.; Murphy, B.

    1984-01-01

    Three cases of choledochal cyst are presented, with a review of previous publications. We re-emphasize the diagnostic dilemma involved and discuss current surgical management. A new complication is illustrated and an association with polycystic kidneys is reported. Choledochal cysts are uncommon, but correct management ensures a symptom-free future for the patient. Recent reports support cyst excision if technically feasible. PMID:6462979

  4. Squamous Papilloma: Case Report and Review of Literature

    PubMed Central

    Jaju, Prashant P; Suvarna, Prashant V; Desai, Rajiv S

    2010-01-01

    Squamous papillomas are common lesions of the oral mucosa with a predilection for the mucosa of the hard and soft palate. As an oral lesion, it raises concern because of its clinical appearance, which may mimic exophytic carcinoma, verrucous carcinoma or condyloma acuminatum. Its pathogenesis is related to human papilloma virus but there is controversy regarding its viral origin. We present a case of squamous papilloma presenting as oral lesion along with a review of the literature. PMID:21404972

  5. Postoperative alopecia: a case report and literature review.

    PubMed

    Boyer, J D; Vidmar, D A

    1994-11-01

    Postoperative alopecia is the temporary or permanent loss of hair that occurs following prolonged immobilization during general anesthesia and intubation. The clinical and histopathologic aspects of a typical case are described and the literature reviewed. Localized pressure-induced ischemia is the likely cause. Patients at highest risk for permanent hair loss include those subject to cardiac or gynecologic surgical procedures where the combined intraoperative and postoperative intubation time exceeds twenty-four hours. Frequent intraoperative and postoperative head repositioning provides excellent prophylaxis.

  6. [One case report of SAPHO syndrome and literature review].

    PubMed

    Liu, Rui; Liu, Xiang Yuan

    2008-12-18

    To study the clinical features and diagnosis of synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (SAPHO) syndrome. One case of SAPHO syndrome was reported and the related data of SAPHO syndrome were reviewed. The main clinical features of the patient were articulatio carpi synovitis, acne, cervical rib hyperostosis, articulatio sternoclavicularis and osteitis, So the diagnosis of SAPHO syndrome was made. Though SAPHO syndrome is rare with yet unknown prevalence, it still can be seen in clinical practice, and can be diagnosed by careful examination.

  7. Oral bullous lichen planus: Case report and review of management

    PubMed Central

    Patil, Archana; Prasad, Shiva; Ashok, L.; Sujatha, G. P.

    2012-01-01

    A 34-year-old female patient with the chief complaint of burning sensation in the oral cavity associated with generalized pruritis, scalp and skin lesions diagnosed as Bullous lichen planus and treated with systemic prednisolone, levamisole, benzydamine oral rinse. Patient is in follow up since 1 year and free of lesions. Here we report the case and review current modalities in the management of oral lichen planus. PMID:23293497

  8. Focal dermal hypoplasia: a case report and literature review.

    PubMed

    Murakami, Christiana; de Oliveira Lira Ortega, Adriana; Guimarães, Antônio Sérgio; Gonçalves-Bittar, Daniela; Bönecker, Marcelo; Ciamponi, Ana Lídia

    2011-08-01

    Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.

  9. Sororicide in preteen girls. A case report and literature review.

    PubMed

    Adam, B S; Livingston, R

    1993-01-01

    All means of exploring the psychological and environmental antecedents of murder by a child should be used toward preventing lethal outcomes in future. The authors present the case of a ten year old girl who killed her sister with details of the sisters' relationship, the perpetrator's psychological characteristics and the family situation. Sibling-rivalry, family stressors, and the perpetrator's compulsive and narcissistic traits and preoccupation with a violent television fantasy are discussed. A literature review and suggestions for future research are provided.

  10. A brief case report and review of ciguatera poisoning.

    PubMed

    Farstad, D J; Chow, T

    2001-01-01

    Although ciguatera fish poisoning is generally a mild, self-limited disease, both life-threatening acute reactions and troublesome chronic symptoms can occur. Because ciguatera has been largely confined to tropical locations, a relative lack of recognition exists among many US physicians. As access to tropical locations has increased, so has the distribution of ciguatera. Herein, we present a case report and review the current literature on ciguatera.

  11. Mental health sequelae of bullying: a review and case report.

    PubMed

    Fleisher, William P; Schwartz, Leonard

    2003-02-01

    This paper is a review of the effects of bullying on children and adolescents. We begin with a case report of a young male who presented at a children's hospital emergency room after being subjected to months of bullying. We then proceed to a review of relevant literature, and focus on a definition of bullying, the incidence of this problem, and the characteristics of bullies, victims and those who both bully and are bullied. The consequences of this behaviour, both for the perpetrator and victim, are also examined. We note that all individuals who participate in bullying, whether as perpetrators, victims, or those who have been both the perpetrators and the targets of this particular form of aggression, have in some way been psychologically affected by such experiences. It is hoped that the significance of bullying behaviour, and its psychological cost on the psychological well-being of the children and adolescents involved with bullying, will be a central theme of this review.

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

    PubMed Central

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

    2015-01-01

    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. PMID:26509181

  13. An Architecture for Case-Based Learning

    ERIC Educational Resources Information Center

    Cifuentes, Laurent; Mercer, Rene; Alverez, Omar; Bettati, Riccardo

    2010-01-01

    We report on the design, development, implementation, and evaluation of a case-based instructional environment designed for learning network engineering skills for cybersecurity. We describe the societal problem addressed, the theory-based solution, and the preliminary testing and evaluation of that solution. We identify an architecture for…

  14. An Architecture for Case-Based Learning

    ERIC Educational Resources Information Center

    Cifuentes, Laurent; Mercer, Rene; Alverez, Omar; Bettati, Riccardo

    2010-01-01

    We report on the design, development, implementation, and evaluation of a case-based instructional environment designed for learning network engineering skills for cybersecurity. We describe the societal problem addressed, the theory-based solution, and the preliminary testing and evaluation of that solution. We identify an architecture for…

  15. Genital pyoderma gangrenosum: report of two cases and published work review of Japanese cases.

    PubMed

    Satoh, Masataka; Yamamoto, Toshiyuki

    2013-10-01

    Pyoderma gangrenosum is an ulcerative skin disorder showing characteristic non-infectious ulcers and affects the lower extremities in approximately 70% of cases. Pyoderma gangrenosum is commonly associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis and hematological malignancies. Herein, we report two cases of Japanese patients diagnosed with genital pyoderma gangrenosum. Case 1 was a 74-year-old woman without associated systemic complications, whose skin lesion resembled a squamous cell carcinoma and was limited to the vulva. Case 2 is an 89-year-old man, who suffered from myelodysplastic syndrome and acute myeloid leukemia, and presented with penile and leg ulcers mimicking pressure sores. Both cases responded well to systemic steroids. We review 13 genital pyoderma gangrenosum cases (76.9% male; aged 30-89 years) from 1996 to 2012 in Japan, including 11 previously reported cases and the present study's two cases. Four of the 13 genital pyoderma gangrenosum cases had associated systemic diseases and their skin lesions spread to the extragenital areas. Eight of the remaining nine genitalia-localized pyoderma gangrenosum cases had no associated systemic diseases. In conclusion, genital pyoderma gangrenosum is rare and may be misdiagnosed. It should therefore be considered in cases of refractory genital ulcers. In addition, genitalia-localized pyoderma gangrenosum tends to be without systemic complications.

  16. 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

  17. Accidental acute alcohol intoxication in infants: review and case report.

    PubMed

    Minera, Gabriella; Robinson, Evan

    2014-11-01

    Acute alcohol intoxication in children younger than 18 months old is both rarely documented and rarely fatal. Previous case reports suggest hypoglycemia and faster than normal rates of alcohol elimination found in children with acute alcohol intoxication compared with adults, but data are lacking. A 2-month-old infant presented with a decreased mental status after accidental ingestion of alcohol. He was diagnosed with acute alcohol intoxication, with a blood alcohol level of 330 mg/dL and was hyperglycemic (167 mg/dL). Alcohol elimination rate was calculated to be 21.6 mg/dL/h, similar to that in adults. To our knowledge, this case is the second youngest documented patient with accidental alcohol intoxication via ingestion in the United States. We present a rare case report of acute alcohol intoxication in an infant and a review of the literature. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although rare in the literature, poison control data suggests that alcohol poisoning in very young children is not rare. Emergency physicians should be prepared for the management of infants with alcohol poisoning. This case report and review brings attention to this subject and briefly discusses ethanol metabolism in infants. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Evidence-based radiology: review and dissemination.

    PubMed

    Medina, L Santiago; Blackmore, C Craig

    2007-08-01

    Evidence-based radiology (EBR) is an important tool for the practice of radiology. The user of the EBR approach identifies evidence in a systematic fashion and then assimilates information through in-depth, explicit critical review of the best-designed and most recent literature on the subject in question. Clinical decision making is then based on the best current evidence, clinical expertise, and patient values. Substantial progress has been made in the review and dissemination of EBR. Dissemination of EBR within radiology has two critical aspects. The first is increased understanding of the methods required for EBR and of the appropriate use of EBR. The second important component is the dissemination of the data and critical literature reviews necessary to allow use of the EBR approach. Resources available for both EBR methods and EBR data in radiology include societies, journals, medical meetings, Web sites, and textbooks. Although radiology has made important progress in this field in recent years, the specialty is still behind other specialties that have been at the forefront of evidence-based medicine in the past decade.

  19. Down-Turner syndrome: case report and review.

    PubMed Central

    Van Buggenhout, G J; Hamel, B C; Trommelen, J C; Mieloo, H; Smeets, D F

    1994-01-01

    We present a male patient with Down-Turner mosaicism (45,X/46,X,+21/47,XY,+21) and review 27 similar cases reported so far. Clinical features of Down's syndrome were present in all cases, whereas a combination of features of both Ullrich-Turner syndrome and Down's syndrome was reported in 61% of the patients. However, one has to bear in mind that several stigmata of Ullrich-Turner syndrome can also be present in patients with Down's syndrome and vice versa. In most of the patients two different cell lines were encountered, although cases with one, three, and even four different cell lines have been reported. Of 28 patients, 21 showed female external genitalia, four were phenotypically male, and three showed ambiguous genitalia. Only six patients (21%) carried a Y chromosome, which is far less than expected. Images PMID:7837259

  20. Radioiodine-induced thyroid storm. Case report and literature review

    SciTech Connect

    McDermott, M.T.; Kidd, G.S.; Dodson, L.E. Jr.; Hofeldt, F.D.

    1983-08-01

    Thyroid storm developed following radioiodine therapy in a 43-year-old man with Graves' disease, weight loss, myopathy, severe thyrotoxic hypercalcemia, and a pituitary adenoma. The hypercalcemia may have been a significant, and previously unreported, predisposing factor for the radioiodine-associated thyroid storm. This case and 15 other well-documented cases of radioiodine-associated storm found in the literature are reviewed, as are several other cases of less severe exacerbations of thyrotoxicosis associated with radioiodine therapy. Although not often seen, these complications are often fatal. High-risk patients, such as the elderly, those with severe thyrotoxicosis, and those with significant underlying diseases, may benefit from preventive measures such as the judicious use of thyrostatic medications during the periods before and after isotope administration.

  1. Lemierre syndrome: study of 11 cases and literature review.

    PubMed

    Righini, Christian Adrien; Karkas, Alexandre; Tourniaire, Romain; N'Gouan, Jean-Michel; Schmerber, Sébastien; Reyt, Emile; Atallah, Ihab

    2014-07-01

    Lemierre syndrome is a rare but serious illness that associates throat infection and thrombosis of the internal jugular vein (IJV) or one of its tributaries with subsequent distant septic emboli. The purpose of our study was to review the pathogenesis, clinical presentation, and treatment of this disease. Patients with confirmed Lemierre syndrome were included in our retrospective monocentric study. All patients had bacteriologic analyses as well as radiologic imaging. There were 11 patients in our study (from 1998-2012). Fusobacterium necrophorum was responsible for the infection in 45% of cases. Surgical drainage of pharyngeal, cervical, or mediastinal abscesses was carried out in 8 cases. All patients received broad-spectrum antibiotics. Six patients were admitted to the intensive care unit (ICU). One patient (9%) died. Treatment with broad-spectrum antibiotics is the primary choice of treatment of Lemierre syndrome. Surgery is indicated in case of abscess formation. Copyright © 2013 Wiley Periodicals, Inc.

  2. Trisomy 9: Review and report of two new cases

    SciTech Connect

    Arnold, G.L.; Kirby, R.S.; Stern, T.P.

    1995-04-10

    Trisomy 9 is a relatively uncommon chromosome abnormality that may sometimes be seen in the nonmosaic state. We reviewed 23 mosaic and 15 nonmosaic cases of trisomy 9, including 2 new cases, in order to better define the prognosis and phenotype of this disorder. A recognizable trisomy 9 phenotype was identified and included a {open_quotes}bulbous{close_quotes} nose, microphthalmia, and dislocated limbs. Other nonspecific anomalies involving various organ systems were also common. With one exception, all survivors had severe mental impairment. Mosaicism for trisomy 9 predicted longer survival, but the degree of mosaicism in lymphocytes or fibroblasts did not predict survival or degree of impairment. Parental chromosome variations were not uncommon. In contrast to prior reports, no specific prognostic finding was identified. A meiotic origin with loss of a trisomic cell line in mosaic cases is suggested. 43 refs., 2 figs., 2 tabs.

  3. Altered Taste and Stroke: A Case Report and Literature Review

    PubMed Central

    Dutta, Tara M.; Josiah, Anne F.; Cronin, Carolyn A.; Wittenberg, George F.; Cole, John W.

    2013-01-01

    Patients with altered taste perception following stroke are at risk for malnutrition and associated complications that may impede recovery and adversely affect quality of life. Such deficits often induce and exacerbate depressive symptomatology, which can further hamper recovery. It is important for clinicians and rehabilitation specialists to monitor stroke patients for altered taste perception so that this issue can be addressed. The authors present the case of a patient who experienced an isolated ischemic infarct affecting a primary cortical taste area. This case is unusual in that the isolated injury allowed the patient to remain relatively intact cognitively and functionally, and thus able to accurately describe her taste-related deficits. The case is further used to describe the relevant neurological taste pathways and review potential taste-related therapies. PMID:23340074

  4. Intratracheal ectopic thyroid tissue: a case report and literature review.

    PubMed

    Byrd, Michael C; Thompson, Lester D R; Wieneke, Jacqueline A

    2003-07-01

    We discuss a case of intratracheal ectopic thyroid tissue (ETT) that was retrieved from the files of the Otorhinolaryngic--Head and Neck Pathology Registry at the Armed Forces Institute of Pathology. The patient was a 54-year-old man who had a history of papillary thyroid carcinoma, which had been treated with a subtotal thyroidectomy. During routine follow-up 4 years later, the patient's primary care physician detected an elevated thyroglobulin level. Further referrals and evaluations revealed that the patient had intratracheal ETT. The patient refused to undergo surgical excision and remains without evidence of recurrent carcinoma. In a MEDLINE literature review, we found only 13 other well-documented cases of intratracheal ETT since 1966; in all but two cases, patients had benign disease. Once the possibility of thyroid carcinoma has been eliminated by histologic examination, intratracheal ETT can be managed by complete surgical excision with the prospect of an excellent long-term clinical outcome.

  5. A Critical Review of OSHA Heat Enforcement Cases: Lessons Learned.

    PubMed

    Arbury, Sheila; Lindsley, Matthew; Hodgson, Michael

    2016-04-01

    The aim of the study was to review the Occupational Safety and Health Administration's (OSHA) 2012 to 2013 heat enforcement cases, using identified essential elements of heat illness prevention to evaluate employers' programs and make recommendations to better protect workers from heat illness. (1) Identify essential elements of heat illness prevention; (2) develop data collection tool; and (3) analyze OSHA 2012 to 2013 heat enforcement cases. OSHA's database contains 84 heat enforcement cases in 2012 to 2013. Employer heat illness prevention programs were lacking in essential elements such as providing water and shade; adjusting the work/rest proportion to allow for workload and effective temperature; and acclimatizing and training workers. In this set of investigations, most employers failed to implement common elements of illness prevention programs. Over 80% clearly did not rely on national standard approaches to heat illness prevention.

  6. Juvenile Huntington's disease: a case report and literature review.

    PubMed

    Reyes Molón, L; Yáñez Sáez, R M; López-Ibor Alcocer, M I

    2010-01-01

    Huntington's disease is the most frequent neurodegenerative disease with a prevalence of fewer than 10 cases per 10,000 inhabitants; the juvenile form is responsible for less than 10% of all cases. Huntington's disease belongs to the group known as "triad syndromes," which evolve with cognitive, motor and neuropsychiatric manifestations. Around 30% of patients debut with behavioral symptoms, which are a major challenge for management by patients, families, and caregivers. Huntington's disease (HD) is reviewed and a case of juvenile onset is reported in this article. The characteristics of juvenile-onset Huntington's disease (HD) differ from those of adult-onset HD, as chorea does not occur, although bradykinesia, dystonia, and signs of cerebellar disorder, such as rigidity, are present, frequently in association with convulsive episodes and psychotic manifestations.

