WorldWideScience

Sample records for medical literature case

  1. Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature.

    Science.gov (United States)

    Wong, Kam Cheong

    2011-03-29

    Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries.In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings.An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

  2. Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature

    Directory of Open Access Journals (Sweden)

    Wong Kam Cheong

    2011-03-01

    Full Text Available Abstract Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries. In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings. An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

  3. Medical management of cerebellar abscess: a case report and review of the literature.

    Science.gov (United States)

    Turner, Ryan C; Dodson, Sean C; Rosen, Charles L

    2011-01-01

    A large abscess of the posterior fossa often warrants surgical intervention. We report a case of a 50-year-old male presenting with a cerebellar abscess measuring 2.8 cm x 1.6 cm located in the left cerebellar hemisphere at the level of the middle cerebellar peduncle that was treated conservatively and successfully with antibiotics. Therapeutic management options are discussed in regards to this case specifically as well as a review of the literature. This case illustrates the successful medical management of a cerebellar abscess of otogenic origin in an adult, a unique result in terms of abscess size and age of the patient.

  4. The Medical Nutritional Therapy for Glycogen Storage Diseases:Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    Chun-wei LI; Kang YU; Rong-rong LI; Ming LI; Min-jie ZHANG

    2014-01-01

    Glycogen storage diseases (GSDs) are a group of inherited metabolic diseases caused by inherited defects in one of enzymes in glycogenolysis or/and gluconeogenesis. The morbidity of GSDs ranges from 0.04% to 0.05%, according to European data. Since limited data are available, more studies are needed in diagnosis and treatment of GSDs. To date, medical nutritional therapy (MNT) has become an effective measure in improving the clinical outcome of GSDs patients. We reported 4 cases of GSDs with different manifestations, including hypoglycemia, hepatomegaly, splenomegaly and growth retardation. We also provided individualized nutritional interventions and literature review was conducted as well.

  5. Medizinhistorische Literatur [Medical history literature

    Directory of Open Access Journals (Sweden)

    Bauer, Bruno

    2012-09-01

    Full Text Available [english] The focus of the current issue 1-2/2012 of GMS Medizin – Bibliothek – Information is on medical history literature. In six articles special collections and recent projects of medical history libraries in Berlin, Hamburg, Heidelberg, Leipzig, Vienna and Zurich are presented. The authors in this issue are Melanie Scholz & Vera Seehausen (From Augusta to Klingsor, from Luise to Benjamin – past, present and future of the library of the Institute of the History of Medicine in Berlin, Alexandra Veith (Library of the Institute for History of Medicine and Ethics of Medicine, Heidelberg, Melanie Kintzel, Meike Knittel & Tanja Krutky (Historic collections of the Medical Library of the University of the University Medical Center Hamburg-Eppendorf and their deacidification, Dagmar Geithner (Library of the Karl Sudhoff Institute for the History of Medicine and Science, Leipzig – a Historical Review, Harald Albrecht, Bruno Bauer & Walter Mentzel (The Josephinian Library and the medical-historic stock of the University Library of the Medical University of Vienna and Monika Huber & Ursula Reis (Library of the Institute and Museum of the History of Medicine Zurich.[german] Schwerpunktthema der aktuellen Ausgabe 1-2/2012von GMS Medizin – Bibliothek – Information ist medizinhistorische Literatur. In sechs Beiträgen werden Bestände und aktuelle Projekte medizinhistorischer Bibliotheken in Berlin, Hamburg, Heidelberg, Leipzig, Wien und Zürich vorgestellt. Verfasst wurden die Beiträge der Schwerpunktausgabe von Melanie Scholz & Vera Seehausen (Von August zu Klingsor, von Luise zu Benjamin – Vergangenheit, Gegenwart und Zukunft der Bibliothek des Instituts für Geschichte der Medizin in Berlin, Melanie Kintzel, Meike Knittel & Tanja Krutky (Medizinhistorische Buchbestände am Universitätsklinikum Hamburg-Eppendorf und ihre Entsäuerung, Ara Veith (Bibliothek des Instituts für Geschichte und Ethik der Medizin in Heidelberg, Dagmar Geithner

  6. Identification of primary thyroid lymphoma with medical imaging: A case report and review of the literature.

    Science.gov (United States)

    Wang, Jia-Huan; Chen, Liang; Ren, Ke

    2014-12-01

    Primary thyroid lymphoma (PTL) is a rare thyroid malignancy. Clinical diagnosis of PTL may not be easily established based on imaging studies, as the imaging features of PTL are similar to those of lymphocytic thyroiditis and primary thyroid cancer. The present study describes the case of a patient who was confirmed to have PTL by intra-operative pathological diagnosis. On color Doppler ultrasound, the PTL was shown as a significantly enlarged thyroid with reduced gland echoes. Color Doppler flow imaging showed increased blood flow. By computed tomography, the thyroid was revealed to be enlarged with reduced tissue density, particularly in the left lobe and the isthmus. In addition, calcified spots and swollen lymph nodes were evident. The clinical history of the patient was obtained and the imaging results were retrospectively analyzed. The imaging features of PTL were investigated through reviewing the literature. PTL exhibits specific features on medical imaging that aid in distinguishing it from other thyroid diseases. PTL exhibits specific features on medical imaging that aid in distinguishing PTL from other thyroid diseases, which may aid the support for clinical diagnosis and improve the clinical accuracy.

  7. How informative are case studies of spider bites in the medical literature?

    Science.gov (United States)

    Stuber, Marielle; Nentwig, Wolfgang

    2016-05-01

    We analyzed the reliability and information content of 134 medical case studies on spider bites, published in 91 journal articles. Overall, we found that only 22% of these studies fulfilled the criteria for a verified spider bite. This means that the majority of such case studies cannot be attributed to a given spider species and usually not even to a spider. Their scientific value is negligible, moreover, such publications are even dangerous because they suggest incorrect conclusions. Secondly, we found that such case studies usually do not follow an obvious structure and many details on the development of symptoms, therapy and healing process are widely lacking. So even for verified spider bites, the comparability of case studies is limited. We discuss the obvious failure of a reviewing process for case studies and give recommendations how to increase the currently low information content of medical case studies on spider bites.

  8. Automated Medical Literature Retrieval

    Directory of Open Access Journals (Sweden)

    David Hawking

    2012-09-01

    Full Text Available Background The constantly growing publication rate of medical research articles puts increasing pressure on medical specialists who need to be aware of the recent developments in their field. The currently used literature retrieval systems allow researchers to find specific papers; however the search task is still repetitive and time-consuming. Aims In this paper we describe a system that retrieves medical publications by automatically generating queries based on data from an electronic patient record. This allows the doctor to focus on medical issues and provide an improved service to the patient, with higher confidence that it is underpinned by current research. Method Our research prototype automatically generates query terms based on the patient record and adds weight factors for each term. Currently the patient’s age is taken into account with a fuzzy logic derived weight, and terms describing blood-related anomalies are derived from recent blood test results. Conditionally selected homonyms are used for query expansion. The query retrieves matching records from a local index of PubMed publications and displays results in descending relevance for the given patient. Recent publications are clearly highlighted for instant recognition by the researcher. Results Nine medical specialists from the Royal Adelaide Hospital evaluated the system and submitted pre-trial and post-trial questionnaires. Throughout the study we received positive feedback as doctors felt the support provided by the prototype was useful, and which they would like to use in their daily routine. Conclusion By supporting the time-consuming task of query formulation and iterative modification as well as by presenting the search results in order of relevance for the specific patient, literature retrieval becomes part of the daily workflow of busy professionals.

