Browne, Juanita M.
The Black woman has been the transmitter of culture in the black community. Two of the important roles of African women were perpetuated during slavery and continue until today. They are her role in economic endeavor and her close bond with her children. The woman in African society was additionally politically significant. The black woman has…
Reinfeld, Patricia M.
This booklet on the status of women, aimed at raising the consciousness of female college students, provides an orientation to feminism and references for further pursuit of the areas covered in the following sections. "On Woman and Her Role" sets the stage with selected quotations, expressing conflicting views of woman's role. "What It Is All…
Not even the first lady of the most powerful nation in the world is immune to stereotypes that have plagued Black women since first setting foot on American soil. Stereotypes of being the "angry Black woman" and curiosity about differences in appearance still persist from the academy to 1600 Pennsylvania Ave. As African-American women rise in…
caper was "Nancy Hart’s dinner party". Five 0 Tories, who had just shot a neighbor, forced their way into her home, demanding a meal. Nancy Hart fed... Barbara and Umlauf, Hana. The Good Housekeeping Woman’s Almanan. New York: Newspaper Enterprise Association, Inc., 1977. Miller, Donald L. An Album of
Goyal, S K
I read Dr. Rao's article on attitudes to women and nutrition programmes in India (Dec. 22/29, p. 1357) with considerable interest. In India parents have to save a lot of money to be able to give a dowry when a daughter marries. In addition they are expected to spend considerable sums when their daughters' children are born and when the grandchildren in turn marry. The task of looking after elderly parents--and of discharging their responsibilities if they themselves are unable to do so--falls upon the sons. In India daughters rarely help out their parents in this way, and the parents will not usually agree to accept help from daughters if they have a son who is prepared to discharge the sacred duty of helping parents in time of need. Once she marries, a daughter's obligations to her parents cease while their obligations to her extend even further to include her husband, children, and in-laws. No wonder the birth of a girl is rarely a cause of celebration in India. The main cause for the plight of women in India is poverty. In most Indian families, the woman of the house will consume less than anyone of nutritious items such as milk, cheese, meat, fish, and butter. Whenever the family's meagre resources are shared out, whether for food, for education, for medical care, it is the males who are given preference. This unequal distribution takes place with the full approval of the woman of the house. Food is normally allocated by the woman, and when food is scarce they tend to favour sons over daughters. Readers in the West may feel that women get the worst possible deal in India. However, although parents do not normally spend as much on the education of their daughters as they do on their sons, in the long run daughters very often get more than their fair share of the family's fortunes because of the dowry system and other social customs.
Growing old as a woman. Since Diderot, a classic writer, and his friend Sophie Volland with whom he corresponded, debated the difference between the "handsome old man" and "beautiful old age", or a hypothetical "beautiful old woman", the representations of growing old have changed, to the benefit of women. Has the considerable contribution of female writers to the debate played a role? In what ways does literature, through its figurations of the ages of life, provide a valuable perspective of the contemporary mutations of the view of old age?
Ras, Janneke E; van Velzen, Edwin; van Berkhout, Ferdinand Teding; van den Brand, Joop J G
A seventy-year-old woman was admitted to hospital with a Staphylococcus aureus respiratory tract infection. She had a history of extensive bronchiectasis and allergic bronchopulmonary aspergillosis (ABPA). Cystic fibrosis (CF) was suspected and cystic fibrosis transmembrane conductance regulator (CFTR) gene analysis showed F508del and R117H-7T mutations. In these mutations there is residual activity in the chloride channel in the cell membrane coded by the CFTR gene. This results in a much milder disease pattern varying from no disease at all to isolated organ disease. This type of disease is known as non-classical cystic fibrosis. In our patient the diagnosis of cystic fibrosis was made exceptionally late in life.
Recent court cases on sexual harassment, and the outcomes, were reviewed in terms of how the court viewed a "reasonable" woman. Rulings in such cases can vary because of different interpretations of the "reasonable" concept. Also discusses how recent rulings will affect sexual harassment policymakers in the workplace and educational institutions.…
Ward, Jane; Turner, Cheryl; Watts, Jane; Eldred, Jan
As people celebrate the 100th anniversary of International Women's Day this year, NIACE has organised an event, "Every woman's right to learn," that will offer an opportunity for educators and learners to celebrate women's progress and achievements in and through learning, to find one's hopes and aspirations for the future and work…
Body image is an important concept that has a significant effect on a person's self-esteem and self-confidence. Appreciating how the older body is perceived by a woman is an important first step to understanding how nurses might support patient dignity. This article reviews the latest literature on ageing and body image and suggests practical dialogues that nurses and patients can share.
Birker, I L; Boons, L S T M; Luyten, G P M
A 20-year-old woman with congenital iris heterochromia presented with loss of vision of her right eye. We made de diagnosis of a large 'uvea melanoma' and enucleated the eye. Pathological examination showed an underlying oculodermal melanocytosis (ODM). The life-time risk of uveal melanoma in the general population is 0.7:100,000, but 1:400 in patients with ODM. Therefore, annual fundoscopy is recommended in these patients.
Müller, Kai Ivar; Bekkelund, Svein Ivar
A woman in her fifties, with a long history of side-locked unilateral headache, was hospitalized for left-sided side-locked paroxysmal headache (attacks with 10-20 min duration). Clinical and neurological examinations, and brain MRI revealed normal findings. She responded well to indomethacin (50 mg three times daily). Due to non-compliance because of dyspepsia, which delayed the final diagnosis of chronic paroxysmal hemicrania (CPH) for 16, months indomethacin was administered both rectally and orally. A retrospective review of her medical history showed 15 years of unsuccessfully treated unilateral headache, until she responded completely to rofecoxib. Ipsilateral cranial autonomic symptoms also supported the diagnosis of hemicrania continua, although these symptoms presented before indomethacin was tried. Diagnostic delay and misdiagnoses of unilateral headaches, as illustrated by this case, shows the clinical controversies and difficulties in diagnosing and treating this condition.
Sagui, Emmanuel; Correa, Éléonore; Ricobono, Diane; Bregigeon, Michel; Brosset, Christian
We present the case of a 33-year-old woman with benign sporadic monomelic amyotrophy of the distal part of the arm, called Hirayama disease. Clinical features included forearm amyotrophy sparing the brachioradialis muscle, cold paresis and causalgia. Neck magnetic resonance imaging was normal in neutral and flexion position. Electromyography showed denervated patterns in the extensor digitorum communis, and conduction studies ruled out multifocal motor neuropathy. Motor evoked potentials were normal. Serum IgG anti-GM1 antibodies were moderately raised but were negative 8 months later. Outcome was favourable within 15 months, with partial motor recovery. Pathogenesis remains controversial: neck flexion induced myelopathy via chronic anterior horn ischaemia due to forward displacement of the posterior wall of the dura mater, or benign variant of lower motor neuron disease? Whatever the pathomechanism is, the clinical features and outcome are the same. PMID:22171230
Sagui, Emmanuel; Correa, Eléonore; Ricobono, Diane; Bregigeon, Michel; Brosset, Christian
We present the case of a 33-year-old woman with benign sporadic monomelic amyotrophy of the distal part of the arm, called Hirayama disease. Clinical features included forearm amyotrophy sparing the brachioradialis muscle, cold paresis and causalgia. Neck magnetic resonance imaging was normal in neutral and flexion position. Electromyography showed denervated patterns in the extensor digitorum communis, and conduction studies ruled out multifocal motor neuropathy. Motor evoked potentials were normal. Serum IgG anti-GM1 antibodies were moderately raised but were negative 8 months later. Outcome was favourable within 15 months, with partial motor recovery. Pathogenesis remains controversial: neck flexion induced myelopathy via chronic anterior horn ischaemia due to forward displacement of the posterior wall of the dura mater, or benign variant of lower motor neuron disease? Whatever the pathomechanism is, the clinical features and outcome are the same.
Bagnall, Carlene; And Others
A college-level women's studies course on the experience of American women is presented in three units on the emerging American woman, woman and others, and the transcendent self. Unit 1 focuses on biological and psychological explanations of being female; the socialization process; Black, Native American, and immigrant women; schooling and its…
Quinlan, Margaret M.; Bates, Benjamin R.
This paper explores a representation of overlapping categories of gender, disability and cyborgs in "Bionic Woman" (2007). The television show "Bionic Woman" (2007) is a popular culture representation that uniquely brings together these categories. Three themes emerged from an analysis of blogger discourse surrounding the show. The themes reveal…
Pallavi, S. K.; Rajkumar, G. C.
Objective: This review aims to give an inside view of professional career of a women dentist, addresses the unique demands of being a woman dentist, and highlight ways to address these issues. Materials and Methods: The Medline database, scholarly literature, and informal literature were considered for this review. Results: Working hours of female dentists do not differ significantly from the working hours of their male counterparts, until they have children. The female dentists’ working hours showed a distinct drop as soon as they started a family. It was also found that women dentists are more likely to take career break. It is clear that childrearing and family responsibilities have a great impact on women's working life. Significant differences between males and females in work title and specialization were evident in an academic institution. Due to the societal orientation which regards women as primarily home makers, the responsibilities for family caretaking continues to fall disproportionately on women, and this fact could explain why women abandon their careers in the advanced stages. Conclusions: Efforts should be made to identify and reduce barriers to women's advancement in dentistry. PMID:24478948
Conry, Jeanne A; Brown, Haywood
The Patient Protection and Affordable Care Act of 2010 includes strong well-woman health care provisions as a means of optimizing preventive health care across a woman's lifetime. In 2013, The American College of Obstetricians and Gynecologists convened a task force of leading professional associations representing women's health clinicians to develop age-specific well-woman health care guidelines with a goal of improving health outcomes. The charge of the Well-Woman Task Force was to provide guidance to women and clinicians with age-appropriate recommendations for a well-woman visit. Evidence-based guidelines, evidence-informed guidelines, and uniform expert agreement formed the foundation for the final recommendations. The resulting list of recommendations, "Components of the Well-Woman Visit," identifies needs across a woman's lifespan and is intended for use by any provider who cares for adolescents or women.
... page: https://medlineplus.gov/news/fullstory_163508.html Divorce May Shrink an Older Woman's Waistline while marriage ... 9, 2017 THURSDAY, Feb. 9, 2017 (HealthDay News) -- Divorce can be plenty stressful for older women. But ...
Kim, Jeong Ok; Jang, Shin A; Yun, Nae Ri; Lee, Sang-Hun; Hwang, Sung Ook
Uterine prolapse during pregnancy is an uncommon condition. It can cause preterm labor, spontaneous abortion, fetal demise, maternal urinary complication, maternal sepsis and death. We report the case of uterine prolapse in a 32-year-old healthy primigravid woman. She had no risk factors associated with uterine prolapse. She was conservatively treated, resulting in a successful vaginal delivery. This report is a very rare case of uterine prolapse in a young healthy primigravid woman, resulting in a successful vaginal delivery. PMID:27200317
information and did not provide safeguards to protect private patient information despite the potential for harm. The court did not find a provision requiring incident reports to the medical licensing board following death or serious injury to violate the right of informational privacy because the type of information requested was narrowly tailored, the information was only required in limited circumstances, the potential for harm was minimized by existing statutory safeguards, and there was a strong state interest in having professional physician licensing boards monitor serious incidences. The court held that the law's provision requiring patients "be treated with consideration, respect and full recognition of the patient's dignity and individuality" was unconstitutionally vague because the meanings of "consideration," "respect," "dignity," and "individuality" were widely variable and the words were not medical terms. As such, the provision was too vague and subjective for providers to know how they should act and did not limit arbitrary enforcement. Finally, the court held that a provision requiring a hospital-admitted physician be on-site was constitutional because it did not violate procedural or substantive due process. The court remanded the case for determination of whether the law unduly burdened a woman's right to an abortion.
Bergmann, Martin S
The relationship between love and the symbiotic phase of childhood is explored from a new angle in terms of a conflict between "the woman I love" and "the woman I cannot live without." Love requires dependency, but it can also lead to giving up independent existence; then it becomes inimical to the relationship.
A letter of recommendation can catapult a woman into the next phase of the interview process for a particular job--or land her in the slush pile. Word choice in describing this female candidate can make or break her career. Letters of recommendation--especially when a reference's word choice paints a negative, less than stellar picture of the…
Zihlman, Adrienne L.
Reactions to the "woman the gatherer" theory, introduced in the 1970's as an alternative to the "man the hunter" thesis in anthropology, have been to accept, ignore it, or combine it with the hunting theory. The "man the hunter" model stresses that primitive males hunted for meat and provided food and protection for their mates and children who…
Presents an interview with Dr. Joyce F. Brown, the first female and first African American president of the Fashion Institute of Technology in New York. Explores the intricacies of being a Black woman president, working in New York higher education systems, and training students for an industry not renowned for its diversity. (EV)
During her lifetime Mary Ground, whose Indian name is Grass Woman, has experienced extreme changes in the life of Blackfeet Indians. Born in 1883, she remembers the travois and teepee days as well as the change to reservation life when the reservation was a fenced compound patrolled by the U.S. military. She has seen the decline in the use of…
In this article, the author profiles Carolyn Brodie, winner of this year's Scholastic Library Publishing Award. One can be completely charmed by Brodie's soft-spoken Arkansas accent, warm demeanor, and genteel manners. While the graciousness is authentic, the woman behind it is fearless, with a clear vision for youth services, remarkable tenacity,…
Crazy Bull, Cheryl
This article introduces Sherry Red Owl, also known as "Stands at Dawn Woman," because she greets each day as a new opportunity and has spent her life working at new things. She worked at Sinte Gleska University (SGU) during its founding years, taught at an elementary school when few Native teachers were employed in the school systems,…
Sosa-Gutierrez, Carolina G.; Solorzano-Santos, Fortino; Walker, David H.; Torres, Javier; Serrano, Carlos A.
Human monocytic ehrlichiosis is a febrile illness caused by Ehrlichia chaffeensis, an intracellular bacterium transmitted by ticks. In Mexico, a case of E. chaffeensis infection in an immunocompetent 31-year-old woman without recognized tick bite was fatal. This diagnosis should be considered for patients with fever, leukopenia, thrombocytopenia, and elevated liver enzyme levels. PMID:27088220
Hardesty, Carolyn, Ed.
Most of the material for this issue of the "Goldfinch," which explores the life of Carrie Chapman Catt, came from the archives of the State Historical Society of Iowa. Carrie Chapman Catt (1859-1947) was an Iowan who advocated woman suffrage and spent 26 years actively working for that cause. The issue contains a biography of Catt, and…
Sosa-Gutierrez, Carolina G; Solorzano-Santos, Fortino; Walker, David H; Torres, Javier; Serrano, Carlos A; Gordillo-Perez, Guadalupe
Human monocytic ehrlichiosis is a febrile illness caused by Ehrlichia chaffeensis, an intracellular bacterium transmitted by ticks. In Mexico, a case of E. chaffeensis infection in an immunocompetent 31-year-old woman without recognized tick bite was fatal. This diagnosis should be considered for patients with fever, leukopenia, thrombocytopenia, and elevated liver enzyme levels.
Written for the woman just graduated from college who wants a big-city job, the book provides coverage of the job scene from New York to San Francisco and offers methods and suggestions on how to create an exciting new career. Tips on where to look for jobs, the resume, and the job interview are some of the introductory topics, followed by a…
Silva, Carla Marins; Lopes, Fernanda Maria do Valle Martins; Vargens, Octavio Muniz da Costa
This article is a systhematic literature review including the period from 1994 to 2009, whose objective was to discuss the aged woman's vulnerability in relation to Acquired Imunodeficiency Syndrome (Aids). The search for scientific texts was accomplished in the following databases: Biblioteca Virtual em Saúde, Scientific Eletronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE). The descriptors used were vulnerability, woman and Aids. Eighteen texts were analyzed, including articles in scientific journals, thesis and dissertations. As a conclusion, it was noted that aged women and vulnerability to Aids are directly related, through gender characteristics including submission and that were built historical and socially. We consider as fundamental the development of studies which may generate publications accessible to women, in order to help them see themselves as persons vulnerable to Aids contagion just for being women.
Renard, C; Garcia, C; Perret, M-R; Vest, P; El Jahiri, Y; Fuilla, C
We report here the case of a young woman, who came by herself at the emergency department, presenting with a severe hyponatremia (106 mmol/L), as shown by her initial biological report. The biological comment leads us to review the hyponatremia considering on one hand osmolarity and on the other hand volemia. Patient's tests results showed hyponatremia with hypoosmolarity and isovolemia, due to her potomania. At last, the authors expose the main guidelines for the correction of hyponatremia.
Plotkin, Howard; Clarke, Roy S.; McCoy, Timothy J.; Corrigan, Catherine M.
The Old Woman meteorite, discovered in March 1976 by two prospectors searching for a fabled lost Spanish gold mine in mountains ˜270 km east of Los Angeles, has achieved the status of a legend among meteorite hunters and collectors. The question of the ownership of the 2753 kg group IIAB meteorite, the second largest ever found in the United States (34°28'N, 115°14'W), gave rise to disputes involving the finders, the Bureau of Land Management, the Secretary of the Department of the Interior, the State of California, the California members of the U.S. Congress, various museums in California, the Smithsonian Institution, and the Department of Justice. Ultimately, ownership of the meteorite was transferred to the Smithsonian under the powers of the 1906 Antiquities Act, a ruling upheld in a U.S. District Court and a U.S. Court of Appeals. After additional debate, the Smithsonian removed a large cut for study and curation, and for disbursement of specimens to qualified researchers. The main mass was then returned to California on long-term loan to the Bureau of Land Management's Desert Discovery Center in Barstow. The Old Woman meteorite litigation served as an important test case for the ownership and control of meteorites found on federal lands. The Old Woman meteorite appears to be structurally unique in containing both hexahedral and coarsest octahedral structures in the same mass, unique oriented schreibersites within hexahedral areas, and polycrystalline parent austenite crystals. These structures suggest that different portions of the meteorite may have transformed via different mechanisms upon subsolidus cooling, making the large slices of Old Woman promising targets for future research.
Weinstein, Lawrence; Laverghetta, Antonio V.; Peterson, Scott A.
The present study determined if the ideal man has changed over the years and who and what the ideal woman is. We asked students at Cameron University to rate the importance of character traits that define the ideal man and woman. Subjects also provided examples of famous people exemplifying the ideal, good, average, and inferior man and woman. We…
Appleby, Richard; Saroya, Haseeb; Postgate, Aymer; Meer, Ziad
We present the case of a 34-year-old woman with haemorrhagic ascites and an extrinsic rectal mass on endoscopy. Endometrioma was subsequently confirmed by laparoscopy and biopsy. Intestinal endometriosis is common, and often mimics other gastrointestinal pathology. Haemorrhagic ascites or intestinal masses are rare presentations of endometriosis, and this is the only reported case of both occurring together. Endometriosis and ascites are more common in women of African descent, and although histological diagnosis requires laparoscopy, MRI has a high negative predictive value; 95% for intestinal endometriosis. Re-accumulation of ascites were prevented by starting a gonadotrophin antagonist. PMID:24717582
Zia, Asif; Zareen, Nabila
Extramammary Paget's disease is a rare disease, which mainly occurs in postmenopausal women. The case of Paget's disease of vulva, in a 40 year old Asian woman, who presented with a history of intense itching in vulva for 1 year is being reported. After being medically treated, she was diagnosed on Vulval biopsy. Local excision of the vulval lesion was performed, and histopathology revealed Paget's disease, extending close to the surgical margins. Therefore, a re-excision was performed and patient remained disease free at six months follow up.
Campbell, J C
This article features a critical review of accumulated research and conceptual issues regarding Battered Woman Syndrome (BWS). BWS is recognized as important in providing legal defense to victims and as basis for diagnosis and treatment. However, there has been confusion as to the definition of BWS such as the use of violence committed against the woman as the defining characteristic. The study introduced by Walker demonstrated cycle of violence and learned helplessness to battered women. In addition, studies found out that BWS, manifested in a form of depression, low self-esteem, anxiety, physical symptoms, is evident in some abused women putting them at risk of suicide and homicide. Symptoms attributed to battering may also be a result of stress from a troubled relationship. The Learned Helplessness and Grief Theory (Campbell, 1989) explains the depression in battered women. Moreover, researchers are in disagreement of the factors that affect the level of trauma such as frequency of abuse, educational status and severity of sexual and emotional abuse. The issue on Post-Traumatic Stress Disorder and learned helplessness in BWS remained unresolved. Some researchers view battered women in the context of "survivors rather than victims". Furthermore, studies prove that battered women may experience stages of abuse where the manifestations of BWS are part of the steps to conflict resolution. Basing on these descriptions and findings, it is made clear that not all battered women experience BWS.
Mulder, M; De Jong, E
This article describes the position of woman surgeons in the Netherlands. In 1913 the first woman, Heleen Robert, was accepted as member of the Dutch Society of Surgery. Three others, Jeanne Knoop, Frieda van Hasselt and Rosalie Wijnberg, followed during the next ten years. The nomination of Rosalie Wijnberg caused a turbulent discussion as she was working as a gynaecologist and not as a surgeon. One can wonder about this argument as other members were gynaecologists too. It seems that the male attitudes towards women were changing as more women entered the male dominated field. Nevertheless, from 1931 on, the year in which the registration of specialists was created, a number of women succeeded in obtaining a registration in surgery. Four of them were interviewed: dr. D.A.E. Norel, A.G. Wiersum-de Kwaadsteniet, J. Leeksma-Lievense and A.A. Fierstra. The general opinion still is that surgery is not a female profession. At the moment there are some twenty women working as general surgeon compared to a seven hundred men.
Schmidt, Sandra J.
The curriculum of US History has improved substantially in its presentation of women over the 40 years since Trecker's 1971 study of US History textbooks. While studies show increased inclusions, they also suggest that women have not yet claimed their own place in the school curriculum. This paper seeks to better understand the woman who is…
Although the Spanish Speaking woman is usually considered to be outside the labor market, 36 percent of the 52 percent Spanish Speaking women were in the labor force in March 1972. These women suffer economic-sexist discrimination due to ascription of work according to sex and race by a racial-sexual hierarchy existing within the traditional…
Epstein, Randi Hutter
This paper looks at the ways that women's reproductive issues, particularly sterility, were explained during the post-World War II period. In the absence of a clear physiological basis, sterility was depicted as a product of psychoanalytic causes rooted in women's psychology. When women were yearning for a reason for their infertility and desperate for effective treatments, a psychoanalytic framework treated deficiencies lurking in the field of infertility. Framing infertility within a psychiatric construct influenced how women were treated by their medical specialists and how they were perceived by a public that expected married women to reproduce. An infertile woman was already considered a failure by society. By establishing her illness within the context of her own repressed desires, she was no longer an unwitting victim, but a culprit.
Hardman, Sarah M R; Gebbie, Ailsa E
Perimenopausal women have low fertility but must still be advised to use contraception until natural sterility is reached if they are sexually active. Patterns of contraceptive use vary in different countries worldwide. Long-acting reversible contraceptive methods offer reliable contraception that may be an alternative to sterilisation. Hormonal methods confer significant non-contraceptive benefits, and each individual woman should weigh up the benefits and risks of a particular method. No method of contraception is contraindicated by age alone, although combined hormonal contraception and injectable progestogens are not recommended for women over the age of 50 years. The intrauterine system has particular advantages as a low-dose method of effective hormonal contraception, which also offers control of menstrual dysfunction and endometrial protection in women requiring oestrogen replacement. Condoms are recommended for personal protection against sexually transmitted infections in new relationships. Standard hormone replacement therapy is not a method of contraception.
Just a few hours after NASA revealed that there is water ice on the Moon, U.S. First Lady Hillary Rodham Clinton introduced Air Force Lieutenant Colonel Eileen Collins to a packed auditorium at Dunbar Senior High School in Washington, D.C., as the first woman who will command a NASA space shuttle mission. With students at this school, which is noted for its pre-engineering program, cheering, Clinton said that Collins' selection “is one big step forward for women and one giant step for humanity.” Clinton added, “It doesn't matter if you are a boy or a girl, you can be an astronaut or a pilot, if you get a first-rate education in math and science.”
Sinha, Santosh Kumar; Verma, Chandra Mohan; Krishna, Vinay; Thakur, Ramesh; Kumar, Barun; Goel, Amit; Kumar, Surendra; Kumar, Ashutosh; Jha, Mukesh Jitendra
ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is an exceedingly rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and rare survival to adulthood. A 75-year-old woman with ALCAPA syndrome presented with angina (Canadian Cardiovascular Society functional class II) over past 8 months. Physical examination was within normal limits except pan-systolic murmur at the apex. Electrocardiography displayed poor R progression in precordial leads and signs of left ventricular hypertrophy. Echocardiography established presence of continuous flow entering the pulmonary trunk and normal systolic function. Coronary angiogram showed absence of left coronary artery originating from aorta, dilated and tortuous right coronary artery (RCA) and abundant Rentrop grade 3 intercoronary collateral communicating with left coronary artery originating from pulmonary trunk which was also confirmed on CT angiogram thus establishing diagnosis of ALCAPA. Survival in eight decade with this anomaly is still an enigma.
Reviews the movie "Lakota Woman," the story of Mary Crow Dog, a young woman who gave birth to her first child during the American Indian Movement's occupation of Wounded Knee, South Dakota, in 1973. Although the majority of the crew and cast were Native Americans, many subtleties and nuances of American Indian culture were overlooked.…
Babow, Irving; Rowe, Robin
Presents case study of suicidal woman diagnosed as catatonic schizophrenic in state mental hospital. Account reveals much about woman's life history, suicide career, problems of living, needs for help, and perceptions of relevant systems. Proposed model would use parts of patient's story for preventive intervention regarding suicidal behavior and…
Kim, Ji-Hye; Lee, Sun Kyung; Hwang, Soo Hyun; Kim, Jung-Sun; Yoon, Gun; Lee, Yoo-Young; Kim, Tae-Joong; Choi, Chel Hun; Kim, Byoung-Gie; Bae, Duk-Soo
Epithelioid trophoblastic tumor (ETT) is a very rare variant of gestational trophoblastic disease (GTD) which arises in reproductive age women with prior gestational history. Although abnormal vaginal bleeding is the most common symptom of ETT, there are no reported pathognomonic symptoms of ETT because of its rarity. ETT is similar to placental site trophoblastic tumor in terms of its slow growing characteristic and microscopic findings. Therefore, it could be misdiagnosed as placental site trophoblastic tumor or other types of GTD. Unlike other types of GTD, primary treatment of ETT is surgical resection because of its chemo-resistant nature. Accordingly, immunohistochemical staining is essential for accurate diagnosis and appropriate treatment. Here, we report a case of a 42-year-old hysterectomized woman with pelvic masses who suffered from abdominal pain. Through laparotomy, tumors were resected completely and they were diagnosed as ETT through immunohistochemical stain. This report provides more evidence about its clinical features, diagnosis, and treatment including a brief review of the literature. PMID:28217684
Romero, Lisa; Wallerstein, Nina; Lucero, Julie; Fredine, Heidi Grace; Keefe, Joanna; O'Connell, JoAnne
HIV risk is the product of social, cultural, economic, and interpersonal forces that create sex-role definitions and expectations that can lead to gender inequalities in health. Woman to Woman: Coming Together for Positive Change is an HIV/AIDS prevention intervention that takes into account that choices and actions may be constrained by poverty,…
Perry, Elissa L; Kulik, Carol T; Bourhis, Anne C
Some federal courts have used a reasonable woman standard rather than the traditional reasonable man or reasonable person standard to determine whether hostile environment sexual harassment has occurred. The current research examined the impact of the reasonable woman standard on federal district court decisions, controlling for other factors found to affect sexual harassment court decisions. Results indicated that there was a weak relationship between whether a case followed a reasonable woman precedent-setting case and the likelihood that the court decision favored the plaintiff. The implications of our findings for individuals and organizations involved in sexual harassment claims are discussed.
Lemon, Lara S; Zhang, Hongfei; Hebert, Mary F; Hankins, Gary D; Haas, David M; Caritis, Steve N; Venkataramanan, Raman
Pregnancy results in many physiologic changes that can alter the pharmacokinetic profiles of medications used during pregnancy. One of the primary factors leading to these pharmacokinetic changes is altered activity of drug-metabolizing enzymes. Ondansetron is a substrate of cytochrome P450 (CYP) 3A4 (primary metabolic pathway), 2D6, and 1A2, all of which are altered during pregnancy. We evaluated the pharmacokinetics of ondansetron at three different gestational time points in a 26-year-old, pregnant, Caucasian woman with normal liver and kidney function, who was maintained on ondansetron 8 mg administered orally 3 times/day throughout her pregnancy. Serial plasma samples were collected from the subject over one 8-hour dosing interval at 14, 24, and 35 weeks' gestation (representing early-, mid-, and late-pregnancy time points, respectively). Ondansetron plasma concentrations were determined using liquid chromatography-tandem mass spectrometry. Ondansetron area under the plasma concentration-time curve decreased progressively across gestation (634 ng hr/ml in early pregnancy, 553 ng hr/ml in mid-pregnancy, and 387 ng hr/ml in late pregnancy), with a corresponding increase in apparent oral clearance (12.6 L/hr in early-pregnancy, 14.5 L/hr in mid-pregnancy, and 20.7 L/hr in late-pregnancy). The decreased area under the plasma concentration-time curve and exposure to ondansetron across gestation is likely due to increased activity of CYP3A4 and CYP2D6 during pregnancy. We were not able to study this patient during the postpartum period; however, as with other CYP3A4 and CYP2D6 substrates, the apparent activities of these isoenzymes are likely return to baseline. To our knowledge, this is the first report to describe ondansetron pharmacokinetics across gestation. Additional pharmacokinetic and pharmacodynamic data are needed to confirm our results and to evaluate clinical impact; however, in the meantime, clinicians should be aware of these pharmacokinetic changes in
Moraloğlu, O; Engin-Ustün, Y; Ozakşit, G; Mollamahmutoğlu, L
Vaginismus is a common sexual dysfunction. The case of a successful water birth in a woman with vaginismus is presented. Water birth should be considered as an alternative method of birth in women with vaginismus.
... gov/news/fullstory_163038.html 'Superbug' Resistant to All Antibiotics Killed Nevada Woman She died after possibly ... in September from a "superbug" infection that resisted all antibiotics, according to a report released Friday. The ...
The policy goal of the MBE/WBE Programs is to assure that minority business enterprises and woman business enterprises are given the opportunity to participate in contract and procurement for supplies, construction, equipment & services under any EPA grant
1. GENERAL VIEW, (the one with the woman at the front door). Photocopy of December 1957 photo on file at Philadelphia Historical Commission - James Keen House, 946 South Front Street, Philadelphia, Philadelphia County, PA
The purpose of this Heideggerian phenomenological study was to uncover the meanings of the clinical experiences of registered nurses working in maternity settings after they studied maternity nursing from a woman-centered, feminist perspective in a generic baccalaureate nursing program. Purposeful sampling was conducted to locate and recruit nurses who had graduated from this nursing program between the December 1996 and December 1998 semesters and were currently working in a maternal-newborn clinical setting. Each participant had taken the required woman-centered, maternity-nursing course during her/his undergraduate education. Data collection included an individual, open-ended interview that focused on the nurses' descriptions of their everyday practices as maternity nurses. Nineteen maternal-newborn nurses between the ages of 23 and 43 years who had been in practice from six months to three years were interviewed. The constitutive patterns identified from the interviews were: “Otherness,” “Being and Becoming Woman-Centered,” and “Tensions in Practicing Woman-Centered Care.” Findings revealed that the nurses had a raised awareness of oppressive maternity care practices and applied ideology of woman-centeredness as a framework for providing more humanistic care. Creating woman-centered maternity care meant negotiating tensions and barriers in medically focused maternity settings and looking for opportunities for advocacy and woman-empowerment. The barriers the nurses faced in implementing woman-centered care exposed limitations to childbearing choices and nursing practices that remain problematic in maternity care. PMID:17273327
Collins, Tracy J R
Between 1885-1900 "Punch" satirized the personality of the New Woman. However, virtually single-handedly it also gave a body and emancipated culture to this otherwise socially abstract personality. Using illustrations from "Punch," this essay argues that using sport specific clothing and equipment in its cartoons, "Punch" completely unintentionally created a liberating picture of women while simultaneously using its captions and border texts to make the New Woman's body signify the anxieties patriarchal culture had about her social personality and politics.
Under the editorship of Oscar Wilde, the "Woman's World" exemplified the popular dissemination of Hellenism through periodical culture. Addressing topics such as marriage, politics, and education in relation to the lives of women in the ancient world, the magazine offered an unfamiliar version of the reception of ancient Greece and Rome in late-Victorian aestheticism, one that was accessible to a wide readership because it was often based on images rather than texts. The classical scholar Jane Ellen Harrison addressed herself to this audience of women readers, discussing the similarities between modern collegiate life and the "woman's world" that enabled Sappho to flourish in ancient Greece. The "Woman's World" thus questions gender stereotypes by juxtaposing ancient and modern women, implicitly endorsing varied models of womanhood.
Adams, Ellise D
A woman has many important decisions to make once discovering a pregnancy. One of those decisions with significant implications is where the birth will take place. The primary consideration for the majority of pregnant women when making a decision about birth environment is safety. However, other factors such as attitudes of family and friends, religious reasons, and confidence in the body's ability to give birth play a factor in the choice of birth environment. It is recommended that birth attendants use the process of shared decision making to assist pregnant women in making choices related to the birth environment. This process empowers the pregnant woman and provides a woman-centered and evidence-based approach to choices related to obstetrical care.
Ciurea, Alexandru-Vlad; Moisa, Horatiu Alexandru; Mohan, Dumitru
The authors present the activity of Mrs. Sofia Ionescu, the one female surgeon who was nominated as the first woman neurosurgeon in the world. Sofia Ionescu worked in the field of neurosurgery for 47 years, performing all the known neurosurgical procedures of the time. She made herself known through her incredible surgical skill and her enormous work power. Due to her incredible modesty and workload, she never participated at international congresses or manifestations. The nomination as first woman neurosurgery took place in Marrakech, Morocco, during the 2005 WFNS Congress. Although some claim that Diana Beck was the first woman neurosurgeon in the world, our theory suggests otherwise. The first documented surgical intervention performed by Diana Beck dates to 1952. Sofia Ionescu operated for the first time on a human brain as early as 1944. Furthermore, Diana Beck's actions surfaced in the year 1947, long after the war had ended and Sofia Ionescu had become a neurosurgeon.
Kunishi, Yosuke; Iwata, Yuri; Ota, Mitsuyasu; Kurakami, Yuichi; Matsubayashi, Mao; Kanno, Masatomo; Kuboi, Yoriko; Yoshie, Koichiro; Kato, Yoshio
A 52-year-old woman presented with recurrent, severe abdominal pain. Laboratory tests and imaging were insignificant, and treatment for functional dyspepsia was ineffective. The poorly localized, dull, and severe abdominal pain, associated with anorexia, nausea, and vomiting, was consistent with abdominal migraine. The symptoms were relieved by loxoprofen and lomerizine, which are used in the treatment of migraine. We herein report a case of abdominal migraine in a middle-aged woman. Abdominal migraine should be considered as a cause of abdominal pain as it might easily be relieved by appropriate treatment. PMID:27725538
Jala, Marjorie; Conil, Emmanuelle; Varsier, Nadège; Wiart, Joe; Hadjem, Abdelhamid; Moulines, Éric; Lévy-Leduc, Céline
In this paper, we introduce a study that we carried out in order to validate the use of a simplified pregnant woman model for the assessment of the fetus exposure to radio frequency waves. This simplified model, based on the use of a homogeneous tissue to replace most of the inner organs of the virtual mother, would allow us to deal with many issues that are raised because of the lack of pregnant woman models for numerical dosimetry. Using specific absorption rate comparisons, we show that this model could be used to estimate the fetus exposure to plane waves.
The essay discusses the role and education of the women of India, with special reference to the women of Bengal during the nineteenth-century and a comparison is made between the education of the Indian woman and the education of the European woman during this era. The education of the Indian woman is also referenced against the backdrop of the…
Morice, Linda C.
This article examines the life of education reformer Flora White, who both represented and deviated from the stereotypical new woman portrayed in popular literature of the late nineteenth and early twentieth century. White's decision to reject marriage and children in favor of a career resulted in greater financial insecurity and an unmet desire…
The purpose of this paper is to describe the educational experiences of a Mexican woman in Chicago's Little Village community in the 1980s. The author was born in Mexico and raised in Little Village which has been home to Mexican immigrant communities for decades. Little Village is also home to the largest Mexican-American population in the…
Pratt, Alice; Bennett, Ruth, Ed.
Traditional and contemporary Hupa songs as sung by a Hupa medicine woman in her 70's are collected in this booklet. Songs are presented in Hupa and English on facing pages that are illustrated with pen and ink drawings. The four songs are "Flower Dance Song" and "Kick Dance Song" (both for traditional religious ceremonial…
Belliard, Juan Carlos; Ramirez-Johnson, Johnny
This case study reflects on the variety of approaches to health care in a pluralistic immigrant urban enclave in Southern California. In-depth interviews were conducted with a Mexican immigrant woman to explore and understand her health worldview and the strategies she uses in deciding among the diverse health care options available to protect and…
Sanverdi, Ilhan; Vural, Fisun; Temizkan, Osman; Temel, Orhan; Ayvaci, Habibe; Gunes, Pembegul
Leiomyomas are benign neoplasms that can develop wherever smooth muscle is present. Primary leiomyomas of the ovary originate from smooth muscle cells of ovarian tissue and are rare, solitary tumors. Approximately 70 cases have been reported. They usually present in premenopausal women. The present case is a report of left ovarian leiomyoma in a postmenopausal woman.
Chickering, Joanne Nelson; Obstfeld, Lisa
Addresses the issue of serving the needs of nontraditional learners using a case study of a reentry woman. Used a collaborative approach to help the student improve her assertive skills and develop some test taking strategies. Also used role playing, flooding, and mnemonic strategies. (JAC)
The sexual imagery of Friedrich Nietzsche and English historian Michael Oakeshott in characterizing perspectives on the past, especially the comparison of the relationship of a historian to history with that of a man to a woman, are compared and discussed. (MSE)
Bruun, Lene Søndberg; Jensen, Michael Skov
Cystic fibrosis is usually diagnosed in early childhood, and patients rarely live beyond the age of 40. We present a case of a 70-year-old woman, in whom cystic fibrosis was diagnosed with the rare mutation, R117C. Cystic fibrosis should therefore also be considered in older patients.
Danielsson, Anna T.
This article explores what it can mean to be a woman physics student. A case study approach is used to explore how five women who are studying physics at a Swedish university simultaneously negotiate their doing of physics and their doing of gender. By conceptualising both gender and learning as aspects of identity formation, the analysis of the…
Calvert, Sandra L.; Kondla, Tracy A.; Ertel, Karen A.; Meisel, Douglas S.
College students viewed "Xena: Warrior Princess" (a woman in a nontraditional heroic role) under differing conditions. Researchers investigated how they perceived and remembered Xena as a function of the amount of shadow, an archetypal personality structure, portrayed in the episode, noting the influence of viewer characteristics. Viewer…
Gilad, Jacob; Wolak, Arik; Borer, Abraham; Benharroch, Daniel; Avidor, Boaz; Giladi, Michael; Schlaeffer, Francisc
We report a case of isolated splenic cat scratch disease in an immunocompetent woman. The clinical presentation of prolonged fever, night sweats, weakness, and intrasplenic lesions was highly suggestive of lymphoma. This is the second reported case of isolated splenic cat scratch disease in an adult and the first in a healthy adult.
Data Associates, Framingham, MA.
The purpose of the report is the presentation of ideas and information to help the working woman save time, effort, and money. Chapter one offers suggestions for child care arrangements such as babysitters, transportation needs, and the possibilities for home employment. Chapter two includes shopping and specific management tips for both clothing…
Revere, Amie B.
This article profiles Velma Dolphin Ashley, a Black woman educator who served as superintendent of schools in Boley (Oklahoma) from 1944 to 1956. During her superintendency, Ashley was responsible for instructional activities in a correctional institution for delinquent Black youth, as well as for administering the all-Black school district. (AF)
National Archives and Records Administration, Washington, DC.
Beginning in the mid-19th century, several generations of woman suffrage supporters lectured, wrote, marched, lobbied, and practiced civil disobedience to achieve what many people considered a radical change in the U.S. Constitution. Militant suffragists used tactics such as parades, silent vigils, and hunger strikes. In 1870 the 15th amendment to…
Beletskaya, I P
A total devotion to your science is the main component of success! In this Guest Editorial, I. P. Beletskaya, Professor of chemistry at Moscow State University and a board member of Chemistry--A European Journal, describes her perspective on being a woman in science and shares some personal insights into her career and life as a chemist.
Hemingway is a famous American writer and a spokesman of the Lost Generation. His life attitude of the characters in the novels influenced the whole world. His first masterpiece "The Sun Also Rises" contributes a lot to the rise of feminism and make the world began to be familiar with a term: The New Woman through the portrayal of Brett.…
Providing information and activities designed to dispel sex role socialization, myths, and stereotypes as bases for prejudiced views, this teaching guide focuses on the American woman's image and diverse roles in our society. It is part of the Louisville Area Ethnic Heritage Studies Project described in ED 150 043. The project materials are…
A Russian woman describes how living in remote Kamchatka helped her develop an aboriginal perspective. Chopping wood, hauling water, gathering food, alternately homeschooling her children and sending them to an ecological school, and interacting with local aboriginal people taught her the importance of conserving natural resources and living in…
Rosenbloom, Arlan L
A young woman's death at home was attributed to new onset diabetic ketoacidosis with subsequent litigation supported by several expert consultants, despite a history and postmortem findings inconsistent with this diagnosis. More thorough tissue study of the heart and analysis of the circumstances led to a credible explanation of the entire scenario.