  7. Mycobacterium fortuitum complex endocarditis-case report and literature review.

    PubMed

    Olalla, J; Pombo, M; Aguado, J M; Rodríguez, E; Palenque, E; Costa, J R; Riopérez, E

    2002-02-01

    Endocarditis due to Mycobacterium fortuitum complex is a rare entity generally linked to the hospital environment. Only 18 cases have been published since 1966. Here we present a case of a female who developed an endocarditis due to Mycobacterium chelonae after valve replacement as well as a review of the literature. The course of this kind of endocarditis is generally subacute and the outcome is usually fatal. Blood cultures were positive in 75% of cases of metallic valve endocarditis, versus 20% in bioprostheses. The treatment must include antibiotics that have shown activity against these mycobacteria, such as amikacin, imipenem, cefoxitin, fluorinated quinolones and macrolides (especially clarithromycin). Surgical removal is recommended. Although the prognosis for the patient is poor, we should expect better outcomes with the use of new antibiotic regimens.

  8. Intraosseous pleomorphic adenoma: case report and review of the literature.

    PubMed

    Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A

    2002-01-01

    Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

  9. Trisomy 4p syndrome: A case report with review

    SciTech Connect

    Patel, S.V.; Dagnew, H.; Parekh, A.J.

    1994-09-01

    We present a case with trisomy of the short arm of chromosome 4, i.e., 46,XX,der(22)t(4;22)(p12;11.2). The most notable clinical findings included: prominent forehead, hypertelorism, small, bulbous nose with depressed and broad bridge, low hairline, retrognathia, notched auricular helix, rocker-bottom feet with prominent heel, arachnodactyly and comptodactyly. An additional, unique finding in our case is the presence of 13 ribs. In the past, the precise characterization of cases with trisomy for the 4p segment has been difficult by routine cytogenetic techniques because the bands involved in this abnormality are quite variable. We used the FISH technique, applying a battery of probes to delineate the genomic morbidity at the molecular level. In our case, the entire short arm is in the trisomic state, yet it could not be identified as a distinct syndrome prior to cytogenetic evaluation. The phenotypic spectrum associated with this gross chromosomal abnormality has been the subject of debate and scrutiny. We provided a comprehensive review of 64 cases and it is concluded that the clinical manifestations of the pure trisomy 4p syndrome are associated with trisomy of the distal two thirds to the entire p arm and that the additional material does not cause a more severe phenotype. Therefore, the molecular characterization of the short arm of chromosome 4 (4p) may be imperative in order to correlate the clinical expression with chromosome bands and ultimately with specific gene(s) in future cases.

  10. Hypospadias. A review of 299 cases operated 1957-69.

    PubMed

    Johanson, B; Avellán, L

    1980-01-01

    A review of 299 unselected primary cases of hypospadias of all types treated during the period 1957 to 1969 is presented. The same indications for operation and the same surgical principles were applied in all cases. The surgical treatment was performed in two stages: meatotomy or meatotomy combined with straightening in the first stage and urethral construction according to Denis Browne's method in the second stage. Complications occurred after the urethral construction in 11/289 cases (separation of the skin flaps in 5/289 and fistulas in 6/289). All 11 patients were reoperated with fully satisfactory results. The long-term results were followed up in a series of 220/299 cases. This series was used to study different problems affecting hypospadias. The mean age at the first operation was 8.5 years and the median age 4.4. The mean age at the latest control was 15.1 years and the median age 18.4. At the latest control no relapses with regard to curvature were observed during erection in the 151/220 cases in which straightening was performed. The meatus was adequate in all cases and the urinary flow, measured with a uroflowmeter, was normal.

  11. Gastric bronchogenic cysts: A case report and literature review

    PubMed Central

    TU, CHAOYONG; ZHU, JINGDE; SHAO, CHUXIAO; MAO, WEIBO; ZHOU, XINGMU; LIN, QIAOMEI; LI, ZHUKAI; ZHANG, JIE; ZHOU, QINGYUE; CHEN, WEI

    2016-01-01

    Gastric bronchogenic cysts are rare lesions, first described in 1956, with only 34 cases reported in the literature to date. The present study described a case of bronchogenic cyst of the stomach in a 17-year-old female who presented with periodic epigastric pain. In addition, the study analyzed the existing literature on these lesions. Gastric bronchogenic cysts are more common in females (female:male ratio, 21:14) and the median age of their development is 43 years. In total, 48.57% of the 34 previously reported cases were identified incidentally, and the remainder presented mainly with epigastric pain. Cyst sizes varied between 1.7 and 15 cm. In 3 cases, preoperative diagnosis was performed using needle biopsy, whereas several studies were initially misdiagnosed as stromal tumors. In 85% of the cases (31/35), cyst resection was performed, with laparoscopy used in 4 of the cases. The findings of the present study and literature review suggested that bronchogenic cysts of the stomach are rare, and surgical resection is warranted to treat symptoms and prevent malignant transformation. PMID:27073434

  12. [Painful tic convulsif: Case series and literature review].

    PubMed

    Revuelta-Gutiérrez, Rogelio; Velasco-Torres, Héctor Sebastián; Vales Hidalgo, Lourdes Olivia; Martínez-Anda, Jaime Jesús

    The coexistence of hemifacial spasm and trigeminal neuralgia, a clinical entity known as painful tic convulsive, was first described in 1910. It is an uncommon condition that is worthy of interest in neurosurgical practice, because of its common pathophysiology mechanism: Neuro-vascular compression in most of the cases. To present 2 cases of painful tic convulsive that received treatment at our institution, and to give a brief review of the existing literature related to this. The benefits of micro-surgical decompression and the most common medical therapy used (botulin toxin) are also presented. Two cases of typical painful tic convulsive are described, showing representative slices of magnetic resonance imaging corresponding to the aetiology of each case, as well as a description of the surgical technique employed in our institution. The immediate relief of symptomatology, and the clinical condition at one-year follow-up in each case is described. A brief review of the literature on this condition is presented. This very rare neurological entity represents less than 1% of rhizopathies and in a large proportion of cases it is caused by vascular compression, attributed to an aberrant dolichoectatic course of the vertebro-basilar complex. The standard modality of treatment is micro-vascular surgical decompression, which has shown greater effectiveness and control of symptoms in the long-term. However medical treatment, which includes percutaneous infiltration of botulinum toxin, has produced similar results at medium-term in the control of each individual clinical manifestation, but it must be considered as an alternative in the choice of treatment. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Pseudologia fantastica à deux: review and case study.

    PubMed

    Dimitrakopoulos, S; Sakadaki, E; Ploumpidis, D

    2014-01-01

    While lying is a diachronic integral part of human interaction, pseudologia fantastica represents probably its psychopathological dimension. There are relatively few reported cases on psychological mechanisms of pathological lying and also on criteria concerning psychopathological development on a ground of lying. A review of literature on possible psychological mechanisms of pseudologia fantastica is presented. Psychopathological qualities are rather controversial, especially whether pathological lying is a conscious act or not. DSM IV-TR recognizes pseudologia fantastica in association with factitious disorder but not as a clinical entity. Diagnostic issues are raised regarding lying, deception, pseudology and its shared dimension. Cases of shared pseudology are rarely reported in literature. Related shared psychopathological phenomena such as pseudologia à deux, folie à deux and mass hysteria are equally examined and compared under the prism of 'mental infection'. Cases of pseudologia fantastica are poorly understood or underecognized and clinicians usually pay minor attention in its psychopathological significance. It remains doubtful, whether pathological lying should be considered as an autonomous clinical entity. The need for research both on phenomenology and pathophysiology is emphasized. In addition to reviewing literature, we also report a case of pseudology à deux in a couple, a female and a male patient. Presented psychopathological manifestations, personality characteristics, psychological and social factors concerning both patients are considered, aiming to determine a sufficient phenomenological analysis. The diagnoses of pseudologia fantastica and folie à deux are discussed and documented. A second axis diagnosis of personality disorder and other diagnostic issues are also considered. A favorable issue of this case, within a follow up of one year, is due to the therapeutic and social potential of a community psychiatry's setting, offering an

  14. Case Study: University of Anyplace: Strategic Legal Risk Review.

    ERIC Educational Resources Information Center

    Hall, John T.; Ferguson, Rowan

    2000-01-01

    Considers legal issues and risks faced by a fictional American university as it seeks to establish an operation based in London. Addresses the first step in the process of risk management, the risk review exercise, and provides an explanation of the legal issues involved to allow progression to the second stage in the process (evaluation of the…

  15. Cheilitis Glandularis: Two Case Reports of Asian-Japanese Men and Literature Review of Japanese Cases

    PubMed Central

    Yanagawa, Toru; Yamaguchi, Akira; Harada, Hiroyuki; Yamagata, Kenji; Ishibashi, Naomi; Noguchi, Masayuki; Onizawa, Kojiro; Bukawa, Hiroki

    2011-01-01

    Cheilitis glandularis (CG) is a rare disorder characterized by swelling of the lip with hyperplasia of the labial salivary glands. CG is most frequently encountered in the lower lip, in middle-aged to older Caucasian men; however Asian cases were rarely reported. In this paper we present two cases of CG in Asian-Japanese men. One was a 23-year-old male with CG of the superficial suppurative type. The other was a 54-year-old male with deep suppurative type. We also reviewed the Japanese cases of CG in the literature and discussed about clinical feature of Japanese CG. PMID:21991474

  16. Foot Infection by Clostridium sordellii: Case Report and Review of 15 Cases in France

    PubMed Central

    Sautereau, Jean; Le Coustumier, Alain; Mory, Francine; Bouchier, Christiane; Popoff, Michel-R.

    2015-01-01

    We report a case of foot infection by Clostridium sordellii and review 15 human infections registered at a Reference Center in France during the period 1998 to 2011. All strains were found nontoxigenic, lacking the lethal toxin gene coding for TcsL. Like Clostridium septicum, several C. sordellii infections were associated with intestinal neoplasms. PMID:25609723

  17. Nanocarbon based ionic actuators—a review

    NASA Astrophysics Data System (ADS)

    Kosidlo, U.; Omastová, M.; Micusík, M.; Ćirić-Marjanović, G.; Randriamahazaka, H.; Wallmersperger, T.; Aabloo, A.; Kolaric, I.; Bauernhansl, T.

    2013-10-01

    Nanocarbons represented especially by carbon nanotubes (CNTs) and graphene have been of great interest during the last two decades, both from a fundamental point of view and for future applications. The most eye-catching features of carbon nanostructures (CNSs) are their electronic, mechanical, optical and chemical characteristics, which open a way for versatile applications. Among those future prospects, actuators are one of the promising technologies. Since 1999 when the first macroscopic actuator containing CNTs was reported, the interest of utilizing these materials as well as other CNSs in active systems has been triggered all over the world. This paper gives a thorough review as well as in-depth descriptions of the many aspects of nanocarbon-based actuators. The review covers aspects of worldwide research and development of nanocarbon ionic actuators up to 2012. Materials which are covered by this review include CNTs and their composites, carbon nanofibres (CNFs), graphene and its derivatives, microporous carbon materials (for example carbide derived carbons (CDCs) and carbon aerogels) as well as the possible combinations of these materials. The considered aspects cover the following fields: synthesis and characterization of the investigated materials, the actuation mechanism as well as modelling and simulation. Applications comprising system integration and device development are also reviewed within this paper.

  18. Game-based versus traditional case-based learning

    PubMed Central

    Telner, Deanna; Bujas-Bobanovic, Maja; Chan, David; Chester, Bob; Marlow, Bernard; Meuser, James; Rothman, Arthur; Harvey, Bart

    2010-01-01

    ABSTRACT OBJECTIVE To evaluate family physicians’ enjoyment of and knowledge gained from game-based learning, compared with traditional case-based learning, in a continuing medical education (CME) event on stroke prevention and management. DESIGN An equivalence trial to determine if game-based learning was as effective as case-based learning in terms of attained knowledge levels. Game questions and small group cases were developed. Participants were randomized to either a game-based or a case-based group and took part in the event. SETTING Ontario provincial family medicine conference. PARTICIPANTS Thirty-two family physicians and 3 senior family medicine residents attending the conference. INTERVENTION Participation in either a game-based or a case-based CME learning group. MAIN OUTCOME MEASURES Scores on 40-item immediate and 3-month posttests of knowledge and a satisfaction survey. RESULTS Results from knowledge testing immediately after the event and 3 months later showed no significant difference in scoring between groups. Participants in the game-based group reported higher levels of satisfaction with the learning experience. CONCLUSION Games provide a novel way of organizing CME events. They might provide more group interaction and discussion, as well as improve recruitment to CME events. They might also provide a forum for interdisciplinary CME. Using games in future CME events appears to be a promising approach to facilitate participant learning. PMID:20841574

  19. Course constructions: A case-base of forensic toxicology.

    PubMed

    Zhou, Nan; Wu, Yeda; Su, Terry; Zhang, Liyong; Yin, Kun; Zheng, Da; Zheng, Jingjing; Huang, Lei; Wu, Qiuping; Cheng, Jianding

    2017-08-01

    Forensic toxicology education in China is limited by insufficient teaching methods and resources, resulting in students with adequate theoretical principles but lacking practice experience. Typical cases used as teaching materials vividly represent intoxication and provide students with an opportunity to practice and hone resolving skills. In 2013, the Department of Forensic Pathology at Zhongshan School of Medicine began to construct top-quality courses in forensic toxicology, with its first step, creating a base containing typical cases of intoxication. This essay reviews the construction process of said cases-base, which is intended to set an example of forensic toxicology education. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Primary amebic meningoencephalitis in Florida: a case report and epidemiological review of Florida cases.

    PubMed

    Budge, Philip J; Lazensky, Becky; Van Zile, Kathleen W; Elliott, Karen E; Dooyema, Carrie A; Visvesvara, Govinda S; Beach, Michael J; Yoder, Jonathan S

    2013-04-01

    Primary amebic meningoencephalitis (PAM) is a rare but nearly always fatal infection of the central nervous system caused by the thermophilic, free-living ameba Naegleria fowleri. Since its first description in 1965 through 2010, 118 cases have been reported in the U.S.; all cases are related to environmental exposure to warm freshwater; most have occurred in children and adolescents and are associated with recreational water activities, such as swimming, diving, or playing in freshwater lakes, ponds, or rivers. Over one-fourth of all national PAM cases have occurred in Florida. The authors describe here a fatal case of PAM in a resident of northeast Florida and the ensuing environmental and public health investigation; they also provide a review of all cases of PAM in Florida from 1962 to 2010 and discuss public health responses to PAM in Florida, highlighting opportunities for positive collaboration between state and local environmental health specialists, epidemiologists, and the Centers for Disease Control and Prevention.

  1. 'Settings' based health promotion: a review.

    PubMed

    Whitelaw, S; Baxendale, A; Bryce, C; MacHardy, L; Young, I; Witney, E

    2001-12-01

    Over the past 10 years, 'settings' based health promotion has become a central feature of efforts to promote health that recognize the significance of context. Emerging in part from a perception of an over-reliance on individualistic methods, the approach was built on a profound belief in its value and deployed a range of novel theoretical resources, mainly from organizational sociology and psychology. This initial enthusiasm has been maintained within policy directives, in the published literature and, from our own experience, amongst health promotion practitioners. At the same time, with the maturing of the approach, has come a healthy element of critical review. Drawing upon the literature and based upon our experiences within the Health Education Board for Scotland, this paper seeks to bring together a range of perspectives, casting a critical yet constructive eye on current settings theory and practice. The paper first reviews the nature of settings based work, highlighting the varied bases and expectations that underpin it. Similarly, the many factors that influence the ability of health promoters to deliver such activities are considered. In relation to the construction and delivery of such activity, the paper suggests that there needs to be an explicit and detailed assessment of the nature of the setting, the skills of the health promoter and the associated expectations.

  2. Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review.

    PubMed

    Monte, Andrew A; Chuang, Ryan; Bodmer, Michael

    2010-12-01

    The aim of this review was to describe a patient with serotonin toxicity after an overdose of dextromethorphan and chlorphenamine and to perform a systematic literature review exploring whether dextromethorphan and chlorphenamine may be equally contributory in the development of serotonin toxicity in overdose. A Medline literature review was undertaken to identify cases of serotonin toxicity due to dextromethorphan and/or chlorphenamine. Case reports were included if they included information on the ingested dose or plasma concentrations of dextromethorphan and/or chlorphenamine, information about co-ingestions and detailed clinical information to evaluate for serotonin toxicity. Cases were reviewed by two toxicologists and serotonin toxicity, defined by the Hunter criteria, was diagnosed when appropriate. The literature was then reviewed to evaluate whether chlorphenamine may be a serotonergic agent. One hundred and fifty-five articles of dextromethorphan or chlorphenamine poisoning were identified. There were 23 case reports of dextromethorphan, of which 18 were excluded for lack of serotonin toxicity. No cases were identified in which serotonin toxicity could be solely attributed to chlorphenamine. This left six cases of dextrometorphane and/or chlorphenamine overdose, including our own, in which serotonin toxicity could be diagnosed based on the presented clinical information. In three of the six eligible cases dextromethorphan and chlorphenamine were the only overdosed drugs. There is substantial evidence from the literature that chlorphenamine is a similarly potent serotonin re-uptake inhibitor when compared with dextrometorphan. Chlorphenamine is a serotonergic medication and combinations of chlorphenamine and dextromethorphan may be dangerous in overdose due to an increased risk of serotonin toxicity. © 2010 The Authors. British Journal of Clinical Pharmacology © 2010 The British Pharmacological Society.

