Sample records for case study review

  1. BOOK REVIEW: Case Studies in Knowledge Management


    BOYACI, Reviewed By Dr. Adnan


    161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM) as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…...

  2. BOOK REVIEW: Case Studies in Knowledge Management

    Directory of Open Access Journals (Sweden)

    Reviewed by Dr. Adnan BOYACI


    Full Text Available 161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…etc. Because of the growingimportance and the popularity of the KM either as a research topic or specialized coursesubject, a crucial need for understanding, conceptualization and implementation of KM asa system has emerged since the mid 1990’s. In this sense, the book contributes criticallyto fill the gap between theory and implementation as a teaching material.This edited book is published by Idea Group Publishing. The book has twenty chaptersdivided into seven sections. In addition to a section of authors’ biography contributing thebook and an index, there is a preface that the basic terms and key concepts underliningthe cases discussed following chapters, which is explained in a schematized way.Besides the editor, total of 47 authors have contributed to the book. These authors arefrom different countries, academic backgrounds, and institutions. Although approximatelyone third of the authors are from USA, the rest of the authors are from Canada, England,Austria, Germany, Australia, New Zealand, Egypt, Bahrain and China. The authorsrepresent a variety of universities, private companies, and military institutions. Most ofthem have strong professional backgrounds, which help them address the issues bothfrom theoretical and practical perspectives. Contributions of authors having differentbackgrounds and institutions enable the book to have very comprehensive spectrum andthis makes the book attractive practically for those working different sectors

  3. Case study methodology in nurse migration research: an integrative review. (United States)

    Freeman, Michelle; Baumann, Andrea; Fisher, Anita; Blythe, Jennifer; Akhtar-Danesh, Noori


    The migration of nurses combined with a global nursing shortage affects the supply of nurses and access to health services in many countries. The purpose of this article was to conduct an integrative review of case study methodology (CSM) in nurse migration research. Findings identify where studies using CSM have been conducted, by whom, and the themes explored. More studies using CSM are required to answer the important "how" and "why" questions related to nurse migration. Nurses should take a leadership role in this research.

  4. Humanitarian logistics: Review and case study of Zimbabwean experiences

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    Charles Mbohwa


    Full Text Available This paper reviews and presents findings on mini-case studies done on the difficulties and problems faced by humanitarian organisations in running logistics systems in Zimbabwe. Document analysis was done and this was complemented by mini-case studies and semi-structured interviews and site visits. Mini-case studies of the operations of the World Food Programme, the International Red Cross Society and the Zimbabwe Red Cross Society, the World Health Organisation, the United Nations Children's Fund and the Zimbabwean Civil Protection Organisation in Zimbabwe are discussed. These clarify the difficulties and problems faced such as the lack of trained logistics personnel, lack of access to specialised humanitarian logistics courses and research information, the difficulty in using and adapting existing logistics systems in attending to humanitarian logistics and the lack of collaborative efforts that address the area specifically. This study seeks to use primary and secondary information to inform decision-making in humanitarian logistics with possible lessons for neighbouring countries, other regions in Africa and beyond. Activities on collaborative networks that are beneficial to humanitarian logistics are also suggested.

  5. Current management of bronchiectasis: review and 3 case studies. (United States)

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne


    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

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

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    Søndergaard Jens


    Full Text Available Abstract Background Recent theories on adult learning recommend that learning is situated in real-life contexts. Learning is considered a continuous process in which every new experience builds on, and integrates with, previously accumulated experiences. Reviewing and reflecting on patient cases is in line with this learning approach. There has, however, been remarkably little research into how patient cases might be applied in professional education. The purpose of this article is to present family physicians' perceptions of the learning process initiated by reviewing patient cases. Methods Thirteen family physicians, who had all participated in a large project on cancer diagnosis in family practice (the CAP-project, currently carried out at the Research Unit for General Practice, University of Aarhus were interviewed on their experiences of reviewing patient cases. In the CAP-project family physicians (n = 467, 81% in the County of Aarhus (640 000 inhabitants completed 2,212 (83% detailed questionnaires on all newly diagnosed patients with cancer encountered in their practices during a one year period (2004–2005. In order to complete the questionnaire the family physicians were required to perform a systematic case review of each patient: they had to consult their records to provide dates of symptom-presentation, investigations and treatments initiated, and reflect on previous encounters with the patients to give detailed information on his/hers knowledge of the patients' care seeking behaviour, mental health and risk factors. The purpose of this article is to present indebt interview-data on family physicians' perceptions of the learning process initiated by reviewing patient cases, and their evaluations of using patient case reviews as a learning method in family practice. Results The process of reflection initiated by reviewing patient cases enabled family physicians to reconsider their clinical work procedures which potentially supported

  7. Educational data mining: a sample of review and study case

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    Alejandro Pena, Rafael Domínguez, Jose de Jesus Medel


    Full Text Available The aim of this work is to encourage the research in a novel merged field: Educational data mining (EDM. Thereby, twosubjects are outlined: The first one corresponds to a review of data mining (DM methods and EDM applications. Thesecond topic represents an EDM study case. As a result of the application of DM in Web-based Education Systems (WBES,stratified groups of students were found during a trial. Such groups reveal key attributes of volunteers that deserted orremained during a WBES experiment. This kind of discovered knowledge inspires the statement of correlational hypothesisto set relations between attributes and behavioral patterns of WBES users. We concluded that: When EDM findings aretaken into account for designing and managing WBES, the learning objectives are improved

  8. Nanomaterial Case Studies: Nanoscale Titanium Dioxide (External Review Draft) (United States)

    This draft document presents two case studies of nanoscale titanium dioxide (nano-TiO2) used (1) to remove arsenic from drinking water and (2) as an active ingredient in topical sunscreen. The draft case studies are organized around a comprehensive environmental asses...

  9. Biventricular takotsubo cardiomyopathy: case study and review of literature. (United States)

    Daoko, Joseph; Rajachandran, Manu; Savarese, Ronald; Orme, Joseph


    Biventricular takotsubo cardiomyopathy is associated with more hemodynamic instability than is isolated left ventricular takotsubo cardiomyopathy; medical management is more invasive and the course of hospitalization is longer. In March 2011, a 62-year-old woman presented at our emergency department with abdominal pain, nausea, and vomiting. On hospital day 2, she experienced chest pain. An electrocardiogram and cardiac enzyme levels suggested an acute myocardial infarction. She underwent cardiac angiography and was found to have severe left ventricular systolic dysfunction involving the mid and apical segments, which resulted in a left ventricular ejection fraction of 0.10 to 0.15 in the absence of obstructive coronary artery disease. Her hospital course was complicated by cardiogenic shock that required hemodynamic support with an intra-aortic balloon pump and dobutamine. A transthoracic echocardiogram revealed akinesis of the mid-to-distal segments of the left ventricle and mid-to-apical dyskinesis of the right ventricular free wall characteristic of biventricular takotsubo cardiomyopathy. After several days of medical management, the patient was discharged from the hospital in stable condition. To the best of our knowledge, this is the first review of the literature on biventricular takotsubo cardiomyopathy that compares its hemodynamic instability and medical management requirements with those of isolated left ventricular takotsubo cardiomyopathy. Herein, we discuss the case of our patient, review the pertinent medical literature, and convey the prevalence and importance of right ventricular involvement in patients with takotsubo cardiomyopathy.

  10. How Does Student Peer Review Influence Perceptions, Engagement and Academic Outcomes? A Case Study (United States)

    Mulder, Raoul; Baik, Chi; Naylor, Ryan; Pearce, Jon


    Involving students in peer review has many pedagogical benefits, but few studies have explicitly investigated relationships between the content of peer reviews, student perceptions and assessment outcomes. We conducted a case study of peer review within a third-year undergraduate subject at a research-intensive Australian university, in which we…

  11. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study (United States)

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


    There is limited literature available on the comorbidity between autism spectrum disorder (ASD) and substance use disorder (SUD). This paper reviews existing literature and exemplifies the challenges of treating this population with a case report of an adult male with ASD and DSM-5 alcohol use disorder. This review and case study seeks to…

  12. Intrauterine exposure to carbamazepine and specific congenital malformations : systematic review and case-control study

    NARCIS (Netherlands)

    Jentink, Janneke; Dolk, Helen; Loane, Maria A.; Morris, Joan K.; Wellesley, Diana; Garne, Ester; de Jong-van den Berg, Lolkje


    Objective To identify specific major congenital malformations associated with use of carbamazepine in the first trimester of pregnancy. Design A review of all published cohort studies to identify key indications and a population based case-control study to test these indications. Setting Review of P

  13. Using Peer Reviews to Examine Micropolitics and Disciplinary Development of Engineering Education: A Case Study (United States)

    Beddoes, Kacey


    This article presents a case study of the peer review process for a feminist article submitted to an engineering education journal. It demonstrates how an examination of peer review can be a useful approach to further understanding the development of feminist thought in education fields. Rather than opposition to feminist thought per se, my…

  14. Degradation in photoelectrochemical devices: review with an illustrative case study (United States)

    Nandjou, Fredy; Haussener, Sophia


    The durability, reliability, and robustness of photoelectrochemical (PEC) devices are key factors for advancing the practical large-scale implementation of cost-competitive solar fuel production. We review the known degradation mechanisms occurring in water-splitting photoelectrochemical devices. The degradation of single components is discussed in detail, and the parameters and conditions which influence it are presented. Device short-term durability depends on the semiconductor material and its interface with the electrolyte. Catalyst and electrolyte degradations are considerable challenges for long-term durability. We highlight how PEC device design choices can affect the salience of alternative degradation mechanisms. The PEC device architecture and the initial operating design point are crucial for observed device performance loss. Device degradation behavior is further impacted by irradiation intensity and concentration, and by current density and concentration. Enhancing a physical understanding of degradation phenomena and investigating their effect on component properties is of utmost importance for predicting performance loss and tackling the durability challenge of PEC devices.

  15. Methodology or method? A critical review of qualitative case study reports. (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia


    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

  16. Poland's syndrome in women: 24 cases study and literature review

    Institute of Scientific and Technical Information of China (English)

    ZHU Lin; ZENG Ang; WANG Xiao-jun; LIU Zhi-fei; ZHANG Hai-lin


    Background Since its first description in 1841,numerous variations and treatments of Poland's syndrome (congenital deficiency of the pectoralis major muscle associated with brachysyndactyly) have been reported.None of the reports,however,involved female Chinese patients.Methods A retrospective study of 24 female patients was conducted to guide the selection of methods of surgical reconstruction.The patients were divided into three groups according to the degree of thoracic tissue development.Type Ⅰ (mild):Limited tissue loss which can be treated with simple filling with autologous fat and/or an artificial breast implant.Type Ⅱ (moderate):Moderate thoracic tissue hypoplasia where the breast parenchyma can still offer adequate implant coverage.Mammoplasty using a latissimus dorsi muscular flap with an implant was performed in this group.The flap was used to fill the infraclavicular hollow,and the implant was placed in the dual-plane pocket.Type Ⅲ (severe):Severe thoracic tissue hypoplasia,without sufficient parenchyma to offer implant coverage.A latissimus dorsi muscular flap was used to form a total submuscular pocket in which an implant was placed.Results The numbers of Type Ⅰ,Ⅱ,and Ⅲ patients were 15,3,and 6,respectively.All of the flaps and injected fat demonstrated good survival.Satisfactory cosmetic results were exhibited during the follow-up period of 1 to 9 years.Conclusions Although this group of patients showed varied conditions,they can be roughly divided into three types according to the degree of thoracic tissue development.In our experience,this classification is simple and useful in choosing the breast reconstruction options.

  17. The use of rapid review methods in health technology assessments: 3 case studies

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    Eva Kaltenthaler


    Full Text Available Abstract Background Rapid reviews are of increasing importance within health technology assessment due to time and resource constraints. There are many rapid review methods available although there is little guidance as to the most suitable methods. We present three case studies employing differing methods to suit the evidence base for each review and outline some issues to consider when selecting an appropriate method. Methods Three recently completed systematic review short reports produced for the UK National Institute for Health Research were examined. Different approaches to rapid review methods were used in the three reports which were undertaken to inform the commissioning of services within the NHS and to inform future trial design. We describe the methods used, the reasoning behind the choice of methods and explore the strengths and weaknesses of each method. Results Rapid review methods were chosen to meet the needs of the review and each review had distinctly different challenges such as heterogeneity in terms of populations, interventions, comparators and outcome measures (PICO and/or large numbers of relevant trials. All reviews included at least 10 randomised controlled trials (RCTs, each with numerous included outcomes. For the first case study (sexual health interventions, very diverse studies in terms of PICO were included. P-values and summary information only were presented due to substantial heterogeneity between studies and outcomes measured. For the second case study (premature ejaculation treatments, there were over 100 RCTs but also several existing systematic reviews. Data for meta-analyses were extracted directly from existing systematic reviews with new RCT data added where available. For the final case study (cannabis cessation therapies, studies included a wide range of interventions and considerable variation in study populations and outcomes. A brief summary of the key findings for each study was presented and

  18. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR Imaging Studies

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    Geraldine H. Chang


    Full Text Available Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

  19. Video Cases in Teacher Education: A review study on intended and achieved learning objectives by video cases

    NARCIS (Netherlands)

    Geerts, Walter; Van der Werff, Anne; Hummel, Hans; Van Geert, Paul


    This literature review focuses on the use of video cases in the education of preservice teachers as a means of achieving higher order learning objectives that are necessary for gaining situated knowledge. An overview of both intended and achieved learning objectives in relevant studies involving the

  20. Body image in cancer survivors : a systematic review of case-control studies

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariet; Tuinman, Marrit A.


    There is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether body ima

  1. The Somalia Country Case Study. Mid-Decade Review of Progress towards Education for All. (United States)

    Bennaars, Gerard A.; Seif, Huda A.; Mwangi, Doris

    In 1995, the International Consultative Forum on Education for All commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines the situation in Somalia, where civil war has completely destroyed the infrastructure of education. Part 1 summarizes Somalia's…

  2. Body image in cancer survivors : a systematic review of case-control studies

    NARCIS (Netherlands)

    Lehmann, Vicky; Hagedoorn, Mariët; Tuinman, Marrit A


    PURPOSE: There is common consensus that cancer and its treatment can impair the body, but combined evidence of the previous literature in cancer survivors is missing. Therefore, we reviewed body image in cancer survivors and focused on case-control studies, in order to draw conclusions as to whether

  3. Online and Paper Evaluations of Courses: A Literature Review and Case Study (United States)

    Morrison, Keith


    This paper reviews the literature on comparing online and paper course evaluations in higher education and provides a case study of a very large randomised trial on the topic. It presents a mixed but generally optimistic picture of online course evaluations with respect to response rates, what they indicate, and how to increase them. The paper…

  4. Prenatal diagnosis of isolated right pulmonary agenesis using sonography alone: case study and systematic literature review. (United States)

    Meller, Cesar H; Morris, R Katie; Desai, Tarak; Kilby, Mark D


    Pulmonary agenesis is a rare congenital anomaly, estimated to complicate around 1 per 15,000 pregnancies, in which there is complete absence or severe hypoplasia of one or both lungs, frequently associated with other abnormalities. A prospective prenatal diagnosis is a challenge, and a substantial proportion of cases are diagnosed by fetal magnetic resonance imaging, postnatal computed tomography, or postmortem. Thus, there are only a few reported cases of prenatal diagnosis in the literature. We report the prenatal diagnosis of isolated right lung agenesis diagnosed with sonography alone at a relatively early gestational age. We also present a systematic review of the literature for this condition to accompany this case study.

  5. Pediatric asthma case management: a review of evidence and an experimental study design. (United States)

    Schulte, Amanda; Musolf, Jeanne; Meurer, John R; Cohn, Jennifer H; Kelly, Kevin J


    Asthma is a complex disease that involves physiological, environmental, and psychosocial factors. This paper reviews childhood asthma case management by social service professionals, lay health workers, and nurses, and it presents a new randomized controlled study using nurse case management in a local community coalition. Evidence suggests the common factor for success involves case managers spending time contacting and patiently and persistently working with the family, thus building a trusting relationship. Although case management time is an expense for a health care payer, provider, and the child and family, the positive outcomes achieved can demonstrate the benefit of these interventions to all parties involved. The described experimental study assesses the cost and effectiveness of home-based nurse case management by a community coalition for children visiting an emergency department for asthma care.

  6. A review of published analyses of case-cohort studies and recommendations for future reporting.

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    Stephen J Sharp

    Full Text Available The case-cohort study design combines the advantages of a cohort study with the efficiency of a nested case-control study. However, unlike more standard observational study designs, there are currently no guidelines for reporting results from case-cohort studies. Our aim was to review recent practice in reporting these studies, and develop recommendations for the future. By searching papers published in 24 major medical and epidemiological journals between January 2010 and March 2013 using PubMed, Scopus and Web of Knowledge, we identified 32 papers reporting case-cohort studies. The median subcohort sampling fraction was 4.1% (interquartile range 3.7% to 9.1%. The papers varied in their approaches to describing the numbers of individuals in the original cohort and the subcohort, presenting descriptive data, and in the level of detail provided about the statistical methods used, so it was not always possible to be sure that appropriate analyses had been conducted. Based on the findings of our review, we make recommendations about reporting of the study design, subcohort definition, numbers of participants, descriptive information and statistical methods, which could be used alongside existing STROBE guidelines for reporting observational studies.

  7. Matched case-control studies: a review of reported statistical methodology

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    Niven DJ


    Full Text Available Daniel J Niven1, Luc R Berthiaume2, Gordon H Fick1, Kevin B Laupland11Department of Critical Care Medicine, Peter Lougheed Centre, Calgary, 2Department of Community Health Sciences, University of Calgary, Calgary, Alberta, CanadaBackground: Case-control studies are a common and efficient means of studying rare diseases or illnesses with long latency periods. Matching of cases and controls is frequently employed to control the effects of known potential confounding variables. The analysis of matched data requires specific statistical methods.Methods: The objective of this study was to determine the proportion of published, peer reviewed matched case-control studies that used statistical methods appropriate for matched data. Using a comprehensive set of search criteria we identified 37 matched case-control studies for detailed analysis.Results: Among these 37 articles, only 16 studies were analyzed with proper statistical techniques (43%. Studies that were properly analyzed were more likely to have included case patients with cancer and cardiovascular disease compared to those that did not use proper statistics (10/16 or 63%, versus 5/21 or 24%, P = 0.02. They were also more likely to have matched multiple controls for each case (14/16 or 88%, versus 13/21 or 62%, P = 0.08. In addition, studies with properly analyzed data were more likely to have been published in a journal with an impact factor listed in the top 100 according to the Journal Citation Reports index (12/16 or 69%, versus 1/21 or 5%, P ≤ 0.0001.Conclusion: The findings of this study raise concern that the majority of matched case-control studies report results that are derived from improper statistical analyses. This may lead to errors in estimating the relationship between a disease and exposure, as well as the incorrect adaptation of emerging medical literature.Keywords: case-control, matched, dependent data, statistics

  8. An International Review of Eco-City Theory, Indicators, and Case Studies

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Williams, Christopher [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)


    This report is intended to answer the question: “What international experiences with ‘eco-cities’ can help the central Chinese government evaluate the performance of Chinese cities that pursue ‘lowcarbon’ urban development?” To answer this question, we reviewed the literature on eco-cities and closely related concepts, surveyed performance indicators used to evaluate sustainable urban development around the world, and compiled case studies of exceptional eco- and sustainable cities.

  9. Sleep and Parkinson's disease: a review of case-control polysomnography studies. (United States)

    Peeraully, Tasneem; Yong, Ming-Hui; Chokroverty, Sudhansu; Tan, Eng-King


    The link between Parkinson's disease (PD) and certain primary sleep disorders has yet to be clarified. We performed a systematic review of case-control polysomnography studies to evaluate the relationship between PD and sleep disorders. A PubMed literature search and bibliography review yielded 15 case-control polysomnography studies in patients with PD. Studies differed by recruitment methods, duration of polysomnography monitoring, and sleep parameters measured. Subjective sleepiness was greater in patients than controls (50%-66% vs 2.9%-12%) despite lack of objective increase in daytime sleepiness by mean sleep latency testing. The 4 case-control polysomnography studies investigating rapid eye movement behavior disorder support a higher prevalence in PD (0%-47% vs 0%-1.8% in controls), although differences in diagnostic criteria hamper interpretation. The preponderance of evidence did not support an increased incidence of obstructive sleep apnea (27%-60% vs 13%-65%) or periodic leg movements of sleep in patients compared to controls. Adequately powered, prospective studies with uniform methodology and healthy controls are needed to further address the association and pathophysiological significance between PD and sleep problems.

  10. Classification of navigation impairment: A systematic review of neuropsychological case studies. (United States)

    Claessen, Michiel H G; van der Ham, Ineke J M


    The neurocognitive architecture of navigation ability has been investigated by extensively studying the navigation problems of individual neurological patients. These neuropsychological case reports have applied highly variable approaches to establish navigation impairment in their patients. This review provides a systematic and up-to-date inventory of all relevant case studies and presents an analysis of the types of navigation impairments that have been described. The systematic literature search revealed 58 relevant papers reporting on 67 neurological patients. Close analysis of their patterns of navigation performance suggests three main categories of navigation impairments. These categories are related to three types of representations that are considered highly relevant for accurate navigation: knowledge of landmarks, locations, and paths. The resulting model is intended to serve both clinical and theoretical advances in the study of navigation ability and its neural correlates.

  11. Improving the implementation of health workforce policies through governance: a review of case studies

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    Shaw Daniel MP


    Full Text Available Abstract Introduction Responsible governance is crucial to national development and a catalyst for achieving the Millennium Development Goals. To date, governance seems to have been a neglected issue in the field of human resources for health (HRH, which could be an important reason why HRH policy formulation and implementation is often poor. This article aims to describe how governance issues have influenced HRH policy development and to identify governance strategies that have been used, successfully or not, to improve HRH policy implementation in low- and middle-income countries (LMIC. Methods We performed a descriptive literature review of HRH case studies which describe or evaluate a governance-related intervention at country or district level in LMIC. In order to systematically address the term 'governance' a framework was developed and governance aspects were regrouped into four dimensions: 'performance', 'equity and equality', 'partnership and participation' and 'oversight'. Results and discussion In total 16 case studies were included in the review and most of the selected studies covered several governance dimensions. The dimension 'performance' covered several elements at the core of governance of HRH, decentralization being particularly prominent. Although improved equity and/or equality was, in a number of interventions, a goal, inclusiveness in policy development and fairness and transparency in policy implementation did often not seem adequate to guarantee the corresponding desirable health workforce scenario. Forms of partnership and participation described in the case studies are numerous and offer different lessons. Strikingly, in none of the articles was 'partnerships' a core focus. A common theme in the dimension of 'oversight' is local-level corruption, affecting, amongst other things, accountability and local-level trust in governance, and its cultural guises. Experiences with accountability mechanisms for HRH policy

  12. [Cytological study in case of gastric leiomyoblastoma. Review of the literature]. (United States)

    Letessier, E; Courant, O; Cuillière, P; Hamy, A; Paineau, J; Visset, J


    The authors describe the fine-needle aspiration cytologic features of leiomyoblastoma. Aspirated tumor cells occur singly, not in clusters. The tumor cells are globular in shape or sometimes have a spindle appearance. The nuclei are round, central or eccentric, with small nucleoli. The cells have well-defined cytoplasmic borders. The cytoplasm is abundant and, to some extent, granular, with sometimes a microvacuolar peripheral pattern. To date five cases of leiomyoblastoma with a cytological study have been published, two of them located to the stomach. A review of the literature is presented.

  13. Esthesioneuroblastoma: a case report of diffuse subdural recurrence and review of recently published studies. (United States)

    Capelle, L; Krawitz, H


    Esthesioneuroblastoma is a rare malignancy arising from the olfactory epithelium. We present a case history of a 75-year-old man who presented with a Kadish stage C esthesioneuroblastoma and underwent craniofacial surgery and adjuvant radiotherapy. Two years later he was found to have diffuse subdural deposits with distant bone and nodal metastases, treated with further radiotherapy. The patient's condition subsequently deteriorated and he died. Given this unusual pattern of failure, we review the recent published studies regarding the natural history, treatment and outcome for this tumour.

  14. Transient lingual papillitis: A retrospective study of 11 cases and review of the literature (United States)

    Tosios, Konstantinos I.; Nikitakis, Nikolaos G.; Kamperos, Georgios; Sklavounou, Alexandra


    Background Transient lingual papillitis (TLP) is a common, under-diagnosed, inflammatory hyperplasia of one or multiple fungiform lingual that has an acute onset, and is painful and transient in nature. Material and Methods Eleven cases of TLP were diagnosed based on their clinical features. Information on demographics, clinical characteristics, symptoms, individual or family history of similar lesions, medical history, management and follow-up were extracted from the patients’ records. The English literature was reviewed on TLP differential diagnosis, pathogenesis and management. Results The study group included 8 females and 3 males (age: 10-53 years, mean age 31.7±12.88 years). Seven cases were classified as generalized form of TLP and 4 as localized form. Nine cases were symptomatic. Time to onset ranged from 1 to 14 days. A specific causative factor was not identified in any case and management was symptomatic. Conclusions Although TLP is not considered as a rare entity, available information is limited. Diagnosis is rendered clinically, while biopsy is required in cases with a differential diagnostic dilemma. TLP should be included in the differential diagnosis of acute, painful tongue nodules. Key words:Transient lingual papillitis, fungiform papillary glossitis, tongue, nodules. PMID:28149482

  15. Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies. (United States)

    Leong, H M; Carter, Mark; Stephenson, Jennifer


    Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control.

  16. Guillain-Barré syndrome associated with monosialotetrahexosylganglioside: three cases study and literature review

    Directory of Open Access Journals (Sweden)

    ZENG Ke-bin


    Full Text Available Background Monosialotetrahexosylganglioside (GM1 is a kind of ganglioside extracted from the neural cells of pig brain, which involves in the pathophysiological processes of neurogenesis, and plays an important role in neural formation, growth and differentiation. GM1 is widely used in the treatment for vascular brain injury and traumatic brain and spinal cord injury, promoting and protecting the recovery of nerve cells. Besides, it can improve the behavior disorders of patients with Parkinson's disease. However, as it is widely used in clinical practice, its adverse reaction has been gradually discovered. There is some evidence to suggest Guillain-Barré syndrome (GBS may occur after GM1 injection intravenously. Both clinical manifestations and possible mechanism of GBS associated with GM1 are unclear, and need further study. Methods Three cases of GBS associated with GM1 were clinically observed including cerebrospinal fluid (CSF testing and nerve conduction studies. These cases were analyzed and subjected to assessment with literature review. Results Three male patients (with the age 39-65 of GBS were observed after injection of GM1 intravenously. At 9-14 days, they developed weakness of all limbs and were unable to stand upright with decreased muscle tone in limbs and absent deep tendon reflexes, accompanied by dyspnea (1 case, albuminocytological dissociation (1 case and axonal degeneration of peripheral nerve (1 case. Conclusion GBS may occur occasionally in patients treated with GM1 injection intravenously for 9-14 days, and the prognosis is not favorable. The possible mechanism is that exogenous gangliosides could be immunogenic and may occasionally result in neural axonal degeneration.

  17. Commentary on "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations" (United States)

    Schmitt, Ara


    This commentary pertains to the article, "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations" by D. Scott Hermann, Jill R. Thurber, Kenneth Miles, and Gloria Gilbert in this issue (2011) regarding pediatric leukemia. The authors present a literature review regarding leukemia in childhood,…

  18. Commentary on "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations" (United States)

    Schmitt, Ara


    This commentary pertains to the article, "Childhood Leukemia Survivors and Their Return to School: A Literature Review, Case Study, and Recommendations" by D. Scott Hermann, Jill R. Thurber, Kenneth Miles, and Gloria Gilbert in this issue (2011) regarding pediatric leukemia. The authors present a literature review regarding leukemia in…

  19. Adapting Peer Review to an Online Course: An Exploratory Case Study (United States)

    Knight, Linda V.; Steinbach, Theresa A.


    With demonstrated benefits to higher level learning, peer review in the classroom has been well researched and popular since at least the 1990s. However, little or no prior studies exist into the peer review process for online courses. Further, we found no prior research specifically addressing the operational aspects of online peer review. This…

  20. Body image among eating disorder patients with disabilities: a review of published case studies. (United States)

    Cicmil, Nela; Eli, Karin


    While individual cases of eating disorder (ED) patients with disabilities have been reported, there has been little synthesis of their experiences of body image and thin idealization. This study reviews 19 published clinical reports of ED patients with sensory, mobility-related, or intellectual disabilities and evaluates the extent to which their experiences align with or challenge current conceptions of body image in ED. ED patients with visual impairment reported a profound disturbance of body image, perceived intersubjectively and through tactile sensations. Reducing dependence in mobility was an important motivation to control body size for ED patients with mobility-related disabilities. ED as a way of coping with and compensating for the psychosocial consequences of disability was a recurrent theme for patients across a range of disabilities. These experiential accounts of ED patients with disabilities broaden current understandings of body image to include touch and kinaesthetic awareness, intersubjective dynamics, and perceptions of normalcy.

  1. The iSchool Community: A Case Study of iConference Reviews

    DEFF Research Database (Denmark)

    Bogers, Toine; Greifeneder, Elke


    A fair review process is essential to the success of any scientific conference. In this paper we present an analysis of the reviewing process of the 2014-2015 iConferences as well as a demographic analysis of the iConference community as a whole. The results show a clear need for making...... cover all the aspects represented by the review scores. The results of our study provide the iSchool community with a descriptive analysis of its community and a better understanding of its review process....... the reviewer pool more representative of the iSchool community as a whole by including more women and more researchers from Asian institutions. Other recommendations are to improve the continuity of the reviewer pool and to provide clearer instructions to reviewers to ensure that written reviews explicitly...

  2. Performance of Modular Prefabricated Architecture: Case Study-Based Review and Future Pathways

    Directory of Open Access Journals (Sweden)

    Fred Edmond Boafo


    Full Text Available Even though tightened building energy efficiency standards are implemented periodically in many countries, existing buildings continually consume a momentous quota of the total primary energy. Energy efficiency solutions range from material components to bulk systems. A technique of building construction, referred to as prefabricated architecture (prefab, is increasing in reputation. Prefab encompasses the offsite fabrication of building components to a greater degree of finish as bulk building structures and systems, and their assembly on-site. In this context, prefab improves the speed of construction, quality of architecture, efficiency of materials, and worker safety, while limiting environmental impacts of construction, as compared to conventional site-built construction practices. Quite recently, a 57 story skyscraper was built in 19 days using prefabricated modules. From the building physics point of view, the bulk systems and tighter integration method of prefab minimizes thermal bridges. This study seeks to clearly characterize the levels of prefab and to investigate the performance of modular prefab; considering acoustic constrain, seismic resistance, thermal behavior, energy consumption, and life cycle analysis of existing prefab cases and, thus, provides a dynamic case study-based review. Generally, prefab can be categorized into components, panels (2D, modules (3D, hybrids, and unitized whole buildings. On average, greenhouse gas emissions from conventional construction were higher than for modular construction, not discounting some individual discrepancies. Few studies have focused on monitored data on prefab and occupants’ comfort but additional studies are required to understand the public’s perception of the technology. The scope of the work examined will be of interest to building engineers, manufacturers, and energy experts, as well as serve as a foundational reference for future study.

  3. Primary Testicular NK/T-Cell Lymphoma: A Study of Two Cases and Review of Literature

    Institute of Scientific and Technical Information of China (English)

    Xiao Lin; Dan Li; Peng Xie; Can Mi; Qing Lin


    Primary testicular NK/T-cell lymphoma is an extremely rare entity progressed rapidly.The aim of this study was to examine clinical and pathological features of primary testicular NK/T-cell lymphoma and to investigate the effective diagnosis and prognosis.In this paper,the two cases of primary testicular NK/T-cell lymphoma were observed by light microscopy,immunohistochemistry and examined by in situ hybridization for Epstein-Barr Virus(EBV)DNA and the literatures were reviewed.The two patients respectively present with bilateral and right-side painless testicular enlargement.The morphology of neoplastic cells of case 1 were small to medium,tumor cells of case 2 were small,medium and large mixed.The tumor cells grew diffusely with irregular and distort nuclear,destructed the organizational structure of the normal testis,and damaged blood vessels,meanwhile,coagulation necrosis was exist.Immunohistochemical staining of neoplastic cells showed positive for CD45,CD2,CD56,CD3ε(cytoplasm staining pattern),CD45RO and Granzyme B,and negative for CD57,CD20,CD79α,CD30,CK,MPO,TdT,Bcl-2 and PLAP were negative.In addition,the EBV DNA was detected in the lymphoma by In situ hybridization.In conclusion,the expression of CD56,CD3ε,and Granzyme B associated proteins and EBV examination by in situ hybridization play a vital role in diagnosis and differential diagnosis of primary testicular NK/T-cell lymphoma.

  4. Primary Testicular NK/T-Cell Lymphoma: A Study of Two Cases and Review of Literature

    Institute of Scientific and Technical Information of China (English)

    Xiao Lin; Dan Li; Peng Xie; Can Mi; Qing Lin


    Primary testicular NK/T-cell lymphoma is an extremely rare entity progressed rapidly.The aim of this study was to examine clinical and pathological features of primary testicular NK/T-cell lymphoma and to investigate the effective diagnosis and prognosis.In this paper,the two cases of primary testicular NK/T-cell lymphoma were observed by light microscopy,immunohistochemistry and examined by in situ hybridization for Epstein-Barr Virus (EBV) DNA and the literatures were reviewed.The two patients respectively present with bilateral and right-side painless testicular enlargement.The morphology of neoplastic cells of case 1 were small to medium,tumor cells of case 2 were small,medium and large mixed.The tumor cells grew diffusely with irregular and distort nuclear,destructed the organizational structure of the normal testis,and damaged blood vessels,meanwhile,coagulation necrosis was exist.Immunohistochemical staining of neoplastic cells showed positive for CD45,CD2,CD56,CD3s (cytoplasm staining pattern),CD45RO and Granzyme B,and negative for CD57,CD20,CD79a,CD30,CK,MPO,TdT,Bcl-2 and PLAP were negative.In addition,the EBV DNA was detected in the lymphoma by In situ hybridization.In conclusion,the expression of CD56,CD3e,and Granzyme B associated proteins and EBV examination by in situ hybridization play a vital role in diagnosis and differential diagnosis of primary testicularNK/T-cell lymphoma.

  5. Review of Ginkgo biloba-induced toxicity, from experimental studies to human case reports. (United States)

    Mei, Nan; Guo, Xiaoqing; Ren, Zhen; Kobayashi, Daisuke; Wada, Keiji; Guo, Lei


    Ginkgo biloba seeds and leaves have been used as a traditional herbal remedy for thousands of years, and its leaf extract has been consumed as a botanical dietary supplement for decades. Ginkgo biloba extract is a complex mixture with numerous components, including flavonol glycosides and terpene lactones, and is one of the most widely sold botanical dietary supplements worldwide. Concerns about potential health risks for the general population have been raised because of the widespread human exposure to Ginkgo biloba and its potential toxic and carcinogenic activities in rodents. The National Toxicology Program conducted 2-year gavage studies on one Ginkgo biloba leaf extract and concluded that there was clear evidence of carcinogenic activity of this extract in mice based on an increased incidence of hepatocellular carcinoma and hepatoblastoma. Recently, Ginkgo biloba leaf extract has been classified as a possible human carcinogen (Group 2B) by the International Agency for Research on Cancer. This review presents updated information on the toxicological effects from experimental studies both in vitro and in vivo to human case reports (caused by ginkgo seeds or leaves), and also summarizes the negative results from relatively large clinical trials.

  6. Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Guilherme Karam Corrêa Leite

    Full Text Available CONTEXT AND OBJECTIVE: The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed. DESIGN AND SETTING: Retrospective descriptive study at Hospital Municipal Maternidade - Escola Dr. Mário de Moraes Altenfelder Silva. METHODS: Data from the medical records of patients with preoperative diagnoses of scar endometrioma who underwent operations between 2001 and 2007 were surveyed and reviewed. The postoperative diagnosis came from histopathological analysis. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size and palpation, duration of complaint, diagnosis and treatment. All patients underwent tumor excision with a safety margin. RESULTS: There were 33 patients, of mean age 30.1 ± 5.0 years (range: 18-41 years. The total incidence was 0.11%: 0.29% in cesarean sections and 0.01% in vaginal deliveries. Twenty-nine tumors (87.9% were located in cesarean scars, two (6.0% in episiotomy scars and two (6.0% in the umbilical region. The main symptom was localized cyclical pain (66.7%, of mean duration 30.5 months (± 23. Surgical treatment was successful in all cases. CONCLUSION: This is an uncommon disease. The most important diagnostic characteristic is coincidence of painful symptoms with menstruation. Patients undergoing cesarean section are at greatest risk: relative risk of 27.37 (P < 0.01. The surgical treatment of choice is excision of the endometrioma with a safety margin.

  7. Are Private Interests Clouding the Peer-Review Process of the WHO Bulletin? A Case Study. (United States)

    Homedes, Nuria; Ugalde, Antonio


    Readers' trust on the medical literature has been eroded, and journal editors and some editorial boards are taking measures to ensure that authors fully and accurately report research findings and disclose conflicts of interest. This article describes a case study in which the papers editor of the World Health Organization (WHO) Bulletin influenced the content of an article that had been approved by the external reviewers. The editor objected to the publication of the large price differentials of the new molecular entities (NMEs) across the Latin American countries where they had been tested and the limited added therapeutic value of the NMEs that had been assessed by independent drug bulletins. This article summarizes the exchanges with WHO staff and posits the hypothesis that the WHO Bulletin might be affected by the shifts in WHO financing. Several authors have raised concern about the impact of financial conflicts of interest in WHO activities in the field of nutrition, intellectual property, and in the emergency response to the flu pandemic. Moreover, it has been reported that powerful WHO contributors pressured WHO into revising its publication policy. This is the first time that authors question if these conflicts of interest are also affecting the editorial independence of the WHO Bulletin.

  8. Nanomaterial Case Study: Nanoscale Silver in Disinfectant Spray (External Review Draft) (United States)

    This draft document presents a case study of engineered nanoscale silver (nano-Ag), focusing on the specific example of nano-Ag as possibly used in disinfectant sprays. This case study is organized around a comprehensive environmental assessment (CEA) framework, which combines a ...

  9. Use of the self-controlled case-series method in vaccine safety studies: review and recommendations for best practice. (United States)

    Weldeselassie, Y G; Whitaker, H J; Farrington, C P


    The self-controlled case-series method was originally developed to investigate potential associations between vaccines and adverse events, and is now commonly used for this purpose. This study reviews applications of the method to vaccine safety investigations in the period 1995-2010. In total, 40 studies were reviewed. The application of the self-controlled case-series method in these studies is critically examined, with particular reference to the definition of observation and risk periods, control of confounders, assumptions and potential biases, methodological and presentation issues, power and sample size, and software. Comparisons with other study designs undertaken in the papers reviewed are also highlighted. Some recommendations are presented, with the emphasis on promoting good practice.

  10. Recreational physical activity and epithelial ovarian cancer: a case-control study, systematic review, and meta-analysis. (United States)

    Olsen, Catherine M; Bain, Christopher J; Jordan, Susan J; Nagle, Christina M; Green, Adèle C; Whiteman, David C; Webb, Penelope M


    It remains unclear whether physical activity is associated with epithelial ovarian cancer risk. We therefore examined the association between recreational physical activity and risk of ovarian cancer in a national population-based case-control study in Australia. We also systematically reviewed all the available evidence linking physical activity with ovarian cancer to provide the best summary estimate of the association. The case-control study included women ages 18 to 79 years with a new diagnosis of invasive (n=1,269) or borderline (n=311) epithelial ovarian cancer identified through a network of clinics, physicians, and state cancer registries throughout Australia. Controls (n=1,509) were randomly selected from the national electoral roll and were frequency matched to cases by age and state. For the systematic review, we identified eligible studies using Medline, the ISI Science Citation Index, and manual review of retrieved references, and included all case-control or cohort studies that permitted assessment of an association between physical activity (recreational/occupational/sedentary behavior) and histologically confirmed ovarian cancer. Meta-analysis was restricted to the subset of these studies that reported on recreational physical activity. In our case-control study, we observed weakly inverse or null associations between recreational physical activity and risk of epithelial ovarian cancer overall. There was no evidence that the effects varied by tumor behavior or histologic subtype. Twelve studies were included in the meta-analysis, which gave summary estimates of 0.79 (95% confidence interval, 0.70-0.85) for case-control studies and 0.81 (95% confidence interval, 0.57-1.17) for cohort studies for the risk of ovarian cancer associated with highest versus lowest levels of recreational physical activity. Thus, pooled results from observational studies suggest that a modest inverse association exists between level of recreational physical activity and

  11. Vascular complications following total hip arthroplasty: a case study and a review of the literature. (United States)

    Barbier, Olivier; Pierret, Charles; Bazile, Fabrice; De Kerangal, Xavier; Duverger, Vincent; Versier, Gilbert


    Vascular complications after total hip arthroplasty (THA) are rare but represent a real risk. The diversity of clinical presentations can make diagnosis difficult. They could manifest as an immediate and acute hemorrhage or subsequent ischemia. We report the case of a patient who presented a thrombosis of the femoral artery associated with a sciatic palsy after THA for a coxa profunda. The diagnosis was actually made 3 years after surgery because of atypical symptoms. The mechanism involved was either a crash of the artery by a retractor on the anterior wall of the acetabulum, or a stretching of the artery. A review of the literature of vascular complications occurring after THA recalls the multiplicity of clinical presentations and the diagnostic difficulties. They could manifest as an immediate and acute hemorrhage or deferred ischemia, as in our case. Knowledge of these complications should help prevent them, and the diagnosis should be considered in atypical sequences after THA.

  12. Retrospective Study of Castleman's Disease: A Report of Fourteen Cases and Review of the Literature

    Institute of Scientific and Technical Information of China (English)

    Waiyi Zou; Huixia Lan; Chang Su; Yunxian Chen; Juan Li; Shaokai Luo


    OBJECTIVE To enhance the understanding of Castleman's disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed.RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situations in the 14 cases, with a lack of specificity. They were previously misdiagnosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.

  13. [Clinical Study on Cerebellar Contusion:A Report on 9 Cases and Literature Review]. (United States)

    Nashimoto, Takeo; Sasaki, Osamu; Nozawa, Takanori; Ando, Kazuhiro; Kikuchi, Bunpei; Watanabe, Masatoshi


    We report 9 cases of cerebellar contusion from April 2011 to September 2014 at our department. Frequency, clinicoradiological findings, mechanism of injury, treatments, and outcomes were retrospectively analyzed. Of 239 head injury cases admitted to our department during the same period, 9(3.8%)were diagnosed as cerebellar contusion. Among these 9 cases, 7 were men, and 2 were women. The patient age ranged from 12 to 83 years with a mean age of 64.7 years. The mechanism of injury was traffic accident in one patient, and fall in 8. All cases were associated with direct head trauma to the occiput, and radiographic studies showed occipital bone fracture in 8 cases. Six cases were managed conservatively. Three cases underwent suboccipital craniectomies and clot evacuations. Glasgow Outcome Scale(GOS)score at discharge were Good Recovery(GR)in 2, Moderate Disability(MD)in 2, Severe Disability(SD)in 3, Vegetative State(VS)in 1, and Dead(D)in 1. GOS scores in surgically treated cases were GR in 1, SD in 1, and VS in 1. Supratentorial severe traumatic lesions were concomitant with poor prognosis. Coup injury was a significant cause of cerebellar contusion. External decompression and clot evacuation were useful in patients who suffered severe cerebellar contusion;however, concomitant supratentorial lesions influenced the prognosis.

  14. Integrating Enterprise Resource Planning (SAP) in the Accounting Curriculum: A Systematic Literature Review and Case Study (United States)

    Blount, Yvette; Abedin, Babak; Vatanasakdakul, Savanid; Erfani, Seyedezahra


    This study investigates how an enterprise resource planning (ERP) software package SAP was integrated into the curriculum of an accounting information systems (AIS) course in an Australian university. Furthermore, the paper provides a systematic literature review of articles published between 1990 and 2013 to understand how ERP systems were…

  15. Wegener`s granulomatosis and mucoromycosis: A case study and review of literature

    Directory of Open Access Journals (Sweden)

    Sayyed Mojtaba Abtahi


    Full Text Available Mucormycosis is a fatal invasive infection which mostly involves diabetic or immunosuppressed patients. Early diagnosis, improving immunosuppression, systemic antifungal therapy, and surgical debridement are necessary for successful treatment. In this case study, we represent a known case of Wegener′s granulomatosis (WG, with concomitant sinusal mucormycosis mimicking vasculitic disease relapse, which was successfully treated with surgical debridement, amphotericine, and intravenous immunoglobuline.

  16. Personal attributes of authors and reviewers, social bias and the outcomes of peer review: a case study. (United States)

    Walker, Richard; Barros, Beatriz; Conejo, Ricardo; Neumann, Konrad; Telefont, Martin


    Peer review is the "gold standard" for evaluating journal and conference papers, research proposals, on-going projects and university departments. However, it is widely believed that current systems are expensive, conservative and prone to various forms of bias. One form of bias identified in the literature is "social bias" linked to the personal attributes of authors and reviewers. To quantify the importance of this form of bias in modern peer review, we analyze three datasets providing information on the attributes of authors and reviewers and review outcomes: one from Frontiers - an open access publishing house with a novel interactive review process, and two from Spanish and international computer science conferences, which use traditional peer review. We use a random intercept model in which review outcome is the dependent variable, author and reviewer attributes are the independent variables and bias is defined by the interaction between author and reviewer attributes. We find no evidence of bias in terms of gender, or the language or prestige of author and reviewer institutions in any of the three datasets, but some weak evidence of regional bias in all three. Reviewer gender and the language and prestige of reviewer institutions appear to have little effect on review outcomes, but author gender, and the characteristics of author institutions have moderate to large effects. The methodology used cannot determine whether these are due to objective differences in scientific merit or entrenched biases shared by all reviewers.

  17. Granulosa cell tumor of ovary: A clinicopathological study of four cases with brief review of literature

    Directory of Open Access Journals (Sweden)

    B R Vani


    Full Text Available Introduction: Adult granulosa cell tumor (GCT is a rare ovarian malignancy having good prognosis in comparison with other epithelial tumors. The study aims to collect data of all granulosa cell tumors diagnosed in ESIC Medical College & PGIMSR, Rajajinagar, Bangalore over the last 3 years and to describe the patient profile, ultrasonographic and various histopathological features.Materials and Methods: A total of 4 granulosa cell tumors were diagnosed in ESIC Medical College & PGIMSR, Rajajinagar, Bangalore during the period from June 2010 to June 2013. The patient′s age, clinical manifestations, radiological and histopathological findings were evaluated.Results: All 4 patients were diagnosed as adult granulosa cell tumor, three of four cases were in premenopausal age group and one case was in perimenopausal age. The clinical manifestations were menorrhagia and abdominal pain. Ultrasonographically, 2 cases of granulosa cell tumors were both solid and cystic and one case each was either solid or cystic. Histologically, variety of patterns like diffuse, trabecular, cords, spindle and clear cells were noted. Both Call-Exner bodies and nuclear grooves were observed in all cases. All four cases showed simple hyperplasia without atypia endometrial findings. Follow up on all patients revealed no evidence of recurrence.Conclusion: Granulosa cell tumor of the ovary is a rare ovarian entity. The important prognostic factor is staging of the tumor. Staging and histopathology helps in prediction of survival. Also diligent endometrial pathology has to be sorted to rule out endometrial carcinoma.

  18. [Coexistence of Celiac Disease and autoimmune hepatitis case study and literature review]. (United States)

    Tagle, Martín; Nolte, Cecilia; Luna, Eduardo; Scavino, Yolanda


    The case of a patient who was initially diagnosed with Systemic Lupus Erythematosus, with subsequent documentation of Celiac Disease histologically and serologically is reported. The patient presented elevation of the aminotransferases, upon detection of the Celiac Disease which was initially attributed to the underlying disease. However, despite the complete resolution of her articular symptoms with a gluten-free diet, the liver chemistry abnormalities persisted. This led to consider an autoimmune hepatitis as the cause which was documented with a liver biopsy three months after the diagnosis of the celiac disease and under a strict gluten-free diet. Treatment with prednisone and azathioprine was initiated with complete normalization of aminotransferase levels. We present the sequence of events with the results and a review of the literature.