Soullier, Noémie; Bouyer, Jean; Pouly, Jean-Luc; Guibert, Juliette; de La Rochebrochard, Elise
Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. This study examined treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue. Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. We aimed to examine treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative
Souto, Selma B; Baptista, Pedro V; Barreto, Filomena; Sousa, Pedro F; Braga, Daniel C; Carvalho, Davide
Virilising ovarian tumours are a rare cause of hyperandrogenism in women, accounting for less than 5% of all ovarian neoplasms. It occurs most often in - and postmenopausal women. We report a case of a 64 year-old woman with signs of virilisation that had started 3 years before. Blood hormone analysis revealed increased levels of testosterone, and 17-hydroxyprogesterone. The tetracosactin test revealed 21-hydroxylase deficiency. Radiological imaging demonstrated a nodule in her left ovary. The patient was submitted to bilateral laparoscopic oophorectomy, and histopathological examination revealed a luteoma of the left ovary. Postoperative serum testosterone level and 17-hydroxyprogesterone returned to normal levels in one month. Virilism regressed within six months. Our patient also showed an elevation in 17-OHP serum levels. Normalization of 17-OHP after oophorectomy suggests a case of intratumoral 21-hydroxylase deficiency. To our knowledge, this is the first description of ovarian intratumoral 21-hydroxylase deficiency in a postmenopausal woman.
Fadhlaoui, Anis; Ben Hassouna, Jamel; Khrouf, Mohamed; Zhioua, Fethi; Chaker, Anis
Background Endometrial adenocarcinoma usually occurs after menopause, but in 2%–14% of cases, it occurs in young patients (less than 40 years of age) who are eager to preserve their fertility. Its treatment includes hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy, and, in some cases, radiation therapy. Aim To describe a case of endometrial adenocarcinoma occurring in a young woman and to undertake a literature review of risk factors and therapeutic options proposed for young women wishing to preserve their fertility. Case We report a case of endometrial cancer in a 27-year-old woman treated for resistant menorrhagia and cared for in our department as well as in the Salah Azaiez Institute. Conclusion Endometrial adenocarcinoma rarely occurs in young women. In such cases, other therapeutic options can be proposed: progesterone therapy and LH-RH (Luteinzing-Hormone-Releasing-Hormone) agonists therapy in order to preserve fertility in younger patients. PMID:21769252
Summary This essay takes seriously Thomas Raynalde’s advice in The Womans Booke that women might read this work aloud. The evidence I use to sketch the scene of reading includes Raynalde’s advice to readers in his long prologue, and also the kind of reading practice that his own writing represents. But I also go outside the text, considering what we know about the experience of listening to a book, and emphasizing the link between this practice and rhetorical education. I also examine the evidence left behind by two male readers: William Ward, who marked his copy of the 1565 edition privately, and Edward Poeton of Petworth, who represented instead a semipublic or shared reading: the evaluation of The Womans Booke and other books of generation by a Midwife and her Deputy in a fictional dialogue “The Midwives Deputie” (ca. 1630s). PMID:26521668
My entry into carbon science and nanoscience at an early stage in my career occurred in part because I was a woman in physics. In these reminiscences I will relate why working on carbon science started because I was a woman interested in working on a topic that interested me greatly, but was unpopular at the time; carbon science and thermoelectricity are two examples. I will elaborate on how our research system allows safe study of unpopular topics so that both the researcher and research sponsor are satisfied with outcomes. I also learned a lot from my family and acknowledge their contributions as well as those of sponsors who supported high-risk projects.
A 25-year-old woman presented with a history of secondary amenorrhoea for the last 3 years, coinciding with her delivery. She delivered at home and had massive postpartum haemorrhage. She was brought in a state of circulatory collapse to the nearest teaching hospital, where she was resuscitated. She developed anaemia, septicaemia and extradural empyema. The complications were managed and the woman improved. Presently, she approached us for infertility. She was investigated and diagnosed with postpartum hypopituitarism, that is, Sheehan's syndrome. Her gonadotrophin levels, luteinising hormone/follicle-stimulating hormone, were normal, serum oestradiol was low and serum prolactin was also on the lower side. She had started with genital atrophy and was given three cycles of cyclic oestrogen +progesterone combination. Ovulation was induced. She conceived and her antenatal period was uneventful. She delivered a full-term baby vaginally. However, she had inadequate lactation after delivery and lost the baby at one-and-a-half months' age due to gastroenteritis.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Culturally Significant Object Imported for Exhibition Determinations: ``Vermeer's Woman in Blue Reading a... ``Vermeer's Woman in Blue Reading a Letter,'' imported from abroad for temporary exhibition within...
Soro Marín, Sandra; Sánchez Trenado, María Asunción; Mínguez Sánchez, María Dolores; Paulino Huertas, Marcos; García Morales, Paula Virginia; Salas Manzanedo, Verónica
Soft tissue infection due to Mycobacterium tuberculosis can affect muscle, tendons, fascia, bursa and synovial tissue. Tuberculous trochanteric bursitis is a rare entity that usually affects immunocompromised patients. Manifestations usually occur insidiously, which delays diagnosis and treatment. We present the case of an immunocompetent young woman who came to our department for chronic left hip pain. The study confirms the diagnosis of tuberculous trochanteric bursitis. This case demonstrates the importance of considering a possible infectious origin of bursitis in immunocompetent patients.
Thompson, R. P. H.; Williams, Roger
The oral contraceptive chlormadinone acetate has been given for eight months to a woman who had developed jaundice during four pregnancies, and twice while taking a combined contraceptive pill. No side-effects or changes in liver function were observed. This is further evidence that progestogens used for contraception, and in particular those derived from hydroxyprogesterone, are less hepatotoxic than the oestrogenic components. PMID:4189931
Greene, James G.
Weakness and sensory changes are common complaints in both the inpatient and the outpatient setting. However, this presentation remains a diagnostic challenge to clinicians due to the many possible underlying etiologies. The initial evaluation of weakness and sensory changes starts a thorough history and physical examination to guide the diagnostic process. In this article, we present the case of an elderly woman with complaints of weakness and sensory changes to highlight a step-wise approach to diagnosis and management. PMID:26753055
Vila, Andrea; Dapás, Juan I; Rivero, Cynthia V; Bocanegra, Florencia; Furnari, Roberto F; Hsu, Amy P; Holland, Steven M
GATA2 deficiency is a genetic disorder caused by inherited or sporadic haploinsufficient mutations in the GATA2 gene. Patients have abnormalities in hematopoiesis, lymphangiogenesis and immunity; encompassing a broad range of clinical syndromes, mainly characterized by monocytopenia, B and NK cell cytopenia, severe or recurrent infections, and a high risk of developing myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). We report a case of an Argentinean woman who presented with multiple opportunistic infections as her first manifestation of GATA2 deficiency.
Makari, G J
After Kant's critique of empiricism, subjectivist epistemologies cropped up in 19th-century German philosophy. Schopenhauer argued that the true essence of every object was an irrational and sexual will. This underlying will distorted a subject's knowledge of the world. Schopenhauer's notion of this true essence was analogous to his portrayal of women; they too were natural, irrational, and instinctual. Nietzsche postulated a will-to-power that structured and hence distorted a chaotic world. That structureless "real" world Nietzsche symbolized as the essential "truth of a woman," a truth which for Nietzsche was unknowable to the desirous male philosopher. Freud, while maintaining belief in empirical truth, developed a psychology of mis-knowledge which had much in common with Schopenhauer's epistemology. His theory of transference grew from a need to explain how female patients libidinally distorted the reality of their male analysts. Conversely, Freud's later writings on women are hampered by the author's realization of his own precarious and subjective position as man trying to know woman. These counter-transferential concerns ultimately made the woman's psychological essence an unknowable riddle for Freud.
Pariser, David M
Born in 1868 and the first American woman to become a dermatologist, Daisy Maude Orleman (later Robinson) graduated from the National Medical College of Columbian University, now George Washington University, in 1890. After training in dermatology in Paris and Zurich and after marriage to Andrew Rose Robinson in 1904, she joined the faculty of the New York Polyclinic Medical School and the Northwestern Dispensary in New York, where she was an attending dermatologist starting in 1905. Her achievements included being the first woman dermatologist to present a case at a dermatologic meeting, to publish a scholarly paper in dermatology, to present a case at an international dermatology meeting, and to have a documented clinical practice in dermatology in the United States. A 1916 publication listed her as the best known woman dermatologist in the world. After service in the US Army Medical Corps during World War I, she had a distinguished career in the US Public Health Service, where she devoted her career to the eradication of venereal diseases and the development of sex education programs, particularly for young women.
Smirnova, Michelle Hannah
The logic and cultural myths that buttress the cosmeceutical industry construct the older woman as a victim of old age, part of an "at-risk" population who must monitor, treat and prevent any markers of old age. A content and discourse analysis of 124 advertisements from the US More magazine between 1998 and 2008, revealed three major themes working together to produce this civic duty: (1) the inclusion of scientific and medical authorities in order to define the cosmeceutical as a 'drug' curing a disease, (2) descriptions of the similarities (and differences) between the abilities of cosmeceuticals and cosmetic surgery to restore one's youth, and (3) the logic equating youth with beauty, femininity and power and older age with the absence of these qualities. Together these intersecting logics produce the "will to youth"-the imperative of the aging woman to promote her youthful appearance by any and all available means. Further, by using images and references to fantasies and traditional fairytales, cosmeceutical advertisements both promise and normalize expectations of eternal youth of the aging woman.
Elley-Brown, Margaret J.
In this qualitative study, the career journey of one New Zealand woman was analysed. Three key findings emerged: the power of narrative as a vehicle for this woman's story, her movement towards greater authenticity and spiritual fulfilment as a mature woman, and the ongoing struggle for concurrent fulfilment from communal and agentic perspectives.…
... AFFAIRS 38 CFR Part 17 RIN 2900-AO05 Medical Benefits for Newborn Children of Certain Woman Veterans... to provide certain health care services to a newborn child of a woman veteran who is receiving... woman veteran who is receiving maternity care furnished by for not more than seven days after the...
Deming, Caren J.
Current television programs create an image of modern woman that is vastly different from the real modern woman as she is reflected in social statistics. Today's average woman can be described as follows: 30 years old, possibly single, employed outside the home, independent and self reliant, sophisticated in tastes and expectations, and concerned…
Romero, Lisa; Wallerstein, Nina; Lucero, Julie; Fredine, Heidi Grace; Keefe, Joanna; O'Connell, JoAnne
HIV risk is the product of social, cultural, economic, and interpersonal forces that create sex-role definitions and expectations that can lead to gender inequalities in health. Woman to Woman: Coming Together for Positive Change is an HIV/AIDS prevention intervention that takes into account that choices and actions may be constrained by poverty, gender roles, and cultural norms. This project educates and empowers, promotes women's perspectives, reaches women "where they are," and encourages women to speak of their experience. The following study presents the evaluation of the effectiveness of an empowerment based participatory HIV prevention program over a 3-year period, implemented in both rural and urban settings in New Mexico, targeting over 300 women at-risk of HIV/AIDS. In addition, the practicalities of conducting participatory process and outcome evaluation with a small nonprofit with minimal budget will be discussed.
Mostafa-Gharabaghi, Parvin; Bordbar, Shima
A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing. There was not any myomectomy scar. PMID:28299219
Hillman, R Tyler; Garabedian, Matthew James; Wallerstein, Robert J
Prune belly syndrome is a rare congenital syndrome that primarily affects male fetuses. Affected men are universally infertile; however, there is a paucity of information published on the reproductive potential of affected women. Pregnancy outcomes in affected women have not been described in the literature. We describe the case of pregnancy in an affected woman. Her pregnancy progressed without complication. Her fetus had no stigmata of the syndrome. Her labour and delivery were, however, complicated by a prolonged second stage of labour and need for vacuum-assisted vaginal delivery.
Aiken, Laura; Linpower, Lisa; Tsitsikas, Dimitris A.
Sickle cell disease is an inherited haemoglobinopathy that can affect multiple organs and systems. The most common neurological complication in sickle cell disease is stroke and silent cerebral infarcts. Peripheral nervous system involvement has been described but is exceedingly rare. Herein, we describe the case of a young woman who presented with acute flaccid paralysis and sensory loss of the left lower extremity in the context of a painful vasoocclusive crisis which resolved rapidly after receiving an emergency automated red cell exchange transfusion. PMID:27994894
This essay represents the first editorial of the series "Recollections, Reflections, and Revelations: Ethnobiologists and their First Time in the Field". In this memoir, the author details the evolvement and intellectual progression of her research focusing on wild food plant consumption within a remote community in the high steppes of Central Anatolia during the early Nineties. The author conveys a human learning journey as a woman and an ethnobiologist, reflecting on the methodological bottlenecks and solutions during her first ethnographic experience in the field. PMID:23819702
Kennedy, John M
Outline pictures depict surface edges, and via extensions from this base they can represent sensory and psychological referents. Outline drawings standing for edges of surfaces are relatively ancient, and lines for actions, sounds, and psychological states quite recent--mostly little more than a century. The novel finding here is that lines for psychological states of several kinds are invented by a blind woman, EW, who began making raised-line drawings as an adult. Notably, she invented novel devices representing thoughts and emotional impressions. If lines depict surface edges literally, they depict motion, sensory effects, impressions, and thoughts metaphorically.
O’Brien, Charles P.
Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmacologic treatment with methadone and the more experimental medication options of buprenorphine and naltrexone. PMID:18594026
Mostafa-Gharabaghi, Parvin; Bordbar, Shima; Vazifekhah, Shabnam; Naghavi-Behzad, Mohammad
A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing. There was not any myomectomy scar.
Mahalingaiah, Shruthi; Berry, Katharine F; Hornstein, Mark D; Cramer, Daniel W; Missmer, Stacey A
The association between educational level and cycle outcomes was quantified by applying multivariable logistic and linear regression within a prospective cohort of 2,569 women commencing their first in vitro fertilization (IVF) cycle. Although a woman's educational attainment was not associated with the likelihood of implantation failure, chemical pregnancy, spontaneous abortion, or live birth, the odds of cycle cancellation before egg retrieval were 40% lower among those with an college degree and 48% lower among those with graduate school attendance compared with women who had no college degree, suggesting that educational attainment is inversely associated with the likelihood of cycle cancellation.
Ferreira, Maria Madalena; Rios, Ana Cristina; Fragata, Isabel; Baptista, José Tiago; Manaças, Rui; Reis, João
Cerebral venous thrombosis (CVT) is a relatively rare but serious condition potentially reversible upon accurate diagnosis and adequate therapy. The peri-partum state and pregnancy are predisposing factors and TVC accounts for about 6% of maternal deaths. Its clinical symptoms depend on the the thrombus site and extension, and also on the existing collateral vessels network. We present the case of a 33 year-old woman, 13 weeks pregnant, that complained of headaches and whose cranial magnetic resonance imaging revealed a subtotal oclusión of the superior sagittal sinus. We discuss the imaging features of dural venous thrombosis in the acute phase.
Kim, Jiyoung; Park, Seung Ha; Jung, Yu Ri; Park, Soon Won; Jung, Dae Soo
Anti N-methyl-D-aspartate (NMDA) receptor encephalitis is one of the most common types of autoimmune synaptic encephalitis. Anti-NMDA receptor encephalitis commonly occurs in young women with ovarian teratoma. It has variable clinical manifestations and treatment responses. Sometimes it is misdiagnosed as a psychiatric disorder or viral encephalitis. To the best of our knowledge, anti-NMDA receptor encephalitis is a rare condition in pregnant women. We report a case of anti-NMDA receptor encephalitis in a pregnant woman who presented with abnormal behavior, epileptic seizure, and hypoventilation.
Valecha, Nishant; Miller, Andrew
We report a case of nonuremic calcific arteriolopathy (NUCA) in an 82-year-old Caucasian woman from rural Australia. The patient had no history of kidney disease or dialysis. NUCA is rare disease suspected on cutaneous and clinical features and diagnosed by characteristic findings on skin biopsy and vasculature imaging. Calcification induced microvascular occlusion in the absence of renal failure may not be immediately apparent. Clinical suspicion and appropriate investigations are essential for making a diagnosis. A diagnosis of NUCA may be missed given the rarity of the disease, and dermatologists and patients alike would benefit from a greater awareness of this disease. PMID:28191356
Sandhu, Harminder S.; Michelis, Michael F.; DeVita, Maria V.
A 36 year-old 5 weeks postpartum lactating woman presented to the emergency room with severe nausea and vomiting for 48 hours. The patient was found to be in non-diabetic ketoacidosis with a serum pH 6.9 and a HCO3 of <5mEq/L. This condition rapidly improved with the administration of intravenous dextrose and bicarbonate and with the cessation of breast feeding. The course and pathophysiology of the rarely described phenomenon of bovine ketosis in a human is discussed here. PMID:25984014
Sandhu, Harminder S; Michelis, Michael F; DeVita, Maria V
A 36 year-old 5 weeks postpartum lactating woman presented to the emergency room with severe nausea and vomiting for 48 hours. The patient was found to be in non-diabetic ketoacidosis with a serum pH 6.9 and a HCO3 of <5mEq/L. This condition rapidly improved with the administration of intravenous dextrose and bicarbonate and with the cessation of breast feeding. The course and pathophysiology of the rarely described phenomenon of bovine ketosis in a human is discussed here.
Shariff, Zakir; Patel, Kuntal J.; Elbo, A.; Guisasola, I.
Radial head fractures are common injuries, occurring in about 20% of all acute elbow injuries. Isolated radial head fractures are not common and include about 2% of all fractures around the elbow. Bilateral radial head fractures are rare and usually associated with severe trauma and associated fractures and dislocations. We report a case of bilateral undisplaced radial head fracture in a woman, following a simple fall. Early recognition, proper management, and physical therapy led to complete recovery and full functional movement of the elbow. PMID:16369234
Patel, Dharmesh R; Knepper, Laurie; Jones, H Royden
We describe a 53-year-old Caucasian woman with a 19-year history of an evolving amyotrophy confined to her dominant right arm and hand. Although this atypical case of a late-onset monomelic amyotrophy in some respects mimics Hirayama disease or O'Sullivan-McLeod syndrome, it does not conform precisely with either of those disorders. We compare this individual's difficulties and clinical temporal profile to other disorders considered in the differential diagnoses with regard to her evolving clinical setting.
Ram, Hari; Mehta, Gagan; Kumar, Manoj; Lone, Parveen
Odontogenic myxoma (OM) is a rare benign but locally aggressive tumour of the jaws. It is usually seen in the second to third decade of life. Women are more frequently affected than men and it has more predilections for the mandible rather than the maxilla. OM presents as an asymptomatic swelling in most of the cases. Owing to the non-capsulated and aggressive nature of OM, a high rate of recurrence has been reported. Here we present a case of OM in a 52-year-old woman managed by segmental mandibulectomy. Sign of recurrence was seen after 18 months of follow-up. PMID:24859552
Phua, C K; Marimuthu, K; Teo, H Y; Ong, K H; Leo, Y S
Aplastic anaemia is a rare clinical syndrome associated with diminished or absent precursors in the bone marrow. Acquired aplastic anaemia secondary to human immunodeficiency virus (HIV) is very rare. We present a 71-year-old woman with severe aplastic anaemia secondary to HIV infection, which was after extensive exclusion of other causes. She achieved undetectable viral load after 5 months of combination antiretroviral therapy but remains profoundly pancytopenic, complicated by recurrent infectious and bleeding complications. HIV infection should be considered in patients with pancytopenia.
Picardi, A; Navajas, F; Spoto, S; Palma Modoni, A; De Galasso, L; Costantino, S
A seventy-four years old woman is assessed for asthenia, fatigue, non ulcerous dyspepsia with macrocytic anemia. The patient's medical history taking in Binswanger disease--diagnosed 5 aa before-, epilepsy-2 aa before- and a previous episode of TVP of the left leg, suggested the hypothesis that a B12 deficiency, by a chronic gastritis, would involve an increase of homocysteine cause of the clinical manifestations of megaloblastic anemia, Binswanger disease, tardive epilepsy and previous TVP. The fisic and blood and instrumental exams confirmed the clinical diagnosis. The patient is having vitamin B12.
Lee, Seung-Hee; Lee, Hae-Hyeog; Lee, Arum; Kim, Yeon-Suk; Jeon, Dong-Su; Kwak, Jeong Ja; Yang, Yo-Sep
Mucinous borderline ovarian tumors (BOTs) occur most often in women between the ages of 20 and 30. Early-stage detection of the condition has a more favorable prognosis. In this case report, the authors present an elderly 93-year old woman who visited our hospital due to severe abdominal pain after being diagnosed with a pelvic mass 2 years ago and not undergoing any treatment since the diagnosis was made. She underwent emergency left salpingo-oophorectomy and was diagnosed with mucinous BOT according to biopsy results. PMID:26793682
Sabzi, Freidoun; Faraji, Reza
The left atrium is the most common location of myxomas, which are benign tumors. Only a few cases of myxomas in pregnancies have been reported. Our thorough medical literature search showed only 17 reported cases in the course of pregnancy. Myxomas during pregnancy and in the preterm period constitute a serious phenomenon that can mimic an early sign of a life-threatening pathology like severe mitral stenosis. We describe a 33-year-old woman, who presented with acute dyspnea to a gynecology center and was referred to our hospital for further evaluation of pulmonary embolism. Transthoracic echocardiography showed a huge left atrial myxoma, and computed tomography scan illustrated paradoxical pulmonary embolism in the left upper lung lobe via a large patent foramen ovale. The tumor required urgent cardiac surgery. In this article, we review causes of dyspnea in pregnancy and the cardiovascular effects of myxomas in pregnancy. We also describe the pathophysiological effects of cardiopulmonary bypass on the mother, fetus, and the feto-placental system during open-heart surgery. We performed a successful surgical resection of a myxoma in a pregnant woman. Given the rarity of such cases, individual multidisciplinary assessment and management strategies are essential. PMID:27365558
Long, G M; McNamara, J R
The main goal of this article is to suggest some processes by which the behavioral interactions of an abusive couple can be developed and maintained. A summary of these processes as they have been adapted from the animal analog and human research follows. First, the pairing of abuse (punishment) with love and affection (reinforcement) could indicate that the battered woman responds to the reinforcement that follows an abusive incident. Second, the battered woman may seek to escape the fear of the tension-building phase but during the escape behavior she is punished (physical abuse), which fortifies and strengthens her initial fear. However, after the abusive incident, there is an absence of tension and fear (negative reinforcement) compounded by the positive reinforcement of the contrition phase. Thus, a cyclical pattern of behavior evolves and sustains itself. Possibly augmenting the vicious cycle is habituation or negative adaptation to the physical abuse, as well as the lack of opportunities to learn adaptive behavioral responses that may break the cycle of violence. Finally, the need for primary reinforcement (i.e., love and affection) may be so powerful that it somewhat mitigates the abuse endured to obtain it.
The purpose of this case study is to understand how a lesbian survivor coped with traumatic stress resulting from woman-to-woman sexual violence in a rural context. This research was grounded on the feminist paradigm, and the case study approach was used for data collection and analysis. The results indicate that the lesbian survivor encountered numerous obstacles to admitting the rape and seeking help. A number of these perceived challenges were associated with the rural sociocultural context (e.g., conservative culture, religious fundamentalism, low levels of anonymity, small gay/lesbian communities, and geographical isolation), myths of lesbian utopia, a heterosexist legal system, and a lack of lesbian-friendly helping resources. Despite being confronted with numerous challenges, the survivor demonstrated her resilience through the use of a variety of strategies to cope with the rape aftermath and detrimental social reactions. Positive social support from her gay and lesbian friends also facilitated her recovery. The findings highlight the importance of considering the intersection of trauma and cultural oppression in understanding lesbian survivors' experiences with same-sex sexual assault.
Speck, Aimee L; Killen, Paul D; Greenhawt, Matthew J
Angioedema is swelling of the deep layers of the dermis and subcutaneous tissue due to an increase in vascular permeability. Angioedema sometimes occurs concomitantly with urticaria and represents an allergic disease. In other cases, angioedema is not associated with an allergic condition. We present the case of a 31-year-old woman with new-onset angioedema in the setting of her first pregnancy. After detailed history, physical examination, and laboratory evaluation, a cause for her angioedema was found that had not been considered previously and had significant implications for future management, particularly in light of her current pregnancy. Because allergists are commonly called on to evaluate and treat angioedema, we should be aware of the many disease processes that can present with this symptom and be well-versed in the workup of new-onset angioedema.
Kępczyńska-Nyk, Anna; Muszel, Marta; Radziszewski, Mikołaj; Wocial, Kamil
19-year-old hirsute woman with obesity, skin lesions with features of acanthosis nigricans around neck, armpits, thoracic cage and wrists escalating for couple of months, elevated testosterone and insulin plasma levels was admitted to hospital to perform diagnostic approach. The final diagnosis was hyperandrogenism-insulin resistance-acanthosis nigricans syndrome (HAIR-AN syndrome), considered as a subtype of policystic ovary syndrome (PCOS) and impaired glucose tolerance. HAIR-AN is characterized by coexistence of: hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). These symptoms are result of increased insulin and androgens levels. Due to accompanying complications (obesity, hyperglycemia, hyperlipidemia, infertility) patients with HAIR-AN syndrome should be monitored and treated. Rarely acanthosis nigricans, especially when occurs rapidly and extensively, may be a paraneoplastic disorder. Life style modification with BMI reduction was recommended and metformin, a drug improving sensitivity to insulin, was administered. Patient should be monitored due to possible complications of obesity, diabetes and hyperinsulinemia.
Milanlıoğlu, Aysel; Tombul, Temel; Sayın, Refah
Hot water epilepsy is a unique form of reflex epilepsy precipitated by the stimulus of bathing with hot water poured over the head. It is mostly seen in infants and children, with a predominance in males. Unlikely, we present a 32-year-old pregnancy woman with the incipient of reflex seizures triggered by pouring hot water over the head while having a bath during the gestation period and treated successfully with carbamazepine 400 mg/day therapy. Hot water epilepsy is known as a benign and self-limited reflex epilepsy, by firstly avoiding hot water or long showers and secondly using intermittent benzodiazepines or conventional antiepileptic drugs, may be sufficient to be seizure-free.
Milanlıoğlu, Aysel; Tombul, Temel; Sayın, Refah
Hot water epilepsy is a unique form of reflex epilepsy precipitated by the stimulus of bathing with hot water poured over the head. It is mostly seen in infants and children, with a predominance in males. Unlikely, we present a 32-year-old pregnancy woman with the incipient of reflex seizures triggered by pouring hot water over the head while having a bath during the gestation period and treated successfully with carbamazepine 400 mg/day therapy. Hot water epilepsy is known as a benign and self-limited reflex epilepsy, by firstly avoiding hot water or long showers and secondly using intermittent benzodiazepines or conventional antiepileptic drugs, may be sufficient to be seizure-free. PMID:21209736
Meningiomas have long been known to be associated with sexual hormones. We discuss here the case of a woman with a huge meningioma that rapidly grew over the course of a couple years while the patient was simultaneously taking fertility treatments. There is substantial evidence suggesting that fertility treatments can fuel the growth of meningiomas. The potential risks should be considered in women with a previous or family history of meningiomas who plan to undergo fertility treatment. These patients need to be evaluated and a screening imaging of brain MRI (Magnetic Resonant Imaging) should be offered in the middle or toward the end of such a treatment to control and prevent complications of these meningiomas. PMID:28116188
Tuck, Claire M
Back pain is a common symptom: up to 70% of UK adults experience this symptom by the age of 60 and most have moderate to severe pain. Back pain accounted for 12% of consultations to traditional acupuncturists in 2001 and is one of the most common reasons for consultation with an acupuncturist. This case report concerns a 54-year-old woman with metastatic breast cancer and degenerative lower back pain, which remained painful despite intensive pharmaceutical management and facet joint injection and was ultimately successfully managed with two 30 min acupuncture treatments 2 weeks apart, using eight points on the BL meridians. Acupuncture treatment using tender points was later trialled for neuropathic pain secondary to local recurrence in her mastectomy scar, however this was unsuccessful and inpatient hospice admission for further intensive pharmaceutical management was required.
Guerrero, Patricia Perez; Zamorano, Marina Martin; Trujillo, Ignacio Garcia; Gonzalez, Jose Antonio Giron
An 87-year-old woman was admitted to our hospital with sepsis and foetid vaginal discharge. She presented an abdominal mass that had been present for the last 20 years, refused diagnostic or therapeutic procedures. A computed tomography scan detected a uterine body with multiple calcifications and an internal collection of 10 cm. No other infectious sources were apparent. A tentative diagnostic of pyometra was made and empiric antibiotic treatment was initiated. A hysteroscopy was performed with incomplete drainage of purulent material, due to important vaginal atrophy. In both blood and vaginal fluid cultures Prevotella spp. was isolated. Clinical evolution was favourable with metronidazole. The patient refused a hysterectomy or other surgical drainages, and she was discharged from hospital with oral antibiotics. The patient underwent antibiotic therapy during 1 month; 1 week after finishing this treatment, the patient died. The characteristics of clinical evolution in these last days were not known. PMID:21686575
Hoffleit, Dorrit; Gay, P. L.
From working as one of Harlan J. Smith's female calculators in 1928 to running Maria Mitchell Observatory in 1957 to being an emeritus research scientist at Yale University today, Dr. Dorrit Hoffleit has been a professional woman in astronomy for 78 years and an astronomy lover for a century. She has faced both accolades, starting with the Carolyn Wilby Prize in 1938 for her dissertation work, as well as discrimination, most notably being hired at the Aberdeen Proving Ground at a sub-professional rating during WWII. Through both good and bad, she kept her eye on the stars, and her focus on doing the best work she could. In this presentation, Dr. Hoffleit reflects on her experiences and her inspirations in an video-interview. Additionally, archival film provided by the AAVSO will be shown.
Talabi, O A; Owolabi, M O; Osotimehin, B O
Autoimmune diseases (AD) are conditions in which there is the development of antibodies against self cells/ organs. AD could either be organ-specific or non-organ specific (systemic) in clinical presentation. Commonly reported ADs includes: Myasthenia gravis, Hashimoto thyroiditis, Guillian-Barre syndrome, vitiligo, type 1 diabetes mellitus, Graves diseases, Goodpastures syndrome, pemphigus, rheumatoid arthritis, systemic lupus erythematosis, Addisons disease, multiple sclerosis, pernicious anaemia, autoimmune haemolytic anaemia, chronic active hepatitis, idiopathic thrombocytopenic purpura. There is paucity of locally documented information on the occurrence of AD in same patient in our environment. We therefore report the case of a 66 year old woman who presented at the University College Hospital (UCH), Ibadan, with a spectrum of the AD, Vitiligo, rheumatoid arthritis, myasthenia gravis, impaired glucose tolerance.
Park, Jin-Wan; Kim, Su-Mi; Yu, Gyu-Bong
Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done. With the finding of aortic dissection, cardiopulmonary arrest occurred 5 hours after the cesarean section, and the patient died without reaction to cardio-pulmonary resuscitation. If a patient with preeclampsia complains of severe dyspnea or chest pain, aortic dissection needs to be suspected and a diagnosis should not be delayed. PMID:27668205
Kim, Yeunjung; Miller, Michael
β-blockers are commonly used therapies after acute myocardial infarction and in the management of congestive heart failure and hypertension. We report a case of a middle-aged woman with a history of mild hypertension who was placed on metoprolol succinate. Before initiation of the β-blocker, her triglyceride level was in the borderline-high range (150-199 mg/dL). On treatment, her triglyceride levels exceeded 1000 mg/dL. She developed fatigue and mild abdominal discomfort but without biochemical evidence of pancreatitis. After discontinuation of metoprolol succinate, her triglyceride levels receded. This case illustrates an uncommon side effect with a very commonly used therapy in clinical practice. Clinicians should closely evaluate medications and/or other therapies in patients presenting with new-onset hypertriglyceridemia especially when levels are sufficiently elevated to pose increased risk of pancreatitis.
Odubamowo, K. H.; Akinpelu, O. M.; Lawal, O. O.; Okolo, C. A.; Odukogbe, A. A.; Adekunle, A. O.
Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive) woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days' duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide). Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation. PMID:25580321
Lee, Justin; Fields, Karl Bertrand
A middle-aged premenopausal woman presented with 3 months of right chest wall pain after beginning a new weight training programme. Examination was significant only for mild-to-moderate tenderness to palpation over the right pectoral muscle and sternoclavicular joint. In-office musculoskeletal ultrasound scan, chest X-ray and shoulder X-rays were unremarkable. Subsequent MRI of the chest wall showed oedema in the sternum at the level of the sternoclavicular joint consistent with a sternal stress fracture. She was started on calcium and vitamin D supplementation and told to rest for 6 weeks. After this she began to gradually increase her activity and was pain free after 4 months.
Holub, Karen; Camune, Barbara
Acute fatty liver of pregnancy, although rare, is usually a third trimester of pregnancy occurrence that may be life threatening for both the pregnant woman and the fetus. Often, the onset resembles gastroenteritis or cholecystitis and correct diagnosis is delayed. Because it can also present with preeclampsia and eclampsia, it may be mistakenly diagnosed as hemolysis, elevated liver enzymes, low platelet syndrome. This article presents diagnostic differences between liver conditions that can complicate pregnancy and management strategies for treating and maintaining the well-being of pregnant women, fetuses, and infants who are affected by acute fatty liver of pregnancy. Early recognition and rapid intervention from antepartum diagnosis through delivery and the postpartum period are required by the nursing team and medical providers to reduce maternal and neonatal morbidity and mortality.
Wilken-Jensen, C; Ottesen, B
The growth of the postmenopausal population demands a change in the medical profession's approach to health and disease. Especially in the developed world, lifespan is increasing, and at the age of 60 the majority of women will still have at least 20 years to live. There will, therefore, be an increasing need for health programs that lead to more years of disability free life. Hormone replacement therapy (HRT) is but one example of the dilemmas medical therapy of the aging woman poses. In the sixties, estrogen was considered a wonder drug, effective for a multitude of postmenopausal problems and illnesses. Recent research has placed this notion into a more balanced perspective, emphasizing that every medical treatment should be based on evidence. It is therefore worrisome if the decline in the use of HRT is followed by an increased use of alternative medicine with mostly undocumented effects.
Pinho, Elika; Gomes, Andre Amaral; Silva, Maria Joao; Torres, Tiago Pinheiro; Coelho, Andreia; Almeida, Pedro Bernardo; Lourenco, Patricia; Bettencourt, Paulo
Atrial Septal Defect (ASD) is one of the most frequently congenital heart diseases in adults and it is often asymptomatic until adulthood. We report a case of a 90-year-old woman admitted to hospital with dyspnea and orthopnea insidiously progressing over the preceding 5 years and becoming severe with dyspnea on minimal activities, orthopnea and paroxysmal nocturnal dyspnea, in the last 2 weeks. The transthoracic echocardiogram revealed an atrial septal defect ostium secundum type, with left-to-right shunt, moderate to severe tricuspid insufficiency, severe pulmonary hypertension (72 mmHg) and preserved biventricular function. With diuretic therapy optimization the patient showed symptomatic improvement. This present case represents and unusual and very late presentation of an atrial septal defect ostium secundum type, which is usually diagnosed at the mild adult age. Our patient lived symptom-free for over 80 years.
Vargens, Octavio Muniz da Costa; Silva, Carla Marins; Azevedo E Silva, Gulnar; Girianelli, Vânia Reis
This is a descriptive research, with qualitative approach, which aimed at analyze the interaction process between woman and her partner starting from the diagnosis of infection by the human papilomavirus (HPV). It was accomplished in 13 communities in the cities of Duque de Caxias and Nova Iguaçu, Rio de Janeiro state, Brazil, from October/2006 to September/2008. Twenty women, diagnosed with HPV infection related to oncogenic high risk, were interviewed. The Symbolic Interactionism and Grounded Theory perspectives guided data collection and analysis. The results revealed that the HPV diagnosis means serious challenges in the women's relationship with her partner mainly regarding to the adoption of preventive initiatives. It is concluded that these issues lead to the need of a humanized care in order to favor the women's empowerment.
Moran, Michael E
A little known 18th century midwife, Angélique Marguerite Le Boursier (1715-1794) may well be the true founder of modern surgical simulation. This fiercely independent medical practitioner stood equally amongst the many enlightened minds of this period and fought with every modern method to reduce infant/maternal mortality during childbirth. Her original textbook Abrégé utilized some of the first color anatomical illustrations, her method of teaching complex birthing techniques to peasant woman throughout France, and most notably her birthing simulator complete with fluids (wet ware) were all available for close scrutiny. The color illustrations in Abrégé remain profoundly effective but the only existent models of her simulator are even more remarkable. Le Boursier du Coudray sought to bring education to the woman and physicians in villages and towns throughout France in response to the population crisis and the high birth morbidity and mortality. Her teaching methods affected untold thousands of medical practitioners, from midwives to surgeons. Voltaire wrote about her and she became an icon of progressive France, but remained ostracized by much of the conventional medical practitioners. She continued to train midwives for 23 years before retiring at the age of nearly 70. Madame du Coudray began to write, illustrate and simulate in the mid 18th century and obtained unprecedented success in bringing to the public the humane practices of modern childbirth with relevant understanding of anatomy and physiology. She is the matron not only of modern simulation methods in healthcare but was the epitome of professional healthcare commitment, educating approximately 10,000 students regardless of social status for free.
Harlow, Siobán D.; Reed, Barbara D.
Background: Psychological disorders may affect the pain experience of women with vulvodynia, but evidence remains limited. The present study aimed to describe the magnitude of the association of depression and posttraumautic stress disorder (PTSD) with the presence of vulvodynia in a nonclinical population from southeastern Michigan. Methods: Baseline data from 1,795 women participating in the Woman to Woman Health Study, a multiethnic population-based study, was used for this analysis. Validated screening questionnaires were conducted to assess vulvodynia, depression, and PTSD. Modified Poisson regression models with a robust variance estimation were used to estimate prevalence ratios (PR) and their 95% confidence intervals (CI) for the association between vulvodynia status and two mental health conditions, depression and PTSD. Results: In the adjusted models, women who screened positive for depression had a 53% higher prevalence of having vulvodynia (PR=1.53; 95% CI: 1.12, 2.10) compared with women who screened negative for depression. Women who screened positive for PTSD had more than a two-fold increase in the prevalence of having vulvodynia (PR=2.37; 95% CI: 1.07, 5.25) compared with women who screened negative for PTSD. Conclusions: The increased prevalence of vulvodynia among those screening positive for depression or PTSD suggests that these disorders may contribute to the likelihood of reporting vulvodynia. Alternatively, vulvodynia, depression, and PTSD may have a common pathophysiological and risk profile. Prospective studies are needed to improve our understanding of the temporal relation between mental health conditions and vulvar pain. PMID:25950702
Corpus, Rina Angela P.
This essay narrates the biography and dance aesthetics of Myra Beltran, a pioneering, independent and contemporary woman dance artist in the Philippines. Featured here are the history, alternative aesthetics, philosophy, and influences of Myra Beltran's works. It comes from the point of view of an author who is also a woman, dancer, and writer…
On consideration of familiar and professional changes sexual psychologic aspects of the woman during the climacteric are being discussed. -- Changes and disturbances in sexuality, lack of libido and failure of orgasm and changed positions to sexuality expecially under the influence of the professional activity of 92 climacteric woman are stated. -- Examinations of the climacteric women were performed by the interview-method.
Discusses the relationship between the prominence of themes of the literate gentry woman in Chinese fiction and the rise of women poets. Examines later Japanese fiction to find influences of the woman reader and of earlier Chinese works. Explores the scholar-beauty novels, women as warriors, female martyrdom, and the equating of virtue with…
Twenty-two short stories and seven novels, each with a woman journalist as a major character, were used in an analysis of the image of the woman journalist in four time periods (1890-1920, 1920-1940, 1940-1945, and 1945 to the present). The themes of the stories changed over time, often reflecting the prevailing cultural attitudes about working…
Birlik, Nurten; Arikan, Arda
In this descriptive study, women's professional lives with a focus on what it means to be a woman in Turkish academia and on whether being a woman differs from being a man in an academic context was put under scrutiny. For this purpose, a questionnaire was conducted among 41 women academics currently working at the Faculties of Education in…
Sparacino, Elizabeth Kenny
The purpose of this annotated bibliography is twofold. The first purpose is to address the question raised by Phyllis Holman Wiesbard, "Where are women on the 'net?" The second purpose is to explore how teachers can use the documents found on the world wide web to teach woman suffrage in their classrooms. Woman suffrage has proved to be a fruitful…
In September 1882, Nebraska was the setting for a significant moment in the history of the United States women's rights movement: the two rival suffrage organizations, the American Woman Suffrage Association (AWSA) and the National Woman Suffrage Association (NWSA), both held their annual conventions in Omaha. The alliance of the AWSA and the NWSA…
Wolfgang, Jeff Drayton; West-Olatunji, Cirecie A.; Overton, Jeanine; Shah, Bindi; Coral, Cristina
The authors applied Relational-Cultural Theory (RCT) to conduct a case study of an Afro-Caribbean woman administrator to explore her perceptions of stress and coping in higher education. While much has been written about the challenges facing Black faculty and students, this study focused on the experiences of a Black woman administrator in a…
... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF STATE Culturally Significant Objects Imported for Exhibition Determinations: ``Woman in Blue, Against Blue Water..., 2003), I hereby determine that the object ``Woman in Blue, Against Blue Water'' by Edvard...