  9. Medical management of aortic coarctation is feasible & durable in selected patients: a case report & literature review.

    Science.gov (United States)

    Khan, Asif N; Carter, William; Mousa, Albeir Y

    2015-01-01

    Long-term survival in patients with complete aortic coarctation (AC) without surgical repair has not been well characterized and is rarely documented. We report a case of an 84 year old male with complete aortic coarctation with history of hypertension for more than 40 years. Since the diagnosis was made in early 1950's medical treatment to control hypertension was initiated as patient was deemed high risk for surgical intervention. He has survived to the age of 84 years with minimal medical problems. This report also reviews the few documented cases of prolonged survival in patients with aortic coarctation. This report demonstrates that prolonged survival is possible in patients with documented complete coarctation and awareness of this report may influence the decision to use medical treatment for selected elderly patients with high risk of mortality associated with surgical repair.

  10. Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature

    OpenAIRE

    Wong Kam Cheong

    2011-01-01

    Abstract Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries. In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learni...

  11. Acute generalised exanthematous pustulosis and other severe drug eruptions from over the counter medications: A case report and review of the literature.

    Science.gov (United States)

    Kline, Amy; Fischer, Gayle

    2016-05-01

    We present a case of acute generalised exanthematous pustulosis in an 11-year-old girl who used Duro-Tuss, an over-the-counter cough mixture containing pholcodine, and present a comprehensive review of the literature on severe drug reactions resulting from using non-prescription medications. This case reinforces the importance of taking a complete medication history.

  12. Successful medical management of renal zygomycosis: a summary of two cases and a review of the Indian literature.

    Science.gov (United States)

    Marak, Rungmei S K; Misra, Richa; Ansari, M S; Dixit, Ajai; Poornima; Prasad, K N; Dhole, T N

    2010-12-01

    We present two cases of renal zygomycosis caused by Apophysomyces elegans and Mycocladus corymbifer in previously healthy immunocompetent males and an overview of the disease in India. In both cases a percutaneous nephrostomy (PCN) was performed and the etiologic agents were identified by direct microscopy and culture. Amphotericin B was administered and both patients recovered completely. A review of the literature revealed 42 cases of renal zygomycosis in India. The majority of them were from the Postgraduate Institute of Medical Education and Research, Chandigarh, in North India. In contrast to cases from the developed world where transplant recipients and patients with hematological malignancies seem to be most vulnerable to zygomycosis, the most common risk factor in India is uncontrolled diabetes mellitus. However, renal zygomycosis is an exception and the patients in both of our cases had no identifiable underlying disorder and recovered successfully without nephrectomy. It is important to emphasize that treatment of A. elegans must be aggressive and lipid formulations of antifungals are typically favored due to their limited side effects profile and ability of the clinician to use higher doses. A high index of clinical suspicion and knowledge of the varied manifestations in diagnosing this condition cannot be overemphasized.

  13. Non-ketotic hyperglycinaemia: case report and review of medical literature.

    Science.gov (United States)

    Madu, Anthony Emeka; Oliver, Lydia

    2013-03-01

    Rare inheritable conditions may present without warning in the neonatal period and thus lead curious staff to institute expansive clinical investigations. Non-ketotic hyperglycaemia (NKH) in a normal fully grown male infant following an essentially eventful pregnancy associated with unrelated condition provoked much clinical curiosity. NKH should therefore be included as a differential diagnosis in an unwell neonate presenting with hiccoughs, seizures, myotonic jerks, and hypotonia as our very unique case clearly demonstrated.

  14. Soft Tissue Infection Caused by Rapid Growing Mycobacterium following Medical Procedures: Two Case Reports and Literature Review

    OpenAIRE

    Lin, Shih-Sen; Lee, Chin-Cheng; Jang, Tsrang-Neng

    2014-01-01

    Non-tubecrulosis mycobacterium infections were increasingly reported either pulmonary or extrapulmonary in the past decades. In Taiwan, we noticed several reports about the soft tissue infections caused by rapid growing mycobacterium such as Mycobacterium abscessus, Mycobacterium chelonae, on newspaper, magazines, or the multimedia. Most of them occurred after a plastic surgery, and medical or non-medical procedures. Here, we reported two cases of these infections following medical procedures...

  15. Medical literature search dot com

    Directory of Open Access Journals (Sweden)

    Vivek Jain

    2011-01-01

    Full Text Available The Internet provides a quick access to a plethora of the medical literature, in the form of journals, databases, dictionaries, textbooks, indexes, and e-journals, thereby allowing access to more varied, individualized, and systematic educational opportunities. Web search engine is a tool designed to search for information on the World Wide Web, which may be in the form of web pages, images, information, and other types of files. Search engines for internet-based search of medical literature include Google, Google scholar, Yahoo search engine, etc., and databases include MEDLINE, PubMed, MEDLARS, etc. Commercial web resources (Medscape, MedConnect, MedicineNet add to the list of resource databases providing some of their content for open access. Several web-libraries (Medical matrix, Emory libraries have been developed as meta-sites, providing useful links to health resources globally. Availability of specific dermatology-related websites (DermIs, DermNet, and Genamics Jornalseek is useful addition to the ever growing list of web-based resources. A researcher must keep in mind the strengths and limitations of a particular search engine/database while searching for a particular type of data. Knowledge about types of literature and levels of detail available, user interface, ease of access, reputable content, and period of time covered allow their optimal use and maximal utility in the field of medicine.

  16. Medication-induced Takotsubo Cardiomyopathy presenting with cardiogenic shock-utility of extracorporeal membrane oxygenation (ECMO): case report and review of the literature.

    Science.gov (United States)

    Rojas-Marte, Geurys; John, Jinu; Sadiq, Adnan; Moskovits, Norbert; Saunders, Paul; Shani, Jacob

    2015-01-01

    Takotsubo cardiomyopathy (TTC) is a transient condition that affects the myocardium and is seen mostly in post-menopausal women secondary to an emotional or physical stressor; however, certain drugs have been described as cause of this syndrome. We report the case of a young female with medication--induced TTC, who presented with cardiogenic shock as initial manifestation, treated successfully with extracorporeal membrane oxygenation (ECMO). To our knowledge, this is the first case in the literature describing the use of ECMO in cardiogenic shock due to medication-induced TTC.