  19. Improving Diabetes Care in the Military Primary Care Clinic: Case Study Review (United States)


    required application of innovative and creative strategies to improve self- management . The cases are representative of some common themes within the patient with type 2 diabetes in a military primary care clinic....enabled patients to engage in self- management . Moreover, this study seeks to better understand how applying the ADA Standards of Care in a military

  20. Biodiversity as a multidimensional construct: a review, framework and case study of herbivory's impact on plant biodiversity. (United States)

    Naeem, S; Prager, Case; Weeks, Brian; Varga, Alex; Flynn, Dan F B; Griffin, Kevin; Muscarella, Robert; Palmer, Matthew; Wood, Stephen; Schuster, William


    Biodiversity is inherently multidimensional, encompassing taxonomic, functional, phylogenetic, genetic, landscape and many other elements of variability of life on the Earth. However, this fundamental principle of multidimensionality is rarely applied in research aimed at understanding biodiversity's value to ecosystem functions and the services they provide. This oversight means that our current understanding of the ecological and environmental consequences of biodiversity loss is limited primarily to what unidimensional studies have revealed. To address this issue, we review the literature, develop a conceptual framework for multidimensional biodiversity research based on this review and provide a case study to explore the framework. Our case study specifically examines how herbivory by whitetail deer (Odocoileus virginianus) alters the multidimensional influence of biodiversity on understory plant cover at Black Rock Forest, New York. Using three biodiversity dimensions (taxonomic, functional and phylogenetic diversity) to explore our framework, we found that herbivory alters biodiversity's multidimensional influence on plant cover; an effect not observable through a unidimensional approach. Although our review, framework and case study illustrate the advantages of multidimensional over unidimensional approaches, they also illustrate the statistical and empirical challenges such work entails. Meeting these challenges, however, where data and resources permit, will be important if we are to better understand and manage the consequences we face as biodiversity continues to decline in the foreseeable future.

  1. [MALT B cell lymphoma with kidney damage and monoclonal gammopathy: a case study and literature review]. (United States)

    Peces, R; Vega-Cabrera, C; Peces, C; Pobes, A; Fresno, M F


    We report a case of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) involving the left kidney and simultaneous onset of a monoclonal gammopathy IgM kappa. No predisposing local inflammatory condition was identified. Following left nephrectomy, the renal specimen showed the centrocyte like cells and lymphoid cells in the lymphoepithelial lesions were positive for CD20 and CD79α. The neoplastic cells expressed monotypic cytoplasmic IgM kappa. The demonstration of bone marrow cells of B-lineage expressing the same monoclonal protein as the tumor suggested bone marrow involvement, even in the absence of identical morphology. Despite chemotherapy and rituximab treatment, clinical follow-up showed right kidney extension with high-grade transformation, and finally systemic dissemination. This case illustrates that the kidney is among the sites that may be involved by MALT B-cell lymphomas in a primary or secondary fashion, and the need for expanded investigation of the possible dissemination. We review the literature on this unusual extranodal lymphoma.

  2. Granulomatous inflammation in acanthamoeba keratitis: An immunohistochemical study of five cases and review of literature

    Directory of Open Access Journals (Sweden)

    Vemuganti G


    Full Text Available Purpose: Acanthamoeba keratitis usually presents as a necrotizing stromal inflammation. We report a rare presentation of granulomatous inflammation in Acanthamoeba keratitis Methods: Retrospective clinico-pathologic case series. Results: Five corneal tissues (3 corneal buttons, 2-eviscerated contents from patients suffering from severe Acanthamoeba keratitis not responding to anti-Acanthamoeba treatment, revealed a florid granulomotous inflammation with multinucleated giant cells in the posterior stroma and around Descemet′s membrane. Phagocytosed parasites were noted within the giant cells. Vascularization of the corneal stroma was noted in two cases. Immunophenotyping revealed a predominance of T lymphocytes and macrophages. Clinically, four of five cases had shown features of limbal and scleral involvement. Conclusion: Granulomatous inflammation in the posterior corneal stroma, is not an uncommon finding in Acanthamoeba keratitis and could possibly be immune-mediated, contributing to persistence and progression of disease. Clinical Relevance: Presence of granulomatous inflammation in Acanthamoeba keratitis, in most cases is associated with limbal and scleral involvement and therefore could be considered as one of the poor prognostic markers. Further studies are required to ascertain the specific clinical features and appropriate management strategies in these cases.

  3. Cervical Spine Immobilization in Sports Related Injuries: Review of Current Guidelines and a Case Study of an Injured Athlete


    Bhamra, JS; Morar, Y; Khan, WS; Deep, K.; Hammer, A.


    Cervical spine immobilization is an essential component of the ATLS® system. Inadequate training in the management of trauma calls and failure of early recognition can have disastrous consequences. Pre-hospital personnel are routinely involved more in the assessment and stabilization of patients in comparison to other health care professionals. This case study and review highlights the importance of early recognition, assessment and correct stabilization of cervical spine injuries both in the...

  4. Torsion of the uterus with myomas in a postmenopausal woman – case study and review of the literature



    Introduction : Torsion of the uterus is defined as a rotation of more than 45° around the long axis of the uterus; 2/3 of cases are dextrorotations. The extent of rotation usually ranges from 45° to 180°. Objective: The purpose of the article was to present a case study of a postmenopausal woman with uterine torsion and myomas and to review the articles discussing the problem of rotated non-pregnant uterus. Material and methods : The article analyses the course of an extremely uncom...

  5. Factors Affecting the Success of Conserving Biodiversity in National Parks: A Review of Case Studies from Africa

    Directory of Open Access Journals (Sweden)

    Moses Muhumuza


    Full Text Available National Parks are a cornerstone for biodiversity conservation in Africa. Two approaches are commonly used to sustain biodiversity in National Parks. Past and current studies show that both approaches are generally ineffective in conserving biodiversity in National Parks in Africa. However, there are a handful of cases where these approaches have been successful at conserving biodiversity in National Parks. The question this paper attempts to answer is why in some cases these approaches have been successful and in other cases they have failed. A metadata analysis of 123 documents on case studies about conservation of biodiversity in National Parks in Africa was conducted. A series of search engines were used to find papers for review. Results showed that all factors responsible for both the success and failure of conserving biodiversity in National Parks in various contexts were socioeconomic and cultural in nature. The highest percentage in both successful case studies (66% and unsuccessful cases studies (55% was associated with the creation and management of the park. These results suggest that future conservation approaches in National Parks in Africa should place more emphasis on the human dimension of biodiversity conservation than purely scientific studies of species and habitats in National Parks.

  6. A review on analytical techniques for natural convection investigation in a heated closed enclosure: Case study

    Directory of Open Access Journals (Sweden)

    Minea Alina Adriana


    Full Text Available The aim of this paper is to present a theoretical analysis of a few convection problems. The investigations were started from the geometry of a classic muffle manufactured furnace. During this analytical study, different methodologies have been carefully chosen in order to compare and evaluate the effects of applying different analytical methods of the convection heat transfer processes. In conclusion, even if there are available a lot of analytical methods, natural convection in enclosed enclosures can be studied correctly only with numerical analysis. Also, in this article is presented a case study on natural convection application in a closed heated enclosure.

  7. Interleukin gene polymorphisms and breast cancer: a case control study and systematic literature review

    Directory of Open Access Journals (Sweden)

    Cross SS


    Full Text Available Abstract Background Interleukins and cytokines play an important role in the pathogenesis of many solid cancers. Several single nucleotide polymorphisms (SNPs identified in cytokine genes are thought to influence the expression or function of these proteins and many have been evaluated for their role in inflammatory disease and cancer predisposition. The aim of this study was to evaluate any role of specific SNPs in the interleukin genes IL1A, IL1B, IL1RN, IL4R, IL6 and IL10 in predisposition to breast cancer susceptibility and severity. Methods Candidate single nucleotide polymorphisms (SNPs in key cytokine genes were genotyped in breast cancer patients and in appropriate healthy volunteers who were similar in age, race and sex. Genotyping was performed using a high throughput allelic discrimination method. Data on clinico-pathological details and survival were collected. A systematic review of Medline English literature was done to retrieve previous studies of these polymorphisms in breast cancer. Results None of the polymorphisms studied showed any overall predisposition to breast cancer susceptibility, severity or to time to death or occurrence of distant metastases. The results of the systematic review are summarised. Conclusion Polymorphisms within key interleukin genes (IL1A, IL1B, IL1RN, IL4R, IL6 and IL10 do not appear to play a significant overall role in breast cancer susceptibility or severity.

  8. Fuzzy Continuous Review Inventory Model using ABC Multi-Criteria Classification Approach: A Single Case Study

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    Meriastuti - Ginting


    Full Text Available Abstract. Inventory is considered as the most expensive, yet important,to any companies. It representsapproximately 50% of the total investment. Inventory cost has become one of the majorcontributorsto inefficiency, therefore it should be managed effectively. This study aims to propose an alternative inventory model, by using ABC multi-criteria classification approach to minimize total cost. By combining FANP (Fuzzy Analytical Network Process and TOPSIS (Technique of Order Preferences by Similarity to the Ideal Solution, the ABC multi-criteria classification approach identified 12 items of 69 inventory items as “outstanding important class” that contributed to 80% total inventory cost. This finding is then used as the basis to determine the proposed continuous review inventory model.This study found that by using fuzzy trapezoidal cost, the inventory turnover ratio can be increased, and inventory cost can be decreased by 78% for each item in “class A” inventory. Keywords:ABC multi-criteria classification, FANP-TOPSIS, continuous review inventory model lead-time demand distribution, trapezoidal fuzzy number

  9. Fuzzy Continuous Review Inventory Model using ABC Multi-Criteria Classification Approach: A Single Case Study

    Directory of Open Access Journals (Sweden)

    Meriastuti - Ginting


    Full Text Available Abstract. Inventory is considered as the most expensive, yet important,to any companies. It representsapproximately 50% of the total investment. Inventory cost has become one of the majorcontributorsto inefficiency, therefore it should be managed effectively. This study aims to propose an alternative inventory model,  by using ABC multi-criteria classification approach to minimize total cost. By combining FANP (Fuzzy Analytical Network Process and TOPSIS (Technique of Order Preferences by Similarity to the Ideal Solution, the ABC multi-criteria classification approach identified 12 items of 69 inventory items as “outstanding important class” that contributed to 80% total inventory cost. This finding  is then used as the basis to determine the proposed continuous review inventory model.This study found that by using fuzzy trapezoidal cost, the inventory  turnover ratio can be increased, and inventory cost can be decreased by 78% for each item in “class A” inventory.Keywords:ABC multi-criteria classification, FANP-TOPSIS, continuous review inventory model lead-time demand distribution, trapezoidal fuzzy number 

  10. Bowel ischaemia and cocaine consumption: case study and review of the literature

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    Almudena Martínez-Vieira


    Full Text Available Background: Amongst others, cocaine consumption has a detrimental effect in the vascular supply to the mesenteric area causing abdominal ischemic changes. Early recognition of these changes and adequate treatment are essential to avoid serious complications and possible death of the patient from sepsis. Case report: In this case study, the subject is a 40-years-old gentleman presenting with acute abdominal pain due to multiple ischemic changes in both small bowel and sigmoid loops. The patient required emergency surgical intervention consisting of bowel resection and anastomosis. The pathologic analysis of the segment showed transmural necrosis and necrotizing phlebitis caused by the ingestion of drugs or toxic agents. The patient later confirmed the habitual consumption of cocaine. Discussion: The increase in cocaine consumption and other recreational toxins substructed from erythroyilon coca alcaloids amongst young people have generated a large number of admissions to Hospital Accident and Emergency Departments with patients complaining of acute abdominal pain. In many of these cases, surgical intervention is required and in some cases patients will sadly die without a proper diagnosis. Some of the most common effects of cocaine and its compounds includes; hollow viscus perforation, gastro-intestinal bleed, and other vascular problems such as enteritis and ischemic colitis. It appears clear that there is a great need for an advance history taking of these patients and their habit to cocaine and other drugs together with a urine test for drug screening. These together with a suspicion of a non- occlusive ischemic bowel caused by the effects of cocaine in young adults with no cardiac risk factors will guide clinicians and establish, and plan the correct treatment for these categories of patients.

  11. Disulfiram induced reversible hypertension: A prospective case study and brief review

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    Ranganath R Kulkarni


    Full Text Available Disulfiram (DSF is one of the recommended aids in the management of alcohol dependence. Hypertension may be a clinically significant, dose-dependent, and usually reversible adverse event of DSF therapy. We report 6 month prospective study of normotensive case of comorbid alcohol and tobacco dependence that developed reversible stage-II hypertension within 2-4 weeks of DSF therapy. We suggest that regular monitoring of blood pressure at least fortnightly for 1 st 3 months, followed by monthly for next 3 months, and later once in 3 months, may possibly detect "silent" adverse event of DSF - hypertension.

  12. Disulfiram Induced Reversible Hypertension: A Prospective Case Study and Brief Review (United States)

    Kulkarni, Ranganath R.; Bairy, Bhavya K.


    Disulfiram (DSF) is one of the recommended aids in the management of alcohol dependence. Hypertension may be a clinically significant, dose-dependent, and usually reversible adverse event of DSF therapy. We report 6 month prospective study of normotensive case of comorbid alcohol and tobacco dependence that developed reversible stage-II hypertension within 2-4 weeks of DSF therapy. We suggest that regular monitoring of blood pressure at least fortnightly for 1st 3 months, followed by monthly for next 3 months, and later once in 3 months, may possibly detect “silent” adverse event of DSF – hypertension. PMID:24049238

  13. Endoscopic ultrasound-guided ethanol ablation ofpancreatic neuroendocrine tumours: A case study andliterature review

    Institute of Scientific and Technical Information of China (English)


    Here we offer a review of the literature regardingendoscopic ultrasound-guided ethanol ablation forpancreatic neuroendocrine tumours and describe thecase of a cystic tumour completely ablated after amultisession procedure. A total of 35 PubMed indexedcases of treated functioning and non-functioningpancreatic neuroendocrinetumours resulted fromour search, 29 of which are well-documented andsummarised. Endoscopic ultrasound-guided ethanolablation appears as a local, minimallyinvasive treatmentof pancreatic neuroendocrinetumours, suitable forselected patients. This techniqueappears feasible,relatively safe and efficient, especiallywhen applied tosymptom relief in functioning tumours, aiming at loss ofendocrine secretion. For non-functioning tumours, wherethe goal is complete tissue ablation, eus guided ethanolablation can provide good results for patients whoare unfit for surgery or for those who refuse surgicalresection. Its role in "fit for surgery" patients requiresassessment through further studies.

  14. Road-corridor planning in the EIA procedure in Spain. A review of case studies

    Energy Technology Data Exchange (ETDEWEB)

    Loro, Manuel, E-mail: [Department of Urban and Regional Planning and Environment, Civil Engineering School, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Transport Research Centre (TRANSyT-UPM) Universidad Politécnica de Madrid, ETSI Caminos, Canales y Puertos, Prof. Aranguren s/n, 28040 Madrid (Spain); Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Arce, Rosa M., E-mail: [Department of Urban and Regional Planning and Environment, Civil Engineering School, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Transport Research Centre (TRANSyT-UPM) Universidad Politécnica de Madrid, ETSI Caminos, Canales y Puertos, Prof. Aranguren s/n, 28040 Madrid (Spain); Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Ortega, Emilio, E-mail: [Transport Research Centre (TRANSyT-UPM) Universidad Politécnica de Madrid, ETSI Caminos, Canales y Puertos, Prof. Aranguren s/n, 28040 Madrid (Spain); Centro de investigación del transporte, TRANSyT-UPM, ETSI Caminos, Canales y Puertos, Universidad Politécnica de Madrid, Prof. Aranguren s/n, 28040 Madrid (Spain); Department of Construction and Rural Roads, Forestry Engineering School, Universidad Politécnica de Madrid, Ciudad Universitaria s/n, 28040 Madrid (Spain); and others


    The assessment of different alternatives in road-corridor planning must be based on a number of well-defined territorial variables that serve as decision making criteria, and this requires a high-quality preliminary environmental assessment study. In Spain the formal specifications for the technical requirements stipulate the constraints that must be considered in the early stages of defining road corridors, but not how they should be analyzed and ranked. As part of the feasibility study of a new road definition, the most common methodology is to establish different levels of Territorial Carrying Capacity (TCC) in the study area in order to summarize the territorial variables on thematic maps and to ease the tracing process of road-corridor layout alternatives. This paper explores the variables used in 22 road-construction projects conducted by the Ministry of Public Works that were subject to the Spanish EIA regulation and published between 2006 and 2008. The aim was to evaluate the quality of the methods applied and the homogeneity and suitability of the variables used for defining the TCC. The variables were clustered into physical, environmental, land-use and cultural constraints for the purpose of comparing the TCC values assigned in the studies reviewed. We found the average quality of the studies to be generally acceptable in terms of the justification of the methodology, the weighting and classification of the variables, and the creation of a synthesis map. Nevertheless, the methods for assessing the TCC are not sufficiently standardized; there is a lack of uniformity in the cartographic information sources and methodologies for the TCC valuation. -- Highlights: • We explore 22 road-corridor planning studies subjected to the Spanish EIA regulation. • We analyze the variables selected for defining territorial carrying capacity. • The quality of the studies is acceptable (methodology, variable weighting, mapping). • There is heterogeneity in the

  15. Methodological Synthesis in Quantitative L2 Research: A Review of Reviews and a Case Study of Exploratory Factor Analysis (United States)

    Plonsky, Luke; Gonulal, Talip


    Research synthesis and meta-analysis provide a pathway to bring together findings in a given domain with greater systematicity, objectivity, and transparency than traditional reviews. The same techniques and corresponding benefits can be and have been applied to examine methodological practices in second language (L2) research (e.g., Plonsky,…

  16. The Reporting Quality of Acupuncture-Related Infections in Korean Literature: A Systematic Review of Case Studies. (United States)

    Kim, Tae-Hun; Kang, Jung Won; Park, Wan-Soo


    Objective. Acupuncture is generally accepted as a safe intervention when it is administered in appropriate clinical setting by well-educated and experienced practitioners. In this study, we reviewed observational studies on adverse events (AEs) or complications relevant to acupuncture practice in Korean literature for assessing their reporting quality and suggested recommendations for future ones on acupuncture-related infections. Method. Electronic databases including Medline, Embase, Cochrane library, Korean studies Information Service System, DBpia, National Digital Science Library, and Korean National Assembly Library were searched until May 2015. Combination of keywords including "acupuncture" and "infection" were used for searching databases. Result. A total of 23 studies from 2,739 literature articles were identified from electronic database searching until May 2015. From this review, we found that most case studies did not report enough information for judging causality between acupuncture and the AEs (or complications) as well as appropriateness of the acupuncture practice. In addition, acupuncture experts rarely participated in the reporting of these AEs (or complications). Conclusion. Based on these limitations, we suggest a tentative recommendation for future case studies on acupuncture-related infection. We hope that this recommendation would contribute to the improvement of the reporting quality of acupuncture-related AEs (or complications) in the future.

  17. Global neonatal and perinatal mortality: a review and case study for the Loreto Province of Peru

    Directory of Open Access Journals (Sweden)

    Warren JB


    Full Text Available Jamie B Warren,1 William E Lambert,2 Rongwei Fu,2 JoDee M Anderson,1 Alison B Edelman31Department of Pediatrics, 2Department of Public Health and Preventive Medicine, 3Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USABackground: Millennium Development Goal 4 calls for the reduction of the under-five mortality rate by two-thirds between 1990 and 2015. To reach this goal, neonatal mortality must be decreased. The lack of information on global neonatal and perinatal mortality impedes appropriate implementation of interventions, as vital registration systems are not available for the majority of the world's neonatal deaths. Verbal autopsy (VA is a tool that has been used to determine cause of death. Recent studies have attempted to standardize and validate the use of this tool in resource-limited areas. The World Health Organization (WHO International Standard VA Questionnaire was used to conduct a needs assessment in nine rural Peruvian villages. The goal was to determine the neonatal mortality rate (NMR, perinatal mortality rate (PMR, and causes of, and risk factors for, death in these villages.Methods: Eligible women were interviewed using the WHO International Standard VA Questionnaire or a set of questions based on the WHO VA Questionnaire. NMR and PMR were calculated using a generalized estimating equation model. Three neonatologists independently reviewed VA records to provide cause of death determination. Reviewer agreement was assessed using percent agreement. Fisher's exact test was used to determine risk factors associated with death.Results: The NMR was 31.4 per 1000 live births and the PMR was 49.7 per 1000 pregnancies. The main contributor to neonatal death was infection (43%. Percent agreement among reviewers was 90.5% and 38.9% for cause of neonatal death and stillbirth, respectively. Risk factors for death were pregnancy with twins (P = 0.001, preterm delivery (P = 0.003, and cesarean

  18. Vascular Parkinsonism and cognitive impairment: literature review, Brazilian studies and case vignettes

    Directory of Open Access Journals (Sweden)

    Thiago Cardoso Vale

    Full Text Available ABSTRACT Vascular Parkinsonism (VP is a form of secondary Parkinsonism resulting from cerebrovascular disease. Estimates of the frequency of VP vary greatly worldwide; 3% to 6% of all cases of Parkinsonism are found to have a vascular etiology. In a Brazilian community-based study on Parkinsonism, 15.1% of all cases were classified as VP, the third most common form, with a prevalence of 1.1% in an elderly cohort. Another Brazilian survey found a prevalence of 2.3% of VP in the elderly. VP is usually the result of conventional vascular risk factors, particularly hypertension, leading to strategic infarcts of subcortical gray matter nuclei, diffuse white matter ischaemic lesions and less commonly, large vessel infarcts. Patients with VP tend to be older and present with gait difficulties, symmetrical predominant lower-body involvement, poor levodopa responsiveness, postural instability, falls, cognitive impairment and dementia, corticospinal findings, urinary incontinence and pseudobulbar palsy. This article intends to provide physicians with an insight on the practical issues of VP, a disease potentially confounded with vascular dementia, idiopathic Parkinson's disease, dementia with Lewy bodies and other secondary causes of Parkinsonism.

  19. Undergraduate Program Review Processes: A Case Study in Opportunity for Academic Libraries (United States)

    Costella, John; Adam, Tom; Gray, Fran; Nolan, Nicole; Wilkins, Catherine


    How can an academic library most effectively participate and expand its contributions to program reviews at the institutional level? By becoming involved in undergraduate reviews, college and university libraries can articulate new and enhanced roles for themselves on campus. Academic libraries have always contributed to a variety of institutional…

  20. Working in Triads: A Case Study of a Peer Review Process (United States)

    Grainger, Peter; Bridgstock, Martin; Houston, Todd; Drew, Steve


    Peer review of teaching has become an accepted educational procedure in Australia to quality assure the quality of teaching practices. The institutional implementation of the peer review process can be viewed as genuine desire to improve teaching quality or an imposition from above as a measure of accountability and performativity. One approach is…

  1. Bound by Tradition? Peer Review and New Scholarship: An Institutional Case Study (United States)

    White, Barbara Jo; Cruz, Laura; Ellern, Jill; Ford, George; Moss, Hollye


    Peer review is by no means a routine process for traditional, or basic, research. Even so, peer review is even less routinized for other forms of scholarship. In 1990, Ernest Boyer called for a reconsideration of scholarship and extended the definition to be inclusive of non-traditional modes of scholarly production and delivery. However, peer…

  2. Crossed Aphasia and Visuo-Spatial Neglect Following a Right Thalamic Stroke: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Lieve De Witte


    Full Text Available Crossed aphasia in dextrals (CAD following pure subcortical lesions is rare. This study describes a right-handed patient with an ischemic lesion in the right thalamus. In the post-acute phase of the stroke, a unique combination of ‘crossed thalamic aphasia’ was found with left visuo-spatial neglect and constructional apraxia. On the basis of the criteria used in Mariën et al. [67], this case-report is the first reliable representative of vascular CAD following an isolated lesion in the right thalamus. Furthermore, this paper presents a detailed analysis of linguistic and cognitive impairments of ‘possible’ and 'reliable' subcortical CAD-cases published since 1975. Out of 25 patients with a pure subcortical lesion, nine cases were considered as ‘possibly reliable or reliable’. A review of these cases reveals that: (1 demographic data are consistent with the general findings for the entire group of vascular CAD, (2 the neurolinguistic findings do not support the data in the general CAD-population with regard to (a the high prevalence of transcortical aphasia and (b the tendency towards a copresence of an oral versus written language dissociation and a ‘mirror-image’ lesion-aphasia profile, (3 subcortical CAD is not a transient phenomenon, (4 the lesion-aphasia correlations are not congruent with the high incidence of anomalous cases in the general CAD-population, (5 neuropsychological impairments may accompany subcortical CAD.

  3. Recording Database Searches for Systematic Reviews - What is the Value of Adding a Narrative to Peer-Review Checklists? A Case Study of NICE Interventional Procedures Guidance

    Directory of Open Access Journals (Sweden)

    Jenny Craven


    Full Text Available This paper discusses the value of open and transparent methods for recording systematic database search strategies, showing how they have been applied at the National Institute for Health and Clinical Excellence (NICE, see Appendix C for definitions in the United Kingdom (UK.Objective – The objectives are to: 1 Discuss the value of search strategy recording methods. 2 Assess any limitations to the practical application of a checklist approach. 3 Make recommendations for recording systematic database searches.Methods – The procedures for recording searches for Interventional Procedures Guidance at NICE were examined. A sample of current methods for recording systematic searches identified in the literature was compared to the NICE processes. The case study analyses the search conducted for evidence about an interventional procedure and shows the practical issues involved in recording the database strategies. The case study explores why relevant papers were not retrieved by a search strategy meeting all of the criteria on the checklist used to peer review it. The evidence was required for guidance on non-rigid stabilisation techniques for the treatment of low back pain.Results – The analysis shows that amending the MEDLINE strategy to make it more sensitive would have increased its yield by 6614 articles. Examination of the search records together with correspondence between the analyst and the searcher reveals the peer reviewer had approved the search because its sensitivity was appropriate for the purpose of producing Interventional Procedures Guidance. The case study demonstrates the limitations of relying on a checklist to ensure the quality of a database search without having any contextual information.Conclusion – It is difficult for the peer reviewer to assess the subjective elements of a search without knowing why it has a particular structure or what the searcher intended. There is a risk that the peer reviewer will concentrate on

  4. Painful ophthalmoplegia from metastatic nonproducing parathyroid carcinoma : Case study and review of the literature

    NARCIS (Netherlands)

    Eurelings, M; Frijns, CJM; Jeurissen, FJF


    Parathyroid carcinoma is an uncommon malignancy. Of the fewer than 400 cases reported, most have been cases of producing parathyroid carcinoma with accompanying hypercalcemia. Only 13 patients with nonproducing parathyroid carcinoma have been described. Nine of these 13 patients had metastatic disea

  5. Pleuropulmonary Manifestations in Juvenile Systemic Lupus Erythematosus; A Review and Descriptive Study in 64 Cases

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    Sam Chitsaz


    Full Text Available Objective: Juvenile systemic lupus erythematosus (JSLE is a multisystemic autoimmune disease that can involve multiple organs such as: skin, kidney, musculoskeletal system, brain, and others as well as lung. Pulmonary manifestations may be an initial and/or life-threatening complication of SLE in children. The aim of this report is to describe the first pleuropulmonary manifestation of childhood lupus erythematosus.Material & Methods: We studied retrospectively 64 children with JSLE, diagnosed as JSLE at the Childrens Medical Center Hospital between 1995 and 2005. All met the American College of Rheumatology (formerly American Rheumatism Association, ARA revised criteria for SLE. They were evaluated for evidence of pleuro-pulmonary involvement.Findings: During the 10-yr study period, 64 patients were diagnosed as childhood-onset JSLE, who had the disease at or before the age of 16 (3-16 years. Fifty five patients (86% were females and 9 patients (14% were males (female: male ratio=6/1. Mean age of this group at the onset of the disease was 10 years (range 3-16. Eighteen cases (28% had pulmonary involvement. Pulmonary complications include: infectious pneumonia in 38%, pleuritis in 33%, pulmonary vasculitis in 11%, and acute lupus pneumonitis, chronic interstitial pneumonitis and pulmonary embolism (so-called lupus anticoagulant each one in 5.5%. Conclusion: The prevalence of pulmonary involvement in patients with JSLE varies according to the method used, but clinically significant pulmonary involvement in our series occurs in approximately 28%. There is few data regarding the treatment for most of the immune mediated pulmonary manifestations of JSLE.

  6. Lipase applications in oil hydrolysis with a case study on castor oil: a review. (United States)

    Goswami, Debajyoti; Basu, Jayanta Kumar; De, Sirshendu


    Lipase (triacylglycerol acylhydrolase) is a unique enzyme which can catalyze various types of reactions such as hydrolysis, esterification, alcoholysis etc. In particular, hydrolysis of vegetable oil with lipase as a catalyst is widely studied. Free lipase, lipase immobilized on suitable support, lipase encapsulated in a reverse micelle and lipase immobilized on a suitable membrane to be used in membrane reactor are the most common ways of employing lipase in oil hydrolysis. Castor oil is a unique vegetable oil as it contains high amounts (90%) of a hydroxy monounsaturated fatty acid named ricinoleic acid. This industrially important acid can be obtained by hydrolysis of castor oil. Different conventional hydrolysis processes have certain disadvantages which can be avoided by a lipase-catalyzed process. The degree of hydrolysis varies widely for different lipases depending on the operating range of process variables such as temperature, pH and enzyme loading. Immobilization of lipase on a suitable support can enhance hydrolysis by suppressing thermal inactivation and estolide formation. The presence of metal ions also affects lipase-catalyzed hydrolysis of castor oil. Even a particular ion has different effects on the activity of different lipases. Hydrophobic organic solvents perform better than hydrophilic solvents during the reaction. Sonication considerably increases hydrolysis in case of lipolase. The effects of additives on the same lipase vary with their types. Nonionic surfactants enhance hydrolysis whereas cationic and anionic surfactants decrease it. A single variable optimization method is used to obtain optimum conditions. In order to eliminate its disadvantages, a statistical optimization method is used in recent studies. Statistical optimization shows that interactions between any two of the following pH, enzyme concentration and buffer concentration become significant in presence of a nonionic surfactant named Span 80.

  7. The Flipped Classroom in Further Education: Literature Review and Case Study (United States)

    Little, Christopher


    The flipped classroom seeks to remove didactic instruction from the classroom and deliver it via electronic videos outside of the classroom, leaving contact time free for more interactive and engaging teaching and learning activities. This paper has two distinct aims: (1) to conduct a literature review of published UK-based "flipped…

  8. A Groupware-based Peer Review Process: An Exploratory Case Study

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    Bridget N. O'Connor


    Full Text Available This paper uses Lewin’s planned change theory and Rogers’ diffusion of innovation theory as lenses through which to describe what occurred in an organizationally flat, team-based organization when it rolled out a groupware-based peer review process. The Information Systems Department wanted to implement a high-level groupware product. The Human Resource Department wanted to enable team members to rate each other on their teambuilding skills as well as provide a criterion to be used by the organization’s Policy Committee in awarding biannual bonuses. Literature related to corporate peer reviews as well as the use of groupware provided the basis for questions posed. Both nondirective and focused interviews were conducted with key players and a sampling of actual evaluation data was collected. Analysis indicated that perceived management (noncommitment to using peer review data and issues of confidentiality may have led many individuals to be skeptical about the value of a peer review. As to the use of groupware to enable the evaluation, users were quite pleased; however, planners’ initial resistance to using this technology was evident and early efforts to devise usable reports were troublesome.

  9. Cinacalcet Monotherapy in Neonatal Severe Hyperparathyroidism: A Case Study and Review (United States)

    Gannon, Anthony W.; Monk, Heather M.


    Context: Neonatal severe hyperparathyroidism (NSHPT) is a severe form of familial hypocalciuric hypercalcemia characterized by severe hypercalcemia and skeletal demineralization. In most cases, NSHPT is due to biallelic loss-of-function mutations in the CASR gene encoding the calcium-sensing receptor (CaSR), but some patients have heterozygous mutations. Conventional treatment consists of iv saline, bisphosphonates, and parathyroidectomy. Objective: The aim of this project was to characterize the molecular basis for NSHPT in an affected newborn and to describe the response to monotherapy with cinacalcet. Methods: Clinical and biochemical features were monitored as cinacalcet therapy was initiated and maintained. Genomic DNA was obtained from the proband and parents. The CASR gene was amplified by PCR and sequenced directly. Results: The patient was a full-term male who developed hypotonia and respiratory failure soon after birth. He was found to have multiple fractures and diffuse bone demineralization, with a marked elevation in serum ionized calcium (1.99 mmol/L) and elevated serum levels of intact PTH (1154 pg/mL); serum 25-hydroxyvitamin D was low, and fractional excretion of calcium was reduced. The serum calcium level was not reduced by iv saline infusion. Based on an extensive family history of autosomal dominant hypercalcemia, a diagnosis of NSHPT was made, and cinacalcet therapy was initiated with a robust and durable effect. Molecular studies revealed a heterozygous R185Q missense mutation in the CASR in the patient and his father, whereas normal sequences for the CASR gene were present in the patient's mother. Conclusions: We describe the first use of cinacalcet as monotherapy for severe hypercalcemia in a newborn with NSHPT. The rapid and durable response to cinacalcet suggests that a trial of calcimimetic therapy should be considered early in the course of NSHPT. PMID:24203066

  10. [Prevention in times of economic crisis and spending review. The Lazio Region as a study case]. (United States)

    Di Marco, Marco; Marzuillo, Carolina; De Vito, Corrado; Matarazzo, Azzurra; Massimi, Azzurra; Villari, Paolo


    With cutbacks being implemented across a wide range of social and government programs throughout Europe and the rest of the world, preventive services have become more vulnerable. In this context, it is essential to properly focus the debate on public healthcare expenditure, stressing that financing preventive services is not merely a cost, but an investment in citizen well-being as well as economic stability and development. In Italy indeed all seem to agree on three priorities: i) strengthening prevention activities; ii) reorganization of hospital care; and iii) reinforcement of primary care. A plenty of data are available in Italy from some recently published authoritative reports. Given that health policies should be driven by a solid evidence base, it is important to look at the available data to understand if these priorities are justified. The Lazio Region, which is particularly under pressure since it is one of the regions with a formal regional recovery plan (Piano di Rientro), was chosen as a case-study. In the Lazio Region public health care expenditure is particularly high, but the health care expenditure for prevention activities is among the lowest of the Italian Regions. Major weakness points documented by the essential levels of care indicators included recommended vaccinations coverage, oncological screening programs, residential beds for the elderly and persons with disability and hospital care efficiency. Avoidable mortality is higher in the Lazio than in the rest of the country, as well as the prevalence of some major behavioral risk factors. Even if all data available support the choice to consider prevention activities as a priority, it is essential to increasing the value of prevention, investing money in preventive interventions of proven effectiveness and cost-effectiveness and promoting synergies with institutions outside the health care sector, implementing in a more efficient way the principle of Health in All Policies.

  11. Torsion of the uterus with myomas in a postmenopausal woman – case study and review of the literature

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    Dobrosława Sikora-Szczęśniak


    Full Text Available Introduction : Torsion of the uterus is defined as a rotation of more than 45° around the long axis of the uterus; 2/3 of cases are dextrorotations. The extent of rotation usually ranges from 45° to 180°. Objective: The purpose of the article was to present a case study of a postmenopausal woman with uterine torsion and myomas and to review the articles discussing the problem of rotated non-pregnant uterus. Material and methods : The article analyses the course of an extremely uncommon pathology, i.e. uterine torsion in a 67-year-old patient. Laparotomy exposed the uterus with myomas and numerous hemorrhages, rotated by 180° to the right side, size of 350 × 300 × 200 mm and bilateral necrosis of the ovaries. Moreover, we present a review of articles discussing surgical management in case of rotated non-pregnant uterus. Results and discussion: The patient was operated on by a team of gynecologists and surgeons. The uterus was derotated and total hysterectomy with salpingoophorectomy was performed. A fragment of the hepatic oval ligament was excised and periumbilical hernioplasty was performed. The patient was released home on the 10th day following the operation. Conclusions : If women complain of pain located within the small pelvis and abdominal cavity it is necessary to remember that it might result from the torsion of reproductive organs which is an uncommon condition but poses a health or life threat to patients. Surgical treatment of uterine torsion is successful if promptly implemented; in certain cases it is even possible to spare the patient’s fertility.

  12. Primary angiitis of CNS : neuropathological study of three autopsied cases with brief review of literature.

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    Panda K


    Full Text Available Primary angiitis of CNS(PACNS or granulomatous angiitis of CNS is a rare inflammatory disease of small blood vessels mostly confined to the CNS. The clinical and pathological features of 3 autopsied cases are described. Clinically all the three PACNS patients were young males, age ranging from 19 to 31 years. All presented with varied neurological manifestations. There was no evidence of systemic disease in any of the cases. The ESR was normal and CSF analysis showed chronic meningitic pattern. The cerebral angiogram in one case was normal and the CT scan done in another case showed multiple intracerebral haematoma due to vasculitis. Brain biopsy was not done. Diagnosis was made at post-mortem examination. Histology showed characteristic but variable degree of granulomatous and non-granulomatous angiitis of small vessels. Venulitis with parenchymal haemorrhages was the predominant feature and in one case phlebitis with thrombosis was noted. Since the disease responds to steroids and immunosuppressive therapy, establishing antemortem diagnosis is important. In view of the association of angiitis of CNS with bacteria and viral infections, their role in the evolution of the disease needs to be investigated.

  13. Nanomaterial Case Study: A Comparison of Multiwalled Carbon Nanotube and Decabromodiphenyl Ether Flame-Retardant Coatings Applied to Upholstery Textiles (Independent Peer Review Draft) (United States)

    This Independent Peer Review Draft document presents a case study of multiwalled carbon nanotubes (MWCNTs); it focuses on the specific example of MWCNTs as used in flame-retardant coatings applied to upholstery textiles. This case study is organized around the comprehensive envir...

  14. The Reasons Requirement in International Investment Arbitration: Critical Case Studies (book review)

    DEFF Research Database (Denmark)

    Tang, Yi Shin


    3. In the article, the Researcher reviews the work of Professors Guillermo A. Alvarez and W. Michael Reisman from Yale Law School, regarding the mechanisms of international investment arbitration and their importance for developing countries. The article provides a critical perspective on the aut......3. In the article, the Researcher reviews the work of Professors Guillermo A. Alvarez and W. Michael Reisman from Yale Law School, regarding the mechanisms of international investment arbitration and their importance for developing countries. The article provides a critical perspective...... on the authors’ argument that arbitrators in investment disputes do not follow any standards of reasoning in their decisions. It particularly points out how the authors seem to overlook the inherently sui generis nature of investment arbitration mechanisms, given that private investors and sovereign states...

  15. Retrospective study of reverse dorsal metacarpal flap and compound flap: a review of 122 cases

    Institute of Scientific and Technical Information of China (English)

    LU Lai-jin; GONG Xu; LIU Zhi-gang; ZHANG Zhi-xin


    Objective:To evaluate the clinical application and discuss the operative indication of the reverse dorsal metacarpal flap and its compound flap on the skin defects of hand.Methods: From 1990 to 2003, we applied the reverse dorsal metacarpal flap and its compound flap to repair soft tissue defects of fingers in 122 cases, which included 90cases of the reverse metacarpal flap and 32 cases of its compound flaps with tendon grafts, nerve grafts or bone grafts. Based on the follow-up observations, we analyzed the indications of the reverse metacarpal flap and its compound flaps, the postoperative contours, flap colors and textures in comparison to contralateral fingers retrospectively.Results: In the series of 122 cases, flaps survived and the donor site defects were closed directly. The follow-up period ranged from 1-12 years. The postoperative contours,colors and textures of the flaps and its compound flaps were similar to those of normal fingers, although linear scar remained. According to standards of sense recovery(British Medical Research Council, BMRC ), the sense function of the flaps resumed S3 after operation for 1 year.In 10 cases with the tendon defects treated by the flap with tendon grafts, function of flexion-extension of fingers resumed 50%-75% in comparison to the contralateral fingers using the method of measurement of total active motion. In 7 cases with the phalangeal nonunion or bone defects treated by the flap with bone grafts, union occurred after operation for 3 months.Conclusions: To soft tissue defects on fingers with bone or tendon exposure, the reverse metacarpal flap and its compound flap are a better choice for repairing. The range of repairing is up to the distal interphalangeal joint of fingers. The second dorsal metacarpal artery is more consistent and larger as the choice of vascular pedicle, in comparison with other dorsal metacarpal arteries.Postoperative flap color and texture are similar to normal fingers.

  16. Using psychodrama to relieve social barriers in an autistic child: A case study and literature review


    Jing Li; Dangyang Wang; Ziqiu Guo; Kun Li


    Objective: To review and update the evidence for the effect of psychodrama for children with autism, and evaluate the effect of psychodrama on an autistic child with severe social barriers, using the theory of mind and psychodrama methodology as the analytical frameworks. Methods: A 5 year-old boy, the research object, was diagnosed as severe autism using behavior observation and autism screening tools, with an DSM-Ⅵcriteria. Autism symptom severity was usually measured by Childhood Autism...

  17. Network Resilience Analysis: Review Of Concepts And A Country-Level. Case Study

    Directory of Open Access Journals (Sweden)

    Mariusz Kamola


    Full Text Available This paper presents the rationale behind performing an analysis of Internet resilience in the sense of maintaining a connection of autonomous systems in the presence of failures or attacks — on a level of a single country. Next, the graph of a network is constructed that represents interconnections between autonomous systems. The connectivity of the graph is examined for cases of link or node failure. Resilience metrics are proposed, focusing on a single autonomous system or on overall network reliability. The process of geographic location of networking infrastructure is presented, leading to an analysis of network resilience in the case of a joint failure of neighboring autonomous systems.

  18. A Review on Leaders in Cloud Computing Service Providers and Cloud SQL a Case Study

    Directory of Open Access Journals (Sweden)

    A. Mahendiran


    Full Text Available Cloud Computing is a kind of Information and Communication Technology, which delivers valuable resources to the people as services such as Software as a Service (SaaS, Infrastructure as a Service (IaaS and Platform as a Service (PaaS. There are several leading IT solution providers offer these services to the customers. Though there are number of Cloud Service Providers available, in this paper we analyze and review the three legends of this field such as Amazon, Google and Microsoft.

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

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


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

  20. Biclonal chronic lymphocytic leukemia: A study of two cases and review of literature

    Directory of Open Access Journals (Sweden)

    Kiran Ashok Ghodke


    Full Text Available Chronic lymphocytic leukemia (CLL is a common, immunophenotypically well-defined mature B-cell neoplasm. Demonstration of more than 5000/μL CD5+ B-cell population with co-expression of CD23, weak expression of CD20, and one type of immunoglobin light chain (either kappa or lambda is necessary for the diagnosis of CLL. However, CLL with two populations of B-cells expressing both kappa as well as lambda (biclonal light chains are extremely rare and has not been reported from India. We report two cases of biclonal CLL presented with leukocytosis, typical morphological features, and distinct immunophenotype of CLL. These cases are also an example which suggests that careful attention to the morphology of the blood smear and the entire immunophenotype panel is a must and will aid the proper diagnosis as only light chain ratios can be misguiding.

  1. The acute radiation syndrome: A study of ten cases and a review of the problem

    Energy Technology Data Exchange (ETDEWEB)

    Hempelmann, L.H.; Lisco, H.


    In this report ten cases of acute radiation syndrome are described resulting from two accidents occurring at the Los Alamos Scientific Laboratory of unique nature involving fissionable material. These cases are described in considerable detail. The report comprises ten sections. This volume, part II of the report, is comprised of sections entitled: (1) the Biological Basis for the Clinical Response seen in the Acute radiation Syndrome, (2) Clinical Signs and Symptoms, (3) Discussion of Hematological Findings, (4) Chemistry of the Blood and Urine, (5) Discussion of Pathological Findings, and (6) Reconsiderations of the Calculated Radiation Doses in Terms of the Observed Biological Response of the Patients. This report was prepared primarily for the clinician who is interested in radiation injuries and therefore emphasis has been placed on the correlation of clinical and pathological changes with the type of cytogenetic change known to be produced by ionizing radiation.

  2. Psychiatric Sequelae of Organophosphorous Poisoning: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    R. H. Bradwell


    Full Text Available This is the case of a young farm worker presenting with episodes of acute organic psychosis superimposed on a state of chronic anergy and hypersomnia. It is suggested that he developed an encephalopathic illness presenting with an organic bipolar affective disorder as a result of organophosphate exposure. In proposing this aetiology, an hypothesis is developed which links clinical observations and investigative results with research findings in relation to organophosphorus compounds and neuropharmacology.

  3. Accidental phosgene gas exposure: A review with background study of 10 cases

    Directory of Open Access Journals (Sweden)

    Arvind Kumar Vaish


    Full Text Available Here, authors present a review on clinical presentation and management of exposure of phosgene gas after reviewing the literature by searching with keywords phosgene exposure on Google, Cochrane, Embase and PubMed with a background of experience gained from 10 patients who were admitted to our institute after an accidental phosgene exposure in February 2011 nearby a city in India. Phosgene is a highly toxic gas, occupational workers may have accidental exposure. The gas can also be generated inadvertently during fire involving plastics and other chemicals and solvents containing chlorine, which is of concern to emergency responders. Phosgene inhalation may cause initially symptoms of respiratory tract irritation, patients feel fine thereafter, and then die of choking a day later because of build up of fluid in the lungs (delayed onset non-cardiogenic pulmonary edema. Phosgene exposure is associated with significant morbidity and mortality. Patients with a history of exposure should be admitted to the hospital for a minimum of 24 h for observation because of the potential for delayed onset respiratory failure and acute respiratory distress syndrome.

  4. Case Study: Testing with Case Studies (United States)

    Herreid, Clyde Freeman


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  5. Lipomas of the oral cavity: clinicopathological and immunohistochemical study of 24 cases and review of the literature. (United States)

    Naruse, Tomofumi; Yanamoto, Souichi; Yamada, Shin-Ichi; Rokutanda, Satoshi; Kawakita, Akiko; Takahashi, Hidenori; Matsushita, Yuki; Hayashida, Saki; Imayama, Naomi; Morishita, Kota; Yamashita, Kentaro; Kawasaki, Goro; Umeda, Masahiro


    Although lipomas are common soft tissue tumors, few cases of lipoma or its variants have been reported in the oral cavity. We here described the clinical, histological, and immunohistochemical features of 24 cases of oral lipoma obtained from medical records at Nagasaki University Hospital between 1977 and 2010, and also retrospectively reviewed 603 cases of oral lipoma reported in the English literatures. The patients examined comprised 11 men and 13 women with a mean age of 59 years, ranging from 31 to 90 years. The main sites involved were the buccal mucosa (n = 9), followed by the tongue (n = 4), lip and retromolar area (n = 3), floor of the mouth (n = 2), and gingiva (n = 1). The mean tumor size was 2.0 cm, ranging from 0.2 to 5 cm. Histological analysis revealed 20 cases of lipoma, 2 cases of fibrolipoma, and one case each of intramuscular lipoma and spindle cell lipoma. Twenty-three cases were treated surgically while one case underwent biopsy and follow-up. Recurrence was not observed in any case. We reviewed the English literatures, and similar results were obtained. In immunohistochemical analysis, PCNA and ki-67 expression indices were higher in intramuscular lipoma cases than in its variants. Especially, it showed that a long time follow-up may be necessary in ki-67 positive cases.

  6. Review of maxillofacial injuries in Chennai, India: a study of 2748 cases. (United States)

    Subhashraj, K; Nandakumar, N; Ravindran, C


    We reviewed the medical records of 2748 patients treated for maxillofacial injuries at Sri Ramachandra Medical and Dental College and Hospital between January 1999 and December 2005. 1332 (42%) had soft tissue injuries, 1176 (37%) had mid face fractures, and 512 (16%) had mandibular fractures. Most patients with midface fractures had fractures of the zygomaticomaxillary region 422 (36%), while fractures of the parasymphyseal region were more common in the mandible 156 (31%). Most patients were in the 21-30 year-old age group, and the male:female ratio was 3.7:1. Road crashes, particularly involving motorcycles, accounted for 1710 (62%), with a high prevalence during the month of September and on Saturdays.

  7. The syndrome of progressive posterior cortical dysfunction: A multiple case study and review

    Directory of Open Access Journals (Sweden)

    Renata Areza-Fegyveres

    Full Text Available Abstract Dementia presenting with prominent higher order visual symptoms may be observed in a range of neurodegenerative conditions and is often challenging to diagnose. Objectives: To describe cases of progressive dementia presenting with prominent visual cortical symptoms. Methods: We conducted a retrospective search of cases of progressive dementia with predominant visual symptoms, seen at our dementia unit from 1996 to 2006. Results: Twelve patients (5 men, 7 women were identified, with ages ranging from 49 to 67 years. At the first examination, the duration of the symptoms ranged from one to ten years and the Mini-Mental State Examination scores from 7 to 27. Eleven patients presented with predominant visuospatial symptoms (partial or complete Balint syndrome and one with visuoperceptive impairment. Other reported manifestations were: constructional apraxia in 11 patients, partial or complete Gerstmann syndrome in ten, ideomotor apraxia in nine, hemineglect or extinction in four patients, alien hand phenomenon in three, and prosopagnosia in one patient. Memory loss was reported by ten patients, but was not the main complaint in any of these cases. Insight was relatively preserved in five patients even after a long period following the onset of symptoms. Six patients developed parkinsonism during evolution. Clinical diagnoses were possible or probable AD in seven patients, cortico-basal degeneration in four, and dementia with Lewy body in one. Conclusions: Clinicians should consider this condition especially in presenile patients with slowly progressive higher-order visual symptoms. Although described in association with different conditions, it may also occur in Alzheimer disease.