Dowdy, Joanne Kilgour; Hamilton, Awilda
This case study presents the findings from a qualitative research project about a Black woman scholar, the first non-White female to serve as chair of a department and the associate dean of the college in its 100 year history. The study focuses on the experiences of a Black woman scholar as a chairperson and the learning she achieved during her…
Murphy, Sharon; Lemire, Lynne; Wisman, Mindi
This qualitative case study explores one American Indian (AI) woman's experience of intimate partner violence and the subsequent murder of her abusive partner. The lens of complex personhood (Gordon, 1997) has been applied as a method for understanding "Annie's" multiple identities of AI woman, victim of intimate partner violence, mother, and…
Gasanova, Marina; Magomedova, Patimat; Gasanova, Salminat
The article is devoted to linguoculturological description of woman's image in the proverbial worldview of the Dagestan languages. The analysis of proverbial expressions revealed androcentric bias of the Dagestan paroemiological worldview where woman, as a rule, appears for an object: mainly for mother, daughter, bride, and wife/mistress. The…
Lloyd, Betty-Ann, Ed.; And Others
This book contains 15 chapters that were written by women from 12 Canadian adult literacy and basic education programs who participated in an exploratory research project designed to document the process and results of woman-positive literacy work. The following sections are included: "Exploring the Concept of Woman-Positive within…
Forbes, Gordon B.; Adams-Curtis, Leah E.; White, Kay B.; Holmgren, Katie M.
Perceptions of menstruating women were studied in a sample of 244, predominantly European American, college freshmen. Both women and men rated the menstruating woman, as compared with the average woman, as higher on the Neuroticism factor from Lippa's (1991) measure of the Big Five personality factors. Men also rated her as lower on the Openness,…
Kathleen Blake Watkins Coleman, known to her readers as "Kit," was a late nineteenth-century journalist who tried to escape the limitations of the woman's sphere in journalism through travel writing, while still complying with the expectation that she describe her adventures from a "woman's point of view." Among her many…
Hermann, G.; Schwartz, I.S.; Slater, G.
A 69-year-old woman was initially seen with constant abdominal pain in the epigastrium and right upper quadrant, with nausea and vomiting of three days' duration. On examination, moderate tenderness and guarding in the right upper quadrant of the abdomen were noted. A leukocytosis of 11,000/cu mm, with a mild shift to the left, was present. Findings from a sonogram and hepatobiliary scan were consistent with a diagnosis of acute cholecystitis for which intravenous (IV) antibiotic therapy was instituted. Results of radiological studies performed on the second hospital day showed a small-bowel obstruction. On surgical exploration, a gangrenous segment of the terminal ileum was resected and an end-to-end anastomosis was performed. The resected bowel demonstrated hemorrhagic infarction with evidence of focal organizing venous thrombosis in the mesentery. The patient was initially started on a regimen of IV heparin and then switched to oral coumarin. On the fourth day of coumarin therapy, massive swelling, tenderness, and erythema were noted to involve the entire right breast. Six months later, the patient was readmitted because of an acute pulmonary embolism. A residual 4x5-cm mass was present in the central portion of the right breast. The overlying skin was slightly retracted. Mammography showed an extensive masslike density behind the right nipple, with evidence of periareolar retraction. Coumarin-induced mammary necrosis was diagnosed.
Pregnancy interruption or abortion may be spontaneous or induced for medical, legal, demographic, and personal reasons. Different events that are present during the woman´s gravid period were described, paying attention to the differences in between fertilization and conception. These issues are very important because people or institutions mix these concepts and posit that pregnancy or conception starts at fertilization in opposition to the actual medical and scientific knowledge. In Mexico there are several millions of spontaneous and induced abortions without medical care, responsible for the high maternal-infant mortality rates. To avoid this undesirable situation, it has been proposed to follow the established WHO guidelines and adopt national health policies to re-orientate population goals on life quality, gender equity, universal public health services, and to promote the new holistic concepts of reproductive and sexual health such as: family planning, use of anti-fertility methods, adolescent reproductive health, sexually transmitted diseases, maternal and newborn health, peri- and post-menopausal women's health, and prevention, diagnosis, and opportune treatment of mammary, cervical-uterine, and ovarian cancers. Finally, it is recommended to revise our national health policies and existing laws on abortion de-penalization.
Taylor, Imogen Aleksandra; Gill, Isaac; Harripaul, Azad
An 80-year-old woman presented with long-standing history of weight loss and malnutrition, which had caused her to become reliant on the use of a wheelchair. Her symptoms were initially attributed to her medical comorbidities, however, during admission it became apparent that she had been suffering from depression and had gone on to develop an eating disorder. Eating disorders are most common in young adults but can affect all age groups, including the elderly population. The diagnosis is rarely considered in such patients and easily overlooked, especially when in the presence of chronic conditions and cognitive decline. A pre-existing psychiatric issue, most often depression, may also be present in this age group. There are no current treatment methods targeting patients in this population, who may not respond as effectively to the available strategies directed at young adults. It is important to always consider an eating disorder as a contributor or direct cause of unexplained weight loss in elderly patients.
Barbosa, Mara; Cotter, José
Osteonecrosis is a very rare complication of Crohn’s disease (CD). It is not clear if it is related to corticosteroid therapy or if it occurs as an extraintestinal manifestation of inflammatory bowel disease. We present the case of a patient with CD who presented with osteonecrosis of both knees. A 22 years old woman was diagnosed with CD in April 2012 (Montreal Classification A2L1 + L4B3p). She was started on prednisolone (40 mg/d), azathioprine (100 mg/d) and messalazine (3 g/d). In July 2012, due to active perianal disease, infliximab therapy was initiated. In September 2012, she had a pelvic abscess complicated by peritonitis and an ileal segmental resection and right hemicolectomy were performed. In December 2012 she was diagnosed with bilateral septic arthritis of both knees with walking impairment. She was treated with amoxicillin-clavulanic acid, started a physical rehabilitation program and progressively improved. However, then, bilateral knee pain exacerbated by movement developed. Magnetic resonance imaging showed multiple osseous medullary infarcts in the distal extremity of the femurs, proximal extremity of the tibiae and patellas and no signs of subchondral collapse, which is consistent with osteonecrosis. The patient recovered completely and maintains therapy with azathioprine and messalazine. A review of the literature is also done. PMID:27867692
The prevalent sociocultural belief about the psychoses and schizophrenia is that intensive psychoanalytic therapy is ineffective if not destructive and contraindicated, and that the treatment of choice is a combination of psychopharmacology and educational techniques designed to provide symptom relief and rehabilitation. The literature contains few detailed reports of successful intensive psychotherapy that might contradict these beliefs. The psychoanalytic psychotherapy of a woman I shall call Sara, who met DSM criteria for chronic paranoid schizophrenia, is presented in detail. Its success in bringing about a fundamental personality transformation from a seriously self-destructive state in which she was unable to care for herself to one in which she became a mature creative person is confirmed by a follow up two decades after termination. The therapy transpired over an 11-year period and was conducted for the most part four times per week. It was supported by numerous hospitalizations in the early years as well as pharmacotherapy which she was able to relinquish prior to termination. During treatment Sara separated both physically and psychologically from an undifferentiated destructive relationship with her mother, internalized the capacity to think and represent emotions, and integrated disparate elements of personality to form a cohesive self. She developed psychosexually and formed a mature gender identity. She achieved the capacity for intimacy and motherhood, and had a successful career.
Rivera-Arkoncel, Maria Luisa Cecilia; Pacquing-Songco, Debby; Lantion-Ang, Frances Lina
Androgen secreting tumours are the least commonly encountered androgen excess disorders, having a prevalence of 0.2%. Androblastomas of the ovary comprise less than 0.5% of all ovarian tumours. Pure Leydig cell tumours are very rare and almost always show secretion of male sex hormones. A 41-year-old multipara Filipino woman presented with a 2-year history of amenorrhoea and virilisation characterised by hirsutism, androgenic alopecia, masculine habitus and clitoromegaly. Diagnostic evaluation showed markedly elevated serum testosterone and normal dehydroepiandrosterone sulfate. Normal ovaries were seen on initial transvaginal ultrasound. A low dose dexamethasone suppression test suggested an ovarian source. A left adrenal nodule was seen on CT scan. Doppler transvaginal ultrasound revealed a solid lobulated structure in the right ovary. The patient underwent surgery and histopathology showed a Leydig cell tumour, hilar type. Serum testosterone levels normalised 3 days after surgery. Specific clinical and biochemical investigation of androgen secreting neoplasms is very important for correct diagnosis of these rare tumours. PMID:22802276
The Programme Committee of the Montreal Congress asked the author to present a case of perversion connected with traumas. Rather than speak about erotization of the effects of the trauma (death or castration anxiety transformed into a source of pleasure) the author relates the first 18 months of analysis of a young woman whose important narcissistic trauma, the result of an inadequate early relationship with her mother, is camouflaged by an avidity for sexual excitations. The aim is to transform narcissistic pain which cannot be worked through into sexuality for which release is possible. Sexuality becomes a means of expressing feelings of hate, revenge and triumph over the primary object. The ensuing perverse solution--an attempt to slip into the primal scene by identification with the sadistic penis--does not succeed. The author advances certain hypotheses concerning the mother-daughter relationship which seem to explain this failure and to explain too the absence of a stable perverse organization in women. There follows a longing to return to the womb, in the shape of the fantasied destruction of the contents of the mother's belly, expressed as the fantasy of the end of the world, and which the author labels as 'the archaic matrix of the Oedipus complex'.
Supriyanti, Retno; Erfayanto, Uji; Ramadani, Yogi; Murdyantoro, Eko; Widodo, Haris B.
Currently, at least 18,000 women die every year in Indonesia due to pregnancy or childbirth. It means that every half hour a woman dies due to pregnancy or childbirth. As a result, every year 36,000 children became orphans. The high maternal mortality rate was put Indonesia on top in ASEAN. The main causes of maternal mortality are high-risk pregnancy. Mothers who have diseases like high blood pressure, pre-eclampsia, diabetes, hyperthyroidism, and already over 40 years old and infectious diseases such as rubella, hepatitis and HIV can be factors that lead to high-risk pregnancy. This paper will discuss the development of a blood pressure monitoring device that is suitable for pregnant women. It is based on convenience for pregnant women to get the equipment that is flexible with her presence. Results indicate that the equipment is in use daily support for pregnant women therefore, one of the causes of maternal mortality can be detected earlier.
Patil, Saurabh S; Shah, Vaibhav R; Choudhary, Vivek A
Retroperitoneal lipomatosis is a rare but distinct clinicopathological entity characterized by non encapsulated lipoma development in the retroperitoneum. Presenting complaints in the early stages are vague, and patients with retroperitoneal lipomatosis are often misdiagnosed because considerable abnormality is not detected by abdomino-pelvic sonography. However, because of the progressive nature of this lesion, most patients eventually present with varying degrees of urinary outflow obstruction and end stage renal disease, or bladder malignancies in few cases. Here we report a case of a 35-year-old Indian woman presenting with complaints of diffuse lumps in the abdomen and constipation. Based on the findings of the imaging [sonography and computed tomography (CT) scan] studies, benign retroperitoneal lipomatosis was preopreratively diagnosed and a confirmatory exploratory laprotomy was performed. Furthermore, we discuss the imaging findings obtained using various radiological modalities such as plain radiographs, intravenous urography, barium enema, sonography, CT and magnetic resonance imaging (MRI). We also discuss the etiopathogenesis, demographics, and various differential diagnoses of retroperitoneal lipomatosis. PMID:27200169
Welle-Strand, Gabrielle Katrine; Kvamme, Odd; Andreassen, Andreas; Ravndal, Edle
Although opioid maintenance treatment (OMT) is the treatment of choice for pregnant opioid-dependent patients, some professionals argue that tapering the medication dose will reduce the severity of neonatal abstinence syndrome (NAS). This case description is based on the patient's detailed blog, and medical records from her general practitioner and the hospital. The patient is an employed, 32-year-old drug-abstinent woman in OMT. Her taper from 24 mg of buprenorphine started at 14 weeks’ gestation and is slow, with withdrawal symptoms increasing gradually. In pregnancy week 31, she is off buprenorphine but she has severe withdrawal symptoms. She chose to go back on 4 mg of buprenorphine. The patient's son was born in pregnancy week 38+3, weighs 2950 g and does not require pharmacological treatment for NAS. The fetus most probably did experience fetal stress during the patient's tapering. It was the right decision by the patient to go back on buprenorphine. PMID:25540212
Berdai, Mohamed Adnane; Labib, Smael; Harandou, Mustapha
Peganum harmala L. is a plant widely distributed in the Mediterranean region. It is commonly used in traditional medicine in Morocco as sedative and abortifacient but exposes users to the risk of overdose and poisoning. The pharmacologically active compounds of this plant include a number of β -carboline and quinazoline alkaloids responsible of its pharmacological and toxicological effects. We report the case of a 24-year-old woman, 22 weeks pregnant, intoxicated with the seeds of Peganum harmala L. On admission, she had disturbance of consciousness, uterine contraction, and oliguria. Laboratory tests revealed renal failure and liver injury, and she benefited then from hemodialysis. During hospitalization, she was intubated after deterioration of consciousness and presented a spontaneous expulsion of the fetus. After extubation, she kept unusual sequelae: cerebellar ataxia and peripheral polyneuropathy. Physicians in regions using Peganum harmala L. as traditional medicine must be able to detect symptoms of its toxicity, in order to establish early gastrointestinal decontamination. The prognosis of this intoxication is variable; most cases can be managed successfully; but in high doses of intoxication, evolution can be fatal.
Browning, Lisa; Leach, John; Watts, Christopher; Kuker, Wilhelm; Stacey, Richard
A 51-year-old woman presented with a 2-month history of double vision and numbness around her left ear. She subsequently became unsteady on her feet and developed further cranial nerve abnormalities, before complaining of headache, nausea and vomiting. Imaging revealed features suggestive of two intracranial lesions; one non-contrast-enhancing high-signal area in the cerebellum with associated calcification, and a second contrast-enhancing low-signal area in association with the fourth ventricle, and at surgery there were two apparent components to the tumor. The histopathological features were those of a low-grade, focally calcified tumor comprising atypical ganglion and glial cells with interspersed Rosenthal fibres. Mitotic figures were not seen, and there was no necrosis. An infiltrate of small reactive lymphocytes was interspersed among the neoplastic cells. Immunohistochemistry revealed expression of synaptophysin by many of the dysplastic ganglion cells, with some co-expressing neurofilament protein and occasionally glial fibrillary acidic protein (GFAP). Several of the dysplastic ganglion cells also expressed CD34. The glial cell population was highlighted by GFAP. Ki-67 (MIB-1) activity was not noted among the neoplastic populations--the few positive nuclei in these areas were those of interspersed reactive CD3-positive T lymphocytes. In addition, at the edge of one of the biopsies was a dense infiltrate of mitotically-active large atypical CD 20-positive B lymphocytes, among which the Ki-67 (MIB-1) labeling index reached 80%. The final diagnosis was diffuse large B cell lymphoma arising within a ganglioglioma of the cerebellum, and this is believed to be the first reported case.
Bhanumathi, V; Balkishan, B; Masood, S V
Wandering spleen is a very rare condition, it is characterized by the absence or weakness of one or more of the ligaments that hold the spleen in its normal position in the left hypochondrium. The disorder is not genetic in origin. Instead of ligaments, the spleen is attached by a stalk-like tissue supplied with blood vessels (vascular pedicle). If the pedicle is twisted in the course of the movement of the spleen, the blood supply may be interrupted or blocked (ischemia) to the point of severe damage to the blood vessels (infarction). Because there is little or nothing to hold it in place the spleen "wanders" in the lower abdomen or pelvis where it may be mistaken for an unidentified abdominal mass. "Acquired" wandering spleen may occur during adulthood due to injuries or other underlying conditions that may weaken the ligaments that hold the spleen in its normal position (e.g., connective tissue disease or pregnancy). We here report a case of 40-year-old woman presented to the surgical emergency department, with complaints of colicky abdominal pain of 8 h duration with increasing severity and bilious vomiting. On examination, the patient well built, nourished, conscious, and coherent with profuse sweating. Vital signs were normal excepting high pulse rate of 120/min with blood pressure of 100/60. On examination, she has a central abdominal distention shifting to different quadrants with colicky pain with vague tender firm mass. Abdominal ultrasonography showed ectopic spleen around the umbilicus with variable echos and whorled appearance of the splenic vessels. The patient was prepared for emergency laparotomy. At laparotomy, the spleen was found just below the umbilicus and it was dusky enlarged with infarction with four anticlockwise twists of the long splenic pedicle in the central quadrant of the abdomen. Splenectomy was carried out as there was clear evidence of splenic ischemia after detorsion of the spleen.
... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false May a woman breastfeed... woman breastfeed her child in a Federal building or on Federal property? Yes. Public Law 108-199, Section 629, Division F, Title VI (January 23, 2004), provides that a woman may breastfeed her child...
Palczewski, Catherine H.
In 1909, at the height of the woman suffrage controversy and during the golden age of postcards, the Dunston-Weiler Lithograph Company of New York produced a twelve-card set of full-color lithographic cartoon postcards opposing woman suffrage. The postcard images reflect, and depart from, verbal arguments concerning woman suffrage prevalent during…
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May a woman breastfeed... woman breastfeed her child in a Federal building or on Federal property? Yes. Public Law 108-199, Section 629, Division F, Title VI (January 23, 2004), provides that a woman may breastfeed her child...
... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false May a woman breastfeed... woman breastfeed her child in a Federal building or on Federal property? Yes. Public Law 108-199, Section 629, Division F, Title VI (January 23, 2004), provides that a woman may breastfeed her child...
... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false May a woman breastfeed... woman breastfeed her child in a Federal building or on Federal property? Yes. Public Law 108-199, Section 629, Division F, Title VI (January 23, 2004), provides that a woman may breastfeed her child...
... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false May a woman breastfeed... woman breastfeed her child in a Federal building or on Federal property? Yes. Public Law 108-199, Section 629, Division F, Title VI (January 23, 2004), provides that a woman may breastfeed her child...
Prevailing law and church dictum in 1989 Poland precluded talking about condoms and sex on the radio. Accordingly, a young woman who did a radio-theater drama with some friends about how to avoid HIV infection was thrown out of school. This youth, however, knew that her audience found the emission to be provocative and interesting, and that people were having unprotected sex at concerts in toilet stalls with unknown partners. The Ministry of Health nonetheless said funds were unavailable for condom distribution. Undeterred, the author, her younger brother, and 2 friends joined forces to make large banners with pictures of condoms, bought 500 condoms with their own money, and went to the largest rock festival in Warsaw. She described on stage what AIDS is and how to contract it while friends handed out condoms and leaflets. Their success how has them cooperating with 20 other groups and going to concerts to talk about AIDS and hand out condoms. They have also sprayed graffiti across Warsaw aimed at preventing HIV transmission and provide leaflets and condoms with money from France to ticket holders at area clubs; letters requesting cooperative action have been received. Despite the success of these activities, the Ministry of Health requires receipt of a project and budget proposal before they may consider funding. Graffiti, however, is illegal in Poland and the new Catholic government made is impossible to obtain cheap Polish condoms in shops. The activists continued to develop banners and graffiti, but failed to keep people from engaging in high risk sex with multiple partners. 3 of the author's attractive and healthy female friends therefore began going to concerts and night clubs where they feigned soliciting sexual relations and being HIV-seropositive. Unsuspecting takers without condoms were informed of the girls contrived HIV serostatus and told they must surely desire death if they are ready to have unprotected intercourse. The desire to use condoms has
Wilson, Candice T; Fletcher, Paula C
stages often overlapped or occurred simultaneously. Additionally, the participant regressed to earlier stages when subjected to negative external factors. Four other highly salient emotions were also prevalent throughout the participant's experience with colon cancer, namely joy, fear, hope, and numbness. The findings from this case study help to validate Kubler-Ross's stages. Further, the importance of the voice of the participant cannot be overemphasized. This case study clearly depicts the unique thoughts and emotions during one woman's struggle with colon cancer, sentiments that are often overlooked in quantitative analysis.
This article describes the activities of film director Shireen Pasha in promoting truth in the mass media in Pakistan. Pasha is described as one who finds it inexcusable in a state-subsidized system that national problems of poverty are not aired openly. Pasha has pursued the goal of exposing the real lives of Pakistanis on film in contrast to the publicly aired segments of "pretty girls in nice drawing rooms." Foreign channels available through satellite communications technology are viewed by Pasha as inappropriate with regard to people's needs and uncreative. Pakistan began with one channel, PTV, which recently refused to air her documentary on living conditions in Pakistan's rural areas "The Travelogue Pakistan." "The Walled City of Lahore" was her film about life in the old city. Both films poetically depicted the honor of humans and their struggle to stay alive. Some of her documentaries are made to show the value of indigenous skills, centuries old know-how, and traditions, regardless of the poverty. Pasha is described as fighting with PTV management over use of resources. Pasha desires to invest in training people to do documentaries or be more field-oriented rather than investing in equipment. Pasha joined PTV in 1975 and left in 1990. Pasha is recognized for her isolation as a woman in the business world, her commitment to exposing remote cultures and truth, and the odds she must confront in attaining her goals. Pasha is committed to doing extensive research, usually conducted during the summer months, in order to construct a credible story line that is produced usually during the winter months. One model of film story line is defined as one where women are portrayed as starting from an indigenous skill or knowledge and shifting to a greater position of power and control over their lives. Pasha believes that people who make films have the responsibility to evoke a reaction in people and to offer solutions. Two acclaimed films, which were supported by
Michiels, I; Roumen, F J M E
Emergency caesarean section was performed in a 40-year-old woman with solutio placentae. A Couvelaire uterus was diagnosed, showing typical blue-purple discolorations of the uterine wall, which are in fact haemorrhages caused by disseminated intravascular coagulation.
Hoffmann, Leonore Noll
Describes the creation of two anthologies of personal narratives by women. Explains how letters can stimulate students to become active readers using, as an example, letters written by a woman during the Civil War. (SRT)
Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa; Lunardi, Valéria Lerch; dos Santos, Silvana Sidnei
This is an integrative review that aims to identify the contribution of nursing care for woman's participation in the decision process of the pregnancy and puerperal cycle, as described in Brazilian scientific publications. The scientific productions were retrieved in May, 2010, from the Virtual Library of Health (Biblioteca Virtual em Saúde) database. From the eight articles reviewed, two themes stood out: Contributions of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle; and Limitations of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle. The following review supports the production of knowledge in nursing, by identifying a gap in what nurses know and do about this issue, as shown by the lack of nursing researches that concern, specifically, the participation of the woman in the decision process during the pregnancy and puerperal cycle and the possible contributions of nursing care to ensure women of this right.
Ascha, Mona; Irfan, Mahwish; Billings, Steven D
An elderly woman developed pruritic follicularpapules over a period of 5 years. A biopsy revealedfocal intraepidermal eosinophilic pustules, leading tothe diagnosis of Ofuji disease or eosinophilic pustularfolliculitis. A discussion of this condition is presented.
There are problems with the "reasonable woman" concept for sexual harassment cases. Also, the 1995 findings of Baird, et al., although statistically significant, identify very small differences between men and women subjects. "Reasonable woman," as employed in sexual harassment cases, is a culture-bound concept used by some feminists to present a specific worldview in which women are seen in the victim's role, and men are viewed negatively.
A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author's knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.
A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature. PMID:23254252
The role of Rwandan women in population, health, nutrition, energy, water, environmental sanitation, and habitat is assessed in these excerpts from a study entitled "Socioeconomic Profile of the Rwandan Woman" which was carried but in collaboration with a Canadian organization. Rwanda's rate of population growth increased from 2.7% in 1970 to 3.7% in 1978. It is currently 3.6%. The total population increased by 57% between 1978-91. Population pressure on Rwanda's resources is reflected in soil exhaustion, fragmentation of land holdings, deforestation, erosion, and declining productivity. The total fertility rate of 8.6 has clear consequences for women's health and for their roles as educators of children and as economic producers. Women are adversely affected by migration and by polygamy. An estimated 22% of households are headed by women, whose economic disadvantages often translate into extreme poverty. The National Office of Population since its creation has attempted to increase awareness of the imbalance between population and resources and of the different contraceptive methods available. Rwanda's contraceptive prevalence rate has increased from 1.2% in 1985 to 10% in 1990. The health budget has been declining for several years. Women are the principal dispensers of health care to children and play an important role in traditional medicine and as midwives. Only 2.8% of deliveries are professionally attended, and the maternal mortality rate is high. Women's excess physical labor and lack of access to modern health care have been joined in recent years by another threat, AIDS. Although data on women's nutritional status are lacking, it is believed to be deficient. Increasing food imports since 1983 attest to the growing inability of the county to feed itself. At the national level, 27% of farm plots are of less than 1/2 hectare and 56% are under 1 hectare. Food distribution is poor between households and between regions, and seasonal shortages occur regularly
Marván, Maria Luisa; Catillo-López, Rosa Lilia; Ehrenzweig, Yamilet; Palacios, Pedro
The psychological meaning of women who have had a hysterectomy, and attitudes toward them, were explored in 121 Mexican gynecologists, 155 women who had undergone a hysterectomy, and 115 women who had not had a hysterectomy. The surveys were completed between January and May 2011. Both groups of women defined a woman who had had a hysterectomy using words with positive meanings (healthy, happy, reassured, and complete), as well as words with negative meanings (sad, incomplete, and irritable). However, the participants who had not had a hysterectomy defined a woman who had had a hysterectomy using more negative words and showed more negative attitudes toward such a woman with a hysterectomy than those women who had undergone a hysterectomy. Among participants who had undergone a hysterectomy, those who were premenopausal prior to the surgery and those who had undergone bilateral salpingo-oophorectomy defined a woman who had had a hysterectomy in a more negative manner and showed the most negative attitudes. The gynecologists did not use words with emotional content regarding women who had had a hysterectomy and showed more neutral attitudes toward such a woman than did both groups of women. These findings could be helpful in designing support programs for women facing a hysterectomy.
Herminia Franco-Espinoza was the first woman to receive a medical degree in the "Colegio del Estado de Puebla", Mexico. She was born in Chietla, Puebla, in 1891, and was daughter of Professor Felipe Franco-Pacheco and Zeferina Espinoza-Nape. Herminia concluded her professional studies in 1915 and graduated in 1917. During the 1910 attack to the house of the Serdán family in Puebla, she provided medical care to the first injured while she was a voluntary practitioner at the Hospital de San Pedro. She participated in the signing of the anti-reelectionist letter of the group "Luz y Progreso", headed by Aquiles Serdán. Thereafter, she moved to Mexico City and established at Plaza de la Constitución 37, where she opened a medical office. In 1920 she undertook a course on gynecology and obstetrics and child welfare at the National University of Mexico. In 1937 she traveled to Paris to undertake a course on Gynecology and Obstetrics and Pediatrics at L'Hôpital Broca, L'Hôpital Baudelóc and L'Hôpital des Enfants Malades. She retired in 1965 when she completed 50 years of professional practice. On 1970 she was recognized as a Veteran of the Mexican Revolution. Dr. Franco was part of the group of women who at the beginning of the last century pioneered in Mexico women's participation in mexican medicine.
Aminimoghaddam, Soheila; Mazloomi, Maryam; Rahimi, Maryam
Hypothyroidism is a common health issue worldwide with varying clinical manifestations. We report a woman who experienced an incomplete abortion and undiagnosed hypothyroidism who was referred to the oncologist with the suspicion of metastatic gestational trophoblastic neoplasm (GTN). A 29-year-old woman with incomplete abortion was referred to an oncologist for possible GTN due to persistent active vaginal bleeding, an elevated beta human chorionic gonadotropin (hCG), abnormal cervical inspection exam, abnormal liver function tests, ovarian enlargement, ascites, and a pleural effusion. She was found to have hypothyroidism in further work-up. She was managed with thyroid hormone replacement therapy and her condition improved after 6 weeks. Complete resolution of the ovarian mass and pericardial and pleural effusion was achieved. This case describes an important experience; hypothyroidism should be considered in the differential diagnosis of any woman with an incomplete abortion presenting with an ovarian mass. Evaluation and correct diagnosis are important to prevent mismanagement. PMID:27034864
Vega-Carrillo, Hector Rene; Manzanares-Acuna, Eduardo; Hernandez-Davila, Victor Martin; Arcos-Pichardo, Areli; Barquero, Raquel; Iniguez, M. Pilar
The use of 131I is widely used in diagnostic and treatment of patients. If the patient is pregnant the 131I presence in the thyroid it becomes a source of constant exposition to other organs and the fetus. In this study the absorbed dose in the uterus of a 3 months pregnant woman with 131I in her thyroid gland has been calculated. The dose was determined using Monte Carlo methods in which a detailed model of the woman has been developed. The dose was also calculated using a simple procedure that was refined including the photons' attenuation in the woman organs and body. To verify these results an experiment was carried out using a neck phantom with 131I. Comparing the results it was found that the simple calculation tend to overestimate the absorbed dose, by doing the corrections due to body and organs photon attenuation the dose is 0.14 times the Monte Carlo estimation.
Vega-Carrillo, Héctor René; Manzanares-Acuña, Eduardo; Hernández-Dávila, Víctor Martín; Arcos-Pichardo, Areli; Barquero, Raquel; Iñiguez, M. Pilar
The use of 131I is widely used in diagnostic and treatment of patients. If the patient is pregnant the 131I presence in the thyroid it becomes a source of constant exposition to other organs and the fetus. In this study the absorbed dose in the uterus of a 3 months pregnant woman with 131I in her thyroid gland has been calculated. The dose was determined using Monte Carlo methods in which a detailed model of the woman has been developed. The dose was also calculated using a simple procedure that was refined including the photons' attenuation in the woman organs and body. To verify these results an experiment was carried out using a neck phantom with 131I. Comparing the results it was found that the simple calculation tend to overestimate the absorbed dose, by doing the corrections due to body and organs photon attenuation the dose is 0.14 times the Monte Carlo estimation.
dl1.41gemwSAeY Pg au IU ) @1 Approved for public release; distribution unlimited The Female Naval Officer A Recruiter’s Guide to the American Woman by...officers are being assigned to a greater variety of jobs (formerly closed to women ) within the Navy. This continuous expanding demand for female officers...meets with hostility by both the men and women and is branded "mannish" or worse. The irony of all this is that to be a successful career woman and
Colao, Emma; Granata, Teresa; Vismara, Marco F. M.; Bombardiere, Francesco; Nocera, Donatella; Luciano, Elisa; Perrotti, Nicola; Malatesta, Paola
Objective. To assess aetiology of a POF in a 33-year-old woman and, if possible, plan a cure. Design. Case report. Setting. medical genetics diagnostic unit in a university hospital. Patient. A 33-year-old woman with premature ovarian failure (POF). Intervention(s). Genetic counseling, karyotyping, FISH study. Result(s). Turner-like diagnosis. Conclusion(s). Most cases of POF remain idiopathic. Turner syndrome can occur in very different phenotypes; cytogenetic and molecular profiling can provide a definitive diagnosis in cases with nonclassical phenotype. PMID:23509644
Colao, Emma; Granata, Teresa; Vismara, Marco F M; Bombardiere, Francesco; Nocera, Donatella; Luciano, Elisa; Perrotti, Nicola; Malatesta, Paola
Objective. To assess aetiology of a POF in a 33-year-old woman and, if possible, plan a cure. Design. Case report. Setting. medical genetics diagnostic unit in a university hospital. Patient. A 33-year-old woman with premature ovarian failure (POF). Intervention(s). Genetic counseling, karyotyping, FISH study. Result(s). Turner-like diagnosis. Conclusion(s). Most cases of POF remain idiopathic. Turner syndrome can occur in very different phenotypes; cytogenetic and molecular profiling can provide a definitive diagnosis in cases with nonclassical phenotype.
Curtit, Elsa; Benhamo, Vanessa; Gruel, Nadège; Popova, Tatiana; Manie, Elodie; Cottu, Paul; Mariani, Odette; Stoppa-Lyonnet, Dominique; Pivot, Xavier; Stern, Marc-Henri; Vincent-Salomon, Anne
We describe the case of a woman carrying a germline pathogenic BRCA1 mutation diagnosed with a breast cancer overexpressing HER2. Clinical presentation of the tumor, HER2-positivity, genomic profile and loss of the mutated BRCA1 allele in tumor evidence that BRCA1 is not inactivated in this breast cancer. It represents the first biological demonstration for the existence of a sporadic HER2-positive breast cancer independent from BRCA loss of function in a woman carrier of a deleterious BRCA1 mutation. In a context where targeted therapies based on BRCA loss of function in the tumor are developed, such case could have direct implications. PMID:26426992
Lu, T Y-T; Kupa, A; Easterbrook, G; Mangoni, A A
We report a case of significant weight loss experienced by a 44-year-old Caucasian woman treated with reboxetine. She was treated with this drug at 12 mg daily for a total duration of 11 months. During the corresponding period her body mass index (BMI) decreased from a baseline of 21.4 kg m−2 to a low of 16.8 kg m−2. Withdrawal of the drug led to a full recovery of her BMI. The strongest evidence linking reboxetine to this woman's weight loss laid in the fact that the re-introduction of the drug subsequently caused a similar negative impact in her BMI. PMID:16042676
Lu, T Y-T; Kupa, A; Easterbrook, G; Mangoni, A A
We report a case of significant weight loss experienced by a 44-year-old Caucasian woman treated with reboxetine. She was treated with this drug at 12 mg daily for a total duration of 11 months. During the corresponding period her body mass index (BMI) decreased from a baseline of 21.4 kg m(-2) to a low of 16.8 kg m(-2). Withdrawal of the drug led to a full recovery of her BMI. The strongest evidence linking reboxetine to this woman's weight loss laid in the fact that the re-introduction of the drug subsequently caused a similar negative impact in her BMI.
Wabnaki Bilingual Educational Program, Indian Township, ME.
This illustrated reader contains Passamaquoddy versions of two traditional Wabnaki legends about Pukcinsquehs, the Tree-Stump Woman, who changes herself into a mosquito, and Koluskap, a giant, who turns people into fish. It is one of a series of readers containing Passamaquoddy legends and is intended for use in a bilingual education setting. Each…
Bachmeyer, C; Mouchnino, G; Thulliez, P; Blum, L
Congenital toxoplasmosis usually results from acquired infection in non-immune pregnant women. However, severely HIV-infected women with a latent Toxoplasma infection can transmit the parasite as a result of reactivation. We report a case of toxoplasmic reactivation in an HIV-infected woman with moderate immunosuppression resulting in a severe congenital toxoplasmosis.
Kıvanç, Sertaç Argun; Olcaysu, Osman Okan; Gelincik, Ibrahim
A 49-year-old woman developed a dark brown nodular mass in the lower eyelid. The lesion had grown fast for 2 months and then had remained stable in size. Excisional biopsy was performed. Histopathological examination of an excisional biopsy specimen pointed to proliferative vessels lined by increased endothelial cells without nuclear atypism. The nodular mass evaluated as a capillary hemangioma. PMID:25370407
Pierce, W. David; Sydie, R. A.; Stratkotter, Rainer
Male and female participants (N = 274) made judgments about the social concepts of "feminist," "man," and "woman" on 63 semantic differential items. Factor analysis identified three basic dimensions termed evaluative, potency, and activity as well as two secondary factors called expressiveness and sexuality. Results for the evaluative dimension…
MirzaeeRabor, Firoozeh; Mirzaee, Fattaneh; MirzaiiNajmabadi, Khadigeh; Taghipour, Ali
Background: Participation of woman in decision-making processes is one of the key indicators of an appropriate relationship between a woman and the health care professionals. This study aimed to recognize the factors facilitating respect for woman's decision-making in spontaneous birth. Materials and Methods: This paper employed a meta-synthesis on articles published in four biomedical databases including MEDLINE, Web of Science, CINAHL, and Cochrane Library. All qualitative studies published after 1990 and directly or indirectly discussing the women's and the health care professional's attitudes toward respect for woman's decision-making in spontaneous birth were searched. Of 5372 citations, 95 full-text papers were considered, of which 14 satisfied the inclusion criteria. Results: In this meta-synthesis, initial codes were obtained through meticulous, line-by-line coding of the findings of the primary studies. Then, thematic synthesis was performed on the codes to search for concepts, and 20 descriptive themes were obtained in the second stage. Finally, through an inductive process, five new interpretations were obtained in the last stage of the thematic synthesis. These interpretations included confidence to health care providers, the central role of midwives in maintenance of women's dignity, childbirth as a natural phenomenon, the impact of contextual conditions, and the political and human factors affecting the delivery management and women seek place of safety for childbirth. Conclusions: Studies suggested that midwifes have a central role in maintenance of women's dignity and their experience of childbirth. PMID:27904626
Villamil-Gómez, Wilmer E; Rodríguez-Morales, Alfonso J; Uribe-García, Ana María; González-Arismendy, Edgardo; Castellanos, Jaime E; Calvo, Eliana P; Álvarez-Mon, Melchor; Musso, Didier
The clinical findings of a pregnant woman from Colombia with a triple co-infection caused by dengue, chikungunya, and Zika viruses are described. Weekly obstetric ultrasounds from 14.6 to 29 weeks of gestation were normal. She remains under follow-up and management according to the standard guidelines for the management of Zika virus-infected pregnant women.
Pitts, Samantha I; Wallace, Gregory S; Montana, Barbara; Handschur, Elizabeth F; Meislich, Debrah; Sampson, Alethia C; Canuso, Suzanne; Horner, Jennifer; Barskey, Albert E; Abernathy, Emily S; Icenogle, Joseph P
We report a case of congenital rubella syndrome in a child born to a vaccinated New Jersey woman who had not traveled internationally. Although rubella and congenital rubella syndrome have been eliminated from the United States, clinicians should remain vigilant and immediately notify public health authorities when either is suspected.
Terrance, Cheryl; Matheson, Kimberly
Student participants (N = 316) viewed a videotaped simulated case involving a woman who had entered a self-defense plea in the shooting death of her abusive husband. As successful claims of self-defense rest on the portrayal of a defendant who has responded reasonably to his/her situation, the implications of various forms of expert testimony in…
This essay argues that Moraga's recent play, "The Hungry Woman," is a meditation on the failure of the "Queer Aztlan" project articulated in 1993 as part of her collection "The Last Generation." It views the play through the lens of Mexican dramatic structures and historiography, explicating how Moraga interrogates the possibilities of indigenismo…
Taylor, R. G.
A multiple-probe design demonstrated the effectiveness of a match to sample paradigm using tactile recipe cards, a positional tray, and systematic prompting in teaching a severely handicapped deaf-blind retarded woman the independent preparation of three breakfast foods. (Author/DB)
Cuklanz, Lisa M.
Critiques prior scholarship that argues Margaret Sanger's magazine "The Woman Rebel" was a failure. Argues that it was a strategic and rhetorical success, offering a coherent description of what is now socialist feminism, and addressing its primary audience of working-class women primarily through simplistic moral reasoning and…
providing convoy security when approximately 50 insurgent fighters ambushed the convoy with small arms, machine gun fire and rocket propelled grenades...September 29, 2011). 27 Hehr, ―Combat Exclusion,‖ 12. 28 Jacqueline M. Hames, ―Army Promotes First Woman to Four-Star General,‖ November 14, 2008
Ek, Lucila D.
This article examines the transnationalism of a Pentecostal Guatemalan-American young woman who is a second-generation immigrant. Amalia traveled to Guatemala from when she was six months old until her sophomore year in college. These visits to Guatemala have helped her maintain her Guatemalan language, culture, and identity in the larger Southern…
Ntoukas, Vasileios; Tappe, Dennis; Pfütze, Daniel; Simon, Michaela
Human cysticercosis caused by Taenia crassiceps tapeworm larvae involves the muscles and subcutis mostly in immunocompromised patients and the eye in immunocompetent persons. We report a successfully treated cerebellar infection in an immunocompetent woman. We developed serologic tests, and the parasite was identified by histologic examination and 12s rDNA PCR and sequencing. PMID:24274258
An American Jewish woman learning Japanese in Japan examines the relationship between language, language learning, and personal identity. Autobiographical reflections are combined with entries from a diary and scholarly observations about the interrelationship of gender, race, culture, social class, historical experiences, and language learning.…
The typical woman officer from the nation's largest industrial, banking, retail and utility companies is married, at least 50 years of age, has had some college, was born into a family of low or lower middle class income, and has a work salary of less than $30,000. While the number of women officers in leading business organizations is small, the…
Massoure, P L; Lamblin, G; Bertani, A; Eve, O; Kaiser, E
The purpose of this report is to describe the first case of left ventricular non compaction diagnosed in Djibouti. The patient was a 74-year-old Djiboutian woman with symptomatic heart failure. Echocardiography is the key tool for assessment of left ventricular non compaction. This rare cardiomyopathy is probably underdiagnosed in Africa.
Ghanbari Jolfaei, Atefeh; Naji, Borzooyeh; Nasr Esfehani, Mehdi
A 29-year-old woman with schizophrenia introduced for application of repetitive transcranial magnetic stimulation for refractory visual hallucinations. Following inhibitory rTMS on visual cortex she reported significant reduction in severity and simplification of complexity of hallucinations, which lasted for three months. rTMS can be considered as a possibly potent treatment for visual hallucinations. PMID:27284279
Snider, Patricia A.; Valente, Patricia L.
Information and suggestions are presented in this guide to assist the re-entering female student in her adjustment to college. First, the guide looks at reasons for attending college and provides an overview of some of the barriers and problems to be overcome by a woman with a family who has been away from school for some time. Some of the…
Garalejić, E; Arsić, B; Perović, M; Vasiljević, M; Usaj, S K; Stanojević, D
This case report presents a 51-year-old woman with an adenosarcoma of ovarian origin which is a very rare tumor. She came for consultation due to abnormal vaginal bleeding. The case also illustrates the difficulty of its correct diagnosis and discusses the possible reasons of wrong preoperative and intraoperative diagnosis.
Montón, F.; Rebollo, M.; Quintana, F.; Berciano, J.