  3. Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review

    PubMed Central

    Monte, Andrew A; Chuang, Ryan; Bodmer, Michael

    2010-01-01

    The aim of this review was to describe a patient with serotonin toxicity after an overdose of dextromethorphan and chlorphenamine and to perform a systematic literature review exploring whether dextromethorphan and chlorphenamine may be equally contributory in the development of serotonin toxicity in overdose. A Medline literature review was undertaken to identify cases of serotonin toxicity due to dextromethorphan and/or chlorphenamine. Case reports were included if they included information on the ingested dose or plasma concentrations of dextromethorphan and/or chlorphenamine, information about co-ingestions and detailed clinical information to evaluate for serotonin toxicity. Cases were reviewed by two toxicologists and serotonin toxicity, defined by the Hunter criteria, was diagnosed when appropriate. The literature was then reviewed to evaluate whether chlorphenamine may be a serotonergic agent. One hundred and fifty-five articles of dextromethorphan or chlorphenamine poisoning were identified. There were 23 case reports of dextromethorphan, of which 18 were excluded for lack of serotonin toxicity. No cases were identified in which serotonin toxicity could be solely attributed to chlorphenamine. This left six cases of dextrometorphane and/or chlorphenamine overdose, including our own, in which serotonin toxicity could be diagnosed based on the presented clinical information. In three of the six eligible cases dextromethorphan and chlorphenamine were the only overdosed drugs. There is substantial evidence from the literature that chlorphenamine is a similarly potent serotonin re-uptake inhibitor when compared with dextrometorphan. Chlorphenamine is a serotonergic medication and combinations of chlorphenamine and dextromethorphan may be dangerous in overdose due to an increased risk of serotonin toxicity. PMID:21175434

  4. Cellulite: an evidence-based review.

    PubMed

    Luebberding, Stefanie; Krueger, Nils; Sadick, Neil S

    2015-08-01

    Cellulite is a multifactorial condition that is present in 80-90 % of post-pubertal women. Despite its high prevalence, it remains a major cosmetic concern for women. A wide range of products and treatments for cellulite reduction is available; however, no systematic review has been performed so far to evaluate the efficacy of the available treatment options for cellulite. The objective of this review is to provide a systematic evaluation of the scientific evidence of the efficacy of treatments for cellulite reduction. This systematic review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses. Only original articles in English or German reporting data on the efficacy of cellulite treatments from in vivo human studies were considered. In total, 67 articles were analyzed for the following information: therapy, presence of a control group, randomization, blinding, sample size, description of statistical methods, results, and level of evidence. Most of the evaluated studies, including laser- and light-based modalities, radiofrequency, and others had important methodological flaws; some did not use cellulite severity as an endpoint or did not provide sufficient statistical analyses. Of the 67 studies analyzed in this review, only 19 were placebo-controlled studies with randomization. Some evidence for potential benefit was only seen for acoustic wave therapy (AWT) and the 1440 nm Nd:YAG minimally invasive laser. This article provides a systematic evaluation of the scientific evidence of the efficacy of treatment for cellulite reduction. No clear evidence of good efficacy could be identified in any of the evaluated cellulite treatments.

  5. Acute appendicitis in pregnancy: Case series and review

    PubMed Central

    Burcu, Busra; Ekinci, Ozgur; Atak, Tuba; Orhun, Kivilcim; Eren, Turgut Tunc; Alimoglu, Orhan

    2016-01-01

    OBJECTIVE: Acute appendicitis is one of the most common acute surgical pathology we encountered. In this study we investigated our pregnant cases of appendicitis, and reviewed literature. METHODS: A total of 21 pregnant women who underwent appendectomy with the initial diagnosis of acute appendicitis in Istanbul Medeniyet University Clinics of General Surgery between January 2012, and December 2014 were retrospectively analyzed. The patients’s ages, trimesters, complaints, abdominal examination, laboratory, and ultrasonographic findings, surgical techniques, complications and hospital stay were noted. RESULTS: The patients were in their first (n=12; 57.1%), second (n=5; 23.8%), and third trimesters (n=4; 19.0%) of their pregnancies Median age was 23.9 years. All of the patients had abdominal pain. Median value of WBC count was 13.297/mm³. Ultrasound was positive in 12 patients (57.1%). In 14 (66.6%) patients McBurney incision, and in 6 (28.6%) cases right paramedian incision were used. One patient (4.8%) underwent laparoscopic appendectomy. Nineteen cases were acute appendicitis (90.5%), and two cases were perforated appendicitis (9.5%). Average hospital stay was 3.8 days. Two cases with perforated acute appendicitis developed wound infection and treated conservatively. There were no fetomaternal mortality. CONCLUSION: Physiologically anatomic and biochemical changes occurring during pregnancy can delay the diagnosis of acute appendicitis threaten the lives of both the mother and the fetus Therefore, rapid diagnosis and appropriate treatment convey importance. PMID:28058387

  6. Acute appendicitis in pregnancy: Case series and review.

    PubMed

    Burcu, Busra; Ekinci, Ozgur; Atak, Tuba; Orhun, Kivilcim; Eren, Turgut Tunc; Alimoglu, Orhan

    2016-01-01

    Acute appendicitis is one of the most common acute surgical pathology we encountered. In this study we investigated our pregnant cases of appendicitis, and reviewed literature. A total of 21 pregnant women who underwent appendectomy with the initial diagnosis of acute appendicitis in Istanbul Medeniyet University Clinics of General Surgery between January 2012, and December 2014 were retrospectively analyzed. The patients's ages, trimesters, complaints, abdominal examination, laboratory, and ultrasonographic findings, surgical techniques, complications and hospital stay were noted. The patients were in their first (n=12; 57.1%), second (n=5; 23.8%), and third trimesters (n=4; 19.0%) of their pregnancies Median age was 23.9 years. All of the patients had abdominal pain. Median value of WBC count was 13.297/mm³. Ultrasound was positive in 12 patients (57.1%). In 14 (66.6%) patients McBurney incision, and in 6 (28.6%) cases right paramedian incision were used. One patient (4.8%) underwent laparoscopic appendectomy. Nineteen cases were acute appendicitis (90.5%), and two cases were perforated appendicitis (9.5%). Average hospital stay was 3.8 days. Two cases with perforated acute appendicitis developed wound infection and treated conservatively. There were no fetomaternal mortality. Physiologically anatomic and biochemical changes occurring during pregnancy can delay the diagnosis of acute appendicitis threaten the lives of both the mother and the fetus Therefore, rapid diagnosis and appropriate treatment convey importance.

  7. A review on five cases of intramedullary dermoid cyst.

    PubMed

    Suocheng, Guo; Yazhou, Xing

    2014-04-01

    Intramedullary dermoid cyst is a type of rare congenital intraspinal lesions. Its proximity and its strong adherence to the surrounding spinal cord tissue often make a complete resection of the cyst wall problematic. We retrospectively studied five cases of intramedullary dermoid cyst, focusing the recurrence of intramedullary dermoid cyst after surgery and the probable method to prevent the recurrence. Five cases of intramedullary dermoid cyst with or without other concomitant deformities were retrospectively reviewed. Subjects consisted of three males and two females, aged 2–24 years. Diagnosis was confirmed by spinal MRI and pathology studies. Surgical outcomes were analyzed. In case 2, an Ommaya reservoir was implanted in the cystic cavity, and the cystic content was sucked though the Ommaya reservoir. An 18–113 months of follow-up was conducted. The contents of intramedullary dermoid cyst were loose and easy to be cleared in the operations. The cyst wall was closely adhered to the spinal cord, and complete resection was difficult. During the follow-up of 18–113 months, the lesion reoccurred in three cases. Intramedullary dermoid cyst is prone to recurrence. The presence of residual cyst wall might be the cause of dermoid cyst recurrence. When a complete resection of cyst wall becomes infeasible, placement of an intraspinal Ommaya reservoir may help to delay and minimize clinical symptoms by aspiration of cystic contents in case of recurrence.

  8. Prosthetic Tricuspid Valve Thrombosis: Three Case Reports and Literature Review

    PubMed Central

    Yaminisharif, Ahmad; Alemzadeh-Ansari, Mohammad Javad; Ahmadi, Seyed Hossein

    2012-01-01

    A common complication of prosthetic heart valves is thrombosis. Although the incidence of prosthetic valve thrombosis (PVT) in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided PVT. Here, we describe three cases of tricuspid PVT with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants; and surgery. The first case was a woman who suffered from recurrent PVT, for which we successfully used Tenecteplase for second and third episodes. We employed Tenecteplase in this case for the first time in the therapy of tricuspid PVT. The second case had fixed leaflets in open position while being symptomless. At six months' follow-up, with the patient having taken oral anticoagulants, the motion of the leaflets was restricted and she was symptomfree. The last case was a woman who had a large thrombus in the right atrium immediately after mitral and tricuspid valvular replacement. The patient underwent re-replacement surgery and a new biological valve was implanted in the tricuspid position. Also, we review the literature on the pathology, signs and symptoms, diagnosis, and management of tricuspid PVT. PMID:23323074

  9. Amyand's Hernia with Appendicitis: A Case Report and Integrative Review

    PubMed Central

    Feitosa Cavalcante, Jéssica; Melo Teixeira Batista, Hermes; Cavalcante Pita Neto, Ivo; Fernandes Frutuoso, Jairo; Rodrigues Pinheiro, Woneska; Maria Pinheiro Bezerra, Italla; de Abreu, Luiz Carlos; de Menezes Silveira, Gylmara Bezerra

    2015-01-01

    Introduction. Inguinal hernia is a common disorder with an estimated prevalence of 1.2% of the entire population and it is 12 times more common in males. Objective. To describe a case of appendix with signs of inflammation in the hernia sac, condition that is rare and difficult to diagnose, and to perform literature review, describing the most relevant aspects and the main controversies. Method. Report of a case and search in PubMed on June 1, 2015, using the terms “Appendix” [MeSH term] AND “hernia, inguinal” [MeSH term]. Results. The search resulted in 38 articles in total, and after deleting the articles that were not part of the inclusion criteria, there were 26 case reports remaining. Discussion. The search resulted in a total of 38 articles and after deleting the articles that were not part of the inclusion criteria, there were 26 case reports remaining. Conclusion. Amyand's hernia is a rare and difficult to diagnose condition, being commonly found occasionally in surgical procedures. It should be remembered in the presence of cases of incarcerated hernia, due to its possible complications if not diagnosed. PMID:26640737

  10. Case-based hospital financing: the case of Norway.

    PubMed

    Magnussen, J; Solstad, K

    1994-03-01

    Several European countries are experimenting with new ways of organising and financing the hospital sector. This paper discusses the present Norwegian reform, where a system of fixed grants is replaced by a combination of payment per case and fixed grants. Initially implemented in four hospitals only, the decision to move to a full-scale reform will be based on the evaluation of this pilot project. The paper presents two alternative hypotheses on how a system with case-based financing will influence the performance of hospitals. Given that hospitals adjust passively to the constraints imposed by the financing system, increased efficiency is to be expected. If hospitals and hospital owners (i.e. the counties) interact in a game dominated by the hospital, however, the efficiency of the hospital will not be influenced by the financing system. We argue that the design of the pilot project limits the possibility of discriminating between these two hypotheses. Nevertheless, a comparison of key variables in the pilot hospitals with a set of reference hospitals indicates that the change of financing system has not had any substantial effect on hospital efficiency. Thus we are inclined to believe that hospitals in fact are able to set the level of efficiency independent of whether they are financed by fixed grants or a payment per case.

  11. Relationship between oral cancer and implants: clinical cases and systematic literature review.

    PubMed

    Jané-Salas, Enrique; López-López, José; Roselló-Llabrés, Xavier; Rodríguez-Argueta, Oscar-Francisco; Chimenos-Küstner, Eduardo

    2012-01-01

    The use of implants for oral rehabilitation of edentulous spaces has recently been on the increase, which has also led to an increase in complications such as peri-implant inflammation or peri-implantitis. Chronic inflammation is a risk factor for developing oral squamous cell carcinoma (OSCC). To review the literature of cases that associate implant placement with the development of oral cancer. We present two clinical cases and a systematic review of literature published on the relationship between oral cancer and implants. We found 13 articles published between the years 1996 and 2009, referencing 18 cases in which the osseointegrated implants are associated with oral squamous cell carcinoma. Of those, 6 articles were excluded because they did not meet the inclusion criteria. Of the 18 cases reported, only 7 cases did not present a previous history of oral cancer or cancer in other parts of the body. Based on the review of these cases, a clear cause-effect relationship cannot be established, although it can be deduced that there is a possibility that implant treatment may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of OSCC.

  12. Relationship between oral cancer and implants: clinical cases and systematic literature review

    PubMed Central

    López-López, José; Roselló-Llabrés, Xavier; Rodríguez-Argueta, Oscar-Francisco; Chimenos-Küstner, Eduardo

    2012-01-01

    The use of implants for oral rehabilitation of edentulous spaces has recently been on the increase, which has also led to an increase in complications such as peri-implant inflammation or periimplantitis. Chronic inflammation is a risk factor for developing oral squamous cell carcinoma (OSCC). Objectives: To review the literature of cases that associate implant placement with the development of oral cancer. Study design: We present two clinical cases and a systematic review of literature published on the relationship between oral cancer and implants. Results: We found 13 articles published between the years 1996 and 2009, referencing 18 cases in which the osseointegrated implants are associated with oral squamous cell carcinoma. Of those, 6 articles were excluded because they did not meet the inclusion criteria. Of the 18 cases reported, only 7 cases did not present a previous history of oral cancer or cancer in other parts of the body. Conclusions: Based on the review of these cases, a clear cause-effect relationship cannot be established, although it can be deduced that there is a possibility that implant treatment may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of OSCC. Key words: Cancer, oral cancer, dental implants, oral squamous cell carcinoma, dental implants complications. PMID:21743414

  13. Clinical Case Reporting in the Peer-Reviewed Physical Therapy Literature: Time to Move Toward Functioning.

    PubMed

    Davenport, Todd E

    2015-12-01

    Physical therapists increasingly are contributing clinical case reports to the health literature, which form the basis for higher quality evidence that has been incorporated into clinical practice guidelines. Yet, few resources exist to assist physical therapists with the basic mechanics and quality standards of producing a clinical case report. This situation is further complicated by the absence of uniform standards for quality in case reporting. The importance of including a concise yet comprehensive description of patient functioning in all physical therapy case reports suggest the potential appropriateness of basing quality guidelines on the World Health Organization's International Classification of Functioning Disability and Health (ICF) model. The purpose of this paper is to assist physical therapists in creating high-quality clinical case reports for the peer-reviewed literature using the ICF model as a guiding framework. Along these lines, current recommendations related to the basic mechanics of writing a successful clinical case report are reviewed, as well and a proposal for uniform clinical case reporting requirements is introduced with the aim to improve the quality and feasibility of clinical case reporting in physical therapy that are informed by the ICF model. Copyright © 2013 John Wiley & Sons, Ltd.

  14. [Neonatal hyperthyroidism: a case report and literature review].

    PubMed

    Li, Ning; Li, Xiao-Hua; Yao, Ying-Min

    2013-10-01

    We report a case of neonatal thyrotoxicosis with concurrent respiratory failure in an infant born to a mother with Graves' disease and review the published literature describing neonatal hyperthyroidism. The male infant who was born by spontaneous delivery at 35 weeks of gestational age presented with fever, tachycardia and tachypnea at rest on day 11 after birth, and developed severe apnea on day 14. Thyroid function studies revealed hyperthyroidism in the infant, and his mother was confirmed to have Grave's disease during pregnancy. Literature review showed that among the 33 infants with similar conditions, tachycardia, tachypnea and poor weight gain were the most distinct clinical features of congenital hyperthyroidism. Accurate diagnosis of Graves' disease in the mother during pregnancy and awareness of the clinical presentations of neonatal hyperthyroidism are key to reducing missed diagnosis or misdiagnosis of neonatal hyperthyroidism.

  15. Eternal Triangulation: Case Studies in the Evaluation of Educational Software by Classroom-Based Teacher Groups.

    ERIC Educational Resources Information Center

    Smith, David; Keep, Ros

    1988-01-01

    Reviews some of the problems involved in the evaluation of educational software, and describes a classroom-based case study approach to software evaluation intended for application by autonomous self-programming groups of teachers. (20 references) (Author/CLB)

  16. [Depression and crime. Review of the literature and original cases].

    PubMed

    Bénézech, M

    1991-02-01

    After mentioning the classical studies of Freud, Fenichel, De Greeff and Lagache, the author reviews contemporary works on the following relationships: depression-homicide; murder-suicide. Two cases of familial murder committed during a state of depression are then studied in depth. Two remarks from previous analyses are then made: the underestimation of the factor of depression in the homicidal act; and the need for reforming the practice of penal psychiatric survey. The author concludes that depressive and suicidal tendencies should be included among the best predictors of psychiatric dangerousness.