  8. Case study

    DEFF Research Database (Denmark)

    Milana, Marcella; Bernt Sørensen, Tore

    of several DHSs. Furthermore ?Udspil? was chosen for being a non-formal learning activity based on individual participation, even though linked to institutionalized learning practices, which were carried out in cooperation between several local institutions.Last but not least, the project represents...... that time Roskilde University Centre and Learning Lab Denmark, DK)3. The case here presented is based on results from research activity carried out over a 1 year period (spring 2006 - spring 2007). Detailed information concerning participation in the project was collected in two DHSs only: the Sports Day......Learning for democratic citizenship is embedded in the general popular education ideal(folkeoplysning), which is the primary source of inspiration for the Day High Schools (DHSs). DHSs are private institutions supported by local authorities, that host primarily low educated and unemployed young...

  9. Pulmonary mixed squamous cell and glandular papilloma mimicking adenocarcinoma: a case study and literature review. (United States)

    Lin, Dongliang; Jiang, Yanxia; Wang, Jigang; Ding, Li; Xin, Fangjie; Zhao, Han; Li, Yujun


    Mixed squamous cell and glandular papilloma of the lung is an extremely rare benign neoplasm. Here we present another case of mixed squamous cell and glandular papilloma in a 64-year-old female nonsmoker. Histologically, the tumor was composed of mainly papillary structures covered with squamous, glandular and transitional epithelium. Some glandular structures extending into adjacent bronchiolar and alveolar spaces with mucus were similar to adenocarcinoma. Immunohistochemical analysis showed the different kinds of epithelia had similar immunophenotype. The different components were positive for cytokeratin (CK)7, CK19, CAM5.2, CK5/6, CK34βE12, and TTF-1, but negative for CK20. The transitional morphology and immunohistochemistry indicate the different components likely come from a same kind of progenitor in the bronchiolar wall.

  10. Primary adrenal leiomyosarcoma: A case report with immunohistochemical study and review of literature

    Directory of Open Access Journals (Sweden)

    Sanjay D Deshmukh


    Full Text Available Primary adrenal mesenchymal tumors are exceptionally rare. Diagnosis is based entirely on histological and immunohistochemical evaluation which is indispensable not only for determining tumor type but also for predicting biological behavior. We report a rare case of primary leiomyosarcoma of the left adrenal gland, in a 60 year old woman who presented with flank pain. Computed tomography revealed a well defined left adrenal tumor which was surgically resected. Histological examination of the tumor showed malignant spindle cells in interlacing fascicles and whorls. Nuclear pleomorphism, tumor giant cells and abnormal mitotic figures were seen. On immunohistochemistry, the tumor cells showed reactivity for smooth muscle actin, vimentin and desmin; and were negative for cytokeratin, S100 protein, CD117 and HMB-45. A diagnosis of primary adrenal leiomyosarcoma was offered. Postoperative recovery of the patient was uneventful and the patient was symptom free with no evidence of tumor metastasis or recurrence 21 months after surgery.

  11. Water and Carbon Footprint of Wine: Methodology Review and Application to a Case Study

    Directory of Open Access Journals (Sweden)

    Sara Rinaldi


    Full Text Available Life cycle assessments (LCAs play a strategic role in improving the environmental performance of a company and in supporting a successful marketing communication. The high impact of the food industry on natural resources, in terms of water consumption and greenhouse gases emission, has been focusing the attention of consumers and producers towards environmentally sustainable products. This work presents a comprehensive approach for the joint evaluation of carbon (CF and water (WF footprint of the wine industry from a cradle to grave perspective. The LCA analysis is carried out following the requirements of international standards (ISO/TS 14067 and ISO 14046. A complete review of the water footprint methodology is presented and guidelines for all the phases of the evaluation procedure are provided, including acquisition and validation of input data, allocation, application of analytic models, and interpretation of the results. The strength of this approach is the implementation of a side-by-side CF vs. WF assessment, based on the same system boundaries, functional unit, and input data, that allows a reliable comparison between the two indicators. In particular, a revised methodology is presented for the evaluation of the grey water component. The methodology was applied to a white and a red wine produced in the same company. A comparison between the two products is presented for each LCA phase along with literature results for similar wines.

  12. Technology installation review. A case study on energy-efficient technologies

    Energy Technology Data Exchange (ETDEWEB)

    Baxter, Van [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)


    The purpose of this Technology Installation Review is to provide an overview of hybrid geothermal heat pump systems. It presents the results of recent research on these systems, looks at system types, energy savings, maintenance considerations, and measured technology performance from several examples. Using the ground as a thermal energy source and/or a heat sink for heat pumps has long been recognized to have a number of advantages over the similar use of ambient air. Ground temperatures at about 3-ft depth or lower are much less variable than ambient air temperatures. Further, soil or rock at these depths is usually warmer than ambient air during the coldest winter months and cooler than ambient air during the summer months. This fact leads directly to cooler condensation temperatures (during cooling operation) and warmer evaporating temperatures (during heating) for a heat pump with consequent improved energy efficiency. It also results in increased heating and cooling capacity at extreme temperatures, thereby reducing or eliminating the need for auxiliary heat.

  13. Diagnosis of Dilated Cardiomyopathy: Patient Reaction and Adaptation—Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Solomis Solomou


    Full Text Available Objective. Heart failure remains a major cause of morbidity and mortality. Given that heart failure generally has a chronic course, it is important to appreciate the impact it can have on the quality of life of patients and also their partners or family carers. Method. Questionnaires were given to a patient newly diagnosed with dilated cardiomyopathy, during his hospital admission, as well as after discharge. The responses are summarised and explored in the discussion section, where we used review of the literature to discuss the implications of a new diagnosis of heart failure. Results. The patient’s responses to the questionnaires suggest certain anxieties that are part of his adaptation to the diagnosis of heart failure. Conclusion. Depression is a common comorbid condition in patients with heart failure. Various tools can be used to screen for depression in patients with heart failure. Both pharmacological and nonpharmacological options are available. Rapid evaluation of ongoing problems and active participation by a psychiatrist can ensure that the patient receives the best possible clinical care.

  14. Radiation recall dermatitis induced by sorafenib. A case study and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Stieb, Sonja [University Hospital Zurich, Department of Radiation Oncology, Zurich (Switzerland); Paul Scherrer Institute, Villigen PSI, Center for Proton Therapy, Villigen (Switzerland); Riesterer, Oliver; Bruessow, Cornelia; Guckenberger, Matthias [University Hospital Zurich, Department of Radiation Oncology, Zurich (Switzerland); Pestalozzi, Bernhard [University Hospital Zurich, Department of Oncology, Zurich (Switzerland); Weiler, Stefan [University Hospital and University of Zurich, Department of Clinical Pharmacology and Toxicology, Zurich (Switzerland)


    Radiation recall dermatitis (RRD) is an acute inflammatory reaction confined to previously irradiated skin, mainly subsequent to the administration of certain chemotherapeutics. Here we present a rare case of RRD induced by the oral multikinase inhibitor sorafenib. A 77-year-old male with hepatocellular carcinoma was irradiated at ten different sites for bone metastases with 20-36 Gray in 5-12 fractions from January to March 2015. Sorafenib 400 mg was administered twice daily from mid-March. One week later the patient presented with fever and erythematous lesions on the right upper arm, mandible, and trunk. All skin symptoms were confined to previously irradiated areas. After RRD was diagnosed by exclusion of other causes and skin biopsy, sorafenib was paused. With the administration of topical corticosteroids and oral antihistamines, the skin reaction subsided within several days. Sorafenib was readministered after 3 weeks, which did not lead to recurrence of RRD but did cause fluctuating fever. Only four other such cases have been reported in the literature and WHO pharmacovigilance database on individual case safety reports. The current report is the first to show a potential relationship between the severity of sorafenib-induced RRD and radiation dose, histopathological features, and simultaneous acute radiation dermatitis and mucositis. RRD induced by sorafenib is a rare phenomenon, but should be considered in patients showing erythematous skin lesions 1-2 weeks after initiation of the drug, predominantly in areas where skin has been irradiated with an equivalent dose ≥ 30 Gy. Discontinuation of sorafenib with possible readministration should be evaluated with respect to the clinical situation and severity of reaction. (orig.) [German] Recall-Strahlendermatitis (RRD) ist eine akute Entzuendungsreaktion der Haut in zuvor bestrahlten Arealen, welche meist nach Einnahme bestimmter Chemotherapeutika auftritt. Nachfolgend praesentieren wir einen seltenen Fall von

  15. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Saeedi Borujeni


    Full Text Available Introduction:Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Case Report:In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy.  Conclusion:In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child.

  16. Exophiala spinifera as a cause of cutaneous phaeohyphomycosis: case study and review of the literature. (United States)

    Harris, John E; Sutton, Deanna A; Rubin, Adam; Wickes, Brian; De Hoog, G S; Kovarik, Carrie


    Exophiala spinifera has been reported as an agent of cutaneous disease 18 times in the literature. Clinical presentations of cutaneous lesions vary widely, including erythematous papules, verrucous plaques, and deep subcutaneous abscesses. The clinical distribution and course of disease are also variable, depending on the age and immune competency of the patient. Histologic appearance occurs in one of two patterns--phaeohyphomycosis or chromoblastomycosis. While E. spinifera appears to be susceptible to multiple antimicrobial agents in vitro, clinical experience with treatment modalities has been variable. Prior to the availability of sequencing methods, species identification was based on the histopathologic presentation in tissue and morphologic features of the fungus in culture. It is likely that E. spinifera cutaneous infections have been underreported due to its incorrect identification based on earlier methods. We report an additional case of E. spinifera phaeohyphomycosis, the first to be definitively identified by sequencing. In addition, we summarize the variable clinical, histopathologic, and morphologic features, as well as treatment responses described in previously reported cutaneous infections caused by E. spinifera.

  17. Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature (United States)

    Saeedi Borujeni, Mohammad Javad; Esfandiary, Ebrahim; Almasi-Dooghaee, Mostafa


    Introduction: Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia. Case Report: In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy. Conclusion: In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child. PMID:28229063

  18. A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb.

    LENUS (Irish Health Repository)

    Neligan, A


    Entrapment neuropathies, particularly those affecting upper limbs, are common reasons for referral for nerve conduction studies (NCS). However, concordance between clinical findings and NCS findings, especially in patients being considered for intervention including decompressive surgery, has not been assessed.

  19. A review of potable water accessibility and sustainability issues in developing countries - case study of Uganda. (United States)

    Nayebare, Shedrack R; Wilson, Lloyd R; Carpenter, David O; Dziewulski, David M; Kannan, Kurunthachalam


    Providing sources of sustainable and quality potable water in Uganda is a significant public health issue. This project aimed at identifying and prioritizing possible actions on how sustainable high quality potable water in Uganda's water supply systems could be achieved. In that respect, a review of both the current water supply systems and government programs on drinking water in Uganda was completed. Aspects of quantity, quality, treatment methods, infrastructure, storage and distribution of water for different water systems were evaluated and compared with the existing water supply systems in the U.S., Latin America and the Caribbean, for purposes of generating feasible recommendations and opportunities for improvement. Uganda utilizes surface water, groundwater, and rainwater sources for consumption. Surface water covers 15.4% of the land area and serves both urban and rural populations. Lake Victoria contributes about 85% of the total fresh surface water. Potable water quality is negatively affected by the following factors: disposal of sewage and industrial effluents, agricultural pesticides and fertilizers, and surface run-offs during heavy rains. The total renewable groundwater resources in Uganda are estimated to be 29 million m3/year with about 20,000 boreholes, 3000 shallow-wells and 200,000 springs, serving more than 80% of the rural and slum communities. Mean annual rainfall in Uganda ranges from 500 mm to 2500 mm. Groundwater and rainwater quality is mainly affected by poor sanitation and unhygienic practices. There are significant regional variations in the accessibility of potable water, with the Northeastern region having the least amount of potable water from all sources. Uganda still lags behind in potable water resource development. Priorities should be placed mainly on measures available for improvement of groundwater and rainwater resource utilization, protection of watersheds, health education, improved water treatment methods and

  20. Oxidative stress in prostate cancer patients: A systematic review of case control studies



    Background: Prostate cancer (PCa) is the most common cancer in men in Western countries. In-vitro and in-vivo studies suggest that oxidative stress (OS) and antioxidants play a key role in the pathogenesis of chronic diseases including PCa, which is promoted by the production of reactive oxygen species and impaired antioxidant defense mechanisms. This study evaluates the association between OS and men with PCa. Methods: A literature search was carried out on Medline, PubMed, and ScienceDirect...

  1. Oxidative stress in prostate cancer patients: A systematic review of case control studies



    Background Prostate cancer (PCa) is the most common cancer in men in Western countries. In-vitro and in-vivo studies suggest that oxidative stress (OS) and antioxidants play a key role in the pathogenesis of chronic diseases including PCa, which is promoted by the production of reactive oxygen species and impaired antioxidant defense mechanisms. This study evaluates the association between OS and men with PCa. Methods A literature search was carried out on Medline, PubMed, and ScienceDirect d...

  2. The Dutch Reference Study: Cases of interventions in bicycle infrastructure reviewed in the framework of Bikeability

    NARCIS (Netherlands)

    Van Goeverden, C.D.; Godefrooij, T.


    The Netherlands have a tradition of high bicycle usage and a long history of research on effective policies for promoting cycling. Findings in Dutch studies can be useful in the Danish Bikeability-project that has the objective to increase the level of knowledge in relation to bicycle based transpor

  3. Form follows function? Proposing a blueprint for ecosystem service assessments based on reviews and case studies

    NARCIS (Netherlands)

    Seppelt, R.; Fath, B.; Burkhard, B.; Fisher, J.L.; Grêt-Regamey, A.; Lautenbach, S.; Pert, P.; Hotes, S.; Spangenberg, J.; Verburg, P.H.; Oudenhoven, van A.P.E.


    Ecosystem service assessments (ESA) hold the promise of supporting the quantification and valuation of human appropriation of nature and its goods and services. The concept has taken flight with the number of studies published on the topic increasing rapidly. This development, and the variation of d

  4. Book Review of Emerging Markets for Ecosystem Services: A Case Study of the Panama Canal Watershed (United States)

    This book is an outstanding contribution to our current, applied knowledge on markets of ecosystems services. In an integrated framework of study, the authors assessed the opportunities and limitations of carbon sequestration mainly via reforestation, hydrological services (water quantity and qualit...


    The study evaluates the technical, economic, and administrative aspects of establishing water quality trading (WQT) programs where the nutrient removal capacity of wetlands is used to improve water quality. WQT is a potentially viable approach for wastewater dischargers to cost-e...

  6. Neurofibromatosis type 1 and attention deficit hyperactivity disorder: a case study and literature review


    Miguel CS; Chaim-Avancini TM; Silva MA; Louzã MR


    Carmen Sílvia Miguel, Tiffany M Chaim-Avancini, Maria Aparecida Silva, Mario Rodrigues LouzãAdult Attention Deficit Hyperactivity Disorder Program (PRODATH), Institute of Psychiatry, University of São Paulo, São Paulo, BrazilBackground: The cognitive profile of children with neurofibromatosis type 1 (NF1) and attention deficit hyperactivity disorder (ADHD) has been well characterized, but few studies have evaluated the cognitive abilities o...

  7. Environmental protection for geothermic exploratory drilling in Mexico: Review of a case study

    Energy Technology Data Exchange (ETDEWEB)

    Ortega-Rubio, A.; Diaz, S.; Arguelles, C.; Arriaga, L. [Centro de Investigaciones Biologicas del Noveste, La Paz (Mexico)


    Mexican legislation specifically establishes very particular measures in order to prevent and/or to mitigate the potential environmental impacts produced by geothermic exploratory drilling. During 1991, we developed an environmental impact assessment study to evaluate the possible environmental impacts produced by the exploratory drilling at the Las Tres Virgenes Geothermic field. We determined that the geothermic electrical project activities analysed have observed most of the official recommendations. As a result, all the potential environmental impacts are local, restricted in extent and time, and mitigated or reversed. 12 refs., 1 fig., 1 tab.

  8. Neurofibromatosis type 1 and attention deficit hyperactivity disorder: a case study and literature review

    Directory of Open Access Journals (Sweden)

    Miguel CS


    Full Text Available Carmen Sílvia Miguel, Tiffany M Chaim-Avancini, Maria Aparecida Silva, Mario Rodrigues LouzãAdult Attention Deficit Hyperactivity Disorder Program (PRODATH, Institute of Psychiatry, University of São Paulo, São Paulo, BrazilBackground: The cognitive profile of children with neurofibromatosis type 1 (NF1 and attention deficit hyperactivity disorder (ADHD has been well characterized, but few studies have evaluated the cognitive abilities of adults with NF1 and ADHD.Objectives: We investigated 1 the cognitive profile of an adult patient with NF1 and inattention problems, 2 changes in his cognition after 14 months of follow-up, and 3 whether the patient exhibited comorbid NF1 and ADHD or secondary ADHD-like symptoms.Methods: We administered neuropsychological tests of executive function, attention, verbal and visual memory, visuospatial function, and language during two evaluations separated by 14 months.Results: We found no changes in sustained attention, language, or verbal memory. Visual memory, verbal learning, selective attention inhibitory control, and problem solving declined over time, whereas visual search, psychomotor speed, visuospatial function, and mental flexibility improved.Conclusion: Our patient exhibited a cognitive profile characteristic of both NF1 and ADHD, leading to the hypothesis that the patient had comorbid ADHD instead of secondary ADHD-like symptoms. More studies are necessary to characterize the cognition of patients with NF1 and ADHD.Keywords: ADHD, executive function, NF1, low-grade pontine glioma, cognition

  9. A review of multivariate social vulnerability methodologies: a case study of the River Parrett catchment, UK (United States)

    Willis, I.; Fitton, J.


    In the field of disaster risk reduction (DRR), there exists a proliferation of research into different ways to measure, represent, and ultimately quantify a population's differential social vulnerability to natural hazards. Empirical decisions such as the choice of source data, variable selection, and weighting methodology can lead to large differences in the classification and understanding of the "at risk" population. This study demonstrates how three different quantitative methodologies (based on Cutter et al., 2003; Rygel et al., 2006; Willis et al., 2010) applied to the same England and Wales 2011 census data variables in the geographical setting of the 2013/2014 floods of the River Parrett catchment, UK, lead to notable differences in vulnerability classification. Both the quantification of multivariate census data and resultant spatial patterns of vulnerability are shown to be highly sensitive to the weighting techniques employed in each method. The findings of such research highlight the complexity of quantifying social vulnerability to natural hazards as well as the large uncertainty around communicating such findings to stakeholders in flood risk management and DRR practitioners.

  10. How long is the peer review process for journal manuscripts? A case study on Angewandte Chemie International Edition. (United States)

    Bornmann, Lutz; Daniel, Hans-Dieter


    One of the most frequently raised criticisms of the review process for manuscripts is that the length of time between submission of a manuscript and the editorial decision is overly long. Taking the journal Angewandte Chemie International Edition as an example and based on nearly 2000 manuscripts, the present study examined just how long the peer review process takes.

  11. Review of Studies Related to Pedagogical Content Knowledge in the Context of Science Teacher Education: Turkish Case (United States)

    Aydin, Sevgi; Boz, Yezdan


    As a review study, the present study was carried out in order to introduce PCK construct to researchers and evaluate which aspects of PCK were studied in our country, and, finally, make recommendations in light of the analysis of the studies for further research. For this purpose, ERIC database, YOK (Higher Education Council) database were…

  12. Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition

    Directory of Open Access Journals (Sweden)

    Mickenautsch Steffen


    Full Text Available Abstract Background This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism. Methods A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare. Results The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials. Conclusions A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.

  13. Case Study: Writing a Journal Case Study (United States)

    Prud'homme-Genereux, Annie


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

  14. Building theories from case study research: the progressive case study

    NARCIS (Netherlands)

    Steenhuis, Harm-Jan; Bruijn, de Erik J.


    Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior litera

  15. An autopsy case of hepatoid carcinoma of the ovary with PIVKA-II production: immunohistochemical study and literature review. (United States)

    Senzaki, H; Kiyozuka, Y; Mizuoka, H; Yamamoto, D; Ueda, S; Izumi, H; Tsubura, A


    A case of hepatoid carcinoma of the ovary in a 61-year-old Japanese woman, who showed high serum levels of alpha-fetoprotein and CA125, is reported. Grossly, the left ovarian tumor, which measured 12 x 9 cm, was solid and multinodular. Histologically, the tumor resembled hepatocellular carcinoma by its architectural and cytological features. Liver cell differentiation was indicated functionally by the immunohistochemical detection of alpha-fetoprotein and protein induced by vitamin K absence or antagonist II (PIVKA-II) and by positive bile production, and the hepatocellular differentiation was structurally in accord with keratin 7, 8 and 18 expression. CA125 expression, commonly present in ovarian surface epithelial carcinomas, suggested that this neoplasm originated from ovarian common epithelial cells. There are only nine such cases in the literature. A review of these cases reveals that hepatoid carcinoma of the ovary occurs exclusively in postmenopausal women (mean age, 62.7 years) and that the prognosis is poor.

  16. Osteogenesis imperfecta - iconographic study of two cases and review of the literature; Osteogenese imperfeita - revisao da literatura e iconografia baseada em dois casos

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Ricardo Pires de; Fernandes, Cintia; Hilario, Marcelo Cobra; Barros, Wagner Moraes; Soares, Aldemir Humberto [Hospital Heliopolis, Sao Paulo, SP (Brazil)


    The authors present a literature review about osteogenesis imperfecta, a disease that leads to bone fragility and low height patterns caused by an abnormality of the collagen synthesis. The iconographic study is based on two cases of the tarda type. (author) 9 refs., 3 figs.

  17. Basic Education for Girls in Yemen: Country Case Study and Analysis. Mid-Decade Review of Progress towards Education for All. (United States)

    Beatty, Sharon

    In 1995, the International Consultative Forum on Education for All (EFA) commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines provision of basic education (grades 1-9) in Yemen, focusing on obstacles to girls' education in rural areas. The report…

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

    Directory of Open Access Journals (Sweden)

    Rudel Ruthann A


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

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

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


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

  20. Schooling's "Contribution" to Contemporary Violent Conflict: Review of Theoretical Ideas and Case Studies in the Field of Education and Conflict (United States)

    Matsumoto, Mitsuko


    Some argue that the field of study of "education and conflict" has yet to be solidified since its emergence in the 1990s, partly due to the weak theory base. This article reviews the literature on the "contribution" of schooling in contemporary violent conflict, via three strands of theoretical ideas, to demonstrate the…

  1. Case Study Teaching (United States)

    Herreid, Clyde Freeman


    This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

  2. Cytomegalovirus Colitis and Subsequent New Diagnosis of Inflammatory Bowel Disease in an Immunocompetent Host: A Case Study and Literature Review (United States)

    Khan, Tipu V.; Toms, Carla


    Patient: Male, 40 Final Diagnosis: CMV colitis Symptoms: Abdominal pain • diarrhea • jaundice Medication: — Clinical Procedure: Flexible sigmoidoscopy • colonoscopy Specialty: Family Medicine Objective: Rare co-existance of disease or pathology Background: Infection with gastrointestinal cytomegalovirus in an immunocompetent host is a rather rare occurrence in the literature. There are a few reports of gastrointestinal infection in the immunocompetent who are then subsequently given a new diagnosis of inflammatory bowel disease. It is speculated that the initial cytomegalovirus colitis infection triggers the onset of inflammatory bowel disease. Case Report: Herein we report a case of cytomegalovirus colitis and new diagnosis of inflammatory bowel disease identified in a 40-year-old immunocompetent adult man who presented with gastrointestinal symptoms and disseminated cytomegalovirus infection requiring anti-viral therapy, which successfully treated the episode of cytomegalovirus infection. He then went on to have persistent symptomatic inflammatory bowel disease confirmed by pathology. Conclusions: In this paper we will review the literature and explore the rare case of cytomegalovirus colitis in the immunocompetent host and discuss the pathology, physiology, diagnosis, and treatment of cytomegalovirus colitis. PMID:27460032

  3. Feasibibility study - cases

    DEFF Research Database (Denmark)

    Lund, Henrik; Hvelplund, Frede Kloster; Sukkumnoed, Decharut


    The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation.......The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation....

  4. Project management case studies

    CERN Document Server

    Kerzner, Harold R


    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  5. Creating a Safe Space: A Case Study of Complex Trauma and a Call for Proactive Comprehensive Psychoeducational Assessments and Reviews (United States)

    Mainwaring, Debra J.


    This article advocates for proactive, dynamic and comprehensive psycho-educational assessments for children and young people who have a history of complex trauma, because of its known effects on development and learning. A case study is shared of a young woman with a history of complex trauma because of exposure to parental neglect, multiple…

  6. Breast cancer in patients with Li–Fraumeni syndrome – a case-series study and review of literature (United States)

    Nandikolla, Amara G; Venugopal, Sangeetha; Anampa, Jesus


    Background Li–Fraumeni Syndrome (LFS) is a rare disease with autosomal dominant inheritance linked to germline mutations of tumor suppressor gene TP53. These patients are predisposed to malignancies such as sarcoma, breast cancer, leukemia, and other malignancies. Breast cancer, the most common malignancy in adult patients with LFS, has an early-onset presentation and is usually treated as per the guidelines for the general population due to the limited literature about breast cancer in LFS. We aimed to describe our institutional experience treating patients with breast cancer and LFS to contribute to literature about this entity. Design Retrospective single-institution case-series study. We searched for cases with LFS and breast cancer from 01/01/2000 to 12/31/2015 with treatment received at our institution. Results We identified 4 cases (2 African Americans, 1 Indian, and 1 Hispanic) in 4 different families, who were diagnosed with LFS after presenting with breast cancer. Three cases were triple-negative disease and 1 case was ER+, HER2 positive disease. They were treated with mastectomy and a third-generation breast chemotherapy regimen and/or trastuzumab-containing regimen. Radiation therapy was used in 2 patients. Breast cancer recurrence was seen in 1 patient, while three other malignancies were identified after breast cancer treatment (1 breast sarcoma, 1 leiomyosarcoma, and 1 myelodysplastic syndrome). A patient, who underwent surveillance with a positron emission tomography-computed tomography scan, was found to have a stage I leiomyosarcoma and was treated with surgical resection, but then developed metastatic disease requiring cytotoxic chemotherapy. Conclusion Breast cancer among patients with LFS needs a multidisciplinary treatment approach. Surgical management follows the guidelines for the general population. Risk–benefit assessment of chemotherapy and radiotherapy needs to be performed carefully in a case-by-case approach. Patients should

  7. Chronic gonococcal arthritis with C5 deficiency presenting with brief flare-ups: case study and literature review. (United States)

    Davido, B; Dinh, A; Lagrange, A; Mellon, G; de Truchis, P; Perronne, C; Cremieux, A C


    Gonococcal arthritis is typically acute and appears within 3 weeks after initial infection. Chronic gonococcal arthritis is now exceptionally rare, since the advent of the antibiotic era. Numerous host factors are involved in gonococcal dissemination, such as complement deficiency, HIV and gonococcus strain characteristics. Gonococcal arthritis shares the same risk factors. In this instance, our patient was a 16-year-old girl suffering from persistent polyarthralgia with joint swelling presenting with brief flare-ups for a period of 1 year. She disclosed a single episode of unprotected sexual intercourse 1 year ago, i.e. just before developing her first rheumatological symptoms. Therefore, we performed a joint aspiration (arthrocentesis), and synovial fluid was inoculated directly into aerobic and anaerobic blood culture bottles, which tested positive for Neisseria gonorrhoeae within 24 h. Clinical presentation was consistent with previous reports of chronic gonococcal arthritis. Further investigation revealed a C5 complement deficiency, which might explain the chronic Neisseria process. A favourable outcome was reached after a ten-day course of IV ceftriaxone, with no apparent sequelae found during follow-up 6 weeks later. This case demonstrates an unusual gonococcal arthritis with brief flare-ups for the course of a year, followed by a subacute form. N. meningitidis infections, similar to N. gonorrhoeae, are typically acute and may sometimes be involved in chronic processes. However, this characteristic appears to be rare in the case of N. gonorrhoeae. Risk factors for this chronic process will be discussed with a review of the literature.

  8. Tympanoplasty Outcomes: A Review of 789 Cases

    Directory of Open Access Journals (Sweden)

    Shabbir Indorewala


    Full Text Available Introduction: Tympanoplasty is indicated to restore hearing disability and prevent recurrent otorrhea.  Materials and Methods: This study was a retrospective review of patients who underwent tympanoplasty with or without mastoidectomy over a 1-year period.  Results: A total of 789 tympanoplasties were reviewed, with a male-to-female ratio of 1:1.1. In total, 91% and 9% of tympanoplasties were performed without and with mastoidectomy, respectively. Complete graft take was observed in 98.6% of cases. Approximately 25% of patients had an air-bone gap (ABG gap ≤20dB pre-operatively, increasing to 75.6% post-operatively. ABG closure improved from 0.8% to 46.7%. Mean ABG improved from 26.30 ±8.1dB pre-operatively to 14 ± 10.41dB post- operatively (t=28.7, P

  9. Fungal spondylodiscitis in a patient recovered from H7N9 virus infection: a case study and a literature review of the differences between Candida and Aspergillus spondylodiscitis * # (United States)

    Yu, Lie-dao; Feng, Zhi-yun; Wang, Xuan-wei; Ling, Zhi-heng; Lin, Xiang-jin


    To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we reviewed cases of spondylodiscitis caused by Candida and Aspergillus species. Data, including patients’ information, pathogenic species, treatment strategy, outcomes, and relapses, were collected and summarized. The characteristics of Candida and Aspergillus spondylodiscitis were compared to see if any differences in clinical features, management, or consequences could be detected. The subject of the case study was first misdiagnosed as having a vertebral tumor, and then, following open biopsy, was diagnosed as having fungal spondylodiscitis. The patient made a good recovery following radical debridement. Seventy-seven additional cases of Candida spondylodiscitis and 94 cases of Aspergillus spondylodiscitis were identified in the literature. Patients with Candida spondylodiscitis tended to have a better outcome than patients with Aspergillus spondylodiscitis (cure rate 92.3% vs. 70.2%). Candida was found more frequently (47.8%) than Aspergillus (26.7%) in blood cultures, while neurological deficits were observed more often in patients with Aspergillus spondylodiscitis (43.6% vs. 25.6%). Candida spinal infections were more often treated by radical debridement (60.5% vs. 39.6%). Patients with Candida spondylodiscitis have better outcomes, which may be associated with prompt recognition, radical surgical debridement, and azoles therapy. A good outcome can be expected in fungal spondylodiscitis with appropriate operations and anti-fungal drugs. PMID:27819134

  10. Anti-Angiogenic Treatment (Sunitinib for Disseminated Malignant Haemangiopericytoma: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    M. Delgado


    Full Text Available Introduction: A meningeal haemangiopericytoma (HP is a mesenchymal tumour that makes up less than 1% of all CNS tumours. HPs arise from pericytes and present high rates of recurrence and distant metastasis. The primary treatment option is surgery. When the disease is disseminated, chemotherapy produces a weak and short-lived response; therefore, new drugs are needed. Case Presentation: We describe the case of a 65-year-old woman with a 13-year history of recurrent HP. After local treatment with radiotherapy, she developed metastases that required systemic treatment, and treatment with sunitinib, an oral inhibitor of the vascular endothelial growth factor receptor and the platelet-derived growth factor receptor, was initiated. As a result, radiological stabilisation of the systemic disease was maintained for over 12 months. Conclusions: Anti-angiogenic agents can be useful for treating disseminated HP, but further studies are needed to confirm their possible role in controlling metastatic disease.

  11. Case study research. (United States)

    Taylor, Ruth; Thomas-Gregory, Annette


    This article describes case study research for nursing and healthcare practice. Case study research offers the researcher an approach by which a phenomenon can be investigated from multiple perspectives within a bounded context, allowing the researcher to provide a 'thick' description of the phenomenon. Although case study research is a flexible approach for the investigation of complex nursing and healthcare issues, it has methodological challenges, often associated with the multiple methods used in individual studies. These are explored through examples of case study research carried out in practice and education settings. An overview of what constitutes 'good' case study research is proposed.

  12. Cochlear Implantation through the Middle Fossa Approach: A Review of Related Temporal Bone Studies and Reported Cases. (United States)

    Lesser, Juan Carlos Cisneros; Brito Neto, Rubens Vuono de; Martins, Graziela de Souza Queiroz; Bento, Ricardo Ferreira


    Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.

  13. Reviewing the concept of healthy communities in traditional neighborhoods of Iran (Case study: Imamzade Yahya neighborhood of Tehran

    Directory of Open Access Journals (Sweden)

    E. Shieh


    In this article, in order to explore the health system and its indicators in urban neighborhoods, after auditing the conceptual model and identifying the structures affecting the health, which are derived from theoretical considerations around issue, components resulting from the conceptual model in the traditional neighborhood of Imamzade Yahya, which is one of the neighborhoods of the historic fabric of Tehran, are assessed. Given the importance of subjective indicators of environment in health and lack of health statistics and information at local scale in Iran, a questionnaire was designed to assess the health of Imamzade Yahya neighborhood’s residents. Results show the interconnected relation between physical- environmental and social indicators of health including quality of housing, neighborhood facilities and sense of belonging to neighborhood, safety perception of residents in the neighborhood of Imamzade Yahya. Another result of the study shows low level of resident’s mobility and physical activity despite mixed uses and the low permeability of the transportation network for riding, which can be caused by physical exhaustion, lack of local facilities and attractions for residents and safety and security of the neighborhood and lack of separate pedestrian and bicycle lanes and numerous barriers to walking out. Another finding suggests the desirability of social indicators of health in this area, despite the possibility of face to face contacts and physical system complementation of the social system which might be caused by the decrease in social cohesion and bonds within neighborhoods and migrant sending from neighborhood and lack of public realms in it to shape social relations.4– ConclusionFindings of this study indicate the importance of physical and social environment of neighborhoods on population health. According to the criteria listed for a healthy neighborhood and according to the case study, in terms of the health system, we cannot distinguish

  14. Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases. (United States)

    Mekinian, Arsène; Braun, Thorsten; Decaux, Olivier; Falgarone, Géraldine; Toussirot, Eric; Raffray, Loic; Omouri, Mohamed; Gombert, Bruno; De Wazieres, Benoit; Buchdaul, Anne-Laure; Ziza, Jean-Marc; Launay, David; Denis, Guillaume; Madaule, Serge; Rose, Christian; Grignano, Eric; Fenaux, Pierre; Fain, Olivier


    We describe the characteristics and outcome of inflammatory arthritis in patients with myelodysplastic syndrome (MDS) in a French multicenter retrospective study. Twenty-two patients with MDS (median age, 77.5 yr [interquartile range, 69-81]; 10 women) were included. Inflammatory arthritis presented as polyarthritis in 17 cases (77%) and with symmetric involvement in 15 cases (68%). At diagnosis, the median disease activity score 28 based on C-reactive protein (DAS28-CRP) was 4.5 [2-6.5]. Two patients had anti-citrullinated protein antibodies (ACPAs), and 1 had radiologic erosions. The median time between the diagnoses of arthritis and MDS was 10 months [6-42], with a median articular symptom duration of 3 months [2-8]. The diagnosis of both diseases was concomitant in 6 cases (27%); arthritis preceded MDS in 12 cases (55%), and occurred after MDS in 4 (18%). While the number of swollen and tender joints significantly decreased during follow-up, as did the median DAS28-CRP (from 4.3 [3.8-4.6] at baseline to 2.9 [1.75-3.3]; p 20 mg/L) in 8 patients (42%). Nevertheless, radiographic progression and new ACPA positivity were not observed during a median follow-up of 29 months [9-76]. While most of the patients were treated with steroids (n = 16) for arthritis, additional treatment was administered in only 4 patients (hydroxychloroquine, n = 2; sulfasalazine [Salazopyrin] and etanercept, n = 1, respectively). Eleven patients died during follow-up from acute myeloid leukemia (n = 5); infections (n = 3); or cerebral bleeding, cardiorespiratory failure, or undetermined cause (n = 1, respectively). Inflammatory arthritis associated with MDS can have various presentations and is often seronegative and nonerosive. Steroids alone are the most common treatment in MDS-associated arthritis, but that treatment is insufficient to control arthritis. Steroid-sparing strategies need to be identified.

  15. Short segment incremental study in ulnar neuropathy at the wrist: report of three cases and review of the literature. (United States)

    Yalinay Dikmen, Pinar; Oge, A Emre; Yazici, Jale


    Ulnar nerve lesions may occur at different sublocations at wrist and may involve various branches of the nerve. Standard neurophysiological studies are generally insufficient in revealing these lesions. Demonstration of conduction block and/or focal slowing of nerve conduction is the most definitive electrodiagnostic evidence for the localization of segmental demyelination. Short-segment incremental study (SSIS) is a sensitive technique for detecting the ulnar neuropathy at the wrist (UNW). We report 3 cases of UNW caused by ganglion cysts in Guyon's canal which were studied by using SSIS across the wrist. Even though SSIS is a time-consuming and technically demanding method, it increases the electrodiagnostic potential of detecting segmental demyelination in this location.

  16. Case report and literature review (United States)

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


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

  17. Efficiency and contribution of strategies for finding randomized controlled trials: a case study from a systematic review on therapeutic interventions of chronic depression

    Directory of Open Access Journals (Sweden)

    Annika Westphal


    Full Text Available Background. Identifying all existing evidence is a crucial aspect in conducting systematic reviews. Since the retrieval of electronic database searches alone is limited, guidelines recommend the use of addi- tional search strategies. The aim of this investigation was to assess the efficiency and contribution of additional search strategies for identifying randomized controlled trials in conducting a systematic review on interventions after performing a sensitive electronic database search. Design and Methods. Seven electronic databases, 3 journals and 11 systematic reviews were searched. All first authors of the included studies were contacted; citation tracking and a search in clinical trial registers were performed. A priori defined evaluation criteria were calculated for each search strategy. Results. A total of 358 full-text articles were identified; 50 studies were included in the systematic review, wherefrom 84.0% (42 were acquired by the sensitive electronic database search and 16.0% (8 through additional search strategies. Screening reference lists of related systematic reviews was the most beneficial additional search strategy, with an efficiency of 31.3% (5 and a contribution of 10.0% (5/50, whereas hand-searching and author contacts contributed two and one additional studies, respectively. Citation tracking and searching clinical trial registers did not lead to any further inclusion of primary studies. Conclusions. Based on our findings, hand-searching contents of relevant journals and screening reference lists of related systematic reviews may be helpful additional strategies to identify an extensive body of evidence. In case of limited resources, a sensitive electronic database search may constitute an appropriate alternative for identifying relevant trials.

  18. Roseomonas gilardii infection: case report and review. (United States)

    Shokar, Navkiran K; Shokar, Gurjeet S; Islam, Jamal; Cass, Alvah R


    Roseomonas gilardii is a bacterium that has been indicated as a rare cause of human infections. The case of a patient presenting with cellulitis and bacteremia secondary to R. gilardii is described together with the clinical characteristics of infection with this organism obtained from a review of cases previously reported.

  19. The Climate Change Collection: A Case Study on Digital Library Collection Review and the Integration of Research, Education and Evaluation (United States)

    McCaffrey, M.


    Designed as an pilot project to assess the scientific and pedagogical quality of selected digital resources in the Digital Library for Earth System Education (DLESE), the Climate Change Collection is thematic collection of digital resources relating to the topic of global climate change. Developed through the collaborative efforts of an interdisciplinary review team made up of professionals from the fields of climate research, geoscience education, cognitive psychology, and evaluation, the findings of the project suggest that the user needs of the reviewers should be considered in any review process, that there is inherent value in the collaboration of scientists, teachers and related fields in determining the quality of particular resources, and that the process of preparing for and conducting such reviews and annotations is time-consuming and challenging. Drawing from the experience of prior collection development efforts associated with DLESE, including the Community Review System and the Digital Water Education Library, the Climate Change Collection was developed during the Fall of 2004 and Winter of 2005. Through a series of monthly meetings with the review team facilitated by the Principal Investigator acting as Editor for the collection, and assisted by an online workspace known as a SWIKI, the Climate Change Collection was designed as an experiment in streamlined collection development that may help inform future digital library review and collection-building efforts. The initial meetings focused on training the reviewers, setting context for the review process, and discussing the perspectives of the various participants in the review team. Each participant received a stipend for their involvement in the process. A rubric "scorecard" was developed, tested, and fine-tuned by the review team with a focus primarily on scientific accuracy and the potential for effective use in the classroom. Specific concepts relating to aspects of natural climate variability

  20. Electroconvulsive therapy as a treatment for refractory neuropsychiatric lupus with catatonia: three case studies and literature review. (United States)

    Bica, B E R G; Moro, A L D; Hax, V; Nicol, N A; Campos, G S; Rivera, L M S; da Costa, A F C; Xavier, R M; Monticielo, O A


    Neuropsychiatric disorders associated with systemic lupus erythematosus are very common. Treatment generally consists of glucocorticoids and immunosuppressive therapy; however, some cases are unresponsive. Electroconvulsive therapy (ECT) is a recognized treatment modality in psychiatry and is an option for refractory cases of neuropsychiatric lupus. This report describes three cases of neuropsychiatric lupus that improved with ECT after failure of antipsychotics and immunosuppressive therapy. All cases met DSM-5 criteria for catatonia (case 1: agitation, stereotypies, and grimacing; case 2: stupor, mutism, and grimacing; case 3: agitation, mutism, and stereotypies); therefore, ECT was indicated. This case series shows that ECT can be a therapeutic option in patients with neuropsychiatric lupus, especially when associated with catatonia and unresponsive to conventional treatment.

  1. Spinal gout: A review with case illustration (United States)

    Elgafy, Hossein; Liu, Xiaochen; Herron, Joseph


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

  2. Adequacy of Reporting Results of School Surveys and Nonresponse Effects: A Review of the Literature and a Case Study (United States)

    Kano, Megumi; Franke, Todd; Afifi, Abdelmonem A.; Bourque, Linda B.


    To ensure accurate interpretation of research findings, researchers should report details about their research design, data collection method, and response rates when presenting findings from survey research. A review of 100 peer-reviewed articles reporting the results of survey research on K-12 schools with principals as the designated…

  3. Product vs corporate carbon footprint: Some methodological issues. A case study and review on the wine sector. (United States)

    Navarro, Alejandra; Puig, Rita; Fullana-I-Palmer, Pere


    Carbon footprint (CF) is nowadays one of the most widely used environmental indicators. The scope of the CF assessment could be corporate (when all production processes of a company are evaluated, together with upstream and downstream processes following a life cycle approach) or product (when one of the products is evaluated throughout its life cycle). Our hypothesis was that usually product CF studies (PCF) collect corporate data, because it is easier for companies to obtain them than product data. Six main methodological issues to take into account when collecting corporate data to be used for PCF studies were postulated and discussed in the present paper: fugitive emissions, credits from waste recycling, use of "equivalent factors", reference flow definition, accumulation and allocation of corporate values to minor products. A big project with 18 wineries, being wine one of the most important agri-food products assessed through CF methodologies, was used to study and to exemplify these 6 methodological issues. One of the main conclusions was that indeed, it is possible to collect corporate inventory data in a per year basis to perform a PCF, but having in mind the 6 methodological issues described here. In the literature, most of the papers are presenting their results as a PCF, while they collected company data and obtained, in fact, a "key performance indicator" (ie., CO2eq emissions per unit of product produced), which is then used as a product environmental impact figure. The methodology discussed in this paper for the wine case study is widely applicable to any other product or industrial activity.

  4. Delftia acidovorans and ndash; Isolated from Umbilical Venous Tip of a Neonate: A Case Study and Mini- review

    Directory of Open Access Journals (Sweden)



    Full Text Available Delftia acidovorans, previously known as Comamonas acidovorans is an aerobic, non-fermentative, Gram negative rod. We report a case of 2 day old male baby, delivered preterm and admitted to NICU with respiratory distress and shock. Umbilical Venous Tip culture grew Delftia acidovorans. It was sensitive to Amikacin, Gentamicin, Tobramycin, Piperacillin and ndash;Tazobactum, Imipenem, Meropenem. Patient was treated with meropenem, teicoplanin and fluconazole while awaiting reports for blood culture and UVL tip culture. Baby became afebrile and later was discharged. Delftia acidovorans is an unusual organism which has been isolated from cases of line related sepsis. Very few cases have been reported from India. To the best of our knowledge, this is the first case report from North India. [Natl J Med Res 2015; 5(2.000: 166-168

  5. 45 CFR 98.101 - Case Review Methodology. (United States)


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

  6. Melorheostosis: a review of 23 cases

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, J. [Dept. of Radiology, Zentralkrankenhaus Bremen (Germany)


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

  7. Burkitt lymphoma presenting as a mass in the thyroid gland: a clinicopathologic study of 7 cases and review of the literature. (United States)

    Quesada, Andrés E; Liu, Huifei; Miranda, Roberto N; Golardi, Natalia; Billah, Shahreen; Medeiros, L Jeffrey; Jaso, Jesse Manuel


    Burkitt lymphoma presenting in the thyroid gland is rare, and only a few cases have been reported. We retrospectively reviewed 7 patients diagnosed with Burkitt lymphoma of the thyroid gland between 2000 and 2015. There were 4 men and 3 women with a median age of 41 years (range, 19-49 years). All patients presented with a rapidly growing neck mass associated with upper airway compression in 5 (71%) patients. Two patients presented with localized (stage I/II) and 5 patients with disseminated (stage III/IV) disease. All cases showed morphologic and immunophenotypic features of Burkitt lymphoma with MYC rearrangement in all 5 cases tested. One case showed evidence of concurrent Hashimoto thyroiditis. Six of 7 patients were treated primarily with rituximab, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone. One patient was treated primarily with dose-adjusted rituximab, etoposide, prednisolone, vincristine, and cyclophosphamide. At the end of the study period, 5 patients were alive: 4 in complete remission and 1 with persistent disease. Two patients died with persistent disease (median follow-up, 25 months; range, 12-361 months). We conclude that Burkitt lymphoma of the thyroid gland shows clinicopathologic features similar to sporadic Burkitt lymphoma at other anatomic sites, but patients present at an older median age. The clinical course is aggressive with a high frequency of disseminated disease at diagnosis; however, a subset of patients responds well to aggressive chemotherapy.

  8. Tracheobronchopathia osteochondroplastica: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Junping Sun


    Full Text Available Tracheobronchopathia osteochondroplastica (TPO is a rare disorder characterized as multiple osseous or cartilaginous nodules in the submucosa of trachea and main bronchi. TPO remains an under recognized entity due to lack of awareness. Four cases of TPO are reported in this review as well as various facets of TPO description.

  9. Performance Measurement in Small and Medium-Sized Enterprises - Literature Review and Results from a German Case Study

    DEFF Research Database (Denmark)

    Brem, Alexander; Kreusel, N.; Neusser, N.


    A literature review of Performance Measurement Systems (PMS) in Small- and Medium-sized Enterprises (SMEs) shows that the main contributions focus on the development of theoretical models, but not on guidelines for practical implementation. In this context, an important neglected aspect is the ge......A literature review of Performance Measurement Systems (PMS) in Small- and Medium-sized Enterprises (SMEs) shows that the main contributions focus on the development of theoretical models, but not on guidelines for practical implementation. In this context, an important neglected aspect...... factors – Corporate Strategy, software-based Enterprise Resource Planning (ERP) and Activity Based Costing (ABC) – strongly supports the successful implementation of a PMS and its later use. Hence, further research shall include these prerequisites as new variables determining the PMS process. Based...