Occlusion of the middle cerebral artery and thrombosis of the superior sagittal sinus are reported in a 30-year-old woman taking oral contraceptives (OC). The coexistence of arterial and venous cerebral pathology as a complication of OC use has only been previously reported in one case. The pathogenesis of this rare association is briefly discussed. Images Fig. 1 Fig. 2 PMID:6462985
In this article, the author profiles Pierre-Auguste Renoir and describes Renoir's work of art, "Woman with Parrot". Renoir gained a reputation among peers for taking exceptional pleasure in painting, and his style was said to celebrate beauty and sensuality. He is recognized for showing significant empathy for the sitters in his portraits, and for…
Kerber, Linda K.
Examines the historical characteristics of women in the United States. Discusses the conceptions of women's roles expressed by writers from Alexis de Tocqueville to Betty Friedan, specifically the notion of the woman's "sphere" in society. Concludes that the idea of "separate spheres" was used to characterize power…
Smith, Megan; Wei, Jenny
Just imagine: you live in a time before electricity. There are no sewing machines, no light bulbs, and certainly no television shows to keep you entertained. You spend six days a week working 12-hours each day inside your small home with four teenage girls and your elderly mother. This was the life of Mary Pickersgill, the woman who sewed the…
This article reports the two-year tenure of a woman superintendent in a small southern city. Placed against the background of local community politics and school district politics it shows that women in the superintendency still face issues of gender stereotyping that influence the way they are perceived as leaders of school systems. A feminist…
Sauer, M.V.; Macaso, T.M.; Ishida, E.H.; Giudice, L.; Marshall, J.R.; Buster, J.E.
We report this country's first nonsurgical donor ovum transfer pregnancy in a functionally agonadal woman who had received chemotherapy and radiation for Hodgkin's lymphoma. For women with ovarian failure, nonsurgical uterine lavage and ovum transfer may provide an opportunity for motherhood that was not possible previously.
Hart, Kathleen; Kenny, Maureen E.
Examines the role that valuing physical appearance, striving for success in multiple roles, and insecure parental attachment are related to eating disorder symptoms. Responses from 156 undergraduate women support the relationship between the Super Woman model (desire to achieve perfection in multiple and often contradictory roles) and the presence…
Contributes to (and draws on) journalism history, mass-culture studies, and women's history in a rhetorical analysis of a series of six full-page illustrations titled "The American Woman" run in 1897 in "The Ladies' Home Journal." Reveals how class and gender issues intersected and underscored the role of the mass media in…
French, Lydia A.
This essay intervenes in contemporary scholarship on Sandra Cisneros's "Woman Hollering Creek" (1991) by examining the canciones she uses as epigraphs and their relationship to the multiple nationalisms that Chicana/os actively negotiate. I argue that Cisneros's decision to include powerfully nationalist Mexican cancion traditions…
Hoffman, Florence Perkell
To determine the relationship between attitudes and feelings of the middle woman, aged 35-55, and the present youth culture, both intrapsychic factors and environmental conditioning, as well as historic/cultural reasons were examined, using an attitudinal survey, administered to a sample population of middle to upper class suburban women.…
A rich and fascinating portrait of education life in America between 1830 and 1920, "Woman's 'True' Profession" is an indispensable contribution to our understanding of the teaching profession. "Women have always been teachers." So begins this second edition of Nancy Hoffman's classic history of women and the teaching…
Bryan, Betsy Morrell; Cohen, Judith Love
This booklet stresses the value of various academic studies (e.g., history, language, art, archaeology) as prerequisites for a career in Egyptology, by depicting real women whose careers provide inspirational role models. The first section is a text designed for use by elementary students and presents the career of Egyptology from a woman's point…
Ntoukas, Vasileios; Tappe, Dennis; Pfütze, Daniel; Simon, Michaela; Holzmann, Thomas
Human cysticercosis caused by Taenia crassiceps tapeworm larvae involves the muscles and subcutis mostly in immunocompromised patients and the eye in immunocompetent persons. We report a successfully treated cerebellar infection in an immunocompetent woman. We developed serologic tests, and the parasite was identified by histologic examination and 12s rDNA PCR and sequencing.
Raj, Sean D.; Raj, Karuna M.; Krishnamurthy, Savitri; Brahmaroutu, Ashrita; Whitman, Gary J.
A new breast mass was identified in an adult woman undergoing treatment for a known ethmoid sinus alveolar rhabdomyosarcoma. Histopathological evaluation revealed alveolar rhabdomyosarcoma metastatic to the breast. Alveolar rhabdomyosarcoma, primarily described in adolescents and especially rare in adults, can uncommonly metastasize to the breast. PMID:27186248
Wu, Junqing; Huang, Zirong
Background. The Woman's Condom, a second-generation female condom designed for acceptability, is poised for introduction in China. Method. This single-arm study was conducted among 60 couples in China in 2010 to assess acceptability of the Woman's Condom. Results. Male participants reported that ease of handling, inserting, and removing the device improved significantly from first to fourth use. Female and male participants reported that comfort during insertion, feel of lubricant during insertion, comfort/fit of outer ring during use, and overall comfort improved significantly from first to fourth use. Further, at fourth use, female participants reported significant improvement in the comfort of the feel of the condom material and lubricant. Female and male participants reported that satisfaction with stability and sensation during sex and ability to achieve orgasm improved significantly from first to fourth use. At fourth use, female participants reported statistically significant improvement in sensation compared to using nothing. A majority of participants (78%) stated that they would use the Woman's Condom in the future, primarily due to its dual protection profile. Conclusion. This study has shown that, in China, the Woman's Condom appears to be acceptable to married couples. User experience contributes to improvement in many aspects of device acceptability. PMID:27547481
Buechler, Steven M.
The Woman Suffrage Movement experienced ideological changes so that earlier and later suffragists had different views. Elizabeth Boynton Harbert was one reformer who first criticized female socialization and the system of separate spheres. Later her views became more sentimental and she idealized the traditional role of women. (VM)
Ramsey, E. Michele
Contributes to scholarship advancing the understanding of human communication by examining the rhetorical invention strategies of suffrage rhetoric in the cultural context of World War I. Shows how the political cartoons published in the mainstream Suffrage Movement's "The Woman Citizen" constructed women as strong, competent, and…
Jarnagin, Whitney L.; Woodside, Marianne
The concept of wellness provides a positive view of life development that can support psychological support and counseling. There is little in the literature about wellness and seniors, especially women. This study describes one senior woman's wellness across the life span by addressing two research questions: (a) What are the experiences of one…
Picardi, A; Navajas, F; De Iorio, F; Amicarelli, M; Spoto, S; De Galasso, L; Vespaciani Gentilucci, U; Scarlata, S; Zardi, E; Di Cuonzo, G
A thirty-five years old woman during her twelfth pregnancy presented fever and pain at the left thigh. After cesarean delivery dyspnea added to the first two symptoms and pulmonary embolism was suspected. A clinical history revaluation suggested a diagnosis of infectious endocarditis and femoural osteomielitis due to a septic embolus.
This article focuses on the complex web of issues involved in Esmeralda Santiago's acculturation to US society after arriving from Puerto Rico as a girl. The article is based on examples from Santiago's second memoir, "Almost a Woman" (1998) and the 2001 film adaptation of this memoir; the observations of critics who have written about…
Werth, Abigail; Perkins, Michael; Boucher, Jill
A case study of a 29-year-old woman with high functioning autism is presented. Examples of her use of puns, jokes, neologisms, "portmanteau" words, irreverent humor, irony, sarcasm, and word play based on her obsessional interests are provided and discussed in relation to current theories of autism and of normal humor. (Contains references.)…
Pal, Subrata; Mondal, Sajeeb; Mondal, Palash Kr; Raychaudhuri, Gargi; Pradhan, Rajashree; Banerjee, Suparna
Calcified broad ligament leiomyoma is a rare benign lesion in postmenopausal age group. It causes diagnostic confusion with solid calcified adnexal mass and large bladder calculi at the pelvic region. Clinical and radiological diagnoses were confirmed by histopathology of the hysterectomy specimen. We hereby present a case of heavily calcified broad ligament fibroid in a postmenopausal woman. PMID:27721644
DeKeseredy, Walter S; Dragiewicz, Molly
Woman abuse in Canada started receiving much sociological attention in the mid-1980s. This article describes past scholarly achievements, assesses current contributions, and suggests progressive ways of responding to future challenges. Special attention is given to how broader political economic forces help shape and constrain research on a variety of highly injurious male-to-female assaults that occur in private settings.
Wu, D; Xu, J; Peng, J M; Ma, L K; Chen, S; Li, X G; Zhang, T P; Qian, J M
A 32 year-old woman in the third trimester of pregnancy was admitted for severe acute pancreatitis due to hypertriglyceridemia. During hospitalization she developed multiorgan dysfunction, infected pancreatic necrosis, abdominal compartment syndrome and intrauterine fetal death. She was successfully treated by multidisciplinary team including department of emergency medicine, ICU, gastroenterology, obstetrics, endocrinology, ultrasonography, radiology, infectious disease, nutrition and surgery.
Parekh, Parth; Oldfield, Edward C; Marik, Paul E
We present a 33-year-old woman with a history significant for HIV/AIDS (CD4 count of 17) and diabetes mellitus who was diagnosed as having progressive outer retinal necrosis (PORN) after presenting with peripheral vision loss. This case provided a diagnostic challenge and demonstrates the devastating effects of a misdiagnosis as it pertains to PORN.
Ellington, David R.; Erekson, Elisabeth A.; Richter, Holly E.
Synopsis As population demographics continue to evolve, specifics on age-related outcomes of stress urinary incontinence interventions will be critical to patient counseling and management planning. Understanding medical factors unique to older woman and their lower urinary tract condition will allow caregivers to optimize surgical outcomes, both physical and functional, and minimize complications within this population. PMID:26476111
Delgado, C; Kent, C; Sedensky, M; Ciliberto, C; Landau, R
Morquio syndrome, a congenital mucopolysaccharidosis, presents several challenges for the provision of effective labor analgesia. We report the case of a woman admitted for induction of labor who received an early epidural and subsequently required cesarean delivery. Optimal bilateral labor analgesia was not achieved despite multiple adjustments, and systemic analgesia was needed for cesarean delivery.
Williams, Elvira S.
University leadership from career and organizational viewpoints are discussed from the perspective of a woman physicist. Laws of physics are used, through appropriate analogies, as templates for structuring useful life lessons on holistic WHAM leadership. Interactive university skill sets and program policies based on holistic WHAM approaches are…
Filaire, M.; Michel-Letonturier, M.; Garcier, J. M.; Escande, G.; Boyer, L.
We report one case of mature mediastinal teratoma with pulmonary extension surgically diagnosed in a 22-year-old woman complaining of recurrent hemoptyses for which no etiological explanation could be found. Thoracic surgery was only decided on after three embolizations proved ineffective.
Ali, Ihsan Ighdeifan; ALkhateeb, Akef Abdallah
This study aimed at identifying the status of services provided to deaf woman in Jordan. The study was conducted on a sample of (100) deaf women chosen by the intended available method. A researcher self developed questionnaire consisting of (75) items covering seven most important domains representing the most important services that should be…
Watson, E.E.; Stabin, M.G.
Existing models that allow calculation of internal doses from radionuclide intakes by both men and women are based on a mathematical model of Reference Man. No attempt has been made to allow for the changing geometric relationships that occur during pregnancy which would affect the doses to the mother's organs and to the fetus. As pregnancy progresses, many of the mother's abdominal organs are repositioned, and their shapes may be somewhat changed. Estimation of specific absorbed fractions requires that existing mathematical models be modified to accommodate these changes. Specific absorbed fractions for Reference Woman at three, six, and nine months of pregnancy should be sufficient for estimating the doses to the pregnant woman and the fetus. This report describes a model for the pregnant woman at nine months. An enlarged uterus was incorporated into a model for Reference Woman. Several abdominal organs as well as the exterior of the trunk were modified to accommodate the new uterus. This model will allow calculation of specific absorbed fractions for the fetus from photon emitters in maternal organs. Specific absorbed fractions for the repositioned maternal organs from other organs can also be calculated. 14 refs., 2 figs.
... Culturally Significant Object Imported for Exhibition Determinations: ``Titian's Woman in a Blue Dress `La... ``Titian's Woman in a Blue Dress `La Bella','' imported from abroad for temporary exhibition within the..., Assistant Secretary, Bureau of Educational and Cultural Affairs, Department of State. BILLING CODE 4710-05-P...
Images of Black women in Hispanic literature tend to be the work of White authors or Black male authors who, however well-intentioned, cannot articulate the direct, lived experience of the black, Hispanic woman. Moreover, the image of the Black woman in Spain and Latin America is the result of a slavocratic, patriarchal system and, therefore,…
... Business, Small Disadvantaged Business and Woman-Owned Small Business Concerns. 970.1907 Section 970.1907... MANAGEMENT AND OPERATING CONTRACTS Small, Small Disadvantaged and Women-Owned Small Business Concerns 970.1907 Subcontracting with Small Business, Small Disadvantaged Business and Woman-Owned Small...
Anyaso, Hilary Hurd
This article presents a conversation with three women college leaders on how their respective Ohio colleges are faring in the economy, leadership and what tops their presidential agendas these days. Patricia L. Hardaway was appointed president of Wilberforce University in April 2008. An attorney and graduate of the historically Black university,…
Weeks, Margaret R; Abbott, Maryann; Liao, Susu; Yu, Wang; He, Bin; Zhou, Yuejiang; Wei, Liu; Jiang, Jingmei
Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women's knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China.
In this article the author explains the social role of Muslim woman in a postmodern society through a public symbol of her identity--the veil. The article's thesis is that the Muslim women's manifestation of their Islamic denomination through veiling and wearing appropriate clothes (in the case of men through growing beards and wearing clothes considered appropriate for them) signifies an expression of a new, Islamic shaped identity. This is a postmodern identity based on modernity rather than a fundamental reaction to modernity. The veil, a public symbol of Muslim identity, is often given a different meaning by its observers than the person actually wearing it. Therefore, the intention of this article is to analyze the elements of a particular, postmodern identity that a Muslim woman's veil, as a public symbol, represents.
Some have challenged Thomson's case of the famous unconscious violinist (UV) by arguing that in cases of consensual sex a woman is partially morally responsible for the existence of a needy fetus; since she is partially responsible she ought to assist the fetus, and so abortion is morally wrong. Call this the Responsibility Objection (RO) to UV. In this paper, I briefly criticize one of the most widely discussed objections to RO and then suggest a new way to challenge RO. In so doing, I investigate the plausibility of the moral principle that appears to be driving RO: If a woman is partially morally responsible for the existence of a needy fetus, she has a moral obligation to assist the fetus. I argue that this principle is false. I suggest modified versions of this principle but argue that, even on the most plausible version, RO does not persuade.
Anquez, Jérémie; Boubekeur, Tamy; Bibin, Lazar; Angelini, Elsa; Bloch, Isabelle
Potential sanitary effects related to electromagnetic fields exposure raise public concerns, especially for fetuses during pregnancy. Human fetus exposure can only be assessed through simulated dosimetry studies, performed on anthropomorphic models of pregnant women. In this paper, we propose a new methodology to generate a set of detailed utero-fetal unit (UFU) 3D models during the first and third trimesters of pregnancy, based on segmented 3D ultrasound and MRI data. UFU models are built using recent geometry processing methods derived from mesh-based computer graphics techniques and embedded in a synthetic woman body. Nine pregnant woman models have been generated using this approach and validated by obstetricians, for anatomical accuracy and representativeness.
Lee, Ji Hoon; Heo, Sung Hyuk; Lee, Jin San; Chang, Dae-Il; Park, Ki-Ho; Sung, Ji-Youn; Hong, Il Ki; Kim, Myeong Hee; Park, Bong Jin; Choi, Woo Suk
Hemiparesis may be the result of lesions in the contralateral pyramidal tract in the brain or, less frequently, in the ipsilateral pyramidal tract in the upper cervical spinal cord. However, although rare, multiple lesions that simultaneously occur in both of these regions may be the cause of acute hemiparesis, and the clinical symptoms can often be misdiagnosed as a stroke. In addition, the correct diagnosis of these multiple central nervous system (CNS) lesions is very challenging if they are caused by infection from an unexpected microorganism. We evaluated an elderly healthy woman who presented with acute hemiparesis and multiple brain and spinal cord lesions that were confirmed to occur from an infection with Propionibacterium acnes. In this report, the differential diagnosis and histopathological findings are discussed for these multiple CNS lesions in this healthy woman. PMID:28377743
Weeks, Margaret R.; Liao, Susu; Abbott, Maryann; He, Bin; Zhou, Yuejiang; Jiang, Jingmei; Wei, Liu; Yu, Wang
Rapid changes in China over the past two decades have led to significant problems associated with population migration and changing social attitudes, including a growing sex industry and concurrent increases in STIs and HIV. This article reports results of an exploratory study of microbicide acceptability and readiness and current HIV prevention efforts among female sex workers in two rural and one urban town in Hainan and Guangxi Provinces in southern China. The study focused on these women’s knowledge and cultural understandings of options for protecting themselves from exposure to STIs and HIV, and the potential viability and acceptability of woman-initiated prevention methods. We report on ethnographic elicitation interviews conducted with women working within informal sex-work establishments (hotels, massage and beauty parlors, roadside restaurants, boarding houses). We discuss implications of these findings for further promotion of woman-initiated prevention methods such as microbicides and female condoms among female sex workers in China. PMID:17599276
Quaynor, Samuel D; Stradtman, Earl W; Kim, Hyung-Goo; Shen, Yiping; Chorich, Lynn P; Schreihofer, Derek A; Layman, Lawrence C
Although androgen resistance has been characterized in men with a normal chromosome complement and mutations in the androgen-receptor gene, a mutation in the gene encoding estrogen receptor α (ESR1) was previously described only in one man and not, to our knowledge, in a woman. We now describe an 18-year-old woman without breast development and with markedly elevated serum levels of estrogens and bilateral multicystic ovaries. She was found to have a homozygous loss-of-function ESR1 mutation in a completely conserved residue that interferes with estrogen signaling. Her clinical presentation was similar to that in the mouse orthologue knockout. This case shows that disruption of ESR1 causes profound estrogen resistance in women. (Funded by the National Institutes of Health.).
Lasheras Amat, M del Pilar; Muriel Fernández, Rafael; Llamas Martínez, M Victoria; Hallaga Messari, Asmaa; Bitoden Yaka, Albert; Ndour, Mame Awa; Dieng, Ousseynou; Márquez Bernal, Victoriano; Sevillano, Manuel Garrido
I was born a woman, the life of Mame is the dramatization a fictitious intergenerational story. However, the story is based on true events and the feelings of real immigrant women. The dramatization narrates the life of a woman, from the time her parents-who had recently emigrated from Senegal-settled in Andalusia, up to the adolescence of Mame's own daughter. The story is told with one person on stage who, through the use of three costume changes, plays three different generations of women: mother, daughter and granddaughter, with the video-recorded testimonies of other characters (a teacher and a midwife), who express their views of the host society against a background of African music and pictures of their native country. The present article describes their goals, such as communication in conferences, and includes a concise summary of the script, reflections on the process of integrating, and the evaluation made after a performance.
Kikuchi, Satoru; Saito, Kazuyuki; Takahashi, Masaharu; Ito, Koichi; Ikehira, Hiroo
This paper presents the computational electromagnetic dosimetry inside an anatomically based pregnant woman models exposed to electromagnetic wave during magnetic resonance imaging. The two types of pregnant woman models corresponding to early gestation and 26 weeks gestation were used for this study. The specific absorption rate (SAR) in and around a fetus were calculated by radiated electromagnetic wave from highpass and lowpass birdcage coil. Numerical calculation results showed that high SAR region is observed at the body in the vicinity of gaps of the coil, and is related to concentrated electric field in the gaps of human body such as armpit and thigh. Moreover, it has confirmed that the SAR in the fetus is less than International Electrotechnical Commission limit of 10W/kg, when whole-body average SARs are 2W/kg and 4W/kg, which are the normal operating mode and first level controlled operating mode, respectively.
Winkelman, William D; Rabban, Joseph T; Korn, Abner P
Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite.
Premenopausal Woman Undergoing Chemotherapy for Breast Cancer PRINCIPLE INVESTIGATOR: Marlene H. Frost, RN, Ph.D...Associated Symptoms in Premenopausal women Undergoing Chemotherapy for Breast Cancer”. Final HSRRB and IRB approval was received 4/05 and recruitment began...6/1/05. The study is continuing under a no cost extension (year one approved April 2005; year two approved June 13, 2006). To date we have 18 women
Kozlov, A; Joeres, R; Braun, U
We describe the case of a 50-year-old woman who presented with tachyarrhythmia, mild fever, peripheral oedema, ascites, epistaxis and gastrointestinal haemorrhage. Blood analysis revealed hyperthyroxinaemia. Analysis of thyroid-stimulating antibodies highlighted Graves' disease being the cause of the prevailing thyrotoxic crisis. Remarkable in this case of thyrotoxicosis is a liver affection without elevated transaminases but disturbed serum protein synthesis leading to hypalbuminaemic oedema and haemorrhagic complications. Thyrostatic treatment led to clinical response.
Pierce, Cameron W
A case of an 85-year-old woman with gradually progressive but severe dyspnea is reported. A thorough workup disclosed platypnea-orthodeoxia syndrome associated with right-to-left shunting through a patent foramen ovale, in the presence of several other recognized risk factors, despite the absence of significant pulmonary hypertension. Successful percutaneous transcatheter closure of the intracardiac defect resulted in resolution of the syndrome.
Pan, Xueni; Gillies, Marco; Barker, Chris; Clark, David M.; Slater, Mel
Background Male volunteers entered an immersive virtual reality that depicted a party, where they were approached by a lone virtual woman who initiated a conversation. The goal was to study how socially anxious and socially confident men would react to this event. Interest focused on whether the socially anxious participants would exhibit sustained anxiety during the conversation or whether this would diminish over time, and differ from the responses of the more socially confident men. Methodology The scenario was a party with five virtual characters, four sitting at a distance from the participant and talking amongst themselves and one lone woman standing closer. The woman approached the participant, introduced herself and initiated a conversation that was first about mundane matters and then became more personal and intimate. Participants were men who were either relatively socially confident (18) or socially anxious in their relationships with women (18). A second experimental factor was whether or not the other four characters occasionally looked towards the participant. There was a post-trial questionnaire about social anxiety in relation to the experience, and skin conductance and ECG physiological measures were recorded. Our expectation was that the socially anxious participants would show greater anxiety throughout. Conclusions Compared to baseline readings both socially confident and socially anxious groups on average showed signs of significantly increased stress at the initial approach of the virtual woman. The stress then diminished once the conversation entered into the mundane phase and then did not significantly change. Comparing pre- and post-questionnaire anxiety scores there was no change for the more confident participants but a significant decrease in average score amongst the anxious group. The methodology of placing socially anxious participants in a virtual reality where they can gain experience of how to act in a stressful situation promises
This paper deals with aging of a remarkable woman from Florida, Wilma E. Davis. After ministering in the Methodist church for over 30 years as the first ordained Methodist minister in the state of Florida, Davis retired and began a PhD program at Boston University at the age of 63. Davis completed her PhD at the age of 68. The pursuit of her…
Furtado, W S; Mello, D A C P G; Santos, V M; Bringel, T L; Oliveira Junior, W P; Moura, H J L
Gastric lipoma is considered a rare condition that may constitute a challenging diagnosis. A 51-year-old woman presented dysphagia and abdominal pain, and an upper digestive endoscopic study disclosed a gastric tumor located in the submucosa of the pyloric antrum. Conclusive diagnosis was established after repeated endoscopic biopsies, and the patient was subjected to an atypical gastrectomy, which evolved into a pyloric stenosis. This complication was appropriately corrected and the patient remains symptomless, under outpatient surveillance.
Mizuno, R; Fujimoto, S; Fujimoto, T; Nishino, T; Shiiki, H; Hashimoto, T; Nakamura, S; Dohi, K
Catastrophic antiphospholipid syndrome (CAPS) is a severe variant of antiphospholipid syndrome (APS) characterized by disseminated microangiopathy that results in multiorgan failure. CAPS mainly occurs in association with systemic lupus erythematosus (SLE). Clinically, CAPS mimics disseminated SLE vasculitis, intravascular coagulation (DIC), and particularly thrombotic thrombocytopenic purpura (TTP). We describe an autopsy case of young woman with CAPS in SLE, which is difficult to differentiate from TTP secondary to SLE.
Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.
Souto, Fernanda Maria; Andrade, Stephanie Macedo; Barreto, Ana Terra Fonseca; Souto, Maria Júlia Silveira; Russo, Maria Amélia; de Mendonça, José Teles; Oliveira, Joselina Luzia Menezes; Gonçalves, Luiz Flávio Galvão
Anomalous pulmonary venous return (APVR) is a rare cardiac anomaly defined as one or more pulmonary veins draining into a structure other than the left atrium, with venous return directly or indirectly to the right atrium. The most common form is partial APVR, in which one to three pulmonary veins drain into systemic veins or into the right atrium. We report the case of a woman diagnosed with partial APVR by magnetic resonance imaging during pregnancy.
Morfaw, Frederick Li; Nana, Philip N
Sirenomelia is a rare congenital malformative disorder characterized by fusion of the lower limbs giving a characteristic mermaid-like appearance to the affected foetus. We report a case of sirenomelia occurring in a 19 year old Cameroonian woman following premature rupture of membranes and associated cord prolapse. This is the first documented case in this country. We highlight some of the cultural myths associated with this disorder and discuss our findings relative to the present literature and related controversies on its etiopathogenesis.
Jahandideh, Hesam; Nasoori, Yasser; Rostami, Sara; Safdarian, Mahdi
Langerhans cell histiocytosis (LCH) is a very rare condition that commonly affects the head and neck region. There are very few cases of isolated laryngeal involvement by LCH, mostly reported in pediatric patients. Here, we report a case of laryngeal LCH in a 62-year-old woman presenting with a neck mass several weeks ago. The clinical and histopathological findings are reported with a brief discussion about the disease. PMID:27127670
Kemfang, Jean Dupont Ngowa; Dobgima, Walter Pisoh; Motzebo, Regine Mbouopda; Ngassam, Anny; Fokou, Marcus; Kasia, Jean-Marie
Klippel Trenaunay syndrome (KTS) is a rare congenital disease characterized by a triad of cutaneous hemangioma, varicose veins and bone or soft tissue hypertrophy. Cases of pregnancy complicated by KTS are rare. There is an increased risk of thrombo-embolic disease and hemorrhage during pregnancy. Both obstetric and anesthetic management of KTS in pregnancy can be rather complicated. We present a successful management of pregnancy in an African woman with KTS at Yaounde General Hospital, Cameroon. PMID:24772228
Kornmeier, Jürgen; Bach, Michael
Ambiguous figures attract observers because perception alternates between different interpretations while the sensory information stays unchanged. Understanding the underlying processes is difficult because the precise time instant of this endogenous reversal event needs to be known but is difficult to measure. Presenting ambiguous figures discontinuously and using stimulus onset as estimation of the reversal event increased temporal resolution and provided a series of well-confirmed EEG signatures. In the current EEG study we used this 'onset paradigm' for the first time with Boring's old/young woman stimulus. We found an early occipital event-related potential (ERP) correlate of reversals between the perception of the old woman and the perception of the young woman that fits well with previous ERP findings. This component was not followed by the often-reported occipito-parietal Reversal Negativity at 260 ms, but instead by an occipito-temporal N170, that is typically reported with face stimuli. We interpret our results as follows: ambiguity conflicts take place during processing of stimulus elements in early visual areas roughly 130 ms after stimulus onset. The disambiguation of these elements and their assembly to object 'gestalts' result from an interplay between early visual and object-specific brain areas in a temporal window between 130 and 260 ms after stimulus onset. In the particular case of Boring's old/young woman the processes of element disambiguation and gestalt construction are already finished at 170 ms and, thus, 90 ms earlier than in the case of ambiguous geometric figures (eg Necker cube or Schroeder staircase) or of binocular rivalrous gratings.
Khodakarami, N; Naji, H; Dashti, M G; Yazdjerdi, M
We carried out a descriptive analysis on the pregnancy outcome in 313 pregnant women abused, 160 non-abused). Abuse was statistically significantly correlated with mean weight gain during pregnancy, mean frequency of the prenatal care, prolonged labour (dystocia), premature rupture of membrane, low mean birth weight and mean gestational age at birth. Given the high likelihood that a woman will access health care services during her pregnancy, physicians providing prenatal care are in a strategic position to screen for partner abuse.
Bañuls Pellicer, G; Domingo-Triadó, V
Non-compaction cardiomyopathy, a genetic primary cardiomyopathy, is being increasingly diagnosed. Pregnant women with non-compaction cardiomyopathy are more susceptible to complications, such as heart failure, arrhythmias and embolic events. This paper reports the case of a pregnant woman with non-compaction cardiomyopathy under treatment and asymptomatic, who received epidural analgesia during labor and delivery. The clinical course is described and a brief review is presented.
Posso, Veronica; Redrobán, Ligia
Secretory breast carcinoma is an exceptionally rare mammary gland neoplasia described mainly in adult females and children of both sexes, and very rarely in the elderly. It has particular histopathological and immunohistochemical features and a favorable prognosis. We report the case of a 79-year-old Hispanic woman with a palpable breast mass. Currently, the patient is disease free after a followup period of 6 years without local recurrence or axillary lymph-nodes nor distant metastases. PMID:28058101
Singh, Sarneet; Pal, Shrestha; Dubrey, Simon William
A young woman presented with general malaise in relation to the metabolic condition ornithine transcarbamylase deficiency. Her ammonia level had risen to 229 µmol/L (normal range 0-59 µmol/L). She was treated using her emergency pack of intravenous medicines and made a complete response. We briefly discuss the need to make an urgent diagnosis, the 'mechanism' for checking serum ammonia levels and therapies.
Photocopy of a photograph showing a woman (not E.E. Lape, but possibly E.F. Read) seated outside of southwest corner of Murdock House (circa 1930s?). (Photo found in Lape-Read House, located at U.S. Fish and Wildlife Service - Murdock Hill, Murdock House, South side of Old Clinton Road (U.S. Route 1), 1 mile east of Horse Hill Road, Westbrook, Middlesex County, CT
O'Donnell, M.R.; Haiduk, J.P.
The fluvial meander belt containing the Old Woman sandstone served as a conduit for clastics transported into the Anadarko basin. Mappable for a distance of more than 30 mi (48 km), sand bodies characterizing this system average 0.5 mi (0.8 km) in width and attain maximum thicknesses of 50-70 ft (15-20 m). Channel and point-bar sandstone facies display a fining-upward sequence and sharp basal contact, as inferred from gamma-ray and resistivity logs. Sandstones of the Old Woman fluvial complex overlie the laminated shales and silts of the penecontemporaneous flood-plain environment. These flood-plain deposits are underlain by crinoidal wackestones and packstones deposited in the subtidal regime. Encroachment of the fluvial complex into a marine setting is interpreted from this sequence. Thin flood-plain deposits and lack of shallow marine clastic sediments suggest rapid advancement. Quartzitic and petrologically mature, the Old Woman sandstone is fine grained, with small-scale troughs and laminations, and a few mudstone rip-up clasts. Diagenesis has altered the mineralogic composition mainly by siliceous and carbonate cementation. Porosity is secondary, resulting from dissolution of various metastable constituents. The Old Woman sandstone was established as a hydrocarbon reservoir in the early 1960s, and sporadic development continued for years. The present-day petroleum market has prompted a resurgence in drilling activity owing to the economic viability of this reservoir. Successful wells are concentrated in newly discovered meander-belt bends; however, the elusiveness of this fluvial system challenges today's exploration geologists as it has for the past quarter century.
Ribas, S. J.; Olarte, S.; Balaguer-Núnez, L.; Figueras, F.; Paredes, J. M.; Rull, J.; Masana, E.
Maria Assumpció Català was born in Barcelona the 14 July 1925. In spite of the hostile environment of the Spanish Civil War and the postwar period, she managed to pave her way in the academic world that was at the time reserved for male scientists. In 1971, she became the first woman to obtain a Ph.D. in Mathematics in Barcelona and in 1974 she became the first woman Professor of Astronomy at a Spanish university. In March 2016, as an homage to our teacher and colleague, the Assumpci ´o Catal`a Telescope was inaugurated in the Centre d'Observació de l'Univers (Àger, Lleida), managed by the Consell Comarcal de la Noguera. This telescope classroom, pioneer in Europe, is a 50-cm reflector Dall-Kirham, designed to allow 70 people simultaneously to observe, learn and enjoy the sky of the Montsec. The itinerant exhibition ''Assumpció Català'' has been designed to show her legacy as well as the impressive evolution of Astronomy in Spain in the last decades. These powerful dissemination tools are a tribute to a great scientist on Astronomy, an extraordinary teacher and, from now on, the first woman to give name to a telescope in Spain.
Kita, Sachiko; Haruna, Megumi; Hikita, Naoko; Matsuzaki, Masayo; Kamibeppu, Kiyoko
This study develops a Japanese version of the Woman Abuse Screening Tool, comprising two simple questions, to examine its accuracy and validity. A cohort study involving women in the third trimester of pregnancy and one month after childbirth was conducted in an antenatal clinic in a Tokyo suburb. The Japanese versions of the Index of Spouse Abuse and Hospital Anxiety and Depression Scale were used to examine the cut-off point, accuracy, and validity of the Woman Abuse Screening Tool. Results showed that the tool demonstrated good accuracy (sensitivity 66.7-71.4%, specificity 89.7%), using an alternative cut-off point (i.e. responses of "some tension" or "some difficulty" [2 points] for one item and "a lot of tension" or "great difficulty" [1 point] for the other), and good concurrent, convergent, and predictive validity. The results indicated that the Woman Abuse Screening Tool could be useful in Japanese perinatal health settings, as an initial screening tool to detect intimate partner violence efficiently and effectively during pregnancy.
Saison, Carole; Peyrard, Thierry; Landre, Caroline; Ballif, Bryan A.; Schlosser, Kate A.; Dettori, Isabelle; Chicheportiche, Colette; Nemeth, Peter; Cartron, Jean-Pierre; Arnaud, Lionel
Background and Objectives The Colton blood group antigens are carried by the AQP1 water channel. AQP1−/− individuals, also known as Colton-null since they express no Colton antigens, do not suffer any apparent clinical consequence but may develop a clinically significant alloantibody (anti-CO3) induced by transfusion or pregnancy. Identification and transfusion support of Colton-null patients are highly challenging, not only due to the extreme rarity of this phenotype, the lack of appropriate reagents in most laboratories, as well as the possibility of confusing its with the recently described CO:-1,-2,3,-4 phenotype where AQP1 is present. This study investigated a new Colton-null case and evaluated three commercially available anti-AQP1s to identify Colton-null red blood cell samples. Methods The Colton-null phenotype was investigated by standard serological techniques, AQP1 sequencing, immunoblot and flow cytometry analyses. Results We identified and characterized the Colton-null phenotype in a Gypsy woman who developed an anti-CO3 during her first pregnancy. After developing a simple and robust method to sequence AQP1, we showed that she was apparently homozygous for a new AQP1 null allele, AQP1 601delG, whose product is not expressed in her red blood cells. We also established the Colton specificity of three commercially available anti-AQP1s in immunoblot and/or flow cytometry analyses. Conclusion This Gypsy woman represents the sixth Colton-null case characterized at the serological, genetic and biochemical levels. The validation here of new reagents and methods should facilitate the identification of Colton-null individuals. PMID:22348807
Nagaoka, Tomoaki; Togashi, Toshihiro; Saito, Kazuyuki; Takahashi, Masaharu; Ito, Koichi; Watanabe, Soichi
The numerical dosimetry of pregnant women is an important issue in electromagnetic-field safety. However, an anatomically realistic whole-body pregnant-woman model for electromagnetic dosimetry has not been developed. Therefore, we have developed a high-resolution whole-body model of pregnant women. A new fetus model including inherent tissues of pregnant women was constructed on the basis of abdominal magnetic resonance imaging data of a 26-week-pregnant woman. The whole-body pregnant-woman model was developed by combining the fetus model and a nonpregnant-woman model that was developed previously. The developed model consists of about 7 million cubical voxels of 2 mm size and is segmented into 56 tissues and organs. This pregnant-woman model is the first completely anatomically realistic voxel model that includes a realistic fetus model and enables a numerical simulation of electromagnetic dosimetry up to the gigahertz band. In this paper, we also present the basic specific absorption rate characteristics of the pregnant-woman model exposed to vertically and horizontally polarized electromagnetic waves from 10 MHz to 2 GHz.
Groeneveld, G J; van der Schaaf, I C
A 48-year-old woman with right-sided hemiplegia by embolic occlusion of the left middle cerebral artery was treated with alteplase. A pre- and post-treatment CT angiography scan showed the vanishing blood clot.
This article considers the objection to abortion that a woman who voluntarily engages in sexual activity is responsible for her fetus and so cannot have an abortion. The conclusion argued for is that the conceptions of responsibility that can ground the objection that are considered do not necessitate a requirement on the part of a pregnant woman to carry her pregnancy to term. Thus, the iterations of the responsibility objection presented cannot be used to curtail reproductive choice.
Hileman, G.E.; Miller, C.F. ); Knoll, M.A. Univ. of Texas, El Paso )
The Old Woman Mountains area is a moderately extended region that lies between two highly extended terranes, the Central Mojave Extensional Complex and the Colorado River Extensional Corridor. Two normal faults and a high-angle fault that the authors interpret to be a transfer structure divide the area into four distinct structural blocks. These blocks correspond to the four mountain ranges of the area: the Old Woman, Piute, Little Piute, and Ship mountains. Other major faults involved in tilting are inferred to be buried beneath alluvium in surrounding valleys. Deformation occurred in part before, but primarily after, deposition of the Peach Springs Tuff, an 18.5 Ma regional stratigraphic marker. Transport directions of hanging walls are westward on the west side of the Old Woman Mountains area and east-southeastward on the east side. The authors suggest that the Old Woman Mountains area is a less extended portion of a continuous extensional terrane that stretches from the central Mojave Desert across the Colorado River to the transition zone of the Colorado Plateau. Lower strain in the Old Woman Mountains area than in most of the Colorado River Extensional Corridor and Central Mojave Extensional Complex and age relations across the terrane can be explained by a model in which the principal locus of upper crustal breakaway to an east dipping low-angle simple shear zone shifted at about 18-20 Ma from a position far to the west to just east of the Old Woman Mountains area.
In the aftermath of slavery and the resulting social, economic, and political effects, Black women have become the victims of negative stereotyping in mainstream American culture. Such stereotypes include the myth of the angry Black woman that characterizes these women as aggressive, ill tempered, illogical, overbearing, hostile, and ignorant without provocation. Symptoms presented by Black women during mental health treatment may reinforce this myth. However, many of the negative characteristics of the angry Black woman developed in response to external stressors and historical factors. Black women also have a unique experience with and expressions of anger that shape the presenting symptoms interpreted by the mental health clinician. This myth and corresponding negative stereotypes significantly affect Black women intrapsychically, interpersonally, and are likely to influence the efficacy of mental health treatment. Understanding and treatment of Black women in a mental health context should be influenced by the cultural norms and sociopolitical dynamics affecting these clients. Successful mental health treatment requires cultural competence and clinicians who are well prepared to navigate the inherent complexities of culture with clients. Awareness of the angry Black woman mythology, including its genesis, manifestations, and the unique experiences of Black women, may raise the standards of cultural competence for clinicians and provide more successful treatment outcomes in working with this population. A case example illustrates the assiduity essential to practicing in a culturally competent manner. A client is presented from a traditional psychotherapeutic perspective and then viewed through a lens that integrates psychotherapeutic practice with conscious awareness of the mythology and stereotypes impacting Black women. Implications for culturally relevant practice are discussed.
Yaqoob, Usman; Bhandari, Sahitya; Cheripalli, Praveen; Tangella, Krishnarao; Khaliq, Waseem
Mastocytosis is a type of myeloproliferative neoplasm characterized by accumulation and proliferation of morphologically and immunophenotypically abnormal mast cells in 1 or more organ systems. Clinical manifestations vary depending upon the organ involved and chemical mediators released by mast cells along with constitutional symptoms and musculoskeletal complaints. We report a case of isolated bone marrow mastocytosis in an 87-year-old woman who presented with a fall resulting in proximal femur fracture. Bone marrow biopsy revealed mastocytosis, and no evidence of systemic involvement or peripheral mastocytosis was found. Physicians should be aware of this entity, especially in patients with osteoporosis.
de Carvalho, João Paulo Mancusi; Severo, Luciano Augusto de Carvalho; de Carvalho, Maria Helena Mancusi; Gomes, Mariano Tamura Vieira; Podgaec, Sergio
We report a case of uterine artery rupture in a woman at 14 weeks' gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin and to its distal uterine portion. The patient exhibited excellent postoperative recovery and was discharged two days after the surgery. The pregnancy continued without other maternal or fetal complications, and the patient delivered a healthy newborn via cesarean section at 39 weeks of gestation. PMID:27891272
Ikeda, Yuji; Oda, Katsutoshi; Matsuzawa, Naoki; Shimizu, Ken
Vaginal calculi are rarely encountered and are often misdiagnosed as bladder calculi because of the difficulty in achieving an appropriate diagnosis. Most vaginal calculi result from the presence of a urethrovaginal fistula; those occurring in the absence of such fistulas are extremely rare. We present a case of a 42-year-old bedridden woman with mental and physical disabilities who had been misdiagnosed for a decade as having a bladder calculus. We removed the calculus nonsurgically and the analyzed the components. Results demonstrated the presence of a primary vaginal calculus. Vaginal calculi may occasionally occur in disabled women, but further investigation of the etiology of such calculi is required.