  17. Pyogenic spinal osteomyelitis: a review of 61 cases.

    PubMed

    Silverthorn, K G; Gillespie, W J

    1986-02-12

    The presentation and outcome of 61 cases of nontuberculous spinal osteomyelitis were reviewed. Although the commonest presentation was subacute, with back pain predominating, 10% had septicaemia and 7% paraperesis or paraplegia. Most infections were caudal to the fourth thoracic vertebra. One third were associated with preceding urinary, respiratory, dental or abdominal sepsis. Staphylococcus aureus was the infecting organism in 85% of isolates. Delay in diagnosis was frequent. There were four deaths, and seven individuals remained severely disabled: outcome was otherwise satisfactory. An algorithm for the investigation and management of this uncommon but serious condition is proposed.

  18. Intracranial Rhabdomyoma: Case Report and Review of the Literature

    PubMed Central

    Santiago-Dieppa, David R; Zhou, Tianzan; Jones, Karra A; Chen, James Y; Hansen, Lawrence; U, Hoi Sang

    2016-01-01

    A 24-year-old male presented with eight months of increasingly severe frontal headaches, decreased right facial sensation, and periodic vertigo. Magnetic resonance imaging demonstrated a heterogeneously contrast-enhancing mass involving and expanding the right foramen ovale.  A biopsy of the lesion was performed, and the final pathologic diagnosis revealed a neoplastic rhabdomyoma. To date, only five cases of intracranial rhabdomyoma have been reported, and a rhabdomyoma involving the trigeminal nerve has never been described in an adult. This manuscript reviews the available literature and highlights the clinical, imaging, pathologic characteristics, and surgical management of these exceedingly rare lesions. PMID:27335706

  19. Focal cemento-osseous dysplasia: review and a case report.

    PubMed

    Salem, Y M Y; Osman, Y I; Norval, E J G

    2010-10-01

    Focal cemento-osseous dysplasia is a benign fibro-osseous condition that can be seen in dentate and edentulous patients. It is an asymptomatic lesion and needs no treatment; however follow-up is essential due to the possibility that focal cemento-osseous dysplasia can progress to a condition called florid osseous dysplasia that involves multiple sites. A case report is presented here, along with a review of the differential diagnoses considered in order to reach a final diagnosis of focal cemento-osseous dysplasia.

  20. Paresthesia during orthodontic treatment: case report and review.

    PubMed

    Monini, André da Costa; Martins, Renato Parsekian; Martins, Isabela Parsekian; Martins, Lídia Parsekian

    2011-10-01

    Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder.

  1. Familial isolated congenital asplenia: case report and literature review.

    PubMed

    Ahmed, Syed Ather; Zengeya, Stanley; Kini, Usha; Pollard, Andrew J

    2010-03-01

    Congenital asplenia is a rare life-threatening condition, often presenting with pneumococcal sepsis. It may arise as part of situs abnormalities or result from an unrelated specific defect of spleen development. The mode of inheritance is usually autosomal dominant, though sporadic cases are also reported. In affected individuals, the use of appropriate antibiotic prophylaxis and immunisations could save lives. In our report, we describe a family of three siblings with isolated congenital asplenia and unaffected parents, suggestive of recessive inheritance. The diagnosis in the proband was made post mortem following overwhelming pneumococcal sepsis. We also review the literature and compare the eight families previously reported with congenital isolated asplenia.

  2. Cold urticaria: a case report and review of the literature.

    PubMed

    La Shell, Mark S; Tankersley, Michael S; Kobayashi, Machiko

    2005-10-01

    Cold urticaria represents a form of physical urticaria. The disorder is uncommon, and patients with the condition are at risk for systemic reactions and thus must be identified, counseled, and treated accordingly. Diagnosis principally is clinical and is confirmed by the results of cold stimulation tests such as placing an ice cube on the patient's forearm. Treatment primarily consists of preventive counseling, epinephrine autoinjections, and antihistamines. We present the case of a 9-year-old girl with acquired cold urticaria and review the literature.

  3. Aarskog-scott syndrome: a review and case report.

    PubMed

    Closs, Luciane Q; Tovo, Maximiano; Dias, Caroline; Corradi, Daniele P; Vargas, Ivana A

    2012-09-01

    This paper reports the treatment and 12-year follow-up of a patient 7 years old who had been diagnosed with Aarskog-Scott syndrome. The patient had a history of premature multiple tooth loss, vertical dimension loss and severe dentoalveolar discrepancy. Orthopedic and orthodontic rehabilitation treatments were performed to improve the patient's esthetic, functional and psychological condition. How to cite this article: Closs LQ, Tovo M, Dias C, Corradi DP, Vargas IA. Aarskog-Scott Syndrome: A Review and Case Report. Int J Clin Pediatr Dent 2012;5(3):209-212.

  4. Case Study and Review: Treatment of Tricuspid Prosthetic Valve Thrombosis

    PubMed Central

    Yi Zhang, David; Lozier, Jay; Chang, Richard; Sachdev, Vandana; Chen, Marcus Y.; Audibert, Jennifer L.; Horvath, Keith A.; Rosing, Douglas R.

    2011-01-01

    Prosthetic valve thrombosis (PVT) is a severe and life-threatening complication of heart valve replacement. Conventional therapy is surgical thrombectomy or valve replacement. Medical thrombolysis is another emerging option. We report the case of a 57 year old woman with a history of Ebstein anomaly who underwent successful treatment of a tricuspid prosthetic valve thrombosis with intra-atrial infusion of very low dose recombinant tissue plasminogen activator (tPA). We review the presentation, etiology, diagnosis, and treatment of the tricuspid PVT emphasizing a modified medical option as a safe, minimally invasive alternative to surgical intervention or conventional medical therapy for tricuspid valve thrombosis. PMID:22000268

  5. [Cerebral hydatid cyst: Clinical case and review of the literature].

    PubMed

    Acha-Sánchez, José Luis; Yaya-Loo, Héctor José; Chipana-Sotomayor, Marco Enrique

    2016-12-13

    Hydatid disease is an accidental parasitosis, with brain location being rare. The case is reported of a 33year-old male, with no history of note, who was admitted to hospital with intracranial hypertension syndrome and right hemiparesis. Computed tomography showed a cystic lesion in the left frontal-parietal lobule. Surgery was performed by complete excision of the lesion, with a good outcome. Hydatid disease is a rare condition in the brain. Clinical suspicion is important for an early diagnosis. A review is presented on the pathogenesis, diagnosis and treatment of cerebral hydatid disease.

  6. Jaguar Attack on a Child: Case Report and Literature Review

    PubMed Central

    Iserson, Kenneth V.; Francis, Adama M.

    2015-01-01

    Jaguar attacks on humans rarely occur in the wild. When they do, they are often fatal. We describe a jaguar attack on a three-year-old girl near her home deep in a remote area of the Guyanese jungle. The patient had a complex but, relatively, rapid transport to a medical treatment facility for her life-threatening injuries. The child, who suffered typical jaguar-inflicted injury patterns and survived, is highlighted. We review jaguar anatomy, environmental status, hunting and killing behaviors, and discuss optimal medical management, given the resource-limited treatment environment of this international emergency medicine case. PMID:25834674

  7. [Endometrial ossification: a report of four cases and literature review].

    PubMed

    Nevarez Bernal, Roberto; Vilchis Nava, Pablo; Kably Ambe, Alberto

    2007-03-01

    Endometrial ossification is a rare endometrial pathology. Its predisposing factors include history of uterine curettage to metabolic abnormalities. It usually presents in patients with secondary infertility and history of first trimester pregnancy loss, accompanied by severe dysmenorrhea and dyspareunia. The diagnosis is suspected by OB-GYN history and USG findings, therapeutic strategies range from D&C to hysterectomy, we propose diagnosis and management by hysteroscopy in order to preserve future fertility and minimize uterine damage. A review of four cases during 1985-2004 from a large assisted reproduction center in Mexico City is presented.

  8. Chondroblastoma-like osteosarcoma: a case report and review.

    PubMed

    Aycan, Osman Emre; Vanel, Daniel; Righi, Alberto; Arikan, Yavuz; Manfrini, Marco

    2015-06-01

    Chondroblastoma-like osteosarcomas are extremely rare malignancies having varying clinical, radiological and histological features. Their rarity causes challenges in both diagnosis and clinical management. They are often misdiagnosed as benign lesions. Their accurate diagnosis is important because they require adequate treatment. Misdiagnosed lesions or undertreatment may result in recurrences. We report a case of chondroblastoma-like osteosarcoma arising in the left first metatarsal bone with tarsometatarsal joint involvement in a 10-year-old boy for whom surgery with an original technique was planned after a multidisciplinary diagnostic review.

  9. Achromobacter species endocarditis: A case report and literature review

    PubMed Central

    Derber, Catherine; Elam, Kara; Forbes, Betty A; Bearman, Gonzalo

    2011-01-01

    Endocarditis due to Achromobacter species is a rare, yet serious, endovascular infection. Achromobacter species infective endocarditis is associated with underlying immunodeficiencies or prosthetic heart valves and devices. A case of prosthetic pulmonary valve endocarditis secondary to Achromobacter xylosoxidans subspecies denitrificans is described in the present report. This life-threatening infection was successfully treated with combined valve replacement and prolonged antibiotic therapy. A Medline/PubMed literature review of Achromobacter endocarditis was also performed. Achromobacter species are an uncommon, yet important, cause of nosocomial endocarditis. Given the significant associated morbidity and mortality, along with a high degree of intrinsic antibiotic resistance, Achromobacter species infective endocarditis remains a clinical treatment challenge. PMID:22942890

  10. Jaguar attack on a child: case report and literature review.

    PubMed

    Iserson, Kenneth V; Francis, Adama M

    2015-03-01

    Jaguar attacks on humans rarely occur in the wild. When they do, they are often fatal. We describe a jaguar attack on a three-year-old girl near her home deep in a remote area of the Guyanese jungle. The patient had a complex but, relatively, rapid transport to a medical treatment facility for her life-threatening injuries. The child, who suffered typical jaguar-inflicted injury patterns and survived, is highlighted. We review jaguar anatomy, environmental status, hunting and killing behaviors, and discuss optimal medical management, given the resource-limited treatment environment of this international emergency medicine case.

  11. 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

  12. Meconium periorchitis: A case report and literature review

    PubMed Central

    Alanbuki, Ammar Hameed; Bandi, Ashwith; Blackford, Nick

    2013-01-01

    Meconium periorchitis (MPO) is an uncommon entity associated with healed meconium peritonitis. The typical presentation is a soft hydrocele at birth which becomes harder in weeks as the meconium calcifies. A lack of awareness of this rare disease may lead to unnecessary surgery of scrotal masses. It can resolve spontaneously without compromising the testicle. Scrotal ultrasound is the mainstay of imaging and abdominal plain film is less sensitive but can help in the diagnosis. We report a case of a meconium periorchitis and discuss its radiological and histological features. We also review the relevant literature. PMID:23914267

  13. Grounded Design of Web-Enhanced Case-Based Activity

    ERIC Educational Resources Information Center

    Kim, Hyeonjin; Hannafin, Michael J.

    2008-01-01

    Cases have been used in education through a variety of methods, such as case written analysis, case discussion, and case development. Recent case definitions and uses have extended their traditional uses. In case-based reasoning, cases are considered to represent knowledge, and the use of cases is integral to an individual's problem-solving…

  14. Karewsky syndrome: A case report and review of the literature

    PubMed Central

    Ploneda-Valencia, César Felipe; Sainz-Escárrega, Victor Hugo; Gallo-Morales, Mariana; Navarro-Muñiz, Eliseo; Bautista-López, Carlos Alfredo; Valenzuela-Pérez, Jesús Alonso; López-Lizárraga, Carlos René

    2015-01-01

    Introduction Gallstone ileus can be a lethal disease, rarely suspected in the clinical scenario. It represents about 25% of all bowel obstruction cases in patients older than 65. There is a classification of gallstone ileus based on the onset time: acute, subacute and chronic (Karewsky syndrome). We describe the first reported case of chronic gallstone ileus. Case presentation A 78-year-old female was admitted to the ER with a 15-day case of consistent bowel obstruction. The subject reported a five-year history of recurrent hospital admissions that resolved spontaneously after non-surgical management. Karewsky syndrome was diagnosed and managed with enterolithotomy. After five days of postoperative evolution the patient was discharged, and at six months follow up, no other hospital admission or relapse has been registered. Discussion The gallstone ileus diagnosis demands a higher clinical suspicion, there is no biochemical marker, and an abdominal CT is ideal for imaging-based diagnosis. There is no consensus on the optimal surgical approach. Conclusion We describe the first case of Karewsky syndrome and a gastro-jejune and gastric-choledochus double fistula. We emphasize the importance of higher clinical suspicion for patients with bowel obstruction older than 65 years old and make evident that although there are not evidence-based guidelines for this treatment, enterolithotomy is a recommended approach. PMID:26073917

  15. Spermatic Cord Lymphoma: A Case Report and Literature Review

    PubMed Central

    Taguchi, Satoru; Takahashi, Sayuri; Iida, Katsuyuki; Mizutani, Takashi; Yamaguchi, Kazumi; Tominaga, Takashi; Niwa, Naoya; Yoshimi, Mayumi; Takahashi, Tsuyoshi; Homma, Yukio

    2012-01-01

    Spermatic cord lymphoma is a rare lethal disease. It has a poor prognosis even in stage I or II disease when treated locally, therefore, multidisciplinary treatment for early stage is recommended. On the other hand, the treatment of choice for stage III or IV spermatic cord lymphoma remains to be determined. It is said that spermatic cord lymphoma is clinicopathologically similar to primary testicular lymphoma, therefore the treatment of spermatic cord lymphoma has often been determined by reference to the recommended treatment for primary testicular lymphoma. Here we report a new case of spermatic cord lymphoma, which was found in stage IV disease. We also review thirty-three cases which have been reported as spermatic cord lymphoma to date, and discuss treatment options. PMID:22431934

  16. Treatment responsive Holmes tremor: case report and literature review

    PubMed Central

    Alqwaifly, Mohammed

    2016-01-01

    Holmes tremor is a rare symptomatic movement disorder, characterized by a combination of resting, postural, and action tremors. It is usually caused by lesions involving the brainstem, thalamus, and cerebellum. It is often difficult to treat, many medications have been used with varying degrees of success. It may respond to stereotactic thalamotomy and deep brain stimulation in ventralis intermedius nucleus. Here I report a case of Holmes tremor secondary to multiple sclerosis that treated with L-dopa/carpidopa and showed marked improvement. A relevant literature search was performed, using PubMed for Holmes tremor as labelled in the literature. I included all patients diagnosed with Holmes tremor who responded to medical treatment. I found 27 cases, which are summarized in this review. This report describes a patient with Holmes tremor, who responded very well to Levodopa. This outcome suggests that Levodopa should be considered in the initial management of Holmes tremor. PMID:27833521

  17. Safety of Moxibustion: A Systematic Review of Case Reports

    PubMed Central

    Xu, Ji; Shen, Xueyong

    2014-01-01

    Moxibustion is a traditional medical treatment originating in China. It involves using the heat of burning moxa to stimulate acupoints. It is considered safe and effective and is widely used throughout the world. The increasing use of moxibustion has drawn attention to the procedure's adverse events (AEs). This review covers a total of 64 cases of AEs associated with moxibustion in 24 articles, reported in six countries. Some evidence of the risks of moxibustion has been found in these cases. AEs include allergies, burns, infection, coughing, nausea, vomiting, fetal distress, premature birth, basal cell carcinoma (BCC), ectropion, hyperpigmentation, and even death. The position, duration, distance between moxa and skin, proficiency of the practitioners, conditions of the patients, presence of smoke, and even the environment of treatment can affect the safety of moxibustion. Improving practitioner skill and regulating operations may reduce the incidence of adverse reactions and improve the security of moxibustion. PMID:24976851

  18. Coral reef aorta, emergency surgical: case report and literature review.

    PubMed

    Belczak, Sergio Quilici; Sincos, Igor Rafael; Aun, Ricardo; Costa, Kaline Viana; Araujo, Etianne Andrade

    2014-04-01

    Coral reef aorta is described as an uncommon entity characterized by the presence of coarse calcifications, which are developed in the visceral aorta. These calcifications grow toward the lumen of the artery and can result in significant stenosis, so that causing malperfusion of the lower limbs, visceral ischemia or hypertension secondary to renal involvement. We report here a case of a 54-year-old patient with coral reef aorta and symptomatic. The clinical presentation of the patient required the surgical approach. A review of literature in major databases was conducted to compare health-related aspects of the disease presentation and management. Coral reef aorta should be considered as the diagnosis for patients with visceral and limbs ischemia. The approach in our case was consistent with other studies previously published in the literature.