  17. INTRODUCTION TO CHINESE MEDICAL LITERATURE.

    Science.gov (United States)

    KAN, L B

    1965-01-01

    The history of medicine in China is divided into four periods, from about 2700 B.C. to the present. Brief descriptions of standard works of these periods (e.g. Pèn-Ts'ao, Nei Ching, Nan Ching, Shang Han Lun, Ch'in K'ue Yao Lüeh, Chai I Ching, Chou Hou Pei Chi Fang, Mo Ching, Ming I Pieh Lu, Ch'ao Shih Pin Yüan, Chien Chin Yao Fang, Wai T'ai Pi Yao, Hsi Yüan Lu, Pèn-Ts'ao Kang-Mu, etc.) are given. The latter part of the paper deals with the state of modern medical research and literature in Mainland China, where equal emphasis is placed on the practice of both traditional Chinese and Western medicine in the treatment of diseases, thus resulting in a new era in Chinese medical history. This is based on the information obtainable in Hong Kong. Information about medical developments in Taiwan is readily available elsewhere and so has been omitted.

  18. Acute bilateral emphysematous pyelonephritis successfully managed by medical therapy alone: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Calleja Juan

    2002-06-01

    Full Text Available Abstract Background Bilateral emphysematous pyelonephritis is a life threatening condition usually occurring in diabetics. Management of this condition has traditionally been aggressive and surgery is considered mandatory. However, this is itself a hazardous intervention in a septic, unstable patient with circulatory or liver failure. When bilateral disease is present, the need for long-term dialysis is obviously unavoidable. Case presentation We herein report one of the few cases of bilateral emphysematous pyelonephritis successfully managed by non-surgical treatment.

  19. Multimodal Surgical and Medical Treatment for Extensive Rhinocerebral Mucormycosis in an Elderly Diabetic Patient: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Paola Di Carlo

    2014-01-01

    Full Text Available Diabetes is a well-known risk factor for invasive mucormycosis with rhinocerebral involvement. Acute necrosis of the maxilla is seldom seen and extensive facial bone involvement is rare in patients with rhino-orbital-cerebral mucormycosis. An aggressive surgical approach combined with antifungal therapy is usually necessary. In this report, we describe the successful, personalized medical and surgical management of extensive periorbital mucormycosis in an elderly diabetic, HIV-negative woman. Mono- or combination therapy with liposomal amphotericin B (L-AmB and posaconazole (PSO and withheld debridement is discussed. The role of aesthetic plastic surgery to preserve the patient’s physical appearance is also reported. Any diabetic patient with sinonasal disease, regardless of their degree of metabolic control, is a candidate for prompt evaluation to rule out mucormycosis. Therapeutic and surgical strategies and adjunctive treatments are essential for successful disease management. These interventions may include combination therapy. Finally, a judicious multimodal treatment approach can improve appearance and optimize outcome in elderly patients.

  20. The Study of Literature in Medical Education.

    Science.gov (United States)

    Hunter, Kathryn Montgomery; And Others

    1995-01-01

    This article argues that study of literature in the medical curriculum develops physician skills in observation and interpretation, clinical imagination, and self-expression and self-knowledge; enriches moral education; fosters tolerance for uncertainty; and promotes empathy for patients. Appropriate courses for inclusion of and classroom…

  1. 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

    2010-08-01

    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.

  2. Bioethics and Medical Issues in Literature

    OpenAIRE

    Stripling, Mahala Yates

    2013-01-01

    Many of the bioethical and medical issues challenging society today have been anticipated and addressed in literature ranging from Mary Shelley's Frankenstein, Albert Camus’s The Plague, to Margaret Edson's Wit. The ten works of fiction explored in this book stimulate lively dialogue on topics like bioterrorism, cloning, organ transplants, obesity and heart disease, sexually transmitted diseases, and civil and human rights. This interdisciplinary and multicultural approach introducing literat...

  3. Maintenance ECT as a therapeutic approach to medication-refractory epilepsy in an adult with mental retardation: case report and review of literature.

    Science.gov (United States)

    Shah, Nilesh; Pande, Nikhil; Bhat, Tushar; Murke, Mukund; Andrade, Chittaranjan

    2012-06-01

    Electroconvulsive therapy (ECT) raises the seizure threshold. This physiological change may benefit patients with seizure disorders. Whereas ECT has recently been used to terminate medication-refractory status epilepticus, there is little current literature on its planned administration as a specific maintenance treatment for medication-refractory epilepsy. We used maintenance ECT to treat an 18-year-old man with a long-standing generalized tonic-clonic seizure disorder who had shown poor response to several antiepileptic drugs administered in combination with antiepileptic medication compliance confirmed through drug level monitoring. A total of 52 ECTs were administered across nearly 20 months at a mean frequency of once in nearly 12 days. From the very outset, ECT dramatically decreased the frequency of spontaneous seizures from approximately 6 to 24 per week at baseline to approximately 1 to 2 per week after ECT initiation. The efficacy of maintenance ECT in spontaneous seizure prophylaxis was greater when the ECT treatment interval was narrower. Improvement with ECT was associated with improved behavior and improved psychosocial functioning on clinical report. No cognitive or other adverse effects were reported or clinically ascertained. The ECT charge administered at the last 10 treatment sessions was 1434 millicoulombs. This is probably the highest electrical stimulus dose recorded in literature. Maintenance ECT may reduce the frequency of breakthrough seizures in patients with seizure disorder that is inadequately responsive to antiepileptic medication regimes. Very high ECT seizure thresholds may be observed when many antiepileptic drugs are concurrently administered in high doses.

  4. The Structure of Medical Informatics Journal Literature

    Science.gov (United States)

    Morris, Theodore A.; McCain, Katherine W.

    1998-01-01

    Abstract Objective: Medical informatics is an emergent interdisciplinary field described as drawing upon and contributing to both the health sciences and information sciences. The authors elucidate the disciplinary nature and internal structure of the field. Design: To better understand the field's disciplinary nature, the authors examine the intercitation relationships of its journal literature. To determine its internal structure, they examined its journal cocitation patterns. Measurements: The authors used data from the Science Citation Index (SCI) and Social Science Citation Index (SSCI) to perform intercitation studies among productive journal titles, and software routines from SPSS to perform multivariate data analyses on cocitation data for proposed core journals. Results: Intercitation network analysis suggests that a core literature exists, one mark of a separate discipline. Multivariate analyses of cocitation data suggest that major focus areas within the field include biomedical engineering, biomedical computing, decision support, and education. The interpretable dimensions of multidimensional scaling maps differed for the SCI and SSCI data sets. Strong links to information science literature were not found. Conclusion: The authors saw indications of a core literature and of several major research fronts. The field appears to be viewed differently by authors writing in journals indexed by SCI from those writing in journals indexed by SSCI, with more emphasis placed on computers and engineering versus decision making by the former and more emphasis on theory versus application (clinical practice) by the latter. PMID:9760393

  5. [The medical literature of the Egyptian campaign].