Verkaeren, Emilienne; Epelboin, Loïc; Epelboin, Sylvie; Boddaert, Nathalie; Brossier, Florence; Caumes, Eric
Group A Streptococcus (GAS) is a well-known cause of vulvovaginitis in prepubescent girls, but it is rarely described in adult women. We describe the case of a 64-year-old woman who presented with endometritis revealed by GAS bacteraemia, followed by recurrent vulvovaginitis due to a wild-type strain of GAS. She relapsed twice despite amoxicillin treatment. Her husband was found to be an asymptomatic carrier after GAS was identified in nasal and rectal swabs. She was cured after eradication of carriage in both herself and her husband with amoxicillin and rifampin. When recurrent Streptococcus pyogenes genital infections occur, test and treat the partner.
Soydinc, Hatice Ender; Ozler, Ali; Evsen, Mehmet Sıddık; Sak, Muhammet Erdal; Basaranoglu, Serdar; Dusak, Abdurrahim; Cetincakmak, Mehmet Guli
Cerebral venous sinus thrombosis (CVST) is a rarely encountered condition during pregnancy. A 21-year-old pregnant woman with labour pains was hospitalized in our clinic. Diagnosis of severe preeclampsia was made based on her clinical and laboratory findings. She suffered from convulsive episodes during postpartum period which lead to initiation of treatment for eclampsia. However neurological and radiological examinations were performed after emergence of additional neurological symptoms disclosed the diagnosis of CVST. In this paper, we aimed to present a case with CVST which diagnosis was confused with eclampsia and resulting in maternal mortality. PMID:23509646
Barcellos, Bruno Mendonça; Loureiro, Fernanda Martins; Sampaio, Livia Fernandes; de Resende, Marco Antonio Cardoso
Aortic coarctation is a discrete narrowing of the proximal thoracic aorta. It is poorly tolerated during pregnancy because of its association with hypertension, cerebrovascular accident, and aortic rupture. We report a case of severe uncorrected congenital aortic coarctation in a 31-year-old symptomatic pregnant woman at 29 weeks of gestation who underwent successful cesarean delivery with an epidural anesthetic technique. Transthoracic echocardiography showed a gradient of 75 mm Hg. To avoid undiagnosed arterial hypotension and inadequate uteroplacental flow distal to the coarctation, double (radial and femoral) invasive arterial blood pressure measurement was used to monitor both pre- and postcoarctation arterial blood pressure.
Jalal, Zakaria; Iriart, Xavier; Thambo, Jean-Benoit
Aortic coarctation is thought to be a rare condition in patients with tetralogy of Fallot. We report the case of a 26 year old woman presenting with systemic hypertension at 17 weeks of pregnancy after repair of tetralogy of Fallot in childhood. Echocardiography and magnetic resonance imaging revealed right aortic arch with severe isthmic coarctation. Her blood pressure was controlled medically during the rest of her pregnancy, and delivery was uneventful. Successful transcatheter placement of a covered stent at the level of the coarctation was performed after delivery. To our knowledge, this is the first reported case of aortic coarctation diagnosed in an adult patient late after repair of tetralogy of Fallot.
Latham, Kerry P; Valerio, Ian; Martin, Barry D; Burget, Gary; VanderKolk, Craig
Military plastic surgeons perform reconstructive surgeries for various congenital, oncologic, and traumatic craniofacial injuries or deformities. Recently, our Walter Reed National Military Medical Center Plastic Surgery team was tasked to care for a woman who bravely sought a new and better life in the United States after she suffered amputation of her nose and bilateral ears while in her home country of Afghanistan. A military-civilian team collaborated throughout her reconstructive planning, treatment, and postoperative course to create both an aesthetically acceptable and functional subtotal nasal reconstruction. This case report details the patient's unique journey, her reconstructive course, and highlights her reintegration into a new life and society.
Seth, Anisha; Ghosh, Basudeb; Gupta, Anika; Goel, Neha
Neurofibromatosis type 1 (NF-1) is an autosomal dominantly inherited disease characterized by café-au-lait spots, neurofibromas, axillary freckling, Lisch nodules of iris, gliomas and various systemic vascular ischemic manifestations mainly in the aorta, brain and kidney. Retinal vascular manifestations in patients with NF-1 are usually representative of retinal capillary hemangiomatosis. Few cases of NF-1 with retinal vascular occlusive disease have been described. We describe a young Indian woman with NF-1 with unilateral peripheral retinal ischemia but no vascular abnormality at the posterior pole. PMID:26949362
Tsai, Po-Hsin; Chen, Hsi-Chung; Liao, Shih-Cheng; Tseng, Mei-Chih Meg; Lee, Ming-Been
We report the development of hyponatremia following initiation of escitalopram therapy in a 73-year-old woman. The patient, with a history of dementia with Lewy bodies, had presented with multiple neuropsychiatric symptoms. Within 2 months of escitalopram, she became delirious with a serum sodium level of 122 mmol/L. After discontinuation of escitalopram, her consciousness improved with resolving hyponatremia. Delirium and hyponatremia (122 mmol/L), however, recurred after escitalopram was rechallenged. Apart from eight other cases to date, this is the only one with recurrent hyponatremia. Rechallenge of the same antidepressant is discouraged especially in patients at risk of developing hyponatremia.
Vinnik, Yu S; Prusov, I A; Serova, E V; Shirokobokov, A O; Berdnikov, S I; Struzik, A S; Loginovsky, A S
Abdominal enterocele is a result of entering abdominal organs into peritoneal pockets and folds through the holes in mesenterium or into the adjoining cavities through defects in their walls. Enteroceles are localized at the sites where one segment of the gastrointestinal tract passes into another, in a pocket behind the cecum and sigmoid, between mesenteric layers of small intestine and colon, in the holes of mesenterium of vermiform appendage, gastrocolic and falciform ligaments, pockets and holes of broad ligament of the uterine, omental foramen, rectouterine excavation, and diaphragmal defects. We observed a 26 year old woman with enterocele entrapment in the abdominal cavity complicated by necrosis of part of the small intestine.
Penot, Pauline; Brichler, Ségolène; Guilleminot, Jean; Lascoux-Combe, Caroline; Taulera, Olivier; Gordien, Emmanuel; Leparc-Goffart, Isabelle; Molina, Jean-Michel
A woman with controlled HIV infection developed in late August 2016 a pruritic rash with fever and conjunctival hyperaemia after a trip to the French Caribbean islands. On day 3 after symptom onset, Zika virus RNA was detected in plasma, urine and vaginal samples with respective viral loads of 3.8, 6.1 and 5.3 log copies/mL. Notably, we demonstrated the presence of infectious Zika virus particles in the vaginal samples by isolation in cell culture. PMID:28128730
Safarik, Mark E; Wurtz, David G
As the investigation and prosecution of sexual homicide cases becomes increasing complex, law enforcement agencies are utilizing alternative avenues of investigative assistance. In 2004, the Oakland County, Michigan Sheriff's Office was faced with the horrific sexual assault and murder of an elderly woman. Although familiar with violent crime, this extremely violent and unusual case motivated the police to enlist the help of forensic scientists and FBI violent crime researchers to assist their investigation. This partnership led to the successful investigation and prosecution of the offender and serves as a model for law enforcement agencies willing to consider using additional available resources in order to successfully resolve unusual and extraordinarily violent sexual crimes.
Deng, Kathy; Nanda, Deepak
Chromosome 22q11.2 deletion syndrome, also known as DiGeorge or velocardiofacial syndrome, is associated with a wide spectrum of phenotypic features. It is known to be associated with severe macrothrombocytopenia. Postpartum hemorrhage is a leading cause of maternal morbidity and mortality globally. Chromosome 22q11.2 deletion syndrome is rare cause of thrombocytopenia that can be a significant risk factor for life-threatening postpartum hemorrhage. We report a case of postpartum hemorrhage in a woman with 22q11.2 deletion syndrome causing severe macrothrombocytopenia. PMID:27366335
Fex, G; Berntorp, K
An elevated level of serum aspartate aminotransferase (ASAT) activity in a subjectively healthy woman was shown to be due to circulating ASAT:IgG complexes. The complexes were demonstrated by taking advantage of the specific interaction between protein A and IgG. Thus, greater than 90% of the patient's ASAT activity in serum could be bound to protein A-Sepharose demonstrating that nearly all the patient's serum ASAT was complexed to IgG. The ASAT-binding capacity of patient serum was calculated as approximately 850 micrograms ASAT/l which corresponds to about 0.01% of patient's IgG.
Larsen, Christian; Jensen, Mogens Pfeiffer
A 35-year-old woman was acutely hospitalized with oedema of the upper limbs, reduced force, severe movement reduction and muscle pain in both upper extremities. Her symptoms started after three days of intense exercise doing kayaking and a lot of pull-ups in crossfit. Rhabdomyolysis is a syndrome, characterized by muscle necrosis. Usually there is a marked elevation of creatine kinase (CK) concentration with symptoms as described and myoglobinuria (dark coloured urine). After hard muscular work there will often be asymptomatic, but significant elevations in CK concentration, and in rare cases life-threatening rhabdomyolysis with electrolyte imbalances and acute kidney failure.
Kherad, Omar; Petriccioli, Nicole; Lobrinus, Johannes Alexander; Guerne, Pierre-André A.
Necrotizing autoimmune myopathy (NAM) is a rare subgroup of idiopathic inflammatory myopathies (IIM). This pathology usually affects proximal limb muscles and in some cases the myocardium. Patients usually display proximal limb weakness. Muscular biopsy is required to confirm the diagnosis. We report the case of a 64-year-old woman with an atypical first presentation of NAM, manifested by chest pain in the context of metastatic endometrial cancer. The diagnosis of NAM was however made when she returned a second time with proximal limb weakness. A treatment with prednisone was then initiated, to which rituximab was rapidly associated, beside a specific chemotherapy. PMID:28373922
Hamilton, R; Keenan, J P; Catala, M; Pascual-Leone, A
Recent functional imaging and neurophysiologic studies indicate that the occipital cortex may play a role in Braille reading in congenitally and early blind subjects. We report on a woman blind from birth who sustained bilateral occipital damage following an ischemic stroke. Prior to the stroke, the patient was a proficient Braille reader. Following the stroke, she was no longer able to read Braille yet her somatosensory perception appeared otherwise to be unchanged. This case supports the emerging evidence for the recruitment of striate and prestriate cortex for Braille reading in early blind subjects.
Shen, D Y; Guay, A T; Silverman, M L; Hybels, R L; Freidberg, S R
A 32-year-old woman with secondary amenorrhea was found to have an elevated level of serum prolactin, partial diabetes insipidus, and a subtle visual field defect. A primary intrasellar tumor was noted on the computed tomographic scan. Although the tumor had some characteristics of a prolactinoma, transsphenoidal exploration revealed a primary germinoma. The tissue diagnosis led to appropriate treatment with radiotherapy. The tumor regressed, and the patient had a spontaneous pregnancy. Had dopamine agonists been used initially, amelioration of the hyperprolactinemia and delay in the proper diagnosis and treatment would have occurred.
A 30-year-old woman with a history of smoking presented with abdominal pain and haematuria. On physical examination, she had a palpable pelvic mass. Imaging revealed a large pelvic mass located on the dome of the bladder, extending from the urachus, with pulmonary metastases. After open biopsy, urachal adenocarcinoma was histologically confirmed. The patient received six cycles of palliative chemotherapy combination 5 fluorouracil and irinotecan with complete response on the pelvic mass and partial response estimated to more than 80% on pulmonary metastasis. PMID:20062662
Gornowicz-Porowska, Justyna; Dmochowski, Marian; Pietkiewicz, Pawel; Bowszyc-Dmochowska, Monika
We describe a 39-year-old woman with an apparent captopril-induced, contact mucosal-dominant pemphigus vulgaris and angioedema, who took captopril during a bout of arterial hypertension. This exposure suggests that captopril and pathophysiology of angioedema stimulated the development of pemphigus vulgaris, which was diagnosed using the novel, indirect immunofluorescence BIOCHIP mosaic, with the modification to detect serum IgG4 autoantibodies. We discuss the patient, who experienced a chain of events leading to the active stage of pemphigus vulgaris, and review concepts of pemphigus vulgaris inducible by drugs and pathological immunity. PMID:26560224
Yun, Ju Sik; Kim, Do Wan; Choi, Yoo Duk; Na, Kook Joo; Song, Sang Yun
Mixed squamous cell and glandular papilloma of the lung is an extremely rare benign epithelial tumor showing a mixture of squamous and glandular epithelium. Here, we report a case of mixed squamous cell and glandular papilloma that presented as a solitary nodule in the left lower lobe of a 64-year-old woman. Chest computed tomography demonstrated a lobulated mass in the basal segment of the left lower lobe. The patient underwent a lobectomy under the suspicion of lung malignancy. The histopathological diagnosis was mixed squamous cell and glandular papilloma.
Tsai, Chang-Youh; Huo, An-Ping; Chou, Chung-Tei; Wu, Tsai-Hung; Tsai, Ying-Yang
A 46-year-old woman presented with chronic fluctuated liver function impairment, Raynaud's phenomenon, digital gangrene, pulmonary hypertension, and intense pruritus within a period of 2 years. Laboratory investigations revealed antinuclear antibodies, anticentromere antibodies (ACA), hypergammaglobulinemia, lymphocytic infiltration of the liver parenchyma, and mild cholangitis. The associated symptoms included thyroiditis, conjunctivitis sicca, xerostomia, and polyarthralgia. There was no conspicuous sclerodactyly, calcinosis, or dysphagia. The symptoms were relieved with intravenous, as well as oral, methylprednisolone. This constellation of presentations, including chronic autoimmune hepatitis with mild cholangitis and pulmonary hypertension, suggested that the presence of serum ACA might indicate relentless visceral organ damage.
Beber, E; Cooper, S A
Many antipsychotic and antidepressant drugs can precipitate life-threatening porphyric crisis in individuals with the underlying condition. However, when people with porphyria develop mental illness, they require treatment in order to maintain their quality of life. For this reason, although the condition is rare, psychiatrists need information regarding the safety profile of psychotropic drugs when used in people with porphyria. This case report describes the safe use of fluoxetine to treat depression in a woman with severe learning disabilities and porphyria, who failed to respond to non-pharmacological approaches.
Sadeghifar, Amir R; Heshmati, Afshin Ahmadzadeh
Dysplasia epiphysealis hemimelica is a rare nonhereditary epiphyseal disease that mimics synovial chondromatosis and osteochondroma of the joints. The disease mainly involves long bones of the lower extremities and tarsal bones. Herein we report 21-year old woman who presented with pain and limited range of ankle motion, who underwent surgical excision of talus exostosis after preoperative imaging and careful planning. after that she was discharged and her problem improved and she have no problem in three year follow up. pathologic examination of specimen confirm the diagnosis. PMID:25207317
Romiopoulos, Iordanis; Pyrpasopoulou, Athina; Varouktsi, Anna; Simoulidou, Elisavet; Kontopoulou, Konstantina; Karantani, Ekaterini; Georgopoulou, Vivian; Kitsios, Konstantinos; Mamopoulos, Apostolos; Antachopoulos, Charalampos; Karagiannis, Asterios
We present a case of previously healthy, immunocompetent, 41-year-old woman who developed systemic inflammatory response syndrome secondary to Neisseria gonorrhoeae bacteremia. Clinical course was complicated by the simultaneous formation of multiple muscular abscesses, epidural abscess, and septic spondylodiscitis. The patient responded well to prolonged ceftriaxone treatment and was released 10 weeks after initial admission. Spinal lesions and/or pyomyositis individually constitute rare complications of disseminated gonococcal infection. This case, combining both manifestations, is to our knowledge unique. Apropos, diversity of the clinical presentation, and therapeutic challenges for this historical disease are discussed for the practicing physician. PMID:28116187
Nguyen, Lan T; Schelbert, Erik B; Cook, Stephen C
Takotsubo cardiomyopathy is a reversible form of cardiomyopathy rarely reported in the adult congenital patient. We describe a case of a 49-year-old woman with repaired tetralogy of Fallot who presented with acute dyspnea. A 12-lead electrocardiogram revealed diffuse anterolateral T-wave inversion suggestive of myocardial ischemia. Cardiac catheterization was performed, demonstrating angiographically normal coronary arteries. A cardiovascular magnetic resonance examination showed apical akinesis with associated myocardial edema, but no myocardial damage on late gadolinium enhancement imaging, which is a characteristic of Takotsubo cardiomyopathy. The patient was treated medically. A follow-up echocardiogram demonstrated normalization of left ventricular systolic function and apical wall motion abnormalities.
John Cleland's 1740s pornographic novel, Memoirs of a Woman of Pleasure repeatedly depicts and eroticises the act of defloration. As such it is a revealing illustration of what Ivan Bloch termed the 'defloration mania' of the eighteenth century. This article maps narrative events on to contemporary medical depictions of first intercourse to show the ways that the theories and ideas presented in medical and pseudo-medical texts transferred into erotic fiction and demonstrates how in some instances the bloody defloration scenes can be read as being sex during menstruation, an act which was culturally forbidden at this time.
Gupta, S.; Radotra, B. D.; Kumar, B.
A 21 year old woman presented with multiple lobulated lesions on the labia majora. The surface of most of the lesions was ulcerated revealing a glistening surface. All lesions were excised. The histopathology revealed features suggestive of lobular capillary haemangioma (pyogenic granuloma). Pyogenic granuloma is considered as a reactive hyperproliferative vascular response to trauma or other stimuli. A literature search revealed reports of a few cases of lobular capillary haemangioma of the glans penis but not on the female genitalia. This case is presented to help physicians become aware that lobular capillary haemangiomas (pyogenic granuloma) may occur at this site. Key Words: pyogenic granuloma; vulva PMID:10817071
Sun, Chyng; Ezzell, Matthew B; Kendall, Olivia
Based on in-depth interviews with 16 heterosexual men, this study focuses on participants' meaning-making surrounding a common and controversial sexual act in pornography: ejaculation on a woman's face (EOWF). We analyze the ways that male consumers decoded EOWF and the ways that EOWF, as a sexual script, was included in the men's accounts of their sexual desires and practices. The majority of the men decoded EOWF through the preferred (encoded) meaning as an act of male dominance and sexual aggression and that they wanted to engage in it despite their general belief that women would not be interested in it.
Singh, Remmi; Rosen, Seymour
Wegener granulomatosis may rarely present with tumor masses that are in areas not typically involved by the disease. Although some cases have an associated positive anti-neutrophilic cytoplasmic antibodies, other cases do not, especially those of the limited form. To prevent misdiagnosis and ensure prompt treatment, it is extremely important to consider Wegener granulomatosis even in cases without the classic clinical findings. We report a case of a 19-year-old woman with no prior significant medical history who presented with persistent ventricular tachycardia and a papillary muscle mass in her left ventricle which upon excision and tissue evaluation demonstrated histologic changes of Wegener granulomatosis.
Gornowicz-Porowska, Justyna; Dmochowski, Marian; Pietkiewicz, Pawel; Bowszyc-Dmochowska, Monika
We describe a 39-year-old woman with an apparent captopril-induced, contact mucosal-dominant pemphigus vulgaris and angioedema, who took captopril during a bout of arterial hypertension. This exposure suggests that captopril and pathophysiology of angioedema stimulated the development of pemphigus vulgaris, which was diagnosed using the novel, indirect immunofluorescence BIOCHIP mosaic, with the modification to detect serum IgG4 autoantibodies. We discuss the patient, who experienced a chain of events leading to the active stage of pemphigus vulgaris, and review concepts of pemphigus vulgaris inducible by drugs and pathological immunity.
Anastasilakis, Athanasios D; Savvides, Mattheos; Polyzos, Stergios A; Georgopoulos, Christos; Delaroudis, Sideris
Intermittent exogenous parathyroid hormone (PTH) is a potent osteoanabolic agent used for the treatment of severe osteoporosis. Two molecules of recombinant PTH are commercially available: the full-length PTH (PTH 1-84) and teriparatide (PTH 1-34). We present the first report of PTH-induced mild, asymptomatic, normochromic normocytic anemia in a postmenopausal woman treated sequentially with PTH 1-84 and PTH 1-34. Anemia was more pronounced with PTH 1-84 compared to PTH 1-34 and was reversed with each regimen discontinuation. We suggest monitoring of hematocrit and hemoglobin in PTH-treated patients, especially when PTH 1-84 is used.
A 73-year-old woman presented with a six-day history of abdominal pain that had started in the epigastrium, but recently had become more intense in the right lower quadrant. Peptic ulcer had been diagnosed three years prior to presentation and had been managed medically. On physical examination, epigastric tenderness as well as guarding and rebound tenderness in the right lower quandrant were present. Mild leukocytosis was reported. Computed tomography demonstrated a 5-cm retrocecal mass with low attenuation (fluid content) surrounded by an irregularly thickened uncalcified wall. Multiple areas of tissue debris were seen extending into the mass, but no true separation was present.
Olmes, David G; Agaimy, Abbas; Kloska, Stephan; Linker, Ralf A
An 80-year-old woman presented with weight loss, fatigue, dizziness and a brain stem lesion. Extensive work-up revealed lymphomatoid granulomatosis (LYG) with primary clinical manifestation in the central nervous system (CNS), a rare Epstein-Barr virus-driven multisystem lymphoproliferative disorder, to be causative for the symptoms. Immunochemotherapy consisting of rituximab and temozolomide was started, but the disease progressed and the patient subsequently died. Histology, diagnostic criteria, differential diagnosis and treatment options for LYG with CNS involvement are discussed. This case demonstrates that LYG with CNS involvement may necessitate more aggressive treatment approaches than combination therapy with rituximab and temozolomide. PMID:25535225
Tan, Shu-Qi; Lim, Jason Shau Khng; Tan, Yin Ru; Tan, Hak Koon
Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient’s delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature. PMID:25631977
Otani, S; Usuki, S; Iwasaki, H; Inoue, S; Yamashita, K
A hyperprolactinemic infertile woman with a pituitary microadenoma, who was resistant to bromocriptine as a method of bringing on pregnancy, succeeded in having a normal pregnancy and delivery with Hachimi-jio-gan treatment. This paper reports that the patient did not succeed in pregnancy in spite of 16 months of bromocriptine treatment, though her prolactin level gradually decreased and continued to be between 40-60 ng/ml with Hachimi-jio-gan treatment. Although the level of prolactin of the patient did not normalize, she, nevertheless, succeeded in having a normal pregnancy and delivery.
Klein, J; Kern, W; Fehm, H L
A 75-year-old woman presented with general fatigue progressing to somnolence. Laboratory tests showed marked hyponatremia. TSH in the normal range, but low levels of free T3 and free T4. Evaluation of pituitary hormones and magnetic resonance imaging of the pituitary unmasked findings characteristic for hypophysitis with secondary adrenal insufficiency and secondary hypothyroidism. Hormonal substitution with hydrocortisone and levothyroxine resulted in rapid improvement of all symptoms and signs. Without additional treatment shrinkage of the pituitary gland could be documented. Our report extends the known clinical and pathological spectrum of hypophysitis and illustrates the need to include this uncommon entity in the differential diagnosis of hyponatremia even in elderly patients.
Althomali, Sarah Ali; Alzubaidi, Lamya Mohammed; Alkhaldi, Dhelal Musleh
Lice feed on human blood, and heavy and chronic lice infestation can lead to chronic blood loss with resultant iron deficiency anaemia. Although no definite relationship between lice infestation and iron deficiency anaemia has been described, the concurrent presence of these two conditions has been reported in children and adults, as well as in cattle. We present a case of a young woman with severe iron deficiency anaemia that could not be explained by the known causes of iron deficiency anaemia. However, the patient was found to have heavy and chronic head lice infestation.
Ansó, M; Veiga-Gil, L; De Carlos, J; Hualde, A; Pérez-Cajaraville, J
We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. When the patient was admitted for labor, an epidural catheter was placed successfully. The patient had a normal vaginal delivery. Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled. The baby continues to develop normally three years after delivery.
Kim, Tae-Hee; Kim, Soo Ah; Heo, Gyeong-Eun
Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to lifethreatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Employing a multidisciplinary team approach to care for vulvar cellulitis and abscess can guide treatment from antibiotic therapies to more aggressive surgical debridement. In this report, we describe a case of vulvar abscess caused by Methicillin-resistant staphylococcus aureus (MRSA) in a postmenopausal woman with underlying diseases of bronchiectasis and atelectasis. PMID:27617247
Bencharif, Sarah; Leung, Lawrence
Premature ventricular complexes (PVCs) are common findings in asymptomatic participants during ECG recordings. While most PVCs are treated conservatively, some patients may develop adverse cardiac events needing further investigations and definitive ablation by radiofrequency. Spectral strain ultrasonography has demonstrated ventricular dysfunction as a sequel to high burden PVCs, but the exact underlying pathophysiology is still uncertain. Cohort studies have associated PVCs with increased risks for overall cardiovascular morbidity and mortality, and yet consensus is still lacking for threshold in treating PVCs. Our case is that of a 54-year-old woman with an unusual bradycardiac presentation of PVCs and an ECG that changed rapidly within minutes. PMID:25827918
Antón Capitán, B; Malillos Torán, M
Low back pain during pregnancy is a common cause of medical consultation. Although back pain is very common, the incidence of low back pain secondary to lumbar disk herniation in pregnancy is low (1: 10,000). Cauda equina syndrome from lumbar disk herniation is a serious complication. The delay in diagnosis and treatment can be a cause of chronic disability secondary to neurological sequelae. Numerous cases of disk herniation in pregnancy have been reported, however the association of a cauda equina syndrome as a result of disk herniation is rare. A case is presented of cauda equina syndrome in a pregnant woman at 12-week gestation.
Fornet, I; Palacio, F J; López, M A; Morillas, P; Ortiz-Gómez, J R
Malaria infection during pregnancy is a serious health problem in most of the world's tropical regions. The disease has also been imported into Western countries, however, as an increasing number of infected women, who may become pregnant, emigrate from areas where malaria is endemic. Infection during pregnancy can have serious repercussions for both mother and fetus. Early diagnosis and multidisciplinary management are essential. We report the case of a woman from Guinea who debuted with severe, acute blood-stage malaria in the 32nd week of pregnancy and was admitted to the recovery care unit.
Hasdemir, Can; Musayev, Oktay; Alkan, Mustafa B; Can, Levent H; Kultursay, Hakan
A 34-year-old pregnant woman presented to the emergency department with the complaints of palpitations at 32 weeks gestation. The diagnosis of right ventricular outflow tract ventricular tachycardia (VT) was made. Intravenous 5 mg of metoprolol and 25 mg of diltiazem did not terminate the VT. Ten milligrams of adenosine were administered. Within 10 s of adenosine administration, sustained VT converted to repetitive monomorphic VT and within 30 s to normal sinus rhythm. The mother and the foetus tolerated the medications well. Non-stress test for the assessment of the foetal well-being was normal.
Choi, Ju Hee; Kim, Kyoung Jin; Lee, Ye Jin; Kim, Sun Hwa; Kim, Sin Gon; Jung, Kwang Yoon; Choi, Dong Seop
A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients. PMID:26354493
Iwata, Kentaro; Toma, Tomoko; Yachie, Akihiro
A 38-year-old woman presented with 2 days history of left-flank pain. She had similar episodes of abdominal pain as well as chest pain several times, but symptoms disappeared spontaneously. Each time she developed pain, there was no fever. After ruling out common causes of recurrent abdominal pain, familial Mediterranean fever (FMF) was considered as a potential diagnosis. Genetic tests revealed multiple heterozygote mutations, which may be associated with FMF. Patients with Mediterranean fever mutations may present with atypical presentations without fever, like in this case. Astute clinical suspicion is required to make an accurate diagnosis. PMID:22505824
Chabowski, Mariusz; Janczak, Dawid; Dorobisz, Tadeusz; Leśniak, Michał; Jeleń, Michal; Janczak, Dariusz
The article presents the rare case of a 64-year-old woman, who was admitted to our thoracic surgery department with a giant tumor in a right hemithorax measuring 88 mm × 137 mm × 188 mm, revealed by a thoracic CT scan. An anterolateral thoracotomy with a radical tumor resection was performed. The final pathological diagnosis of the poorly differentiated synovial sarcoma (PDSS) was made. The adjuvant radiotherapy of 60 Gy in 30 fractions was applied postoperatively. One year after operation patient remains in good health. The literature review on pleural synovial sarcoma has been shortly presented. PMID:27747031
Hartman, Joshua; Protano, Marion-Anna; Jaffin, Barry
A 67-year-old woman with a 15-year history of intestinal scleroderma presented with recurrent melena. Upper endoscopies revealed a healing, non-bleeding, large gastric ulcer. After the third bleed, angiography demonstrated bleeding from a splenic artery pseudoaneurysm adjacent to the gastric ulcer. Scleroderma patients are at risk of bleeding from esophagitis or gastric arteriovenous malformations, while splenic artery pseudoaneurysms are primarily attributed to pancreatitis and trauma. This is the first reported case of gastrointestinal bleeding from a splenic artery pseudoaneurysm in a patient with intestinal scleroderma and a large gastric ulcer.
Kern, L; Carberry, N; Haidara, C
A functional analysis was conducted with a young woman who engaged in both self-injury and aggression. Self-injury functioned to access preferred stimuli while aggression served an escape function. Intervention, a package consisting of gradually increasing the delay to reinforcement (access or escape), mand training, and extinction was effective for decreasing self-injury. However, this intervention was less effective in reducing aggression. A modification of the intervention, in which the gradual delay procedure was eliminated, resulted in reductions in aggression. The findings are discussed in the context of assessment and intervention selection with individuals who engage in multiple topographies of challenging behavior.
Rezaieyazdi, Zahra; Sharifi-Doloui, Davood; Hashemzadeh, Kamila; Shirdel, Abbas; Mansouritorghabeh, Hassan
Acquired haemophilia A, secondary to systemic lupus erythematosus (SLE) is a rare bleeding diathesis. Here we report a 37-year-old woman with autoimmune hepatitis who developed SLE and acquired haemophilia caused by factor VIII inhibitors. She presented with spontaneous ecchymosis and haematuria. There were a prolongation of the activated partial thromboplastin time, reduced factor VIII activity and a high titer of FVIII inhibitors. Therapeutic regimen was started with intravenous methylprednisolone pulse, continued with prednisolone, intravenous pulse cyclophosphamide and fresh frozen plasma. After 8 weeks, factor VIII inhibitor assay was negative.
Rezaieyazdi, Zahra; Sharifi-Doloui, Davood; Hashemzadeh, Kamila; Shirdel, Abbas; Mansouritorghabeh, Hassan
Acquired haemophilia A, secondary to systemic lupus erythematosus (SLE), is a rare bleeding diathesis. Here we report a 37-year-old woman with autoimmune hepatitis who developed SLE and acquired haemophilia caused by factor VIII (fVIII) inhibitors. She presented with spontaneous ecchymosis and haematuria. There were a prolongation of the activated partial thromboplastin time, reduced fVIII activity and a high titre of fVIII inhibitors. Therapeutic regimen was started with intravenous methylprednisolone pulse, continued with prednisolone, intravenous pulse cyclophosphamide and fresh frozen plasma. After 8 weeks, fVIII inhibitor assay was negative.
Santos, V M; Castro, R A; Lima, C C; Moraes, M B; Sugai, T A M
Antibiotic and non-antibiotic sulphonamides are often prescribed. Although chemical differences make cross-reactivity rare, reactions may be severe in patients allergic to sulphur. Adverse reactions are common with sulphonamides but low platelets and skin changes are rarely associated with eye-drops for glaucoma. A woman treated with dorzolamide and timolol presented with disseminated eruption. On admission, her physical examination was unremarkable except for the skin changes and severe thrombocytopaenia was detected. Skin biopsy showed hyperkeratosis, acanthosis, perivascular and periadnexal infiltrates with no vasculitis. After discontinuation of eye-drops, the eruption improved but low platelets persisted. Skin changes reappeared with use of dapsone which suggested sulphonamide cross-reactivity.
Serpytis, Pranas; Kibarskis, Aleksandras; Katkus, Rimgaudas; Samalavicius, Robertas; Glaveskaite, Sigita; Rackauskas, Gediminas
Therapeutic hypothermia is method used to improve the neurological status of patients who are at risk of ischaemia after myocardial infarction. We report a case of a 28-year-old woman who suffered acute myocardial infarction complicated by ventricular fibrillation. The patient was successfully resuscitated. Invasive and non-invasive medical treatment was applied including therapeutic hypothermia. Success was achieved due to adequate public reaction, fast transportation, blood vessel revascularization and application of therapeutic hypothermia. The patient was successfully discharged after one week of treatment, and just minor changes in heart function were present. PMID:24570755
Niknam, Ramin; Kazemi, Mohammad Hassan; Mahmoudi, Laleh
Fasciola hepatica (F. hepatica) as a foodborne trematode can occasionally cause hepatobiliary diseases. We report a 67-year-old woman who was referred to our center because of the diagnosis of cholangitis. She was a resident of mountainous area with the history of unsafe water and contaminated vegetables. Endoscopic retrograde cholangiopancreatography (ERCP) was performed as a diagnostic and therapeutic modality for her. Three living F. hepatica was removed from biliary tract with a basket via ERCP. Clinical and laboratory condition of the patient improved after therapy of antibiotics and triclabendazole. PMID:26379355
Wright, Natalie A; Cohen, Philip R
Fixed drug eruption, a medication-associated mucocutaneous reaction, rarely presents as a delayed adverse reaction to intravenous non-ionic contrast media. We describe a 57-year-old woman with a history of metastatic renal cell carcinoma who repeatedly developed a sharply demarcated, erythematous patch on her left breast after receiving the iodinated non-ionic contrast media iohexol for staging computed tomography scans. Recurrent fixed drug eruption may be avoided by using another contrast medium. Prophylactic treatment with systemic corticosteroids may prevent repeated fixed drug eruption if an alternative contrast agent cannot be used.
Tan, Shu-Qi; Lim, Jason Shau Khng; Tan, Yin Ru; Tan, Hak Koon
Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient's delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature.
Park, Sung Hee; Choi, Seung Joon; Jung, Hyun Kyung
Sclerosing lymphocytic lobulitis (SLL) is a rare inflammatory disorder, which is also known as fibrous mastopathy and lymphocytic mastitis. It is commonly associated with autoimmune disorders, particularly type 1 diabetes and thyroiditis. We report the case of a 28-year-old woman diagnosed as SLL with Hashimoto's thyroiditis, but without diabetes. She presented suspicious microcalcifications without palpable mass in routine mammograms in both breasts. She had been diagnosed as Hashimoto's thyroiditis several years before and had been followed up in endo-clinics.
Ueda, Takashi; Nozoe, Masahiko; Nakamoto, Yasuhisa; Irie, Yoshikazu; Mizushige, Katsufumi
There are few case reports regarding patients with right lung agenesis living to old age because of both severe mediastinal and cardiac displacements. We report a 61-year-old woman with right pulmonary agenesis complicated by a transient ischemic attack that was evaluated by a three-dimensional reconstruction of helical computed tomography and an echocardiography. This patient was able to survive until old age because she had no critical anomalies in other organs including the heart. A mitral valve prolapse was detected by a two-dimensional echocardiography and we treated her with anti-platelet aggregation therapy for the prevention of recurrent stroke.
Mirra, Marco; Kola, Nertil; Mattiello, Giacomo; Morisco, Carmine; Spinelli, Letizia
Polycystic ovarian syndrome (PCOS) affects 4% to 12% of women in reproductive age, representing a clinical condition that could predispose to cardiovascular diseases. We report a case of a 34-year-old woman with PCOS, presenting with chest pain, onset two days before, and ST segment-elevation myocardial infarction. She was not pregnant or in a postpartum state. Subsequent cardiac angiography revealed spontaneous left anterior descending coronary artery dissections, managed by conservative approach. The patient was discharged in medical therapy after 5days. This is the first observation of spontaneous coronary artery dissection occurring in a PCOS patient.
Woods, Gina N; Saitman, Alec; Gao, Hanlin; Clarke, Nigel J; Fitzgerald, Robert L; Chi, Nai-Wen
The CYP24A1 gene encodes a mitochondrial 24-hydroxylase that inactivates 1,25(OH)2 D. Loss-of-function mutations in CYP24A1 cause hypercalcemia, nephrolithiasis and nephrocalcinosis. We describe a woman with CYP24A1 deficiency and recurrent gestational hypercalcemia. Her first pregnancy, at age 20, resulted with the intrauterine demise of twin fetuses. Postpartum, she developed severe hypercalcemia (14 mg/dL), altered mental status, and acute pancreatitis. Her PTH was suppressed (6 pg/mL) and her 1,25(OH)2 D was elevated (165 and 195 pg/mL on postpartum day 1 and 5, respectively). Between one and three months postpartum, her serum calcium decreased from 11.4 to 10.2 mg/dL while her 1,25(OH)2 D level decreased from 83 to 24 pg/mL. Her 24-hour urine calcium was 277 mg. Six months postpartum, she became pregnant again. At 14 weeks, her albumin-corrected calcium level was 10.4 mg/dL and her 1,25(OH)2 D level exceeded 200 pg/mL. To establish the diagnosis of CYP24A1 deficiency, we showed her 24,25(OH)2 D level to be undetectable (<2 ng/mL). Exon sequencing of the CYP24A1 gene revealed a homozygous, 8-nucleotide deletion in exon 8, causing an S334V substitution and premature termination due to a frame shift (c.999_1006del, p.Ser334Valfs*9). To prevent hypercalcemia, she was advised to discontinue prenatal vitamins, avoid sun exposure and calcium-rich foods, and start omeprazole and a calcium binder (250 mg K-Phos-neutral with meals). Despite these measures, both hypercalcemia (11.5 mg/dL) and acute pancreatitis recurred. Labor was induced and a healthy, normocalcemic boy was delivered. In the absence of lactation, maternal hypercalcemia resolved within 2 months. This report shows that CYP24A1-deficient subjects may be normocalcemic at baseline. Hypercalcemia may be unmasked by pregnancy through the routine use of calciferol-containing prenatal vitamins, increased 1-alpha hydroxylation of VitD by the placenta and maternal kidney, and production of
Sorrentino, Jasmin; Augoustinos, Martha
Former Prime Minister Julia Gillard's speech in the Australian parliament on sexism and misogyny received considerable public attention and controversy. However, less attention has been paid to how Gillard attended and oriented to issues related to her status as a woman during the period between her elevation to the position of Prime Minister in June 2010 and the delivery of the misogyny speech in October 2012. Using a discursive psychological approach, this article examines a corpus of interview transcripts in which gender was occasioned both explicitly and implicitly by speakers, thus requiring Gillard to attend to her gender identity. The analysis demonstrates that far from making gender a salient and relevant membership category, Gillard worked strategically to mitigate her gender as merely inconsequential to her role as Prime Minister. These findings are discussed in relation to existing research examining how gender is oriented to, negotiated, and resisted in talk to accomplish social actions, and more specifically what may be at stake for women in leadership positions who explicitly orient to gender as an identity category.
Groundwater resources of the Hanging Woman Creek basin, Montana include Holocene and Pleistocene alluvial aquifers and sandstone , coal, and clinker aquifers in the Paleocene Fort Union Formation. Surface water resources are composed of Hanging Woman Creek, its tributaries, and small stock ponds. Dissolved-solids concentrations in groundwater ranged from 200 to 11,00 mg/L. Generally, concentrations were largest in alluvial aquifers and smallest in clinker aquifers. Near its mouth, Hanging Woman Creek had a median concentration of about 1,800 mg/L. Mining of the 20-foot to 35-foot-thick Anderson coal bed and 3-foot to 16-foot thick Dietz coal bed could increase dissolved-solids concentrations in shallow aquifers and in Hanging Woman Creek because of leaching of soluble minerals from mine spoils. Analysis of saturated-paste extracts from 158 overburden samples indicated that water moving through mine spoils would have a median increase in dissolved-solids concentration of about 3,700 mg/L, resulting in an additional dissolved-solids load to Hanging Woman Creek of about 3.0 tons/day. Hanging Woman Creek near Birney could have an annual post-mining dissolved-solids load of 3,415 tons at median discharge, a 47% increase from pre-mining conditions load. Post-mining concentrations of dissolved solids, at median discharge, could range from 2,380 mg/L in March to 3,940 mg/L in August, compared to mean pre-mining concentrations that ranged from 1,700 mg/L in July, November, and December to 2,060 mg/L in May. Post-mining concentrations and loads in Hanging Woman Creek would be smaller if a smaller area were mined. (USGS)
Groundwater resources of the Hanging Woman Creek basin, Montana include Holocene and Pleistocene alluvial aquifers and sandstone, coal, and clinker aquifers in the Paleocene Fort Union Formation. Surface water resources are composed of Hanging Woman Creek, its tributaries, and small stock ponds. Dissolved-solids concentrations in groundwater ranged from 200 to 11,000 mg/L. Analysis of saturated-paste extracts from 158 overburden samples indicated that water moving through mine spoils would have a median increase in dissolved-solids concentration of about 3,700 mg/L, resulting in an additional dissolved-solids load to Hanging Woman Creek of about 3.0 tons/day. Hanging Woman Creek near Birney could have an annual post-mining dissolved-solids load to Hanging Woman Creek of about 3.0 tons/day. Hanging Woman Creek near Birney could have an annual post-mining dissolved-solids load of 3,415 tons at median discharge, a 47% increase from pre-mining conditions load. Post-mining concentrations of dissolved solids, at median discharge, could range from 2,380 mg/L in March to 3,940 mg/L in August, compared to mean pre-mining concentrations that ranged from 1,700 mg/L in July, November, and December to 2,060 mg/L in May. Post-mining concentrations and loads in Hanging Woman Creek would be smaller if a smaller area were mined. 56 refs., 9 figs., 14 tabs.