  10. Histologic characteristics of thymic adenocarcinomas: Clinicopathologic study of a nine-case series and a review of the literature. (United States)

    Kwon, Ah-Young; Han, Joungho; Chu, Jinah; Choi, Yong Soo; Jeong, Byeong-Ho; Ahn, Myung-Ju; Ahn, Yong Chan


    Primary thymic adenocarcinoma is an extraordinarily rare malignancy; only 49 cases have been reported in the medical literature to date. Because of its rarity, clinical and pathologic characteristics of thymic adenocarcinoma are unclear. We present nine cases of primary thymic adenocarcinoma and discuss clinicopathologic findings in the context of the existing literature. Two-hundred twenty-six thymic carcinoma cases were diagnosed at Samsung Medical Center in Korea, from January, 2001 to July, 2016. Nine of these 226 cases were primary thymic adenocarcinomas. The mean age of primary thymic adenocarcinoma patients was 53.6 years, slightly younger than the mean age of patients with thymic squamous cell carcinomas. The male to female ratio was 2:1. Symptoms, if present, were usually due to compression by the tumor. Tumors showed an extra- or intra-cellular mucin and tubular growth pattern, with CK20- and CDX2-immunoreactivity, similar to adenocarcinomas of the lower intestinal tract. Twenty-five previously reported cases, classified as mucinous adenocarcinoma and adenocarcinoma, not otherwise specified, also had similar characteristics to enteric-type adenocarcinoma and generally expressed CK20, CDX2, CEA, and/or MUC2. Some of these cases had a thymic cyst. These characteristics are different from those of papillary thymic carcinomas, which are morphologically similar to papillary thyroid carcinomas, express CK7 but not CK20, and are often associated with thymoma. The prognosis of thymic adenocarcinoma, enteric type appeared to be worse than the prognosis of papillary thymic carcinoma or carcinoma with adenoid cystic carcinoma-like features. In summary, we demonstrated that common primary thymic adenocarcinomas show enteric-type differentiation with mucin. This tumor type has distinct clinical, pathological, immunohistochemical and prognostic characteristics and is different from other subtypes of thymic adenocarcinoma, papillary thymic carcinoma, and carcinoma with

  11. Duodenal gossypiboma: a case report and literature review. (United States)

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


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

  12. Review: Biodiversity conservation strategy in a native perspective; case study of shifting cultivation at the Dayaks of Kalimantan

    Directory of Open Access Journals (Sweden)



    Full Text Available Setyawan AD. 2010. Biodiversity conservation strategy in a native perspective; case study of shifting cultivation at the Dayaks of Kalimantan. Nusantara Bioscience 2: 97-108. Native tribes generally are original conservationists; they build genuine conservation strategy of natural resources and environment for sustainable living. Dayak is a native tribe of Kalimantan that has been living for thousands of years; they use shifting cultivation to manage the communal forest lands due to Kalimantan’s poor soil of minerals and nutrients, where the presence of phosphorus becomes a limiting factor for crops cultivation. In tropical forests, phosphorus mostly stored in the trees, so to remove it, the forest burning is carried out. Nutrients released into the soil can be used for upland rice (gogo cultivation, until depleted; after that, cultivators need to open a forest, while the old land was abandoned (fallow until it becomes forest again (for 20-25 years. The consecutive land clearing causes the formation of mosaics land with different succession ages and diverse biodiversity. This process is often combined with agroforestry systems (multicultural forest gardens, where the will-be-abandoned fields are planted with a variety of useful trees that can be integrated in forest ecosystems, especially rubber and fruits. These systems of shifting cultivation are often blamed as the main factor of forest degradation and fires, but in the last 300 years, this system has little impact on forest degradation. But, this is relatively low in productivity and subsistent, so it is not suitable for the modern agriculture which demands high productivity and measurable, mass and continuous yield, as well as related to the market. The increased population and industrial development of forestry, plantation, mining, etc. make the communal forest become narrower, so the fallow periods are shortened (5-15 years and the lands are degraded into grasslands. In the future

  13. Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake

    Directory of Open Access Journals (Sweden)

    Donald L. Chi


    Full Text Available Background. Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. Objective. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB intake among Alaska Native children. Design. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA Statement, the terms “Alaska Native”, “children” and “oral health” were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970–2012 for relevant clinical trials and evaluation studies. Results. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Conclusions. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions

  14. Thymic Germinal Centers and Corticosteroids in Myasthenia Gravis: an Immunopathological Study in 1035 Cases and a Critical Review. (United States)

    Truffault, Frédérique; de Montpreville, Vincent; Eymard, Bruno; Sharshar, Tarek; Le Panse, Rozen; Berrih-Aknin, Sonia


    The most common form of Myasthenia gravis (MG) is due to anti-acetylcholine receptor (AChR) antibodies and is frequently associated with thymic pathology. In this review, we discuss the immunopathological characteristics and molecular mechanisms of thymic follicular hyperplasia, the effects of corticosteroids on this thymic pathology, and the role of thymic epithelial cells (TEC), a key player in the inflammatory thymic mechanisms. This review is based not only on the literature data but also on thymic transcriptome results and analyses of pathological and immunological correlations in a vast cohort of 1035 MG patients without thymoma. We show that among patients presenting a thymic hyperplasia with germinal centers (GC), 80 % are females, indicating that thymic follicular hyperplasia is mainly a disease of women. The presence of anti-AChR antibodies is correlated with the degree of follicular hyperplasia, suggesting that the thymus is a source of anti-AChR antibodies. The degree of hyperplasia is not dependent upon the time from the onset, implying that either the antigen is chronically expressed and/or that the mechanisms of the resolution of the GC are not efficiently controlled. Glucocorticoids, a conventional therapy in MG, induce a significant reduction in the GC number, together with changes in the expression of chemokines and angiogenesis. These changes are likely related to the acetylation molecular process, overrepresented in corticosteroid-treated patients, and essential for gene regulation. Altogether, based on the pathological and molecular thymic abnormalities found in MG patients, this review provides some explanations for the benefit of thymectomy in early-onset MG patients.

  15. Social acceptance of CO{sub 2} storage: Review of case studies and literature review; Aceptabilidad Social del Almacenamiento de CO{sub 2}: Revision de Estudios de Caso y Revision de la Literatura

    Energy Technology Data Exchange (ETDEWEB)

    Sola, R.; Oltra, C.; Sala, R.; Di Masso, M.


    Stake holder and public acceptance of CCS will play an important role in the efficient technology development. Together with socio-political acceptance, local acceptance could raise significant challenges to CCS deployment. The objective of the present work is to analyse the social acceptance of CO{sub 2} storage. First, we review the social science literature on local reactions and acceptance of risk technology projects. Lessons learned during these last decades around possible local reactions to risk technology facilities could help in the design of communication strategies for the context of CO{sub 2} storage. Second, we review different case studies of European CCS projects in which some strategy of public information, communication or engagement has been initiated from the promoters of the project. (Author) 26 refs.

  16. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg


    be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  17. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature. (United States)

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose


    A 31-year-old patient with obstructive voiding symptoms and apareunia in the setting of Type III female genital mutilation/cutting (FGM/C) is presented. The patient underwent ambulatory clinic defibulation to relieve her symptoms. FGM has been shown to have serious immediate complications and many chronic complications that greatly impact patients' lives. Several case series have been published describing center-specific experience with defibulation procedures for Type III FGM/C. Here, we present the treatment of a patient with Type III FGM/C in an ambulatory urology clinic in the United States.

  18. Female genital mutilation management in the ambulatory clinic setting: a case study and review of the literature (United States)

    Craven, Spencer; Kavanagh, Alex; Khavari, Rose


    A 31-year-old patient with obstructive voiding symptoms and apareunia in the setting of Type III female genital mutilation/cutting (FGM/C) is presented. The patient underwent ambulatory clinic defibulation to relieve her symptoms. FGM has been shown to have serious immediate complications and many chronic complications that greatly impact patients’ lives. Several case series have been published describing center-specific experience with defibulation procedures for Type III FGM/C. Here, we present the treatment of a patient with Type III FGM/C in an ambulatory urology clinic in the United States. PMID:27333917

  19. Pseudocarcinoma: A Case Report and Review

    Directory of Open Access Journals (Sweden)

    T Isaac Joseph


    Full Text Available Pseudocarcinoma is another name for keratoacanthoma, which is a self-limiting benign epithelial proliferative lesion that originates from the pilosebaceous glands. Currently, Kerato- acanthoma is consi dered as a low grade variant of squamous cell carcinoma (SCC, due to the clinical and histological resem - blance to well differentiated SCC. Various etiological factors have been implicated in pathogenesis of keratoacanthoma. Most keratoacanthomas occur in sun exposed areas of skin and 8% of all the cases occur in vermilion border of the lips. The present article discusses and reviews a case of kerato- acanthoma in mucosal surface of lip commissure which is rare when compared to the cutaneous counterpart

  20. Giant cell tumor of the tendon sheath restricting joint movement in the thumb: A case study and review of literature

    Directory of Open Access Journals (Sweden)

    Muzaffer Durmus


    Full Text Available Giant cell tumors of the tendon sheath are the second most common type of subcutaneous benign tumors found in the hand. These tumors are slow growing soft tissue mases that develop over a long period of time and can occur at any age. Although such lesions are usually painless, there is a possibility of recurrence of the tumor. Patients should seek postoperative management in order to prevent any possibility of recurrence. In view of the current literature, we present a case involving a patient suffering from a multifocal giant cell tumor of the tendon sheath that restricted movement of the interphalangeal joints of the thumb. [Hand Microsurg 2015; 4(1.000: 16-19

  1. Testing the emergence of New Caledonia: fig wasp mutualism as a case study and a review of evidence.

    Directory of Open Access Journals (Sweden)

    Astrid Cruaud

    Full Text Available While geologists suggest that New Caledonian main island (Grande Terre was submerged until ca 37 Ma, biologists are struck by the presence of supposedly Gondwanan groups on the island. Among these groups are the Oreosycea fig trees (Ficus, Moraceae and their Dolichoris pollinators (Hymenoptera, Agaonidae. These partners are distributed in the Paleotropics and Australasia, suggesting that their presence on New Caledonia could result from Gondwanan vicariance. To test this hypothesis, we obtained mitochondrial and nuclear markers (5.3 kb from 28 species of Dolichoris, used all available sequences for Oreosycea, and conducted phylogenetic and dating analyses with several calibration strategies. All our analyses ruled out a vicariance scenario suggesting instead that New Caledonian colonization by Dolichoris and Oreosycea involved dispersal across islands from Sundaland ca 45.9-32.0 Ma. Our results show that successful long-distance dispersal of obligate mutualists may happen further suggesting that presence of intimate mutualisms on isolated islands should not be used as a priori evidence for vicariance. Comparing our results to a review of all the published age estimates for New Caledonian plant and animal taxa, we showed that support for a vicariant origin of the island biota is still lacking. Finally, as demonstrating a causal relationship between geology and biology requires independent evidence, we argue that a priori assumptions about vicariance or dispersal should not be used to constrain chronograms. This circular reasoning could lead to under or overestimation of age estimates.

  2. Planned complex suicide by penetrating captive-bolt gunshot and hanging: case study and review of the literature. (United States)

    Viel, Guido; Schröder, Ann Sophie; Püschel, Klaus; Braun, Christian


    Captive-bolt guns or slaughterer's guns are devices widely used in meat industry and private farmer households for slaughtering animal stocks. They consist of a simple cylindrical metal tube (barrel) with a metal bolt placed in their centre (around 9-15cm long and 1-1.5cm wide). The bolt is actuated by a trigger pull and is propelled forward by compressed air or by the discharge of a blank powder gun cartridge. Violent deaths inflicted by captive-bolt guns are rarely encountered in forensic practice and are predominantly suicidal events. We report an unusual complex suicide by hanging and self-shooting with a slaughterer's gun in a 21-year-old boy. The victim after putting a ceiling fixed rope around his neck shot himself in the head (occipital region) with a Kerner captive-bolt gun. He used two mirrors (a cosmetic mirror and a man-sized one) in order to properly visualize his back and to target the occipital region of his head. Radiological data (computed tomography with three dimensional reconstruction) and autopsy findings are discussed according to the clinical and forensic literature. A brief review on planned complex suicides is also given.

  3. [Review of the psychiatric aspects of anti-NMDA (N-methyl-D-aspartic acid) receptor encephalitis, case report, and our plans for a future study]. (United States)

    Herman, Levente; Zsigmond, Ildiko Reka; Peter, Laszlo; Rethelyi, Janos M


    disorders with psychotic symptoms is still not clear. After reviewing the most important studies regarding the psychiatric aspects of anti-NMDAR encephalitis, we present a case report of a patient with a pure psychiatric manifestation of this disease. We conclude with a short outline of the design and plan of our future study.

  4. Disability Case Review of Administrative Law Judge Hearing Decisions (United States)

    Social Security Administration — The Disability Case Review is a post-effectuation quality review of administrative law judge (ALJ) disability hearing decisions. This dataset includes results from...

  5. MUC1 Predicts Colorectal Cancer Metastasis: A Systematic Review and Meta-Analysis of Case Controlled Studies.

    Directory of Open Access Journals (Sweden)

    Yunhui Zeng

    Full Text Available To evaluate the predicting value of MUC1 expression in lymph node and distant metastasis of colorectal cancer (CRC.Pubmed/ MEDLINE and EMBASE were searched to identify eligible studies that evaluated the correlation between MUC1 and CRC. A meta-analysis was conducted to evaluate the impact of MUC1 expression on CRC metastasis.A total of 18 studies (n = 3271 met inclusion criteria and the mean Newcastle-Ottawa Scale (NOS score was 6.3 with a range from 4 to 8. The pooled OR in the meta-analysis of 15 studies indicated that positive MUC1 expression correlated with more CRC node metastasis (OR = 2.32, 95% CI = 1.63-3.29. The data synthesis of 6 studies suggested that MUC1 expression predicted more possibility of CRC distant metastasis (OR = 2.22, 95% CI = 1.23-4.00. In addition, the combined OR of 7 studies showed that MUC1 expression indicated higher Duke's stage (OR = 3.02, 95% CI = 2.11-4.33. No publication bias was found in the mate-analysis by Begg's test or Egger's test with the exception of the meta-analysis of MUC1 with CRC node metastasis (Begg's test p = 0.729, Egger's test p = 0.000.Despite of some modest bias, the pooled evidence suggested that MUC1 expression was significantly correlated with CRC metastasis.

  6. Earthdata Search Client: Usability Review Process, Results, and Implemented Changes, Using Earthdata Search Client as a Case Study (United States)

    Siarto, Jeff; Reese, Mark; Shum, Dana; Baynes, Katie


    User experience and visual design are greatly improved when usability testing is performed on a periodic basis. Design decisions should be tested by real users so that application owners can understand the effectiveness of each decision and identify areas for improvement. It is important that applications be tested not just once, but as a part of a continuing process that looks to build upon previous tests. NASA's Earthdata Search Client has undergone a usability study to ensure its users' needs are being met and that users understand how to use the tool efficiently and effectively. This poster will highlight the process followed for usability study, the results of the study, and what has been implemented in light of the results to improve the application's interface.

  7. Review - Critical Han Studies

    Directory of Open Access Journals (Sweden)

    Zhiguo Ye


    Full Text Available Review of: Thomas Mullaney, James Leibold, Stéphane Gros, and Eric Armand Vanden Bussche (eds. 2012. Critical Han Studies: The History, Representation, and Identity of China's Majority. Berkeley, Calif: University of California Press. This path-breaking volume is an academic collaboration that emerged out of the "Critical Han Studies Conference and Workshop" at Stanford University in April 2008. Eleven scholars contributed to the question of what it means to be 'Han' in China, both historically and at present. Constituting over ninety percent of China's population, the Han are not only the largest ethnic group in China, but are also one of the largest categories of collective identity in the world. Despite this, the dominant Han group has so far eluded careful scholarly scrutiny, with the Han often referred to as an unmarked majority category in contemporary China. This volume challenges such conventional views by conceptualizing new interdisciplinary approaches to the question of Hanness. The eleven essays of the volume are divided into three themes: 'Han and China', 'The Problem of Han Origins', and 'The Problem of Han Formations'. The first theme, comprised of four essays, analyzes the ties that bind the category of Han to those of Chinese ethnicity, race, and polity. Kevin Carrico in "Recentering China: The Cantonese in and Beyond the Han" questions a single, unitary Hanness that he believes conceals "countless other perceived and imagined lines of differentiation" (25. The study examines how multiple identities...

  8. Interventions to Support Social Interaction in Children with Autism Spectrum Disorders: A Systematic Review of Single Case Studies (United States)

    Ozuna, Jennifer; Mavridis, Alexis; Hott, Brittany L.


    Social interaction is a core deficit in individuals with autism spectrum disorder (ASD). Therefore, parents and teachers need effective interventions to support students with ASD. This synthesis provides a quantitative analysis of single-subject studies that examine interventions to support social interactions in children with ASD. Results suggest…

  9. Impedance of SOFC electrodes: A review and a comprehensive case study on the impedance of LSM:YSZ cathodes

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Hjelm, Johan


    It was shown through a comprehensive impedance spectroscopy study that the impedance of the classic composite LSM:YSZ (lanthanum strontium manganite and yttria stabilized zirconia) solid oxide fuel cell (SOFC) cathode can be described well with porous electrode theory. Furthermore, it was illustr......It was shown through a comprehensive impedance spectroscopy study that the impedance of the classic composite LSM:YSZ (lanthanum strontium manganite and yttria stabilized zirconia) solid oxide fuel cell (SOFC) cathode can be described well with porous electrode theory. Furthermore...... acquired in the very broad temperature range of 200–900°C for complete elucidation of the impedance. All impedance spectra were analyzed in terms of porous electrode theory. Physical materials parameters were extracted from the analysis, which were in excellent accordance with literature values. Valuable...

  10. A Review on Pollution Sources of Rivers with Regard to the Origin of their Production (Case Study: Babol Roud River

    Directory of Open Access Journals (Sweden)

    Mohammad Yousefinejad


    Full Text Available In Iran, the use of surface water and groundwater has always been a priority for farmers, industries, and so forth due to the geographical location and arid climate. Unfortunately, the human causes pollution and destruction by the wrong and excessive consumption of resources. This study aims to investigate the main factors of water pollution for Babol Roud River and classify factories that are the main causes of pollution of the river, such as Fiber factory in Babolsar and zinc oxide production factory in Amir Kala. Wastewater of these factories plays a key role in the water pollution of Babol Roud River. Other factors that impose excessive pollution on the river include the slaughterhouse of Babol, the entry of the oil into the river, toxic pollution and farming. Mismanagement and the entry of large quantities of wastewater that are dumped daily into the river have increased pollution and aquatic life, wildlife and even people in this region are facing a serious threat. In this regard, the present study considered the contaminants in Babol Roud River, the most important and the most practical suggestions to reduce and mitigate pollutants entering the river. Hence, this study is considered important to advance vital goals and the more accurate decision-making and help enforcement authorities with reducing pollutants of this river.

  11. Cloacal Prolapse in Raptors: Review of 16 Cases. (United States)

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


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

  12. Reviews and Practice of College Students Regarding Access to Scientific Knowledge: A Case Study in Two Spanish Universities

    Directory of Open Access Journals (Sweden)

    José Manuel Sáez López


    Full Text Available This study analyzes the concepts, attitudes, and practices of 327 pedagogy students from two major Spanish universities related to the process of finding academic information utilizing open access. A training program has been developed through an innovation project (PIMCD to address the problem of the lack of university training designed to enable students to access reliable sources of scientific knowledge. A mixed questionnaire with a pretest-posttest design, applying a descriptive analysis, a factor analysis, and a Wilcoxon test was administered to students. The results show that it is essential to provide information and training to encourage university students to learn how to find and manage rigorous and reliable sources of information. While searching for academic information, Spanish students tend to focus on the use of Google and, to a lesser extent, Google Scholar. Although there are no significant limitations of access to Spanish language articles, students’ attitudes remain very positive towards the concept of open access. In short, in accordance with the study results, the promotion of educational activities relating to the search for and selection of information and the use of reliable and rigorous academic content is highly recommended in the university context.

  13. Case Studies in Biology. (United States)

    Zeakes, Samuel J.


    A case study writing exercise used in a course on parasitology was found to be a powerful learning experience for students because it involved discipline-based technical writing and terminology, brought the students in as evaluators, applied current learning, caused interaction among all students, and simulated real professional activities. (MSE)

  14. Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate:a concise literature review and case study

    Institute of Scientific and Technical Information of China (English)

    Salah Mohamed El Sayed; Ali Abdel-Rahman Abd-Allah; Walaa Gamal Mohamed; Minnat-Allah Hassan Seddik; Al-Shimaa Ahmed Ahmed; Asmaa Gamal Mahmoud; Wael Hassan Amer; Manal Mohamed Helmy Nabo; Ahmed Roshdi Hamed; Nagwa Sayed Ahmed


    3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic celldeath in sensitive cels, whereas high glutathione (GSH) content made other melanoma cels resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP treatment

  15. Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate: a concise literature review and case study. (United States)

    El Sayed, Salah Mohamed; Mohamed, Walaa Gamal; Seddik, Minnat-Allah Hassan; Ahmed, Al-Shimaa Ahmed; Mahmoud, Asmaa Gamal; Amer, Wael Hassan; Helmy Nabo, Manal Mohamed; Hamed, Ahmed Roshdi; Ahmed, Nagwa Sayed; Abd-Allah, Ali Abdel-Rahman


    3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic cell death in sensitive cells, whereas high glutathione (GSH) content made other melanoma cells resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP

  16. Utilizing direct skin feeding assays for development of vaccines that interrupt malaria transmission: A systematic review of methods and case study. (United States)

    Brickley, Elizabeth B; Coulibaly, Mamadou; Gabriel, Erin E; Healy, Sara A; Hume, Jen C C; Sagara, Issaka; Traore, Sekou F; Doumbo, Ogobara; Duffy, Patrick E


    Shifting the malaria priorities from a paradigm of control and elimination to a goal of global eradication calls for renewed attention to the interruption of malaria transmission. Sustained progress toward eradication will require both improved understanding of infectious reservoirs and efficient development of novel transmission-blocking interventions, such as rapidly acting and highly efficacious therapeutics and vaccines. Here, we review the direct skin feeding assay (DSF), which has been proposed as a valuable tool for measuring the in natura transmission of malaria parasites from human hosts to mosquito vectors across heterogeneous populations. To capture the methodological breadth of this assay's use, we first systematically review and qualitatively synthesize previously published investigations using DSFs to study malaria transmission in humans. Then, using a recent Phase 1 trial in Mali of the Pfs25H-EPA/Alhydrogel® vaccine candidate (NCT01867463) designed to interrupt Plasmodium falciparum transmission as a case study, we describe the potential opportunities and current limitations of utilizing the endpoints measured by DSF in making early clinical decisions for individually randomized transmission-interrupting intervention candidates. Using simulations based on the data collected in the clinical trial, we demonstrate that the capacity of the DSF to serve as an evaluative tool is limited by the statistical power constraints of the "effective sample size" (i.e. the number of subjects that are capable of transmitting at the time of feeding). Altogether, our findings suggest DSFs have great potential utility for assessing the public health impacts of emerging antimalarial tools, but additional research is needed to address issues of scalability and to establish correlation with community-wide clinical endpoints as well as complementary in vitro measures, such as standard membrane feeding assays.


    Directory of Open Access Journals (Sweden)

    V. V. Vasilenko


    Full Text Available Cameron syndrome is the ulcerative or erosive lesions of mucosal layer at the sac of hiatal hernia which can cause chronic occult or overt bleeding and iron-deficiency anemia. Hiatal hernia is a relatively frequent finding, which is in most cases asymptomatic or manifested by dyspeptic symptoms of varying severity. Despite of being a very important association of hiatal hernia Cameron syndrome is not widely represented in medical literature. That`s the reason of a lack of awareness among physicians, surgeons and endoscopists about that pathology. Cameron lesions are significant pathology because they can become a source of chronic occult as well as an acute life-threatening bleeding. Those lesions of upper gastrointestinal tract are often misinterpreted or overlooked during standard diagnostic procedures. It can lead to the misdiagnosis and false ways of treatment. The review focuses on the pathogenesis, main diagnostic problems and treatment options of that pathology. The diagnostics of the Cameron syndrome is difficult because sometimes the lesions can`t be seen on upper gastrointestinal tract endoscopy. The review describes the criteria by which the physician may suspect Cameron syndrome when endoscopy results are not certain. Clinical case represents an important problem which is often faced by the doctors — the severe iron-deficiency anemia refractory to the medication and blood transfusions in the patients with Cameron lesions. It`s very important for doctor to be aware of that complication to include Cameron syndrome into the diagnostic search for the sources of persistent blood loss. Cameron lesions can be asymptomatic as well as be manifested in the form of severe chronic anemia. And that`s the reason why there are an important issue about the proper treatment which have to be provided in each case. The review describes the effectiveness of different treatment options and makes the conclusion about the principles on which doctor can

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

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


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

  19. [Review of 15 cases of hypervitaminosis D]. (United States)

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


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

  20. A Case Study of Peer Review Practices of Four Adolescent English Language Learners in Face-to-Face and Online Contexts (United States)

    Vorobel, Oksana


    Peer review is a complex collaborative activity, which may engage English language learners in reading, writing, listening, and speaking and carry many potential benefits for their language learning (Hu, 2005). While many research studies focused on peer review practices of adult language learners in academic settings in the USA or abroad in…

  1. Goldenhar Syndrome: A Case Report with Review (United States)

    Goswami, Mridula; Jangra, Babita


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

  2. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts


    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  3. Obsessive-Compulsive Disorder and quality of life outcomes: protocol for a systematic review and meta-analysis of cross-sectional case-control studies

    Directory of Open Access Journals (Sweden)

    Anna Coluccia


    Full Text Available Background. Obsessive-compulsive Disorder (OCD is a chronic disabling psychological condition, which can severely affect quality of life (QOL. Growing interest has been dedicated to assessing which domains of QOL are more severely affected in patients with OCD. However, research yielded conflicting findings. Investigating QOL in OCD could suggest the need for integration of interventions aimed at improving those specific domains more severely impaired by obsessions and compulsions.Methods. We will conduct a systematic review of cross-sectional case-control studies according to PRISMA guidelines, where patients with a primary OCD diagnosis were compared on QOL outcomes with healthy controls. Primary objectives will be to examine differences in QOL outcomes between patients with OCD and healthy controls, and to assess which QOL domains are more severely impaired in patients compared with controls, particularly subjective well-being, social and interpersonal functioning, work functioning, and family functioning. Subsequently, the study will investigate potential moderators of QOL in OCD, including participants characteristics (age, sex, presence of comorbid personality disorders, OCD symptom severity, severity of concurrent depressive symptoms, duration of OCD symptoms, and generational cohort, and study characteristics (date of publication and methodological quality of the studies. Online databases will be searched (PsycINFO, PubMED, Science Direct, Cinahl, Biological Abstracts, Psyclit, Embase, The Cochrane Central Register of Controlled Trials, and Google Scholar. To locate unpublished records, conference abstracts, doctoral dissertations and theses will be handsearched, and experts will be contacted. Statistical analyses will be performed though random effect model meta-analysis. Risk of bias assessments will be conducted using the instrument Methodological Index for Non-Randomized Studies.

  4. Case-only designs in pharmacoepidemiology: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sandra Nordmann

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

  5. An Action Research Case Study of an Office of Civil Rights Compliance Review in a Diverse Urban Southeast Texas School District (United States)

    Dupre, Charles E.


    The purpose of this case study was to examine the perspectives and disciplinary practices of teachers and administrators in one school that demonstrated the least disproportionality of disciplinary referrals between African American students and other student groups. The researcher determined that a qualitative action research case study conducted…

  6. Case Study - Alpha

    Directory of Open Access Journals (Sweden)

    Stephen Leybourne


    Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University.  The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion.  The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group.  It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products.  Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’

  7. Criteria Based Case Review: The Parent Child Psychological Support Program

    Directory of Open Access Journals (Sweden)

    Pilar Bujia-Couso


    Full Text Available The Parent Child Psychological Support Program (PCPS was established in an area of South West Dublin in 2001. Since then until May 2008 it has offered its services to over 700 children and their parents. This preventative, parenting support service is available to all parents of children aged 3 to 18 months within its catchment area. During periodical visits, the infant’s development and growth are measured and parents receive specific information about their child’s progress. Parents are empowered in their parenting practices, thus promoting consistency and synchrony in parent-child interaction. Between 2001 and 2006, 538 parents and their infants participated in the Program. Out of these cases, 130 (24.16% were considered to require additional support and were included in the Monthly Meeting Case Review (MM based on initial concerns The aims of this study were: 1. to review the first five years of MM cases and to explore the socio-demographic profile of the MM cases in comparison to those not in need of additional support (non-MM and 2. To illustrate an approach to refining the case review process which will inform practice and provides the service providers with better understanding of the early detection of parent-child relation difficulties. In pursuing this goal the cases screened over five years of practice were analyzed to explore the structure of the different factors by using statistical techniques of data reduction, i.e. factor analysis. The results showed that the MM group differed on several socio-demographic dimensions from the non-MM group and there was a four factor structure underlying the case review decision process. Implications of this research are discussed.

  8. 7 CFR 275.13 - Review of negative cases. (United States)


    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Review of negative cases. 275.13 Section 275.13... § 275.13 Review of negative cases. (a) General. A sample of households whose applications for food stamp... month or effective for the sample month shall be selected for quality control review. These...

  9. Left-sided appendicitis:Review of 95 published cases and a case report

    Institute of Scientific and Technical Information of China (English)

    Sami; Akbulut; Abdullah; Ulku; Ayhan; Senol; Mahmut; Tas; Yusuf; Yagmur


    AIM:To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM).METHODS:We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA,accessed via PubMed and Google Scholar databases.RESULTS:Ninety-five published cases of LSAA were evaluated and a 25-year-old female,who presented to our clinic with left lower abdominal pain caused by LSAA,is reported.In the reviewe...

  10. Are Staphylococcus intermedius Infections in Humans Cases of Mistaken Identity? A Case Series and Literature Review. (United States)

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


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

  11. Neurobrucellosis: three case reports and literature review

    Directory of Open Access Journals (Sweden)

    WANG Jia-wei


    Full Text Available Background Brucellosis is a multisystem disease which may present with a broad spectrum of clinical manifestations and complications. Neurobrucellosis is an uncommon complication of this infection. This article aims to present clinical manifestations and to discuss the clinical features and management of 3 neurobrucellosis cases. Methods The diagnosis, treatment, laboratory results and accessory examination findings of 3 patients with neurobrucellosis between August 2010 and March 2012 were retrospectively analyzed, and relevant literature was reviewed. Results All the 3 cases had definite history of exposure to epidemic areas or infectious diseases, and history of being infected with Brucella by drinking raw milk. During the screening because of fever for reasons unknown, they were proved to be infected with Brucella by etiological or serological tests. Initial clinical manifestations consisted of fever and headache, with meningitis symptoms and signs, spondylitis, uroschesis and constipation (which might be caused by lumbosacral nerve root lesion, or neurological manifestations in auditory nerve and abducent nerve, such as hearing loss and diplopia. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Conclusion Neurobrucellosis presents with various clinical signs and symptoms, and is often accompanied by systemic infection. Brucellosis should be kept in mind during the screening of fever for reasons unknown, and be differentiated from Mycobacterium tuberculosis infection. The combined treatment by antibotics of different pharmacological mechanisms with full dose and long range is effective, and the prognosis is favorable.

  12. How Environmental "Merchants of Doubt" Use Peer-Reviewed Publication as a Means to Commandeer Scientific Debate: A Case Study of a Publishing Problem. (United States)

    Siegel, D. I.


    This year, the USEPA reported no systemic problem with respect to pollution of potable waters by solutes or natural gas resulting from unconventional drilling for oil and gas, despite attempts by anti-fracking opponents to frighten the public about water pollution from rare circumstances (much as those who have cherry- picked climate data to suggest burning fossil fuels does not affect climate). Scientific "merchants of doubt" have figured out how to use peer-reviewed papers to advocate their bias, regardless of the side for which they advocate. I present a personal example. Prior to the EPA report, authors of a highly-cited peer-reviewed paper argued that more dissolved methane than usual should be expected in ground water located close to unconventional gas wells. This paper figured prominently in the New York State's recent ban on fracking. To test the reproducibility of this conclusion, colleagues and I redid the study but by sampling ~13,000 NE Pennsylvania domestic wells, densely arrayed near ~800 gas wells. Not surprising, we found no systemic relationship between methane in drinking water and proximity to gas wells; failed gas wells actually are rare. The peer reviewed system of publication has been broken for years, because of continual pressure to publish more to achieve academic success coupled to a flood of international submissions. Editors routinely have a difficult time finding senior scientists to agree to review papers, and so they wind up relying more on reviewers suggested by authors, who can and have gamed the peer review system through it. To resolve this problem, I suggest that journal editors be more far more draconian before releasing papers for review and that they enforce clear rubrics to insure that reviewers address reviews properly. Finally, conflict of interest disclosure needs to be clearer, since common assumption that bias inherently evolves from funded research outside of Federal and non-profit organizations, appears to be, at

  13. Primary melanocytic tumors of the central nervous system: A neuroradiological and clinicopathological study of five cases and brief review of literature

    Directory of Open Access Journals (Sweden)

    Sushila Jaiswal


    Full Text Available Primary melanocytic tumors of the central nervous system (CNS are uncommon lesions. These lesions arise from the melanocytes located within leptomeninges and include diffuse melanocytosis and meningeal melanomatosis (seen in neurocutaneous melanosis, melanocytoma, and malignant melanoma. To study, the clinical course, neuroradiological features, morphology and immunohistochemistry of primary melanocytic tumor of CNS. Demographic, clinical and surgico-pathologic findings of five patients with melanocytic tumors seen between 1996 and 2003 were studied. In this study, five cases of primary melanocytic tumors have been reported: four cases of malignant melanoma and one case of melanocytoma. Three of the 5 cases were intracranial and 2 were spinal. The mean age in the present study was 26 years. Presenting features varied according to the location. Primary melanocytic tumor of CNS are rare. Whenever possible, complete surgical excision is the best treatment.

  14. Case Study 1

    DEFF Research Database (Denmark)

    Kolbæk, Ditte


    This article focuses on measurements on Proactive Reviews - a method of organizational learing. While this article highlights the difficulties of measuring the ROI of knowledge initiatives, it also shows how Proactive Reviews can be measured and aligned with the business strategy....

  15. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.


    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  16. What physicians reason about during admission case review. (United States)

    Juma, Salina; Goldszmidt, Mark


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

  17. [One case report of SAPHO syndrome and literature review]. (United States)

    Liu, Rui; Liu, Xiang Yuan


    To study the clinical features and diagnosis of synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (SAPHO) syndrome. One case of SAPHO syndrome was reported and the related data of SAPHO syndrome were reviewed. The main clinical features of the patient were articulatio carpi synovitis, acne, cervical rib hyperostosis, articulatio sternoclavicularis and osteitis, So the diagnosis of SAPHO syndrome was made. Though SAPHO syndrome is rare with yet unknown prevalence, it still can be seen in clinical practice, and can be diagnosed by careful examination.

  18. Schwannoma of the tongue: two case reports and review of the literature



    The aim of this study was to describe clinicopathologic and radiographic features of two cases of schwannoma involving the oral tongue and to review the literature of this unusual clinical entity. Case reports with review of the pathologic, radiologic and clinical data for two patients with schwannoma of the tongue are reported. Review of the literature of case reports of schwannomas (neurilemmomas) of the tongue from 1955 to 2006 with analysis of the patient’s age, gender, presenting symptom...


    Directory of Open Access Journals (Sweden)

    D. A. Ferreyra


    Full Text Available The jejunal diverticula are an uncommon usually asymptomatic small bowel pathology, which should be suspected in cases of malabsorption, anemia, chronic abdominal pain or abdominal discomfort. Complications such as diverticulitis, perforation, bleeding or intestinal obstruction increase morbidity and mortality of the disease. This is a retrospective study based on a case treated at “Hospital Provincial de Rosario”, of a 53 years-old woman that was primarily treated for an intestinal occlusion due to adhesions from previous surgeries. It was primarily interpreted as an ileus from adhesions, but due to its torpid evolution surgical treatment should be performed, where diagnose a complication of this disease. It is concluded that yeyunal diverticulae are generally a benign condition, which affects principally the elder population. Because of its low incidence rate and the inespecificity of its symptoms, it is usually diagnosed during surgery. Incidentally diagnosed asymptomatic diverticula should not be treated due to its low rate of complications. Sometimes, they can lead to complications of surgical treatment. A high level of suspicion because of the high morbidity and mortality in cases of late diagnosis is required. In case of complications, resection of the affected bowel segment is usually the best treatment option. diagnose

  20. Suicide pacts: six cases and literature review. (United States)

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


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

  1. Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis. (United States)

    Tardío, Juan C; Pinedo, Fernando; Aramburu, José Antonio; Martínez-González, Miguel Á; Arias, Dolores; Khedaoui, Radia; Suárez-Massa, Dolores; Santonja, Carlos


    Atypical fibroxanthoma (AFX) is an uncommon dermal-based neoplasm arising on the sun-damaged skin of elderly people. Clear cell AFX is a rare variant with only 12 cases reported until the present date, all of them as case reports, except for 1 small series of 3 cases. The authors report 6 new cases and review the literature with special emphasis on the differential diagnosis. The clear cell variant represents 5% of AFX from their files. Histopathologically, it consists of sheets of epithelioid, pleomorphic cells, intermixed with a varying number of giant multinucleated and spindle cells, the latter arranged in a fascicular pattern. All cell types predominantly exhibit a clear, microvacuolated cytoplasm with well-demarcated cell borders. The clinical and immunohistochemical features of this variant are similar to those of the classic type. Clear cell AFX must be differentiated from other cutaneous clear cell neoplasms, some of them with an aggressive clinical behavior, including clear cell melanoma, primary cutaneous and metastatic clear cell carcinomas, clear cell sarcoma, pleomorphic liposarcoma, tumor of perivascular epithelioid cells, and distinctive dermal clear cell mesenchymal neoplasm. The clinical presentation and immunohistochemical profile play a key role in the differential diagnosis.

  2. Prader-Willi Disease: A Case Study. (United States)

    Forbus, William R., III

    A case study focuses on the characteristics and physical management of a 15-year-old with Prader-Willi Syndrome, a birth defect associated with hypotonia, insatiable appetite, hypogonadism, central nervous system dysfunction, and abnormal growth and development . A literature review addresses studies dealing with behavior modification of obesity…

  3. Djenkolism: case report and literature review

    Directory of Open Access Journals (Sweden)

    Bunawan NC


    Full Text Available Nur C Bunawan,1 Asghar Rastegar,2 Kathleen P White,3 Nancy E Wang41Alam Sehat Lestari Clinic, West Kalimantan, Borneo, Indonesia; 2Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA; 3General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 4Department of Surgery and Pediatric Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Djenkolism is an uncommon but important cause of acute kidney injury. It sporadically occurs after an ingestion of the djenkol bean (Archidendron pauciflorum, which is native to Southeast Asia. The clinical features defining djenkolism include: spasmodic suprapubic and/or flank pain; urinary obstruction; and acute kidney injury. The precise pathogenesis of acute kidney injury following djenkol ingestion remains unknown. However, it is proposed that an interaction between the characteristics of the ingested beans and the host factors causes hypersaturation of djenkolic acid crystals within the urinary system, resulting in subsequent obstructive nephropathy with sludge, stones, or possible spasms. We report a case of djenkolism from our rural clinic in Borneo, Indonesia. Our systematic literature review identified 96 reported cases of djenkolism. The majority of patients recovered with hydration, bicarbonate therapy, and pain medication. Three patients required surgical intervention; one patient required ureteral stenting for the obstructing djenkolic acid stones. Four of the 96 reported patients died from acute kidney failure. We stress the importance of awareness of djenkolism to guide medical practitioners in the treatment of this rare disease in resource-poor areas in Southeast Asia.Keywords: djenkolism, acute renal failure, acute kidney injury, tropical medicine

  4. Cromoblastomicose: relato de 27 casos e revisão da literatura Chromoblastomycosis: study of 27 cases and review of medical literature

    Directory of Open Access Journals (Sweden)

    Rafaela Teixeira Marinho Correia


    Hospital of the Faculty of Medicine of São Paulo State during the ten-year period from 1997 to 2007. METHODS: It is a retrospective study and the medical report cards of 27 Brazilian patients diagnosed as suffering from Chromoblastomycosis from 1997 to 2007 at the Dermatology Department of the Medical School, University of Sao Paulo were reviewed. The following items were analyzed: previous therapeutic approaches; treatment implemented by the group; length of time between the appearing of the lesion and diagnosis; age; gender; profession; origin; site of lesions; isolated agents found in culture and histopathology. RESULTS: Twenty two patients were from the state of Sao Paulo whereas the others came from the states of Bahia and Rondonia. 37% of them were rural workers. Men were more frequently infected (85%. Lesions were more commonly found on the lower limbs (59.2%. In 52% of the cases the isolated agent was the dematiaceous fungus Fonsecaea. pedrosoi. Biopsies showed sclerotic bodies in 92.5% of the cases. CONCLUSION: Data found are in accordance with medical literature on the subject. The disease had been previously studied in our institution in 1983 by Cucé et al. This present study is the second retrospective one about the characteristics of patients suffering from chromoblastmycosis which has been published in indexed medical literature in the state of Sao Paulo.

  5. Program evaluation and case study


    Kushner, S


    This entry looks at the convergence of case study methodology and program evaluation. An early insight of some educational evaluation theorists was of the convergence of case study and program evaluation – the fusion of method with purpose. Program evaluation and case study came to be mutually-bracketed. In the educational evaluation field 'Responsive', 'Democratic', 'Illuminative' methodologies were developed in parallel with case study methods - the same authors contributing freely to both ...

  6. Sarcoidosis: Case Presentation and Literature Review

    Directory of Open Access Journals (Sweden)

    Dayana Alomá Fortún


    Full Text Available Sarcoidosis is a systemic disease of unknown etiology in which infectious agents have been implicated, inorganic powders or organic substances, characterized by the presence of necrotizing granulomatous inflammation with no accumulation of CD4 + lymphocytes and monocytes in the affected tissues. It is presented the case of a patient who went to the General University Hospital Dr. Gustavo Aldereguía Lima of Cienfuegos reporting dry cough, fever, chest tightness and slight weight loss three of three months evolution which did not improve despite receiving treatment in his health area. After several studies it was diagnosed a proliferative pulmonary sarcoidosis, systemic granulomatous disease whose etiology remains anonymous. Biopsy remains the basis for definitive diagnosis. As this is a difficult entity to explain and understand, besides being scarcely diagnosed in our area, it is decided to present that clinical case.

  7. Phidippides cardiomyopathy: a review and case illustration. (United States)

    Trivax, Justin E; McCullough, Peter A


    Phidippides was a Greek messenger who experienced sudden death after running more than 175 miles in two days. In today's world, marathon running and other endurance sports are becoming more popular and raising concern about sudden deaths at these events. Once etiologies such has hypertrophic cardiomyopathy, anomalous coronary arteries, and coronary atherosclerosis have been excluded, there is now an additional consideration termed Phidippides cardiomyopathy. Because endurance sports call for a sustained increase in cardiac output for several hours, the heart is put into a state of volume overload. It has been shown that approximately one-third of marathon runners experience dilation of the right atrium and ventricle, have elevations of cardiac troponin and natriuretic peptides, and in a smaller fraction later develop small patches of cardiac fibrosis that are the likely substrate for ventricular tachyarrhythmias and sudden death. Cardiac magnetic resonance imaging is emerging as the diagnostic test of choice for this condition. This review and case report summarizes the key features of this newly appreciated disorder.

  8. Examples and Case Studies

    NARCIS (Netherlands)

    Asbach, C.; Aguerre, O.; Bressot, C.; Brouwer, D.H.; Gommel, U.; Gorbunov, B.; Bihan, O. le; Jensen, K.A.; Kaminski, H.; Keller, M.; Koponen, I.K.; Kuhlbusch, T.A.J.; Lecloux, A.; Morgeneyer, M.; Muir, R.; Shandilya, N.; Stahlmecke, B.; Todea, A.M.


    Release of nanomaterials may occur during any stage of the life-cycle and can eventually lead to exposure to humans, the environment or products. Due to the large number of combinations of release processes and nanomaterials, release scenarios can currently only be tested on a case-by-case basis. Th

  9. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann


    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  10. Natural Learning Case Study Archives (United States)

    Lawler, Robert W.


    Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

  11. Case studies--ergonomics in projects. (United States)

    Pikaar, Ruud N


    The aim of a series of sessions on Company Case Studies, is to learn from practical experiences, to give feed back to researchers on applicability of theories, methods and techniques, and last but not least, to market ergonomics. In order to learn from case material, reports need to be easy accessible and well structured. System ergonomics provides such a structure. Usually a project is not done twice, i.e. with and without ergonomics. Therefore, it is not possible to make comparisons and determine the impact of ergonomics directly. A different approach is needed. It has been suggested at the IEA2006 World Congress, to compile a database of published case studies, each case to be reported in a fixed report format and critically reviewed to enable generalizing the outcomes. This paper proposes such a format. At the IEA2012 World Congress 40 case studies have been accepted, representing applied ergonomics cases in manufacturing, process industries, aviation and logistic systems.

  12. Dioxin: a case study. (United States)

    Bond, G G


    The need to notify individuals of a possible health risk from their past exposure to potentially hazardous agents frequently extends beyond workers to include community groups. The issues to consider in community notification are frequently similar to those that are important for worker notification but may include some that are unique. This case study traces the evolution of one company's strategy for communicating with the public about possible dioxin contamination associated with its operations. Early communications tended to emphasize the technical aspects of the issues in the fashion of scientists talking to other scientists. This was interpreted by some to be symptomatic of an arrogant and uncaring attitude. Beginning in the early 1980s, the company's management recognized the need to reach out to a variety of audiences on multiple levels, and shifted to a more comprehensive communications strategy. A similar shift is now occurring throughout the chemical manufacturing industry as top managers realize that, if they expect to continue to operate, they must become more accountable and responsive to the public.

  13. Pancreaticopericardial Fistula: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Muhammad S. Khan


    Full Text Available Purpose. Pancreaticopericardial fistula (PPF is an extremely rare complication of acute or chronic pancreatitis. This paper presents a rare case of PPF and provides systematic review of existing cases from 1970 to 2014. Methods. A PubMed search using key words was performed for all the cases of PPF from January 1970 to December 2014. Fourteen cases were included in the study. The cases were reviewed for demographic characteristics, diagnostic modalities, and treatment. Descriptive analysis of these variables was performed. Results. Median age was 43 years. 78% were known alcoholics and 73.3% had chronic pancreatitis. Dyspnea was present in 78%. Cardiac tamponade was present in 53%; 75% of patients had known chronic pancreatitis (RR = 0.74. Surgery was associated with best treatment outcomes and 50% of patients who underwent endoscopic treatment survived. Conclusion. PPF is a rare disease. This paper indicates that acute cardiac tamponade in patients with history of alcoholism and chronic pancreatitis could be a sign of an existing pancreaticopericardial fistula and early surgical intervention could be life-saving.

  14. [Infective endocarditis: review of 36 cases]. (United States)

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


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

  15. Is chronic toxoplasmosis a risk factor for diabetes mellitus? A systematic review and meta-analysis of case-control studies

    Directory of Open Access Journals (Sweden)

    Hamidreza Majidiani

    Full Text Available ABSTRACT Introduction: The global protozoan parasite, Toxoplasma gondii, infects many warm-blooded animals and humans by employing different transmission routes. There have been some recent studies on the probable relevance of infectious agents and diabetes. Therefore, we conducted a systematic review and meta-analysis to identify the possible association between chronic toxoplasmosis and diabetes mellitus. Methods: This study was conducted following the general methodology recommended for systematic reviews and meta-analysis. Nine English literature databases (Google scholar, PubMed, Scopus, Web of science, Science Direct, Ovid, ProQuest, IngentaConnect, and Wiley Online Library were searched, up to January 2016. Random effects model was used to determine odds ratios and their 95% confidence intervals. Results: Our review resulted in a total of seven publications meeting the inclusion criteria. Because of significant heterogeneity, we estimated a common OR by a random effects model at 1.10 (95% CI = 0.13-9.57 with p = 0.929 and 2.39 (95% CI = 1.20-4.75 with p = 0.013 for type 1 and type 2 diabetes mellitus, respectively. Conclusion: Despite the limitations such as low number of studies, this meta-analysis suggests chronic toxoplasmosis as a possible risk factor for type 2 DM. However, based on random effects model no statistically significant association was observed between T. gondii and type 1 DM. It is highly recommended for researchers to carry out more accurate studies aiming to better understand this association.

  16. Adult Pancreatic Hemangioma: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Gerhard S. Mundinger


    Full Text Available We report an adult pancreatic hemangioma diagnosed on pathological specimen review following pylorus preserving pancreaticoduodenectomy for a symptomatic cystic mass in the head of the pancreas. Eight cases of adult pancreatic hemangioma have been reported in literature since 1939. Presenting symptoms, radiographic diagnosis, pathologic characteristics, and treatment of adult pancreatic hemagiomas are discussed following review of all published cases.

  17. 儿童文学阅读导读教学案例研究%Teaching case ' studies of children's literature reading REVIEW

    Institute of Scientific and Technical Information of China (English)



    Children's Literature for children with special educational function, play to the characteristics of the chidren's literature to improve the education of primary school language This paper discusses issues of education and teaching practice. The author has targeted selection of children's literature reading REVIEW teaching case practice research, the statements during the experiment and summarizes research revelation.%儿童文学对儿童具有特殊的教育功能,发挥儿童文学的特点提高小学语文教育是本文探讨的教育教学实践问题。笔者具有针对性的选取“儿童文学阅读导读教学”案例进行实践研究,陈述实验过程并总结研究启示。

  18. Giant-cell interstitial pneumonia and hard-metal pneumoconiosis. A clinicopathologic study of four cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Ohori, N.P.; Sciurba, F.C.; Owens, G.R.; Hodgson, M.J.; Yousem, S.A.


    We report four cases of giant-cell interstitial pneumonia that occurred in association with exposure to hard metals. All patients presented with chronic interstitial lung disease and had open-lung biopsies that revealed marked interstitial fibrosis, cellular interstitial infiltrates, and prominent intraalveolar macrophages as well as giant cells displaying cellular cannibalism. We also review the literature to determine the sensitivity and specificity of giant-cell interstitial pneumonia for hard-metal pneumoconiosis. Although hard-metal pneumoconiosis may take the form of usual interstitial pneumonia, desquamative interstitial pneumonia, and giant-cell interstitial pneumonia, the finding of giant-cell interstitial pneumonia is almost pathognomonic of hard-metal disease and should provoke an investigation of occupational exposure. 25 references.

  19. Nanomaterial Case Study: A Comparison of Multiwalled Carbon Nanotube and Decabromodiphenyl Ether Flame-Retardant Coatings Applied to Upholstery Textiles (External Review Draft) (United States)

    The draft document is intended to be used as part of a process to identify what is known and, more importantly, what is not yet known that could be of value in assessing the broad implications of specific nanomaterials. Like previous case studies (see History/ Chronology below), ...