    Science.gov (United States)

    Hutin, Jean-François

    2012-01-01

    Bonaparte's Egyptian Campaign (1798 - 1801), like all other episodes from the Napoleonic era, gave rise to an extensive literature on the subject, but most of all a significant medical literature. This fact is due to many reasons:--an important health service for this expeditionary corps of more than 36.000 men, with two main figures at its hea, Desgenettes and Larrey--but also with valuable subordinates like Assalini, Savaresi, Balme, Pugnet or Barbès.--A Commission for Science and Art, of which a few doctors and surgeons were members, but most of all pharmacists like Boudet or Rouyer--The presence in the field of Ludwig Frank, the nephew of the famous Johann Peter Frank.--The creation in Cairo of an Egyptian Institute and the publication of the masterly Description of Egypt and the establishment of printing houses.--The emergence of the myth of the Orient and its mysteries.--An extensive array of indigenous pathologies, which is characteristic of those countries. For instance: plague, dysentery, yellow fever, Egyptian ophthalmia, as well as more common diseases like tetanus, scurvy or venereal diseases. The main medical works that cover this period and its pathologies are skimmed.

  6. [Artificial illness as a result of non-medical use of anabolic androgenic steroids: A case report and a review of literature].

    Science.gov (United States)

    Povzun, S A

    2016-01-01

    A 42-year-old female body builder who had used anabolic androgenic steroids (AASs) for 18 years to build up muscle mass died from liver rupture. The cause of the latter was multiple abscesses caused by Actinomyces, which developed in the presence of immunodeficiency. The postmortem changes in different organs were due to hormonal imbalance. The paper gives the data available in the literature pertaining to the analysis of the effects of AASs taken in supraphysiological doses on the body and their non-medical application.

  7. Case report and literature review

    Science.gov (United States)

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

    2016-01-01

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

  8. Properties of publications on anatomy in medical education literature.

    NARCIS (Netherlands)

    Vorstenbosch, M.A.T.M.; Bolhuis, S.; Kuppeveld, S. van; Kooloos, J.G.M.; Laan, R.F.J.M.

    2011-01-01

    Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and se

  9. Properties of Publications on Anatomy in Medical Education Literature

    Science.gov (United States)

    Vorstenbosch, Marc; Bolhuis, Sanneke; van Kuppeveld, Sascha; Kooloos, Jan; Laan, Roland

    2011-01-01

    Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and second to evaluate the development of this…

  10. Drug interaction databases in medical literature

    DEFF Research Database (Denmark)

    Kongsholm, Gertrud Gansmo; Nielsen, Anna Katrine Toft; Damkier, Per

    2015-01-01

    PURPOSE: It is well documented that drug-drug interaction databases (DIDs) differ substantially with respect to classification of drug-drug interactions (DDIs). The aim of this study was to study online available transparency of ownership, funding, information, classifications, staff training...... and the three most commonly used subscription DIDs in the medical literature. The following parameters were assessed for each of the databases: Ownership, classification of interactions, primary information sources, and staff qualification. We compared the overall proportion of yes/no answers from open access...... databases and subscription databases by Fisher's exact test-both prior to and after requesting missing information. RESULTS: Among open access DIDs, 20/60 items could be verified from the webpage directly compared to 24/36 for the subscription DIDs (p = 0.0028). Following personal request, these numbers...

  11. Tracking medical genetic literature through machine learning.

    Science.gov (United States)

    Bornstein, Aaron T; McLoughlin, Matthew H; Aguilar, Jesus; Wong, Wendy S W; Solomon, Benjamin D

    2016-08-01

    There has been remarkable progress in identifying the causes of genetic conditions as well as understanding how changes in specific genes cause disease. Though difficult (and often superficial) to parse, an interesting tension involves emphasis on basic research aimed to dissect normal and abnormal biology versus more clearly clinical and therapeutic investigations. To examine one facet of this question and to better understand progress in Mendelian-related research, we developed an algorithm that classifies medical literature into three categories (Basic, Clinical, and Management) and conducted a retrospective analysis. We built a supervised machine learning classification model using the Azure Machine Learning (ML) Platform and analyzed the literature (1970-2014) from NCBI's Entrez Gene2Pubmed Database (http://www.ncbi.nlm.nih.gov/gene) using genes from the NHGRI's Clinical Genomics Database (http://research.nhgri.nih.gov/CGD/). We applied our model to 376,738 articles: 288,639 (76.6%) were classified as Basic, 54,178 (14.4%) as Clinical, and 24,569 (6.5%) as Management. The average classification accuracy was 92.2%. The rate of Clinical publication was significantly higher than Basic or Management. The rate of publication of article types differed significantly when divided into key eras: Human Genome Project (HGP) planning phase (1984-1990); HGP launch (1990) to publication (2001); following HGP completion to the "Next Generation" advent (2009); the era following 2009. In conclusion, in addition to the findings regarding the pace and focus of genetic progress, our algorithm produced a database that can be used in a variety of contexts including automating the identification of management-related literature.

  12. Abusive head trauma in Spanish language medical literature.

    Science.gov (United States)

    Cooper, M Townsend; Szyld, Edgardo; Darden, Paul M

    2016-08-01

    Anecdotal experiences raise concerns that abusive head trauma (AHT) is significantly underdiagnosed and perhaps poorly recognized in Latin American settings. With increasing interest in international collaboration in pediatrics, differences in perspectives regarding complex diagnoses should be explored to facilitate a productive exchange of knowledge and ideas. The purpose of this study was to describe the medical literature pertaining to AHT available to physicians who read only in Spanish. In this review, LILACS, SciELO (major Spanish language databases) and Pubmed were searched with appropriate terms and filters in English, Spanish, and Portuguese for Spanish language articles on AHT. Identified articles' reference lists were then examined for possible additional articles on AHT. All relevant articles were sorted by country and examined for article type and content. Thirty-four unique articles were located for review from 8 of 21 countries. Most of the articles identified were case reports, case series, or educational, and there were no studies regarding overall incidence or prevalence of AHT. Some scientific information contained in the articles varied considerably from that in the English language literature in the areas of etiology and preventive strategies. This survey highlights that the Spanish language literature regarding AHT is sparse and variable. This must be considered when working collaboratively in a global setting. Additionally, identification of this gap presents an opportunity for education and information exchange among global medical communities.

  13. Factors associated with dropout in medical education: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; Wallstedt, Birgitta; Eika, Berit

    2011-01-01

    Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised.......Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised....

  14. Primitive neuroectodermal tumour of kidney with thrombosis of the inferior vena cava and good responsive to surgical and medical treatment: description of a case and revision of literature.

    Science.gov (United States)

    Giliberto, Giovanni L; Di Franco, Carmelo A; Rovereto, Bruno

    2017-03-15

    Primitive neuroectodermal tumour (PNET) of kidney is a rare cancer typical of young adults with few cases described in the literature. We report a case of renal PNET in a 31-year-old man who presented to our department with a computed tomographic (CT)-scan revealing a large renal mass of 20 cm, massive thrombosis of the inferior vena cava (IVC). The patient underwent radical nephrectomy with contextual retroperitoneal lymphadenectomy and resection of IVC needing Dacron prosthesis substitution. Definitive histopathological examination showed PNET of kidney infiltrating ipsilateral adrenal gland, massive cava thrombosis with infiltration of vena cava wall and one lymph nodal metastasis. Postoperative PET-scan showed metastatic lesions in bilateral adrenal glands and pancreas. The patient received chemotherapy, and currently, he is in follow-up after 26 months from first diagnosis without any sign of recurrence of disease. Kidney PNET usually is associated with poor prognosis, so, it needs an early identification and differentiation from other similar small cells tumours in order to obtain a good response to the treatments.