Cervantes, M; Ruelas, R; Alcalá, V
The presence of electroencephalographic signs of "relaxation behavior"; i.e., groups of synchronic, 6-10 Hz, 100-150 microV EEG waves mainly appearing in parieto-occipital regions, have been investigated in a nursing woman during breast-feeding. EEG was recorded once a week from right and left frontal-central, central-parietal, parietal-temporal and parietal-occipital derivations of the mother during breast-feeding of her own child throughout 16 weeks of nursing (from the 4th to the 20th week after delivery). Groups of synchronic 6-10 Hz, 100-150 microV EEG waves were recorded in central-parietal and parietal-temporal derivations, 15-80 sec after starting of suckling of either breast. Proportions of this synchronic EEG activity ranged between 5 to 28% in the central-parietal and 6 to 22% in the parietal-temporal derivations, and significantly higher proportions were found in the right hemisphere. Similarities between EEG signs of "relaxation behavior" elicited by suckling in nursing cats and those elicited by suckling in a nursing woman lead to the possibility that the above described EEG phenomena are an expression of a functional state of the central nervous system which is a part of the integral response involved in the consummatory activity of nursing behavior in women.
Kolarski, Milenko; Joksić, Gordana; Beres, Maja; Krstić, Aleksandar; Joksić, Ivana; Dobrojević, Boris; Nikić, Slavko
We report the first case of Pallister-Killian syndrome diagnosed prenatally in Western Balkan region where one of the ultrasound markers was intrauterine growth restriction. During routine ultrasound control of the pregnancy at 21st gestation week (second pregnancy of the 25 year old woman) symmetrical intrauterine growth restriction (IUGR), short long bones, ventriculomegaly and oligoamnion were noted. Amniotic fluid was examined cytogenetically. Fetal karyotype obtained by GTG banding of amniocytes revealed mosaic female karyotype 46,XX/47,XX,+mar (F-like). C-banding indicated that F-like marker does not belong to F, E or G chromosomal group. Employing targeted FISH with arm-specific probe for chromosome 12, tetrasomy 12p was confirmed. Fetal lymphocytes revealed normal female karyotype. This case showed that i(12p) could be found in pregnancy of young woman, not only in those of advanced age, as usually reported in the literature. This case also showed that intrauterine growth restriction could be one of the ultrasound markers associated with Pallister-Killian syndrome.
Monié, Marguerite; Drieux, Laurence; Nzili, Bernadette; Dicko, Michèle; Goursot, Catherine; Greffard, Sandrine; Decré, Dominique; Mézière, Anthony
Klebsiella pneumoniae necrotizing fasciitis is a rare infection in regions outside of Asia. Here, we present a case of necrotizing fasciitis of the leg caused by K. pneumoniae in a 92-year-old French woman hospitalized in a geriatric rehabilitation unit. The patient initially presented with dermohypodermitis of the leg that developed from a dirty wound following a fall. A few hours later, this painful injury extended to the entire lower limb, with purplish discoloration of the skin, bullae, and necrosis. Septic shock rapidly appeared and the patient died 9 hours after the onset of symptoms. The patient was Caucasian, with no history of travel to Asia or any underlying disease. Computed tomography revealed no infectious metastatic loci. Blood cultures showed growth of capsular serotype K2 K. pneumoniae strains with virulence factors RmpA, yersiniabactin and aerobactin. This rare and fatal case of necrotizing fasciitis caused by a virulent strain of K. pneumoniae occurred in a hospitalized elderly woman without risk factors. Clinicians and geriatricians in particular should be aware of this important albeit unusual differential diagnosis.
The TV series, Brothers & Sisters, broadcast from 2006 to 2011 by ABC (USA) and a year later by Channel 4 (UK) with quite high audience rates, starts when the patriarchal figure, William Walker, dies of a heart attack and two female figures around their sixties come center stage: his wife, Nora Walker, and his long-term lover, Holly Harper. Once the patriarchal figure disappears, the female characters regain visibility by entering the labor market and starting relationships with other men. In that sense, both protagonists experience aging as a time in which they are increasingly freed from social and family constraints. However, their roles as nurturers keep on bringing them back to the domestic space in which they are safe from being involved in uncomfortable and unsuitable situations. Drawing on previous studies on the representation of the older woman in fictional media, this article intends to discern to what extent stereotypes related to the older woman are challenged through the two main protagonists of a contemporary TV series.
Chapman, David; Gori, Gigliola
Edmondo De Amicis (1843-1908) was one of Italy's most popular writers, and perhaps more than any other figure in post-Risorgimento Italy, he reflected the common hopes, dreams and prejudices of his countrymen. De Amicis was particularly interested in gymnastics and physical education, and he wrote about them frequently. His most famous work on these subjects is his novella Amore e ginnastica [Love and Gymnastics] (1892) which explores female fitness, sexual stereotypes and gender roles in nineteenth-century Italy. This opus, along with two others (a lecture and a magazine article), can help modern readers understand the role of female sport and gender expectations in post-Risorgimento Italy. In addition to exploring women's gymnastics, De Amicis was also interested in female mountain climbing. By examining the activities and physical appearance of lady mountaineers, the author reveals his personal criteria for the perfect woman. When these are combined with the gymnasts in the earlier work, we can distill the writer's own particular attitudes toward gender and female perfection. For De Amicis a woman was required to be athletic, beautiful, modest, faithful, loving and with just a soupon of uncertainty about her sexuality to make her interesting.
Arikan, Deniz Cemgil; Kiran, Gurkan; Sayar, Hamide; Kostu, Bulent; Coskun, Ayhan; Kiran, Hakan
Introduction. Although pyogenic granulomas (PG) are common and benign vascular proliferations of the skin and mucous membranes, they are relatively rare on the vulva. Case Presentation. A 57-year-old G7P7 postmenopausal woman presented with a 3-year history of a foul smell and bleeding lesions in the genital region. A gynecologic examination revealed multiple large papillomatous, pedunculated, and lobulated lesions that were cherry-red and infective in appearance. There was a 2-cm lesion at the upper intersection of the labia majora, a 2-cm lesion on the right labium majus, and a 4-cm lesion on the clitoris. The patient complained of itching, and the lesions were asymptomatic, except for occasional bleeding. All lesions were excised and sent for histopathological examination, which revealed an ulcerated polypoidal structure with extensive proliferation of vascular channels lined by a single layer of endothelium. The histopathological features were consistent with PG. Conclusion. The present case is the first case of multiple pyogenic granulomas on the vulva in a postmenopausal woman. PMID:21912553
Roberts, Leissa; Gulliver, Brenda; Fisher, Janet; Cloyes, Kristin G
The documentation of pain in the labor and delivery setting is one of the essential tasks of all health care providers who care for women in labor. The Joint Commission standards mandate regular pain assessments, but compliance with this mandate in the highly unique patient population of laboring woman is problematic when using the standard 0 to 10 Numeric Rating Scale. Labor pain is always unique given the various contributing physiologic, emotional, social, and cultural components. This article describes the work of a process improvement group to create an alternative pain assessment tool named the Coping With Labor Algorithm. The group, consisting of nurses and nurse-midwives, used the FOCUS format and Deming's "Plan, Do, Check, and Act" cycle to create a formalized assessment tool for use with laboring women. The Coping With Labor Algorithm is currently in use in the labor unit of a large tertiary care facility, which successfully passed a Joint Commission inspection while using the coping algorithm. The value of the coping algorithm is two-fold: it provides a mechanism for pain documentation, and it provides nursing care suggestions for the laboring woman. This article reports nurses' perceptions of the tool.
Summary A previously healthy 32-year-old woman developed cyclical mood swings after being prescribed cabergoline for a pituitary microprolactinoma. These mood swings persisted for over 2 years, at which point she developed an acute manic episode with psychotic features and was admitted to a psychiatry unit. Cabergoline was discontinued and replaced with aripiprazole 10 mg/day. Her manic episode quickly resolved, and she was discharged within 6 days of admission. The aripiprazole suppressed her prolactin levels for over 18 months of follow-up, even after the dose was lowered to 2 mg/day. There was no significant change in tumor size over 15 months and treatment was well tolerated. However, after 9 months of taking 2 mg aripiprazole, she developed brief manic symptoms, and the dose was returned to 10 mg daily, with good effect. Learning points Dopamine agonists such as cabergoline, which are a standard treatment for microprolactinomas, can have serious adverse effects such as psychosis or valvular heart disease.Aripiprazole is a well-tolerated atypical antipsychotic that, unlike other antipsychotics, is a partial dopamine agonist capable of suppressing prolactin levels.Adjunctive, low-dose aripiprazole has been utilized to reverse risperidone-induced hyperprolactinemia.This case report demonstrates how aripiprazole monotherapy, in doses ranging from 2 to 10 mg/day, was effective in suppressing prolactin in a woman with a microprolactinoma who developed psychiatric side effects from cabergoline. PMID:26587235
Okolo, Abu Clement; Manga, Mohammed Mohammed; Anaedobe, Chinenye Gloria; Salami, Ayodeji Akeem; Akang, Effiong Essien Udo
Infection with genital herpes simplex virus (HSV) remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.
Nelson, M S; Jovanovic, L
One system of management for the pregnant woman with Type I diabetes is to instruct her in the strategies of achieving and maintaining normoglycemia with the use of self blood glucose monitoring, split doses of insulin, and titration of insulin to cover the meal plan. Normoglycemia is achieved only when the meal plan is adhered to in a rigid fashion to facilitate the insulin dose surrounding the meal. A 30 kcal/kg diet is divided into three meals and three snacks, of which 40% is composed of carbohydrate. These frequent small feedings must be perfectly timed to meet the insulin injected. Such systems require 35 hours of intensified training to become skilled in the techniques of diabetes self-care, but still the regimen does not provide much flexibility. When a pregnant woman also wishes to honor her religious beliefs by keeping kosher and so following another set of rigid laws surrounding the meal plan, adherence to both sets of rules becomes a challenge. Specifically, attention to separating milk and meat and eating only kosher foods must be part of the program. This article describes not only the basic diabetes self-care method but also how to adapt the method to the laws of keeping kosher while sustaining normoglycemia.
Paxton, Pamela; Painter, Matthew A; Hughes, Melanie M
The expansion of women's political representation ranks among the most significant trends in American politics of the last 100 years. In this paper, we develop two longitudinal theories to explain patterns of growth and change in women's state legislative representation over time. Gender salience suggests that years in which women's absence from politics is problematized (e.g., 1992-the Year of the Woman) will demonstrate higher levels of growth. Political climate suggests that periods in which domestic issues are stressed (e.g., the 1990s) will produce higher levels of growth than periods in which international issues are stressed (e.g., post 9/11). Combinations of these two theories create four possible trajectories of growth in women's representation that may be observed over time. We use latent growth curve models to assess the four theoretical trajectories, using data on women's state legislative representation from 1982 to 2006. We find that while women achieved fleeting success in the Year of the Woman, further gains were limited in the remainder of the 1990s and average growth stalled completely after 2001. Our results show futher that gender salience and, to a lesser extent political, climate matter to growth and change in women's political power over time.
Bhandari, H M; Gorecha, M; Woodman, J
A 35-year-old woman, a non-smoker with a normal body mass index, 'felt wheezy' and developed profound hypoxia 30 min after preterm vaginal delivery at 24+ weeks of gestation. She denied other symptoms, had no fever but was tachycardic and tachypnoeic with normal blood pressure. Pulmonary embolism, amniotic fluid embolism, cardiomyopathy, arrhythmias, sepsis and non-cardiogenic pulmonary oedema were considered as differential diagnoses. Chest X-ray showed an increased pulmonary vasculature, but the blood tests, ECG, echocardiogram and CT pulmonary angiogram were essentially normal. She was managed on a high dependency area with high-flow oxygen and intravenous antibiotics. She improved dramatically and the oxygen requirements dropped to 2 L over the next 4 h. It is plausible that this woman had acute non-cardiogenic pulmonary oedema secondary to a combination of risk factors. This case highlights the importance of a methodical and multidisciplinary approach for a prompt diagnosis and successful treatment of an acutely ill parturient.
van der Sluis, Wouter B; Verweij, Stephan P; Özer, Mujde; Meijerink, Wilhelmus J; Bouman, Mark-Bram
A 46-year-old, HIV-positive transgender woman of South American ethnicity consulted our outpatient clinic to discuss the possibilities of a surgical, secondary neovaginal reconstruction because of complete stenosis of her inverted penile skin-lined neovagina. She was taking abacavir/lamivudine and nevirapine as antiretroviral therapy. We successfully performed a total laparoscopic sigmoid vaginoplasty without any complications. There was no short-term morbidity and no complications were reported after 15 months of follow-up. To our knowledge, this is the first report of laparoscopic sigmoid vaginoplasty as vaginal reconstruction in a HIV-positive transgender woman. Worldwide, transgender women have a high burden of HIV infection. This report shows that intestinal vaginoplasty is a feasible surgical option for HIV-positive transgender women in need of vaginal reconstruction. Because patients are again able to engage in penetrative sexual intercourse, we emphasise the importance of practicing safe sex and early initiation of adequate antiretroviral therapy in this patient population.
A 21-year-old woman of Romany origin, in the third trimester of her fourth pregnancy, was admitted to the hospital because of a generalized erythematous and pustular eruption and desquamation involving her face, neck, trunk, and extremities. The skin changes were accompanied by fever (100.4 degrees F [38 degrees C]) and malaise. The patient was convinced that the dermatitis was induced by the consumption of "spoilt" pork sausage (bad smell, changed taste) approximately 24 hours earlier. Clinical examination revealed a woman with phototype III skin, black eyes, and black hair, in good general health. Widespread, symmetrical, moderately intense erythema and isolated or coalescing targetoid lesions studded with discrete, pinhead-sized, nonfollicular pustules in the center or at the periphery were distributed over her face, trunk, groins, and upper and lower extremities (Figures 1). On the neck and abdomen, lamellar desquamation was observed (Figure 2). Palms, soles, scalp, mucous membranes, hair, and nails were not affected. Nikolsky's sign was negative. The patient complained of very slight skin burning and itching. The pregnancy was proceeding without any complications and her obstetric status was normal. The woman had neither any accompanying diseases, nor previous personal or family history of psoriasis, nor any known allergies. She had taken no systemic medication (not even vitamins). She had three pregnancies; two ended with the delivery of healthy babies and one of them was aborted at her will. Laboratory studies revealed leukocytosis (13.2 x 109/L), neutrophilia (8 x 109/L), anemia (hemoglobin, 108 g/L), and an elevated erythrocyte sedimentation rate (68-110 mm/h). The results from the following investigations were normal: urinalysis, renal and hepatic function, serum albumin, Ca, Na, K, aspartate aminotransferase titer, cryoprotein, hepatitis B surface antigen, and serum markers for syphilis. Bacterial and fungal cultures of pustular content were sterile. A
Srey, Krisna; Canales, Alexander; Kiffin, Chauniqua; Ashmawy, Yessin
Factor XIII deficiency is a rare inherited coagulopathy. Factor XIII is the last clotting factor in the coagulation cascade to insure strength and stability to fibrin clots. Without this enzyme, the fibrous clot is unstable and nonresistant to fibrinolysis. Gravid women with this congenital disease are especially at risk for complications including miscarriages and hemorrhage without appropriate interventions. We present a case of a woman in her 20s with Factor XIII deficiency who was treated with cryoprecipitate and had a successful normal spontaneous vaginal delivery; subsequently, patient suffered from postpartum hemorrhage and consumptive coagulopathy due to consumption of Factor XIII, requiring emergency surgical intervention. Intraoperative management was challenged by an ethical dilemma involving the patient's religious beliefs about not receiving blood. This paper will discuss the mechanism of Factor XIII and the medical and surgical management involved with this patient. PMID:27635271
A 41-year-old woman, suffering from continuous abdominal pain, only presented a non-specific inflammation of the whole colon and an unclaryfied hyponatriaemia; in spite of the only doubtful explanation by an enormous elongation of the colon, it was partially resected. Thereafter, the patient's decline, hypaesthesia, areflexia and tetraparesis required intensive care. Despite immunoglobulin therapy, assuming a Guillain-Barré syndrome, the patient needed resuscitation, followed by signs of severe hypoxia (high level of neuron-specific enolase, hippocampal lesions). The abdominal pain, hyponatriaemia, persistent tachycardia, sensory deficits, tetraplegia, circulation arrest, later epileptic seizures and unusual urine color were finally explained by an acute intermittent porphyria (AIP). Although the symptoms were classic, the disease was recognized only very late. Indeed, it is so rare that most physicians will never be confronted with an AIP or only once or twice.
Abu-Wasel, Bassam; Keough, Valerie; Molinari, Michele
A 44-year-old Caucasian woman without any identified predisposing factors, presented to her local emergency room with multiple episodes of recurrent ascending cholangitis. She underwent a laparoscopic cholecystectomy several years prior to her admission to the hospital for parenteral antibiotic therapy and she had no personal or family history of hypercholesterolaemia. Transferred to a tertiary hospital for surgical therapy, she underwent a left hepatic resection for a chronically infected left lobe hepatolithiasis (HL) conditioning atrophy of the parenchyma due to obstruction of the biliary tree by multiple large cholesterol stones. HL is a very rare condition in Western countries and its aetiology and predisposing factors are still unclear. We present her symptomatology, diagnostic and therapeutic management and discuss the epidemiology and risk factors of HL, that is, a common condition in South East Asia while exceptional in Caucasian patients who have not travelled in high-prevalence regions. PMID:23112263
Zaraa, Inès; Belghith, Ikram; El Euch, Dalenda; Karoui, Samy; Mokni, Mourad; Fillali, Azza; Ben Osman, Amel
Pellagra is a rare condition that has been known for many years to be related to niacin deficiency. Clinically known as the 4 "D" symptoms for dermatitis, diarrhea, dementia, and even death, skin changes remain one of the most important features of this pathology, leading frequently to the diagnosis. Pellagra is mostly seen in poor populations with a deficient diet; still, it is sporadically observed in developed countries, usually in association with digestive disorders. We report a new case of pellagra in a 29-year-old woman in whom the diagnosis of megaduodenum was made. Megaduodenum is a rare condition that can be idiopathic or secondary to visceral myopathy or neuropathy. Parenteral supplementation with niacin has resulted in a quick response of dermatological and psychiatric symptoms. To our knowledge, no case of pellagra due to megaduodenum has been reported in literature.
Kang, Ah Young; Baek, Yang Hyun; Sohn, You Jung; Lee, Soo-Keol; Son, Choon Hee; Kim, KyeongHee
Propylthiouracil (PTU) is known to be a potential cause of antineutrophil cytoplasmic antibody (ANCA) positive small vessel vasculitis, resulting in glomerulonephritis and diffuse alveolar hemorrhage (DAH). Herein, we describe a 25-year-old pregnant woman who developed a perinulcear ANCA (p-ANCA) and myeloperoxidase ANCA (MPO-ANCA) positive DAH during PTU therapy. The patient improved after corticosteroid therapy and discontinuation of the PTU. Methimazole was prescribed in spite of the risk of recurrence of DAH because of the pregnancy. The patient is currently free from pulmonary problems. Our case shows that the alternative agent, methimazole, can be used to treat hyperthyroidism in a pregnant patient with PTU associated DAH. PMID:17249506
The capacity of the human mind to discover and invent both imagistic analogies and mathematical structures to represent reality is strikingly juxtaposed in the ancient Chinese text of the I Ching. Its emphasis on containing all sorts of opposites and its plastic appeal to multi-valenced experience has kept it alive through millennia and across cultures. Jung was introduced to its Taoist wisdom by the Sinologist Richard Wilhelm. The Nobel Laureate quantum physicist Wolfgang Pauli became familiar with its philosophy and mathematics through his reading of Schopenhauer and Leibniz. In their correspondence about the nature of the unconscious and synchronicity, Pauli and Jung also exchanged their musings on Pauli's dreams of a Chinese woman, her role in his psyche and his scientific theories(1).
Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Keohane, Catherine; Bermingham, Niamh; Kaar, George
The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient's age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with 'red flag' symptoms.
Alblowi, Mohammed A.; Alosaimi, Fahad D.
Tardive dyskinesia (TD) is one of the most serious and disturbing side-effects of dopamine receptor antagonists. It affects 20-50% of patients on long-term antipsychotic therapy. The pathophysiology of TD remains poorly understood, and treatment is often challenging. Here, we present a 32-year-old woman presenting with a 9-month history of TD occurring after risperidone withdrawal, and characterized almost exclusively by tongue protrusion. After being seen by different specialties and undergoing multiple investigations, she was eventually correctly diagnosed with TD by a specialist team and successfully treated with amantadine. Vigilance and awareness of this condition and its risk factors are required to make the correct diagnosis, especially in cases with unusual presentations caused by atypical antipsychotics, and treatment can be challenging. PMID:26492119
In September 1997, the Guy's and St. Thomas' Hospital Trust opened its African Well Woman's Clinic to provide counseling and support to pregnant survivors of female genital mutilation. The clinic offers deinfibulation to women at 18-20 weeks' gestation. The clinic is operated by a qualified specialist midwife with the support of a female obstetrician/gynecologist. While it is only open the first Monday of every month, the clinic has already served 33 infibulated immigrants from Somalia, one from Ethiopia, three from Sudan, and three from Eritrea. In addition, the clinic has seen five women from Nigeria and four from Sierra Leone with clitoridectomy. A December 1997 survey conducted by clinic staff revealed that health care workers felt they needed more information about female genital mutilation. Therefore, the clinic organizes lectures for medical and midwifery students and other health care workers.
Bhatia, Vishwas; Bhatia, Garima; Jain, Nitul; Jadon, Ashwani Kumar
Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation resulting from irreversible changes in the hormonal and reproductive functions of the ovaries and is associated with a large number of symptoms ranging from physical to psychological. Some of the common oral manifestations are oral burning sensation with associated mucosal infections, pain, altered taste perception, and alveolar bone loss. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to devise newer methods that would add along to the treatment modalities advised by gynecologists in relieving menopausal women from above symptoms. The present case report describes an innovative method of fabricating a metal base denture in an edentulous female that would help perimenopausal/menopausal/post-menopausal edentulous women feel hot/cold sensations of food/liquids, thereby giving them relief from pain, better taste perception, and relief from associated allergic and candidal infections that are common with conventional acrylic base dentures. PMID:24082754
Merra, Giuseppe; Lago, Antonio Dal; Ricci, Roberta; Antuzzi, Daniela; Gasbarrini, Giovanni; Gasbarrini, Antonio; Ghirlanda, Giovanni
Gaucher disease is the most common lysosomal storage disease. It is caused by the defective activity of acid β-glucosidase, which results in the accumulation of lipid glucocerebroside in macrophages throughout the body. In this case report we describe the case of a young adult woman with splenomegaly as the primary manifestation of this pathology. This is a case of type 1 Gaucher disease because there is a lack of primary neurological involvement but we have, instead, an age-independent involvement of the visceral organs. It is very important to classify or characterize these patients in a precise manner and to make a complete diagnosis with the help of the many diagnostic resources now at our disposal, especially with genetics, radiology and new techniques of advanced microscopy, also because Gaucher disease requires a long and complex management from early life to adulthood. PMID:21897802
Griffith, Kevin S; Mead, Paul; Armstrong, Gregory L; Painter, John; Kelley, Katherine A; Hoffmaster, Alex R; Mayo, Donald; Barden, Diane; Ridzon, Renee; Parashar, Umesh; Teshale, Eyasu Habtu; Williams, Jennifer; Noviello, Stephanie; Perz, Joseph F; Mast, Eric E; Swerdlow, David L; Hadler, James L
On November 20, 2001, inhalational anthrax was confirmed in an elderly woman from rural Connecticut. To determine her exposure source, we conducted an extensive epidemiologic, environmental, and laboratory investigation. Molecular subtyping showed that her isolate was indistinguishable from isolates associated with intentionally contaminated letters. No samples from her home or community yielded Bacillus anthracis, and she received no first-class letters from facilities known to have processed intentionally contaminated letters. Environmental sampling in the regional Connecticut postal facility yielded B. anthracis spores from 4 (31%) of 13 sorting machines. One extensively contaminated machine primarily processes bulk mail. A second machine that does final sorting of bulk mail for her zip code yielded B. anthracis on the column of bins for her carrier route. The evidence suggests she was exposed through a cross-contaminated bulk mail letter. Such cross-contamination of letters and postal facilities has implications for managing the response to future B. anthracis-contaminated mailings.
Carney, J. Aidan; Stratakis, Constantine A.
A woman with Carney complex presented at age 22 years with abdominal pain and hirsutism. As a baby, she had excision of a right eyelid lesion and at age 14 years removal of a left lower eyelid nodule that subsequently recurred. Investigation revealed an elevated level of serum testosterone and a 2-cm left ovarian tumor. A left salpingo-oophorectomy was performed. Postoperatively, the abdominal pain was relieved, the serum level of testosterone was normalized, and the hirsutism was ameliorated. The tumor featured sheets of eosinophilic cells with lipochrome pigment, myeloid metaplasia, stromal metaplasia, and markedly abnormal blood vessels. Immunocytochemically, the tumor cells were positive for vimentin, synaptophysin, inhibin A and calrenin. Because of the clinical setting in which the neoplasm occurred, it is unlikely that the occurrence was unrelated to Carney complex.. PMID:21934476
Ramirez, Maria Del Pilar; Restrepo, Juan E; Syro, Luis V; Rotondo, Fabio; Londoño, Francisco J; Penagos, Luis C; Uribe, Humberto; Horvath, Eva; Kovacs, Kalman
We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI) demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before.
Ramirez, Maria del Pilar; Restrepo, Juan E.; Syro, Luis V.; Rotondo, Fabio; Londoño, Francisco J.; Penagos, Luis C.; Uribe, Humberto; Horvath, Eva; Kovacs, Kalman
We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI) demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before. PMID:23346440
Lu, Yang; Wang, Shu Jun; Li, Xin; Hu, Li; Zhang, Wen Jie; Li, Wei
A 26-year-old woman (G2P1A1) presented with a 5-week history of multiple red marks on her body after a therapeutic abortion. A physical examination found 15 palpable red marks on her head, neck, chest, arms and legs. Proliferating endothelial cells, which expressed CD31, CD34, von Willebrand factor, but not Glut-1 and merosin, were observed in the lesional area by histopathological analyses. Histocompatibility antigen typing of 2 lesions was identical to a sample from peripheral blood. Accelerated regression was observed in 2 lesions treated by intralesional injection of betamethasone, while spontaneous regression was observed within 9 months in the remaining lesions without any treatment. Rapid growth, spontaneous regression and histological analyses in this case support the diagnosis of 'infantile hemangioma-like vascular lesion'.
Al-Hinti, Jomana T; Nagan, Narasimhan; Harik, Sami I
Few women with Fragile X tremor ataxia syndrome (FXTAS) have been reported. They have milder manifestations at a later age than men. This gender difference may be related to the X inactivation pattern in women. We describe a woman who presented to her geriatrician with poor memory and was found to have ataxia and tremor. Additional queries yielded history of premature ovarian failure. Genetic testing showed heterozygous fragile X mental retardation gene premutation with 103 CGG repeats in the abnormal allele and 31 CGG repeats in the normal allele. Also, the X inactivation pattern was skewed with the active X chromosome predominantly having the premutation allele. We believe that FXTAS is more common in women than is generally thought and that many such patients masquerade as dementia of old age. Action tremor and ataxia associated with a history suggestive of premature ovarian failure should raise suspicions for FXTAS.
Takayanagi, Hiroyuki; Hayami, Ryosuke; Tsuneizumi, Michiko; Nakagami, Kazuhiko
In this study, we report the rare case of an elderly woman who developed thrombophlebitis after being treated with tamoxifen for breast cancer. She visited our department with a lump in her left breast. She underwent core needle biopsy, and she was diagnosed with breast cancer (invasive ductal carcinoma, ER- and PgR-positive, HER2-negative). We chose hormonal therapy because surgical treatment was deemed too invasive considering her general status. She was administered tamoxifen (20 mg/day) instead of an aromatase inhibitor in consideration of her osteoporosis. Six months after initiating tamoxifen therapy, she exhibited swelling in her left leg. Computed tomography and ultrasound revealed thrombophlebitis in her left femoral vein. She stopped taking tamoxifen and started warfarin potassium as thrombolytic therapy, after which thrombophlebitis was relieved. Advanced age may be a risk factor for thrombophlebitis associated with tamoxifen treatment; therefore, precautions should be taken accordingly.
Kacem, Faten Hadj; Charfi, Nadia; Mnif, Mouna Feki; Kamoun, Mahdi; Akid, Faouzi; Mnif, Fatma; Naceur, Basma Ben; Rekik, Nabila; Mnif, Zainab; Abid, Mohamed
We report a 22-year-old woman who presented with asthenia, weight loss and hypotension in which extensive pituitary and adrenal investigations were diagnostic of isolated adrenocorticotropic hormone deficiency (IAD) of pituitary origin. Magnetic resonance imaging of the hypothalamus and pituitary showed a normal-sized pituitary, with no mass lesion. The diagnosis of IAD probably secondary to lymphocytic hypophysitis (LYH) was made. IAD is able to be the way of presentation of LYH, although the disease could or could not turn into a panhypopituitarism. Prompt recognition of this potentially fatal condition is important because of the availability of effective treatment. Indeed, regular endocrine and imaging follow up is important for patients with IAD and normal initial pituitary imaging results to detect early new-onset pituitary hormones deficiencies or imaging abnormalities. PMID:24251125
Dennis, A T; Gerstman, M D
Supraventricular tachycardia is uncommon in pregnancy. It is defined as intermittent pathological and usually narrow complex tachycardia >120 beats/min which originates above the ventricle, excluding atrial fibrillation, flutter and multifocal atrial tachycardia. It is usually self-limiting or relatively easily treated with most cases responding to physical or pharmacological therapies. We describe a case of a woman in the third trimester of pregnancy who developed treatment-resistant supraventricular tachycardia and required induction of labour and delivery to stop the arrhythmia. A multidisciplinary team approach with a critical care trained nurse and a midwife, continuous arterial blood pressure monitoring, transthoracic echocardiography, and neuraxial analgesia facilitated safe birth in the delivery suite and termination of the arrhythmia.
Lin, Hao; Lin, Chih-Che; Huang, Wan-Ting
Background. Small bowel ischemia due to superior mesenteric vein thrombosis (MVT) is rare during pregnancy. However, additional precipitating factors should usually be identified. Case. A 31-year-old woman, pregnant at 34 weeks, was sent to the emergency department because of acute peritonitis. An emergency exploration revealed a segmental gangrene of the small intestine without any mechanical obstruction. Together with the termination of pregnancy, resection of the damaged small bowel was performed, and an end-to-end enterostomy was followed. Based on the operative and pathological findings, small bowel ischemia might be attributed to superior mesenteric vein thrombosis. Conclusion. Hypercoagulation state normally found in pregnant women is believed to lead to this catastrophic condition without other precipitating factors. PMID:22567515
Takeshita, Jun; Arai, Yasumichi; Hirose, Nobuyoshi; Tsukamoto, Hideko; Shirahase, Jyoichiro
We report the case of a 17-year-old woman with anorexia nervosa (AN) who developed an abetalipoproteinemia-like lipid profile and acanthocytosis. These abnormalities resolved slowly as her nutritional status improved. We considered 3 possible causes of an abetalipoproteinemia-like lipid profile in AN: (1) depletion of hepatic substrate for apolipoprotein B synthesis, (2) lack of exogenous fatty acids with exhaustion of endogenous stores of triglycerides in adipose tissue, and (3) preservation of the lipoprotein lipase (LPL) mass. This unusual case provides important clues that enhance our understanding of lipid metabolism under exogenous and endogenous fat deprivation and highlights the pivotal role of LPL as a gatekeeper of the energy source.
Vakil, Abhay; Upadhyay, Hinesh; Sherani, Khalid; Cervellione, Kelly; Trepeta, Scott; Patel, Mahendra C
A 44-year-old woman was brought to the ED from John F. Kennedy International Airport. The patient was returning with her son from a 3-month visit to Bangladesh. Her journey started with a 4-h flight from Dhaka, Bangladesh to Dubai, United Arab Emirates. She consumed 240 mL of whiskey during the flight. This was followed by a 14-h flight from Dubai to New York. According to the patient's son, she did not consume any alcohol during the second flight. The patient was in her usual state of health with normal mentation throughout her journey. Upon landing, she started complaining of shortness of breath. After disembarking, she was witnessed to have seizure-like activity with involuntary passage of urine, following which she collapsed. The patient was intubated by emergency medical services in the field.
Oguzkurt, Levent Tercan, Fahri; Gulcan, Oner; Turkoz, Riza
A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD.
Laban, N B; Tasic, V B; Danilovski, D; Polenakovic, M; Gucev, Z S
Wildervanck syndrome (WS) combines features of Klippel-Feil syndrome (KFS), sixth nerve palsy, and deafness. This is a case of a 23 year old woman, diagnosed with KFS (a triad of short neck, low posterior hairline and restricted neck movements) at the age of 20 days. The manifestations of the WS in this patient are severe: she has torticollis, and an extremely severe scoliosis. In addition, she is short (-3 SD; parental target height + 0.8SD) and has mixed sensorineural and conductive deafness. She also has ptosis, strabismus and a high myopia. Radiologically, there are multiple coalitions of cervical vertebrae. Intelligence is unaffected (IQ 95), but deafness, strabismus and high myopia forced her early out of school. Karyotype is 46, XX. In brief, this is a patient with severe WS and additional anomalies. Short and/or reduced parental target height is a part of WS.
Introduction Bilateral ectopic pregnancies are increasing due to an increase in the incidence of pelvic inflammatory disease and increase in assisted reproductive techniques. Spontaneous conception after bilateral ectopic pregnancies is extremely rare. Case presentation A 33-year-old Indian woman presented with ruptured ectopic pregnancy associated with hemoperitoneum for which she underwent a laparotomy. The diagnosis of bilateral ectopic pregnancies was made during surgery. Salpingectomy was done on one side and the other tube was conserved with salpingostomy. Six months after surgery, she conceived spontaneously and a transvaginal ultrasound examination revealed a 5-weeks live intrauterine pregnancy. Conclusion A meticulous surgical technique conserving one fallopian tube resulted in subsequent viable intrauterine pregnancy. The approach to such a case along with steps to minimize tubal damage is presented. PMID:23786635
Okafor, U H; Nwobodo, M U; Ezeugwu, F O
There is increasing incidence and prevalence of chronic kidney disease worldwide. The developing countries including Nigeria are facing greater challenges because of the prevailing poverty and high burden of infectious diseases. There are various prevalent co-morbid conditions that influence and are influenced by the status of the kidney function of the patient. These conditions pose some peculiar challenges and management of the challenges will determine the outcome. The aim of this report is to highlight the chalIenges of pregnancy in women with chronic kidney disease and possible outcome. We report a 24 years Nigerian woman diagnosed with chronic kidney disease who presented with 10 weeks gestation and deteriorating kidney function. Her management was associated with various challenges including non adherance to medications and not regular to follow up visits. She later developed ecclampsia and had intra uterine fetal death. She had various interventional measures including haemodialysis. She recovered kidney function appreciably but has defaulted follow up since discharge.
Maya, E T; Buntugu, K A; Pobee, F; Srofenyoh, E K
Clinicians sometimes are confronted with the challenge of transfusing haemorrhaging Rhesus (Rh) D negative patients with Rh D positive blood to save their lives. There are concerns about alloimmunization and future haemolytic disease of the newborn in women of the reproductive age. Another fear is transfusion reaction if they receive another Rh D positive blood in future. We present a 32-year-old Rh D negative woman, who had postpartum haemorrhage in her first pregnancy and was transfused with Rh D positive blood because of unavailability of Rh D negative blood. She did not receive anti D immunoglobin but subsequently had a normal term pregnancy of an Rh positive fetus without any detectable anti D antibodies throughout the pregnancy. In life threatening situations from obstetric haemorrhage, transfusion of Rh D negative women with Rh D positive blood should be considered as the last resort.
Chen, Lei; Fang, Lu; Liu, Zhiqi; Yu, Dexin; Wang, Daming; Wang, Yi; Xie, Dongdong; Min, Jie; Ding, Demao; Zhang, Tao; Zou, Ci; Zhang, Zhiqiang
Adrenal germ cell tumour is very rare. We report a case of a 59-year-old woman who presented with right flank discomfort. The laboratory examinations were normal and the chest computed tomography (CT) showed right pleural effusion. The abdominal CT scan revealed a large mass on the right adrenal gland. The patient underwent an adrenalectomy. Histopathologic examination and immunohistochemical findings were consistent with mixed germ cell tumour. Three months later following the operation, the patient was admitted to our hospital again with chest tightness and shortness of breath. The chest CT showed right pleural effusion recurrence and enlargement of mediastinal lymph nodes and right hilar lymph nodes. The patient had right supraclavicular lymphadenectasis on physical examination. Fine needle aspiration cytology from the supraclavicular lymph nodes showed groups of malignant tumour cells. The patient died within 6 months postoperatively. In this case, the lymph node pathway played an important role in the metastatic procedure. PMID:27790306
Gourineni, Venkata C; Juvet, Tristan; Kumar, Yogesh; Bordea, Doru; Sena, Kanaga N
Progressive multifocal encephalopathy (PML) is a rare demyelinating disease that typically presents in immunodeficient patients. We report a case of a previously healthy 62-Year-Old woman who suffered from an unsteady gait, throbbing headaches, and progressive left-sided weakness and numbness. Stroke was initially suspected based on imaging and symptoms. A series of follow-up magnetic resonance images of the brain showed a right parietal lesion growing in size as the patient became unable to walk and experienced increasing lethargy and confusion. A biopsy of the lesion was positive for the John Cunningham virus (JCV). A diagnosis of PML was made and she was started on mefloquine. No improvement was seen on this treatment and her condition worsened. Although PML remains uncommon in immunocompetent individuals, it cannot be ruled out based on their immune status. Although the exact cause remains uncertain, underlying or transient states of immunosuppression may be responsible for reactivation of the JCV in these patients.
Hassan, A; Babadoko, A A; Isa, A H; Abunimye, P
Hereditary spherocytosis (HS) is a familial hemolytic disorder with marked heterogeneity of clinical features, ranging from an asymptomatic condition to a fulminant hemolytic anemia. Although a positive family history of spherocytosis increases the risk for this disorder, it may be sporadic in some cases. In severe cases the disorder may be detected in early childhood, but in mild cases it may go unnoticed until later in adult life. A 27-year-old Nigerian woman presented with mild anemia, jaundice, splenomegaly and a history of multiple blood transfusion. Blood film showed about 70% spherocytes, reticulocytosis of 6.5%, increased osmotic fragility test and a negative direct antiglobulin test. She was managed conservatively on nutritional supplements and a significant regression of symptoms after 6 months was achieved.
Sheybani, Fereshte; Naderi, Hamid Reza; Moghaddam, Ahmad Bagheri; Amiri, Bezat
The presented case features a rare manifestation of pulmonary tuberculosis in a previously healthy young woman who had acute presentation of tuberculous pneumonia complicated by acute respiratory distress syndrome. In developing countries, mycobacterium tuberculosis is an important cause of community-acquired pneumonia (CAP). TB can present as an acute process and should be included in the differential diagnosis of CAP. This case is special in its manifestation from several clinical perspectives, including the lack of an underlying medical condition or immune defect and the development of acute respiratory distress syndrome (ARDS) in non-miliary and non-disseminated tuberculosis. In conclusion, the diagnosis of TB should be considered in all patients who present with CAP in endemic regions. PMID:27957312
Sommer, Ulrich; Baretton, Gustavo B; Aust, Daniela E; Laniado, Michael; Hoffmann, Ralf-Thorsten; Platzek, Ivan
Pancreatic endometriosis is very rare with only a few cases reported in the literature. The imaging features are non-specific and the definitive diagnosis is usually only established after surgery. We report on a 68-year-old woman with left upper quadrant pain who demonstrated a mass in the pancreatic tail on imaging. Laboratory results showed only mildly elevated liver enzymes, tumor markers were within the normal range. A left pancreatectomy was performed, frozen section suggesting a benign lesion, and final histopathology confirmed endometriotic cysts. A research of the literature found only eight reported cases of endometriotic cysts of the pancreas, with the majority affecting premenopausal women. Preoperative diagnosis is challenging and most patients undergo resection because of suspected neoplasm. Thorough diagnostic workup may help in avoiding extensive surgery and reduce postoperative complications. PMID:27733937
Ørum, Matilde; Fuglsang-Damgaard, David; Nielsen, Hans Linde
The Gram-negative, rod-shaped, anaerobe bacteria Tissierella praeacuta was first described in 1908 by Tissier. However, during the past decade, Clostridium hastiforme has been recognised as a later synonym of T. praeacuta. C. hastiforme/T. praeacuta has only rarely been described in previous literature as a cause of human infection. We present here a case report of C. hastiforme/T. praeacuta bacteraemia secondary to pyometra in a 64-year-old woman with a history of multiple sclerosis and an intrauterine device inserted three decades earlier. C. hastiforme/T. praeacuta was isolated from blood as well as pus from the site of infection. The patient was cured with a combination of drainage and antibiotic therapy.