  20. A Case Study: Review of an Indigenous Digital Resource as a Potential Medium for Dance Undergraduate Teaching and Learning: "Cassie's Story: Dyan Ngal" (Wiradjuri for "Fix Me") (United States)

    Jefferson-Buchanan, Rachael


    The following article comprises a case study that considers the potential for an Indigenous digital resource to be used within a dance undergraduate context. In this manner, suggestions for dance pedagogy and practice are offered in relation to the Indigenous Education Strategy at Charles Sturt University, together with a university digital…

  1. Disability Case Adjudication and Review System (United States)

    Social Security Administration — DICARS is the legacy system supporting business processes in the Disability Quality Branches (DQBs). It supports quality reviews of DDS disability determinations....

  2. Intercultural Communicative Case Study

    Institute of Scientific and Technical Information of China (English)



    The essay is mainly about the author's comprehension of cultural differences and intercultural communication after reading the book Communication Between Cultures.In addition,the author also analyses three cases with the theories and approaches mentioned in Communication Between Cultures.

  3. Supply Chain Strategy: Empirical Case Study in Europe and Asia


    Ilkka Sillanpää; Sebastian Sillanpää


    The purpose of this case study research is to present a literature review of supply chain strategy approaches, develop supply chain strategy framework and to validate a framework in empirical case study. Literature review and case study research are the research methods for this research. This study presents the supply chain strategy framework which merges together business environment, corporate strategy, supply chain demand and supply chain strategy. Research argues that all the different c...

  4. Imaging in isolated sacral tuberculosis: a review of 15 cases

    Energy Technology Data Exchange (ETDEWEB)

    Patankar, T.; Krishnan, A.; Kale, H.; Prasad, S. [Department of Radiology, King Edward Memorial Hospital, Bombay (India); Patkar, D.; Shah, J. [Department of Radiology, Dr. Balabhai Nanavati Hospital, Bombay (India); Castillo, M. [Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7510 (United States)


    Objective. To review imaging studies of isolated involvement of the sacrum due to tuberculosis and determine the role of imaging in the diagnosis and management of these patients.Design and patients. A retrospective analysis of 15 cases of isolated sacral tuberculosis imaged with MR imaging was performed. The CT images were also reviewed where available, and the various lesion characteristics were identified. We also reviewed the medical records in an attempt to determine the impact of the imaging studies on the management of these patients.Results. Fifteen patients (5 male, 10 female) presented with symptoms of 3-15 months' duration. Chronic localized backache with muscle spasm was the commonest presenting symptom; discharging sinuses with abscess formation was found in six patients, five of whom were children. MR imaging of the sacrum revealed a hypointense marrow signal on T1-weighted images and hyperintense signal on T2-weighted images in 14 of 15 patients, the S2 vertebra being always involved. CT revealed osteolytic changes in the sacrum in all the five patients in whom CT was performed. All patients showed marked clinical improvement within 1 year of anti-tuberculous chemotherapy.Conclusion. Isolated tuberculosis of the sacrum is uncommon but should be suspected in patients presenting with chronic low backache or children with discharging sinuses/abscesses and showing sacral destruction on CT or MR imaging. MR imaging can identify cases and enables early institution of anti- tuberculous chemotherapy. (orig.)

  5. Treacher Collins syndrome: a case review. (United States)

    Jensen-Steed, Ginger


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

  6. Advanced nuclear systems. Review study; Fortgeschrittene Nuklearsysteme. Review Study

    Energy Technology Data Exchange (ETDEWEB)

    Liebert, Wolfgang; Glaser, Alexander; Pistner, Christoph [Interdisziplinaere Arbeitsgruppe Naturwissenschaft, Technik und Sicherheit (IANUS), Darmstadt University of Technology, Hochschulstrasse 10, D-64289 Darmstadt (Germany); Baehr, Roland; Hahn, Lothar [Institute for applied ecology (Oeko-Institut), Elisabethenstrasse 55-57, D-64283 Darmstadt (Germany)


    The task of this review study is to from provide an overview of the developments in the field of the various advanced nuclear systems, and to create the basis for more comprehensive studies of technology assessment. In an overview the concepts for advanced nuclear systems pursued worldwide are subdivided into eight subgroups. A coarse examination raster (set pattern) is developed to enable a detailed examination of the selected systems. In addition to a focus on enhanced safety features, further aspects are also taken into consideration, like the lowering of the proliferation risk, the enhancement of the economic competitiveness of the facilities and new usage possibilities (for instance concerning the relaxation of the waste disposal problem or the usage of alternative fuels to uranium). The question about the expected time span for realization and the discussion about the obstacles on the way to a commercially usable reactor also play a substantial role as well as disposal requirements as far as they can be presently recognized. In the central chapter of this study, the documentation of the representatively selected concepts is evaluated as well as existing technology assessment studies and expert opinions. In a few cases where this appears to be necessary, according technical literature, further policy advisory reports, expert statements as well as other relevant sources are taken into account. Contradictions, different assessments and dissents in the literature as well as a few unsettled questions are thus indicated. The potential of advanced nuclear systems with respect to economical and societal as well as environmental objectives cannot exclusively be measured by the corresponding intrinsic or in comparison remarkable technical improvements. The acceptability of novel or improved systems in nuclear technology will have to be judged by their convincing solutions for the crucial questions of safety, nuclear waste and risk of proliferation of nuclear weapons

  7. [Castleman's disease. Review of five cases]. (United States)

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


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

  8. Emotion, Engagement, and Case Studies (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric


    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  9. Review of Case Studies for Quantitative Reasoning: A Casebook of Media Articles by Bernard L. Madison, Stuart Boersma, Caren L. Diefenderfer, and Shannon W. Dingman

    Directory of Open Access Journals (Sweden)

    Samuel L. Tunstall


    Full Text Available Bernard L. Madison, Stuart Boersma, Caren L. Diefenderfer, and Shannon W. Dingman. Case Studies for Quantitative Reasoning: A Casebook of Media Articles (Pearson Learning Solutions, 2012. 215 pp. ISBN 9781256512875. Concisely organized and timely to a tee, Case Studies for Quantitative Reasoning contains a wealth of articles and exercises to promote higher-order thinking in any course where quantitative literacy is a goal. The text is a self-contained package complete with just enough mathematics to ensure that all students can join in. It contains a total of twenty-four case studies, each of which highlights how numbers appear in day-to-day media. The text is broken into six broad mathematical topics, each of which includes any background mathematics necessary for reading. Each individual study includes warm-up exercises and follow-up questions that demand critical thinking. Notwithstanding the elementary mathematics prerequisite to read the text, the topics and questions are sufficiently challenging to keep a class – and accompanying instructor – engaged for an entire semester.

  10. Hepatic Angiosarcoma: a Review of Twelve Cases

    Institute of Scientific and Technical Information of China (English)

    Qiang Li; Xishan Hao


    OBJECTIVE Hepatic angiosarcoma (HAS), a lethal disease, is the most common sarcoma arising in the liver. Little information about the epidemiology, etiology, diagnosis and management of HAS has been reported. Increased familiarity with this disease will facilitate correct diagnosis and help to improve management of this condition in the future.The objective of this study was to describe cases of hepatic angiosarcoma and to discuss the etiologic, diagnostic, therapeutic features and prognosis of this tumor. This report not only serves to give more evidence of the relationship between hepatic angiosarcoma and carcinogenic exposure, but also demonstrates the key points in different methods of diagnosis and the optimal treatment of hepatic angiosarcoma.METHODS Twelve cases of hepatic angiosareoma were analyzed retrospectively, representing the different character in clinical presentations and laboratory computed tomographical scans; pathological data and treatment are described. Clinical and biologic follow-up was carried out for two years after surgical treatment.RESULTS There were nine men and three women varying in ages from 57 to 71 years with an average of 64.3 years. Ten patientshad a history of exposure to vinyl chloride or thorotrast. Mild or moderate abdominal pain and bloating, abdominal mass and fever were the common clinical presentations. Tumors were visualized by ultrasonography and CT scans in all patients. Biochemical profiles yielded variable results and proved to be of little value in detection or diagnosis. Surgical resection was feasible for each patient who was treated as follows: two wedge resections, six segementectomies and four bisegmentectomies. Five patients received Neoadjuvant chemotherapy postoperatively. The survival rate of those cases was poor. The maximum survival time was fourteen months. The mean survival time for this chemotherapeutic group was 11 months. The difference between the survival time of those treated with an operation

  11. Thoracic injury: a review of 276 cases

    Institute of Scientific and Technical Information of China (English)

    Moosa Zargar; Ali Khaji; Mojgan Karbakhsh Davari


    Objective: Chest injury, one of the most important aspects of trauma, directly accounts for 25% of all traumarelated deaths and plays a major contributing role in another 25% of trauma deaths. This paper aimed to explore the spectrum and outcome of thoracic injuries seen in a multi centric study of trauma patients.Methods: A total of 276 consecutive trauma patients in 6 general hospitals were analyzed. The feature of injury,injury severity score (ISS), clinical treatment and mortality were recorded in a prospective manner and analyzed retrospectively. Multiple logistic regression analysis was used to determine the independent predictors of mortality following the chest trauma.Results: There were 246 males ( 89.1%) and 30 females (10.9% ) ranging from 3 to 80 years with a mean age of (34 ± 17) years. Road traffic accident was the main cause of injury, especially for pedestrians, followed by stab wound (89 cases, 32.1% ) and falling injuries (32 cases,11.6% ), respectively. Haemothorax or pneumothorax (50.4%) and rib fracture (38.6%) were the most common types of chest injury. Extremity fracture was the most common associated injury with the rate of 37% ( 85/230), followed by head injury (25.2% ) and abdominal trauma (19.6%). These injuries contributed significantly to the morbidity and mortality of trauma patients.Conclusions: According to the results, most patients with chest injury can be treated conservatively with close observation and tube thoracostomy. The presence of blunt trauma, head injury and abdominal injury independently adversely affect mortality after chest trauma. It is necessary to investigate the causes and patterns of injuries resulting from stab wound for effective prevention.

  12. Case Study: Case Studies and the Flipped Classroom (United States)

    Herreid, Clyde Freeman; Schiller, Nancy A.


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses the positive and negative aspects of the "flipped classroom." In the flipped classroom model, what is normally done in class and what is normally done as…

  13. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille


    testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different......The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... research paths....

  14. Analysis of SOD1 mutations in a Chinese population with amyotrophic lateral sclerosis: a case-control study and literature review (United States)

    Wei, QianQian; Zhou, QingQing; Chen, YongPing; Ou, RuWei; Cao, Bei; Xu, YaQian; Yang, Jing; Shang, Hui-Fang


    Although the copper/zinc superoxide dismutase-1 (SOD1) gene has been identified in both familial ALS (FALS) and sporadic ALS (SALS), it has rarely been studied in Chinese patients with ALS, and there are few studies with large samples. This study sought to assess the prevalence of SOD1 mutations in Chinese ALS patients. We screened a cohort of 499 ALS patients (487 SALS and 12 FALS) from the Department of Neurology at the West China Hospital of Sichuan University and analyzed all coding exons of SOD1 by Sanger sequencing. In addition, we reviewed the mutation frequencies of common ALS causative genes in Chinese populations. Eight missense mutations in SOD1 were found in 8 ALS individuals: two novel mutations (p.G73D and p.V120F) and six previously reported mutations. The frequencies of SOD1 mutations were 1.03% (5/487) in SALS and 25% (3/12) in FALS from Southwest China. A literature review indicated that the mutation rates of major ALS causative genes were 53.55% in FALS and 6.29% in SALS. In Chinese SALS and FALS, the highest mutation frequency was in the SOD1 gene. Our results suggest that SOD1 mutation is the most common cause of ALS in Chinese populations and that the mutation spectrum of ALS varies among different ethnic populations. PMID:28291249

  15. Histoplasma capsulatum sinusitis: case report and review. (United States)

    Alves, Marcelle D; Pinheiro, Lia; Manica, Denise; Fogliatto, Laura M; Fraga, Christina; Goldani, Luciano Z


    Histoplasma capsulatum has not typically been associated with sinusitis in either immunocompetent or immunocompromised hosts. We report a case of sinusitis caused by H. capsulatum in a patient with chronic lymphocytic leukemia and discuss the reported cases of this rare clinical manifestation of histoplasmosis in the medical literature.

  16. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...... on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  17. Asteroid hyalosis: clinical review of 58 cases

    Directory of Open Access Journals (Sweden)

    José Nuno Vargas Galveia


    Full Text Available OBJECTIVE: Understand the behavior, functional repercussion and relationship with epidemiological factors of asteroid hyalosis (AH and retrospective observational case series. METHODS: Fifty-eight patients diagnosed with AH (24 women and 34 men were studied. All patients were submitted to a thorough ophthalmological examination. RESULTS: We observed a statistical association between the presence of AH and male sex (p=0,042. An increase in prevalence of this pathology was observed with increasing age. We determined an odds ration of 5,24 of a patient over 50 years old having AH, when compared to patients bellow this threshold. Eighty-six percent of patients had unilateral vitreous deposits. We measured a lower IOP in the affected eye, with the difference being in average 2,68 ± 1,45 mmHg (p=0,037. We observed no statistical association between AH and age related macular degeneration, diabetes or glaucoma. Five eyes were submitted to facoemulsification combined with pars plana vitrectomy with an average gain of 7 lines (Snellen in visual acuity (p=0,03. CONCLUSION: In our sample a clear association between AH, ageing and male sex was observed. The majority of patients had unilateral vitreous deposits. Vitrectomy in association with facoemulsification is a safe and effective intervention in this group of patients.

  18. Case Study: A Strategic Research Methodology

    Directory of Open Access Journals (Sweden)

    Khairul B.M. Noor


    Full Text Available This research reviews the literature on case study as a strategic qualitative research methodology. Although case studies have been criticised by some authors as lacking scientific rigour and do not address generalizability, this research, however, reiterated its appropriateness when dealing with a process or a complex real-life activities in great-depth. Case study has been commonly used in social science fields like sociology, industrial relations and anthropology eventhough generally was considered an underutilized strategy. Hence, this research explained the general concept of a case study, strengths and weaknesses of using this method knowing that theoretically case is exciting and data rich. Based on a study of four organizations and the researcher’s own experience, this article described matters on how case study was undertaken, gaining excess to those organizations and the systematic process of data collection and triangulation (multiple techniques. It was noted that combining multiple techniques for elicitng data in case study research actually strengthens and confirmed results.

  19. Instructional Computing: Ten Case Studies. (United States)

    Hargan, Carol; Hunter, Beverly

    These case studies are written for educational institutions that wish to plan, extend, or improve their use of computers for learning and teaching. Each case study includes a brief description of each of the following: profile of the institution, history of the development of instructional computing, organization and management, student access to…

  20. Three Community College Case Studies (United States)

    Wojtysiak, Joseph; Sutton, William J., II; Wright, Tommy; Brantley, Linda


    This article presents three case studies that focus on specific projects that are underway or have been completed. In the first case study, Joseph Wojtysiak and William J. Sutton, II discuss the Green Center of Central Pennsylvania, which is designed to serve as the state's preeminent source for education, training and public information about…

  1. Spontaneous coronary artery dissection: case report and literature review. (United States)

    D'Ovidio, Cristian; Sablone, Sara; Carnevale, Aldo


    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction and sudden cardiac death. It occurs most commonly in otherwise healthy women during pregnancy or the postpartum period. The true incidence of SCAD is underestimated, as most cases are diagnosed at autopsy. The pathophysiology of SCAD is still not fully understood, and its management can be challenging. This report describes a 35-year-old pregnant female who presented with an acute antero-lateral ST elevation secondary to spontaneous dissection of the left anterior descending artery and the circumflex artery. The diagnosis was established by coronary artery angiography. However, the patient died following cardiac tamponade. The examination of this case represented a starting point for the reviewing of the diagnosis, clinical course, and management of SCAD, and for the placing of this in context with the existing literature. This study highlights the importance of prompt diagnosis and subsequent lifesaving treatment.

  2. Paracoccidioidomycosis of the male genital tract. Report of eleven cases and a review of Brazilian literature

    Directory of Open Access Journals (Sweden)

    SEVERO Luiz Carlos


    Full Text Available Eleven cases of involvement of the genital tract in paracoccidioidomycosis were collected in a retrospective study of the clinical records of 683 patients seen in Porto Alegre, Rio Grande do Sul, Brazil. These cases are herein summarily reported. Eighteen similar cases were gathered in review of the Brazilian literature. Obtained data are discussed.

  3. Mobile Technologies Adoption: An Exploratory Case Study

    Institute of Scientific and Technical Information of China (English)

    CHU Yan; HUANG Lihua


    Based on the theory of task-technology fit and literature review of mobile technology acceptance, a research model is presented based on the features of mobile technologies and the actual usage of mobile applications in business environments, which identifies the characteristics of mobile applications and fitting tasks. An exploratory case is studied to understand how ABC Company, Hong Kong, utilizes mobile selling applications in their sales management process. This study gives some managerial suggestions for enterprises to successfully use mobile applications.

  4. Case report and review of lumbar hernia. (United States)

    Walgamage, Thilan B; Ramesh, B S; Alsawafi, Yaqoob


    Lumbar hernias are uncommon and about 300 cases have been reported till date. They commonly occur due to trauma, surgery and infection. They are increasingly being reported after motor vehicle collision injuries. However, spontaneous lumbar hernias are rare and are reported infrequently. It is treated with different surgical approaches and methods. We report a case of primary spontaneous lumbar hernia which was repaired by transperitonial laparoscopic approach using Vypro (polypropylene/polyglactin) mesh and covered with a peritoneal flap.

  5. [Malignant melanoma (review of 68 cases)]. (United States)

    Sittart, J A; Valente, N Y; Stevale, J N


    A clinica pathologic revision was performed about 68 patients with malignant melanoma of the Hospital dos Servidores Publicos do Estado de São Paulo. The authors had checked the data concerning to color, age and sex of the patients, localisation, clinical aspect of the lesions and clinical evolution of the cases. They made comments on the histopathology related to Clark's levels, the depth of tumors (Breslow), solar elastosis and inflammatory infiltrate, in relation with the clinical evolution of the cases.

  6. Intraosseous pneumatocysts: a case based review. (United States)

    Oehler, Erwan; Valour, Florent; Pascart, Tristan


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


    Directory of Open Access Journals (Sweden)

    DENEGRI Guillermo M.


    Full Text Available The presence of Bertiella mucronata and Bertiella studeri (Cestoda: Anoplocephalidae in humans is reviewed, and international infection rates and a bibliography included. Taxonomic, biological, epidemiological, pathological, diagnostic, control, prevention and therapeutic aspects of the zoonosis are analyzed, and the increase in zoonotic potentiality of the parasitosis is discussed

  8. Musical obsessions: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jitender Aneja


    Full Text Available The phenomenon of musical obsessions is scantly researched and poorly established. Here we present a case with musical obsessions in addition to body dysmorphophia and severe depression and review the available literature for musical obsessions.

  9. Individual and environmental contributions to treatment outcomes following a neuroplasticity-principled speech treatment (LSVT LOUD) in children with dysarthria secondary to cerebral palsy: a case study review. (United States)

    Boliek, Carol A; Fox, Cynthia M


    This study describes the use of a neuroplasticity-principled speech treatment approach (LSVT(®)LOUD) with children who have dysarthria secondary to cerebral palsy. To date, the authors have treated 25 children with mild-to-severe dysarthria, a continuum of gross and fine motor functions, and variable cognitive abilities. From this data set, two case studies are presented that represent as weak or strong responders to LSVT LOUD. These case studies demonstrate how individual and environmental features may impact immediate and lasting responses to treatment. Principles that drive activity-dependent neuroplasticity are embedded in LSVT LOUD and may contribute to positive therapeutic and acoustic outcomes. However, examination of the response patterns indicated that intensity (within and across treatment sessions) is necessary but not sufficient for change. Weak responders may require a longer treatment phase, better timing (e.g., developmentally, socially), and a more prominent desire to communicate successfully during daily activities. Strong responders appear to benefit from the intensity and saliency of treatment as well as from intrinsic and extrinsic rewards for using the trained skills for everyday communication. Finally, possibilities are presented for technological solutions designed to promote accessibility to the intensive task repetition and maintenance required to drive lasting changes.

  10. Congenital intracranial meningioma. A case report and literature review

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D


    A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed.......A case report of congenital intracranial meningioma is presented. We describe what appears to be the first fetal meningioma of the fibroblastic subtype. The literature is reviewed, and the subtype and sex distribution of fetal meningiomas is discussed....

  11. A Posteriorly Displaced Distal Metaphyseal Clavicular Fracture (Type IV AC Joint Dislocation-Like in Children: A Case Report and Literature Review Study

    Directory of Open Access Journals (Sweden)

    Ahmed Kotb


    Full Text Available Fractures of the lateral end of the clavicle are common in pediatric patients; most of these fractures occur at the physeal level representing Salter Harris injuries. The vast majority of fractures of the lateral end of the clavicle are managed nonoperatively. In this report, we describe a unique type of fracture of the distal end of the clavicle in the pediatric patients in which the fracture occurs in the metaphyseal lateral clavicle with the proximal edge of the fracture displaced posteriorly through the trapezius muscle causing obvious deformity. It is similar in pathology to type IV AC joint dislocation. In this study we report this injury in eleven-year-old boy. Literature review showed that similar injuries were described before three times (two of them in pediatric patients. Due to the significant clinical deformity of this category with entrapment of the bone through the trapezius muscle, reduction (open or closed of the fracture is the recommended treatment.

  12. Roundabouts Canada case study

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, M. [Ryerson Polytechnic Univ., Toronto, ON (Canada); Lenters, M. [Roundabouts Canada, Whitby, ON (Canada)


    A modern roundabout was constructed in the community of Ancaster, Ontario in response to growing complaints regarding speeding along the major roadway, and queuing on the minor roadway. The roundabout opened on October 25, 2002. The before and after speeds at the roundabout are being studied, and the fastest path characteristics are assessed in an effort to determine whether the predicted fastest path data correlates with the in-service operating speeds. The speed at R1, R2 and R3 locations on the east west, and north south approaches are measured. tabs., figs.

  13. Pompe disease: literature review and case series. (United States)

    Dasouki, Majed; Jawdat, Omar; Almadhoun, Osama; Pasnoor, Mamatha; McVey, April L; Abuzinadah, Ahmad; Herbelin, Laura; Barohn, Richard J; Dimachkie, Mazen M


    Pompe disease is a rare multi-systemic metabolic myopathy caused by autosomal recessive mutations in the acidic alpha glucosidase (GAA) gene. Significant progress had been made in the diagnosis and management of patients with Pompe disease. Here, we describe our experience with 12 patients with various forms of Pompe disease including 4 potentially pathogenic, novel GAA variants. We also review the recent the recent advances in the pathogenesis, diagnosis, and treatment of individuals with Pompe disease.

  14. Lyme Meningoradiculitis: Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Smaranda Maier


    Full Text Available The clinical manifestations of Lyme disease are protean. The meningoradiculitis is a common and well-recognized complication of neuroborreliosis but can be easily misdiagnosed without a high degree of clinical suspicion, mainly if the tick bite is not present in the medical history. We report two cases of Lyme meningoradiculitis with excellent outcome after appropriate antibiotic therapy. In an endemic area in case of neurological manifestations suggestive for neuroborreliosis the serological testing for B. burgdorferi in serum and cerebrospinal fluid is imperative for the correct diagnosis.

  15. Case Studies in Science Ethics (United States)

    Williams, Karen


    Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

  16. [Review of 1,172 clinical cases with human communication disorders]. (United States)

    de Díaz, M R; de Pustilnik, N F; Tortolero, Y


    The study comprised 1,172 clinical cases that were classified according to sex, age and speech disorders. A review is made on the most common alterations that they present, the selective treatment in each type and their rehabilitation.

  17. General review of flashing jet studies. (United States)

    Polanco, Geanette; Holdø, Arne Erik; Munday, George


    The major concern on the management of superheated liquids, in industrial environments, is the large potential hazards involved in cases of any accidental release. There is a possibility that a violent phase change could take place inside the fluid released generating a flashing jet. This violent phase change might produce catastrophic consequences, such as explosions, fires or toxic exposure, in the installations and in the surroundings. The knowledge and understanding of the mechanisms involved in those releases become an important issue in the prevention of these consequences and the minimization of their impact. This work presents a comprehensive review of information about flashing processes. The review begins with a description of the single phase jet followed by a description of the two-phase flashing jet. The concepts and implications of the thermodynamic and mechanical effects on the behaviour of the jets are considered at the beginning of the review. Following the review is devoted to the classification of the different study approaches used to understand flashing processes in the past, highlighting various critical parameters on the behaviour and the hazard consequences of flashing jets. The review also contains an extensive compilation of experimental, theoretical and numerical data relating to these phenomena, which includes information on the distinct characteristics of the jet, since type of jet, velocity distribution, expansion angle and mass phase change all require individual estimation.

  18. General review of flashing jet studies

    Energy Technology Data Exchange (ETDEWEB)

    Polanco, Geanette, E-mail: [Simon Bolivar University, Caracas (Venezuela, Bolivarian Republic of); Holdo, Arne Erik, E-mail: [Narvik University College, Narvik (Norway); Munday, George, E-mail: [Coventry University, Coventry (United Kingdom)


    The major concern on the management of superheated liquids, in industrial environments, is the large potential hazards involved in cases of any accidental release. There is a possibility that a violent phase change could take place inside the fluid released generating a flashing jet. This violent phase change might produce catastrophic consequences, such as explosions, fires or toxic exposure, in the installations and in the surroundings. The knowledge and understanding of the mechanisms involved in those releases become an important issue in the prevention of these consequences and the minimization of their impact. This work presents a comprehensive review of information about flashing processes. The review begins with a description of the single phase jet followed by a description of the two-phase flashing jet. The concepts and implications of the thermodynamic and mechanical effects on the behaviour of the jets are considered at the beginning of the review. Following the review is devoted to the classification of the different study approaches used to understand flashing processes in the past, highlighting various critical parameters on the behaviour and the hazard consequences of flashing jets. The review also contains an extensive compilation of experimental, theoretical and numerical data relating to these phenomena, which includes information on the distinct characteristics of the jet, since type of jet, velocity distribution, expansion angle and mass phase change all require individual estimation.

  19. Indoor radon exposure and lung cancer risk: a review of case-control studies; Exposition domestique au radon et risque de cancer du poumon: bilan des etudes cas-temoins

    Energy Technology Data Exchange (ETDEWEB)

    Baysson, H.; Tirmarche, M. [Institut de Radioprotection et de Surete Nucleaire (IRSN), Service de Radiobiologie et d' Epidemiologie, Dir. de la Radioprotection de l' Homme, 92 - Fontenay aux Roses (France)


    Background: Radon is a radioactive gas that tends to accumulate in indoor environment. A causal relationship between lung cancer and radon exposure has been demonstrated in epidemiologic studies of miners. The objective of this paper is to present the results of case-control studies of lung cancer risk associated with indoor radon exposure. Methods: Case-control studies published since 1990 are included in this review. This type of proto ol is particularly well suited for studying the relationship between indoor radon exposure and lung cancer risk, taking into account possible confounding factors such as tobacco smoking. The characteristics and results of these studies are summarized. The limitations associated with each of these studies are also discussed. Results: The results of available studies are relatively concordant and suggest a positive association between lung cancer risk and indoor radon exposure with an estimated excess relative risk of about 6 to 9% per 100 Bq/m{sup 3} increase in the observed time-weighted average radon concentration. The order of magnitude of this estimation agrees with extrapolations from miners but some studies may suffer from inadequate statistical power. Conclusion: At present, efforts are underway to pool together the data from the existing studies of indoor radon. This pooling analysis with thousands of cases and controls will provide a more precise estimate of the lung cancer risk from indoor radon exposure and explore the effect of modifying factors, such as smoking. (author)

  20. Systemic mastocytosis: Case report with literature review

    Directory of Open Access Journals (Sweden)

    Mitrović Mirjana


    Full Text Available Introduction. Mastocytosis is a clonal neoplastic disorder of the mast cells. The clinical signs and symptoms of mastocytosis are heterogeneous ranging from indolent disease with a longterm survival to a highly aggressive neoplasm with survival of about 6 months. Systemic mastocytosis (SM is characterized by mastocyte infiltration of one or more organs, with or without skin involvment. Case Outline. The presented patient presents a highly challenging diagnostic and therapeutic case. A 46-year-old man was referred to our Centre due to the 7-year-long history of hepatosplenomegaly and mild thrombocytopenia. Ultrasound examination showed hepatosplenomegaly (liver 170 mm; spleen 200 mm, platelet count was 90Č109/L, serum tryptase level was elevated and bone marrow biopsy showed infiltration with mast cells (CD117, CD25 and mast cell tryptase positive. Our patient was diagnosed with aggressive systemic mastocytosis (SM according to WHO Classification (2008, although the clinical course of the disease was indolent, without complications for more than 7 years. Because of the ‘intermediate’ course, this patient was referred to as smouldering or intermediate SM and was not treated with cytostatics. Conclusion. Utilizing the established criteria, indolent SM can be discriminated from the aggressive subvariants of SM in most cases. However, a small group of patients, like our case belongs to the „grey zone“. Therapeutic approach to these patients is individual and prognosis is uncertain.

  1. Hyperlipidemic myeloma: review of 53 cases. (United States)

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


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

  2. Radiation Retinopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Young Lorna


    Full Text Available Abstract Background Ocular damage from radiation treatment is a well established phenomenon. Many factors are now known to influence the incidence of radiation retinopathy, including total dosage and daily fraction size. Patients who are diabetic, hypertensive or received previous chemotherapy are more susceptible to radiation retinopathy. Case Presentation A 55 year old male was referred from the oncology department with epiphora. His medical history included Type 2 Insulin treated Diabetes Mellitus and hypertension. One year prior to presentation he had undergone a total rhinectomy with a 4 week course of post-operative radiotherapy for an aggressive sqaumous cell carcinoma of the nose. On examination the visual acuity was noted to be 6/36 left eye and 6/9 right eye. Posterior segment examination revealed marked retinal ischaemia present in the posterior pole and macular region of both eyes. The appearance was not thought to be typical of diabetic changes, radiation retinopathy being the more likely diagnosis especially in view of his history. Over the next four months the vision in both eyes rapidly deteriorated to 3/60 left eye and 1/60 right eye. Bilateral pan retinal photocoagulation was thought to be appropriate treatment at this point. Conclusion This case highlights the importance for ophthalmologists and oncologists to be aware of the close relationship between diabetes and radiation treatment and the profound rapid impact this combination of factors may have on visual function. Radiation is being used with increasing frequency for ocular and orbital disease, because of this more cases of radiation retinopathy may become prevalent. Factors which may potentiate radiation retinopathy should be well known including, increased radiation dosage, increased fraction size, concomitant systemic vascular disease and use of chemotherapy. Counselling should be offered in all cases at risk of visual loss. As no effective treatment currently exists

  3. Pancreatic liposarcoma: case report with review of retroperitoneal liposarcomas. (United States)

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


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

  4. Gorlin-Goltz Syndrome: Case report and literature review. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    Maya Ramesh


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

  6. Erupted complex odontoma: a case report and literature review. (United States)

    Litonjua, Luis A; Suresh, Lakshmanan; Valderrama, Lucia S; Neiders, Mirdza E


    A case involving a 17-year-old girl with a large erupted odontoma associated with a deeply impacted mandibular molar is reported. The molar, which previously had been displaced to the border of the mandible, erupted successfully three years after surgical removal of the odontoma. A review of the literature presents guidelines for treating similar cases.

  7. Hip salvage surgery in cerebral palsy cases: a systematic review. (United States)

    de Souza, Rafael Carboni; Mansano, Marcelo Valentim; Bovo, Miguel; Yamada, Helder Henzo; Rancan, Daniela Regina; Fucs, Patricia Maria de Moraes Barros; Svartman, Celso; de Assumpção, Rodrigo Montezuma César


    Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients' quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The literature search focused on studies that evaluated results from hip salvage surgery in cases of cerebral palsy, published from 1970 to 2011, which are present in the Embase, Medline, PubMed, Cochrane Library and SciELO databases. Although the results were not statistically comparable, this systematic review demonstrates that hip salvage surgery should be indicated after individual evaluation on each patient, due to the wide spectrum of presentations of cerebral palsy. Therefore, it seems that no surgical technique is superior to any other. Rather, there are different indications.

  8. Hip salvage surgery in cerebral palsy cases: a systematic review

    Directory of Open Access Journals (Sweden)

    Rafael Carboni de Souza


    Full Text Available Imbalance and muscle spasticity, in association with coxa valga and persistent femoral anteversion, compromises hip development in cases of cerebral palsy and may result in chronic pain and even dislocation. Some of these hips undergo salvage surgery because of the severe impact of their abnormalities in these patients' quality of life. We conducted a systematic review of the literature to compare the results from the main hip salvage techniques applied to these individuals. The literature search focused on studies that evaluated results from hip salvage surgery in cases of cerebral palsy, published from 1970 to 2011, which are present in the Embase, Medline, PubMed, Cochrane Library and SciELO databases. Although the results were not statistically comparable, this systematic review demonstrates that hip salvage surgery should be indicated after individual evaluation on each patient, due to the wide spectrum of presentations of cerebral palsy. Therefore, it seems that no surgical technique is superior to any other. Rather, there are different indications.

  9. [Sheehan's syndrome - case report and review]. (United States)

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


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

  10. Case report and review of literatures:

    Directory of Open Access Journals (Sweden)

    Megahed Mohamed Abdl Fatah


    Full Text Available Thoracic epidural anaesthesia for elective laparoscopic myomectomy is good alternative to general anaesthesia and seems to be effective technique, with minimal hemodynamic consequences and excellent patient satisfaction and no post-operative complications provided patient cooperation, minimal inflation pressure and mild table tilt. We present here one case of laparoscopic myomectomy under thoracic epidural anaesthesia in patient with relative contraindication to general anaesthesia.

  11. Biperiden Dependence: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fernando Espi Martinez


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

  12. Hydrogeologic Case Studies (Seattle, WA) (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  13. Nasopharyngeal Case-Control Study (United States)

    A case-control study conducted in Taiwan between 1991-1994 among approximately 1,000 individuals to examine the role of viral, environmental, and genetic factors associated with the development of nasopharyngeal carcinoma

  14. Case Studies in Strategic Planning (United States)


    Contains developed case studies in strategic planning on The Navy General Board, Joint Service War Planning 1919 to 1941, Navy Strategic Planning , Strategic Planning NPS-56-88-031-PR of September 1988. Strategic planning , Strategic Management.

  15. Case Study: del Amo Bioventing (United States)

    The attached presentation discusses the fundamentals of bioventing in the vadose zone. The basics of bioventing are presented. The experience to date with the del Amo Superfund Site is presented as a case study.

  16. Deep Venous Thrombosis with Pulmonary Embolism Related to IVIg Treatment: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Michael T. Flannery


    Full Text Available IVIg therapy has potentially been related to arterial and venous therapy. We performed an Ovid review focusing on IVIg and thrombotic events. While a few case reports were reviewed case series and case control studies were particularly reviewed in relation to thrombotic events. Outcomes demonstrate a correlation between underlying cardiovascular risk factors with predominately arterial events which typically occurred within 4–24 hours of infusion. While venous events occurred less commonly they were associated with traditional risk factors and occurred later, typically, 1–7 days following infusion of IVIg. Potential causation of thrombotic events was discussed.

  17. Applying a Health Network approach to translate evidence-informed policy into practice: A review and case study on musculoskeletal health

    Directory of Open Access Journals (Sweden)

    Briggs Andrew M


    Full Text Available Abstract Background While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA, disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. Case presentation A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs. The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by

  18. Personal attributes of authors and reviewers, social bias and the outcomes of peer review: a case study [v2; ref status: indexed,

    Directory of Open Access Journals (Sweden)

    Richard Walker


    Full Text Available Peer review is the "gold standard" for evaluating journal and conference papers, research proposals, on-going projects and university departments. However, it is widely believed that current systems are expensive, conservative and prone to various forms of bias. One form of bias identified in the literature is “social bias” linked to the personal attributes of authors and reviewers. To quantify the importance of this form of bias in modern peer review, we analyze three datasets providing information on the attributes of authors and reviewers and review outcomes: one from Frontiers - an open access publishing house with a novel interactive review process, and two from Spanish and international computer science conferences, which use traditional peer review. We use a random intercept model in which review outcome is the dependent variable, author and reviewer attributes are the independent variables and bias is defined by the interaction between author and reviewer attributes. We find no evidence of bias in terms of gender, or the language or prestige of author and reviewer institutions in any of the three datasets, but some weak evidence of regional bias in all three. Reviewer gender and the language and prestige of reviewer institutions appear to have little effect on review outcomes, but author gender, and the characteristics of author institutions have moderate to large effects. The methodology used cannot determine whether these are due to objective differences in scientific merit or entrenched biases shared by all reviewers.

  19. Meningeal melanocytoma: case report and literature review. (United States)

    Kraft Roverea, Rodrigo; Dagnonia, Carini; Gomes de Oliveiraa, Godofredo; Sapellia, Jaqueline


    We report a case of a 54-year-old female with progressive chronic pain in lower extremity, paraplegia and loss of function of the anal sphincter. MRI revealed an expansive solid intradural and intramedullar lesion located at the T6 to T9 levels. Histology of the lesion showed melanocytes with the results of immunohistochemistry consistent with a melanocytoma. Melanocytic tumors are rare tumors which present a diagnostic and management challenge for the modern neurosurgeon and neuro-oncologist since MRI and CT features are non-specific and there is scant data to standardise best strategic therapy.

  20. Grynfelt hernia: case report and literature review. (United States)

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


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

  1. Papilomatosis in dogs: literature review and study of twelve cases/ Papilomatose oral em cães: revisão da literatura e estudo de doze casos

    Directory of Open Access Journals (Sweden)

    Jane Megid


    Full Text Available Canine papillomatosis is an infectious viral disease characterized by oral, cutaneous or ocular papillomas, usually benign. The treatment is indicated in animals, with multiple tumors that produce pharyngeal obstruction, and problems of eating or for aesthetic reasons. Different treatment protocols have been proposed, including surgical excision, cryosurgery, electro surgery, autogenous or recombinant vaccines, imunomodulators drugs, systemic and intralesional chemotherapy. In this study were reviewed the more important aspects of canine oral papillomatosis. In the 12 studied animals, the papillomas were observed predominantly in mouth, gum and palate regions, in puppies until 12 months, presenting combined infection with ehrlichiosis. The treatment using Propionibacterium acnes and/or autogenous vaccine showed efficacy in eight dogs (66.7%.Papilomatose canina é uma enfermidade infecto-contagiosa viral caracterizada pela formação de papilomas orais, cutâneos ou oculares, geralmente benignos. O tratamento é indicado quando ocorre persistência dos tumores, lesões múltiplas causando obstrução faringeana, disfagia ou por razões estéticas. Diferentes protocolos de tratamento são descritos incluindo excisão cirúrgica, criocirurgia, eletrocirurgia, vacinas autógenas ou recombinantes, drogas imunomoduladoras, quimioterapia sistêmica ou intralesional. Foram revisados os principais aspectos clínico-epidemiológicos da papilomatose oral canina. Nos 12 animais estudados foram observados papilomas predominantemente em região de língua, gengiva e palato, com até 12 meses de idade e infecção combinada com erliquiose. O tratamento com Propionibacterium acnes e/ou vacina autócne surtiu efeito em oito animais (66,7%.

  2. The Role of Subtotal Petrosectomy in Cochlear Implant Surgery-A Report of 32 Cases and Review on Indications

    NARCIS (Netherlands)

    Free, Rolien H.; Falcioni, Maurizio; Di Trapani, Giuseppe; Giannuzzi, Anna Lisa; Russo, Alessandra; Sanna, Mario


    Objective: To report and review 32 cases of subtotal petrosectomy (SP) in cochlear implant (CI) surgery and to define the indications and contraindications for this procedure Study Design: Retrospective case review + case reports. Setting: Tertiary skull base center. Patients: Cochlear implant datab

  3. Cervical cerclage. A review of 74 cases. (United States)

    Schwartz, R P; Chatwani, A; Sullivan, P


    The records of seventy-four patients who had had cervical cerclage procedures were surveyed. Without suture placement, these patients would have had a fetal salvage rate of 23%. The Shirodkar method was performed in 67 cases and the McDonald in 7. Spontaneous abortions occurred in ten women (13.5%). Four pregnancies terminated between the 20th and 26th week of gestation; two of these losses were due to chorioamnionitis and two to immature labor. No congenital anomalies were noted. In the remaining 60 patients, 6 pregnancies terminated between the 28th and the 36th week of gestation, and 54 pregnancies were carried beyond the 36th week; all of these infants survived. The salvage rate after the cerclage procedure was 81.8%. The average length of labor in the patients who delivered vaginally was 9 hours, 18 minutes. The incidence of cervical lacerations was 3%. Eight cesarean sections were performed (13.3%) for various reasons.

  4. Opercular syndrome: A case report and review

    Directory of Open Access Journals (Sweden)

    Soaham Dilip Desai


    Full Text Available We present a 9-year-old boy with history of perinatal asphyxia and neonatal seizures; who presented with delayed development of speech, with predominant dysarthria, dysphagia, and drooling of saliva and unable to protrude tongue along with delayed motor and mental milestones. He had complex partial seizures since last 3 years requiring multiple anti-epileptic drugs. He had dysarthria, nasal twang, and drooling of saliva with difficulty in chewing and swallowing. Hearing and understanding were normal. Bilateral trigemino-facio-linguo-pharyngeal palsy was noticed on voluntary movements with normal jaw jerk with preserved automatic and emotional motor movements. Electroencephalography revealed focal left fronto-temporal epileptiform discharges and brain imaging was suggestive of bilateral cortical and subcortical region encephalomalacia, predominantly involving bilateral opercular region. The clinical and neuroimaging features correspond to bilateral opercular syndrome which could have resulted from the perinatal insult in this case.

  5. Cases of Trademark Examination Review and Adjudication

    Institute of Scientific and Technical Information of China (English)

    Cao Xinwei


    @@ Case of Reexamination of Rejection of Trademark "GE" On 20 December 2001, the US General Electric Company (GE) filed with the Trademark Office an application for regG Eistration of the trademark "GE"(see Fig.l) on goods in class 8 of the International Classification: hand tools, table cutlery (knives, forks and spoons), side arms other than firearms, fish forks. Upon examination, the Trademark Office, pursuant to Article 11, paragraph one (3) and Article 28 of the Trademark Law of the People's Republic of China, rejected, on 9 October 2002, the application for registration of said mark, and made no publication thereof on the grounds that "the trademark applied for registration was the combination of two letters of ordinary typeface, which was not distinctive, so should not be registered as a trademark".

  6. Ciliated Median Raphe Cyst of Perineum Presenting as Perianal Polyp: A Case Report with Immunohistochemical Study, Review of Literature, and Pathogenesis

    Directory of Open Access Journals (Sweden)

    Jayesh Sagar


    Full Text Available Median raphe cyst is a very rare, benign congenital lesion occurring mainly on the ventral aspect of the penis, but can develop anywhere in the midline between the external urethral meatus and anus. We report a case of median raphe cyst in the perineum presenting as a perianal polyp in a 65-year-old, English white male with exceptionally rare ciliated epithelium. According to our knowledge, this is the third such case of ciliated median raphe cyst in the English literature. This case, also the first case of ciliated median raphe cyst in the perineum location, focuses on pathogenesis of median raphe cyst.

  7. Pachydermodactyly: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Paravina Mirjana


    Full Text Available Pachydermodactyly is a rare, benign form of digital fibromatosis, characterized by asymptomatic and progressive, periarticular and usually symmetrical soft tissue finger swelling, specifically on the lateral aspects of the proximal interphalangeal joints mainly of the second, third, and fourth fingers; it mostly affects young adolescents and is probably due to repeated mechanical injury of the skin (such as repeated clasping or rubbing of crossed fingers, sometimes as a result of obsessive-compulsive disorder, which must be distinguished from obsessive “chewing pads”. This paper presents a male patient aged 19, who presented with first symptoms at the age of 12, and was diagnosed with periarticular hypertrophy: localized soft tissue thickening around the proximal interphalangeal joints of all fingers except the thumbs; slight hypertrophy of the skin; absence of subjective complaints; normal joint function. Dermatological status on admission revealed: symmetrical soft tissue swelling of all fingers of both hands except the thumbs at the level of the proximal interphalangeal joints; normal appearance of the distal parts of all fingers; thickening at the level of the proximal interphalangeal joints, bilateral, almost symmetrical hypertrophy (ulnar and radial of phalanges of the affected fingers except both index fingers, affecting only the ulnar side. The skin lesions were pain-free on palpation, with homogeneous texture and elastic consistency, freely movable over underlying structures. The affected joints showed no functional deficit. The test results, sonography, radiography and histopathology confirmed our clinical diagnosis-pachydermodactyly. The review of the currently available literature, published between 1973 and 2014, including 99 papers and 160 patients, provided important insight into the characteristics and variations of the disease.

  8. Unilateral lumbosacral dislocation: case report and a comprehensive review. (United States)

    Grivas, Theodoros B; Papadakis, Stamatios A; Katsiva, Vassiliki; Koufopoulos, George; Mouzakis, Vassilios


    Lumbosacral fracture-dislocation is a rare occurrence. There are more than 73 cases reported in the English literature. We report on the imaging findings and surgical treatment in a patient suffered of unilateral traumatic L5-S1 dislocation associated with severe disruption of the posterior ligamentous complex. The patient underwent open reduction and stabilization of L4-S1 vertebrae with posterior instrumentation system. Open reduction and internal fixation was mandatory as post-traumatic ligamentous insufficiency would lead to abnormal motion. Operative treatment managed to produce a solid arthrodesis and restore stability of the lumbosacral junction. Follow-up revealed excellent results. This study reports a rare injury of the lumbosacral junction, and the literature concerning this unusual condition is extensively reviewed.

  9. Vascular hemichorea: case report and review

    Directory of Open Access Journals (Sweden)

    Bárbara Martínez Alfonzo


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

  10. Emphysematous osteomyelitis: a case report and review of the literature. (United States)

    Luey, Christopher; Tooley, Debbie; Briggs, Simon


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

  11. Symptomatic cluster headache: a review of 63 cases. (United States)

    Edvardsson, Bengt


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

  12. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund


    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  13. Case Study on Logistics Performance

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian


    Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

  14. The case of #arseniclife: Blogs and Twitter in informal peer review. (United States)

    Yeo, Sara K; Liang, Xuan; Brossard, Dominique; Rose, Kathleen M; Korzekwa, Kaine; Scheufele, Dietram A; Xenos, Michael A


    Using the "#arseniclife" controversy as a case study, we examine the roles of blogs and Twitter in post-publication review. The controversy was initiated by a scientific article about bacteria able to substitute arsenic for phosphorus in its genetic material. We present the debate chronologically, using prominent online media to reconstruct the events. Using tweets that discussed the controversy, we conducted quantitative sentiment analysis to examine skeptical and non-skeptical tones on Twitter. Critiques of and studies refuting the arsenic life hypothesis were publicized on blogs before formal publication in traditional academic spaces and were shared on Twitter, influencing issue salience among a range of audiences. This case exemplifies the role of new media in informal post-publication peer review, which can complement traditional peer review processes. The implications drawn from this case study for future conduct and transparency of both formal and informal peer review are discussed.

  15. Cotton expansion and biodiversity loss in African savannahs, opportunities and challenges for conservation agriculture: a review paper based on two case studies

    NARCIS (Netherlands)

    Baudron, F.; Corbeels, M.; Monicat, F.; Giller, K.E.


    We review agricultural impacts on biodiversity and the potential of conservation agriculture in developing productive and environment-friendly cropping systems. We then analyse experiences from two African landscapes of global importance for conservation: the Mid Zambezi Valley in Southern Africa an

  16. Nonverbal Communication, Music Therapy, and Autism: A Review of Literature and Case Example (United States)

    Silverman, Michael J.


    This article presents a review of nonverbal literature relating to therapy, music, autism, and music therapy. Included is a case study of a woman with autism who was nonverbal. The case highlights and analyzes behaviors contextually. Interpretations of communication through the music therapy, musical interactions, and the rapport that developed…

  17. Teaching Case: Enterprise Architecture Specification Case Study (United States)

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy


    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  18. Intracranial arachnoid cyst (review of 20 cases

    Directory of Open Access Journals (Sweden)

    Alireza Birjandi


    Full Text Available Introduction: The purpose of this study is to evaluate the distribution, clinical features, and treatment modalities of arachnoid cyst in our department. The study was carried out between April 1, 1996 and October 1, 2006 at the neurosurgery department, Ghaem hospital, Mashhad university of medical sciences. Material and Methods: Twenty patients with arachnoid cyst underwent surgery between April 1, 1996 until October 1, 2006, consisting of 12 males and 8 females ranging in age 5 to 68 years (mean age 32.4 years. Twelve patients underwent surgery and one patient underwent endoscopic fenestration, and cystoperitoneal shunting (medium pressure was performed in 7 patients. All patients were followed for minimum of 6 months after surgery. Results: During the study period, 20 patients were investigated. The cysts had strong predilection for the middle cranial fossa in 12 patients (60%, suprasellar region in 1 patient (5%, the cerebral convexity in 1 patient (5%, posterior cranial fossa in 2 patients (10%, cerebellopontine angle in 3 patients (15%, quadrigeminal cisterns in 1 patient (5%. All of 20 cysts had clearly unilateral distribution, 12 (60% were located on the left side and 8 (40% on the right side. The most common symptoms on presentation were epileptic seizures (46%, increased intracranial pressure (34%, visual impairment (5%, headache (10%, cerebellar sign (5%. Conclusion: Arachnoid cysts have a strong predilection for the middle cranial fossa that may be explained by a meningeal maldevelopment theory. We also conclude that the major indication for surgery in patients with arachnoid cyst is the presence of intractable seizures, increased intracranial pressure, and compression of neuronal tissues. Headache only is not a surgical indication.    