  15. Health economic analyses in medical nutrition: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Walzer S

    2014-03-01

    via journal webpages for further assessment. Thirty-two papers were finally included in a thorough data extraction procedure, including those identified by a “gray literature search” utilizing the Google search engine and cross-reference searches. Results regarding content of the studies showed that malnutrition was the underlying clinical condition in most cases (32%. In addition, gastrointestinal disorders (eg, surgery, cancer were often analyzed. In terms of settings, 56% of papers covered inpatients, whereas 14 papers (44% captured outpatients, including patients in community centers. Interestingly, in comparison with the papers identified overall, very few health economic models were found. Most of the articles were modeling analyses and economic trials in different design settings. Overall, only eight health economic models were published and were validated applying the Drummond checklist. In summary, most of the models included were carried out to quite a high standard, although some areas were identified for further improvement. Of the two systematic health economic reviews identified, one achieved the highest quality score when applying the AMSTAR checklist. Conclusion: The reasons for finding only a few modeling studies but quite a large number of clinical trials with health economic endpoints, might be different. Until recently, health economics has not been required for reimbursement or coverage decisions concerning medical nutrition interventions. Further, there might be specifics of medical nutrition which might not allow easy modeling and consequently explain the limited uptake so far. The health economic data on medical nutrition generated and published is quite ample. However, it has been primarily based on database analysis and clinical studies. Only a few modeling analyses have been carried out, indicating a need for further research to understand the specifics of medical nutrition and their applicability for health economic modeling. Keywords

  16. Updated Cases for Medical Microbiology

    Directory of Open Access Journals (Sweden)

    Brinda Govindan

    2015-08-01

    Full Text Available Review of: Cases in Medical Microbiology and Infectious Diseases, 4th ed.; Peter H. Gilligan, Daniel S. Shapiro, and Melissa B. Miller; (2014. ASM Press, Washington, DC. 589 pages.

  17. Medical Case Literature Analysis of Clinical Characterization on Pectoral Qi Insufficiency Syndrome%宗气不足证临床表征医案文献分析

    Institute of Scientific and Technical Information of China (English)

    杨燕; 彭锦; 胡镜清; 陈亦辉

    2015-01-01

    Objective To identify the common clinical symptoms and signs of pectoral qi insufficiency syndrome;To provide evidence for its clinical treatment.Methods By retrieving 129 medical cases related to pectoral qi insufficiency syndrome in CNKI from January 1954 to October 2013 and Wanfang Database from January 1985 to October 2013, the authors made a statistical analysis of the symptoms and signs in medical cases related to pectoral qi insufficiency syndrome and elementarily generalized the common clinical characterization on pectoral qi insufficiency syndrome under the guidance of the TCM specialists.Results The cardinal syndromes of common clinical manifestation on pectoral qi insufficiency syndrome were shortness of breath and panting on exertion. The concomitant syndromes were pale or dim complexion, lassitude of spirit, lack of strength, shortage of qi and disinclination to talk, inability to sleep, dizziness, dizzy vision, etc. And it commonly superimposed failing to circulation qi-blood of cardiopulmonary as oppression in the chest, chest pain, palpitations, cyanosis, cough, etc, dysfunction of the spleen in transportation and transformation as torpid intake, sloppy stool, abdominal distension, and impairment of qi transformation due to Yang deficiency as cold limbs, fear of cold, edema, inhibited urination, and dry mouth.Conclusion The authors summarized cardinal syndrome, concomitant syndromes and superimposed symptoms on pectoral qi insufficiency syndrome from reported medical cases, which can provide scientific basis for normalizing the clinical diagnosis and treatment and interpreting the scientific connotation of pectoral qi insufficiency syndrome.%目的:了解宗气不足证临床常见症状、体征,为其临床诊治提供依据。方法通过检索中国期刊全文数据库(CNKI)1954年1月-2013年10月及中国学术期刊数据库(万方数据)1985年1月-2013年10月所收录期刊中129则宗气不足医案,将医案中所含有的症

  18. CAMERON LESIONS: LITERATURE REVIEW AND CASE PRESENTATION

    Directory of Open Access Journals (Sweden)

    V. V. Vasilenko

    2016-01-01

    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

  19. Piodermatite-pioestomatite vegetante: relato de caso e revisão de literatura Pyodermatitis-pyostomatitis vegetans: case report and review of medical literature

    Directory of Open Access Journals (Sweden)

    Fernanda de Abreu Toledo Matias

    2011-08-01

    Full Text Available A piodermatite-pioestomatite vegetante é uma rara dermatose inflamatória de etiologia desconhecida, com típico comprometimento mucocutâneo. Relatamos caso de paciente feminina com lesões pustulosas e vesiculosas em axilas, evoluindo com placas vegetantes e pústulas com agrupamento anular. Houve progressão com comprometimento vulvar, inguinal e mucosas oral, nasal e ocular. Proposto o diagnóstico, optou-se por iniciar prednisona 40mg ao dia, com remissão das lesões após um mês de uso da medicação. A associação com doença inflamatória intestinal ocorre em 70% dos casos. A imunofluorescência é um fator que ajuda a caracterizar a doença, sendo tipicamente negativa. A rápida resposta à terapêutica com corticosteroides sistêmicos é esperadaPyodermatitis-pyostomatitis vegetans is a rare inflammatory dermatosis of unknown etiology, with a typical mucocutaneous involvement. We report the case of a woman with pustular and vesicular lesions in the axillae, evolving with vegetating plaques and pustules with annular grouping. The disease progressed with vulvar and inguinal involvement as well as involvement of the oral, nasal and ocular mucous membranes. She started the treatment with prednisone (40 mg/day, with remission of the lesions after one month of use of such medication. Association with inflammatory bowel disease occurs in 70% of the cases. Immunofluorescence, which is typically negative, helps to characterize the disease. A rapid response to systemic steroids is expected

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

    Directory of Open Access Journals (Sweden)

    Molly B. Kraus, MD

    2015-12-01

    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.

  1. Djenkolism: case report and literature review

    Directory of Open Access Journals (Sweden)

    Bunawan NC

    2014-04-01

    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

  2. Using Computer and Internet for Medical Literature Searching Among Medical Students in Hadramout University, Yemen

    Directory of Open Access Journals (Sweden)

    Abdulla Salim Bin Ghouth

    2008-04-01

    Full Text Available Background: Some researchers have observed that medical students used computer and internet for nonmedical purposes. Is this the case among medical students in a newly established medical college of Hadramout University in Yemen?Objectives: To assess the knowledge and usage of computer and internet among medical students of Hadramout University, find out the medical applications for which they use internet, and the factors that encourage the students to use computer and internet, with an emphasis on gender variations.Methods: In a cross-sectional study, data were collected from 102 randomly selected students from second to sixth year at the academic year 2005/2006 by using structured questionnaire of 23 items. Results: Seventy four students have computer at home (73%, 77 students use internet for general purposes (76.2% and lesser use internet for educational and research purposes, with significant gender variations. The students opined that accessibility of internet in the college (84.2% and training about online searching (74.3% were the most expected factors to improve using of internet for medical research.Conclusion: Incorporating online search of medical literature in curriculum planning is essential to improve the student skills in research.