  19. Glomerulonephritis associated with tuberculosis: a case report and literature review.

    PubMed

    Solak, Yalcin; Gaipov, Abduzhappar; Anil, Melih; Atalay, Huseyin; Ozbek, Orhan; Turkmen, Kultigin; Polat, Ilker; Turk, Suleyman

    2013-06-01

    Rapidly progressive glomerulonephritis caused mycobacterium tuberculosis is rare; however, three case have been reported to date. Crescentic glomerulonephritis is a life-threatening disease and together with the presence of tuberculous infection is associated with a poor outcome if treatment is inadequate and delayed. We describe the case of a 31-year-old female patient with nephrotic syndrome and progressive renal failure secondary to pulmonary tuberculosis. Renal biopsy showed crescent formation in 14 out of 27 glomeruli, and there was diffuse linear staining of immunoglobulin G deposits. Treatment included corticosteroids in combination with antituberculosis drugs for 2 months, and resulted in a significant improvement in renal function, the disappearance of proteinuria and pulmonary symptoms. We also present a review of the pertinent literature and discuss the pathophysiology of tuberculosis-related acute postinfectious glomerulonephritis. Copyright © 2012. Published by Elsevier B.V.

  20. Holocord spinal epidural abscess: Case report and literature review.

    PubMed

    Xiang, H; Ma, X; Shen, N; Yue, B; Zhang, G; Chen, B

    2016-10-01

    Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.

  1. Lyell's Syndrome and Antimalarials: A Case Report and Clinical Review

    PubMed Central

    Nunes, Joana Miranda; Santareno, Sofia; Guerreiro, Lina; Margalho, Ana Filipa

    2017-01-01

    Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare, however, life-threatening mucocutaneous disorder with an epidermal detachment of a total body surface area (TBSA) of >30%. It is triggered by an idiosyncratic immune-allergic reaction to a drug, with many possible drugs implicated. Treatment success relies on early diagnosis and withdrawal of suspected/causative drug(s) and supportive care. Clinical evidence for specific therapies is still sparse. It is described a case of Lyell syndrome by sulfonamides for chemoprophylaxis of malaria. The patient presented with an extensive, rapidly evolving skin detachment, which progressed, despite supportive therapy, involving about 80% of TBSA. This led us to initiate a course of immunoglobulin with good clinical response. The aim of this work is to provide a discussion of the case and simultaneously make a practical literature review of TEN. PMID:28250622

  2. Coral reef aorta, emergency surgical: case report and literature review

    PubMed Central

    Belczak, Sergio Quilici; Sincos, Igor Rafael; Aun, Ricardo; Costa, Kaline Viana; Araujo, Etianne Andrade

    2014-01-01

    ABSTRACT Coral reef aorta is described as an uncommon entity characterized by the presence of coarse calcifications, which are developed in the visceral aorta. These calcifications grow toward the lumen of the artery and can result in significant stenosis, so that causing malperfusion of the lower limbs, visceral ischemia or hypertension secondary to renal involvement. We report here a case of a 54-year-old patient with coral reef aorta and symptomatic. The clinical presentation of the patient required the surgical approach. A review of literature in major databases was conducted to compare health-related aspects of the disease presentation and management. Coral reef aorta should be considered as the diagnosis for patients with visceral and limbs ischemia. The approach in our case was consistent with other studies previously published in the literature. PMID:25003933

  3. Aphallia: Report of three cases and literature review

    PubMed Central

    Talebpour Amiri, Fereshteh; Nasiry Zarrin Ghabaee, Davood; Naeimi, Ramezan Ali; Seyedi, Seyed Javad; Mousavi, Seyed Abdollah

    2016-01-01

    Background: Aphallia or penile agenesis is a rare malformation accompanying with no phallus. This anomaly is extremely rare with abnormality of urogenital system and psychological consequences. Its outbreak is estimated 1 out of 10-30 million births. Case: Reviewing 3 cases of male external genitalia agenesis, which associated with multiple anomalies of musculoskeletal, cardiovascular and genitourinary system. Conclusion: Aphallia has psychosocial consequences and a guarded prognosis. This study showed that if the kidney failure is due to its obstruction, these patients will be born in more favorable conditions and the future treatment measures will be directed to keep the external genitalia (male) through timely diagnosis and prenatal surgery and timely bladder drainage. PMID:27351031

  4. Congenital defects of pericardium: case reports and review of literature.

    PubMed

    Cuccuini, Matteo; Lisi, Francesca; Consoli, Arturo; Mancini, Sara; Bellino, Valentina; Galanti, Giorgio; Capaccioli, Leonardo

    2013-01-01

    Pericardial defects are a rare condition, generally asymptomatic, due to failure in development of pericardial sac. They are difficult to detect, particularly the complete absence of the pericardium. At present magnetic resonance imaging (MRI) is considered the best performing exam and it could be the first choice in the diagnosis of agenesia of the pericardium. A comprehensive review of dedicated books and PubMed literature was performed and three clinical cases have been analyzed. We report three cases, one with partial and two with total agenesia of the left pericardium, seen at our Institute and diagnosed at MRI as unexpected findings. The diagnosis of a congenital defect of the pericardium is challenging, even for expert radiologists, because this kind of deformity does not provide specific clinical nor conventional radiology findings. Nowadays, the most effective instrument for a certain diagnosis is MRI, interlocked with electrocardiography.

  5. Accessory parotid gland lesions: case report and review of literature.

    PubMed

    Stenner, M; Preuss, S F; Hüttenbrink, K-B; Klussmann, J P

    2008-09-01

    There are numerous causes for chronic cheek swelling, including masseteric hypertrophy, lymphadenopathy, diffuse inflammatory changes and neoplasia. We report an unusual case of a recurrent swelling as the result of sialolithiasis of an accessory parotid gland, which lay isolated from the main parotid gland along the Stensen's duct. The calculi developed in the accessory salivary tissue whereas all major salivary glands presented without sialolithiasis. Clinical findings as well as imaging results are shown and surgical management and histopathology are discussed. Hereby, for the first time we report a case with multiple calculi in an accessory parotid gland removed via a standard parotid incision. Further to this, we give a comprehensive review of literature on accessory parotid gland lesions.

  6. Primary pulmonary malignant fibrous histiocytoma: case report and literature review

    PubMed Central

    Li, Xiongfei; Liu, Renwang; Shi, Tao; Dong, Shangwen; Ren, Fan; Yang, Fan; Ren, Dian; Fan, Haiyang; Wei, Sen; Chen, Gang

    2017-01-01

    Malignant fibrous histiocytoma (MFH) is an aggressive soft tissue sarcoma known to occur in various organs. Primary MFH arising in the lung is quite rare. Herein we report a case of a 61-year-old male with primary pulmonary MFH and explore the underlying molecular mechanisms by next-generation sequencing (NGS). Five gene mutations in TSC2, ARID1B, CDK8, KDM5C and CASP8 were detected, and the mTOR inhibitor might be an effective treatment for this patient. In addition, we reviewed the scientific literature of approximately 23 primary pulmonary MFH case reports since 1990 and summarized the clinical features and prognosis of this rare pulmonary malignant tumor. PMID:28932590

  7. A case of miliary pulmonary cryptococcosis and review of literature.

    PubMed

    Severo, Cecília Bittencourt; Bruno, Rosana Mussoin; Oliveira, Flávio de Mattos; Teixeira, Paulo Zimmermann; Hochhegger, Bruno; Severo, Luiz Carlos

    2015-04-01

    We describe a case of cryptococcal fungemia in a 62-year-old male renal transplant patient. The diagnosis was established by isolation of Cryptococcus neoformans using the Isolator(®) blood culture lysis-centrifugation system. Testing for cryptococcal antigens was negative in the serum and cerebrospinal fluid. Transbronchial lung biopsies and bronchoalveolar lavage were negative. Antifungal therapy with fluconazole was started, resulting in fever remission, and a sustained clinical response was achieved. The literature on miliary pulmonary cryptococcosis is reviewed, and three similar cases were previously reported with disseminated cryptococcosis that resembled miliary tuberculosis on imaging. These emphasize the importance of eliminating causes other than tuberculosis in patients presenting with miliary pulmonary disease, even in countries with a high prevalence of tuberculosis.

  8. [Alrternating hemiplegia of childhood: a case report and literature review].

    PubMed

    Traut, Martín; Cavagnari, Brian M; Méndez, José H; Amartino, Hernán

    2012-10-01

    Alternating hemiplegia of childhood is an entity of uncertain etiology, with an incidence of about one case per million. This paroxysmal disease with progressive course is characterized by repeated episodes of hemiplegia that alternates its location and that may last from a few minutes to several days. These episodes are usually aborted during sleep. Paroxysmal eye movements, cognitive impairment and autonomic disorders, can also be seen. Due to its progressive course and bad prognosis, it turns out to be important for the generalist physician to be aware of this entity, thus facilitating an early diagnosis and avoiding empiric pharmacologic ineffective treatments. We present the case of a ten year-old girl with alternating hemiplegia of childhood, show imaging of this disease and make a brief review of the literature.

  9. Metastasis to the Jawbones: A review of 453 cases.

    PubMed

    Irani, Soussan

    2017-01-01

    The purpose of the present article was to review the characteristics of the jawbone metastases to analyze all variables. A relevant English Literature search in PubMed, Scopus, and Google Scholar was performed. All variables such as age, gender, primary and secondary tumor sites were analyzed. There were 453 metastatic cases. The male-to-female ratio was 1.2:1, and the mean age of the patients was 53.4 years. The lung was the most common primary site in men, and breast in women. The most common metastatic site was the mandible, and adenocarcinoma was the most frequent histological diagnosis. Metastases to the jaw bones occur in the advanced stages of a malignancy hence; a careful examination of patients with jaw bone lesions is strongly suggested. Dentists, as well as general physicians, should take into consideration the possible presence of jaw metastases in cases which present atypical symptoms, especially in patients with known malignant disease.

  10. Urethral hemangioma: case report and review of the literature.

    PubMed

    Regragui, Souhail; Slaoui, Amine; Karmouni, Tarik; El Khader, Khalid; Koutani, Abdelatif; Attya, Ahmed Ibn

    2016-01-01

    Hemangiomas are benign vascular tumors. They are the prerogative of the liver and skin. And genitourinary localizations are rare and have only been rarely reported in the prostat, bladder, ureter or the perineum. In the light of published cases, urethral hemangiomas are mostly found in males. Few cases of hemangioma in the female urethra were reported. We report a cavernous hemangioma of the urethra in a 61 years old patient who presented bleeding from the urethra and micturition disorders. Physical examination revealed a tumor 3 cm x 2 polyploid arising from the terminal urethra (urethral hemangioma). We performed surgical resection of the tumor, along with bladder drainage. The postoperative course was simple. We update through a review of the literature aspects of the diagnostic and therapeutic care of the urethral hemangioma.

  11. Managed care and ERISA: synopsis and case law review.

    PubMed

    Gerbasi, Joan B

    2003-01-01

    Managed care organizations (MCOs) have become the predominant health care model in the United States. Through cost containment arrangements with providers, incentives for patients to pursue less costly care and reductions in the provision of unnecessary care, MCOs are more intimately involved in the delivery of health care than their former fee-for-service insurance company counterparts. However, this new role has not implied increased liability, largely because of The Employee Retirement Income Security Act of 1974 (ERISA). This article provides an overview of ERISA and a review of the important legal cases in this area, including the three most recent Supreme Court cases. Courts have struggled with interpreting ERISA, and decisions have been difficult to reconcile. Frustration with this statute and the failure of the U.S. Congress to amend it, has led to more liberal interpretations of ERISA in recent years.

  12. Radiation-induced osteosarcoma of the skull base after radiation therapy in a patient with nasopharyngeal carcinoma: a case report and review of the literature.

    PubMed

    Echchikhi, Yassine; Loughlimi, Hasna; Touil, Asmae; Kebdani, Tayeb; Benjaafar, Noureddine

    2016-12-01

    Radiation-induced osteosarcomas are a recognized complication of radiation therapy. Owing to the fact that it is rare, publications on radiation-induced osteosarcoma of the skull base are limited to a small series and some case reports. We describe a rare case of a patient with a skull base radiation-induced osteosarcoma treated 11 years before with ionizing radiation for an undifferentiated carcinoma of the nasopharynx. The patient was treated with chemotherapy alone, but he died after the third cycle. Radiation-induced osteosarcoma of the skull base after treatment of nasopharyngeal carcinoma is a very rare but very aggressive complication with a poor prognosis. Chemotherapy gives bad results, and regular follow-up of treated patients should be considered.

  13. Florid Osseous Dysplasia-Report of Two Cases and Review of Literature

    PubMed Central

    Manoharan, G.V. Murali Gopika

    2017-01-01

    Florid osseous dysplasia is a rare benign fibro-osseous multiquadrant dysplastic lesion confined to the alveolar process of jaws, generally asymptomatic and usually detected incidentally during radiologic examination and requires no treatment unless symptomatic or cosmetically concerning. In this article, we present two rare cases of florid osseous dysplasia in Indian women with their clinical, radiographic and histologic findings and a brief review of literature. The first case was asymptomatic and the lesion was detected during routine radiographic examination and required no treatment whereas, the second case presented with features of osteomyelitis. Based on the clinical findings, the case was diagnosed as chronic suppurative osteomyelitis, but, after radiologic examination, diagnosis of florid osseous dysplasia with secondary osteomyelitis was made. Besides diagnostic challenge, management of the lesion is difficult due to poor vascularity. In our case, antibiotic prophylaxis along with surgical debridement and sequestrectomy was done with regular recall visits. PMID:28274069

  14. Bilateral sporotrichoid lymphocutaneous dermatosis in a drug abuser: case report and review of the literature.

    PubMed

    Chang, Shyue-Luen; Chung, Wen-Hung; Huang, Yu-Huei; Hong, Hong-Shang

    2008-01-01

    Bilateral sporotrichoid mycobacterial cutaneous infection is unusual and has been reported in only three cases involving different species and with an unknown route of infection in the literature.We report a case of bilateral sporotrichoid dermatosis in an immunocompetent patient with a history of intravenous heroin injection before development of the skin lesions. Both special stain and culture of biopsy specimen were negative. Finally, Mycobacterium fortuitum was identified by a polymerase chain reaction-based method. The patient responded well to clarithromycin and ciprofloxacin therapy. This case represents an unusual primary cutaneous M. fortuitum infection manifested as bilateral sporotrichoid lesions of the limbs. Review of previous reported cases of bilateral sporotrichoid mycobacterial infection shows different isolated organisms and routes of infection to that found in our case.

  15. Pediatric asthma case management: a review of evidence and an experimental study design.

    PubMed

    Schulte, Amanda; Musolf, Jeanne; Meurer, John R; Cohn, Jennifer H; Kelly, Kevin J

    2004-08-01

    Asthma is a complex disease that involves physiological, environmental, and psychosocial factors. This paper reviews childhood asthma case management by social service professionals, lay health workers, and nurses, and it presents a new randomized controlled study using nurse case management in a local community coalition. Evidence suggests the common factor for success involves case managers spending time contacting and patiently and persistently working with the family, thus building a trusting relationship. Although case management time is an expense for a health care payer, provider, and the child and family, the positive outcomes achieved can demonstrate the benefit of these interventions to all parties involved. The described experimental study assesses the cost and effectiveness of home-based nurse case management by a community coalition for children visiting an emergency department for asthma care.

  16. [Bronchiolitis obliterans organizing pneumonia. Review of six cases].

    PubMed

    Garay, J B; Zurdo, M R; López, O A; Gaviria, A Z; Medina, L V; Delgado, E G; Entrecanales, M V; Galiana, J R

    1996-02-01

    Bronchiolitis obliterans with organizing pneumonia (BOOP) is recently described clinicopathological entity, with only a few series of patients reported. Terminology is unclear, which together with its rarity lead to a poor understanding of the entity. To review the clinical, radiological, and laboratory features and the response to therapy in cases of BOOP in our environment. A total of 463 lung biopsies were obtained at Móstoles Hospital, Madrid, from 1992 to 1994. In six cases the anatomo-pathological diagnosis was BOOP. Clinical histories of these patients were reviewed. Six patients were diagnosed with BOOP. From these six patients, four (66%) were female, with a mean age of 59 years (45-74 years). Three patients (50%) were smokers. BOOP was idiopathic in four cases (66%) and secondary to rheumatoid arthritis in one (17%) and Legionella pneumonia in another patient (17%). Patients presented with cough and dyspnea (100%), chest pain and constitutional syndrome (66%) and fever (34%) of one to eight weeks evolution. Laboratory data included: increased ESR (100%), abnormal levels of liver enzymes (83%), hypoxemia (83%) and abnormal spirometry (50%). Radiological studies demonstrated alveolar infiltrates in 83%, predominantly in lower lobes, which were of a migratory nature in 33%. CT, performed in five patients, demonstrated alveolar infiltrates in all patients, which were bilateral and peripheric in two. Transbronchial biopsy was diagnostic in five cases, and in one patient thoracotomy had to be performed. One patient died (17%); the remaining patients (83%) improved with steroids, although 34% relapsed. Mean follow-up time was eleven months (5-24 months). BOOP observed in our environment is a rare entity, usually of an idiopathic nature, which presents with characteristic clinical course and laboratory findings. Transbronchial biopsy is diagnostic in many patients. The clinical course is good with steroids in most patients, although relapses are common.

  17. Collaborative Learning Utilizing Case-Based Problems

    ERIC Educational Resources Information Center

    Hilvano, Nestor T.; Mathis, Karen M.; Schauer, Daniel P.