Lee, Jae-Young; Kwon, Hyun-Jung; Park, Sang-Wook; Lee, Yu-Mi
Abstract Background: The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy. Methods: We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage. Results: Intraoperative chest radiography revealed severe pulmonary edema and echocardiography indicated moderate left ventricular dysfunction with akinesia of the mid to apical left ventricular wall segment, which is reflective of takotsubo cardiomyopathy. Conclusion: With early detection and appropriate management, the patient was stabilized in a relatively short period of time. Based on her clinical signs and symptoms, we suspect that the pulmonary edema was caused by takotsubo cardiomyopathy. PMID:28072695
Poon, Maggie Wai-Ling
This paper described the application of eye movement desensitization reprocessing (EMDR) for addressing the posttraumatic stress disorder (PTSD) symptoms in a Chinese woman who had experienced multiple traumas in her childhood. EMDR is an integrative therapeutic intervention that uses a standardized eight-phase approach to treatment. It is also a proven, effective, and efficient treatment for trauma. In this client with multiple traumas, the etiological event that lay the foundation of her dysfunctional responses was reprocessed first. The successful resolution of this event allowed the positive treatment effects to transfer to other traumatic events of a similar theme. This case also illustrates the importance of identifying a culturally appropriate positive cognition (PC) in contributing to the success of the treatment. PMID:22937416
Ballas, Samir K; Martinez, Ubaldo; Savage, Michael
The most common cause of stroke in children with sickle cell anemia is infarction due to ischemia. In adults, however, stroke is most commonly hemorrhagic in nature. Other causes of stroke in patients with sickle cell disease are very rare. In this short communication, we describe a woman with sickle cell anemia responsive to hydroxyurea (HU) therapy who had primary stroke due to paradoxical embolization caused by a large atrial septal defect. Successful management of the stroke included surgical closure of the defect with trans-esophageal echocardiographic guidance. To the best of our knowledge, this is the first patient with sickle cell anemia and stroke due to congenital heart disease who did not require open heart surgery for successful management.
This article traces the connections between the public career and private life of Constance Pascal (1877-1937), the first woman psychiatrist in France, in the social context of the Belle Epoque. Pascal, of Romanian origin, attained professional success at the cost of suppressing her personal life. Best known for her work on dementia praecox, she researched the social as well as the biological causes of mental illness. She founded one of the first 'medical-pedagogic' institutes in France. Her monograph, Chagrins d'amour et psychoses (1935) reflects her wide cultural interests. Until recently, Pascal has been neglected by historians of psychiatry and of French women's history. Her life exemplified many of the conflicts experienced by women entering hitherto all-male professions.
Wilkinson, M; Isler, H
This is a presentation of a doctoral thesis of 1870. The author was English but the thesis and the examinations were in French. Elizabeth Garrett Anderson, usually referred to as E.G.A., was the first woman in Britain to obtain the title of M.D., but not the first in Europe. Nadeshda Prokofevna Suslova, a Russian, received her M.D. in 1867 in Zurich, the most liberal university at that time, soon to be flooded by female students from Russia. E.G.A. had been applying to the few possible European universities but she settled for Paris after the Empress Eugenie had decided that she should be accepted there. This meant that she could succeed without having to be a Paris resident, just by writing a thesis and passing a series of examinations presided over by Paul Broca. This was important as she was already conducting private and dispensary practice, and could not find a locum (she insisted on a woman). E.G.A. had suffered many setbacks, for being a woman, as such being unacceptable in dissection rooms and operating theatres, and generally in a professional career where women were unheard of. She was finally permitted to receive her medical diploma from the Worshipful Society of Apothecaries of London. She wrote about her thesis: "I have chosen Headache as its subject. I had to find a subject which could be well studied without post-mortem observations, of which I can have but very few in either private or dispensary practice; and I wished also to take a large subject, one that demanded some insight into the harmony that exists between the main physiological functions." Marcia Wilkinson (M.W.), who worked in the Elizabeth Garrett Anderson Hospital in London for 35 years, heard there of E.G.A.'s thesis on migraine and sent for it from Paris. In 1966 she translated it into English from the original French, being interested both in the subject and in the person of this resolute and lucid woman. When H. Isler found the French thesis in the British Library he intended to
Trinca, Francisco; Inácio, Mariana; Timóteo, Teresa; Dinis, Rui
A woman aged 35 years was diagnosed with triple-negative breast cancer in October 2012. During the investigation, it was discovered that she was pregnant, the patient decided to have an abortion. She was submitted to a radical modified mastectomy and adjuvant chemotherapy followed by adjuvant breast radiotherapy of the left breast. 2 months after the adjuvant treatment, she began to have headaches and dizziness. The cranial MRI (head MRI) showed brain metastasis. She was then treated with whole brain radiotherapy, stereotactic radiosurgery and concomitant temozolomide which resulted in complete response. 1.5 year later, she was able to get pregnant and gave birth to a baby without complications. The previous imaging reassessment performed in September 2016 shows no evidence of recurrent breast cancer.
Søreide, Kjetil; Søreide, Annbjørg Hegelstad
Injuries caused by glass occur frequently, in particular in children, and make up an estimated 3% to 5% of all emergency visits, most frequently involving lacerations of hands, feet, and face. About 30% to 40% of glass injuries occur at home and often involve so-called architectural glass or bottles and glass containers. Accidents reported in association with showering mostly refer to falls or scalding by hot water. However, an increasing number of shower screens are made of tempered glass, which may potentially brake. Such injuries may be potentially severe, causing laceration of extremity arteries; requiring hospitalization or outpatient treatment for injuries; causing absence from work. These injuries are likely underreported in the medical literature but could have potential medicolegal consequences for the patient. We report a case of multiple lacerations developed in a third-trimester pregnant woman caused by the spontaneous shattering of a shower screen glass and discuss the apparent unawareness to this potential hazard in the scientific literature.
Takeuchi, K; Murata, K; Funaki, K; Fujita, I; Hayakawa, Y; Morita, H
We report a case of successful pregnancy in a woman who was initially diagnosed with renal failure in mid-pregnancy. She was started on hemodialysis, and her fluid balance was serially monitored with bioelectrical impedance analysis. Her body weight decreased and bioelectrical impedance values increased, along with resolution of pulmonary edema in the process of the removal of excessive fluid retention with hemodialysis. The bioelectrical impedance values decreased immediately after the usual dose of oral ritodrine was administered, partly because producing sodium and water retention by ritodrine were enhanced in the setting of fluid imbalances. This decrease preceded the onset of pulmonary edema, while no changes were noted in maternal body weight before hemodialysis. These results suggest that the serial measurement of bioelectrical impedance values enables more reliable and earlier detection of abnormal water retention in pregnant women undergoing dialysis than the effect of body weight changes.
Zhu, Cheng-Yao; Zhang, Guo-Xue; Yu, Zuo-Zhong; Li, Zhao-Jun; Fan, Yi-Ming
A 35-year-old woman with postoperative recurrent Graves' disease presented with a 5-day history of a red swelling on the right cheek associated with 4 days of remittent hyperpyrexia. Investigations revealed fever, a gangrenous ulcer on the right cheek, submandibular lymphadenopathy, and thyroid gland enlargement. Her white blood cell count, immunoglobulins, and lymphocyte subsets were unremarkable. Thyroid function tests showed low thyroid-stimulating hormone, high free thyroxine, and elevated radioactive iodine uptake. Repeated pus cultures grew Pseudomonas aeruginosa, but blood cultures were negative. An ill-demarcated erythematous plaque occurred on the right leg on hospital day 3. She was treated with intravenous antibiotics with topical gentamicin, recombinant bovine basic fibroblast growth factor, and radioiodine therapy with anti-thyroid drugs. The ulcer healed leaving a depressed scar at 35 days after discharge. This patient may represent the first case of P. aeruginosa ecthyma gangrenosum and cellulitis in postoperative recurrent Graves' disease.
Akdemir, Zülküf; Arslan, Harun; Çalli, Iskan; Akdeniz, Hüseyin
The incidence of all malignant tumours during pregnancy is extremely rare and esophageal carcinoma ranges from 0.07 to 0.1% of all malignant neoplasms. The physiological changes during pregnancy frequently mask the complaints and symptoms related to the disease. The physical and physiological clinical conditions limit the diagnostic approaches. Therefore, the stage of cancer at the time of diagnosis is usually advanced. The management with cancer surgery and chemotherapy regimens must be modified in pregnant women in order to minimize fetal and maternal risks. Here, we report a very rare case of metastatic esophagus cancer in a 39-year-old woman with 28 weeks of pregnancy and aim to show the ultrasound (USG) and magnetic resonance imaging (MRI) findings with treatment and follow up management. PMID:26894146
Baba, Yosuke; Morisawa, Hiroyuki; Saito, Koyomi; Rifu, Kazuma
Hyperemesis gravidarum can cause various vitamin deficiencies. Vitamin K deficiency can lead to coagulopathy or hemorrhagic diathesis. A nulliparous Japanese woman with hyperemesis gravidarum at 105/7 weeks was admitted with giant myoma, intestinal obstruction, and abdominal pain. Treatment for a degenerative myoma was instituted with intravenous antibiotics. The abdominal pain ameliorated, but intestinal obstruction persisted. At 166/7 weeks, we performed laparotomy for release of intestinal obstruction, when intraabdominal bleeding of 110 mL existed. Blood tests revealed coagulopathy secondary to vitamin K deficiency. The coagulopathy responded to intravenous vitamin K injection. Coagulopathy due to vitamin K deficiency can occur with hyperemesis gravidarum, and coexisting intestinal obstruction and broad-spectrum antibiotics can aggravate the deficiency. PMID:27597910
Han, Ju Young; Lee, Jungjin; Kim, Gyung Eun; Yeo, Jin Yeob; Kim, So hun; Nam, Moonsuk; Kim, Yong Seong
Cushing's syndrome is characterized by central obesity, fatigability, weakness, amenorrhea, hirsutism, edema, hypertension, impaired glucose tolerance, and osteoporosis due to excessive production of steroids. Cushing's syndrome is an important cause of secondary osteoporosis. Patients with Cushing's syndrome have a high incidence of osteoporotic fractures. At least, 30-50% of patients with Cushing's syndrome experience fractures, particularly in the vertebral body. And it is consistent with the 50% prevalence of osteoporosis in patients with Cushing's syndrome. However, reports of multiple pathological fractures in young patients with Cushing's syndrome are rare. Thus, we describe the case of a 26-year-old woman with Cushing's syndrome accompanied with recurrent multiple osteoporotic fractures and being treated by parathyroid hormone. Careful consideration for the possibility of Cushing's syndrome will be necessary in case of young patients with a spontaneous multiple compression fractures in spine. PMID:24524047
de Macedo, José Fernando; de Macedo, Gustavo Capinzaiki; Campos, Luciana Aparecida; Baltatu, Ovidiu Constantin
Patients with systemic lupus erythematosus have a poor prognosis of pregnancy, since it is associated with significant maternal and fetal morbidity, including spontaneous miscarriage, pre-eclampsia, intrauterine growth restriction, fetal death and pre-term delivery. We report a case with successful pregnancy in a patient with systemic lupus erythematosus and hypertension. A 39-year-old nulliparous woman presented with systemic lupus erythematosus with antinuclear and antiphospholipid antibodies, hypertension and recurrent pregnancy loss presented for assisted reproduction. The patient responded well to enoxaparin and prednisone during both assisted reproduction and prenatal treatment. This case report indicates that prescription of immunosuppressant and blood thinners can be safely recommended throughout the whole prenatal period in patients with systemic lupus erythematosus. Enoxaparin and prednisone may be prescribed concurrently during pregnancy.
Venous thromboembolism is well known as one of the rare but serious adverse effects of combined oral contraceptives (COCs). The COCs with third and fourth generation progestogens were found to have higher risk of venous thrombosis than those with second generation progestogens. We present a case of pulmonary embolism in a 23-year-old nulligravid woman who was using COCs containing the third generation progestogen (desogestrel). At the time of presentation of the adverse effect, she had been using the COCs for 4 months. She had no additional risk factors for thrombosis such as smoking, surgery, tumor as well as genetic factors. This case demonstrates even young women in otherwise good health may be at risk of venous thromboembolism from low-dose formulations of COCs as an over-the-counter drug. We describe this case with a brief review of literatures. PMID:28344968
Łazar-Poniatowska, Małgorzata; Seredyńska, Joanna; Biernat, Wojciech; Jassem, Jacek
Laryngeal cancer occurs rarely in adolescents and young people. Castleman’s disease is a rare lymphoproliferative disorder of uncertain etiopathogenesis and heterogeneous clinicopathological forms. Involved lymph nodes and extranodal lesions in the course of Castleman’s disease may mimic malignant involvement. We report a case of an 18-year-old woman with T2N0M0 laryngeal glottis cancer treated with definitive radiotherapy. During the irradiation, the patient underwent an excision of incidentally discovered left-sided enlarged cervical lymph nodes located outside the irradiated area. Coincidental hyaline vascular type of Castleman’s disease was diagnosed. During six-year follow-up she has been free of cancer relapse and Castleman’s disease symptoms.
Bock, Meredith; Garcia, Hector H; Chin-Hong, Peter; Baxi, Sanjiv M
Summary Neurocysticercosis (NCC) is a significantly neglected tropical disease and, with increasing globalisation, a notable emerging infection in the developed world. We describe a case of ventricular NCC in a 22-year-old Mexican-American woman with a history of seizures, who presented with 2 weeks of headaches and intermittent fevers progressing to altered mental status and vomiting. Initial imaging revealed a cystic mass at the posteroinferior aspect of the third ventricle superior to the aqueduct of Sylvius, calcifications scattered throughout the parenchyma, and enlargement of the lateral and third ventricles. Initial laboratories were unrevealing and serum investigations for Taenia solium antibody were negative, but T. solium antibody was subsequently returned positive from cerebrospinal fluid. This case highlights important issues regarding the clinical presentation, diagnostic evaluation and treatment of NCC relevant to providers not only in areas with endemic disease but, importantly, in locales with diverse immigrant populations. PMID:26682841
Moonen, G; Lievens, I; Bianchi, E
We report the diagnostic workup of a 75-year old woman seen in the outpatient clinic and complaining of a very common symptom that is walking difficulty and falls. We stress the complexity of the clinical examination and of the pathophysiology of equilibrium and gait disorders. They are numerous aetiologies that are very often associated in elderly patients. The therapeutic approach is necessarily multidisciplinary, both medical and paramedical. In the particular case of the patient illustrated in this vignette, the diagnosis was myofibrillar myopathy, a rare and recently described muscle disease. This is the occasion to stress that for many rare disorders, it is the disease, but not the signs or symptoms, which is rare.
Rutkove, Seward B
Ms Q is a 52-year-old woman who has had progressive polyneuropathy in the setting of diabetes for the past 8 years. Ms Q's major disability is that of increasingly severe neuropathic pain and cramps that have been poorly responsive to a variety of therapies, including gabapentin and topiramate. The diagnosis of and differential diagnosis for diabetic polyneuropathy are reviewed herein. In general, treatment options for diabetic polyneuropathy remain primarily symptomatic. Improving the metabolic profile through weight loss, exercise, and if necessary, medications may help slow neuropathy progression. Many medications are effective in reducing pain, and newly developed ones, such as pregabalin and duloxetine, while specifically marketed for diabetic neuropathy, are likely to be no better and are considerably more expensive than older ones. Alpha-lipoic acid appears to be effective as well.
Gustavsson, Carl Gunnar; Svensson, Peter J.; Hertervig, Erik; Sandhall, Lennart; Hårdhammar, Peter; Malcevschi-Lind, Natascia; Olsson, Sven-Erik
Background. The thrombosis risk is increased in active ulcerative colitis. The limited number of reported complications have predominantly been cerebrovascular but other vessel territories may also be affected. Patient. During a severe attack of ulcerative colitis a 37-year-old woman suffered occlusion of all left coronary artery branches. Serial angiographies showed progressive recanalisation of the coronary arteries during anticoagulation, but no atherosclerotic stenosis. The cause of infarction was thus considered to be an extensive coronary thrombosis. However, a large battery of blood tests failed to identify any procoagulant abnormality. Conclusion. Evidence is now accumulating that the increased thrombosis risk also may involve the coronary arteries, even in young patients. To the best of our knowledge this is the third reported case of myocardial infarction despite angiographically normal coronary arteries in a patient with active ulcerative colitis. The extent of affected myocardium was in this case exceptionally large. PMID:22347627
Beavers, Charles T; Parker, Joseph J; Flinchum, Dane A; Weakley-Jones, Barbara A; Jortani, Saeed A
Acephate is a commercial organophosphate pesticide formerly used in households and now used primarily for agriculture. Poisoning symptoms include salivation, lacrimation, urination, defecation, gastrointestinal illness, and emesis. In addition to these classic symptoms, neurodegeneration can result from increased and continued exposure of organophosphates. This 55-year-old woman presented with organophosphate-induced delayed neuropathy in the form of quadriplegia due to the commonly used pesticide acephate. She was exposed to this pesticide through multiple sprayings in her work office with underrecognized poisoning symptoms. She presented to her primary care physician with neuropathic pain and paralysis in her arm following the sprayings and eventual complete paralysis. The patient lived for 2 years following her toxic exposure and quadriplegia. A complete autopsy after her death confirmed a transverse myelitis in her spinal cord. We conclude that in susceptible individuals, acephate in excessive amounts can produce severe delayed neurotoxicity as demonstrated in animal studies.
van Genderen, Michel E; Carels, Ginette; Lonnee, Edward R; Dees, Adriaan
A 33-year-old Caucasian pregnant woman (26 weeks' gestation) presented to the emergency department. She had a 2-day history of severe itching of the scalp and steadily worsening swelling of the face over the previous 12 h, which had extended to the neck. She had no difficulty breathing. The itching and swelling had developed 3 days after she had used hair dye. The patient had no history of allergic responses to hair dye or black henna tattoos. A diagnosis of type IV delayed hypersensitivity reaction was made. Permanent hair dyes are the most frequently used professional hair dyes and are most commonly based on paraphenylenediamine (PPD) or related chemicals. PPD is known to be one of the most potent allergens which cause allergic contact dermatitis. After treatment with intravenous antihistamines and steroids, the facial swelling reduced and the patient had completely recovered by the following day.
Sabageh, Donatus; Amao, Emmanuel Afolabi; Ayo-Aderibigbe A, Adebisi; Sabageh, Adedayo Olukemi
Tuberculous mastitis is an uncommon disease even in countries where tuberculosis is highly endemic. It typically presents a diagnostic challenge masquerading as carcinoma or other primary disease of the breast. We report the case of a young multiparous Nigerian woman who presented with a tender left breast lump and enlargement of the left axillary lymph nodes for which a provisional diagnosis of carcinoma of the breast was made after clinical and radiological evaluation. The mass was pathologically diagnosed as tuberculous mastitis and anti-tuberculous therapy was instituted although she later absconded. This case shows that TM may present a diagnostic challenge on clinical, radiologic and microbiological investigation. Therefore, a high index of suspicion as well as FNAC and/or histological evaluation of tissue samples remain very important its diagnosis.
Fernández Sánchez, L J; Pérez González, R; Guasch Arévalo, E; Martín Reyes, R; Gilsanz Rodríguez, F
Recent-onset noncompaction of the myocardium is a rare but serious entity with uncertain prognosis. Cerebral infarction is among the forms of presentation, and pregnancy and hypercoagulability increase risk. We report the case of a pregnant woman brought to the emergency department with ischemic cerebral infarction. Investigation demonstrated the cause to be cardiac embolism, and noncompaction of the myocardium was diagnosed. She was stabilized and a few days later underwent elective cesarean section under general anesthesia. Surgery and postoperative recovery were uneventful, and she was transferred for rehabilitation. Myocardial injury and progression to cerebrovascular accident must be prevented in such cases; the patient must be stabilized and antiplatelet and/or anticoagulant therapy initiated before surgery. Hemodynamic stability must be maintained throughout the perioperative period and neonatal depression avoided after delivery. Various approaches are available to be adapted to the patient's situation.
Madan, Karan; Dhungana, Ashesh; Madan, Neha Kawatra; Mohan, Anant; Hadda, Vijay; Garg, Rakesh; Jain, Deepali; Guleria, Randeep
A 30-year-old woman presented with a history of progressive shortness of breath, cough, and hoarseness. Stridor was audible on examination. Chest X-ray showed normal lung fields and contrast-enhanced computed tomography thorax showed lower tracheal occlusion with endoluminal growth. Diagnostic flexible bronchoscopy demonstrated multiple whitish glistening nodules over both vocal cords and lower tracheal occlusion by whitish nodular growth. In view of critical central airway obstruction, rigid bronchoscopy and excision of the lower tracheal growth were performed. Histopathological examination of the excised specimen demonstrated features of squamous papillomas. A diagnosis of respiratory papillomatosis was established. On follow-up surveillance bronchoscopy, there was a gradual spontaneous regression of the residual lesions, and the patient remains currently asymptomatic 1 year since the procedure. PMID:27891001
Di Crescenzo, Vincenzo; Napolitano, Filomena; Vatrella, Alessandro; Zeppa, Pio; Laperuta, Paolo
Pulmonary arteriovenous malformations (PAVMs), although most commonly congenital, are usually detected later in life. Case report: We present a case of a 19-year-old woman with no previous history of AVM or telangiectasia, who presented dyspnea and hypoxia by massive left hemothorax in the 34th week of gestation. After emergent cesarean delivery, a chest computed tomography (CT) with i.v. contrast showed a likely 3 cm area of active contrast in left lower lung. Chest tube placement revealed about 2 liters of blood. The patient was subsequently found to have pulmonary AVM. A successful embolisation of AVM followed by lung atipic resection involving AVM and decortication for lung re-expansion were the treatments provided. Conclusions: Women with known pulmonary AVM should be maximally treated prior to becoming pregnant, and the physician should be alert to complications of pulmonary AVM during pregnancy. PMID:28352753
Vukovic, Petar M; Kosevic, Dragana; Milicic, Miroslav; Jovovic, Ljiljana; Stojanovic, Ivan; Micovic, Slobodan
Cor triatriatum dexter is a rare congenital heart anomaly in which a membrane divides the right atrium into 2 chambers. We report the case of a 43-year-old woman who had cor triatriatum dexter and a large atrial septal defect. During attempted percutaneous closure, the balloon disrupted the membrane and revealed that the defect had no inferior rim, precluding secure placement of an Amplatzer Septal Occluder. Surgical treatment subsequently proved to be successful. In patients with an incomplete membrane and a septal defect with well-defined rims, percutaneous treatment can be the first choice. In patients who have cor triatriatum dexter and unfavorable anatomic features or concomitant complex heart anomalies, open-heart surgery remains the gold standard for treatment.
Chen, Shih-Hsiang; Hung, Chia-Sui; Yang, Chao-Ping; Lo, Fu-Sung; Hsu, Hsun-Hui
Pernicious anemia is a megaloblastic anemia caused by vitamin B12 deficiency, and is the end-stage of autoimmune gastritis that typically affects persons older than 60 years. It is the most common cause of vitamin B12 deficiency. Pernicious anemia can also be diagnosed concurrently with other autoimmune diseases. We report the occurrence of megaloblastic anemia in a 22-year-old woman with chronic autoimmune thyroiditis for 10.5 years. Recently, she presented with microcytic anemia, and iron deficiency anemia was diagnosed initially. After administration of ferrous sulfate, macrocytic anemia was revealed and vitamin B12 deficiency was detected. Pernicious anemia was highly suspected because of the endoscopic finding of atrophic gastritis, and high titer of antigastric parietal cell antibody, as well as elevated serum gastrin level. After intramuscular injections of hydroxycobalamine 100 microg daily for 10 days, and monthly later, her blood counts returned to normal.
Werth, A; Perkins, M; Boucher, J
A case study of Grace, a 29-year-old woman with high-functioning autism, is presented. Grace is unusual for a person with autism in that she produces a great deal of humorous and creative word play. She is also unusual in that she writes and then audio-records 'letters' to her family, and produces copious cartoon-like drawings which she annotates, with the result that multiple examples of her humour are available in permanent form. We present examples of Grace's use of puns, jokes, neologisms, 'portmanteau' words, irreverent humour, irony, sarcasm and word play based on her obsessional interests. The examples are used to illustrate the forms and content of Grace's humour, and are discussed in relation to current theories of autism and of normal humour.
Gavand, Y; Krausz-Grignard, M; Barrucand, B; Courtois, L; Samain, E
A 41-year-old woman suffering from a left cor triatrium, pregnant for the first time, was hospitalized for a caesarean section in the context of a pulmonary arterial hypertension with severe anaemia. The anaesthetic strategy which was decided on involved setting up a haemodynamic monitoring prior to induction of a general anaesthetia with etomidate, remifentanil and succinylcholine and maintained with propofol, sufentanil and cisatracurium. This strategy allowed the hemodynamic to be stabilized during the operation. The improvement of the arterial pulmonary hypertension immediately after coming out of the operating theatre allowed the patient to be briefly monitored in the intensive care unit and to be allowed home on the 10th day following the operation. The patient's cardiopathy was corrected in the 5th month after the birth.
Tanaka, Nami; Minomi, Yayoi
In Japan, we try to educate pregnant women on the dangers of smoking and the positive outcomes of quitting, but they cannot quit smoking with that support. So we developed a program for quitting smoking based on the counseling given by our medical staff. As a result, 76% of them succeeded in quitting smoking. But there was not the nursing care tool to show the nonsmoking process. We believe that it is important to measure the carbon monoxide level taken from someone when they exhale; the result is then able to determine the person's smoking history. It has proven to be an effective way of preventing pregnant women from smoking. So we want to find a developing nursing care tool for pregnant woman to quit first and secondhanded smoking using Micro-smokerizer.
Despite recent advances in models and instruments to understand the role of a client's cultural background, clinical psychologists are not immune to implicit cultural biases that are potentially damaging to the therapeutic alliance. In this article, I present a Therapeutic Assessment with a young Sicilian woman conducted in a university-based student clinic in Italy. During the assessment, I assumed that because we were both Italians, my client shared my perspective (northern Italian) about family and individual values, which resulted in a therapeutic impasse when I responded on the basis of my individual and culturally shaped view of interpersonal and family relationships without appreciating important differences between my own and my client's microcultures. To overcome the impasse, I had to openly acknowledge such differences and reorient myself to my client's goals. I discuss the core processes involved in such a repair in the context of a cross-cultural psychological assessment.
Luna, Darling Valverde; Dulcey, Isabel; Nogales, Francisco F
We report a unique case of the coexistence of cervical cancer and placental site nodule (PSN) in a 72-year-old multiparous woman presenting with vaginal bleeding. She had undergone tubal sterilization 30 years before. On admission, she had profuse vaginal bleeding, and a bulky cervical mass was seen on vaginal examination. Histology revealed the coexistence of a moderately differentiated invasive squamous cell carcinoma with a PSN in its stroma. Its immunohistochemistry revealed characteristic phenotypes for both lesions--the squamous carcinoma was strongly positive for p16. The intermediate trophoblasts of the PSN showed a diffuse positivity for CAM 5.2, human placental lactogen, CD10, and α-inhibin and, focally, for human chorionic gonadotropin. This is the first report on the coexistence of these 2 lesions in an elderly postmenopausal patient and demonstrates that PSN can be found after the menopause as an unexpected lesion in this age group, mimicking various cervical malignancies.
van Genderen, Michel E; Carels, Ginette; Lonnee, Edward R; Dees, Adriaan
A 33-year-old Caucasian pregnant woman (26 weeks’ gestation) presented to the emergency department. She had a 2-day history of severe itching of the scalp and steadily worsening swelling of the face over the previous 12 h, which had extended to the neck. She had no difficulty breathing. The itching and swelling had developed 3 days after she had used hair dye. The patient had no history of allergic responses to hair dye or black henna tattoos. A diagnosis of type IV delayed hypersensitivity reaction was made. Permanent hair dyes are the most frequently used professional hair dyes and are most commonly based on paraphenylenediamine (PPD) or related chemicals. PPD is known to be one of the most potent allergens which cause allergic contact dermatitis. After treatment with intravenous antihistamines and steroids, the facial swelling reduced and the patient had completely recovered by the following day. PMID:24686800
Parmar, Kishan R; Patel, Ekta; McCann, Peter
Crohn's disease (CD) has a bimodal distribution in incidence, with a second peak in the elderly. However, its diagnosis in the elderly is difficult due to a wider range of more common differential diagnoses such as diverticulitis, ischaemic colitis and colorectal cancer. We report a likely case of CD in a 95-year-old woman. She presented with diarrhoea and rectal bleeding and was found to have multiple pleomorphic ulcers with a patchy cobblestone mucosa on sigmoidoscopy. Histopathology demonstrated focal ulceration, altered crypt architecture and adjacent neutrophil polymorph infiltration with no granolomata or features of malignancy. The patient passed away after steroid treatment was started. This case is a reminder that CD can present in the elderly and highlights the challenging diagnosis and high mortality of CD-related hospitalisation in the elderly. When considering management, attention should be given to comorbid disease, age-related changes in pharmacokinetics and patients social circumstances. PMID:23001095
Laway, Bashir A; Mir, Shahnaz A; Zargar, Abdul H
Sheehan's syndrome (SS) presents with hypopituitarism after parturition, usually preceded by postpartum hemorrhage. The first symptom of the disorder is lactation failure because of lactotroph cell necrosis. Recovery of lactotroph function after initial insult has not been reported in the literature. We describe the evaluation of a case of SS in whom lactotroph function recovered after the second pregnancy. A young woman delivered her first child at the age of 25 years; delivery was followed by severe postpartum hemorrhage and required blood transfusion. Sheehan's syndrome was diagnosed because of lactotroph, corticotroph, thyrotroph and somatotroph failure and empty sella on MRI. She conceived twice spontaneously and had normal lactation after the second delivery; investigations confirmed the normal basal and stimulable prolactin levels. We presume that recovery of lactotroph function after the second pregnancy in a patient with SS is possibly because of stimulatory effect of estrogen and progesterone on residual lactotroph cells.
Laway, Bashir A.; Mir, Shahnaz A.; Zargar, Abdul H.
Sheehan's syndrome (SS) presents with hypopituitarism after parturition, usually preceded by postpartum hemorrhage. The first symptom of the disorder is lactation failure because of lactotroph cell necrosis. Recovery of lactotroph function after initial insult has not been reported in the literature. We describe the evaluation of a case of SS in whom lactotroph function recovered after the second pregnancy. A young woman delivered her first child at the age of 25 years; delivery was followed by severe postpartum hemorrhage and required blood transfusion. Sheehan's syndrome was diagnosed because of lactotroph, corticotroph, thyrotroph and somatotroph failure and empty sella on MRI. She conceived twice spontaneously and had normal lactation after the second delivery; investigations confirmed the normal basal and stimulable prolactin levels. We presume that recovery of lactotroph function after the second pregnancy in a patient with SS is possibly because of stimulatory effect of estrogen and progesterone on residual lactotroph cells. PMID:24910842
ten Hoope-Bender, Petra; Lopes, Sofia Tavares Castro; Nove, Andrea; Michel-Schuldt, Michaela; Moyo, Nester T; Bokosi, Martha; Codjia, Laurence; Sharma, Sheetal; Homer, Caroline
The 2014 State of the World's Midwifery report included a new framework for the provision of woman-centred sexual, reproductive, maternal, newborn and adolescent health care, known as the Midwifery2030 Pathway. The Pathway was designed to apply in all settings (high-, middle- and low-income countries, and in any type of health system). In this paper, we describe the process of developing the Midwifery2030 Pathway and explain the meaning of its different components, with a view to assisting countries with its implementation. The Pathway was developed by a process of consultation with an international group of midwifery experts. It considers four stages of a woman's reproductive life: (1) pre-pregnancy, (2) pregnancy, (3) labour and birth, and (4) postnatal, and describes the care that women and adolescents need at each stage. Underpinning these four stages are ten foundations, which describe the systems, services, workforce and information that need to be in place in order to turn the Pathway from a vision into a reality. These foundations include: the policy and working environment in which the midwifery workforce operates, the effective coverage of sexual, reproductive, maternal, newborn and adolescent services (i.e. going beyond availability and ensuring accessibility, acceptability and high quality), financing mechanisms, collaboration between different sectors and different levels of the health system, a focus on primary care nested within a functional referral system when needed, pre- and in-service education for the workforce, effective regulation of midwifery and strengthened leadership from professional associations. Strengthening of all of these foundations will enable countries to turn the Pathway from a vision into reality.
Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process. PMID:27812519
Shagina, N B; Fell, T P; Tolstykh, E I; Harrison, J D; Degteva, M O
A biokinetic model for strontium (Sr) for the pregnant woman and fetus (Sr-PWF model) has been developed for use in the quantification of doses from internal radiation exposures following maternal ingestion of Sr radioisotopes before or during pregnancy. The model relates in particular to the population of the Techa River villages exposed to significant amounts of ingested Sr radioisotopes as a result of releases of liquid radioactive wastes from the Mayak plutonium production facility (Russia) in the early 1950s. The biokinetic model for Sr metabolism in the pregnant woman was based on a biokinetic model for the adult female modified to account for changes in mineral metabolism during pregnancy. The model for non-pregnant females of all ages was developed earlier with the use of extensive data on (90)Sr-body measurements in the Techa Riverside residents. To determine changes in model parameter values to take account of changing mineral metabolism during pregnancy, data from longitudinal studies of calcium homeostasis during human pregnancy were analysed and applied. Exchanges between maternal and fetal circulations and retention in fetal skeleton and soft tissues were modelled as adaptations of previously published models, taking account of data on Sr and calcium (Ca) metabolism obtained in Russia (Southern Urals and Moscow) relating to dietary calcium intakes, calcium contents in maternal and fetal skeletons and strontium transfer to the fetus. The model was validated using independent data on (90)Sr in the fetal skeleton from global fallout as well as unique data on (90)Sr-body burden in mothers and their still-born children for Techa River residents. While the Sr-PWF model has been developed specifically for ingestion of Sr isotopes by Techa River residents, it is also more widely applicable to maternal ingestion of Sr radioisotopes at different times before and during pregnancy and different ages of pregnant women in a general population.
El moho forma parte del medio ambiente natural. Afuera del hogar, el moho juega un papel en la naturaleza al desintegrar materias organicas tales como las hojas que se han caido o los arboles muertos. El moho puede crecer adentro del hogar cuando las espor
Anty, R; Ollier, L; Péron, J M; Nicand, E; Cannavo, I; Bongain, A; Giordanengo, V; Tran, A
In European countries, epidemiology of hepatitis E virus (HEV) infection is not well known. Although, seroprevalence of HEV Immunoglobulin G reached a few percent in European women, no acute hepatitis E during pregnancy has been described so far. Here, we report a case of an autochthonous HEV genotype 3 infection in a 41-years-old pregnant woman living in a non-endemic country. The acute hepatitis had a spontaneous good outcome for the mother and the child. In non-endemic areas where Hepatitis E infections are emerging, unexplained cytolysis, whatever its level, in a pregnant woman could be investigated for HEV, using biological molecular and serology tools.
Barnett-Johnson, Kim R.
The purpose of this case/phenomenological study was to examine a collegiate administrative search and selection process and the experience of an African American woman who was selected to the position of chancellor. A case concerning the search process of a regional campus of Ivy Tech Community College of Indiana was identified and chosen.…
Gaskin, Cadeyrn J.; Andersen, Mark B.; Morris, Tony
Although physical activity can have substantial mental and physical health benefits, people with cerebral palsy usually lead sedentary lives. To understand, at an individual level, this inactivity, we interviewed a 29-year-old minimally active woman with cerebral palsy (Alana) about the meanings and experiences of physical activity throughout her…
Gaskin, Cadeyrn J.; Andersen, Mark B.; Morris, Tony
We used a life-history approach to investigate the meanings and experiences of physical activity in the life of a 25-year-old woman with severe cerebral palsy (Amy). Amy and her mother were interviewed about Amy's life and her involvement in physical activity. The conversation was audio-recorded and transcribed verbatim. We interpreted Amy's story…
Alvord, Lori Arviso; Van Pelt, Elizabeth Cohen
In this autobiography, Lori Arviso Alvord describes her journey to become the first Navajo woman surgeon and her realization of the benefits of Navajo philosophy to the healing process. Raised on the Navajo reservation by a White mother and a Navajo father and grandmother, Alvord learned to walk in two worlds. Encouraged to get an education, she…
Discusses recent feminist theory, in particular feminist theory related to "cyborg" identity and examines some media representations of a woman-of-color superintendent. Suggests that the cyborg image offers alternative ways to consider the issue of diversity and educational leadership, including the superintendency. (Author/SLD)
For high school and adult readers this autobiography of Polingaysi Qoyawayma (Elizabeth Q. White) relates a Hopi Indian woman's struggle to adjust to an alien culture and to develop teaching methods to bridge the gap between Indians and the white world. Information on Hopi legends and ceremonies introduce the reader to the Hopi way of life. Born…
Cannovo, Nunzia; Agangi, Annalisa; Sansone, Matilde; Buccelli, Paola; Martinelli, Pasquale
The trend to have children even if one or both parents suffer from chronic diseases is influenced by personal, psycho-organic and social factors. The Authors face the moral and professional dilemma of honouring a woman's intentions, or persuading her to interrupt her pregnancy to prevent damage to her health.
Fernández-Valencia, Jenaro A; García, Sebastian; Prat, Salvio
Pasteurella multocida, a gram-negative coccobacillus, is a commensal in the nasopharynx of many animals. P. multocida infections most commonly involve the skin, soft tissues, and respiratory tract, particularly in immunosuppressed patients. The present case illustrates a severe articular infection caused by this bacterium, leading to septic shock, in an elderly, otherwise healthy woman, after a simple scratch of a cat.
Aubin, G. G.; Bémer, P.; Guillouzouic, A.; Crémet, L.; Touchais, S.; Fraquet, N.; Boutoille, D.; Reynaud, A.; Lepelletier, D.; Corvec, S.
We describe the first case of hip prosthetic infection due to Lactococcus garvieae. The patient, a 71-year-old woman fishmonger, developed a hip infection 7 years after total hip arthroplasty. The origin of infection was possibly due to the manipulation or intake of seafood or fish contaminated with Lactococcus garvieae. PMID:21367987
Aubin, G G; Bémer, P; Guillouzouic, A; Crémet, L; Touchais, S; Fraquet, N; Boutoille, D; Reynaud, A; Lepelletier, D; Corvec, S
We describe the first case of hip prosthetic infection due to Lactococcus garvieae. The patient, a 71-year-old woman fishmonger, developed a hip infection 7 years after total hip arthroplasty. The origin of infection was possibly due to the manipulation or intake of seafood or fish contaminated with Lactococcus garvieae.
Sharma, Vinod Kumar; Bhari, Neetu; Subhadarshani, Sweta; Taneja, Neha; Deepak, Rakesh Kumar
A 70-year-old woman presented with generalized reticulate pigmentation, scarring alopecia, and few discrete, violaceous plaques over the trunk and forearm. Dermoscopic evaluation of the reticulate plaque showed reticulate hyperpigmentation with multiple telangiectasias, and skin biopsy showed lichenoid interface dermatitis with marked pigment incontinence. Thus, a final diagnosis of poikiloderma due to lichen planus pigmentosus was considered. PMID:27904206
Sharma, Vinod Kumar; Bhari, Neetu; Subhadarshani, Sweta; Taneja, Neha; Deepak, Rakesh Kumar
A 70-year-old woman presented with generalized reticulate pigmentation, scarring alopecia, and few discrete, violaceous plaques over the trunk and forearm. Dermoscopic evaluation of the reticulate plaque showed reticulate hyperpigmentation with multiple telangiectasias, and skin biopsy showed lichenoid interface dermatitis with marked pigment incontinence. Thus, a final diagnosis of poikiloderma due to lichen planus pigmentosus was considered.
An undergraduate course in rhetorical criticism at Wilkes University incorporated a major component on the rhetoric of the American Woman's Suffrage Movement. Considerable time was devoted to critiquing "traditional" approaches to rhetorical criticism from a feminist perspective and to questioning the appropriateness of various…
Vickers, Caroline H.; Deckert, Sharon K.
This article demonstrates how one woman's identity changed as she was empowered through her participation in a sewing cooperative community of practice. A community of practice framework allows examination of participation in ongoing negotiated interactions in which people construct expert and novice identities as they work together. Identity, as…
Dugdale, A. E.; Chen, S. T.
The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 school children in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. Journal availability: British Medical Journal, 1172 Commonwealth Ave., Boston, MA 02134. (Author)
Using the work of Judith Butler on gender regulation, Black Feminist Thought (BFT), and autobiographic storytelling, this piece illustrates how essentialist notions of gender, and discourses related to gender create conflict in shaping identity construction for a Black woman academic and single mother (BWA/SM) in the United States. This piece…
Kitchener, Karen Strohm; And Others
This study examined the effect of raters' level of self-acceptance on the ratings of three candidate types: a "traditional" woman, a "feminist", and a candidate with sex unspecified. Subjects were 81 male counseling center directors. Results reveal that subjects with higher self-acceptance were more likely to evaluate all candidates as more…
Murro, Diana; Novo, Jorge; Arvanitis, Leonidas
Classic cerebral toxoplasmosis typically presents with neurologic symptoms such as seizures and mental status changes and histological examination shows focal lesions with necrosis. However, in the diffuse "encephalitic" form, patients are asymptomatic with diffuse, inflammatory, non-necrotic lesions. Asymptomatic diffuse "encephalitic" toxoplasmosis has been reported only in four acquired immunodeficiency syndrome patients and one human immunodeficiency virus (HIV) negative patient with chronic lymphocytic leukemia. We present a 36-year-old HIV-negative woman with systemic lupus erythematosus and lupus nephritis who was on immunosuppression for 9years after cadaveric renal transplant and died from pulmonary hemorrhage and cytomegalovirus pneumonia. Brain autopsy findings revealed multifocal microglial nodules containing Toxoplasma bradyzoites and associated astrogliosis. These nodules were prominent in the cerebellum, midbrain and medulla and also present in the cortex and thalamus. No coagulative necrosis, necrotizing abscesses, or other opportunistic infections were present. The patient had previously exhibited no neurologic symptoms and there was no clinical suspicion for toxoplasmosis. To the best of our knowledge, this is the first case of diffuse, non-necrotizing, "encephalitic" cerebral toxoplasmosis reported in a lupus patient and also the first reported female case.