  3. Evaluating Medical Residents' Literature-Appraisal Skills.

    Science.gov (United States)

    Stern, David T.; And Others

    1995-01-01

    A study of 28 medical residents' skills in evaluating research compared student evaluations of a journal article with 1 developed by means of a Delphi technique utilizing 5 experts. Residents' scores were not significantly associated with residency year or self-assessed critical appraisal skill. The method is proposed as an objective means of…

  4. Factors associated with dropping out of medical school: a literature review

    DEFF Research Database (Denmark)

    O’Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research...... literature on medical education is ongoing. Inclusion criteria are: Study population=medical students, outcome=dropout, follow up period=minimum 1 year, study designs=cohort/case-control/experimental. An experienced research librarian performed a primary search of the databases PubMed, ERIC, Psyc...

  5. Assurance Cases for Medical Devices

    Science.gov (United States)

    2011-04-28

    Test  your  audio   Submit  text  ques2ons       Q&A  addressed  at  the  end  of  today’s  session...SEI’s  Research,  Technology,  and  System   Solu2ons  program.  With  his  colleague  John   Goodenough ,  Weinstock...contact The SEI and Medical Devices *Charles B. Weinstock and John B. Goodenough , Towards an Assurance Case Practice for Medical Devices,

  6. Women, bodies, and Hebrew medieval medical literature

    Directory of Open Access Journals (Sweden)

    Caballero Navas, Carmen

    2008-06-01

    Full Text Available This essay explores different views on the female body articulated within Hebrew medieval texts on women’s health care. It also investigates whether texts also integrate women’s own perceptions of their bodies, and of their needs and care. I have analysed how this genre of Hebrew literature understood two key issues in the construction of sexed bodies: menstruation and cosmetics.

    Este trabajo examina distintas visiones sobre el cuerpo femenino que articulan los textos hebreos medievales dedicados al cuidado de la salud de las mujeres e investiga en qué medida están representadas en ellos las percepciones que las propias mujeres tienen de sus cuerpos, y de sus necesidades y preocupaciones. Para ello, he analizado el tratamiento que este género de la literatura hebrea ha dado a dos temas clave en la sexuación de los cuerpos: la menstruación y la cosmética.

  7. Argument-based medical ethics: a formal tool for critically appraising the normative medical ethics literature.

    Science.gov (United States)

    McCullough, Laurence B; Coverdale, John H; Chervenak, Frank A

    2004-10-01

    Although there are critical appraisal tools for other genres of the medical literature, there currently is no formal tool for physicians to use in their critical appraisal of the normative medical ethics literature. We present a formal assessment tool for the critical appraisal of the normative medical ethics literature that incorporates the intellectual standards of argument-based medical ethics and evidence-based medicine. We draw on the intellectual standards of argument-based ethics, ethical analysis and argument, and the literature on evidence-based medicine. The tool involves 4 questions about normative medical ethics papers: (1) Does the article address a focused ethics question? (2) Are the arguments that support the results of the article valid? (3) What are the results? (4) Will the results help me in clinical practice? Obstetrician-gynecologists can use this tool to appraise the normative literature of ethics in obstetrics and gynecology formally.

  8. How to apply clinical cases and medical literature in the framework of a modified "failure mode and effects analysis" as a clinical reasoning tool--an illustration using the human biliary system.

    Science.gov (United States)

    Wong, Kam Cheong

    2016-04-06

    Clinicians use various clinical reasoning tools such as Ishikawa diagram to enhance their clinical experience and reasoning skills. Failure mode and effects analysis, which is an engineering methodology in origin, can be modified and applied to provide inputs into an Ishikawa diagram. The human biliary system is used to illustrate a modified failure mode and effects analysis. The anatomical and physiological processes of the biliary system are reviewed. Failure is defined as an abnormality caused by infective, inflammatory, obstructive, malignancy, autoimmune and other pathological processes. The potential failures, their effect(s), main clinical features, and investigation that can help a clinician to diagnose at each anatomical part and physiological process are reviewed and documented in a modified failure mode and effects analysis table. Relevant medical and surgical cases are retrieved from the medical literature and weaved into the table. A total of 80 clinical cases which are relevant to the modified failure mode and effects analysis for the human biliary system have been reviewed and weaved into a designated table. The table is the backbone and framework for further expansion. Reviewing and updating the table is an iterative and continual process. The relevant clinical features in the modified failure mode and effects analysis are then extracted and included in the relevant Ishikawa diagram. This article illustrates an application of engineering methodology in medicine, and it sows the seeds of potential cross-pollination between engineering and medicine. Establishing a modified failure mode and effects analysis can be a teamwork project or self-directed learning process, or a mix of both. Modified failure mode and effects analysis can be deployed to obtain inputs for an Ishikawa diagram which in turn can be used to enhance clinical experiences and clinical reasoning skills for clinicians, medical educators, and students.

  9. Post-bariatric abdominoplasty resulting in wound infection and dehiscence—Conservative treatment with medical grade honey: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Reem Dina Jarjis

    2016-01-01

    Conclusion: Although more research is needed for definitive conclusions of honey’s efficacy, it is safe and as presented in our case, it may under certain circumstances reduce the need of surgical wound debridement and serve as a remedy for conservative treatment.

  10. Acromegaly and gigantism in the medical literature. Case descriptions in the era before and the early years after the initial publication of Pierre Marie (1886).

    Science.gov (United States)

    de Herder, Wouter W

    2009-01-01

    In 1886 Pierre Marie used the term "acromegaly" for the first time and gave a full description of the characteristic clinical picture. However several others had already given clear clinical descriptions before him and sometimes had given the disease other names. After 1886, it gradually became clear that pituitary enlargement (caused by a pituitary adenoma) was the cause and not the consequence of acromegaly, as initially thought. Pituitary adenomas could be found in the great majority of cases. It also became clear that acromegaly and gigantism were the same disease but occurring at different stages of life and not different diseases as initially thought. At the end of the 19th and beginning of the 20th century most information was derived from case descriptions and post-mortem examinations of patients with acromegaly or (famous) patients with gigantism. The stage was set for further research into the pathogenesis, diagnosis and therapy of acromegaly and gigantism.

  11. Primary Renal Lymphoma: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    J Zhang

    2014-05-01

    Full Text Available Primary renal lymphoma is very rare. The prognosis is usually poor with median survival less than a year. We report a case in a 55-year old man with a mass in the left kidney detected by ultrasonography and computed tomography. Radical nephrectomy was performed under a preliminary diagnosis of renal cell carcinoma. After the surgery, four courses of chemotherapy were performed. Prognosis may have improved since those reports in the earlier medical literature.