    2014-01-01

    Engaging students in discussion and creating high impact teaching and learning practices are a challenge in every classroom. Small group discussion and poster presentations were used to solve case-based problems to highlight issues for the learner and to allow each student to demonstrate understanding and application of theory to real life…

  18. Gossypiboma in the oral region: Case report and literature review

    PubMed Central

    Pimenta-do-Amaral, Tania-Mara; Ribeiro-Souto, Giovanna; Alves-Mesquita, Ricardo

    2014-01-01

    Gossypiboma is an inflammatory reaction to a foreign body, specifically composed of a cotton matrix left behind after surgery. The present study aims to present a case report of gossypiboma 23 years after a dental surgery and to make a literature review of the English language cases published on the issue. A 42-year-old woman was attended to evaluate complaints of pain on the right side of the maxilla. The patient reported that dental extractions in this region had been performed over a period of nearly 23 years. The panoramic radiograph demonstrated an opacity in the right maxillary sinus, which presented a spongiform aspect, irregularly shaped radiopaque image, as well as a rupture of the maxillary sinus’s lower cortical layer. A surgical excision was performed, and the histopathological diagnosis was of gossypiboma. Six similar cases have also reported of gossypiboma in the oral region; however, calcification was only identified in the present case report. The patient is currently undergoing follow-up and has presented no complaints of pain or recurrence. Key words:Gossypiboma, textiloma, muslinoma, gauzoma, oral region. PMID:25593672

  19. Amyand hernia: Case report and review of the literature

    PubMed Central

    Morales-Cárdenas, Adrián; Ploneda-Valencia, César Felipe; Sainz-Escárrega, Victor Hugo; Hernández-Campos, Alvaro Cuauhtemoc; Navarro-Muñiz, Eliseo; López-Lizarraga, Carlos René; Bautista-López, Carlos Alfredo

    2015-01-01

    Introduction Amyand Hernia is a rare disease seen in approximately 1% of all hernias, complications of it, like acute appendicitis, or perforated appendicitis are even more rare, about 0.1%. Its diagnosis is very difficult in the pre-operative period; it is usually an incidental finding. Presentation of case This paper describes the case of a forty-year-old male patient, which was presented to the outpatient clinic of surgery with an incarcerated right side inguinal hernia without any signs of ischemic complications. He was admitted, and an hernioplasty was performed, as an incidental finding we encountered an Amyand hernia treated without appendectomy and placement of a prosthetic mesh without any complications. Discussion This disease represents a very challenging diagnosis, seven years ago the standardization of management had already been established; in this case we encountered a type 1 Amyand's Hernia so we performed a standard tension free hernioplasty without complications. Conclusion Amyand hernia is a rare condition, which represents two of the most common diseases a general surgeon has to face. Standardization of treatment is still ongoing and more prospective studies need to be done. This case demonstrates that this pathology must remain in the mind of the surgeons especially in the event of a strangulated hernia and offer a comprehensive review. PMID:25941568

  20. Two Cases of Human Thelaziasis and Brief Review of Korean cases

    PubMed Central

    Na, Byoung-Kuk; Yoo, Ji Myong

    2011-01-01

    The present study was performed to describe 2 cases of human thelaziasis (HT) which occurred in Gyeongsangnam- do and to briefly review the previously reported Korean cases. A 58-year old woman, residing in Hadong-gun, Gyeongsangnam-do, came to Gyeongsang National University Hospital (GNUH) complaining of foreign body sensation and itching of the right eye in March 2000. Total 6 adult nematodes of Thelazia callipaeda (2 males and 4 females) were detected in her right eye. A 80-year old man, residing in Jinju-si, Gyeongsangnam-do, came to GNUH complaining of foreign body sensation, itching, and pain of the right eye in December 2007. A total of 5 worms (4 females and 1 degenerated) were removed from his right eye. We analyzed characteristics of the total 39 Korean HT cases reported to date, including the present 2 cases. Most of the cases (71.8%) occurred in Seoul and Gyeonggi-do before 2000, and 21 cases (53.8%) were males and 18 (46.2%) were females. The prevalence was higher in younger ages below 30 years (48.7%) than 31-60 years (41.0%) and over 61 years (10.3%). The seasonal prevalence showed a higher incidence in autumn (43.6%) than in other seasons. Most of the cases (94.9%) were conjunctival sac infections and only 2 (5.1%) were intraocular cases. The present 2 HT cases are the first reported cases in Gyeongsangnam-do. Some characteristics of Korean HT cases were analyzed. PMID:22072826

  1. Network-based recommendation algorithms: A review

    NASA Astrophysics Data System (ADS)

    Yu, Fei; Zeng, An; Gillard, Sébastien; Medo, Matúš

    2016-06-01

    Recommender systems are a vital tool that helps us to overcome the information overload problem. They are being used by most e-commerce web sites and attract the interest of a broad scientific community. A recommender system uses data on users' past preferences to choose new items that might be appreciated by a given individual user. While many approaches to recommendation exist, the approach based on a network representation of the input data has gained considerable attention in the past. We review here a broad range of network-based recommendation algorithms and for the first time compare their performance on three distinct real datasets. We present recommendation topics that go beyond the mere question of which algorithm to use-such as the possible influence of recommendation on the evolution of systems that use it-and finally discuss open research directions and challenges.

  2. Magnesium based degradable biomaterials: A review

    NASA Astrophysics Data System (ADS)

    Gu, Xue-Nan; Li, Shuang-Shuang; Li, Xiao-Ming; Fan, Yu-Bo

    2014-09-01

    Magnesium has been suggested as a revolutionary biodegradable metal for biomedical applications. The corrosion of magnesium, however, is too rapid to match the rates of tissue healing and, additionally, exhibits the localized corrosion mechanism. Thus it is necessary to control the corrosion behaviors of magnesium for their practical use. This paper comprehensively reviews the research progress on the development of representative magnesium based alloys, including Mg-Ca, Mg-Sr, Mg-Zn and Mg-REE alloy systems as well as the bulk metallic glass. The influence of alloying element on their microstructures, mechanical properties and corrosion behaviors is summarized. The mechanical and corrosion properties of wrought magnesium alloys are also discussed in comparison with those of cast alloys. Furthermore, this review also covers research carried out in the field of the degradable coatings on magnesium alloys for biomedical applications. Calcium phosphate and biodegradable polymer coatings are discussed based on different preparation techniques used. We also compare the effect of different coatings on the corrosion behaviors of magnesium alloys substrate.

  3. Skull Base Inverted Papilloma: A Comprehensive Review

    PubMed Central

    Wassef, Shafik N.; Batra, Pete S.; Barnett, Samuel

    2012-01-01

    Skull base inverted papilloma (IP) is an unusual entity for many neurosurgeons. IP is renowned for its high rate of recurrence, its ability to cause local destruction, and its association with malignancy. This paper is a comprehensive review of the reports, studies, and reviews published in the current biomedical literature from 1947 to September 2010 and synthesize this information to focus on its potential invasion to the base of the skull and possible intradural extension. The objective is to familiarize the clinician with the different aspects of this unusual disease. The role of modern diagnostic tools in medical imaging in order to assess clearly the limits of the tumors and to enhance the efficiency and the safety in the choice of a surgical approach is pointed out. The treatment guidelines for IP have undergone a complex evolution that continues today. Radical excision of the tumour is technically difficult and often incomplete. Successful management of IP requires resection of the affected mucosa which could be achieved with open surgery, endoscopic, or combined approach. Radio and chemotherapy were used for certain indications. More optimally research would be a multicenter randomized trials with large size cohorts. PMID:23346418

  4. Raman-based microarray readout: a review.

    PubMed

    Haisch, Christoph

    2016-07-01

    For a quarter of a century, microarrays have been part of the routine analytical toolbox. Label-based fluorescence detection is still the commonest optical readout strategy. Since the 1990s, a continuously increasing number of label-based as well as label-free experiments on Raman-based microarray readout concepts have been reported. This review summarizes the possible concepts and methods and their advantages and challenges. A common label-based strategy is based on the binding of selective receptors as well as Raman reporter molecules to plasmonic nanoparticles in a sandwich immunoassay, which results in surface-enhanced Raman scattering signals of the reporter molecule. Alternatively, capture of the analytes can be performed by receptors on a microarray surface. Addition of plasmonic nanoparticles again leads to a surface-enhanced Raman scattering signal, not of a label but directly of the analyte. This approach is mostly proposed for bacteria and cell detection. However, although many promising readout strategies have been discussed in numerous publications, rarely have any of them made the step from proof of concept to a practical application, let alone routine use. Graphical Abstract Possible realization of a SERS (Surface-Enhanced Raman Scattering) system for microarray readout.

  5. Orbitofrontal epilepsy: Case series and review of literature.

    PubMed

    Chibane, Imane Samah; Boucher, Olivier; Dubeau, François; Tran, Thi Phuoc Yen; Mohamed, Ismail; McLachlan, Richard; Sadler, R Mark; Desbiens, Richard; Carmant, Lionel; Nguyen, Dang Khoa

    2017-09-16

    Orbitofrontal epilepsy (OFE) is less known and is poorly characterized in comparison with temporal lobe epilepsy, partly because it is rare and possibly because it is unrecognized and therefore underestimated. This paper aimed to better characterize seizure semiology, presurgical findings, and surgical outcomes in patients with OFE. We retrospectively reviewed all confidently established OFE cases from six Canadian epilepsy monitoring units between 1988 and 2014, and in the literature between 1972 and 2017. Inclusion criteria were identification of an epileptogenic lesion localized in the OFC or if the patient was seizure-free after surgical removal of the OFC in nonlesional cases. Sixteen cases were identified from our databases. Fifty percent had predominantly sleep-related seizures; 56% had no aura (the remaining had nonspecific or vegetative auras), and 62.5% featured hypermotor (mostly hyperkinetic) behaviors. Interictal epileptiform discharges over frontal and temporal derivations always allowed lateralization. Magnetic resonance imaging (MRI) identified an orbitofrontal lesion in 8/16, positron emission tomography (PET) identified a hypometabolism extending outside the orbital cortex in 4/9, ictal single-photon emission computed tomography (SPECT) identified an orbital hyperperfusion in 1/5, magnetoencephalography (MEG) identified lateral orbital sources in 2/4, and intracranial electroencephalography (EEG) identified an orbitofrontal onset in 9/10. Fourteen patients underwent surgery, all reaching a favorable outcome (71.4% Engel 1; 28.6% Engel 2; mean FU=5.6years). Pre- and postoperative neuropsychological assessments revealed heterogeneous findings. Our review of literature identified 71 possible cases of OFE, 32 with confident focus localization. Extracted data from these cumulated cases supported observations made from our case series. Orbitofrontal epilepsy should be suspected with sleep-related, hyperkinetic seizures with no specific aura, and

  6. Histological Stains: A Literature Review and Case Study.

    PubMed

    Alturkistani, Hani A; Tashkandi, Faris M; Mohammedsaleh, Zuhair M

    2015-06-25

    The history of histology indicates that there have been significant changes in the techniques used for histological staining through chemical, molecular biology assays and immunological techniques, collectively referred to as histochemistry. Early histologists used the readily available chemicals to prepare tissues for microscopic studies; these laboratory chemicals were potassium dichromate, alcohol and the mercuric chloride to harden cellular tissues. Staining techniques used were carmine, silver nitrate, Giemsa, Trichrome Stains, Gram Stain and Hematoxylin among others. The purpose of this research was to assess past and current literature reviews, as well as case studies, with the aim of informing ways in which histological stains have been improved in the modern age. Results from the literature review has indicated that there has been an improvement in histopathology and histotechnology in stains used. There has been a rising need for efficient, accurate and less complex staining procedures. Many stain procedures are still in use today, and many others have been replaced with new immunostaining, molecular, non-culture and other advanced staining techniques. Some staining methods have been abandoned because the chemicals required have been medically proven to be toxic. The case studies indicated that in modern histology a combination of different stain techniques are used to enhance the effectiveness of the staining process. Currently, improved histological stains, have been modified and combined with other stains to improve their effectiveness.

  7. Colonoscopic diagnosis of amebiasis: a case series and systematic review.

    PubMed

    Lee, Ko-Chao; Lu, Chien-Chang; Hu, Wan-Hsiang; Lin, Shung-Eing; Chen, Hong-Hwa

    2015-01-01

    Nonspecific gastrointestinal symptoms make diagnosis of amebiasis difficult. Certain colonoscopic findings predict amebic colitis while others suggest different diagnoses. We aimed to evaluate the diagnostic capability of colonic evaluation of amebiasis. We retrospectively reviewed data of all amebiasis cases admitted to our institution between 2003 and 2012. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and microscopic examination. Patients were stratified as right-sided colitis and proctosigmoiditis. A systematic review was conducted by searching Medline, Cochrane, EMBASE, and Google Scholar using key words amebiasis, amebic colitis, amebic proctosigmoiditis, colonoscopy, and Entamoeba histolytica. Data were extracted from articles meeting the inclusion criteria. Colonoscopic findings were described and studies were assessed for quality. The current series included 20 patients (5 male, 15 female, median age 51), 7 with amebic liver abscess and 13 with amebic colitis. Colonoscopic findings of right-sided colitis included aphthae or erosions, ulcers, exudates, or edematous swollen mucosa in cecum, and findings for proctosigmoiditis were edematous swollen mucosa with bloody exudate. In 25 studies, colonoscopic findings of 41 patients (36 male, 5 female, median age 43.39 years) included mainly ulcers in the cecum and rectum, ulcerated mass, and edematous mucosa; and in fewer patients, submucosal invasion suggestive of colon cancer, bleeding ulcers, proctitis, and ulcers with aphthae in rectum. Colonic evaluation of suspected amebiasis is of diagnostic value when accompanied by biopsy and microscopic identification of Entamoeba species. Colonoscopic manifestations vary between right-sided colitis and proctosigmoiditis.

  8. Histological Stains: A Literature Review and Case Study

    PubMed Central

    Alturkistani, Hani A; Tashkandi, Faris M; Mohammedsaleh, Zuhair M

    2016-01-01

    The history of histology indicates that there have been significant changes in the techniques used for histological staining through chemical, molecular biology assays and immunological techniques, collectively referred to as histochemistry. Early histologists used the readily available chemicals to prepare tissues for microscopic studies; these laboratory chemicals were potassium dichromate, alcohol and the mercuric chloride to harden cellular tissues. Staining techniques used were carmine, silver nitrate, Giemsa, Trichrome Stains, Gram Stain and Hematoxylin among others. The purpose of this research was to assess past and current literature reviews, as well as case studies, with the aim of informing ways in which histological stains have been improved in the modern age. Results from the literature review has indicated that there has been an improvement in histopathology and histotechnology in stains used. There has been a rising need for efficient, accurate and less complex staining procedures. Many stain procedures are still in use today, and many others have been replaced with new immunostaining, molecular, non-culture and other advanced staining techniques. Some staining methods have been abandoned because the chemicals required have been medically proven to be toxic. The case studies indicated that in modern histology a combination of different stain techniques are used to enhance the effectiveness of the staining process. Currently, improved histological stains, have been modified and combined with other stains to improve their effectiveness. PMID:26493433

  9. Hip salvage surgery in cerebral palsy cases: a systematic review.

    PubMed

    de Souza, Rafael Carboni; Mansano, Marcelo Valentim; Bovo, Miguel; Yamada, Helder Henzo; Rancan, Daniela Regina; Fucs, Patricia Maria de Moraes Barros; Svartman, Celso; de Assumpção, Rodrigo Montezuma César

    2015-01-01

    Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients' quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The literature search focused on studies that evaluated results from hip salvage surgery in cases of cerebral palsy, published from 1970 to 2011, which are present in the Embase, Medline, PubMed, Cochrane Library and SciELO databases. Although the results were not statistically comparable, this systematic review demonstrates that hip salvage surgery should be indicated after individual evaluation on each patient, due to the wide spectrum of presentations of cerebral palsy. Therefore, it seems that no surgical technique is superior to any other. Rather, there are different indications.

  10. Breast tuberculosis in northeast Iran: review of 22 cases.

    PubMed

    Khodabakhshi, Behnaz; Mehravar, Fatemeh

    2014-05-31

    Breast tuberculosis (breast TB) is an extremely rare disease, so case reviews are also rare. This study is a retrospective review of patients with breast TB who were treated between 2002 and 2012 at the Health Center of Gorgan City. All 22 patients were females, their mean age was 32.4 years, and all were new cases. Patients presented with swelling of the breast (22%), lump (55%) and excretion from the involved breast (27%), and breast pain (55%). The highest rate of breast TB occurred in 2011 (27%). All patients received the DOTS regimen for a mean duration of 7.3 ± 0.7 months; in addition, segmental resection was performed on 11 patients (50%). The findings confirmed that breast TB in Iran should be considered as a differential diagnosis of breast masses. All patients in our study received the daily and 'Directly Observed Treatment Short-course' (DOTS) regimens. Anti-tubercular therapy for six months with or without minimal surgical intervention currently is the main treatment.

  11. Severe oropharyngeal trauma caused by toothbrush--case report and review of 13 cases.

    PubMed

    Kumar, S; Gupta, R; Arora, R; Saxena, S

    2008-10-25

    Foreign body trauma to the oral cavity is fairly common. However, severe injuries caused by a toothbrush are rarely reported. We report a case of a 35-year-old epileptic patient who suffered seizures while brushing his teeth. During this episode, he self-inflicted a grievous injury to his oro-pharynx with his toothbrush which went unnoticed for 11 months. Thirteen cases of toothbrush induced trauma to this area are reviewed and a classification of these injuries is proposed. Complications related to these injuries are highlighted and their management discussed.