Zyczynski, Laura E; McHugh, Jonathan B; Gribbin, Thomas E; Schuetze, Scott M
A 69-year-old woman was diagnosed with alveolar rhabdomyosarcoma (ARMS) of the nasopharynx. She has a history of catastrophic thromboembolic event in the abdomen that caused short-gut syndrome and dependence on total parenteral nutrition (TPN) twelve hours per day. She was treated for short-gut syndrome with teduglutide, a glucagon-like peptide-2 (GLP-2) analog, which led to reduction of TPN requirements. However, a few months later, she developed metastatic alveolar rhabdomyosarcoma. Though a causative relationship is unlikely between the peptide and ARMS due to the brief time course between teduglutide therapy and sarcoma diagnosis, neoplastic growth may have been accelerated by the GLP-2 analog, causing release of IGF-1. The transmembrane receptor for IGF-1 is frequently overexpressed in ARMS and is implicated in cell proliferation and metastatic behavior. This case describes a rare incidence of metastatic alveolar rhabdomyosarcoma in a sexagenarian and possibly the first case reported associated with the use of teduglutide. Teduglutide was discontinued due to a potential theoretical risk of acceleration of sarcoma growth, and the patient's rhabdomyosarcoma is in remission following sarcoma chemotherapy.
Genovese, Maurilio; Todeschini, Alessandra; Moratti, Claudio; Galassi, Giuliana
Acute nontraumatic myelopathies include vascular etiologies most commonly caused by atherosclerotic vascular disease. Other causes that have been reported to occur with varying frequencies include thrombosis, embolism of thrombi and tumor, arteritis, hypotension, dissecting aortic aneurysm, sickle cell disease, intervertebral disk herniation, vertebral body subluxation and iatrogenic causes, usually angiography or surgery. In case of acutely progressing spinal cord syndromes, the diagnosis often given is of transverse myelitis or unknown cause of infarction. Fibrocartilaginous embolism (FCE) is possible cause of spinal ischemia due to embolization of nucleus pulposus fragments through retrograde spinal artery flow. A young woman after intensive exercise developed profound weakness of her upper extremities, progressing to flaccid quadriplegia with sensory level from C3 dermatome. Magnetic resonance imaging (MRI) showed linear hyperintense intramedullary lesion from C2 to Th2 confined to anterior horn area, with typical"owl's eye" appearance. Although exact mechanism of patient's neurological syndrome remains undetermined, we suspected a cord infarction due to FCE related to her vigorous physical exercise.
Lee, Seung Hyun; Han, Myoungseok; Bae, Jong Woon; Park, Jung-Woo; Oh, So Ra; Kim, Sujin
Superficial angiomyxomas (SAMs) are rare benign cutaneous tumors that involve the subcutaneous layer. They are commonly located in the trunk, lower limbs and head or neck of women of reproductive age. SAMs in the vulva of postmenopausal women are especially rare case. Herein, we report a vulvar SAM in a postmenopausal 60-year-old woman. The patient presented with a palpable cutaneous mass in the right labium majora that had appeared 3 months earlier. The mass was slow growing and approximately 5 cm in size and resembled a soft tissue malignancy. It appeared as a well-defined multilocular cystic mass in magnetic resonance images. The preoperative diagnosis was a benign cystic lesion such as an epidermoid cyst. Grossly, the completely excised mass was 6 × 5 cm in size and well circumscribed with a multilocular outer surface, a yellowish-gray gelatinous cut surface, and a smooth rubbery inner surface. Histologic review revealed that the mass contained small to moderate amount of cellular angiomyxoid nodules and bland-looking spindle-shaped to ovoid cells without atypia. Neutrophil infiltration, which is a diagnostic feature of SAMs, was observed. Immunohistochemistry showed expression of CD34, but not of estrogen receptors, progesterone receptors, or desmin in the SAM. The patient has been followed up for 12 months without recurrence. PMID:28119899
Kataoka, Tatsunori; Iizawa, Norishige; Takai, Shinro
Superior dislocation of the patella without patellar ligament injury is an extremely rare condition. A review of the English-language literature found only 23 reported cases. In addition, the primary factor for dislocation in most of these cases was considered to be osteophytes in the inferior pole of the patella and the anterior surface of the femoral condyle; only 1 case had no osteophytes. We treated a 19-year-old woman who sustained a painful locking of the left knee after colliding with a friend. Plain radiography and computed tomography showed superior-lateral dislocation of the patella and an interlocking between notches in the inferior pole of the patella and the anterior surface of the femoral condyle. Closed reduction without sedation was performed without difficulty, and the patient was able to walk home without pain. After 1 week, the knee was without problems. The patient had no osteophytes in the knee and had no other common risk factors, such as patella alta, ligamentous laxity, genu recurvatum, and paralytic disorders. After a comparison with previously reported cases of superior patella dislocation, we concluded that the primary factor in the present case might have been a different condition.
Negenborn, Vera Lidwina; Ham, Simon Johannes
Multiple osteochondromas (MO) is characterized by the formation of osteochondromas throughout the entire body. Although the evidence regarding its pathogenesis is well understood, no curative treatment for the disorder is available. Patients can be treated symptomatically by surgical removal of painful osteochondromas. Unfortunately, some patients still suffer from severe pain, even after surgery. We report on a case concerning a 48-year-old woman with a history of MO who presented with persistent pain after surgical removal of a symptomatic osteochondroma of the left scapula and multiple symptomatic osteochondromas of the left foot and trochanteric region. Several interventions to reduce the pain did not have any lasting effect. Subsequently, she was treated with autologous fat grafting (AFG). After each session she was pain-free for at least one year and reported only partial recurrence of the pain. This is the first case report describing AFG for the treatment of pain after both surgical removal of an osteochondroma and symptomatic osteochondromas in a patient suffering MO with promising results. The treatment is more effective and clearly continues to remain active longer than injection therapy or pain medication. Future studies are necessary to confirm our results. PMID:28352606
Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Keohane, Catherine; Bermingham, Niamh; Kaar, George
The authors describe an unusual case of metastatic thyroid follicular adenocarcinoma presenting with sciatica in a 79-year-old woman. The primary thyroid tumour was undiagnosed until this clinical presentation. The patient gave a short history of back pain and right-sided sciatica, which was progressive and nocturnal in nature. Neuroimaging revealed an enhancing intradural mass lesion, which was completely excised through a right L1-L3 hemilaminectomy. Histopathological examination of the excised tissue revealed a follicular thyroid carcinoma. Subsequent metastatic investigation revealed a heterogeneously attenuating mixed solid cystic mass in a retrosternal thyroid gland, with multiple solid pulmonary nodules suggestive of metastatic disease. She opted for palliative radiotherapy for the primary thyroid cancer and made remarkable postoperative improvement. The authors conclude that surgical treatment of solitary metastatic lesion may produce good symptomatic relief irrespective of patient’s age and primary pathology, while emphasising the need for detailed clinical evaluation of patients with ‘red flag’ symptoms. PMID:22674960
Igata, Ryohei; Hori, Hikaru; Atake, Kiyokazu; Katsuki, Asuka; Nakamura, Jun
A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around May 2013, the patient experienced gastric discomfort, so metoclopramide was prescribed. Beginning on June 4, 2013, the patient was given metoclopramide, 10 mg intravenously, twice per week. On the seventh day after beginning metoclopramide, facial hot flushes, increased sweating, muscle rigidity, and galactorrhea were noted. Extrapyramidal symptoms (EPS) rapidly subsided in response to an intramuscular injection of biperiden. Blood biochemical tests revealed an elevated serum prolactin level of 44 ng/mL. After stopping metoclopramide, EPS disappeared. Serum prolactin level decreased to 15 ng/mL after 4 weeks. In our case, although no adverse reactions had previously occurred following the administration of metoclopramide, the patient developed EPS and hyperprolactinemia following the administration of this antiemetic in combination with paroxetine. Paroxetine and metoclopramide are mainly metabolized by CYP2D6, and they are inhibitors for CYP2D6. We report a case with EPS and hyperprolactinemia whose plasma paroxetine and metoclopramide level rapidly increased after the addition of metoclopramide. Our experience warrants the issuing of a precaution that adverse reactions may arise following the coadministration of metoclopramide and paroxetine even at their respective standard dose levels. PMID:27621638
Abdul Ghaffar, Nor Aliza; Ismail, M Pazudin; Nik Mahmood, N M Zaki; Daud, Khurshiah; Abu Dzarr, G A
Uterine fibroid or leiomyoma is the commonest benign uterine tumour. Its occurrence in the postmenopausal age group is rare and if enlargement of the fibroid noted during this time, the diagnosis of leiomyosarcoma is provisional until proven otherwise. A case of a postmenopausal woman with a huge uterine fibroid associated with polycythaemia is presented whereby the mass was noted to increase in size within 2 years. The patient was otherwise well except for the growing uterine mass. She had venesection done to treat her polycythaemia and later underwent surgery for total abdominal hysterectomy and bilateral salpingoophoorectomy. The histopathology report confirmed leiomyoma of uterus with no evidence of sarcomatous changes. It was suggested that large uterine myoma may cause secondary polycythaemia by three postulated mechanisms, i.e. presence of hypoxia suggesting shunting within the tumour, second, the uterine fibroid was compressing the ureters resulting in inappropriate excessive production of erythropoietin by the kidneys, and third, the tumour itself may have been producing the erythropoietin.
Shakerian, Behnam; Mandegar, Mohammad Hossein; Moradi, Bahieh; Roshanali, Farideh
Introduction: Low-grade endometrial stromal sarcoma (LG-ESS) is a malignant intrauterine tumor that rarely presents with distant metastasis. Simultaneous lung and cardiac metastases from LG-ESS is also an extremely rare event. Case Presentation: A 42-year-old woman presented with dyspnea and exercise intolerance. She had a history of hysterectomy and left salpingoophorectomy. She underwent second laparotomy as well as right oophorectomy after new finding of vaginal mass with histopathologic diagnosis of LG-ESS. Cardiac imaging techniques demonstrated tumoral process in the right atrium and ventricle, coronary sinus, and pulmonary outlet tract as well as multiple metastases in the lung fields. Successful complete surgical resection of the metastatic tumor in the right side of the heart and then radiotherapy were done. After 28 months, follow-up examination revealed no abnormality. Conclusions: We describe the first documented case of isolated intracardiac and lung metastases of a LG-ESS without concurrent abdominal or caval metastasis. PMID:26436070
Baena-Antequera, Francisca; Jurado-García, Estefanía
Within the assistance and support to coping with perinatal death, it must be considered that there is a group of women whose process has some features that give specific connotations. We talked about when the perinatal loss occurs due to a maternal decision to the presence of a fetal malformation. These cases today, thanks to advances in the techniques of control fetal development, are not uncommon. In their assistance, healthcare professionals should be aware that they often present a great sense of guilt and ambivalence between well-made decision and the hardness of having to come to it. A case of a pregnant woman undergoing a fetal fetolisis and care plan developed in her assistance for the induction of labor, delivery and immediate postpartum period is presented. This plan includes the problems of collaboration and the independent problems that are formulated according to the NANDA, NOC and NIC taxonomies. The implication for practice after studying this case leads to the duty to equally address the coping with a stillbirth, whether it was spontaneous or had it been determined by fetal malformation completion, giving parents the ability to view and contact with their child.
Neonakis, Ioannis; Mantadakis, Elpis; Gitti, Zoe; Mitrouska, Ioanna; Manidakis, Louis George; Maraki, Sofia; Samonis, George
Background Female genital tuberculosis is an uncommon disease that is rarely diagnosed in developed countries. Case presentation A 61-year-old postmenopausal woman who had undergone surgery and treated with adjuvant chemotherapy for infiltrating ductal carcinoma of the breast five years ago, presented with bloody vaginal discharge, fatigue, weight loss, and low grade fevers at night for two months. Histological examination of the endometrium, done based on the suspicion of a second primary cancer due to the tamoxifen therapy, revealed a granulomatous reaction. Liquid and solid mycobacterial cultures of the tissues were performed. Although the acid fast staining was negative, the liquid culture was positive for Mycobacterium tuberculosis. Involvement of other systems was not detected. The patient was treated with a three-drug antituberculosis regimen for 9 months and recovered fully. Conclusion Female genital tuberculosis is a rare but curable disease that should be included in the differential diagnosis of women with menstrual problems. Early diagnosis is important and may prevent unnecessary invasive procedures for the patient. PMID:16948834
Andrade, S J
Reviewing the social science literature on the Chicana or Mexican American woman reveals a tenaciously perpetuated stereotype in which she appears almost exclusively as a submissive maternal figure. This may be related to an on-going trend to support studies of interpersonal or cultural characteristics of Chicanas and a resistance to undertake evaluations of systemic discrimination against Mexican American women. Almost all such studies investigated lower class samples, thus confounding ethnicity with socioeconomic status. The size and selection of many of the samples are questionable for purposes of generalizing to the entire population. Because many concepts are not defined in behavioral terms, they are seldom assessed empirically. The main concern is to what extent social scientists and the media are dictating norms to the Chicano family and to what extent are social planners and educators being influenced by these images. Examples from 3 distinct areas of research conclude with interpretations of Mexican American women that differ considerably from those with a heavy emphasis on cultural values: 1) demographic analyses of the 1970 Public Use Samples of the census that acknowledge the disadvantaged economic position of Mexican Americans; 2) studies that are beginning to measure empirically the family dynamics of Mexican Americans; and 3) family planning studies that attempt to examine the interaction between health care delivery systems and Mexican American contraceptive behavior. Trained and experienced Chicana researchers are needed to offset the male orientation and ethnocentrism that have characterized the social sciences.
Sood, Neha; Desai, Kaniksha; Chindris, Ana-Maria; Lewis, Jason; Dinh, Tri A.
Steroid cell tumor not otherwise specified (NOS) is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms. The majority of tumors occur in pre-menopausal women (mean age: 43 years), in which 56-77% of patients present with virilization due to excess testosterone. An 80-year-old woman with worsening alopecia and excessive growth of coarse hair on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL). Radiologic studies were consistent with bilateral adrenal adenomas. Bilateral adrenal venous sampling ruled out the adrenal gland as origin of hormone secretion. A diagnostic and therapeutic bilateral salpingo-oophorectomy confirmed steroid cell tumor NOS of the left ovary. Post-operatively, the patient had complete resolution of her symptoms and normalization of testosterone level. Our case emphasizes the importance of a clinical suspicion for an occult testosterone secreting ovarian tumor in a symptomatic patient without obvious ovarian mass on imaging. PMID:27441075
Ünal, Betül; Doğan, Selen; Karaveli, Fatma Şeyda; Şimşek, Tayup; Erdoğan, Gülgün; Candaner, Işıl
The objective of this study is to determine and discuss the causes of a giant endometrial polyp in a postmenopausal woman without hormone/drug use and to submit interesting clinical presentation. Here we report a seventy-year-old female patient who was admitted to our hospital with lower back pain. There were no other complaints from her. Physical examination was normal. For further examination, computed tomography was performed and a heterogeneous mass, with a diameter of 10 × 9 centimeters, was detected in the uterine cavity. Hysterectomy because of suspected endometrial cancer was performed. Histopathological examination showed us a giant endometrial polyp with edematous and focal fibrotic stroma, large thick walled blood vessels between normal sized and cystically dilated endometrial glands. To the best of our knowledge, this is the first report of a giant endometrial polyp which is unrelated to use of drugs such as tamoxifen and raloxifene; however, based on the history of the patient it may be associated with long-term consumption of thyme, which is a kind of phytoestrogen. PMID:25093134
Mori, Fumiaki; Miki, Yasuo; Tanji, Kunikazu; Ogura, Eriko; Yagihashi, Norito; Jensen, Poul H; Wakabayashi, Koichi
We report an incipient case of intranuclear inclusion body disease (INIBD) in a 78-year-old woman. No apparent neurological symptoms were noticed during the clinical course. Post mortem examination revealed widespread occurrence of eosinophilic intranuclear inclusions in neuronal and glial cells of the central and peripheral nervous systems, as well as in parenchymal cells of the visceral organs. The inclusions were observed more frequently in glial cells than in neuronal cells. Ultrastructurally, the inclusions consisted of granular and filamentous material. Immunohistochemically, the inclusions were positive for ubiquitin, ubiquitin-related proteins (NEDD8 ultimate buster 1, small ubiquitin modifier-1, small ubiquitin modifier-2 and p62), promyelocytic leukemia protein and abnormally expanded polyglutamine. Consistent with previous studies, the vast majority of inclusion-bearing glial cells were astrocytes. Furthermore, p25α-positive oligodendrocytes rarely contained intranuclear inclusions. These findings suggest that INIBD may occur in non-demented elderly individuals and that oligodendrocyte is also involved in the disease process of INIBD.
Kawabata, Kosuke; Morikawa, Mamoru; Yamada, Takahiro; Minakami, Hisanori
A woman with twin pregnancy had a gradual decline in anti-thrombin (AT) activity from 72% at gestational week (GW) 29(-3/7) , to 53% at GW31(-2/7) , and to 41% at GW32(-2/7) , at which time hypertension (148/90 mmHg) and proteinuria (protein-to-creatinine ratio [P/Cr], 0.79 mg/mg) developed in the presence of normal platelet count (159 × 10(9) /L) and serum aspartate aminotransferase/lactate dehydrogenase (22/164 IU/L). AT product was given three times to maintain AT activity >50% and blood pressure was maintained below 155/95 mmHg with no treatment, but generalized edema with a weekly weight gain of 4.9 kg and increased proteinuria (to P/Cr, 7.6 mg/mg) required cesarean section at GW33(-3/7) . This case highlights the occurrence of pregnancy-induced AT deficiency alone in the absence of any other abnormality, including hypertension, proteinuria, or thrombocytopenia. Measurement of AT activity was considered helpful for determination of the appropriate time for delivery in this patient.
Hasegawa, Yuichi; Sago, Haruhiko
Calyceal diverticula are congenital, nonsecretory abnormalities in which the transitional cell-lined cavity communicates with the renal collecting system. Here we present the case of a calyceal diverticular abscess during pregnancy. A 40-year-old primiparous woman developed the abscess at 23 weeks of gestation, with right flank pain and a 37.8°C fever. A transabdominal ultrasound revealed a 12 × 10 cm cystic mass in the right kidney. She was initially diagnosed with a simple renal cyst infection, and intravenous antibiotics were initiated. Percutaneous drainage was started at 26 weeks of gestation. When urine excretion from the cyst was confirmed by dye test using indigotindisulfonate sodium, the patient was diagnosed with a calyceal diverticular abscess. She gave birth to a 2,870 g healthy male at 38 weeks of gestation. Percutaneous drainage with low-dose antimicrobial therapy could thus allow for the continued pregnancy of women with a calyceal diverticular abscess until full term. PMID:25525537
Wong, Jennifer WH; Williams, Steven R
A 61-year-old woman with an unknown psychiatric history presented with mutism, stupor, negativism, and withdrawn behavior. She was admitted to the psychiatric unit for what appeared to be catatonia. Medical records were not readily available. A comprehensive evaluation did not uncover any medical etiology. Lorazepam was ineffective at consistently reversing her catatonic symptoms. During week three of hospitalization, she was given olanzapine with subsequent improvement in her negativism. Several physicians believed her catatonic symptoms were feigned given multiple episodes of spontaneous purposeful movement when she was not under the direct supervision of staff. There is minimal literature on distinguishing catatonia and factitious disorder. This distinction is crucial because these diagnoses require very different treatments, and the iatrogenic complications related to the treatment of catatonia with high-dose benzodiazepines and electroconvulsive therapy are significant. Rapid access to electronic health records can facilitate treatment for patients who cannot provide a medical history, especially when factitious disorder is included in the differential diagnosis. PMID:28352494
Foppiani, Luca; Massobrio, Bruno; Cascio, Christian; Antonucci, Giancarlo
Anorexia nervosa (AN) is a serious psychiatric disorder which typically occurs in young women; however, more and more cases in middle-aged women are being reported. The management of this complex disease requires a team approach, and full recovery occurs only in 50% of patients. Endocrine and metabolic complications are commonly observed, the latter of which may even be life-threatening, and require prompt and proper management. Infections, albeit reported, are not usually a major clinical problem in these patients. We herein report the case of a severely malnourished middle-aged woman with long-standing AN who was hospitalized with marked hypokalaemia (1.5 mEq/L) and rhabdomyolysis; during hospitalization she developed septic shock and acute respiratory distress syndrome, which required urgent admission to the intensive care unit. She underwent sedation and tracheal intubation for mechanical ventilation and was managed with combined therapies, which eventually led to a successful outcome. Life-threatening medical complications can occur not only in young women but in middle-aged women with AN as well and require a combined multidisciplinary approach.
Qureshi, Ihtesham Aatif; Korya, Daniel; Kassar, Darine; Moussavi, Mohammed
Background: Alien hand syndrome [AHS] is a rare and ill-defined neurological disorder. It produces complex, goal-directed motion of one hand that is involuntarily instigated. This syndrome characteristically arises after brain trauma, brain surgery, stroke or encephalitis. We describe a case of AHS in a patient who had a previous episode of subarachnoid hemorrhage affecting the left frontal lobe and corpus callosum. Case presentation: An 84-year-old woman presented to the emergency department complaining of headaches and several episodes of her left arm moving as if it was groping around trying to grab at her own body. A computed tomography scan of the head demonstrated an acute left superior frontal hemorrhage with compression of the corpus callosum. Transcranial Doppler report showed no significant abnormality in the insonated vessels. After being stabilized for the acute bleed, she was treated with clonazepam 0.5 mgat night for the uncontrolled hand movements. Her movements resolved by her next month follow up. The diagnosis of AHS was made based on her clinical presentation, characterization of the movement and localization correlating with findings in neuroimaging. Conclusion: We document a rare neurologic disorder seen in patients presenting with a history of previous strokes and a typical description of involuntary and unintentional, uncontrolled unilateral arm movements with repetitive grasping. The present case has a combination of frontal and callosal lesions. These findings appear to support a potential destruction leading to the rare syndrome.
Rates of obesity in the United States have increased rapidly over the past several decades, and physicians should be prepared to care for obese patients in a nonjudgmental manner, being cognizant of the medical, social, and ethical implications of obesity. It is the responsibility of the physician to recognize the medical risks that are associated with obesity and to counsel the patient regarding these risks in an unbiased manner, respecting her autonomy and maintaining her dignity. Classifying obesity as a medical condition can serve to reduce bias toward obese patients and to change the approach toward the patient from one of blame to one of caring. It is unethical for physicians to refuse to accept a patient or decline to continue care that is within their scope of practice solely because the patient is obese. However, if physicians lack the resources necessary for the safe and effective care of the obese patient, consultation or referral or both are appropriate. Obesity education that focuses on the specific medical, cultural, and social issues of the obese woman should be incorporated into physician education at all levels.
Nishihara, Kyoko; Ohki, Noboru; Kamata, Hideo; Ryo, Eiji; Horiuchi, Shigeko
Fetal movement is an important biological index of fetal well-being. Since 2008, we have been developing an original capacitive acceleration sensor and device that a pregnant woman can easily use to record fetal movement by herself at home during sleep. In this study, we report a newly developed automated software system for analyzing recorded fetal movement. This study will introduce the system and compare its results to those of a manual analysis of the same fetal movement signals (Experiment I). We will also demonstrate an appropriate way to use the system (Experiment II). In Experiment I, fetal movement data reported previously for six pregnant women at 28-38 gestational weeks were used. We evaluated the agreement of the manual and automated analyses for the same 10-sec epochs using prevalence-adjusted bias-adjusted kappa (PABAK) including quantitative indicators for prevalence and bias. The mean PABAK value was 0.83, which can be considered almost perfect. In Experiment II, twelve pregnant women at 24-36 gestational weeks recorded fetal movement at night once every four weeks. Overall, mean fetal movement counts per hour during maternal sleep significantly decreased along with gestational weeks, though individual differences in fetal development were noted. This newly developed automated analysis system can provide important data throughout late pregnancy.
Subirà, Olaia; Muñoz, Silvia; Sánchez, Juan José; Puyalto, Paloma; Lee, Andrew G
A 32-year-old woman experienced dizziness and headache for 5 months. She also complained of painless, progressive bilateral visual loss for several weeks. Prior to developing the initial symptoms, she had an uncomplicated pregnancy except for dizziness and systemic hypotension during the first term. Fundus examination disclosed prominent retinal arteries, as well diffuse microaneurysms, widespread intraretinal hemorrhages, and hyperemic optic discs. Brain magnetic resonance imaging revealed multiple supratentorial white matter lesions suggestive of ischemic strokes. Initially she had severe systemic hypotension (41/17 mmHg). When reassessed, blood pressure was normal in the lower limbs, but there was severe hypotension in the upper limbs. An angio-computed tomography of the supraortic trunks showed occlusion of both primitive carotid arteries, both subclavian arteries and the right axilary and humeral arteries. Based on these findings, the diagnosis of Takayasu type I arteritis with ischemic retinopathy, and cerebrovascular disease was established. Bilateral retinal panphotocoagulation and aorta ti right carotid bypass were performed because of the severity of the ischemic lesions.
Schroeder, Steven A
Smoking among patients with mental illness is a major and underappreciated public health problem. The case of Ms G, a 51-year-old woman with bipolar disorder who wishes to quit smoking, illustrates the importance and feasibility of smoking cessation in patients with psychiatric disorders. Persons with chronic mental illness and/or substance abuse constitute 22% of the US population yet are estimated to consume 44% of cigarettes. As many as 200,000 of the 435,000 annual deaths related to smoking in the United States are estimated to occur in this population. On average, patients with mental illness die 25 years earlier than the general population, and smoking is a major contributor to these premature deaths. In the past, mental health clinicians have tended not to address smoking cessation with their patients, but increasing evidence suggests that such reticence is unwarranted, as smoking cessation in this population is feasible. The approach to cessation should include standard interventions of counseling and pharmacotherapy, for which substantial evidence of efficacy exists in patients with and without mental illness. If patients with mental illness are to achieve wellness, smoking cessation must be an integral component of their treatment regimen.
Maman, Esther; Briot, Karine; Roux, Christian
We report a 51-year old woman who suffered 2 atypical subtrochanteric femoral fractures (AFFs). She had a history of several metatarsal fractures. She had a normal bone densitometry. An adult form of hypophosphatasia (HPP) was diagnosed from low serum alkaline phosphatase (ALP), and tissue nonspecific isoenzyme of ALP (TNSALP) mutation analysis revealing 2 heterozygous mutations: c.299C>T (p. T100M) and c.571G>A (p. E191K). Low ALP is the hallmark of the diagnosis of HPP; which is associated in adults with premature loss of deciduous teeth, recurrent metatarsal stress fractures, and joints and tendons disorders. The incidence of AFFs in the population is 5.9 per 100,000 person-years. Physicians and patients with bone fragility must pay attention to prodromal pain, which require urgent radiographic evaluation of both femurs. Rheumatoid arthritis, use of glucocorticoids, and proton pump inhibitors have been associated with an excess risk of AFFs. Healthy subjects carrying a TNSALP mutation with low ALP value may be exposed to develop AFF spontaneously or while receiving potent anti-resorptive drugs. Low ALP must be checked as a cause of bone fragility.
Bergin, Patrick F; Milchteim, Charles; Beaulieu, Gregory P; Brindle, Kathleen A; Schwartz, Arnold M; Faulks, Craig R
A 51-year-old woman presented with moderate knee pain refractory to conservative measures. Radiographs revealed a well-defined, but irregularly-shaped ovoid soft tissue density at the posterior superior aspect of the infrapatellar fat pad of Hoffa. On magnetic resonance imaging, the mass was mildly heterogeneous and had intermediate signal in the proton density series and mixed signal intensity on the T2-weighted images. A low-signal rim could be seen around a portion of the lesion. Arthroscopic resection was performed and a vascular stalk was encountered. The differential diagnosis included: ganglion cyst, meniscal cyst, intra-articular lipoma, villous proliferation of the synovial membrane, Hoffa disease, and intracapsular chondroma. Histologic examination revealed a fibrous capsule partially surrounding a benign lipomatous neoplasm containing an abundance of thin- and thick-walled blood vessels with periadventitial myxoid stroma. To our knowledge, this is the first reported case of an intra-articular angiomyxolipoma in the literature. At 8-month follow-up, the patient was asymptomatic with no sign of recurrence. We postulate a low recurrence rate based on the insidious growth rate and benign histological appearance of such lesions. To our knowledge, no other intra-articular lipomatous lesion of the knee has been removed solely with arthroscopic techniques. Further follow-up information is needed to better understand the natural course of these lesions.
Dogan, Bercem Aycicek; Sennaroglu, Engin; Dam, Gamze; Dogan, Nurettin Ozgur; Cicekcioglu, Hulya
We present a 24-year-old woman with symptoms of backache, acute peripheral arthritis, joint swelling, and erythema, diagnosed with ankylosing spondylitis (AS) and determined to have cor triatriatum sinister (CTS) without cardiac symptoms. On physical examination, the patient had a rythmic S1 with a loud pulmonic component to her S2 and a grade 2/6 systolic murmur along the left sternal edge. Pulmonary examination was normal. Also her left knee and left metacarpophalangeal joints were swollen. Chest radiography revealed a slight prominence of the pulmonary arteries. Her echocardiogram showed a normal left ventricle and that the left atrium was divided into 2 distinct chambers by a membranous septum. In the left atrium, a moderately obstructive fibromuscular membrane was imaged, resulting in a transmembrane mean pressure gradient of 6 mm Hg. Pulmonary artery pressure was increased (peak systolic pulmonary pressure: 44 mm Hg). There was also mild mitral regurgitation and the atrial septum was intact. Cardiac MRI demonstrated CTS. Cardiovascular involvement is a common finding in patients with AS. Thus, careful cardiac evaluation appears to be mandatory in all cases of AS. Our case may be interesting in that to the best of our knowledge, AS with CTS has not been previously reported. Also a patient with CTS who has no cardiac symptoms is a very rare occurrence in the literature.
Introduction Cardiogenic shock is very uncommon in healthy people. The differential diagnosis for patients with acute heart failure in previously healthy hearts includes acute myocardial infarction and myocarditis. However, many drugs can also depress myocardial function. Propofol and fentanyl are frequently used during different medical procedures. The cardiovascular depressive effect of both drugs has been well established, but the development of cardiogenic shock is very rare when these agents are used. Case presentation After a minor surgical intervention, a 32-year-old Caucasian woman with no significant medical history went into sudden hemodynamic deterioration due to acute heart failure. An urgent echocardiogram showed severe biventricular dysfunction and an estimated left ventricular ejection fraction of 20%. Extracorporeal life support and mechanical ventilation were required. Five days later her ventricular function had fully recovered, which allowed the progressive withdrawal of medical treatment. Prior to her hospital discharge, cardiac MRI showed neither edema nor pathological deposits on the delayed contrast enhancement sequences. At her six-month follow-up examination, the patient was asymptomatic and did not require treatment. Conclusion Although there are many causes of cardiogenic shock, the presence of abrupt hemodynamic deterioration and the absence of a clear cause could be related to the use of propofol and fentanyl. PMID:21846377
Chang, Nen-Chung; Lin, Mei-Shu; Huang, Chun-Yao; Shih, Chun-Ming; Bi, Wei-Fung
Reversible left ventricular apical ballooning, without coronary artery stenosis, is a novel heart syndrome mimicking acute myocardial infarction, and is very rare in Taiwan. A 74-year-old Taiwanese woman returned from travelling abroad for one week and suffered from persistent, severe jet lag with sleep disturbance. She had a cold exacerbated by bronchial asthma for three days. She presented with sudden onset of chest pain after drinking three cups of coffee and taking a sauna for more than 1 h. On admission, an electrocardiogram showed ST segment elevation in leads II, III, aVF and V3–6, and cardiac enzyme tests revealed minimal elevation. An echocardiogram showed apical ballooning and basal hyperkinesias of the left ventricle (LV) in systole. A coronary angiogram on the second day was normal, while the ST segment was still elevated, and the patient continued to experience chest pain. A negative T wave developed three days later. The electrocardiogram abnormality and LV dysfunction resolved completely six months later. A takotsubo (ampulla) cardiomyopathy was diagnosed. The activated myocardial adrenergic nervous system, stimulated by acute and marked stress in this patient, with more adrenergic innervations distributed in the apex of the LV, may be the trigger for this novel cardiac syndrome. PMID:22477274
Ito, Shoji; Sugiura, Takeshi; Azami, Takafumi; Sasano, Hiroshi; Sobue, Kazuya
A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th(10-11) in the epidural space, accessed via the L(2-3) interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day. After she had experienced several chemical abortions, finally she got pregnant via artificial insemination. She had an uneventful delivery of a healthy baby by cesarean resection under spinal anesthesia. In a patient with CRPS who has an implanted SCS system and wishes to get pregnant, the electrode lead into the low thoracic epidural space should be accessed via the high lumbar intervertebral space in consideration of a future requirement for spinal or epidural anesthesia for cesarean section. The generator should be placed in the buttock to prevent impairment of the SCS system being caused by the enlarged abdomen during pregnancy. Although we were apprehensive of adverse effects owing to the electromagnetic field force and change of blood flow in the pelvic viscera, our patient had a successful delivery. SCS is a favorable option for patients with CRPS who wish to get pregnant.
Sredl, Darlene; Aukamp, Virginia
Pregnancy presents many problems without working through additional problems in coping with an ostomy. Yet many women with an ostomy do get pregnant and do deliver healthy babies. Evidence-based nursing is of the utmost importance, as there is little published information on this topic. Because of the scarcity of pregnant subjects within the ostomy category, most studies, by necessity, select a purposive subject base. Therefore, other information sources regarding nursing management of the pregnant woman with an ostomy take on considerably more importance. This article explores other forms of evidence that can be used in managing the care of pregnant ostomy patients and specifically how nurses can integrate various sources of information in designing an evidence-based nursing care plan. Nonpharmacologic forms of relaxation therapy, easily used by nurses, such as mindfulness-based stress reduction, guided imagery, and hypnosis, are also identified as some ways nurses can relieve anxiety and experiential stress associated with pregnancy in women who have an ostomy.
Foppiani, Luca; Massobrio, Bruno; Cascio, Christian; Antonucci, Giancarlo
Anorexia nervosa (AN) is a serious psychiatric disorder which typically occurs in young women; however, more and more cases in middle-aged women are being reported. The management of this complex disease requires a team approach, and full recovery occurs only in 50% of patients. Endocrine and metabolic complications are commonly observed, the latter of which may even be life-threatening, and require prompt and proper management. Infections, albeit reported, are not usually a major clinical problem in these patients. We herein report the case of a severely malnourished middle-aged woman with long-standing AN who was hospitalized with marked hypokalaemia (1.5 mEq/L) and rhabdomyolysis; during hospitalization she developed septic shock and acute respiratory distress syndrome, which required urgent admission to the intensive care unit. She underwent sedation and tracheal intubation for mechanical ventilation and was managed with combined therapies, which eventually led to a successful outcome. Life-threatening medical complications can occur not only in young women but in middle-aged women with AN as well and require a combined multidisciplinary approach. PMID:28154278
Hans Christian Andersen's story 'The Little Mermaid' is read as a creation myth and a metaphor for woman's condition in patriarchy, broadly conceptualised within a Lacanian framework. In the first part, the psychoanalytic concept of castration (broadly conceptualised as containing any existential severance which forms the basis for sexual difference and subjectivity) is utilised to argue that the myth is about a construction of (mostly female) subjectivity through a series of separations or splits: (1) birth, (2) growing up, (3) desire and (4) death. Birth and death are read as representing real separations. Growing up is read as structured around a symbolic castration of tongue and voice, while desire is read as structured around lack. In the second part the ideological implications of Disney's adaptation of the original for its symbolic status are explored. It is argued that by simplifying and externalising internal complex conflicts in the Andersen story, Disney's version reduces the myth to a fairy tale, and reproduces the ideology of romantic love.
Di Benedetto, Luisa; Giovanale, Valentina; Caserta, Donatella
Introduction: Tamoxifen is the usual endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer in pre and post-menopausal women. Previous studies have suggested an increased prevalence of endometrial diseases after treatment with tamoxifen. Case presentation: The authors report a case of 38-year-old woman with diagnosis of endometrial polyp and tubal metaplasia, during puerperium and after micropapillary ductal breast cancer surgery, 5 years of tamoxifen treatment, spontaneous pregnancy without complications and full-term vaginal delivery. Conclusion: Tamoxifen is a safe and reliable treatment of breast cancer, but data suggest an association with endometrial polyps, hyperplasia, metaplasia and carcinoma. One of the most common types of endometrial metaplasia is ciliated tubal metaplasia. It is generally known that endometrial tubal metaplasia is a benign disease. However studies propose endometrial tubal metaplasia to be a potential premalignant endometrial lesion and its association with endometrial hyperplasia and well-differentiated endometrioid carcinoma. We propose close monitoring of patients taking tamoxifen and prompt evaluation of any uterine bleeding or pelvic complaint or abnormal TVUS images. PMID:26261678
Ukita, Masahiko; Hasegawa, Masaaki; Nakahori, Takashi
Survival beyond the age of 10 years is rare among 18-trisomic individuals. Most of these long-term survivors, when more than one tissue is studied, are normal/trisomy mosaics. They are usually mentally severely retarded with a variety of anomalies. There is another group of mosaic individuals: 7 women and a 13-year-old girl, with a low frequency of 18-trisomic cells, normal or mildly retarded intelligence, and minor anomalies. Two of them were diagnosed after delivering malformed stillborn infants. One of them was the mother of a trisomy 18 patient who was coincidentally found to have trisomy 18 mosaicism. Pigmentary dysplasia, previously called hypomelanosis of Ito, is a disorder with linear, swirly, or patchy, hypo- or hyperpigmented areas of skin, resulting from migration and interaction of melanoblasts of different pigmentary potential. The disorder is often accompanied by mosaic chromosomal abnormalities, including mosaic trisomy 18. Here we report a 26-year-old woman with low frequency trisomy 18 mosaicism, normal intelligence, and pigmentary dysplasia, who gave birth to an 18-trisomic girl. 12 refs., 1 fig.
Borbinha, Cláudia; Marto, João Pedro; Calado, Sofia; Viana-Baptista, Miguel
Ischemic and hemorrhagic stroke are recognized complications of Varicella zoster virus (VZV) infections, although uncommon and poorly documented. The authors report the case of a 31-year-old woman admitted with acute ischemic stroke of the right posterior cerebral artery and a history of a thoracic rash 1 month before. Aspirin and simvastatin were prescribed, but the patient suffered a stepwise deterioration the following days, with new areas of infarction on brain imaging. Despite no evidence of cardiac or large vessel embolic sources, anticoagulation was started empirically 6 days after stroke onset. One week later, symptomatic hemorrhagic transformation occurred. The diagnosis of VZV vasculopathy was then considered, and treatment with acyclovir and prednisolone was started with no further vascular events. Cerebrospinal fluid analysis and digital subtraction angiography findings corroborated the diagnosis. The patient was discharged to the rehabilitation center with a modified Rankin scale (mRS) score of 4. On the 6-month follow-up, she presented only a slight disability (mRS score 2). In conclusion, VZV vasculopathy needs to be considered in young adults with stroke. A high index of suspicion and early treatment seem to be important to minimize morbidity and mortality. Anticoagulation should probably be avoided in stroke associated with VZV vasculopathy. PMID:27504091
Torres, Daniele; Parrinello, Gaspare; Cardillo, Mauro; Pomilla, Marina; Trapanese, Caterina; Michele, Bellanca; Lupo, Umberto; Schimmenti, Caterina; Cuttitta, Francesco; Pietrantoni, Rossella; Vogiatzis, Danai; Licata, Giuseppe
Hiatal hernia (HH) is a frequent entity. Rarely, it may exert a wide spectrum of clinical presentations mimicking acute cardiovascular events such as angina-like chest pain until manifestations of cardiac compression that can include postprandial syncope, exercise intolerance, respiratory function, recurrent acute heart failure, and hemodynamic collapse. A 69-year-old woman presented to the emergency department complaining of fatigue on exertion, cough, and episodes of restrosternal pain with less than 1 hour of duration. Her medical history only included some episodes of bronchitis and no history of hypertension. The 12-lead electrocardiogram demonstrated sinus rhythm with right bundle-branch block. Laboratory tests, including cardiac troponin I, were within normal reference values. Chest radiography showed no significant pulmonary alterations and revealed in mediastinum a huge abnormal shadow overlapping the right heart compatible with a gastric bubble.The gastroscopy confirmed a large HH. A 2-dimensional transthoracic echocardiogram, using all standard and modified apical and parasternal views, revealed an echolucent mass, compatible with HH, compressing the right atrium. Also, it showed an altered left ventricular relaxation and a mild increase of pulmonary artery pressure (35 mm Hg). Spirometry showed a mild obstruction of the small airways, whereas coronary angiography showed normal coronary arteries. We concluded that the patient's symptomatology was related to the compressive effects of the large hiatal ernia, a neglected cause of cardiorespiratory symptoms. The surgical repair of HH was indicated.
Wong, Jennifer Wh; Williams, Steven R
A 61-year-old woman with an unknown psychiatric history presented with mutism, stupor, negativism, and withdrawn behavior. She was admitted to the psychiatric unit for what appeared to be catatonia. Medical records were not readily available. A comprehensive evaluation did not uncover any medical etiology. Lorazepam was ineffective at consistently reversing her catatonic symptoms. During week three of hospitalization, she was given olanzapine with subsequent improvement in her negativism. Several physicians believed her catatonic symptoms were feigned given multiple episodes of spontaneous purposeful movement when she was not under the direct supervision of staff. There is minimal literature on distinguishing catatonia and factitious disorder. This distinction is crucial because these diagnoses require very different treatments, and the iatrogenic complications related to the treatment of catatonia with high-dose benzodiazepines and electroconvulsive therapy are significant. Rapid access to electronic health records can facilitate treatment for patients who cannot provide a medical history, especially when factitious disorder is included in the differential diagnosis.