  12. Case-based medical informatics

    Directory of Open Access Journals (Sweden)

    Arocha José F

    2004-11-01

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

  13. Personality factors and medical training: a review of the literature.

    Science.gov (United States)

    Doherty, Eva M; Nugent, Emmeline

    2011-02-01

    it has been acknowledged that certain personality characteristics influence both medical students' and doctors' performance. With regard to medical students, studies have been concerned with the role of personality, and performance indicators such as academic results and clinical competence. In addition, the link between personality and vulnerability to stress, which has implications for performance, has been investigated at both undergraduate and postgraduate levels. Most of the studies cited in the literature were published before the year 2000. The authors therefore undertook a literature search to determine whether any prospective systematic studies have been published since 2000. a review of the literature for 2000-2009 was performed, using the databases MEDLINE, PsycINFO and CINAHL. The search terms used were 'personality', 'performance', 'stress' and 'medical student'. Specific inclusion criteria required studies to be cohort studies carried out over a minimum period of 2 years, which measured medical student scores on valid and reliable personality tests, and used objective measures of performance and stress. the authors identified seven suitable studies. Four of these looked at personality factors and academic success, one looked at personality factors and clinical competence, and two looked at personality factors and stress. The main personality characteristic repeatedly identified in the literature was conscientiousness. the personality trait known as conscientiousness has been found to be a significant predictor of performance in medical school. The relationship between personality and performance becomes increasingly significant as learners advance through medical training. Additional traits concerning sociability (i.e. extraversion, openness, self-esteem and neuroticism) have also been identified as relevant, particularly in the applied medical environment. A prospective national study with the collaboration of all medical schools would make it

  14. How to Use Current Medical Literature and APA Format Style.

    Science.gov (United States)

    Peek, Robin

    Directives and guidance in obtaining current medical literature are provided in this publication with special emphasis given to locating material in the Portland, Oregon area. The uses and types of periodical indexes are identified and periodical index citation examples are indicated. Explanations are offered on: (1) how to conduct an effective…

  15. The Medical Literature as a Resource for Health Care Practice.

    Science.gov (United States)

    McKibbon, K. Ann; And Others

    1995-01-01

    Discussion of evidence-based medicine (EBM) focuses on information tools to facilitate the practice of EBM that were developed, evaluated, and made more accessible by the McMaster University (Canada) Faculty of Health Sciences. Highlights include users' guides to medical literature, strategies for improving MEDLINE searches, new journals, and…

  16. How to Use Current Medical Literature and APA Format Style.

    Science.gov (United States)

    Peek, Robin

    Directives and guidance in obtaining current medical literature are provided in this publication with special emphasis given to locating material in the Portland, Oregon area. The uses and types of periodical indexes are identified and periodical index citation examples are indicated. Explanations are offered on: (1) how to conduct an effective…

  17. Concept maps in medical education: an analytical literature review.

    Science.gov (United States)

    Daley, Barbara J; Torre, Dario M

    2010-05-01

    OBJECTIVES As the medical profession continues to change, so do the educational methods by which medical students are taught. Various authors have acknowledged the need for alternative teaching and learning strategies that will enable medical students to retain vast amounts of information, integrate critical thinking skills and solve a range of complex clinical problems. Previous research has indicated that concept maps may be one such teaching and learning strategy. This article aims to: (i) review the current research on concept maps as a potential pedagogical approach to medical student learning, and (ii) discuss implications for medical student teaching and learning, as well as directions for future research. METHODS The literature included in this review was obtained by searching library databases including ACADEMIC SEARCH, ERIC, EBSCOHost, PsychINFO, PsychARTICLES, PubMed/MEDLINE, CINAHL and EMBASE. This literature review is a summary of both conceptual and empirically published literature on the uses of concept mapping in medical education. RESULTS The 35 studies reviewed here indicate that concept maps function in four main ways: (i) by promoting meaningful learning; (ii) by providing an additional resource for learning; (iii) by enabling instructors to provide feedback to students, and (iv) by conducting assessment of learning and performance. CONCLUSIONS This review provides ideas for medical school faculty staff on the use of concept maps in teaching and learning. Strategies such as fostering critical thinking and clinical reasoning, incorporating concept mapping within problem-based learning, and using concept mapping in group and collaborative learning are identified. New developments in medical education include the use of serial concept maps, concept maps as a methodology to assist learners with lower cognitive competence, and the combination of group concept maps with structured feedback.

  18. Properties of publications on anatomy in medical education literature.

    Science.gov (United States)

    Vorstenbosch, Marc; Bolhuis, Sanneke; van Kuppeveld, Sascha; Kooloos, Jan; Laan, Roland

    2011-01-01

    Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and second to evaluate the development of this literature toward more "best evidence" between 1985 and 2009. Four databases were searched for publications on anatomy in medical education published between 1985 and 2009, resulting in 525 references. Hundred publications were characterized by five variables (journal category, paper subject, paper category, author perspective, and paper perspective). Statements from these publications were characterized by two variables (category and foundation). The publications contained 797 statements that involved the words "anatomy," "anatomical," or "anatomist." Forty-five percent of the publications contained no explicit research question. Forty percent of the statements made were about "teaching methods" and 17% about "teaching content," 8% referred to "practical value," and 10% to "side effects" of anatomy education. Ten percent of the statements were "positional," five percent "traditional," four percent "self-evident," and two percent referred to "quality of care." Fifty-six percent of the statements had no foundation, 17% were founded on empirical data, and 27% by references. These results substantiated the critical comments about the anecdotal nature of the literature. However, it is encouraging to see that between 1985 and 2009 the number of publications is rising that these publications increasingly focus on teaching methods and that an academic writing style is developing. This suggests a growing body of empirical literature about anatomy education.

  19. Lyme Meningoradiculitis: Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Smaranda Maier

    2016-09-01

    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.

  20. Medical humanities in healthcare education in Italy: a literature review

    Directory of Open Access Journals (Sweden)

    Laura Fieschi

    2013-03-01

    Full Text Available OBJECTIVE. The introduction of medical humanities (MH in undergraduate medical education in Italy has been an issue of debate since the 90's and few years later it was extended to other healthcare degrees. The aims of this Italian literature review, after considering the international scene, are: to evaluate the extent to which the interest in this subject has gradually developed throughout the country; which professional groups have contributed to the debate; to identify which theoretical constructs led to the introduction of MH in undergraduate medical education; to identify whether a clear and shared definition of MH exists in Italian literature; to verify what kinds of MH experiences have been accomplished in Italy. MATERIALS AND METHODS. A comprehensive literature search was conducted, including electronic databases, bibliographies, manual sorting of articles in paper format, congress proceedings. RESULTS. The analysis of the chosen articles underlines that, however limited, Italian literature does not present a very different picture from the international scene. It emerges that teaching MH is believed to be an important feature in undergraduate education of healthcare professionals who intend to propose a bio-psychological-social approach to care, in spite of the difficulty to measure its short and long term effectiveness. The lack of a multidisciplinary, multi-professional approach is also evident. CONCLUSION. Further research aiming to implement the quantity and quality of MH studies in the curricula of undergraduate healthcare education is desirable.