  12. Sleeping Beauty Syndrome: A Case Report and Review of Female Cases Reported from India.

    PubMed

    Nebhinani, Naresh; Suthar, Navratan

    2017-01-01

    Kleine-Levin syndrome (KLS), also called "Sleeping beauty syndrome" is a rare, disorder predominantly reported in adolescent males, characterized by recurrent episodes of hypersomnia and to various degrees, hyperphagia, cognitive disturbances, and hypersexuality. Here, we are reporting a case of a middle-aged female, with 16 years delay in diagnosing KLS, poor response to most of the psychotropics, except good response to a combination of lithium, sertraline, and modafinil for last 12 months and also reviewing other female cases with KLS reported from India.

  13. Transverse sacral fractures: case series and literature review

    PubMed Central

    Kim, Miriam Y.; Reidy, Declan P.; Nolan, Paul C.; Finkelstein, Joel A.

    2001-01-01

    Objectives To report experience with transverse sacral fracture, an uncommon injury frequently associated with neurologic deficit, and to perform a meta-analysis of the literature in order to define the role of decompression for the management of sacral fractures. Design A review of 7 cases. Setting A university-affiliated tertiary care centre. Patients Seven patients with transverse fractures of the sacrum. The mean follow-up was 13 months. Interventions A review of the clinical data and a search of the literature for studies that reported on 4 or more patients with a transverse sacral fracture. Main outcome measures Mechanism of injury, type of neurologic deficit and its management. Results The most common mechanism in the 7 study patients was a fall from a height. Six patients had neurologic deficits, mostly in the form of bowel or bladder disturbance. Five of these were treated with surgical decompression, and 4 of them had an improvement in neurologic function. The 7 original studies from the literature dealt with a total of 55 patients. As in the study patients, falls from a height and motor vehicle accidents predominated as the mechanisms of injury. In contrast to patients in this study, 20 of 48 patients in the literature review with neurologic deficits were treated conservatively. Conclusions The outcomes in this study are similar to those reported in the literature. The place of surgical decompression for patients with neurologic deficit cannot be clearly determined from the evidence currently available. PMID:11603749

  14. [Solitary bone plasmacytoma: about 3 cases and review of the literature].

    PubMed

    Masmoudi, Karim; Elleuch, Emna; Akrout, Rim; Mnejja, Mohamed Amine; Feki, Afef; Ezzeddine, Mariam; Baklouti, Sofiène; Jemaâ, Ben

    2016-01-01

    Solitary plasmocytomas are rare, accounting for less than 5% of all plasmocytes proliferations. Its diagnosis is based on the presence of localized tumor of monoclonal plasma cells cytologically identical to those of multiple myeloma, in the absence of other signs of a disseminated form. This study aims to carry out a retrospective study of three cases of solitary bone plasmocytomas associated with a detailed review of the literature describing the diagnostic, therapeutic and evolving characteristics of this rare entity.

  15. Foot infection by Clostridium sordellii: case report and review of 15 cases in France.

    PubMed

    Bouvet, Philippe; Sautereau, Jean; Le Coustumier, Alain; Mory, Francine; Bouchier, Christiane; Popoff, Michel-R

    2015-04-01

    We report a case of foot infection by Clostridium sordellii and review 15 human infections registered at a Reference Center in France during the period 1998 to 2011. All strains were found nontoxigenic, lacking the lethal toxin gene coding for TcsL. Like Clostridium septicum, several C. sordellii infections were associated with intestinal neoplasms. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  16. Graphitic carbon nitride based nanocomposites: a review.

    PubMed

    Zhao, Zaiwang; Sun, Yanjuan; Dong, Fan

    2015-01-07

    Graphitic carbon nitride (g-C(3)N(4)), as an intriguing earth-abundant visible light photocatalyst, possesses a unique two-dimensional structure, excellent chemical stability and tunable electronic structure. Pure g-C(3)N(4) suffers from rapid recombination of photo-generated electron-hole pairs resulting in low photocatalytic activity. Because of the unique electronic structure, the g-C(3)N(4) could act as an eminent candidate for coupling with various functional materials to enhance the performance. According to the discrepancies in the photocatalytic mechanism and process, six primary systems of g-C(3)N(4)-based nanocomposites can be classified and summarized: namely, the g-C(3)N(4) based metal-free heterojunction, the g-C(3)N(4)/single metal oxide (metal sulfide) heterojunction, g-C(3)N(4)/composite oxide, the g-C(3)N(4)/halide heterojunction, g-C(3)N(4)/noble metal heterostructures, and the g-C(3)N(4) based complex system. Apart from the depiction of the fabrication methods, heterojunction structure and multifunctional application of the g-C(3)N(4)-based nanocomposites, we emphasize and elaborate on the underlying mechanisms in the photocatalytic activity enhancement of g-C(3)N(4)-based nanocomposites. The unique functions of the p-n junction (semiconductor/semiconductor heterostructures), the Schottky junction (metal/semiconductor heterostructures), the surface plasmon resonance (SPR) effect, photosensitization, superconductivity, etc. are utilized in the photocatalytic processes. Furthermore, the enhanced performance of g-C(3)N(4)-based nanocomposites has been widely employed in environmental and energetic applications such as photocatalytic degradation of pollutants, photocatalytic hydrogen generation, carbon dioxide reduction, disinfection, and supercapacitors. This critical review ends with a summary and some perspectives on the challenges and new directions in exploring g-C(3)N(4)-based advanced nanomaterials.

  17. Graphitic carbon nitride based nanocomposites: a review

    NASA Astrophysics Data System (ADS)

    Zhao, Zaiwang; Sun, Yanjuan; Dong, Fan

    2014-11-01

    Graphitic carbon nitride (g-C3N4), as an intriguing earth-abundant visible light photocatalyst, possesses a unique two-dimensional structure, excellent chemical stability and tunable electronic structure. Pure g-C3N4 suffers from rapid recombination of photo-generated electron-hole pairs resulting in low photocatalytic activity. Because of the unique electronic structure, the g-C3N4 could act as an eminent candidate for coupling with various functional materials to enhance the performance. According to the discrepancies in the photocatalytic mechanism and process, six primary systems of g-C3N4-based nanocomposites can be classified and summarized: namely, the g-C3N4 based metal-free heterojunction, the g-C3N4/single metal oxide (metal sulfide) heterojunction, g-C3N4/composite oxide, the g-C3N4/halide heterojunction, g-C3N4/noble metal heterostructures, and the g-C3N4 based complex system. Apart from the depiction of the fabrication methods, heterojunction structure and multifunctional application of the g-C3N4-based nanocomposites, we emphasize and elaborate on the underlying mechanisms in the photocatalytic activity enhancement of g-C3N4-based nanocomposites. The unique functions of the p-n junction (semiconductor/semiconductor heterostructures), the Schottky junction (metal/semiconductor heterostructures), the surface plasmon resonance (SPR) effect, photosensitization, superconductivity, etc. are utilized in the photocatalytic processes. Furthermore, the enhanced performance of g-C3N4-based nanocomposites has been widely employed in environmental and energetic applications such as photocatalytic degradation of pollutants, photocatalytic hydrogen generation, carbon dioxide reduction, disinfection, and supercapacitors. This critical review ends with a summary and some perspectives on the challenges and new directions in exploring g-C3N4-based advanced nanomaterials.

  18. Isolated pulmonary vasculitis: case report and literature review.

    PubMed

    Riancho-Zarrabeitia, Leyre; Zurbano, Felipe; Gómez-Román, Javier; Martínez-Meñaca, Amaya; López, Marta; Hernández, Miguel A; Pina, Trinitario; González-Gay, Miguel A

    2015-04-01

    Single-organ vasculitis has been reported to affect the skin, kidneys, central nervous system, peripheral nerves, genitourinary tract, calf muscles, aorta, coronary arteries, retina, or gastrointestinal tract. However, isolated pulmonary vasculitis is a very rare entity. Our aims were to describe a case of localized pulmonary vasculitis affecting medium-sized vessels and review the literature. A patient with localized pulmonary vasculitis affecting medium-sized vessels that presented as pulmonary arterial hypertension is described. A MEDLINE database search of cases with localized pulmonary vasculitis was also conducted. A 30-year-old man presented with pulmonary hypertension due to isolated pulmonary medium-sized vessel vasculitis that was confirmed histologically. Initially he responded to corticosteroids and vasodilator treatment, but therapy eventually lost efficacy. Treatment with rituximab was not effective, and as the clinical situation worsened, lung transplant was performed. Isolated large pulmonary vessel disease, often related to Takayasu disease or giant cell arteritis, may present as pulmonary artery hypertension, thus mimicking chronic thromboembolic disease. Medium- and small-vessel pulmonary vasculitis usually develops in the context of a systemic disease. Some cases of isolated small-vessel vasculitis have been reported presenting as diffuse alveolar hemorrhage. In contrast, our case developed pulmonary artery hypertension secondary to medium-sized vessels vasculitis. To our knowledge, this is the first case of lung transplantation in isolated pulmonary vasculitis. Pulmonary isolated vasculitis is a rare cause of pulmonary hypertension but it must be taken into consideration after more common disorders are excluded. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. [Food-borne botulism: review of five cases].

    PubMed

    Cardoso, Teresa; Costa, Manuela; Almeida, H Cristina; Guimarães, Mário

    2004-01-01

    Food-borne botulism is a disease caused by the ingestion of food contaminated with botulinum toxin, often present in smoked meat, canned food and preserved food; it can occur as sporadic case or as an outbreak. In the last decades there has been an increasing incidence of food-borne botulism in Portugal. The authors do a review of five cases of food-borne botulism, three isolated cases and 2 familiar. Four were associated with the ingestion of smoked ham and one of canned tunafish. The incubation period was 48 hours in one patient and 4 days in another, in the remaining patients it was not possible to determine this period. The clinical picture was dominated in all patients by diplopy, dysphagia, dizziness, blurred vision, dry mouth and constipation, and in two patients there were gastrointestinal complains. In one patient the electromyography findings were compatible with pre-synaptic neuromuscular blockage. A toxin type B was found in the serum of one patient and in the food involved in the two familiar cases. All patients experienced complete recovery with only symptomatic treatment. With this article the authors intend to call attention to this diagnosis, which is not rare, but difficult for someone not familiar with its presentation, being of notice that the diagnosis is essentially clinic with a strong epidemiological history, confirmed by typical electromyography findings and by the identification of the toxin involved. In Portugal there is only descriptions of clinical cases associated with the type B and the type E toxins, not being necessary the resource to the antitoxin therapy.

  20. Primary pancreatic lymphoma: two case reports and a literature review

    PubMed Central

    Yu, Lili; Chen, Yajun; Xing, Ligang

    2017-01-01

    Primary pancreatic lymphoma (PPL) is an extremely rare disease, with only a few cases reported in the literature. Clinical manifestations of PPL are often nonspecific and may mimic other pancreatic diseases. Because of the limited experience of PPL, clinicopathological features, differential diagnosis, optimal therapy, and outcomes are not well defined. We described two cases diagnosed as PPL and confirmed by histological examination and immunohistochemical analysis. Case 1 was a young man with obstructive jaundice and upper abdominal malaise mimicking a pancreatic adenocarcinoma. A computed tomography (CT) scan revealed a diffuse heterogeneous mass in the head of the pancreas along with dilated bile ducts, no dilated pancreatic duct, no liver or splenic involvement, or evident retroperitoneal adenopathies. The patient underwent a pancreatico-duodenectomy, and the postoperative histopathology confirmed diffuse large B-cell non-Hodgkin lymphoma. Postoperatively, he received six courses of the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisolone). Case 2 was an older man with left flank pain. A CT confirmed a mass with irregular margins at the tail of the pancreas and the hilum of the spleen. The mass was heterogeneous, with no clear boundary between lesions, spleen, stomach, and pancreas, with nearby blood vessels wrapped around it, and multiple enlarged lymph nodes in the abdominal cavity. A CT-guided biopsy was performed. The immunohistological findings of the specimen revealed a diffuse large B-cell lymphoma. The size of the tumor was significantly reduced after four cycles of the CHOP chemotherapy regimen. These two cases were different in clinical manifestation, location, and treatment. We reviewed the literature and discussed the clinicopathological features, differential diagnosis, optimal therapy, and outcomes of this neoplasm. PMID:28356755

  1. Melioidosis in Malaysia: A Review of Case Reports

    PubMed Central

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

    2016-01-01

    Background Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. Objective We sought to review case reports of melioidosis from Malaysia. Methods We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Results Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24–48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common—genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of

  2. Melioidosis in Malaysia: A Review of Case Reports.

    PubMed

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

    2016-12-01

    Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. We sought to review case reports of melioidosis from Malaysia. We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common-genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

  3. Polyamide as a Denture Base Material: A Literature Review.

    PubMed

    Vojdani, Mahroo; Giti, Rashin

    2015-03-01

    The purpose of this article was to review the biocompatibility, physical, and mechanical properties of the polyamide denture base materials. An electronic search of scientific papers from 1990-2014 was carried out using PubMed, Scopus and Wiley Inter Science engines using the search terms "nylon denture base" and "polyamide denture base". Searching the key words yielded a total of 82 articles. By application of inclusion criteria, the obtained results were further reduced to 24 citations recruited in this review. Several studies have evaluated various properties of polyamide (nylon) denture base materials. According to the results of the studies, currently, thermo-injectable, high impact, flexible or semi-flexible polyamide is thought to be an alternative to the conventional acrylic resins due to its esthetic and functional characteristics and physicochemical qualities. It would be justifiable to use this material for denture fabrication in some cases such as severe soft/ hard tissue undercuts, unexplained repeated fracture of denture, in aesthetic-concerned patients, those who have allergy to other denture base materials, and in patients with microstomia.  Although polyamide has some attractive advantages, they require modifications to produce consistently better properties than the current polymethyl methacrylate (PMMA) materials. Moreover, since there is a very limited knowledge about their clinical performance, strict and careful follow-up evaluation of the patients rehabilitated with polyamide prosthesis is recommended.

  4. Chondroblastoma of the Clivus: Case Report and Review

    PubMed Central

    Liu, Jonathan; Ahmadpour, Arjang; Bewley, Arnaud F.; Lechpammer, Mirna; Bobinski, Matthew; Shahlaie, Kiarash

    2015-01-01

    Background and Importance Chondroblastoma is a benign primary bone tumor that typically develops in the epiphyses of long bones. Chondroblastoma of the craniofacial skeleton is extremely rare, with most cases occurring in the squamosal portion of the temporal bone. In this report, we describe the first case of chondroblastoma of the clivus presenting with cranial neuropathy that was treated with endoscopic endonasal resection. We review the literature on craniofacial chondroblastomas with particular emphasis on extratemporal lesions. Case Presentation A 27-year-old woman presented with severe headache, left facial dysesthesias, and diplopia. Physical examination revealed hypesthesia in the left maxillary nerve dermatome, and complete left abducens nerve palsy. Imaging demonstrated an expansile intraosseous mass originating in the upper clivus with extension superiorly into the sella turcica and laterally to involve the medial wall of the left cavernous sinus. The tumor was completely resected via an endoscopic endonasal approach, with postoperative improvement in lateral gaze palsy. Histopathology was consistent with chondroblastoma. Conclusion Chondroblastoma is a rare tumor of the craniofacial skeleton that should be included in the differential diagnosis of an osteolytic lesion of the clivus. Complete surgical resection remains the mainstay of treatment. PMID:26623238

  5. Cervicofacial Lymphatic Malformations: A Retrospective Review of 40 Cases

    PubMed Central

    Cho, Byung Chae; Kim, Jae Bong; Lee, Jeong Woo; Choi, Kang Young; Yang, Jung Dug; Lee, Seok-Jong; Kim, Yong-Sun; Lee, Jong Min; Huh, Seung

    2016-01-01

    Background Lymphatic malformation (LM) is a form of congenital vascular malformation with a low incidence. Although LM has been studied, no consensus has emerged regarding its cause or treatment. Methods In this study, we retrospectively evaluated 40 patients who visited our vascular anomalies center for the treatment of cervicofacial LM, which is a common manifestation of LM. The medical records of patients over a period of 12 years were reviewed and analyzed for commonalities regarding the diagnosis and the results of treatment. Results Suspected cervicofacial LM was confirmed through imaging studies. No difference in incidence was observed according to sex, and 73% of patients first presented with symptoms before the age of two years. The left side and the V2–V3 area were most commonly affected. No significant differences in incidence were observed among the macrocystic, microcystic, and combined types of LM. A total of 28 out of 36 patients received sclerotherapy as the first choice of treatment, regardless of the type of lesion. Complete resolution was achieved in only 25% of patients. Conclusions LM is important to confirm the diagnosis early and to choose an appropriate treatment strategy according to the stage of the disease and each individual patient's symptoms. When treatment is delayed or an incorrect treatment is administered, patient discomfort increases as the lesion gradually spreads. Therefore, more so than is the case for most other diseases, a team approach on a case-by-case basis is important for the accurate and appropriate treatment of LM. PMID:26848440