  19. A case report of recurrent anencephaly and literature review. (United States)

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


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

  20. Orbital Myositis Complicating Sinusitis: Case Report and Review

    Directory of Open Access Journals (Sweden)

    Joe S Dylewski


    Full Text Available Orbital myositis is a common cause of extraocular muscle enlargement. It is characterized by nonspecific inflammation of one or more extraocular muscles. Although often idiopathic in origin, orbital myositis has been associated with various noninfectious diseases. Several cases have also been reported as occurring after upper respiratory tract infections. The present report describes a case of orbital myositis together with subclinical sinusitis and its rapid resolution after antibiotic treatment. The literature on this clinical entity is also reviewed.

  1. Emerging pathogen: a case and review of Raoultella planticola. (United States)

    Ershadi, A; Weiss, E; Verduzco, E; Chia, D; Sadigh, M


    Raoultella planticola has been considered a relatively harmless Gram-negative bacteria, rarely associated with clinical infection. However, in recent years, the frequency at which severe infection by R. planticola and drug-resistant strains are reported in literature has increased. Here, we present one case of acute cholecystitis caused by R. planticola, and review all previously reported cases of the infection in an attempt to identify new trends in biological and clinical features of R. planticola infections.

  2. Orbitofrontal epilepsy: Electroclinical analysis of surgical cases and literature review


    Smith, Joseph R.; Sillay, Karl; Winkler, Peter; King, Don W.; Loring, David W.


    Clinical and electrographic data were reviewed on 2 of our patients with orbitofrontal epilepsy who were seizure free at 5-year follow-up, and on 2 similar patients from the literature. One of our patients was lesional, and the other was nonlesional. Interictal EEG discharges were lateralized to the side of invasively recorded orbitofrontal seizures in the nonlesional case. In this case, no clinical manifestations occurred until the orbitofrontal discharge had spread to the opposite orbitofro...

  3. Examining End-of-Life Case Management: Systematic Review

    Directory of Open Access Journals (Sweden)

    Roger E. Thomas


    Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

  4. -251 T/A polymorphism of the interleukin-8 gene and cancer risk: a HuGE review and meta-analysis based on 42 case-control studies. (United States)

    Wang, Na; Zhou, Rongmiao; Wang, Chunmei; Guo, Xiaoqing; Chen, Zhifeng; Yang, Shan; Li, Yan


    The -251T/A (rs4073), a single nucleotide polymorphism, has been identified in the promoter region of the interleukin-8 (IL-8) gene. It's presence could influence the production of IL-8 protein by regulating the transcriptional activity of the gene. A large number of studies have been performed to evaluate the role of -251T/A polymorphism on various cancers, with inconsistent results being reported. In this paper, we summarized 13,189 cases and 16,828 controls from 42 case-control studies and attempted to assess the susceptibility of -251T/A polymorphism to cancers by a comprehensive meta-analysis. Pooled odds ratios and 95% confidence intervals were calculated by using the random-effects model. Publication bias, subgroup, and sensitivity analysis were also performed. Results showed that the carriers of the -251A allele had about a 12-21% increased risk for the reviewed cancer, in total. The carriers of -251A had an elevated risk to breast cancer, gastric cancer and nasopharyngeal cancer and a reduced risk to prostate cancer, but no evidence was found to indicate that the -251A allele predisposed its carriers to colorectal and lung cancers. When stratified separately by 'racial descent' and 'study design', it was found that the carriers of the -251A allele among the African group, Asian group and hospital-based case-control study group were at a higher risk for cancer, but not in European group and population-based case-control study. These results show that -251A allele is susceptible in the development of low-penetrance cancers.

  5. Trombose de seios venosos cerebrais: Estudo de 15 casos e revisão de literatura Cerebral venous thrombosis: Study of fifteen cases and review of literature

    Directory of Open Access Journals (Sweden)

    Paulo Pereira Christo


    Full Text Available OBJETIVO: Analisar uma série de 15 pacientes com trombose venosa cerebral (TVC e comparar os resultados com dados da literatura. MÉTODOS: Foram avaliados, por meio de estudo retrospectivo, transversal e descritivo, as características epidemiológicas, o quadro clínico, os fatores de risco e o prognóstico de 15 pacientes com TVC admitidos no serviço de Neurologia da Santa Casa de Belo Horizonte no período de abril de 2007 a Dezembro de 2008. RESULTADOS: O diagnóstico de TVC foi confirmado por exame de ressonância nuclear magnética de encéfalo em 14 casos e por angiografia cerebral em um caso. Os principais fatores de risco identificados foram o uso do anticoncepcional oral (40% e uma história prévia ou familiar de trombose venosa profunda. Trombofilia foi encontrada em dois pacientes (13%. O seio mais acometido foi o transverso (73%, seguido pelo sagital superior, em 53%. Quatro pacientes apresentaram acidente vascular cerebral e outros 5 apresentaram-se apenas com cefaleia isolada. Doze pacientes foram tratados com heparina e anticoagulação oral sequencial. CONCLUSÃO: A terapêutica com heparina na fase aguda seguida do anticoagulante oral demonstrou-se segura e eficaz na prevenção da progressão da doença, de sua recidiva e na rápida recuperação do quadro neurológico de todos os pacientes tratados. A TVC deve ser considerada no diagnóstico de cefaleia secundária mesmo em pacientes com ausência de outros sinais ou sintomas.OBJECTIVE: To analyze a series of 15 patients with cerebral venous thrombosis (CVT who had follow-ups at the neurology service of Santa Casa de Belo Horizonte Hospital from April, 2007 to December, 2008. These results were compared with data in literature. METHODS: Cases were evaluated by retrospective study of the epidemiologic characteristics, signs and symptoms, risk factors and prognosis of 15 patients with cerebral venous thrombosis. RESULTS: Diagnoses were reached through magnetic resonance


    Directory of Open Access Journals (Sweden)

    Piyush HEDA


    Full Text Available Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed intense interest for the treatment of facial deformities, being widely practiced throughout the world. Orthognathic surgery has become an acceptable treatment plan for patients with various maxillofacial deformities, giving pleasing results. The present study reports the successful treatment method of Class II division 1 malocclusion through orthognathic surgery.

  7. [Pelvic actinomycosis in menopausal patient, case review]. (United States)

    Treviño Salinas, Emilio Modesto; Martínez Palones, José María; Pérez Benavente, Ma Asunción; Xercavins Montosa, Jordi


    Pelvic actinomycosis is a granulomatous chronic illness due to anaerobic, gram-positive, branching filamentous bacteria (Actinomyces israelii), this and other species of actinomyces occur in the normal flora of the gastrointestinal and genital tract in humans. Infection is associated in women using an IUD (Intrauterine device) for long periods and it has the characteristic of simulate malignant diseases causing most of the times wrong preoperative diagnosis. We analyzed a postmenopausal patient who was treated surgically without specific diagnosis, then by anatomo-pathologic study of the specimen the result was actinomycosis. The main purpose to obtain the correct preoperative diagnosis is because we have to use antibiotics in the treatment and it may reduce the frequency of radical surgeries.

  8. Femoral hernia: a review of 83 cases. (United States)

    Alimoglu, O; Kaya, B; Okan, I; Dasiran, F; Guzey, D; Bas, G; Sahin, M


    We evaluate the factors that affect morbidity and mortality in patients who underwent surgery due to femoral hernia. The medical records of 83 patients who underwent femoral hernia repair between January 1996 and June 2004 were retrospectively analyzed. The femoral hernias were repaired either with McVay or mesh plug hernioplasty. Sex, age, surgical repair technique, presence of incarceration/strangulation, incarcerated/strangulated organs, postoperative complications, duration of hospitalization, recurrence rate, and factors that affect mortality and morbidity were studied. There were 83 patients with femoral hernia in our study. Patients' age ranged from 10 to 75 years (mean age was 46.84) with a predominance of female (71%). Thirty-six patients (40%) underwent emergency surgery with the diagnosis of strangulation or incarceration of femoral hernia. Seventeen patients had strangulation and underwent resection; eleven of these patients had omentum in the hernial sac, whereas six patients had intestines. Four of these patients underwent laparotomy. The remaining 19 patients had incarceration and underwent simple reduction of hernial sac content without resection. Forty-seven (60%) patients underwent elective surgery. McVay technique was used for 79 patients, while the other four patients were treated with mesh-plug. Twelve patients (15%) developed a variety of complications (nine patients (25%) in emergency, three patients (6%) in elective group). There was one mortality. Recurrences occurred in two patients. Femoral hernia is an important surgical pathology with high rates of incarceration/strangulation and intestinal resection. Emergency surgery can increase morbidity and mortality especially in the elderly. Early elective surgery may reduce complication.

  9. Paget's disease of the vulva: A review of 89 cases

    Directory of Open Access Journals (Sweden)

    Cherry O. Onaiwu


    Full Text Available The purpose of this study was to retrospectively review the clinical characteristics and outcomes of a series of women with Paget's disease of the vulva. A retrospective review was performed of 89 women with Paget's disease of the vulva evaluated at a single institution between 1966 and 2010. Medical records were reviewed for demographic information, clinical data, pathologic findings, treatment modalities and outcomes. We found that the primary treatment was surgery for 74 (83.1% patients, with positive margins noted in 70.1% of cases. Five patients (5.6% underwent topical treatment with imiquimod and/or 5-fluorouracil, one patient (1.1% underwent laser ablation and treatment was unknown in 9 patients (10.1%. The majority of patients had multiple recurrences, with 18% having four or more recurrences. There were no significant differences in recurrence rates between patients who underwent surgery and those who did not. Furthermore, there was no association between positive margins following primary surgery and recurrence. Forty-one patients (46.1% were diagnosed with 53 synchronous or metachronous cancers. Seven patients (7.9% were found to have invasive vulvar cancer with 1 mm or more depth of invasion, but none of the patients died of Paget's disease or associated vulvar/vaginal cancer. Our findings suggest that the majority of patients with Paget's disease of the vulva develop multiple recurrences regardless of treatment modality or margin status. Alternatives to surgery are needed to better care for women with this disease.

  10. Hungarian Librarianship in Transition: An Academic Case Study. (United States)

    Koltay, Zsuzsa; Parmer, Coleen

    This case study of the Kossuth Lajos Tudomanyeyetem, an academic library in Debrecen (Hungary), conducted in May 1992, describes its functioning and needs. Information gathered through a series of interviews, tours, library reports, and a review of relevant literature forms the basis for the case study. An overview of the library in its historical…

  11. Chronic multifocal neuropathy with persistent conduction block (Lewis-Sumner syndrome). A clinico-morphologic study of two further cases with review of the literature. (United States)

    Gibbels, E; Behse, F; Kentenich, M; Haupt, W F


    We present data of 2 patients suffering from chronic motor-sensory multifocal neuropathy with persistent conduction block. The first case concerns a 9-year follow-up of a female, aged 24 years at onset with persistent multiple conduction blocks and a tendency towards generalization of clinical deficits. Eight years after onset sural nerve biopsy revealed extreme interfascicular variations of de/remyelination, onion bulb formation, fiber loss, edema, and proliferation of basal lamina of endoneurial capillaries. Serum antibodies against GM1 gangliosides were not detected. The second case, a 29-year-old Yemenitic male with a 5-year history, exhibited conduction blocks in motor and sensory fibers, and a normal sural nerve biopsy. Our results are discussed with respect to those of some 30 cases individually reported in the literature.

  12. The Case Study of Frank (United States)

    Eynde, Peter Op't; Hannula, Markku S.


    As a unifying feature of this Special Issue, we have asked proponents of each framework to analyse an empirical classroom account of one student's process of solving a mathematical problem. Here, for the case study of "Frank", we give the main data that were available to all authors.

  13. Case Studies in Sports Nutrition. (United States)

    Clark, Nancy


    This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)

  14. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris


    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  15. Overview of the Case Studies

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul


    A series of case studies are used to illustrate many of the underlying modelling principles within the book. To facilitate this, the ICAS-MoT modelling tool has been used. A wide range of application areas have been chosen to ensure that the principal concepts of effective and efficient modelling...

  16. Equatorial jet - a case study

    Digital Repository Service at National Institute of Oceanography (India)

    Muraleedharan, P.M.; PrasannaKumar, S.

    Detailed EOF analysis of wind data reportEd. by Wunsch over Gan (00 degrees 41'S; 73 degrees 10'E) is made for the period 1963-70. The year 1964, which exhibited least variability from mean wind structure, has been chosen for the case study. EOF...

  17. Lumboperitoneal shunts: Review of 409 cases

    Directory of Open Access Journals (Sweden)

    Yadav Y


    Full Text Available BACKGROUND AND AIMS: A prospective study was carried out to evaluate the lumboperitoneal shunt procedure. MATERIAL AND METHODS: Four hundred and nine patients having communicating hydrocephalus were selected for the procedure during a 10-year period from March 1992 to February 2002. The average follow-up was 45.34 months. RESULTS: Tubercular meningitis (TBM-related hydrocephalus was detected in 285 patients. Forty per cent of the patients were less than 15 years of age. Glasgow Coma Scale (GCS of less than 8 was seen in 40% patients and 14.9% patients were in GCS 13-15. At the time of discharge 56.7% patients improved in their GCS to 13 -15 and 14.9% were in GCS 8 or less. The overall mortality was 5.13% and shunt-related mortality was seen in 2% patients. Shunt malfunction requiring revision was seen in 32 patients (7.8% and the total number of shunt revisions was 44 (11%. Shunt infection was noted in 3.4% patients. CSF leak at the lumbar end occurred in 12 patients. Four patients required conversion of LP shunt to VP shunt. CONCLUSIONS: Lumboperitoneal shunt is an effective shunting procedure in communicating hydrocephalus.

  18. Primary cutaneous myoepithelial carcinoma: a case report and review of the literature. (United States)

    Frost, Markus Winther; Steiniche, Torben; Damsgaard, Tine Engberg; Stolle, Lars Bjørn


    This study describes a case of primary myoepithelial carcinoma of the skin and reviews the available literature on this topic. Myoepitheliomas and carcinomas arise most frequently from myoepithelial cells within the salivary glands but are found in many anatomical locations. We documented a case of an 80-year-old man with a 2 × 2 × 1 cm tumour located on the scalp. This tumour emerged over a period of 2 months. The tumour was radically excised, and histological examination revealed a cutaneous myoepithelial carcinoma. At an 18-month follow-up, no recurrence of the tumour was found. A systematic literature search identified 23 papers that reported 58 cases of cutaneous myoepitheliomas and myoepithelial carcinomas. All cases are reviewed in the presented paper. This case report and literature review serves to increase awareness regarding myoepithelial carcinomas. These tumours exhibit high metastatic potential, and it is thus very important to perform radical surgery.

  19. "Burn catatonia": a case report and literature review. (United States)

    Quinn, Davin Kenneth


    Thermal injuries have been recognized to cause significant neuropsychiatric symptoms and disability in their sufferers since the middle of the 20th century, when Drs. Stanley Cobb and Erich Lindemann of the Massachusetts General Hospital (Boston, MA) studied survivors of the Cocoanut Grove nightclub fire in Boston. Although "burn encephalopathy" or burn-induced delirium is a common occurrence in the acute phase, catatonia in burn patients is not often reported. This report describes a case of malignant catatonia occurring in a 51-year-old male patient acutely suffering from burns acquired in a chemical explosion, effectively treated with reinstitution of a selective serotonin reuptake inhibitor. The literature on burn encephalopathy and catatonia in burns is reviewed. Few examples of burn catatonia exist. Burn encephalopathy is common, and may occur in patients with low TBSA burns such as described in the case above. Descriptions of burn encephalopathy are numerous, but have not included catatonia as a possible etiology. Catatonia in burn patients as an etiology of burn encephalopathy is likely underrecognized. Clinicians should be aware of the possibility of catatonia when a patient's confusional state after a burn does not respond to usual care.

  20. Twenty-three Years of Evolving "State-of-the-Art" CORK Borehole Geophysical Monitoring: A Review of Technologies and Case Studies (United States)

    Davis, E. E.; Becker, K.; Meldrum, R.; Heesemann, M.; Villinger, H. W.; Kinoshita, M.; Paros, J. M.; Inderbitzen, K. E.


    The first successful attempt to instrument an Ocean Drilling Program borehole for formation pressure and temperature monitoring and fluid sampling was accomplished in 1991 in Hole 857D, and the system there has been in nearly continuous operation since that time. This hole and others that followed have provided many new insights into ocean crustal and subduction zone hydrogeology and geodynamics, while at the same time being the "proving ground" for a number of technological advances in ocean borehole monitoring, including 1) the CORK scheme itself for sealing holes for hydrologic recovery to natural-state conditions after drilling; 2) the use of absolute pressure sensors for monitoring both relative formation pressures and changes in seafloor depth; 3) multi-level completions for pressure monitoring that leave cased borehole interiors open for other instrumentation; 4) the development of ultra-high-precision, low-power digital recording systems for examining the effects on the formation of seismic and microseismic loading; and 5) the proof-of-concept of an optical communications system that eliminates dependence on submersibles or ROVs for data download operations (see Tivey et al., this session). Relatively low-sample-rate data spanning the first part of the more than two decades of operations have shown how large anomalous pressures generated thermally and by deformation can be; how seafloor tidal loading influences formation pressure and can drive an "a.c." component of flow; and how seismogenic and slow strain can be observed by way of formation-fluid pressure transients. More recent instrumentation has allowed much higher fidelity observations (1 Hz sampling at a resolution of 10-8 of full-scale), and thus is permitting complementary studies of hydrologic, oceanographic, seismic, and microseismic phenomena. Plans for the future include connections to shore via observatory cable systems, such as those of NEPTUNE Canada and DONET, for unlimited power supply and

  1. 42 CFR 431.816 - Case review completion deadlines and submittal of reports. (United States)


    ... ADMINISTRATION Quality Control Medicaid Eligibility Quality Control (meqc) Program § 431.816 Case review... of the total reviews; within 125 days of the end of the review month for which those cases were reviewed for 95 percent of the total reviews; and within 150 days of the end of the review month for...

  2. Treatment of Klebsiella Pneumoniae Carbapenemase (KPC infections: a review of published case series and case reports

    Directory of Open Access Journals (Sweden)

    Lee Grace C


    Full Text Available Abstract The emergence of Klebsiella pneumoniae carbapenemases (KPCs producing bacteria has become a significant global public health challenge while the optimal treatment remains undefined. We performed a systematic review of published studies and reports of treatment outcomes of KPC infections using MEDLINE (2001–2011. Articles or cases were excluded if one of the following was fulfilled: no individual patient data provided, no treatment regimen specified, no treatment outcome specified, report of colonization, or greater than three antibiotics were used to treat the KPC infection. Data extracted included patient demographics, site of infection, organism, KPC subtype, antimicrobial therapy directed at KPC-infection, and treatment outcome. Statistical analysis was performed in an exploratory manner. A total of 38 articles comprising 105 cases were included in the analysis. The majority of infections were due to K. pneumoniae (89%. The most common site of infection was blood (52%, followed by respiratory (30%, and urine (10%. Forty-nine (47% cases received monotherapy and 56 (53% cases received combination therapy directed at the KPC-infection. Significantly more treatment failures were seen in cases that received monotherapy compared to cases who received combination therapy (49% vs 25%; p= 0.01. Respiratory infections were associated with higher rates of treatment failure with monotherapy compared to combination therapy (67% vs 29% p= 0.03. Polymyxin monotherapy was associated with higher treatment failure rates compared to polymyxin-based combination therapy (73% vs 29%; p= 0.02; similarly, higher treatment failure rates were seen with carbapenem monotherapy compared to carbapenem-based combination therapy (60% vs 26%; p= 0.03. Overall treatment failure rates were not significantly different in the three most common antibiotic-class combinations: polymyxin plus carbapenem, polymyxin plus tigecycline, polymyxin plus aminoglycoside (30%, 29

  3. Multi-reader multi-case studies using the area under the receiver operator characteristic curve as a measure of diagnostic accuracy: systematic review with a focus on quality of data reporting.

    Directory of Open Access Journals (Sweden)

    Thaworn Dendumrongsup

    Full Text Available We examined the design, analysis and reporting in multi-reader multi-case (MRMC research studies using the area under the receiver-operating curve (ROC AUC as a measure of diagnostic performance.We performed a systematic literature review from 2005 to 2013 inclusive to identify a minimum 50 studies. Articles of diagnostic test accuracy in humans were identified via their citation of key methodological articles dealing with MRMC ROC AUC. Two researchers in consensus then extracted information from primary articles relating to study characteristics and design, methods for reporting study outcomes, model fitting, model assumptions, presentation of results, and interpretation of findings. Results were summarized and presented with a descriptive analysis.Sixty-four full papers were retrieved from 475 identified citations and ultimately 49 articles describing 51 studies were reviewed and extracted. Radiological imaging was the index test in all. Most studies focused on lesion detection vs. characterization and used less than 10 readers. Only 6 (12% studies trained readers in advance to use the confidence scale used to build the ROC curve. Overall, description of confidence scores, the ROC curve and its analysis was often incomplete. For example, 21 (41% studies presented no ROC curve and only 3 (6% described the distribution of confidence scores. Of 30 studies presenting curves, only 4 (13% presented the data points underlying the curve, thereby allowing assessment of extrapolation. The mean change in AUC was 0.05 (-0.05 to 0.28. Non-significant change in AUC was attributed to underpowering rather than the diagnostic test failing to improve diagnostic accuracy.Data reporting in MRMC studies using ROC AUC as an outcome measure is frequently incomplete, hampering understanding of methods and the reliability of results and study conclusions. Authors using this analysis should be encouraged to provide a full description of their methods and results.

  4. Calciphylaxis following acute renal injury: a case and literature review


    Oda, Tomoko; Sawada, Yu; YAMAGUCHI, TAKASHI; Ohmori, Shun; Omoto, Daisuke; Haruyama, Sanehito; Yoshioka, Manabu; Okada, Etsuko; Nakamura, Motonobu


    Background Calciphylaxis following acute renal failure is rare. Findings We report A 57-year-old male with an acute renal failure associated with necrotizing fasciitis. We also review the cases of calciphylaxis due to acute renal disorder further. Conclusions It should be kept in mind that calciphylaxis is observed in patient with not only chronic renal disease but also acute renal failure.

  5. Sigmoid volvulus: A pediatric case report and review of management

    Directory of Open Access Journals (Sweden)

    Lena M. O'Keefe


    Full Text Available Volvulus in the pediatric population commonly occurs in the small bowel associated with malrotation or internal hernia whereas sigmoid volvulus (SV is extremely rare. Herein we report a case of SV, review the literature and provide a suggested algorithm for diagnosis and management.

  6. Glossopharyngeal schwannoma : a case report and review of literature.

    Directory of Open Access Journals (Sweden)

    Gupta V


    Full Text Available We report a rare case of glossopharyngeal schwannoma whose clinical presentation and the radiological work up suggested an acoustic schwannoma. The diagnosis was made at surgery, once attachment to ninth cranial nerve was seen. The clinical presentation, radiological features and surgical findings of the glossopharyngeal schwannoma are presented along with the review of literature.

  7. Painful Ejaculation with Cyclobenzaprine: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Molly B. Kraus, MD


    Conclusion: Painful ejaculation is likely an underreported side effect of tricyclic antidepressants and cyclobenzaprine use. Fortunately, these symptoms are reversible and discontinuation of these medications is typically an effective cure. Kraus MB, Wie CS, Gorlin AW, Wisenbaugh ES, and Rosenfeld DM. Painful ejaculation with cyclobenzaprine: A case report and literature review. Sex Med 2015;3:343–345.

  8. Cleidocranial dysplasia: Report of 4 cases and review

    Directory of Open Access Journals (Sweden)

    Virender Gombra


    Full Text Available Patients with cleidocranial dysplasia commonly present with significant dental problems such as retention of multiple deciduous teeth, impaction or delay in eruption of permanent teeth and often, the presence of supernumerary teeth. We report 4 cases of 2 families presenting with cleidocranial dysplasia disorder with their clinical and radiological diagnosis and illustrating its pathogenesis and various treatment modalities, review of literatures.

  9. Spontaneous coronary artery dissection. Case report and literature review

    DEFF Research Database (Denmark)

    Elming, H; Køber, L


    descending artery (LAD). Her condition stabilized during treatment with intravenous heparin, aspirin, nitrates, beta-blockers, digoxin, ACE inhibitor and anticoagulants. At discharge she had no symptoms of heart failure. One hundred and forty one cases from the literature are reviewed with special reference...

  10. Splenic Vein Leiomyosarcoma: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Damiano Patrono


    Full Text Available Context Primary venous leiomyosarcoma (LMS is a rare disease, most commonly affecting the retroperitoneal veins and in particular the inferior vena cava. Five-year survival rate ranges between 33% and 68%. Case Report Complete surgical resection represents the only potentially curative treatment, occasionally achieving long-term survival. LMS of the splenic vein is extremely rare, with only three cases reported in the literature. Conclusion We report a case of primary venous LMS arising from the splenic vein and we briefly review the relevant literature.

  11. Does asymptomatic septal agenesis exist? A review of 34 cases

    Energy Technology Data Exchange (ETDEWEB)

    Belhocine, Ouardia; Andre, Christine; Kalifa, Gabriel; Adamsbaum, Catherine [St Vincent de Paul Hospital, Radiology Department, Paris (France)


    Primary septal agenesis (PSA) is a rare brain malformation that can be isolated or part of developmental brain abnormalities (holoprosencephaly, septo-optic dysplasia or cortical malformation). Such associated malformation can be subtle, leading to difficulties in the prenatal management of PSA. Moreover, the neurological prognosis of isolated PSA remains debatable. The aims of the study were to specify the patterns and frequency of brain malformations associated with septal agenesis (SA), to identify the clinical prognosis, and to discuss the aetiology of PSA with the new insights provided by molecular genetics. The study consisted of a 14-year retrospective review of brain MRI in 34 patients having PSA (mean age, 5 years). Chiasm and optic nerves were not evaluated. Post-hydrocephalus SA or incomplete data were excluded. The clinical data were correlated to the MRI patterns. The study disclosed 82.5% associated lesions with MRI (28/34): 11 neuronal migration disorders, 9 holoprosencephalies (HP), 7 pituitary stalk interruptions, 1 corpus callosum partial agenesis; 17.5% (6/34) of cases were apparently isolated PAS. Clinically, the patients had motor dysfunction in 68% (23/34), mental retardation in 65% (22/34), blindness in 24% (8/34), endocrinological defects in 21% (7/34) and epilepsy in 18% (6/34) of cases. Nine percent of patients (3/34) were neurologically normal (including one with scoliosis and two infants younger than 2 years at the last follow-up). Patients with bilateral cortical anomalies and HP (even if mild) had the worst neurological prognosis. A severe motor impairment was present without evidence of hemispheric anomaly in 12% of patients (4/34). Interestingly, the frontal lobes were involved in 90% of cortical anomalies and HP, supporting the malformative aetiology of PSA. PSA rarely appears isolated and severe psychomotor impairment may occur in apparently isolated forms. These unfavourable results should be highlighted and need to be confirmed

  12. Skeletal metastasis of carcinoid tumors: Two case reports and review of the literature




    Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Skeletal metastases from carcinoid tumors are considered to be extremely rare. In this study, we present two cases of carcinoid tumors that metastasized to the bone. Furthermore, we review 50 published case reports and reveal the features of skeletal metastasis of carcinoid tumors. The first case involved a 59-year-old man with a history of multiple metastases of a lung carcinoid tumor. The patient complained o...

  13. Exertional rhabdomyolysis after spinning: case series and review of the literature. (United States)

    Ramme, Austin J; Vira, Shaleen; Alaia, Michael J; VAN DE Leuv, Jonathan; Rothberg, Robert C


    Spinning is a popular indoor stationary cycling program that uses group classes as a motivational tool. Exertional rhabdomyolysis (ER) is frequently reported in athletes and military recruits; however, infrequently it has been reported after spinning class. ER is diagnosed by clinical history, physical exam, and laboratory values. Hydration, electrolyte management, and pain control are key components to treatment of this condition. Severe cases can be complicated by acute renal failure, compartment syndrome, arrhythmia, and disseminated intravascular coagulation. We describe three cases of admission due to rhabdomyolysis after spinning. The diagnosis, admission criteria, and medical treatment of ER are presented in the context of a literature review. A retrospective review of three cases with review of the current literature. The medical and laboratory records of three patient cases were reviewed. A search of the PubMed database was used to perform a comprehensive review of exertional rhabdomyolysis. Our institution's IRB reviewed this study. We report three cases of exertional rhabdomyolysis after spinning and describe the diagnostic workup and medical management of these patients. The diagnosis of ER is made by clinical history, physical exam, and laboratory values. The disease spectrum ranges from mild to severe with the potential of serious complications in some patients. We demonstrate three cases of ER in deconditioned individuals who presented to the emergency department for evaluation. Careful medical management and patient monitoring resulted in improved patient symptomatology and eventual return to physical activity.

  14. (Re)Viewing a Review: A Case History of the "Review of Educational Research." (United States)

    Grant, Carl A.; Graue, Elizabeth


    Examined work that appeared in the "Review of Educational Research" (RER) since its first volume to explore the ways that educational issues and educational research found their ways into the journal and to consider what a review really is. Identifies three periods in the history of RER and shows changes in the review genre over time.…

  15. Sacral Stress Fracture Mimicking Lumbar Radiculopathy in a Mounted Police Officer: Case Report and Literature Review. (United States)

    Bednar, Drew A; Almansoori, Khaled


    Study Design Case report and review of the literature. Objective To present a unique case of L5 radiculopathy caused by a sacral stress fracture without neurologic compression. Methods We present our case and its clinical evolution and review the available literature on similar pathologies. Results Relief of the unusual mechanical loading causing sacral stress fracture led to rapid resolution of radiculopathy. Conclusion L5 radiculopathy can be caused by a sacral stress fracture and can be relieved by simple mechanical treatment of the fracture.

  16. Responding to the Increased Needs of College Students: A Case Study of Case Management (United States)

    Shelesky, Kristin; Weatherford, Ryan D.; Silbert, Janelle


    The psychological needs of college students lead to overwhelming demand on college counseling centers' resources. In this article, we review models of case management in Higher Education including the administrative, behavioral intervention, and counseling center models. We also present a case study of the 3-year development of a counseling center…

  17. Concomitant septic arthritis and tophaceous gout of the knee managed with intermittent closed joint irrigation combined with negative pressure therapy: a case study and literature review. (United States)

    V N, Panicker; J K, Turner; M J, Chehade


    Tophaceous gout complicated by septic arthritis presents a management dilemma which can often require multiple surgical debridements. There is little published in the literature regarding treatment of these concomitant conditions. We postulate that biofilm may play a role increasing the difficulty of sterilising a tophaceous joint. The use of topical negative pressure therapy that targets biofilm has been well established for a range of wounds. A new device that incorporates both intermittent negative pressure therapy and wound irrigation was introduced in 2012. This case report describes the use of this topical negative device with the instillation option in the management of severe septic arthritis with concomitant gout and suggests directions for further research.

  18. Refeeding syndrome or refeeding hypophosphatemia: a systematic review of cases. (United States)

    Skipper, Annalynn


    Nutrition support clinicians refer to the abnormalities in laboratory data and changes in clinical signs and symptoms that follow refeeding of starved or malnourished patients as refeeding syndrome. Theoretical descriptions of refeeding syndrome include a complex and extensive list of changes, such as hypophosphatemia, hypomagnesemia, hypokalemia, hyponatremia, hypocalcemia, hyperglycemia, and vitamin deficiency--all of which are accompanied by clinical signs and symptoms. In practice, clinicians see asymptomatic refeeding hypophosphatemia more often than a full-blown syndrome with multiple laboratory and clinical abnormalities. Confusion results because there is no widely accepted or uniformly applied set of defining characteristics for diagnosing refeeding syndrome. To gain insight into the clinical characteristics of refeeding syndrome described in the literature, a systematic review of reported cases and case series was conducted. Since 2000, 20 authors described 27 cases that contained sufficient data for review. Hypophosphatemia occurred in 26 patients (96%). While 19 patients (71%) experienced at least 1 other laboratory abnormality, only 14 (51%) exhibited a consistent pattern of abnormally low phosphorus and magnesium levels. Seven patients had hypocalcemia (26%), and hyponatremia was reported in 3 patients (11%). There were no reports of hyperglycemia. Mean data reported in case series containing data from 63 patients showed that hypophosphatemia was a consistent finding but that other abnormalities were not consistently identified. Findings suggest that refeeding hypophosphatemia is not accompanied by a consistent pattern of biochemical or clinical abnormalities among case reports or case series of patients reported to have refeeding syndrome.

  19. Pulmonary toxocariasis: a case report and literature review. (United States)

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


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

  20. Unilateral Pigmented Extramammary Paget's Disease of the Axilla Associated with a Benign Mole: A Case Study and a Review of Literature. (United States)

    Ladak, Aleem; Bramley, Maria; Titi, Sami


    Pigmented extramammary Paget's disease (PEMPD) is an uncommon intraepithelial adenocarcinoma and a rare variant of Paget's disease affecting skin that is rich in apocrine sweat glands such as the axilla, perianal region and vulva. It most commonly occurs in postmenopausal women and presents as a superficial pigmented scaly macule, mimicking a melanocytic lesion. The histological presentation is adenocarcinoma in situ with an increased number of melanocytes scattered between the Paget's cells. Therefore, PEMPD may be misdiagnosed as a melanocytic tumour both clinically and histologically. The tumour cells are usually positive for cytokeratin 7, epithelial membrane antigen, Cam 5.2, HER2, and mucicarmine stain while S100 and human melanoma black-45 highlight the processes of reactive dendritic cells. The association between Paget's cells and intratumoural reactive melanocytes is still unclear. We report our first case of PEMPD associated with an intradermal naevus involving the axilla in a 63-year-old woman.

  1. [Exclusive radiotherapy and concurrent endocrine therapy for the management of elderly breast cancer patients: case study and review of hypofractionated schemes]. (United States)

    Auberdiac, P; Chargari, C; Cartier, L; Mélis, A; Malkoun, N; Chauleur, C; Jacquin, J-P; de Laroche, G; Magné, N


    Normofractionated radiotherapy is standard for adjuvant management of patients treated with breast conservative surgery for breast cancer. However, many elderly patients are not eligible to such strategy, either because of concurrent diseases, or because the tumor is inoperable. Several protocols of exclusive radiotherapy have been reported in the literature, frequently using hypofractionated radiotherapy and endocrine therapy. We report a case of a patient treated with exclusive endocrine and radiotherapy and address the state of the art on hypofractionated schemes for the management of elderly breast cancer patients. While hypofractionated radiotherapy does not compromise the oncologic or cosmetic outcome, there is no prospective data that assesses the place of radiotherapy for the exclusive treatment of elderly patients. This strategy should be further assessed in clinical randomized trial.

  2. Review of Current Student-Monitoring Techniques used in eLearning-Focused recommender Systems and Learning analytics. The Experience API & LIME model Case Study

    Directory of Open Access Journals (Sweden)

    Alberto Corbi


    Full Text Available Recommender systems require input information in order to properly operate and deliver content or behaviour suggestions to end users. eLearning scenarios are no exception. Users are current students and recommendations can be built upon paths (both formal and informal, relationships, behaviours, friends, followers, actions, grades, tutor interaction, etc. A recommender system must somehow retrieve, categorize and work with all these details. There are several ways to do so: from raw and inelegant database access to more curated web APIs or even via HTML scrapping. New server-centric user-action logging and monitoring standard technologies have been presented in past years by several groups, organizations and standard bodies. The Experience API (xAPI, detailed in this article, is one of these. In the first part of this paper we analyse current learner-monitoring techniques as an initialization phase for eLearning recommender systems. We next review standardization efforts in this area; finally, we focus on xAPI and the potential interaction with the LIME model, which will be also summarized below.

  3. IPv6 and IPv4 Threat reviews with Automatic Tunneling and Configuration Tunneling Considerations Transitional Model:A Case Study for University of Mysore Network

    CERN Document Server

    J., Hanumanthappa


    The actual transition from IPv4 to IPv6 requires network administrators to become aware of the next generation protocol and the associated risk problems.Due to the scale and complexity of current internet architecture how to protect from the existing investment and reduce the negative influence to users and service providers during the transition from IPv4 to IPv6 is a very important future topic for the advanced version of an internet architecture.This paper summarizes and compares the IPv6 transition mechanism methods like Dual Stack,Tunneling issues like IPv6 Automatic tunneling and manually configured tunneling considerations, the IPv6 transition scenarios,IPv6 transition security problems,highlights IPv6 and IPv4 threat review with automatic tunneling and configuration tunneling considerations.In this paper we have proposed a transitional threat model for automatic tunneling and a configuration tunneling that could be followed by the University of Mysore(UoM),to estimate automatic tunneling and a manuall...

  4. Memantine and catatonia: a case report and literature review. (United States)

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


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

  5. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P


    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

  6. Effects of climate change on the delivery of soil-mediated ecosystem services within the primary sector in temperate ecosystems: a review and New Zealand case study. (United States)

    Orwin, Kate H; Stevenson, Bryan A; Smaill, Simeon J; Kirschbaum, Miko U F; Dickie, Ian A; Clothier, Brent E; Garrett, Loretta G; van der Weerden, Tony J; Beare, Michael H; Curtin, Denis; de Klein, Cecile A M; Dodd, Michael B; Gentile, Roberta; Hedley, Carolyn; Mullan, Brett; Shepherd, Mark; Wakelin, Steven A; Bell, Nigel; Bowatte, Saman; Davis, Murray R; Dominati, Estelle; O'Callaghan, Maureen; Parfitt, Roger L; Thomas, Steve M


    Future human well-being under climate change depends on the ongoing delivery of food, fibre and wood from the land-based primary sector. The ability to deliver these provisioning services depends on soil-based ecosystem services (e.g. carbon, nutrient and water cycling and storage), yet we lack an in-depth understanding of the likely response of soil-based ecosystem services to climate change. We review the current knowledge on this topic for temperate ecosystems, focusing on mechanisms that are likely to underpin differences in climate change responses between four primary sector systems: cropping, intensive grazing, extensive grazing and plantation forestry. We then illustrate how our findings can be applied to assess service delivery under climate change in a specific region, using New Zealand as an example system. Differences in the climate change responses of carbon and nutrient-related services between systems will largely be driven by whether they are reliant on externally added or internally cycled nutrients, the extent to which plant communities could influence responses, and variation in vulnerability to erosion. The ability of soils to regulate water under climate change will mostly be driven by changes in rainfall, but can be influenced by different primary sector systems' vulnerability to soil water repellency and differences in evapotranspiration rates. These changes in regulating services resulted in different potentials for increased biomass production across systems, with intensively managed systems being the most likely to benefit from climate change. Quantitative prediction of net effects of climate change on soil ecosystem services remains a challenge, in part due to knowledge gaps, but also due to the complex interactions between different aspects of climate change. Despite this challenge, it is critical to gain the information required to make such predictions as robust as possible given the fundamental role of soils in supporting human well-being.

  7. Mixed exocrine-neuroendocrine carcinoma of the nasal cavity: clinico-pathologic and molecular study of a case and review of the literature. (United States)

    La Rosa, Stefano; Furlan, Daniela; Franzi, Francesca; Battaglia, Paolo; Frattini, Milo; Zanellato, Elena; Marando, Alessandro; Sahnane, Nora; Turri-Zanoni, Mario; Castelnuovo, Paolo; Capella, Carlo


    Sinonasal intestinal-type adenocarcinomas (ITACs) are rare neoplasms histologically resembling intestinal adenocarcinomas. Although a neuroendocrine differentiation in ITACs has been described, true mixed exocrine-neuroendocrine carcinomas, neoplasms in which each component represents at least 30 % of the lesion, are extremely rare and their molecular alterations are largely unknown. We describe herein the clinico-pathologic features, the methylation profile, chromosomal gains and losses, and mutation analysis of KRAS, BRAF and p53 in a nasal mixed exocrine-neuroendocrine carcinoma resected in a 79-year-old man. The tumor was composed of an ITAC and a poorly differentiated neuroendocrine carcinoma. Both exocrine and neuroendocrine components were CK8, CK20, CDX2 and p53 positive, and CK7 and TTF1 negative. The neuroendocrine component also showed immunoreactivity for chromogranin A, synaptophysin, serotonin and glicentin. Gains and losses were found at following chromosome regions: 17p13 (TP53), 14q24 (MLH3), 19q13 (KLK3), 5q21 (APC), 7q21 (CDK6), 9q34 (DAPK1), 12p13 (TNFRSF 1A, CDKN1B), 13q12 (BRCA2), 17p13.3 (HIC1), 18q21 (BCL2), and 22q12 (TIMP3). Aberrant methylation was detected only in the neuroendocrine component and involved APC and DAPK1 genes. No mutation of KRAS (exons 2-4), BRAF (exon 15), and p53 (exons 4-10) was found in both components. The results suggest a monoclonal origin of the tumor from a pluripotent cell undergoing a biphenotypic differentiation and that the neuroendocrine differentiation may be from an exocrine to an endocrine pathway. We have also reviewed the literature on sinonasal mixed exocrine-neuroendocrine carcinomas to give to the reader a comprehensive overview of these very rare tumor types.

  8. Anaplastic carcinoma of the pancreas: Case report and literature review of reported cases in Japan (United States)

    Hoshimoto, Sojun; Matsui, Junichi; Miyata, Ryohei; Takigawa, Yutaka; Miyauchi, Jun


    We report a case of a 64-year-old woman with anaplastic carcinoma of the pancreas (ACP) with cyst formation and review 60 ACP cases reported in Japan. In 20% of cases, laboratory tests revealed severe anemia (hemoglobin level 12000/mm3), which were likely attributable to rapid tumor growth, intratumoral hemorrhage, and necrosis. Elevated serum CA19-9 levels were observed in 55% of cases. Cyst-like structures were observed on imaging in 47% of cases, and this finding appears to reflect subsequent cystic degeneration in the lesion. Macroscopically, hemorrhagic necrosis was observed in 77% of cases, and cyst formation was observed in 33% of cases. ACP should be considered when diagnosing pancreatic tumors with a cyst-like appearance, especially in the presence of severe anemia, elevated leucocyte counts, or elevated serum CA19-9 levels.

  9. Small cell neuroendocrine carcinoma of the endometrium with pulmonary metastasis: A clinicopathologic study of a case and a brief review of the literature

    Directory of Open Access Journals (Sweden)

    Antonio D'Antonio


    Full Text Available Neuroendocrine carcinomas (NEC of the female genital tract are aggressive and rare tumors that usually involve the cervix and ovary, and are seen rarely in the endometrium in perimenopausal or postmenopausal women. We presented a case of a73 year-old postmenopausal woman with vaginal bleeding and abdominal pain. A subsequent computerized tomography (CT scan of pelvis showed an enlarged uterus (20,0 × 12,0 cm with para-aortic and pelvic lymph node metastases. She underwent surgical debulking and staging of an endometrial tumor with omental metastasis and positive lymph nodes. The pathological diagnosis was primary small cell carcinoma (SCC combined with endometrioid carcinoma of uterine corpus. Her final FIGO stage was IVB. Three months after surgery CT-total body showed a metastasis to left lung of SCC. Because the small-cell component of endometrial tumor showed a strong positivity for TTF1 as pulmonary counterpart a differential diagnosis with a primary small cell carcinoma of the lung should be made. Identifying an appropriate therapeutic management for SCC of endometrium is challenging since these are extremely rare tumors. An optimal initial therapeutic approach to this rare disease, especially at an advanced stage, has not yet been clearly defined. However, in these a multidisciplinary therapy, including surgery, chemotherapy, and radiotherapy represent until this time the only therapeutic option.

  10. Small cell neuroendocrine carcinoma of the endometrium with pulmonary metastasis: A clinicopathologic study of a case and a brief review of the literature (United States)

    D'Antonio, Antonio; Addesso, Maria; Caleo, Alessia; Guida, Maurizio; Zeppa, Pio


    Neuroendocrine carcinomas (NEC) of the female genital tract are aggressive and rare tumors that usually involve the cervix and ovary, and are seen rarely in the endometrium in perimenopausal or postmenopausal women. We presented a case of a73 year-old postmenopausal woman with vaginal bleeding and abdominal pain. A subsequent computerized tomography (CT) scan of pelvis showed an enlarged uterus (20,0 × 12,0 cm) with para-aortic and pelvic lymph node metastases. She underwent surgical debulking and staging of an endometrial tumor with omental metastasis and positive lymph nodes. The pathological diagnosis was primary small cell carcinoma (SCC) combined with endometrioid carcinoma of uterine corpus. Her final FIGO stage was IVB. Three months after surgery CT-total body showed a metastasis to left lung of SCC. Because the small-cell component of endometrial tumor showed a strong positivity for TTF1 as pulmonary counterpart a differential diagnosis with a primary small cell carcinoma of the lung should be made. Identifying an appropriate therapeutic management for SCC of endometrium is challenging since these are extremely rare tumors. An optimal initial therapeutic approach to this rare disease, especially at an advanced stage, has not yet been clearly defined. However, in these a multidisciplinary therapy, including surgery, chemotherapy, and radiotherapy represent until this time the only therapeutic option. PMID:26900464

  11. Blastomycosis in China: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    ZHAO Tie-mei; GAO Jie; SHE Dan-yang; CHEN Liang-an


    Blastomycosis is a fungal disease that is endemic in parts of North America.It is very rare in China and also commonly misdiagnosed,often as cancer or other infectious diseases.The clinical profile of a case of disseminated blastomycosis with pulmonary changes and skin ulcers was described.He had been misdiagnosed with tuberculosis,after adequate therapy with a lipid formulation of amphotericin B,followed by itraconazole,the lung and skin lesions improved.Then the five cases reported in China and literatures were reviewed.The aim of this report was to improve the knowledge regarding blastomycosis for physicians in China to avoid delaying adequate therapy.

  12. Fetal-Maternal Hemorrhage: A Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Nino Solomonia


    Full Text Available Nearly all pregnancies include an insignificant hemorrhage of fetal blood into the maternal circulation. In some cases, the hemorrhage is large enough to compromise the fetus, resulting in fetal demise, stillbirth, or delivery of a severely anemic infant. Unfortunately, the symptoms of a significant fetal-maternal hemorrhage can be subtle, nonspecific, and difficult to identify at the time of the event. We present the case of a severely anemic newborn who was delivered in our facility with an extensive literature review.

  13. Meningeal melanocytoma: case report and review of the literature. (United States)

    Ibáñez, J; Weil, B; Ayala, A; Jimenez, A; Acedo, C; Rodrigo, I


    We report a case of meningeal melanocytoma in the thoracic spinal cord of a 44-year-old woman and review previously documented cases. Our patient experienced numbness and tingling in her left leg for 8 years, and low back pains with intermittent claudication for the previous 2 months. A histologically benign 20-mm tumour was totally resected. Radiation therapy was not given. The tumour showed the histological, immunohistochemical and ultrastructural features of a meningeal melanocytoma. The patient is alive without recurrence 4.5 years after surgery.

  14. Parathyroid Carcinoma: A Review with Three Illustrative Cases

    Directory of Open Access Journals (Sweden)

    Antoine Digonnet, Adelaïde Carlier, Esther Willemse, Marie Quiriny, Cécile Dekeyser, Nicolas de Saint Aubain, Marc Lemort, Guy Andry


    Full Text Available Parathyroid carcinoma is a rare disease, which accounts for less than 1% of all case of primary hyperparathyroidism and is usually not detected until the time of surgery or thereafter. For most patients preoperative staging is not available. A radical excision remains the standard management; the place of adjuvant radiotherapy is not well established yet. Local recurrence and/or the metastases are unfortunately frequent. The present paper presents an up to date review of the literature illustrated by three clinical cases.

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

    Directory of Open Access Journals (Sweden)

    Nagihan Koç


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

  16. Primary tumors of the patella. A review of 42 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kransdorf, M.J. (Walter Reed Army Medical Center, Washington, DC (USA). Dept. of Radiology; University of the Health Sciences, Bethesda, MD (USA). Dept. of Radiology and Nuclear Medicine); Moser, R.P. Jr. (Armed Forces Inst. of Pathology, Washington, DC (USA). Dept. of Radiologic Pathology; University of the Health Sciences, Bethesda, MD (USA). Dept. of Radiology and Nuclear Medicine); Vinh, T.N. (Armed Forces Inst. of Pathology, Washington, DC (USA). Dept. of Orthopaedic Surgery); Aoki, J. (Armed Forces Inst. of Pathology, Washington, DC (USA). Dept. of Radiologic Pathology); Callaghan, J.J. (Duke Univ., Durham, NC (USA). Dept. of Orthopaedic Surgery)


    This study reports 42 cases of histologically proven and radiographically correlated primary patellar tumors. Despite diverse histologic diagnoses, the radiographic appearanaces of benign as opposed to malignant patellar neoplasms are essentially indistinguishable. Although the literature suggests that giant cell tumor is the most frequent benign tumor of the patella, the most common benign neoplasm in this series is chondroblastoma (16 cases). Only four primary malignant lesions were encountered, three cases of lymphoma and one case of hemangioendothelioma. Since 38 (90%) of the 42 cases were benign, a benign etiology should be strongly favored, notwithstanding the radiographic appearance, whenever a primary patellar tumor is encountered. (orig.).