  6. Acromegaloid Facial Appearance: Case Report and Literature Review

    PubMed Central

    Becker, Kenneth

    2013-01-01

    Pseudoacromegaly is characterized by an acromegalic appearance without any abnormality of growth hormone function. It may be caused by several congenital and acquired conditions. One such condition is the acromegaloid facial appearance (AFA) syndrome. This condition has been described in approximately eight cases/families. It encompasses a spectrum of acromegaloid physical findings, normal growth hormone (GH) and insulin-like growth factor one (IGF-1) levels, and variable mode of inheritance. The most common physical findings are coarse facies, bulbous nose, and thickened lips. We present a case and a review of the literature on this illness. The patient is a 57-year-old woman who was referred to the endocrinology division for evaluation of suspected acromegaly. She had an acromegaloid appearance since birth as well as a terminal hypertrichosis. Her endocrine laboratory evaluation and chromosomal analyses were normal. AFA needs to be considered when evaluating any patient with pseudoacromegaly. Additional cases/families need to be identified in order to better understand the clinical spectrum, clinical implications, and mode of inheritance of AFA. PMID:23533839

  7. Prostate sarcoma: report of 2 cases and bibliographic review.

    PubMed

    Busto Martín, Luis; Carral Freire, Maria; Hermida, Teresa; Aller, Marcos; Busto Castañón, Luis

    2014-10-01

    To report two cases of prostate sarcoma and perform a review of the published literature. The first case is a 21 year old patient who presented acute urine retention and lung metastases on diagnosis. He was diagnosed by TURP of rhabdomyosarcoma of the prostate dying 1 month after surgery. The second case was a 33 years old male who presented to the emergency room with anal pain, urinary symptoms, hematochezia and loss of 20 kg over the past 3 months. Abdominal CT scan showed an 11 x 10 x 9 cm mass in the lower pelvis that infiltrated the bladder and rectum, being unable to define its origin. CA 19.9, CEA and PSA were normal. The suspected diagnosis was a prostate sarcoma infiltrating rectum and bladder. A pelvic exenteration was performed with a wet colostomy. The pathologic diagnosis was a high grade sarcoma not clearly identified of the prostate. He was treated with adriamycin as adjuvant chemotherapy, having local recurrence, nodal involvement and multiple pulmonary metastases after 3 months of follow up Prostate sarcomas are rare tumors. This makes difficult to know their natural history. Their rapid progression and systemic spread, despite multimodal treatment, gives a mean survival of 24 months. Main survival factors are grade, a complete resection of the tumor and a low local stage. There is a need to find new chemotherapy protocols to increase survival rates as it has been shown in extremities sarcomas.

  8. Zygomatic Intraosseous Hemangioma: Case Report and Literature Review.

    PubMed

    Powers, David B; Fisher, Elda; Erdmann, Detlev

    2017-03-01

    Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area. They have a tendency to bleed briskly upon removal or biopsy, making preoperative detection of the vascular nature of the lesion of significant importance. There are four variants: (1) capillary type, (2) cavernous type, (3) mixed variant, and (4) scirrhous type. Generally most common in the vertebral skeleton, they can also present in the calvarium and facial bones. In the head, the most common site is the parietal bone, followed by the mandible, and then malar and zygomatic regions. Intraosseous hemangiomas of the zygoma are rare entities with the first case reported in 1950 by Schoenfield. In this article, we review 49 case reports of intraosseous hemangioma of the zygoma, and also present a new case treated with excision followed by polyether-ether ketone implant placement for primary reconstruction.

  9. Extramedullary nasal plasmacytoma: Literature review and a rare case report

    PubMed Central

    Corvo, Marco Antonio dos Anjos; Granato, Lídio; Ikeda, Felipe; de Próspero, José Donato

    2013-01-01

    Summary Introduction: Extramedullary plasmacytoma is a plasma cell tumor that grows within any of the soft tissues of the organism. Similar to all plasmacytic dyscrasia, the disease is extremely rare. Aim: This study reports a case of an extramedullary plasmacytoma of the nasal cavity and provides a literature review on the topic. Case report: A 51-year-old woman presented at our tertiary university hospital with a 6-month history of progressive nasal obstruction, predominantly to the right side, and self-limiting epistaxis. Examination revealed a large pale-reddish tumor within the right nasal cavity. Anatomopathological analysis showed features consistent with a plasmacytoma diagnosis, which was subsequently confirmed by immunohistochemical techniques. Further assessment revealed the solitary nature of the condition, consistent with extramedullary plasmacytoma. Radiotherapy was initiated, which led to partial regression of the symptoms. The tumor was surgically removed by using a mid-facial degloving approach. The patient evolved with a naso-oral fistula and underwent 3 corrective surgeries. No evidence of associated systemic disease was found after 5 years of follow-up. Conclusions: This case report, which describes a rare tumor of the nasal cavity, is expected to improve the recognition and referral of this condition by ear, nose, and throat (ENT) specialists for multidisciplinary management and long-term follow-up. PMID:25992016

  10. Urinothorax: Case report and systematic review of the literature

    PubMed Central

    Casallas, Alexander; Castañeda-Cardona, Camilo; Rosselli, Diego

    2016-01-01

    Urinothorax, the presence of urine in the pleural space, is a rare cause of pleural effusion, usually associated with obstructive uropathy, or urinary trauma. We present the case of a 3 year-old boy and a systematic review of the literature of the 44 cases encountered. After resection of a Wilm's tumour in the right kidney our patient presented acute respiratory distress associated with radiographically confirmed pleural effusion. With the initial diagnosis of pneumonia or malignant pleural effusion, a closed thoracotomy was performed. The liquid obtained suggested urine, which was confirmed by the laboratory. Cystoscopy with retrograde pyelography detected a fistula on the posterior wall of the right kidney. The report of cases worldwide is low, probably due to its low incidence but also to underdiagnosis. Respiratory symptoms are not always present and urological symptoms usually predominate. Diagnosis requires a high degree of clinical suspicion and is confirmed by the main biochemical marker: The ratio >1.0 pleural fluid creatinine and creatinine serum. PMID:26834411

  11. Lateral subtalar dislocation: Case report and review of the literature

    PubMed Central

    Veltman, Ewout S; Steller, Ernst JA; Wittich, Philippe; Keizer, Jort

    2016-01-01

    A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation. Eight studies including fifty patients could be included, thirty out of 50 patients suffered a complicated injury. Mean follow-up was fifty-five months. Ankle function was reported as good in all patients with closed lateral subtalar dislocation. Thirteen out of thirty patients with complicated lateral subtalar joint dislocation developed a complication. Avascular necrosis was present in nine patients with complicated injury. Four patients with complicated lateral subtalar dislocation suffered deep infection requiring treatment with antibiotics. In case of uncomplicated lateral subtalar joint dislocation, excellent functional outcome after closed reduction and immobilization can be expected. In case of complicated lateral subtalar joint dislocation immediate reduction, wound debridement and if necessary (external) stabilisation are critical. Up to fifty percent of patients suffering complicated injury are at risk of developing complications such as avascular talar necrosis and infection. PMID:27672576

  12. Maxillary Sinus Inflammatory Myofibroblastic Tumors: A Review and Case Report

    PubMed Central

    Hansen, Chase C.; Eisenbach, Colby; Torres, Carlos; Graham, Suzanne

    2015-01-01

    An inflammatory myofibroblastic tumor (IMT) is an immunohistochemically diverse entity demonstrating neoplastic and nonneoplastic qualities. Although IMTs can arise in any area of the body, lesions arising in certain sites, namely, the nasal cavity, paranasal sinuses, and pterygopalatine fossa, demonstrate a heightened neoplastic and invasive potential. Despite case specific complete tumor regression and disease remission in response to pharmacotherapeutics, a subset of IMTs remain resistant to all forms of therapy. We present such a case, a 34-year-old female patient, with a highly resistant, maxillary sinus IMT. Her refractory, ALK-1 negative IMT has not responded well to novel therapies reported in current literature. This case suggests the role of zonal expressivity within a single lesion as a probable mechanism for its highly resistant nature and should promote determination of each IMT's cytogenetic profile to provide more effective targeted therapy. Paper includes a literature review of all maxillary sinus IMTs from 1985 to 2014 along with their immunohistochemical staining, treatments, and outcomes. PMID:25763286

  13. [Conjugal leprosy infection in Japan--case report and review].

    PubMed

    Ozaki, Motoaki; Tomoda, Masakazu

    2012-04-01

    The authors reported a conjugal leprosy infection observed in Japan. The husband, index case, first noticed sensory disturbance at the lower right leg in his forties. He developed edematous swelling with redness of the right hand and forearm at the age of 72 (1989), and then developed multiple erythema and hypesthesia at the extremities. He was diagnosed as BL type leprosy (reactional stage) and treated with multi-drug therapy. His 71-year-old wife developed a few erythema at the right forearm in 1993. She was classified as BT type. The duration of their marriage life was over forty years. The couple did not have consanguinity. No other leprosy patients were found in their lineage. From their clinical courses the authors concluded that the husband infected his wife. According to Japanese literatures, the frequency of conjugal leprosy among new patients in Japan was approximately 1%. There were worldwide observations that the husband often infected the wife, and mostly the index case was multibacillary and the secondary case paucibacillary. The authors reviewed definition and frequency of conjugal leprosy, factors in conjugal infection and leprosy infection among the adults.

  14. Studies of modern pollen assemblages for pollen dispersal- deposition- preservation process understanding and for pollen-based reconstructions of past vegetation, climate, and human impact: A review based on case studies in China

    NASA Astrophysics Data System (ADS)

    Xu, Qinghai; Zhang, Shengrui; Gaillard, Marie-jose; Li, Manyue; Cao, Xianyong; Tian, Fang; Li, Furong

    2016-10-01

    Fossil pollen, as a direct proxy record of past vegetation, and indirect proxy record of past climate, plays an essential role in revealing and reconstructing past vegetation and climate. However, relationships between pollen, vegetation and climate are not linear, hence quantitative reconstructions of past vegetation and climate based on pollen records are not straightforward, and results may be highly contradictory and difficult to interpret. One of the main causes of discrepancies between results has been the lack of comprehensive and systematical studies on modern pollen dispersal and deposition processes, particularly on the quantification of these processes. Based on empirical studies performed in China over the last 30 years, this paper provides the state-of-the-art of the understanding of pollen dispersal and deposition processes in China and the remaining questions to be investigated. We show that major progress has been achieved in the study of modern pollen dispersal and deposition processes, and in the application of models of the pollen-vegetation-climate relationships for quantitative reconstruction of past vegetation and climate. However, several issues are not entirely solved or understood yet, such as how to quantify the reworking and re-deposition of pollen grains in quaternary alluvial sediments, the influence of pollen preservation on pollen assemblages, and human impact on vegetation. Even so, the progress made during the last decades makes it possible to achieve significantly more precise and informative reconstructions of past vegetation, land-use and climate in China than was possible earlier.

  15. Acute disseminated encephalomyelitis following meningoencephalitis: case report and literature review.

    PubMed

    Elias, Matthew D; Narula, Sona; Chu, Andrew S

    2014-04-01

    Meningoencephalitis and acute disseminated encephalomyelitis (ADEM) are both neurological disease processes, but there have been few cases of meningoencephalitis progressing to ADEM in the pediatric population. A case of a 4-year-old girl with an initial diagnosis of meningoencephalitis is presented here, whose initial presentation was manifested by prolonged fever, gray matter signal abnormality on brain magnetic resonance imaging, cerebrospinal fluid pleocytosis, and a markedly irritable mental status. As her neurological examination changed with focal abnormalities, a repeat magnetic resonance imaging demonstrated new areas of both gray and white matter signal abnormality, consistent with ADEM. Her symptoms and imaging findings completely resolved with a course of methylprednisolone. Based on the literature and this current case, it is our recommendation to consider ADEM as a diagnosis if meningoencephalitis is not improving.

  16. Benzene-contaminated toluene and acute myeloid leukemia: a case series and review of literature.

    PubMed

    Peckham, Trevor; Kopstein, Melvyn; Klein, Jason; Dahlgren, James

    2014-02-01

    We report seven cases of acute myeloid leukemia (AML) with occupational exposure to a toluene-based hydrocarbon solvent. The cases were employed at a facility, which manufactured rubber belts and hoses, between 1950 and 2005 for periods ranging from 21 to 37 total years. Detailed histories were obtained for three workers who were diagnosed with AML within a 3-year period (2003-2005). Death certificates, medical records, and accounts by workers were reviewed. Benzene, a known cause of AML, is typically a contaminant of toluene. Benzene contamination in toluene and other widely used solvents and the potential for concurrent benzene exposure during usage of these solvents in occupational settings are discussed.

  17. [Cauda equina syndrome secondary to neurolymphomatosis: Case report and literature review].

    PubMed

    Jiménez Zapata, Herbert Daniel; Rojas Medina, Luis Mariano; Carrasco Moro, Rodrigo; Martínez Rodrigo, Aurora; García-Cosio Piqueras, Mónica

    2017-09-20

    Neurolymphomatosis is a rare disorder characterised by infiltration of neoplastic lymphocytes into the peripheral nervous system. A wide variety of symptoms can manifest depending on its nature and location, making its diagnosis a real challenge. Treatment is based on methotrexate, although various chemotherapy regimens are currently available for patients with systemic disease. We present the case of a male patient with neurolymphomatosis of the cauda equina, together with a review of all cases published to date. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. [The "Oxford" unicondylar knee prostesis (UCP): 21 reviewed cases].

    PubMed

    Kehr, P; Nonn, P; Graftiaux, A; Bogorin, I; Leculée, F; Lang, G

    1995-12-01

    The unicompartimental knee prosthesis known as "Oxford" is a non constraint prosthesis, entrusting the whole of its stability to an intact ligamentary apparatus. Where the support surfaces of most prostheses remain limited, even punctiform, the originality of the Goodfellow prosthesis lies in the fact that the prosthetic condyle, whatever the flexion angle is, leans against a mobile prosthetic meniscus with spheric superior concavity of the same radius as the condylian radius, which increases considerably the prosthetic leaning surfaces and therefore lessens the pressure constraints. The superior surface, concave, of this prosthetic meniscus takes charge of the rolling, where the inferior plane surface realizes the gliding on the metallic tibial plate. The total conformity of the components minimizes the forces of friction.Between July 1988 and March 1993, 24 patients underwent the placing of UCP. Three patients died and 2 were lost of sight. 19 patients could be seen again or checked, corresponding of 21 operated knees. Two knees benefited from the start from UCP (medial and lateral) and 2 knees had a UCP in the first instance and then a second UCP in the compartment left safe primarily. For the 21 UCP, there are 16 medial and 3 lateral. Our mean drawback is of 3 years and 3 months, all the drawbacks being superior to 1 year and 4 months. The mean age is of 64 years. There were 17 female and 2 male patients. The mean weight is of nearly 80 kg (79,8) and nearly 52% of the operated patients have an important overweight (Body Mass Index superior to 30). Preoperative clinical analysis. It is based on a retrospective study of files using the quotation described by AUBRIOT for the «GUEPAR» group. This one establishes a gradation of four levels for each of the three criteria retained (Pain, Mobility, Instability), thus determining a global result imposed by the lowest level retained.For walking, other factors than just the state of the operated knee may intervene, this

  19. Case-Based Tutoring from a Medical Knowledge Base

    PubMed Central

    Chin, Homer L.

    1988-01-01

    The past decade has seen the emergence of programs that make use of large knowledge bases to assist physicians in diagnosis within the general field of internal medicine. One such program, Internist-I, contains knowledge about over 600 diseases, covering a significant proportion of internal medicine. This paper describes the process of converting a subset of this knowledge base--in the area of cardiovascular diseases--into a probabilistic format, and the use of this resulting knowledge base to teach medical diagnostic knowledge. The system (called KBSimulator--for Knowledge-Based patient Simulator) generates simulated patient cases and uses these cases as a focal point from which to teach medical knowledge. It interacts with the student in a mixed-initiative fashion, presenting patients for the student to diagnose, and allowing the student to obtain further information on his/her own initiative in the context of that patient case. The system scores the student, and uses these scores to form a rudimentary model of the student. This resulting model of the student is then used to direct the generation of subsequent patient cases. This project demonstrates the feasibility of building an intelligent, flexible instructional system that uses a knowledge base constructed primarily for medical diagnosis.

  20. Delayed Case of Congenital Bilateral Trigger Thumb: A Case Report and Review of Literature

    PubMed Central

    Rekha, Y Bhanu

    2014-01-01

    Introduction: Congenital trigger thumb is an uncommon anomaly of children. Its management is controversial, ranging from observation to extensive surgical release. We report a case of delayed presentation of bilateral trigger thumb along with a brief review of past literature. Case Report: A six year old girl presented with fixed flexion deformity of interphalangeal joints of both thumbs and Notta’s nodules. It is diagnosed as trigger thumb and release of bilateral A1pulleys is done. But we found another constricting annular pulley just distal to A1. Only after splitting the distal pulley, we could get complete extension of interphalangeal joints. At two years follow-up, the child is free of complications. Conclusion: Splitting of A1 pulley alone may not be sufficient in few cases of trigger thumb which may require distal release too PMID:27298940