  17. Sororicide in preteen girls. A case report and literature review. (United States)

    Adam, B S; Livingston, R


    All means of exploring the psychological and environmental antecedents of murder by a child should be used toward preventing lethal outcomes in future. The authors present the case of a ten year old girl who killed her sister with details of the sisters' relationship, the perpetrator's psychological characteristics and the family situation. Sibling-rivalry, family stressors, and the perpetrator's compulsive and narcissistic traits and preoccupation with a violent television fantasy are discussed. A literature review and suggestions for future research are provided.

  18. Pulmonary myopericytoma: a case report and review of the literatures

    Institute of Scientific and Technical Information of China (English)

    CAO Jian-hua; XU Jin-ping; LI Yong-cheng; LAI Jun; LI Qiang


    @@ Myopericytoma belongs to a family of benign tumors that exhibit a myoid/pericvtic line of differentiation.1 The most common anatomical sites for myopericytoma are the skin and superficial soft tissues of the distal extremities.2 With increased clinical recognition, a wider distribution has been described;3-5 however, a pulmonary lesion has never been reported. We now report a case of primary pulmonary myopericytoma and review the literature on this rare entity.

  19. Literature review of amelogenesis imperfecta with case report

    Directory of Open Access Journals (Sweden)

    Sumathy C Chanmougananda


    Full Text Available Amelogenesis impertecta (Al is a diverse collection of inherited diseases that exhibit qualitative or quantitative tooth enamel defects in the absence of systemic manifestations. Also known by varied names, such as hereditary enamel dysplasia, hereditary brown opalescent teeth, this defect is entirely ectodermal, since mesodermal components of the teeth are basically normal. This article details a case of Al along with complete review which presents in his twin siblings with clinical, radiological and histopathological report.

  20. A brief case report and review of ciguatera poisoning. (United States)

    Farstad, D J; Chow, T


    Although ciguatera fish poisoning is generally a mild, self-limited disease, both life-threatening acute reactions and troublesome chronic symptoms can occur. Because ciguatera has been largely confined to tropical locations, a relative lack of recognition exists among many US physicians. As access to tropical locations has increased, so has the distribution of ciguatera. Herein, we present a case report and review the current literature on ciguatera.

  1. Class II barodontalgia: review and report of a case. (United States)

    Woodmansey, Karl


    Barodontalgia is a rarely reported condition involving changes in ambient pressure resulting in tooth pain. According to Ferjentsik and Aker, Class II barodontalgia is observed in teeth that have pre-existing pulpal disease and an ultimate diagnosis of irreversible pulpitis.1 This article describes a case of Class II barodontalgia that was experienced on a commercial airline flight and reviews current knowledge regarding this phenomenon, including proposed etiologic mechanisms.

  2. Multifocal and metastatic hepatic hemangioendothelioma: case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Torres, Lucas Rios; Galvao Filho, Mario Melo [Hospital Sao Luiz, Sao Paulo, SP (Brazil); Timbo, Luciana Satiro; Verrastro, Carlos Gustavo Yuji; D' Ippolito, Giuseppe, E-mail: [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Ribeiro, Cristiane Maria de Freitas [Laboratorio Diagnostica, Sao Paulo, SP (Brazil)


    Epithelioid hemangioendothelioma is a rare neoplasm of vascular origin whose involvement of organs such as lung, spleen, bone, breast and liver has already been reported. The clinical signs and the prognosis of this tumor are quite variable. From the present case report, the authors have sought to contribute with literature data, by reviewing clinical and radiological features which may be useful to include such a condition in the differential diagnosis of liver lesions. (author)

  3. Unilateral condylar hyperplasia: A case report and review of literature


    Bharathi, Saravana C.; Senthilnathan, S.; Kumar, Lokesh D.; Mohan, Anand C. S.; Taranath, M.


    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle ‘differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature.

  4. Unilateral condylar hyperplasia: A case report and review of literature. (United States)

    Bharathi, Saravana C; Senthilnathan, S; Kumar, Lokesh D; Mohan, Anand C S; Taranath, M


    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle 'differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature.

  5. Clostridium difficile causing acute renal failure: Case presentation and review

    Institute of Scientific and Technical Information of China (English)

    Jasmin Arrich; Gottfried H. Sodeck; Gürkan Seng(o)lge; Christoforos Konnaris; Marcus Müllner; Anton N. Laggner; Hans Domanovits


    AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

  6. Chronic subdural hematomas: a review of 94 cases

    Directory of Open Access Journals (Sweden)

    Murat Yilmaz


    Material and Methods: Consecutive patients operated with a diagnosis of chronic subdural hematoma between January 2003 and December 2012 were reviewed retrospectively. Etiology and medical status of the patients at the time of admission were noted. Exact localization of the chronic subdural hematoma was detected by computed tomography scans and follow-up was maintained with magnetic resonance imaging. The outcome of the patients was evaluated one month after injury, by assesing activities of daily living. Results: Ninety-four consecutive patients met the eligibility criteria for the study. The mean age was 65 (range 45 to 85 years. In 74 (78.7% patients, head injury was the supposed origin. In 20 (21.3% patients, no trauma was evident. Most common symptom reported at the time of admission was headache (100%, and the most common neurological finding was confusion (87.2%. The majority of the patients had a mild neurological deficit with a Glascow Coma Scale score over eight. In general, 90.4% of cases were sufficiently treated by a single operation, while 9.6% needed a second procedure. During the follow-up, 91.5% of the patients returned to daily living activities on the first month kontrol. Conclusion: Surgical treatment of chronic subdural haematoma can give a high rate of complete recovery to normal life. [Cukurova Med J 2015; 40(1.000: 22-27

  7. Orbitofrontal epilepsy: electroclinical analysis of surgical cases and literature review. (United States)

    Smith, Joseph R; Sillay, Karl; Winkler, Peter; King, Don W; Loring, David W


    Clinical and electrographic data were reviewed on 2 of our patients with orbitofrontal epilepsy who were seizure free at 5-year follow-up, and on 2 similar patients from the literature. One of our patients was lesional, and the other was nonlesional. Interictal EEG discharges were lateralized to the side of invasively recorded orbitofrontal seizures in the nonlesional case. In this case, no clinical manifestations occurred until the orbitofrontal discharge had spread to the opposite orbitofrontal and both mesial temporal areas. Unresponsiveness or arrest of activity were the initial manifestations of complex partial seizures in both cases. The 2 cases from the literature with long-term seizure-free follow-up had little impairment of awareness and displayed vigorous motor automatisms. Interictal epileptiform activity was bifrontally synchronous in 1 case. Ipsilateral frontotemporal discharges were seen in both. Invasive ictal epileptiform activity appeared maximal in the ipsilateral orbitofrontal region in both patients. No consistent electrographic or clinical pattern characterized these 4 cases. Seizures of orbitofrontal origin may be characterized by either unresponsiveness associated with oroalimentary automatisms or limited alteration of awareness and associated with vigorous motor automatisms. Invasive monitoring of the orbitofrontal cortex should be considered in nonlesional cases with complex partial seizures that show nonlocalizing ictal patterns and interictal frontal or frontotemporal epileptiform discharges.


    Institute of Scientific and Technical Information of China (English)



    In recent years ELT has stressed the role which teachers' beliefs play in shaping what they do in the classroom. But so far as teaching English in China is concerned, we lack empirical insight into the relationship between teachers' beliefs and their classroom practice. With specific reference to the use of English in intensive reading classes, by presenting and discussing data from a case study of a non-native college English teacher,this exploratory qualitative classroom research sheds light on the nature of teachers' beliefs held consciously or unconsciously.Their subsequent change and impact on the classroom will also be reported and discussed.

  9. Few adverse reactions to metal on metal articulation in total hip arthroplasty in a review study on 358 consecutive cases with 1 to 5 years follow-up

    DEFF Research Database (Denmark)

    Stürup, Jens; Dahl, Line; Jensen, Karl Erik;


    The aim of the present study was to determine the frequency of adverse reaction to metal on metal total hip arthroplasty using a M2a-38 articulation and a Magnum articulation, (Biomet Warsaw, Indiana).All patients who had received a Metal on Metal bearing prosthesis, in two centres in Copenhagen...

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

    Directory of Open Access Journals (Sweden)

    Sara Díaz Angulo


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

  11. Sporotrichosis as an unusual case of osteomyelitis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Henry T. Lederer


    Full Text Available Sporotrichosis is an infection of worldwide distribution caused by the dimorphic fungus, Sporothrix schenckii. Acquisition typically occurs via cutaneous inoculation with development of a localized cutaneous and/or lymphocutaneous infection. We present a rare case of osteoarticular sporotrichosis in a 39-year-old man and review the literature noting only 20 published cases since 1980. Recommendations on the diagnosis and management of this unusual infection are provided.

  12. Palatine tonsillar metastasis of rectal adenocarcinoma: a case report and literature review. (United States)

    Wang, Hao; Chen, Ping


    Cases of primary colorectal adenocarcinoma metastasized to the palatine tonsil are extremely rare. To the best of our knowledge, only 10 cases have thus far been previously documented in the English literature. A 37-year-old Chinese woman presented with a right palatine tonsil swelling and odynophagia 5 months after a surgical resection of rectal adenocarcinoma was performed. The patient underwent a tonsillectomy, and a metastatic poorly differentiated adenocarcinoma from a colorectal origin was revealed by immunohistochemical analysis. The manner in which tonsillar metastases are involved remains unknown and should be further studied. Here, we report a new case, briefly summarize these 10 cases and review the literature.

  13. Apocrine Fibroadenoma on the Face: Case Report and Review of the Literature. (United States)

    Khalsa, Amrit; Conway, Andrea; Ali, Liaqat; Heaney, Steven; Helm, Klaus


    Apocrine fibroadenoma (AFA) is a common benign entity found in the breast but is rarely seen at other sites. Several studies have documented cases in the anogenital region, but to date, there have been only 4 cases (excluding the current case) of an AFA located in the skin on other parts of the body. The authors present a case of a 66-year-old woman with a 6-year history of a slow growing red nodule on her face. The histopathologic diagnosis was consistent with an AFA. An extensive review of the literature to elucidate a possible pathogenesis of these lesions and relationship to the anogenital counterparts is presented.

  14. Traumatic bilateral basal ganglia bleed: A report of rare two cases and review of the literature (United States)

    Kankane, Vivek Kumar; Gupta, Tarun Kumar; Jaiswal, Gaurav


    Traumatic basal ganglia hemorrhage (TBGH) is relatively uncommon. Bilateral basal ganglia hematoma after trauma is extremely rare and is limited to case reports. We report two cases of traumatic bilateral basal ganglia hemorrhage and review the literature in brief. Both cases were managed conservatively. The general incidence of TBGH is reported between 2.4% and 3% of closed head injury. However, the incidence is higher in postmortem studies (9.8%). Bilateral traumatic basal ganglia hematoma is extremely rare. Descriptions are limited to case reports.

  15. Cerebellar Hemangioblastoma: Four Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sevgi Bakaris


    Full Text Available Hemangioblastoma (HB is a benign, slow-growing, highly vascular tumour of not well defined histological origin. These tumors make up about 1 to 2 percent of all intracranial neoplasms and occur primarily in the posterior fossa. Hemangioblastomas can occur sporadically but in about 20% to 30% cases, it is associated with von Hippel-Lindau (VHL disease. Four cases of cerebellar haemangioblastoma, not associated with von Hippel-Lindau disease (sporadic haemangioblastomas, were presented and reviewed the relevant literature.Four hemangioblastomas of the central nervous system were examined with haematoxylin and eosin (H and E, reticulin stain and with a panel of antibodies including CD34, vimentin, NSE, S-100, CD99, CD56, GFAP, cytoceratin, epithelial membrane antigen (EMA, CD10. Of the 4 patients in this study 1 was male and 3 were female. Their ages ranged from 46 years to 60 years with a mean age of 54.75 years. All of them were as cystic nodules about 2-3 cm in diameter. In the histopathological examination, the tumors sections showed large and vacuolated stromal cells and numerous arborizing capillary-size blood vessels. Some tumors showed atypical nuclei. Vimentin was strongly positive both stromal cells and blood veessels in all tumors. In 4 cases of HB, some stromal cells were positive for NSE and CD99. Three tumors were positive for S-100 and CD56, two tumors were focally positive for glial fibrillary acidic protein (GFAP. CD34 immunostaining highlighted the arborizing and complex vascular network, whereas the tumor stromal cells were negative. The stromal cells were negative for epithelial markers such as cytokeratin, EMA and CD10. Ki-67 index was less than 1% of the tumor cells. Hemangioblastoma, a rare, benign tumors of uncertain histogenesis, is characterized histologically by the presence of vacuolated, lipid containing cells and a well developed, fine capillary network. The main histological differential diagnosis of HB is metastatic

  16. Physiologic amputation: a case study. (United States)

    Long, Jeri; Hall, Virginia


    Acute limb ischemia is a complication of severe peripheral arterial disease that can be a threatening limb as well as life. Multiple procedures exist today to help revascularize extremities; however, even with the latest technologies, surgical amputation of the limb may still be necessary. Cryoamputation, or physiologic amputation, is a method used to treat patients who are hemodynamically unstable for the operating room and who are in need of urgent amputation owing to arterial ischemia. This procedure is used in the rare instance where not only a persons' limb is threatened, but also their life. This is a case study regarding one patient who presented to the hospital with limb-threatening ischemia who became hemodynamically unstable owing to the rhabdomyolysis associated with the ischemia of his lower extremity. Cryoamputation was used to stabilize the patient and prevent further deterioration, so that he could safely undergo surgical amputation of the limb without an increase in mortality risk. Cryoamputation must be followed by formal surgical amputation when the patient is hemodynamically stabilized. It is not a limb salvaging, procedure but it is a life-saving procedure. This case study demonstrates the usefulness of the procedure and discusses the technique used for cryoamputation.

  17. Parotidite recorrente da infância: estudo em longo prazo de cinco casos e revisão da literatura Infantile recurrent parotitis: follow up study of five cases and literature review

    Directory of Open Access Journals (Sweden)

    Ivan Dieb Miziara


    five RP cases; (2 to examine the role of sialography and ultrasound in diagnosis and follow up; and (3 to make a literature review. STUDY DESIGN: series review. MATERIAL AND METHOD: We reviewed all recurrent parotitis cases from the files of the Otolaryngology Division at University of Sao Paulo, Brazil. The criteria for inclusion were at least two years of evolution and more than one year and a half follow-up in our service. We included five children in the study. Sialograhpy was performed in the first evaluation and sonography was executed annually. Recurrent parotitis showed male predominance, and affected mainly children between the ages of 3 and 6. Frequency of crisis improved with time in all cases. Sialography showed sialectasis aspect in the affected glands and sonographic exams demonstrated hipoechoic and heterogeneous internal echoes. One case showed regression of ultrasound changes after clinical improvement.

  18. What Can We Learn About Regulatory Agencies and Regulated Parties from the Empirical Study of Judicial Review of Regulatory Agencies’ Decisions? The Case of Croatia

    Directory of Open Access Journals (Sweden)

    Bajakić Ivana


    Full Text Available The purpose of this paper is to examine regulatory agencies and regulated parties in an empirical study of administrative disputes initiated against the decisions of regulatory agencies in Croatia. We first aim to provide an overview of the status and trend estimates regarding these disputes; second, to answer the question how well does the system work from the perspectives of both the plaintiffs and the regulatory agencies; third, to identify the problem areas and to compare these with problem areas identified by the authors studying the broader area of administrative judiciary in Croatia, and finally to compare efficiency level of regulatory agencies to other public authorities in confirming the legality of their decisions and actions. Data on all administrative disputes against 12 Croatian regulatory agencies’ decisions in the 17-year period between 1995 and 2011 are used to identify the main characteristics and trends relating to these disputes. Data for 2012 to 2013 was also examined to identify initial changes and emerging trends in the new administrative judiciary system resulting from fundamental legal reform as part of Croatia’s process of accession to the European Union in 2013. The results show these administrative disputes to be often costly and timely with modest outcome for the plaintiff and impressive success rate for the most of regulatory agencies.

  19. Five misunderstandings about Case-study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  20. Five misunderstandings about case study research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent


    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  1. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.


    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study thi

  2. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.


    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study thi

  3. Metronidazole Induced Pancreatitis. A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Casey KJ


    Full Text Available CONTEXT: Pancreatitis is a very rare adverse effect of metronidazole with only six cases of metronidazole-induced pancreatitis reported in the English literature so far. CASE REPORT: We report a case of recurrent acute pancreatitis in a 46-year-old female associated with oral metronidazole therapy and review the literature with regards to metronidazole-induced pancreatitis. We are also highlighting the fact that the time lag between metronidazole exposure and development of pancreatitis is very variable. CONCLUSION: High degree of suspicion is warranted on the part of physicians to diagnose metronidazole induced pancreatitis in patients presenting with gastrointestinal symptoms after metronidazole exposure. If metronidazole is suspected as the causative agent then it should be discontinued and rechallenge should be avoided.

  4. Streptococcus gordonii septic arthritis : two cases and review of literature

    Directory of Open Access Journals (Sweden)

    Yombi Jean cyr


    Full Text Available Abstract Background Despite advances in antimicrobial and surgical therapy, septic arthritis remains a rheumatologic emergency that can lead to rapid joint destruction and irreversible loss of function. In adults, Staphylococcus aureus is the most common microorganism isolated from native joints. Streptococcus gordonii is a prominent member of the viridans group of oral bacteria and is among the bacteria most frequently identified as being primary agent of subacute bacterial endocarditis. To the best of our knowledge, Streptococcus gordonii has not yet been described as agent of septic arthritis. Case Presentation We describe here two cases of septic arthritis due to Streptococcus gordonii. It gives us an opportunity to review epidemiology, diagnosis criteria and management of septic arthritis. Conclusion Although implication of S. gordonii as aetiologic agent of subacute endocarditis is well known, this organism is a rare cause of septic arthritis. In this case, the exclusion of associated endocarditis is warranted.

  5. Surgical reconstruction of charcot foot neuroarthropathy, a case based review. (United States)

    Kučera, Tomáš; Šponer, Pavel; Šrot, Jaromír


    Our case-based review focuses on limb salvage through operative management of Charcot neuroarthropathy of the diabetic foot. We describe a case, when a below-knee amputation was considered in a patient with chronic Charcot foot with a rocker-bottom deformity and chronic plantar ulceration. Conservative treatment failed. Targeted antibiotic therapy and operative management (Tendo-Achilles lengthening, resectional arthrodesis of Lisfranc and midtarsal joints, fixation with large-diameter axial screws, and plaster cast) were performed. On the basis of this case, we discuss options and drawbacks of surgical management. Our approach led to healing of the ulcer and correction of the deformity. Two years after surgery, we observed a significant improvement in patient's quality of life. Advanced diagnostic and imaging techniques, a better understanding of the biomechanics and biology of Charcot neuroarthropathy, and suitable osteosynthetic material enables diabetic limb salvage.

  6. Eruption cyst: A literature review and four case reports

    Directory of Open Access Journals (Sweden)

    N B Nagaveni


    Full Text Available Eruption cyst is a benign cyst associated with a primary or permanent tooth in its soft tissue phase after erupting through the bone. It is most prevalent in the Caucasian race. Intraoral examination of four patients revealed eruption cyst. Among these, in three patients it occurred in the maxillary arch and one had it in the mandibular arch. All were associated with permanent tooth. Surgical treatment was done in three cases and in one case the cyst disappeared gradually and tooth erupted in normal pattern. Four cases of eruption cyst from India are presented and literature on this condition is reviewed. It is clinically significant in that knowledge among general dentists is very essential regarding this developmental disturbance to reach the correct diagnosis and to provide proper treatment.

  7. Trisomy 9: Review and report of two new cases

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, G.L.; Kirby, R.S.; Stern, T.P. [Univ. of Arkansas, Little Rock, AR (United States)] [and others


    Trisomy 9 is a relatively uncommon chromosome abnormality that may sometimes be seen in the nonmosaic state. We reviewed 23 mosaic and 15 nonmosaic cases of trisomy 9, including 2 new cases, in order to better define the prognosis and phenotype of this disorder. A recognizable trisomy 9 phenotype was identified and included a {open_quotes}bulbous{close_quotes} nose, microphthalmia, and dislocated limbs. Other nonspecific anomalies involving various organ systems were also common. With one exception, all survivors had severe mental impairment. Mosaicism for trisomy 9 predicted longer survival, but the degree of mosaicism in lymphocytes or fibroblasts did not predict survival or degree of impairment. Parental chromosome variations were not uncommon. In contrast to prior reports, no specific prognostic finding was identified. A meiotic origin with loss of a trisomic cell line in mosaic cases is suggested. 43 refs., 2 figs., 2 tabs.

  8. Adverse events associated with yoga: a systematic review of published case reports and case series. (United States)

    Cramer, Holger; Krucoff, Carol; Dobos, Gustav


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

  9. Review of Economic, Social and Cultural Factors and Challenges Pertaining to non-textbook Reading Tendencies by Youths: Case Study of Metropolitan Shiraz

    Directory of Open Access Journals (Sweden)

    Khadijeh Sarvestani


    Full Text Available The present study was undertaken to investigate the economic, social and cultural factors relevant to Non-textbook readership (NTR among youth. A survey was carried out on a sample taken from youth between 14 and 29 years old in Metropolitan Shiraz. A questionnaire was used in conjunction with interview. SPSS was used for descriptive and inferential data analysis. It was demonstrated that there is significant correlation between youth tendency towards reading with age, social standing, educational level of the individual and parents, ethnicity, family income, access to books and library, and membership in a given establishment or society. The most pressing matters regarding NTR among youths are shortage of cultural centers and libraries, suitable book titles, financial issues, costliness, and lack of interest or motivation for reading.

  10. Intraosseous hibernoma: characterization of five cases and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Bonar, S.F. [Douglass Hanly Moir Pathology, Macquarie Park, NSW (Australia); Watson, Geoffrey [Royal Prince Alfred Hospital, Camperdown, NSW (Australia); Gragnaniello, Cristian; Seex, Kevin; Magnussen, John [Macquarie University Hospital, Macquarie Park, NSW (Australia); Earwaker, John [Princess Alexandra Hospital, Brisbane, Queensland (Australia)


    To describe the imaging and histopathological findings and provide an overview of a recently described and rare cause of bone sclerosis. Five cases of intra-osseous hibernoma of bone that presented over the last year. The imaging and histopathology is reviewed. All cases were identified in asymptomatic middle-aged to elderly adults as incidental findings with bone sclerosis in the axial skeleton. MRI showed lesions that were T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle and one showed contrast enhancement. Glucose avidity was demonstrated on FDGPET in both cases tested and isotope bone scan performed in three cases showed strong positivity in two, but uptake was inconspicuous in one case. Intra-osseous hibernoma is a rare cause of sclerotic bone lesions, predominating in the axial skeleton of middle-aged and elderly adults. They have a non-aggressive appearance on CT and on MRI are T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle. They are usually T2 hyperintense and may show peripheral contrast enhancement. They may show increased glucose avidity on FDGPET and may or may not be positive on isotope bone scans. We suspect that with ever-increasing use of a variety of imaging techniques, particularly in a setting of staging for malignant disease, more such cases will come to light. This diagnosis should be added to the differential diagnosis of sclerotic bone lesions. (orig.)

  11. Intraosseous pleomorphic adenoma: case report and review of the literature. (United States)

    Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A


    Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

  12. Evaluation of School Uniform Policy in Turkey: A Case Study (United States)

    Cinoglu, Mustafa


    The purpose of this study is to evaluate the results of current school uniform policies according to views of stakeholders. Descriptive case study method was used for this study to understand the concerns of the stakeholders about school uniforms. Data was collected through interviews with stakeholders and also reviewing the documents in TOKI…

  13. Thyroid leiomyosarcoma: presentation of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Mehmet İlhan Şahin

    Full Text Available Abstract Introduction: Leiomyosarcoma is a tumor which is rarely seen in the thyroid gland. The diagnosis may be difficult and the treatment is controversial. Objective: The objective of the study is to review the literature about a rare malignant disease of the thyroid gland which has high mortality. Methods: Two cases of thyroid leiomyosarcoma are presented and the previous 23 cases in the current literature are reviewed. Results: A total of 25 cases of thyroid leiomyosarcoma are reviewed; the most common complaint was rapidly growing anterior neck mass, and ten of the 25 patients had distant metastasis at the initial admission. Fifteen of the 25 patients died with the disease in the first 12 months after the diagnosis. Conclusion: The differential diagnosis of thyroid leiomyosarcoma is important and should be performed with other malignancies of the gland, especially with anaplastic carcinoma. The prognosis is poor and there is no consensus regarding the treatment.

  14. Intracranial epithelioid hemangioendothelioma: two cases report and literature review

    Directory of Open Access Journals (Sweden)

    Jun-chao FANG


    Full Text Available Background Epithelioid hemangioendothelioma is an uncommon low-grade malignant tumor with various biological behaviors. This paper retrospectively analyzed the clinical data of 2 cases with epithelioid hemangioendothelioma which were confirmed by histopathological features, and reviewed relevant literatures, so as to summarize clinical and radiological features, diagnosis and differential diagnosis, treatment and prognosis of this disease.  Methods and Results The tumor in Case 1 was cystic accompanied with hemorrhage. Hematoma clearance, decompressive craniectomy and total removal of the tumor were performed. The tumor in Case 2 was misdiagosed as meningioma firstly, and craniotomy was implemented to remove the tumor. But 8 months later, the tumor relapsed. The tumor was vascularized in operation and subtotally removed with moderate blood loss. Postoperative pathological diagnosis revealed epithelioid hemangioendothelioma in both cases. Immunohistochemical staining showed the tumor cells were positive for CD34, FⅧ RAg in Case 1, while CD31, vimentin (Vim and Fli-1 in Case 2, and both negative for cytokeratin (CK and epithelial membrane antigen (EMA. Case 1 was followed up for one year, and no recurrence was found. Case 2 received postoperative auxiliary radiotherapy, but tumor metastasis was found 3 months later. Conclusions Epithelioid hemangioendothelioma is a unique vascular tumor characterized by proliferation of epithelioid or histiocytoid endothelial cells. The histopathological features and biological behaviors are intermediate between hemangioma and angioscarcoma, and its intracranial occurrence is extremely rare. A preoperative diagnosis is usually difficult because of lacking characteristic clinical and radiological features. Diagnosis mainly depends on histopathology and immunohistochemistry. Gross resection is currently the firstline treatment for these tumors. Otherwise, adjuvant therapies are required. The prognosis of this

  15. A case of symmetrical lipomatosis of the tongue and a literature review

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Byung Je; Lee, Eun Joo; Yeo, Soo Hyun; Chang, Hyuk won; Kim, Sang Hyon; Sohn, Sung Il; Lee, Sang Kwon [Keimyung University College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of)


    Symmetrical lipomatosis of the tongue is an extremely rare condition. To date, few cases have been reported in the literature. Symmetrical lipomatosis remains controversial as to whether it is identical to benign symmetrical lipomatosis or not. We present an extremely rare case of symmetrical lipomatosis of the tongue in a 77-year-old male. We reviewed the literature and discussed the clinical characteristics as well as the role of imaging studies of this disease.

  16. Echocardiographic features of Candida species endocarditis: 12 cases and a review of published reports


    Donal, E.; Abgueguen, P; Coisne, D.; Gouello, J; McFadden, E; Allal, J.; Corbi, P.


    OBJECTIVE—To describe the specific echocardiographic features of Candida species endocarditis.
DESIGN—Retrospective review of the case records of patients with confirmed candida endocarditis.
SETTING—Cases referred to three French university centres over an eight year period were studied.
DESIGN—12 patients with confirmed Candida species endocarditis infection were identified. The transthoracic (n = 12) and transoesophageal (n = 12) echocardiographic appearances were compared with the surgica...

  17. Broadening Public Participation in Systematic Reviews: A Case Example Involving Young People in Two Configurative Reviews (United States)

    Oliver, Kathryn; Rees, Rebecca; Brady, Louca-Mai; Kavanagh, Josephine; Oliver, Sandy; Thomas, James


    Background: Arguments supporting the involvement of users in research have even more weight when involving the public in systematic reviews of research. We aimed to explore the potential for public involvement in systematic reviews of observational and qualitative studies. Methods: Two consultative workshops were carried out with a group of young…

  18. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies (United States)

    Pai, Aditi


    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  19. KAIZEN – A case study

    Directory of Open Access Journals (Sweden)

    Manjunath Shettar


    Full Text Available The ultimate objective of manufacturing industries is to increase productivity with high quality. At present, many manufacturing companies are facing problems such as high quality rejection, high inventories, high lead time, high costs of production, and inability to cope with customer orders. By implementing and practicing the lean production system many problems can be solved without employing high-tech and high-touch approaches but by involving people on the shop floor in Kaizen activities. Kaizen is one of the powerful tools of lean manufacturing. Kaizen refers to continuous improvement in performance, cost and quality. Kaizen ensures that manufacturing processes become leaner and fitter, but eliminate waste (problem where value is added. The main objective of this paper is to provide a background on kaizen, present an overview of kaizen concepts that are used to transform a company into a high performing lean enterprise. A case study of implementation of Kaizen‟s has been discussed.

  20. STS Case Study Development Support (United States)

    Rosa de Jesus, Dan A.; Johnson, Grace K.


    The Shuttle Case Study Collection (SCSC) has been developed using lessons learned documented by NASA engineers, analysts, and contractors. The SCSC provides educators with a new tool to teach real-world engineering processes with the goal of providing unique educational materials that enhance critical thinking, decision-making and problem-solving skills. During this third phase of the project, responsibilities included: the revision of the Hyper Text Markup Language (HTML) source code to ensure all pages follow World Wide Web Consortium (W3C) standards, and the addition and edition of website content, including text, documents, and images. Basic HTML knowledge was required, as was basic knowledge of photo editing software, and training to learn how to use NASA's Content Management System for website design. The outcome of this project was its release to the public.

  1. Statins and their role in acute pancreatitis: Case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Denzil; Etienne; Yousef; Reda


    Statin induced pancreatitis has historically been considered a diagnosis of exclusion,with literature references typically in the form of case reports and observational studies. Recently,larger studies have challenged the correlations made by earlier case reports,and instead demonstrate a mild protective effect in statin users. We present a case report of likely statin induced pancreatitis in a 58-year-old male(which we have attributed to drug-drug interaction with resulting inhibition of hepatic cytochrome P450 enzymes) and have reviewed the apparent dichotomy in the available literature.

  2. Using teaching case studies for management research


    Ambrosini, Veronique; Bowman, Cliff; Collier, Nardine


    Teaching case studies are widely deployed in business schools. They are contextually rich in detail, and students learn by applying and adapting theoretical concepts to specific business situations described in the case. This article proposes a new way to use teaching case studies, as research materials for academics. The article addresses three questions: (1) Can teaching cases be used as an alternative to field research? (2) When can teaching case studies be used as second...

  3. Value of case studies in disaster assessment? (United States)

    Grynszpan, Delphine; Murray, Virginia; Llosa, Silvia


    Case studies can be useful in assessing and learning lessons from emergency situations. In this paper, different uses for disaster case studies, are explored with identification of potential pitfalls that should be avoided. In addition, ways to improve the rigor and significance of case studies are suggested. Case studies can be used as examples or as a research tool. If conducted properly, they can provide robust and compelling results. It is argued that sharing a common guide to conducting and writing case studies among all disaster risk reduction professionals could improve the quality of case study reports and thereby strengthen their value in advancing the prevention, preparedness, and management of disasters and emergencies.

  4. Prosthetic Tricuspid Valve Thrombosis: Three Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Ahmad Yaminisharif


    Full Text Available A common complication of prosthetic heart valves is thrombosis. Although the incidence of prosthetic valve thrombosis (PVT in the tricuspid position is high, there are not enough data on the management of it, in contrast to left-sided PVT. Here, we describe three cases of tricuspid PVT with three different management approaches: thrombolytic therapy; close observation with oral anticoagulants; and surgery. The first case was a woman who suffered from recurrent PVT, for which we successfully used Tenecteplase for second and third episodes. We employed Tenecteplase in this case for the first time in the therapy of tricuspid PVT. The second case had fixed leaflets in open position while being symptomless. At six months' follow-up, with the patient having taken oral anticoagulants, the motion of the leaflets was restricted and she was symptom- free. The last case was a woman who had a large thrombus in the right atrium immediately after mitral and tricuspid valvular replacement. The patient underwent re-replacement surgery and a new biological valve was implanted in the tricuspid position. Also, we review the literature on the pathology, signs and symptoms, diagnosis, and management of tricuspid PVT.

  5. Schwannoma base tongue: Case report and review of literature. (United States)

    George, N A; Wagh, M; Balagopal, P G; Gupta, S; Sukumaran, R; Sebastian, P


    Schwannomas are benign peripheral nerve sheath tumors. These are rare in the oral cavity (1%). The most common site of involvement in oral cavity is the tongue. Posterior third of tongue is not frequently involved. The aim of this paper is to present a case report of base tongue schwannoma and review literature of this rare tumor. Data from literature were analyzed for age, gender, presenting symptom, size at presentation, and surgical approach. We report a case of 26 year-old male who presented with swelling posterior 1/3rd tongue and change in quality of voice. He was evaluated for the same with MR and incision biopsy and was planned for surgery. Surgery was abandoned at a district hospital due to difficulty in intubation. At our center he underwent fibro optic bronchoscopy guided intubation followed by general anesthesia. He underwent excision of mass using left paramedian lip spitting approach with mandibulotomy and mandibular swing. Tumor was excised in toto. His postoperative recovery was uneventful. Literature review between 2001 and 2012 was done. 15 cases of base tongue schwannoma were identified. The most common age group involved was between 30-40 years. There was a slightly higher incidence in females. All patients were symptomatic at presentation. Most common complaints were related to swallowing and throat pain. Most patients underwent transoral excision of the tumor.

  6. [Labial melanotic macule. Review of the literature. Report of a case]. (United States)

    Salazar, N; Tinoco, P J; Segall, N


    A review of the literature is done concerning labial melanotic macule. Several aspects are studied such as definition, clinical significance and histopathology. A new case is added, located in the lower lip. Several observations are done and conclusions are drawn. Emphasis is given to the need of determining the etiology of the lesion.

  7. Effects of case management for frail older people or those with chronic illness - a systematic review

    NARCIS (Netherlands)

    Oeseburg, Barth; Wynia, Klaske; Middel, Berry; Reijneveld, Sijmen A.


    Background: Financial constraints and quality requirements demand that interventions selected are most effective. A previous systematic review of the effectiveness of the patient advocacy case management model was not found. Objective: The objective of this study was to evaluate the effects of patie

  8. Applying Quality Indicators to Single-Case Research Designs Used in Special Education: A Systematic Review (United States)

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


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

  9. Review of relevant studies of isolated systems

    DEFF Research Database (Denmark)

    Hansen, L.H.; Lundsager, P.


    The report presents the results of a review of studies relating to integration of wind energy in isolated power supply systems, based on a systematic literature survey. The purpose of the study is to develop a methodology consisting of a set of guidelinesfor wind energy projects in isolated energy...... systems and a set of tools and models that are operational on an engineering level. The review is based on a literature search in the ETDE Energy Database with a main search covering the period 7/88 to 6/97 andsupplemented by partial update periods. A few newer references have been included in the review......, most notably the IEC/PAS 62111 specification. The amount of wind energy literature related to the subject is excessively large, and a complete review inwhich every relevant abstract is identified and examined is not feasible within the framework of this (or probably any other) study. The review results...

  10. Metastatic pituitary carcinoma: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    ZHANG Shang-fu


    Full Text Available Background As a kind of rare tumor, metastatic pituitary carcinoma is very difficult to diagnose clinically and is easy to be misdiagnosed. This article aims to discuss the clinical manifestations and histopathological features of this tumor. Methods The clinical presentations, histopathological features and immunophenotype were studied in one case of poorly differentiated lung adenocarcinoma metastatic to pituitary gland, and related literature was reviewed. Results A 47-year-old woman mainly presented with faint, headache and blurred vision. CT scan demonstrated abnormal signals in suprasellar cistern. During the resection, the tumor could be seen locating in sellar region, the size of which was about 2 cm × 1 cm × 1 cm. Histopathological examination revealed that the structure of pituitary gland was damaged and the tumor was composed of atypical round or oval cells arranged in nest or glandular patterns, in which a number of enlarged plump tumor cells contained abundant eosinophilic cytoplasm with eccentrical caryogenesis. The immunohistochemistry showed that epithelial membrane antigen (EMA, pan cytokeratin (PCK, thyroid transcription factor-1 (TTF-1 and cytokeratin 7 (CK7 were positive in tumor cells with Ki-67 labeling index being 15%, but chromogranin (CgA, cancer embryo antigen (CEA, human chorionic gonadotropin (hCG, placental alkaline phosphatase (PLAP, CD117, leukocyte common antigen (LCA, CD30, anaplastic lymphoma kinase-1 (ALK-1 were negative in tumor cells. After operation the patient received treatment with levothyroxine sodium and γ knife, but died 4 months later. Conclusion Histopathological examination and immunohistochemistry can confirm the diagnosis of metastatic pituitary carcinoma and locate the primary lesion. Postoperative comprehensive therapy is necessary.

  11. Cystosarcoma phyllodes: Pathological enigma: A retrospective review of 162 cases

    Directory of Open Access Journals (Sweden)

    R P Narayanakar


    Full Text Available Purpose: Phyllodes tumor (PT is a rare fibroepithelial neoplasm comprising <1% of all breast tumors. Clinical spectrum ranges from benign (B, borderline (BL, and locally recurrent to malignant (M and metastatic type. The aim of our study was to analyze the clinicopathological factors, compare treatment options, and evaluate outcome in patients with PT. Methods: We retrospectively reviewed 162 women with PT. The surgical intervention varied from simple excision (lumpectomy/wide local excision (WLE in benign cases to simple/modified radical or radical mastectomy (SM/MRM/RM in malignant and recurrent tumors. Results: Out of 162 patients, B, BL, and M were 95 (58.64%, 29 (18%, and 38 (23.45%, respectively. Mean age, duration of lump, and size were 38 ± 8 years, 28 ± 10 months, and 12 ± 5 cm, respectively. Recurrence rate with B, BL, and M was 15.78%, 41.37%, and 55.26%, respectively (P = 0.00001. As compared to WLE (22%, SM (23.8%, and MRM/RM (14.2%, recurrence was higher with lumpectomy (48.9% (P = 0.004. Positive correlation was found between recurrence rate with the size of tumor (P = 0.008 and also number of recurrence with holoprosencephaly (P = 0.047. There was no association between the number of recurrences and size of tumor (P = 0.63. Malignant PT was seen in 38 (24% and distant metastasis was seen in 7 (18%. Mean duration of follow-up was 42 months. Conclusion: WLE with negative margins should be the initial surgery for PT. The role of adjuvant radiotherapy and chemotherapy is uncertain. PT is pathological enigma. Till date, no factors can accurately predict the recurrence and outcome. PT is known for unpredictable behavior and high recurrence rates, hence long-term follow-up is advised.

  12. Third ventricle liponeurocytoma: one case report and review of literature

    Directory of Open Access Journals (Sweden)

    Wu-wu DING


    Full Text Available Objective To study clinicopathological features, diagnosis, differential diagnosis and prognosis of central nervous system (CNS liponeurocytoma outside the cerebellum.  Methods One case of the third ventricle liponeurocytoma was reported focusing on the following aspects: clinical manifestations, histopathological features and immunophenotypes, and the relevant literatures were reviewed.  Results A 52-year-old female presented headache, and her head CT scan showed that there was a low-density lesion area at the former of the brain midline. The tumor was detected in the third ventricle during surgery. The size of tumor was 5.80 cm × 4.00 cm × 3.80 cm. Under optical microscopy, the tumor was biphasic in appearance, which consisted isomorphic small neuronal cells and mature adipose cells and adipose-like cells. Mature osseous tissue and intensive areas of calcification could also be seen. There was no necrosis or mitosis. By using immunohistochemical staining, the tumor cells were diffusely positive for S-100 protein (S-100 and β-catenin. A part of tumor cells were positive for neuronal nuclear antigen (NeuN, synaptophysin (Syn, murine double minute 2 (MDM2 and P53. Besides, the tumor cells were negative for glial fibrillary acidic protein (GFAP, oligodendrocyte transcription factor-2 (Oligo-2, isocitrate dehydrogenase 1 (IDH1, desmin (Des, CD68 and myelin basic protein (MBP. Ki-67 labeling index was about 1%.  Conclusions Central nervous system liponeurocytoma is a rare tumor, which is predominantly located in the cerebellar hemispheres, and those located out of cerebellum are much more seldom. Definite diagnosis could be made by typical histopathological characteristics and immunohistochemical expressions. Central nervous system liponeurocytoma has a very well prognosis. Most patients can survive over 5 years, and the longest sugvival is more than 18 years. doi: 10.3969/j.issn.1672-6731.2014.09.012

  13. Anterior mediastinal synovial sarcoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Wen-xiang YUE


    Full Text Available Objective To study the clinical manifestations, pathologic features, diagnosis, treatment and prognosis of primary synovial sarcoma in the anterior mediastinum. Methods A case of primary synovial sarcoma in the anterior mediastinum was reported. Clinical features, imaging manifestations, pathology features and therapeutic effect were analysed and the relevant literature was reviewed. Results A 48-year-male patient was admitted with complaint of right chest pain for 4 days. Chest computerized tomography revealed a large mass located at the right anterior mediastinum, and it was primarily diagnosed as invasive thymoma. Pathological examination by CT-guided percutaneous needle biopsy manifested that, under microscope, the tumor cells were short and spindle in shape forming a nest structure, suggested it was a thymoma. The patient then underwent resection of thymoma with removal of fat and connective tissue in the anterior mediastinum. During the operation the size of the tumor was 15cm×15cm×10cm, being located at the anterior mediastinum, and it tended to bleed. The diagnosis of primary monophasic synovial sarcoma in the mediastinum was confirmed by postoperative/pathology examination. Immunohistochemistry staining showed that the tumor cells were positive for the markers Bcl-2 and EMA, but negative for the markers CK (pan and S100. The patient suffered from local recurrence with metastases to lung 4 months after surgery. The patient received 2 chemotherapeutic courses with ifosfamide, epirubicin and cisplatin. He died 6 months after surgery. Conclusion Primary synovial sarcoma in the anterior mediastinum is an extremely rare and highly malignant tumor with poor prognosis. The diagnosis depends on the pathological features, immunohistochemistry and RT-PCR. Radical resection combined with comprehensive treatment may improve the survival rate. DOI: 10.11855/j.issn.0577-7402.2014.12.12

  14. Lactation studies of anticonvulsants : A quality review

    NARCIS (Netherlands)

    van der Meer, Douwe H.; Wieringa, Andre; Wegner, Ilse; Wilffert, Bob; Ter Horst, Peter G.J.


    AIM: The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research. METHODS: We reviewed the quality of the available lactation studies for 19 anticonvu

  15. Mucormycosis in Cairo, Egypt: review of 10 reported cases. (United States)

    Zaki, Sherif M; Elkholy, Iman M; Elkady, Nadia A; Abdel-Ghany, Khayria


    We report on 10 cases of mucormycosis, as defined by The European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) standards of invasive fungal diseases, among patients with a recent history of neutropenia, prolonged use of corticosteroids and treatment with immunosuppressants. They were all observed at the Ain Shams University Specialized Hospital in Cairo, Egypt, during the year 2010. These cases were categorized as 50% proven and 50% probable, with none considered to be possible mucormycosis. The median age of the patients discussed in this report was 50 years (range 22-68 years), of which 80% were male and 20% were female. Uncontrolled diabetes with ketoacidosis was noted in 60% of cases, while 40% of the patients had undergone liver transplantations. Pulmonary mucormycosis was the predominant presentation as it was noted in 80% of cases, but there was only 20% sinus involvement. Members of the genus Lichtheimia were the most common etiologic agents (40% of all cases), whereas Rhizopus ssp. were recovered from 30% of cases, Syncephalastrum spp. in 20%, and 10% of patients were infected with Rhizomucor. Liposomal formulation of amphotericin B (LAMB) was successfully used to treat all the cases described in this report. We concluded that the incidence of mucormycosis was relatively high during the study period in this one-center study and that additional studies looking into the diagnosis and the control of mucormycosis in Egypt are required.

  16. Ovarian metastasis in colorectal cancer: retrospective review of 180 cases

    Directory of Open Access Journals (Sweden)

    Omranipour R


    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Routine oophorectomy in women with colorectal cancer is under debate, the aim of this study is to determine incidence, clinicopathologic features and prognostic factors of ovarian involvement in primary colorectal cancer (CRC and to clear the role of prophylactic oophorectomy."n"nMethods: Data from primary CRC women treated between years 1990 and 2004 were retrieved and clinical and pathologic features of those who had undergone oophorectomy during CRC surgery were reviewed."n"nResults: One hundred eighty cases (mean age 47.5 years were included. In 120(66.6%, ovaries were preserved and 60(33.3% cases underwent bilateral oophorectomy in addition to primary CRC resection. Reasons for oophorectomy were prophylactic in 22(36.6%, abnormal morphology in 35(58.3%, and undetermined in 3(5% cases. There were five metastatic carcinomas, eight primary ovarian tumors and 47 normal ovaries in pathologic evaluation. No complication directly related to oophorectomy was noted. Patients with ovarian metastases had higher stages of tumor. Ovarian metastases were not related to menstrual status, CRC location, size, differentiation, and mucin production, as well as abnormal morphology of ovary. The global prevalence of

  17. Brown Tumors: A Case Report and Review of the Literature (United States)

    Can, Özgür; Boynueğri, Başak; Gökçe, Ali Murat; Özdemir, Ebru; Ferhatoğlu, Ferhat; Canbakan, Mustafa; Şahin, Gülizar Manga; Titiz, Mesut İzzet; Apaydın, Süheyla


    Brown tumors are focal bone lesions, encountered in patients with uncontrolled hyperparathyroidism. They can be located in any part of the skeleton. Clinically significant lesions in the craniofacial bones are rare. Craniofacial involvement may cause facial disfiguration and compromise social ease of the patient and normal functions, such as chewing, talking, and breathing. In this case report, we present a patient with a brown tumor of the craniofacial bones provoked by secondary hyperparathyroidism and review the last 10 years of craniofacial brown tumors associated with secondary hyperparathyroidism in the English literature. PMID:27066494

  18. Diffuse pulmonary lymphangiomatosis: a case report with literature review

    Institute of Scientific and Technical Information of China (English)

    DU Ming-hua; YE Ruan-jian; SUN Kun-kun; LI Jian-feng; SHEN Dan-hua; WANG Jun; GAO Zhan-cheng


    Diffuse pulmonary lymphangiomatosis (DPL) is a rare disease that is characterized by diffuse proliferation of abnormal pulmonary lymphatic channels. DPL occurs mostly in children and young adults and often undergoes a progressive clinical course, eventually causing deterioration of the lung. Both the clinical diagnosis and treatment of DPL remain a challenge. Here, we report a case of DPL in a 53-year-old Chinese woman with comprehensive investigations including pulmonary function tests, computer tomography (CT), bronchoscopy and histological examination of the lung biopsy, and review the literature.

  19. Primary intracranial peripheral PNET" - A case report and review

    Directory of Open Access Journals (Sweden)

    Kiranchand Velivela


    Full Text Available The site of origin of primitive neuroectodermal tumors (PNETs is quite varied and has significant influence on the prognosis. We report a case of intracranial peripheral PNET/Ewing′s sarcoma arising from the superior tentorial surface in a 13-year-old girl. Gross total excision of the tumor was done. We have discussed the distinction between central nervous system PNET (CNS PNET and Intracranial Peripheral PNET (pPNET/ES as their treatment and prognosis varies radically. A review of literature shows that prognosis is better in intracranial pPNET/ES.

  20. Pyogenic spinal osteomyelitis: a review of 61 cases. (United States)

    Silverthorn, K G; Gillespie, W J


    The presentation and outcome of 61 cases of nontuberculous spinal osteomyelitis were reviewed. Although the commonest presentation was subacute, with back pain predominating, 10% had septicaemia and 7% paraperesis or paraplegia. Most infections were caudal to the fourth thoracic vertebra. One third were associated with preceding urinary, respiratory, dental or abdominal sepsis. Staphylococcus aureus was the infecting organism in 85% of isolates. Delay in diagnosis was frequent. There were four deaths, and seven individuals remained severely disabled: outcome was otherwise satisfactory. An algorithm for the investigation and management of this uncommon but serious condition is proposed.

  1. Gardner's syndrome: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    C Fotiadis; DK Tsekouras; P Antonakis; J Sfiniadakis; M Genetzakis; GC Zografos


    Gardner's syndrome is an autosomal dominant disease characterized by the presence of colonic polyposis,osteomas and a multitude of soft tissue tumors. The syndrome may present at any age from 2 mo to 70 years with a variety of symptoms, either colonic or extracolonic.We present a case of a 11-year-old female patient with Gardner's syndrome who presented with a lumbar area desmoid tumor and treated with resection of the desmoid,restorative proctocolectomy and ileal pouch anal anastomosis,A review of the current literature has been performed.

  2. Primary Lymphoma of the Liver: A Case Report and Review

    Directory of Open Access Journals (Sweden)

    Franzjosef Schweiger


    Full Text Available The case of a previously healthy man who developed primary non-Hodgkin’s lymphoma of the liver is presented. Biopsy confirmed that the tumour was of the diffuse large cell type and was of apparent T-cell origin. The diagnosis of these rare tumours is suggested by the presence of a hepatic mass without lymphadenopathy, splenomegaly or bone marrow involvement, as well as normal carcinoembryonic antigen and alpha-fetoprotein levels. However, histological examination of tissue is essential to confirm the diagnosis. The response to treatment varies, but surgical resection and/or chemotherapy can result in prolonged remissions. The literature on this topic is briefly reviewed.

  3. Treacher Collins Syndrome: A Review and Case Presentation



    The Treacher Collins syndrome (TCS) is a dominant, autosomal craneofacial disorder. Its incidence is 1 in 25,000 to 50,000 live births. It’s caused secondary to mutations in the gen that codifies the treacle protein. Mala hipoplasia and anti mongoloid folds characterize it. The diagnosis is made by clinical examination and its treatment requires a multidisciplinary approach. This article makes a brief review of the STC and presents the case of a patient diagnosed and treated in the Hospital U...

  4. Paresthesia during orthodontic treatment: case report and review. (United States)

    Monini, André da Costa; Martins, Renato Parsekian; Martins, Isabela Parsekian; Martins, Lídia Parsekian


    Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder.

  5. Jaguar attack on a child: case report and literature review. (United States)

    Iserson, Kenneth V; Francis, Adama M


    Jaguar attacks on humans rarely occur in the wild. When they do, they are often fatal. We describe a jaguar attack on a three-year-old girl near her home deep in a remote area of the Guyanese jungle. The patient had a complex but, relatively, rapid transport to a medical treatment facility for her life-threatening injuries. The child, who suffered typical jaguar-inflicted injury patterns and survived, is highlighted. We review jaguar anatomy, environmental status, hunting and killing behaviors, and discuss optimal medical management, given the resource-limited treatment environment of this international emergency medicine case.

  6. Chondroblastoma-like osteosarcoma: a case report and review. (United States)

    Aycan, Osman Emre; Vanel, Daniel; Righi, Alberto; Arikan, Yavuz; Manfrini, Marco


    Chondroblastoma-like osteosarcomas are extremely rare malignancies having varying clinical, radiological and histological features. Their rarity causes challenges in both diagnosis and clinical management. They are often misdiagnosed as benign lesions. Their accurate diagnosis is important because they require adequate treatment. Misdiagnosed lesions or undertreatment may result in recurrences. We report a case of chondroblastoma-like osteosarcoma arising in the left first metatarsal bone with tarsometatarsal joint involvement in a 10-year-old boy for whom surgery with an original technique was planned after a multidisciplinary diagnostic review.

  7. Thrombophilia—A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Samer Abdelrazeq


    Full Text Available Upper limb ischemia presenting in neonatal period is extremely rare. Moreover, presenting newborn with evidence of intrauterine upper limb vascular occlusion is even rarer. It needs prompt intervention to restore perfusion and avoid morbidity. We present a newborn with right upper limb brachial artery thrombosis causing ischemia that was noted at birth and appeared later to be homozygous for factor V Leiden and glycoprotein IIIa with no other identifiable risk factors. In this report, we present the case, its successful medical management, proper counseling, and review of the literature. We recommend investigating the neonates and their parents for thrombophilia mutations when they present with unusual vascular occlusion site as newborns.

  8. Odontomas: Review Of Literature And Report Of A Case

    Directory of Open Access Journals (Sweden)

    Sumeeta Kaswan


    Full Text Available Odontomas are the most common of the odontogenic tumors of the jaws, which are benign, slow growing and nonaggressive. Odontomas are usually asymptomatic but sometimes may interfere with the eruption of the associated tooth leading to impaction or delayed eruption. These lesions are usually diagnosed on routine radiological examination in the second decade of the life. The aim of this paper is to present a thorough review on the etiology, clinical presentation, histopathological features and treatment aspects of odontomas. A case of compound odontoma has been reported along with.

  9. Multifocal spinal meningeal melanocytoma: an illustrated case review. (United States)

    Reddy, Rajesh; Krishna, Vamsi; Sahu, Barada Prasad; Uppin, Megha; Sundaram, Challa


    Primary melanocytic tumors of the central nervous system are rare. In this article the authors describe a case of C1C2 intradural extramedullary melanocytoma in a 43-year-old patient who presented with neck pain. C1-3 laminectomy was performed followed by excision of the lesion and an adjoining satellite nodule, along with the dural attachment. The histopathological features were consistent with a meningeal melanocytoma despite the presence of a satellite nodule. The patient has no evidence of recurrence during the six month follow up period. A brief review of literature pertaining to the radiological features, pathological findings, management and prognosis of this rare tumor is discussed.

  10. Acanthamoeba encephalitis: A Case Report and Review of Therapy

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    A Zamora


    Full Text Available Background: Acanthamoeba is a rare cause of encephalitis yet is associated with high mortality. Treatment protocols vary greatly and generally include combination therapy across a wide spectrum of antiinfective classes. Case Description: A 63-year-old male who underwent renal transplantation presented 6 months after transplantation with depressed level of consciousness. Imaging of the head with computerized tomography showed an enhancing lesion suspicious for brain abscess. Biopsy of the lesion showed Acanthamoeba cysts. The patient was treated with sulfadiazine, fluconazole, flucytosine, azithromycin, and miltefosine but without success. We review recently published cases of Acanthamoeba encephalitis with an emphasis on treatment protocols and outcomes. Conclusion: Free-living protozoans such as Acanthamoeba are ubiquitous in the environment and should be suspected in immunosuppressed persons who present with central nervous system findings and brain abscess. Biopsy is critical to establish the etiology so that appropriate combination therapy can be deployed.

  11. Dorsal extradural meningioma: Case report and literature review (United States)

    Dehcordi, Soheila Raysi; Ricci, Alessandro; Chiominto, Alessandro; De Paulis, Danilo; Di Vitantonio, Hambra; Galzio, Renato J.


    Background: Extradural spinal mass lesions are most commonly metastatic tumors. Extradural meningiomas are rare, accounting for approximately 2.5–3.5% of spinal meningiomas; intraoperatively, they are easily mistaken for malignant tumors, especially in the en plaque variety, resulting in inadequate surgical treatment. Case Description: Our case is one of the first to describe a patient with two purely extradural meningiomas, one each between D3–D4 and between D5–D6 vertebral levels. Surgical resection was radical, and pathologically both lesions were meningothelialmeningiomas. Conclusions: Reviewing the literature, we discuss the pathogenesis, treatment strategies, and long-term behavior of these uncommon lesions. PMID:27625886

  12. Mesonephric adenocarcinoma of the cervix: Case report and literature review

    Directory of Open Access Journals (Sweden)

    A. Dierickx


    Full Text Available A mesonephric adenocarcinoma of the cervix is a very rare tumor deriving from remnants of the mesonephric duct. Differential diagnosis from other cervical carcinomas is difficult and little is known regarding its biological behavior, prognosis, and the optimal management strategy. We present a case of a mesonephric adenocarcinoma of the cervix with a comprehensive review of the existing literature. In this case a 66-year-old woman presented with postmenopausal vaginal bleeding. She was diagnosed with a FIGO stage IIB mesonephric adenocarcinoma of the cervix and treated with neoadjuvant chemoradiotherapy and a Wertheim hysterectomy. The recovery from surgery was uneventful and the patient remains with no evidence of disease with 2 years of follow-up.

  13. Holocord spinal epidural abscess: Case report and literature review. (United States)

    Xiang, H; Ma, X; Shen, N; Yue, B; Zhang, G; Chen, B


    Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.

  14. Primary hepatic amyloidosis: A case report and review ofliterature

    Institute of Scientific and Technical Information of China (English)


    We describe a case of 42-year-old female presentingwith abdominal pain associated with loss of weightand fever for 8 mo. On evaluation she had grosshepatomegaly with raised alkaline phosphatase andraised GGT levels with normal transaminases andbilirubin. On imaging she had diffuse enlargement ofliver with heterogeneous contrast uptake in liver. Herviral marker and autoimmune markers were negative.Liver biopsy depicted massive deposition of amyloidin peri-sinusoidal spaces which revealed apple greenbirefringence on polarizing microscopy after Congo redstaining. Cardiac and renal evaluation was unremarkable.Abdominal fat pad and rectum biopsy was negativefor amyloid deposit. There was no evidence of primaryamyloidosis as bone marrow examination was normal.Serum and urine immunofixation electrophoresiswerenormal. Immunoperoxidase staining for serum amyloidassociated protein for secondary amyloidosis wasnegative from liver biopsy. We present this rare case ofprimary hepatic amyloidosis and review the literatureregarding varied presentationsof hepatic involvement inamyloidosis.

  15. Herpes Simplex Mastitis: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Holly Brown


    Full Text Available The most common sites of herpes simplex virus (HSV infection are around the oral cavity and the genitalia. However, HSV can infect any skin or mucous membrane surface. One uncommon site of HSV infection is the breast. Reports of herpetic breast infections are predominantly cases of transmission from a systemically HSV-infected neonate to the mother during breast-feeding. A review of the literature identified only six reports suggesting HSV breast lesions acquired by means other than through an infected infant. Of these, only one report suggests HSV transmission to the breast from a male sexual partner. A second case of clinically unsuspected symptomatic herpes mastitis presumably acquired from sexual contact in a 46-year-old woman is presented. Herpes simplex type 1 was isolated by using polymerase chain reaction and restriction fragment length polymerization techniques. The purpose of this report is to alert physicians to HSV mastitis.

  16. Lipoma causing Guyon's canal syndrome: a case report and review

    Directory of Open Access Journals (Sweden)

    Narayanathu Chellappantilla Sreekumar


    Full Text Available Compression of the ulnar nerve in Guyon's canal leads to Guyon's canal syndrome. Lipoma is a rare cause of such compressions with only 12 cases reported previously. We report a 55-year-old man who presented with swelling in the left hand with decreased sensation in the ring and little fingers. Magnetic resonance imaging revealed high signals in T1-weighted and T2-weighted images with suppression of the short T1 inversion recovery signal, suggestive of lipoma. On exploration a well-encapsulated, dumbbell-shaped, fatty tumor was seen in the hypothenar space and Guyon's canal. The tumor was enucleated in toto. At 6-month follow-up, the patient had fully regained sensation. A review of the literature is presented for similar cases where a lipoma was the cause of Guyon's canal syndrome.

  17. Calcification of vestibular schwannoma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang Yang


    Full Text Available Abstract Calcification rarely occurs in vestibular schwannoma (VS, and only seven cases of calcified VS have been reported in the literature. Here, we report a 48-year-old man with VS, who had a history of progressive left-sided hearing loss for 3 years. Neurological examination revealed that he had left-sided hearing loss and left cerebellar ataxia. Magnetic resonance imaging and computerized tomography angiography showed a mass with calcification in the left cerebellopontine angle (CPA. The tumor was successfully removed via suboccipital craniotomy, and postoperative histopathology showed that the tumor was a schwannoma. We reviewed seven cases of calcified VS that were previously reported in the literature, and we analyzed and summarized the characteristics of these tumors, including the calcification, texture, and blood supply. We conclude that calcification in VS is associated with its texture and blood supply, and these characteristics affect the surgical removal of the tumor.

  18. Scedosporium prolificans Endocarditis: Case Report and Literature Review. (United States)

    Wakabayashi, Yoshitaka; Okugawa, Shu; Tatsuno, Keita; Ikeda, Mahoko; Misawa, Yoshiki; Koyano, Saho; Tsuji, Eiichi; Yanagimoto, Shintaro; Hatakeyama, Shuji; Moriya, Kyoji; Yotsuyanagi, Hiroshi


    Scedosporium prolificans, a hyaline filamentous fungus, is widely distributed in the environment and is currently an emerging human pathogen, especially among immunocompromised patients. However, S. prolificans endocarditis is rare. We herein report a case of S. prolificans endocarditis in a 64-year-old patient with breast cancer in complete remission for 30 years after chemotherapy and radiation treatment who was not cured. Susceptibility testing showed resistance to all antifungal drugs, except echinocandin. A review of the literature revealed 10 cases of S. prolificans endocarditis; of these, only one involved an immunocompetent host with no risk factors and only two patients survived. In order to improve the mortality rate, it is necessary to establish rapid diagnostic methods and efficient therapeutic approaches.

  19. Safety of Moxibustion: A Systematic Review of Case Reports

    Directory of Open Access Journals (Sweden)

    Ji Xu


    Full Text Available Moxibustion is a traditional medical treatment originating in China. It involves using the heat of burning moxa to stimulate acupoints. It is considered safe and effective and is widely used throughout the world. The increasing use of moxibustion has drawn attention to the procedure’s adverse events (AEs. This review covers a total of 64 cases of AEs associated with moxibustion in 24 articles, reported in six countries. Some evidence of the risks of moxibustion has been found in these cases. AEs include allergies, burns, infection, coughing, nausea, vomiting, fetal distress, premature birth, basal cell carcinoma (BCC, ectropion, hyperpigmentation, and even death. The position, duration, distance between moxa and skin, proficiency of the practitioners, conditions of the patients, presence of smoke, and even the environment of treatment can affect the safety of moxibustion. Improving practitioner skill and regulating operations may reduce the incidence of adverse reactions and improve the security of moxibustion.

  20. Catalog of NASA-Related Case Studies (United States)

    National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...

  1. [Prenatal diagnosis. Review, personal and prospective studies]. (United States)

    Engel, E; Empson, J; DeLozier, D; McGee, B; da Costa Woodson, E; Engel-de Montmollin, M; Carter, T; Lorber, C; Cassidy, S B; Millis, J; Heller, R M; Boehm, F; Vanhooydonk, J


    1. In a review of methods developed for the identification of fetal malformations, the technique, risks and results of amniocentesis are presented. 2. Large series already published have demonstrated the relative simplicity and feasibility of the procedure as well as current indications for its utilization. These include the detection of chromosomal anomalies, the determination of sex (in certain sex-linked disorders), documentation of enzymatic and metabolic deficiencies, and the demonstration of open lesions of the neural tube by appropriate techniques. 3. Experience with over 500 cases personally tested by the authors entirely confirms the major indications for and benefits of this modern method for the detection and prevention of severe congenital anomalies during early pregnancy. 4. The identification of chromosomal alterations is currently the major objective of the method. Increased risks are associated with pregnancies involving a maternal age of 35 years or older (which account for 1-3% of aneuploidies), the birth of a previous infant with free trisomy 21 (1% recurrence risk) or secondary to a parental chromosome translocation (as much as 10% risk of aneuploidy). Fetal karyotyping for determination of sex, in cases where the mother is a carrier of an X-linked recessive gene (on average, 50% of male offspring will be affected), is an inadequate method of diagnosis to be utilized only until alternative techniques render possible specific diagnosis of the anomalies under consideration (hemophilias A and B, muscular dystrophy, etc). 5. Several of these techniques are now nearing development through the advent of fetoscopy and advanced ultrasound methodology, and have already been applied to the detection of certain sex-linked disorders and also for diagnosis of hemoglobinopathies (thalassemias, sickel cell anemia) and other conditions requiring the obtaining of fetal blood for diagnosis. Technology allowing direct examination of fetal parts by means of optical

  2. Iatrogenic surgical microscope skin burns: A systematic review of the literature and case report. (United States)

    Lopez, Joseph; Soni, Ashwin; Calva, Daniel; Susarla, Srinivas M; Jallo, George I; Redett, Richard


    Cutaneous burns associated with microscope-use are perceived to be uncommon adverse events in microsurgery. Currently, it is unknown what factors are associated with these iatrogenic events. In this report, we describe the case of a 1-year-old patient who suffered a full thickness skin burn from a surgical microscope after a L4-S1 laminectomy. Additionally, we present a systematic review of the literature that assessed the preoperative risk, outcome, and management of iatrogenic microscope skin burns. Lastly, a summary of the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database of voluntary adverse events was reviewed and analyzed for clinical cases of microscope thermal injuries. The systematic literature review identified only seven articles related to microsurgery-related cutaneous burns. From these seven studies, 15 clinical cases of iatrogenic skin burns were extracted for analysis. The systematic review of the FDA MAUDE database revealed only 60 cases of cutaneous burns associated with surgical microscopes since 2004. Few cases of microscope burns have been described in the literature; this report is, to our knowledge, one of the first comprehensive reports of this iatrogenic event in the literature.

  3. Assessment of scientific research: a case-study of CERN

    Energy Technology Data Exchange (ETDEWEB)

    Martin, B.R.; Minchin, N.; Skea, J.; Peacock, T.; Crouch, D.; Irvine, J.


    The review aims to demonstrate that formal methods of evaluating research performance can play a valuable role in overcoming some of the problems with decision-making in basic science based on peer review. An approach which combines a number of research output indicators, including bibliometric measures derived from publication and citation analysis, is first outlined and then applied in a case study of the European Laboratory for Particle Physics, CERN, over the period 1961-1984.

  4. Review of traffic conflicts technique studies.

    NARCIS (Netherlands)

    Hondel, M. van den & Kraay, J.H.


    A review of literature concerning traffic conflicts technique studies is presented. The 101 references arranged alphabetically by authors' names are given with abstract. The procedure used in compiling this survey is outlined.

  5. Case Study: The Chemistry of Cocaine (United States)

    Dewprashad, Brahmadeo


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  6. Writing case studies in information systems research

    NARCIS (Netherlands)

    van der Blonk, H.C.


    Case study research can be reported in different ways. This paper explores the various ways in which researchers may choose to write down their case studies and then introduces a subsequent typology of writing case studies. The typology is based on a 2 x 2 matrix, resulting in four forms of writing

  7. A Case for Limiting the Reach of Institutional Review Boards (United States)

    Hessler, Richard M.; Donnell-Watson, D. J.; Galliher, John F.


    Institutional review boards (IRBs) governing social and behavioral research seem to systematically exceed the guidelines established by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. We examine a clandestine study of prostitution and another of employment discrimination and conclude that IRBs,…

  8. Follicular dendritic cell sarcoma: a report of six cases and a review of the Chinese literature

    Directory of Open Access Journals (Sweden)

    Wen Jifang


    Full Text Available Abstract Goals The main purpose of this study is to broaden the clinicopathological spectrum and increase recognition of follicular dendritic cell sarcoma (FDCS through analysis of the clinical and pathological features of 50 cases. Methods The clinicopathological features of total 50 cases of FDCS were analyzed including a review of 44 cases reported in Chinese literature before October 2009 and six original cases from the pathology files conducted by the authors. Results The youngest patient came under observation in this study is only seven years old. Including the cases contributed by the authors, our literary review indicated that male dominated the tumor cases (M: F = 3: 2. 28 cases (56% present with this disease in extranodal sites. Tumor cells demonstrated positive staining for the follicular dendritic cell markers CD21 (47/49, CD35 (43/45, CD23 (20/23 and CD68 (23/25. In situ hybridization for Epstein-Barr virus-encoded RNA was performed in 10 cases. Nevertheless, EBV expression was absent in all these cases. The follow-up analysis of all cases shows that 26 (81.2% patients were alive and disease free; 6 (18.8% patients were alive with recurrent disease or metastasis; and nobody had died of this disease at the time of last follow-up. Conclusions The diagnosis of the FDCS is based on the findings of morphology and immunohistochemistry. The FDCS occurred in China should be viewed and treated as a low-grade sarcoma, and the role of the EBV in the pathogenesis of this tumor is still uncertain. There is a possibility that the tumor might be racial or geographic correlated, because most cases were reported from Eastern Asia area; it's particular the case of the liver or spleen tumor.

  9. Case Study of the California Cement Industry

    Energy Technology Data Exchange (ETDEWEB)

    Coito, Fred; Powell, Frank; Worrell, Ernst; Price, Lynn; Friedmann, Rafael


    California is the largest cement producing state in theU.S., accounting for between 10 percent and 15 percent of U.S. cementproduction and cement industry employment. The cement industry inCalifornia consists of 31 sites that consume large amounts of energy,annually: 1,600 GWh of electricity, 22 million therms of natural gas, 2.3million tons of coal, 0.25 tons of coke, and smaller amounts of wastematerials, including tires. The case study summarized in this paperfocused on providing background information, an assessment ofenergy-efficiency opportunities and barriers, and program recommendationsthat can be used by program planners to better target products to thecement industry. The primary approach to this case study involvedwalk-through surveys of customer facilities and in depth interviews withcustomer decision makers and subsequent analysis of collected data. Inaddition, a basic review of the cement production process was developed,and summary cement industry energy and economic data were collected, andanalyzed. The analysis of secondary data provides background informationon the cement industry and identification of potential energy-efficiencyopportunities. The interviews provide some understanding of the customerperspective about implementation of energy-efficiencyprojects.

  10. Management of dentinogenesis imperfecta: a review of two case reports. (United States)

    Rafeek, Reisha N; Paryag, Amit; Al-Bayaty, Haytham


    Dentinogenesis imperfecta (DI) is an inherited disorder that affects dentin and often manifests as tooth discoloration; in addition, the dentition is also extremely susceptible to wear. Treatment of DI focuses primarily on protecting affected dentin, reducing sensitivity, and improving esthetics. Routine restorative materials, such as amalgams and composites, may be used. In more severe cases, the treatment of choice is full coverage crowns, while bonding of veneers may be used to improve the esthetics of the anterior teeth. This study presents two cases of Type II DI in the same family and the management of each case. Restorative management included amalgams, composite veneers, crowns, bridges, and overdentures.

  11. Concentrated photovoltaics, a case study

    Directory of Open Access Journals (Sweden)

    Antonini Piergiorgio


    Full Text Available Concentrated Photovoltaics (CPV, once a niche technology, has now reached the maturity and reliability for large scale power generation. Especially in regions where temperatures are very high, the use of high efficiency triple junction solar cells with concentrating optics allows stable energy yield. Thus CPV can be seen as complementary and not in concurrence with silicon photovoltaics. The state of the art, the advantages and limitations of this technology will be shown. Among the main advantages of CPV is the possibility of a much higher energy supply, when compared to silicon photovoltaics, both comparing CPV and silicon with same area or the same installed power. The use of recycled and recyclable materials allows a more environmentally friendly production. The possibility to couple CPV with desalination facilities, energy storage will be analysed. As an example a case study of a CPV installation in Northern Italy is discussed. Here the use of mature technologies, derived from automotive and lighting sectors resulted in a simple and efficient module.

  12. Concentrated photovoltaics, a case study (United States)

    Antonini, Piergiorgio; Centro, Sandro; Golfetto, Stelvio; Saccà, Alessandro


    Concentrated Photovoltaics (CPV), once a niche technology, has now reached the maturity and reliability for large scale power generation. Especially in regions where temperatures are very high, the use of high efficiency triple junction solar cells with concentrating optics allows stable energy yield. Thus CPV can be seen as complementary and not in concurrence with silicon photovoltaics. The state of the art, the advantages and limitations of this technology will be shown. Among the main advantages of CPV is the possibility of a much higher energy supply, when compared to silicon photovoltaics, both comparing CPV and silicon with same area or the same installed power. The use of recycled and recyclable materials allows a more environmentally friendly production. The possibility to couple CPV with desalination facilities, energy storage will be analysed. As an example a case study of a CPV installation in Northern Italy is discussed. Here the use of mature technologies, derived from automotive and lighting sectors resulted in a simple and efficient module.

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

    Institute of Scientific and Technical Information of China (English)

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


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

  14. Dorsal intramedullary spinal epidermoid cysts: Report of two cases and review of literature

    Directory of Open Access Journals (Sweden)

    Cincu Rafael


    Full Text Available Intramedullary epidermoid cysts of the spinal cord are rare tumors, especially those not associated with spinal dysraphism. About 50 cases have been reported in the literature. Of these, only seven cases have had magnetic resonance imaging (MRI studies. We report two cases of spinal intramedullary epidermoid cysts with MR imaging. Both were not associated with spina bifida. In one patient, the tumor was located at D4 vertebral level; while in the other, within the conus medullaris. The clinical features, MRI characteristics and surgical treatment of intramedullary epidermoid cyst are presented with relevant review of the literature.

  15. Adalimumab-associated antiphospholipid syndrome: a case report and review of the literature. (United States)

    Hemmati, Iman; Kur, Jason


    This study aims for the presentation of the first reported case of adalimumab-associated antiphospholipid syndrome (APS) and review of the literature on adalimumab-induced vasculitis and APS. A case of APS associated with adalimumab use in a 67-year-old woman is reported. The English medical literature was reviewed for antitumor necrosis factor (TNF) agents and their association with APS and vasculitis. Adalimumab is a fully humanized monoclonal antibody targeted against TNF alpha that is widely used in the treatment of rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis, and Crohn's disease. Literature review reveals several cases of anti-TNF-induced vasculitis including cases associated with adalimumab. We report the first case of adalimumab-induced APS in a 67-year-old woman who developed APS and vasculitis associated with de novo positive anti-cardiolipin (aCL) antibody following the third dose of adalimumab therapy for the treatment of spondyloarthropathy. This is the first case demonstrating that a short course of adalimumab therapy may induce immunoglobulin M aCL autoantibodies leading to APS. With the growing use of anti-TNF medications in immune-mediated and inflammatory diseases, adalimumab and other anti-TNF medications should be considered as a possible explanation for APS.

  16. Delusion of pregnancy: A systematic review of 84 cases in the literature

    Directory of Open Access Journals (Sweden)

    Sagar Chandra Bera


    Full Text Available Case reports of delusion of pregnancy have emanated from all over the world, yet the rarity of this phenomenology has precluded systematic large scale descriptive or cohort studies. This systematic review was conducted to assess the demographic characteristics, clinical profile, treatment outcome and aetiological factors from the published case reports of delusion of pregnancy. Electronic databases including PubMed, PsychInfo and Google Scholar were used to identify case reports relating to delusion of pregnancy published in peer-reviewed English language journals. All such cases were systematically evaluated by investigators, and information was extracted using a structured proforma. A total 40 articles were reviewed which included 84 cases. Demographic characteristics revealed that about half of the patients were aged 20-40 years. The most common diagnoses were schizophrenia (35.7%, bipolar disorders (16.7% and depression (9.5%. Single foetus was reported by 79.8% of the patients, and 45.2% perceived foetal movements. Good treatment response was noted in 64.3 % of the cases. The prominent aetiological factors that were implicated included psychosocial factors, coenaesthopathological processes, socio-cultural factors and hyperprolactinaemia. Delusion of pregnancy is a heterogeneous symptom which emerges during the course of various neuropsychiatric disorders. A range of aetiopathological mechanisms have been implicated in the causation of this disorder.

  17. Spinal epidural abscess in hemodialysis patients: a case series and review. (United States)

    Wong, San S; Daka, Smitha; Pastewski, Andrew; Kyaw, Win; Chapnick, Edward; Sepkowitz, Douglas


    Spinal epidural abscess (SEA) is a rare but potentially devastating condition. We noticed an increase in the number of cases of SEA, with the majority in hemodialysis (HD) patients. This prompted a retrospective chart review of all cases of SEA admitted from 2000 to 2005 and a literature search of similar cases. We identified 19 SEA cases treated at Long Island College Hospital during this 6-year period, of which six were on HD: four were dialyzed via catheter, one via arteriovenous fistula, and in one the method of dialysis was not documented. Four patients had bacteremia with Staphylococcus aureus. Four patients presented with paresis or paralysis; only one improved. The mortality rate was 33% (2/6). We found 30 other cases of SEA in patients on HD from the literature. These 36 HD cases were compared with 85 SEA cases that were not on HD (13 from our study and 72 described in two large case series). The mortality rate was noted to be much higher in HD patients (23% [6/26] versus 7% [6/85]). Neurologic deficit at presentation was noted in 47% (17/36) of HD patients versus 69% (59/85) of non-HD patients, but neurologic improvement was higher in non-HD patients (71% [42/59] versus 29% [5/17]). This is the largest literature review of SEA in patients on HD. When compared with non-HD patients, HD patients had a higher mortality rate and were less likely to improve neurologically.

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

    Directory of Open Access Journals (Sweden)

    Benjamin Hopkins


    Conclusion: Numerous cases of trauma associated cruciate paralysis have been reported in the literature; however, there remains a strong need for further study of the condition. While certain risk factors can be elicited from currently reported studies, insignificant data exist to make any sound conclusion concerning whether surgical intervention is always the best method of treatment.

  19. Groundwater and climate change in Africa : review of recharge studies


    Bonsor, H. C.; MacDonald, A. M.


    The review of recharge studies was conducted as part of a one year DFID-funded research programme, aimed at improving understanding of the impacts of climate change on groundwater resources and local livelihoods – see The review is one of a series of components within the project. The overall outputs of the project are: Two hydrogeological case studies in West and East Africa – which assess the storage and availability of groundwater in different aquifers a...

  20. [Food-borne botulism: review of five cases]. (United States)

    Cardoso, Teresa; Costa, Manuela; Almeida, H Cristina; Guimarães, Mário


    Food-borne botulism is a disease caused by the ingestion of food contaminated with botulinum toxin, often present in smoked meat, canned food and preserved food; it can occur as sporadic case or as an outbreak. In the last decades there has been an increasing incidence of food-borne botulism in Portugal. The authors do a review of five cases of food-borne botulism, three isolated cases and 2 familiar. Four were associated with the ingestion of smoked ham and one of canned tunafish. The incubation period was 48 hours in one patient and 4 days in another, in the remaining patients it was not possible to determine this period. The clinical picture was dominated in all patients by diplopy, dysphagia, dizziness, blurred vision, dry mouth and constipation, and in two patients there were gastrointestinal complains. In one patient the electromyography findings were compatible with pre-synaptic neuromuscular blockage. A toxin type B was found in the serum of one patient and in the food involved in the two familiar cases. All patients experienced complete recovery with only symptomatic treatment. With this article the authors intend to call attention to this diagnosis, which is not rare, but difficult for someone not familiar with its presentation, being of notice that the diagnosis is essentially clinic with a strong epidemiological history, confirmed by typical electromyography findings and by the identification of the toxin involved. In Portugal there is only descriptions of clinical cases associated with the type B and the type E toxins, not being necessary the resource to the antitoxin therapy.

  1. Otomastoiditis caused by Sphingomonas paucimobilis: case report and literature review

    Directory of Open Access Journals (Sweden)

    Gabriel Nuncio Benevides


    Full Text Available Sphingomonas paucimobilis is an aerobic Gram-negative bacillus that, although rare in humans, most commonly infects immunocompromised and hospitalized patients. Among the 59 pediatric cases of S. paucimobilis infection reported in the literature, the most common diagnosis involves isolated bacteremia. These cases are related to sporadic or epidemic infections. Death related to this infection occurred in only one case. The authors report a case of an 11-year-old boy with the diagnosis of Sphingomonas paucimobilis otomastoiditis and a thorough review of the literature on this infection in pediatrics. The patient presented a 20-day history of fever, otalgia, otorrhea, and progressive retroauricular swelling with protrusion of the left ear; despite 15 days of amoxicillin regimen. His past medical history included chronic bilateral otitis media, but no cause of immunosuppression was found. A brain computed tomography scan showed left otomastoiditisassociated with a large circumscribed fluid collection with deep involvement of the soft tissues of the temporal region, including the subperiosteal space. Blood tests showed neutrophilia and elevated C-reactive protein. Surgical manipulation of the cited collection drained a large amount of a fetid purulent secretion. Ceftazidime and clindamycin were empirically initiated. The outcome was favorable, with fever defervescence and resolution of the scalp deformation. Culture of the drained secretion was positive for S. paucimobilis. Ciprofloxacin was scheduled for a further 10 days after discharge. The follow-up showed complete recovery. As far as we know, this is the first case of S. paucimobilis otomastoiditis, complicated with subperiosteal abscess in an immunocompetent child. The authors call attention to the increasing number of reports on S. paucimobilis infection over the years, and therefore to the importance of this pathogen, which was previously underestimated.

  2. Melioidosis in Malaysia: A Review of Case Reports (United States)

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini


    Background Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. Objective We sought to review case reports of melioidosis from Malaysia. Methods We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Results Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24–48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common—genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of

  3. Demystifying Instructional Innovation: The Case of Teaching with Case Studies (United States)

    Kantar, Lina D.


    Issues emerging from instructional innovation are inevitable, yet basing any curriculum shift on a theoretical framework is paramount. This paper grounds the case-based pedagogy in three learning theories: behaviorism, cognitivism, and constructivism. The three theories are described and situated in relation to the case study method. An…

  4. Alstrom syndrome (OMIM 203800: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hegele Robert A


    Full Text Available Abstract Background Alstrom syndrome (AS is a rare autosomal recessive disease characterized by multiorgan dysfunction. The key features are childhood obesity, blindness due to congenital retinal dystrophy, and sensorineural hearing loss. Associated endocrinologic features include hyperinsulinemia, early-onset type 2 diabetes, and hypertriglyceridemia. Thus, AS shares several features with the common metabolic syndrome, namely obesity, hyperinsulinemia, and hypertriglyceridemia. Mutations in the ALMS1 gene have been found to be causative for AS with a total of 79 disease-causing mutations having been described. Case presentation We describe the case of a 27-year old female from an English (Caucasian kindred. She had been initially referred for hypertriglyceridemia, but demonstrated other features suggestive of AS, including blindness, obesity, type 2 diabetes, renal dysfunction, and hypertension. DNA analysis revealed that she is a compound heterozygote with two novel mutations in the ALMS1 gene – H3882Y and V424I. Examination of her family revealed that her phenotypically unaffected mother and younger sister also had heterozygous mutations in the ALMS1 gene. In addition to presenting these novel molecular findings for AS, we review the clinical and genetic features of AS in the context of our case. Conclusion Two novel mutations in the ALMS1 gene causative for AS have been reported here, thereby increasing the number of reported mutations to 81 and providing a wider basis for mutational screening among affected individuals.

  5. [Conjugal leprosy infection in Japan--case report and review]. (United States)

    Ozaki, Motoaki; Tomoda, Masakazu


    The authors reported a conjugal leprosy infection observed in Japan. The husband, index case, first noticed sensory disturbance at the lower right leg in his forties. He developed edematous swelling with redness of the right hand and forearm at the age of 72 (1989), and then developed multiple erythema and hypesthesia at the extremities. He was diagnosed as BL type leprosy (reactional stage) and treated with multi-drug therapy. His 71-year-old wife developed a few erythema at the right forearm in 1993. She was classified as BT type. The duration of their marriage life was over forty years. The couple did not have consanguinity. No other leprosy patients were found in their lineage. From their clinical courses the authors concluded that the husband infected his wife. According to Japanese literatures, the frequency of conjugal leprosy among new patients in Japan was approximately 1%. There were worldwide observations that the husband often infected the wife, and mostly the index case was multibacillary and the secondary case paucibacillary. The authors reviewed definition and frequency of conjugal leprosy, factors in conjugal infection and leprosy infection among the adults.

  6. Zygomatic Intraosseous Hemangioma: Case Report and Literature Review. (United States)

    Powers, David B; Fisher, Elda; Erdmann, Detlev


    Intraosseous hemangiomas are uncommon intrabony lesions, representing approximately 0.5 to 1% of all intraosseous tumors. Their description varies from "benign vasoformative neoplasms" to true hamartomatous proliferations of endothelial cells forming a vascular network with intermixed fibrous connective tissue stroma. These commonly present as a firm, painless swelling. Intraosseous hemangiomas present more commonly in females than in males and most likely occur in the fourth decade of life. The most common etiology of intraosseous hemangioma is believed to be prior trauma to the area. They have a tendency to bleed briskly upon removal or biopsy, making preoperative detection of the vascular nature of the lesion of significant importance. There are four variants: (1) capillary type, (2) cavernous type, (3) mixed variant, and (4) scirrhous type. Generally most common in the vertebral skeleton, they can also present in the calvarium and facial bones. In the head, the most common site is the parietal bone, followed by the mandible, and then malar and zygomatic regions. Intraosseous hemangiomas of the zygoma are rare entities with the first case reported in 1950 by Schoenfield. In this article, we review 49 case reports of intraosseous hemangioma of the zygoma, and also present a new case treated with excision followed by polyether-ether ketone implant placement for primary reconstruction.

  7. Chondroblastoma of the Clivus: Case Report and Review. (United States)

    Liu, Jonathan; Ahmadpour, Arjang; Bewley, Arnaud F; Lechpammer, Mirna; Bobinski, Matthew; Shahlaie, Kiarash


    Background and Importance Chondroblastoma is a benign primary bone tumor that typically develops in the epiphyses of long bones. Chondroblastoma of the craniofacial skeleton is extremely rare, with most cases occurring in the squamosal portion of the temporal bone. In this report, we describe the first case of chondroblastoma of the clivus presenting with cranial neuropathy that was treated with endoscopic endonasal resection. We review the literature on craniofacial chondroblastomas with particular emphasis on extratemporal lesions. Case Presentation A 27-year-old woman presented with severe headache, left facial dysesthesias, and diplopia. Physical examination revealed hypesthesia in the left maxillary nerve dermatome, and complete left abducens nerve palsy. Imaging demonstrated an expansile intraosseous mass originating in the upper clivus with extension superiorly into the sella turcica and laterally to involve the medial wall of the left cavernous sinus. The tumor was completely resected via an endoscopic endonasal approach, with postoperative improvement in lateral gaze palsy. Histopathology was consistent with chondroblastoma. Conclusion Chondroblastoma is a rare tumor of the craniofacial skeleton that should be included in the differential diagnosis of an osteolytic lesion of the clivus. Complete surgical resection remains the mainstay of treatment.

  8. Urinothorax: Case report and systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Alexander Casallas


    Full Text Available Urinothorax, the presence of urine in the pleural space, is a rare cause of pleural effusion, usually associated with obstructive uropathy, or urinary trauma. We present the case of a 3 year-old boy and a systematic review of the literature of the 44 cases encountered. After resection of a Wilm's tumour in the right kidney our patient presented acute respiratory distress associated with radiographically confirmed pleural effusion. With the initial diagnosis of pneumonia or malignant pleural effusion, a closed thoracotomy was performed. The liquid obtained suggested urine, which was confirmed by the laboratory. Cystoscopy with retrograde pyelography detected a fistula on the posterior wall of the right kidney. The report of cases worldwide is low, probably due to its low incidence but also to underdiagnosis. Respiratory symptoms are not always present and urological symptoms usually predominate. Diagnosis requires a high degree of clinical suspicion and is confirmed by the main biochemical marker: The ratio >1 .0 pleural fluid creatinine and creatinine serum.

  9. Barodontalgia among flyers: a review of seven cases. (United States)

    Holowatyj, R E


    Once referred to as "flyer's toothache," barodontalgia is defined as tooth pain occurring with changes in ambient pressure. It usually occurs in people who fly or dive. It can develop in conjunction with sinusitis, and in teeth experiencing pulpitis after restorative treatment, new and recurrent caries, intra-treatment endodontic symptoms, dental and periodontal cysts, or abscesses. Although the causal process of barodontalgia is not well understood, it may be related to pulpal hyperemia, or to gases that are trapped in the teeth following incomplete root canal treatment. Patients who are frequently exposed to changes in ambient pressure should be encouraged to follow good oral health practices, attend regularly-scheduled dental recall examinations and accept the timely completion of restorative treatment to minimize the possibility of developing barodontalgia. By employing a classification system to document cases of barodontalgia, dentists will be better prepared to provide appropriate and successful treatment. Seven case reports of barodontalgia are presented and compared to previously documented cases. The author also reviews the reasons why military flyers are more likely to develop barodontalgia than others, although the passengers and crews of commercial airliners may also suffer from this condition.

  10. Background: GIS Applications and Case Studies


    01, CCTP; Albert, Don


    This unit presents (1) a case study and (2) a bibliographic resource for GIS in the medical field. The case study illustrates the use of a GIS to monitor and analyze spatial patterns of physicians' multiple locations. This case highlights data location, acquisition and assessment, join and relational operators, geocoding and distance calculations, and standard query language.

  11. Clinical Case Studies in Psychoanalytic and Psychodynamic Treatment (United States)

    Willemsen, Jochem; Della Rosa, Elena; Kegerreis, Sue


    This manuscript provides a review of the clinical case study within the field of psychoanalytic and psychodynamic treatment. The method has been contested for methodological reasons and because it would contribute to theoretical pluralism in the field. We summarize how the case study method is being applied in different schools of psychoanalysis, and we clarify the unique strengths of this method and areas for improvement. Finally, based on the literature and on our own experience with case study research, we come to formulate nine guidelines for future case study authors: (1) basic information to include, (2) clarification of the motivation to select a particular patient, (3) information about informed consent and disguise, (4) patient background and context of referral or self-referral, (5) patient's narrative, therapist's observations and interpretations, (6) interpretative heuristics, (7) reflexivity and counter-transference, (8) leaving room for interpretation, and (9) answering the research question, and comparison with other cases. PMID:28210235

  12. Actinic Prurigo Cheilitis: A Clinicopathologic Review of 75 Cases. (United States)

    Plaza, Jose A; Toussaint, Sonia; Prieto, Victor G; Mercadillo, Patricia; Diez de Medina, Juan C; Lourenco, Silvia; Batdorf, Bjorn; Sangueza, Martin


    Actinic prurigo (AP) is a chronic idiopathic photodermatosis that primarily affects American Indians in the United States and Mestizos in Latin American countries. Clinically, the onset of the disease is usually in the first decade of life but may appear initially in adult life, and it is characterized by symmetric involvement of sun-exposed areas of the skin, particularly areas of the face, resulting in polymorphic erythematous papules, macules, and plaques in different stages of evolution. Lower lip involvement includes swelling, scaling, fissures, hyperpigmentation, and ulcerations of the vermilion border. and in some cases could represent the only manifestation of the disease. The histopathologic features of AP have been studied; however, there is a controversy regarding whether AP cheilitis has distinct histopathologic features that could allow accurate separation from other specific and nonspecific forms of cheilitis. The diagnosis can be challenging, mainly when lip lesions are the only manifestation of the disease. In this study, the authors investigate the clinicopathologic features of 75 cases of AP cheilitis to provide further criteria for its diagnosis and classification. All 75 patients presented with lip lesions. Thirty-three cases were diagnosed as AP cheilitis with cutaneous lesions and 42 cases were diagnosed as AP cheilitis without cutaneous lesions (only lip lesions). Histologically, of the 33 cases with AP cheilitis with cutaneous lesions, 17 (52%) cases showed follicular cheilitis, and of the 42 cases that had only lip lesions, 18 (43%) cases showed follicular cheilitis. Histologically, AP cheilitis can present as follicular cheilitis; thus, supporting the diagnosis. Also, our findings confirm that lip lesions can present as the only manifestation of the disease, showing typical histological and clinical features. This form of cheilitis has not being well described in the dermatologic and dermatopathologic literature.

  13. Summary of the LIU Beam Studies Review

    CERN Document Server

    Rumolo, G; Bartmann, W; Bartosik, H; Huschauer, A; Raginel, V; Timko, H


    A review of the status of the LHC injector beam studies related to the LHC Injectors Upgrade (LIU) project took place on the 28 August 2012 at CERN. The main goal of the review was to define work priorities for the rest of the run before the Long Shutdown 1 (LS1) and be able to: • specify the equipment to be built for the LIU project; • estimate achievable beam characteristics in the various accelerators. A team of external reviewers was also asked to participate in the event and comment on the status of the presently ongoing activities as well as give recommendations for future work.

  14. A rare case of infantile myofibromatosis and review of literature. (United States)

    Hausbrandt, Peter A; Leithner, Andreas; Beham, Alfred; Bodo, Koppany; Raith, Johannes; Windhager, Reinhard


    Infantile myofibromatosis is a rare benign tumor-disease (1/400,000). Four different types have been reported in literature. The most commonly affected body areas are the head, the neck, and the trunk. We would like to present a rare case of a multicentric type with singular visceral involvement and a literature review of all case series with more than five patients. A 9-month-old boy presented with a swelling on the medial side of his proximal left tibia. The lesion which was present since birth, was well palpable, indolent, hard, and mobile in relation to the surrounding tissue. Radiographic films and ultrasound examination presented a pretibial soft-tissue tumor mass with calcifications and two osteolytic lesions with a sclerotic rim. A skeletal survey showed more osteolytic lesions, but the magnetic resonance imaging showed no more soft-tissue lesions. The rapid frozen section biopsy hinted at the diagnosis of histiocytosis X. The definitive histological result 6 days later was infantile myofibromatosis. As therapy, we determined a wait-and-see policy with controls all 3 months. At 20 months follow-up, the boy showed beginning of regression of all lesions. Infantile myofibromatosis is a very rare benign tumor-disease. Radiologically often soft-tissue masses with calcifications and osteolytic lesions with sclerotic rims are described. These findings also can be interpreted as histiocytosis X, which is a potential differential diagnosis. Histopathologically, cells characteristically appear as spindle-shaped fibroblast cells with pale pink cytoplasm and elongated nuclei and the immunophenotype is defined with a positive reaction on smooth-muscle antigen vimentin and the muscle-specific antigen HHF-35. The data of the literature review underline that a wait-and-see-policy should be considered as the first treatment of choice as in most instances the bony lesions regress spontaneously. However, a thorough examination has to be carried out to exclude lesion in other

  15. Case Study: Pepperdine University Libraries' Migration to OCLC's Worldshare (United States)

    Dula, Michael W.; Ye, Gan


    In this case study the authors describe Pepperdine University Libraries' migration to OCLC's WorldShare Management Services. They elaborate on the rationale for the decision, review some of the challenges and lessons encountered along the way, and briefly discuss some effects of the new system on our libraries. The focus is on technical services…

  16. Savant Syndrome: Case Studies, Hypotheses, and Implications for Special Education. (United States)

    Cheatham, Susan Klug; And Others


    The concept of savant syndrome, encompassing those individuals historically known as "idiot savants," is reviewed. Case studies demonstrating special abilities in the areas of calendar calculating, musical ability, artistic talent, memorization, mathematical skills, mechanical achievement, and fine sensory discrimination are discussed, as well as…

  17. Savant Syndrome: Case Studies, Hypotheses, and Implications for Special Education. (United States)

    Cheatham, Susan Klug; And Others


    The concept of savant syndrome, encompassing those individuals historically known as "idiot savants," is reviewed. Case studies demonstrating special abilities in the areas of calendar calculating, musical ability, artistic talent, memorization, mathematical skills, mechanical achievement, and fine sensory discrimination are discussed,…

  18. Bilateral desmoid tumor of the breast: case seriesand literature review (United States)

    Wongmaneerung, Phanchaporn; Somwangprasert, Areewan; Watcharachan, Kirati; Ditsatham, Chagkrit


    Background Desmoid tumor of the breast is very rare and locally aggressive but has no distant metastasis. Bilateral lesions are extremely rare, found in only 4% of patients. Two cases of bilateral desmoid tumor of the breast are reported. The clinical presentation, diagnosis, imaging, treatment, and follow-up outcomes of recurrence as well as a brief literature review are provided. Case reports Case 1 is a 31-year-old woman who presented with nipple retraction. An ultrasound revealed BIRAD V in both breasts. She underwent a bilateral excisional biopsy under ultrasound mark with the pathology result of extra-abdominal desmoid tumor in both breasts. The patient had a bilateral mastectomy with silicone implantation due to the involved margins by excision. She remained tumor free after 7-year follow-up. Case 2 is a 28-year-old woman who presented with a lump on her right breast that she had discovered ~2 months earlier. An ultrasound showed a spiculated mass in the right breast and some circumscribed hypoechoic masses in both breasts. A bilateral breast excision was done. The pathology result was an extra-abdominal desmoid tumor. She had recurrence on both sides and underwent a mastectomy and silicone implantation. The tumor has not recurred after 1-year follow-up. Conclusion Imaging cannot distinguish between benign breast lesions and malignancy. Pathology results are helpful in making a definitive diagnosis. Given that the desmoid tumor is locally aggressive, a local excision with clear margins is recommended. Chemotherapy and hormonal treatment are controversial. PMID:27578999

  19. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes


    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  20. [Charles Bonnet syndrome: case reports and short review]. (United States)

    Lagoudis, A; Bozikas, V


    Charles Bonnet first described visual hallucinations in a ground of visual deprivation in the 18th century. In this paper, two case reports with the syndrome are presented (female 83 years old, male 68 years old) along with a short literature review. The distinction of the syndrome from other psychiatric disorders (delirium, dementia), where visual hallucinations are also present, demands the presence of the diagnostical triad: visual hallucinations, visual impairment, intact cognitive status. The hallucinations are rich in colors and tension, people usually have the "leading roles" and patients mostly are curious, enjoy the hallucinations and are not afraid of them. More often hallucinations appear after acute visual impairment and in older patients. There are several theories concerning the mechanisms that lead to the syndrome. The Charles Bonnet syndrome appears to be self-restricted and there are no clear guidelines regarding its treatment.