  1. Interventional tools to improve medication adherence: review of literature

    Science.gov (United States)

    Costa, Elísio; Giardini, Anna; Savin, Magda; Menditto, Enrica; Lehane, Elaine; Laosa, Olga; Pecorelli, Sergio; Monaco, Alessandro; Marengoni, Alessandra

    2015-01-01

    Medication adherence and persistence is recognized as a worldwide public health problem, particularly important in the management of chronic diseases. Nonadherence to medical plans affects every level of the population, but particularly older adults due to the high number of coexisting diseases they are affected by and the consequent polypharmacy. Chronic disease management requires a continuous psychological adaptation and behavioral reorganization. In literature, many interventions to improve medication adherence have been described for different clinical conditions, however, most interventions seem to fail in their aims. Moreover, most interventions associated with adherence improvements are not associated with improvements in other outcomes. Indeed, in the last decades, the degree of nonadherence remained unchanged. In this work, we review the most frequent interventions employed to increase the degree of medication adherence, the measured outcomes, and the improvements achieved, as well as the main limitations of the available studies on adherence, with a particular focus on older persons. PMID:26396502

  2. Publication trends in the medical informatics literature: 20 years of "Medical Informatics" in MeSH

    Directory of Open Access Journals (Sweden)

    LaVallie Donna L

    2009-01-01

    Full Text Available Abstract Background The purpose of this study is to identify publication output, and research areas, as well as descriptively and quantitatively characterize the field of medical informatics through publication trend analysis over a twenty year period (1987–2006. Methods A bibliometric analysis of medical informatics citations indexed in Medline was performed using publication trends, journal frequency, impact factors, MeSH term frequencies and characteristics of citations. Results There were 77,023 medical informatics articles published during this 20 year period in 4,644 unique journals. The average annual article publication growth rate was 12%. The 50 identified medical informatics MeSH terms are rarely assigned together to the same document and are almost exclusively paired with a non-medical informatics MeSH term, suggesting a strong interdisciplinary trend. Trends in citations, journals, and MeSH categories of medical informatics output for the 20-year period are summarized. Average impact factor scores and weighted average impact factor scores increased over the 20-year period with two notable growth periods. Conclusion There is a steadily growing presence and increasing visibility of medical informatics literature over the years. Patterns in research output that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline, and highlight specific journals in which the medical informatics literature appears most frequently, including general medical journals as well as informatics-specific journals.

  3. Biventricular takotsubo cardiomyopathy: case study and review of literature.

    Science.gov (United States)

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

    2013-01-01

    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.

  4. Cultural differences in medical communication: a review of the literature.

    Science.gov (United States)

    Schouten, Barbara C; Meeuwesen, Ludwien

    2006-12-01

    Culture and ethnicity have often been cited as barriers in establishing an effective and satisfying doctor-patient relationship. The aim of this paper is to gain more insight in intercultural medical communication difficulties by reviewing observational studies on intercultural doctor-patient communication. In addition, a research model for studying this topic in future research is proposed. A literature review using online databases (Pubmed, Psychlit) was performed. Findings reveal major differences in doctor-patient communication as a consequence of patients' ethnic backgrounds. Doctors behave less affectively when interacting with ethnic minority patients compared to White patients. Ethnic minority patients themselves are also less verbally expressive; they seem to be less assertive and affective during the medical encounter than White patients. Most reviewed studies did not relate communication behaviour to possible antecedent culture-related variables, nor did they assess the effect of cultural variations in doctor-patient communication on outcomes, leaving us in the dark about reasons for and consequences of differences in intercultural medical communication. Five key predictors of culture-related communication problems are identified in the literature: (1) cultural differences in explanatory models of health and illness; (2) differences in cultural values; (3) cultural differences in patients' preferences for doctor-patient relationships; (4) racism/perceptual biases; (5) linguistic barriers. It is concluded that by incorporating these variables into a research model future research on this topic can be enhanced, both from a theoretical and a methodological perspective. Using a cultural sensitive approach in medical communication is recommended.

  5. Thrombophilia—A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Samer Abdelrazeq

    2013-01-01

    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.

  6. [Medical novels as a supplement to medical literature in the (postgraduate) study of medicine].

    Science.gov (United States)

    Landex, Nadia Lander

    2011-12-05

    Medically relevant fiction and biographies are thought to possibly improve the reader's emotional competences, thus contributing to the (postgraduate) study of medicine. This paper evaluates whether medical novels might be relevant in the (postgraduate) study of medicine. The contents of four medical novels were evaluated qualitatively as regard to the professional and cultural contents and relevance. The medical novels were composed uniformly and considered to be both professional and cultural subjects. The professional subjects were mostly described correctly, and milieu and cultural subjects were realistic. The contents of the medical novels were relevant, but briefly described. Students of medicine and junior doctors may identify with the environment and the cultural subjects. It is not ruled out that medical novels can be used to acquire cultural competences, but - as regards professional knowledge - the study of professional literature will be more time-effective.

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

    Science.gov (United States)

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

    2016-02-01

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

  8. Self-Medication Practice with Nonprescription Medication among University Students: a review of the literature

    Directory of Open Access Journals (Sweden)

    Dedy Almasdy

    2011-09-01

    Full Text Available Objective: To review the literature relating to self-medicationpractice with nonprescription medication among universitystudents.Methods: A narrative review of studies on self-medicationpractice with nonprescription medication among universitystudent was performed. An extensive literature search wasundertaken using indexing services available at UniversitiSains Malaysia (USM library. The following keywords wereused for the search: self-care, self-medication, over-thecountermedicine, nonprescription medicine, minor illnesses,minor ailment, university population and communitypharmacy. Electronic databases searched were Science Direct,Medline, ISI Web of Knowledge, Inside Web, JSTOR, SpringerLink, Proquest, Ebsco Host and Google Scholar. Theseelectronic databases were searched for full text paperspublished in English.Results: Eleven studies were identified. In general, the reviewhas shown that self-medication practice with nonprescriptionmedication highly prevalence among university students. Thereasons for self-medication are vary among this populationand the main symptoms leading to self-medication areheadache or minor pain; fever, flu, cough, or cold; anddiarrhoea.The common medication is analgesic, antipyreticproducts, cough and cold remedies, anti allergy andvitamins or minerals. The sources of the medicines arepharmacy, home medicine cabinet, supermarket/shopand other person such as family, friend, neighbours andclassmates. The sources of drug information are familymember, previous experience, pharmacy salesman,doctor or nurse, advertisement and others. The reviewalso has shown that the self-medication practice couldhave many problems.Conclusions: The review provides insights about theself-medication practices among the university students.These practices were highly prevalence among universitystudents. The symptoms leading to self-medication arevary, thus the medication used and the medicationsources. It needs an adequate drug information

  9. A literature review of medical record keeping by foreign medical teams in sudden onset disasters.

    Science.gov (United States)

    Jafar, Anisa J N; Norton, Ian; Lecky, Fiona; Redmond, Anthony D

    2015-04-01

    Medical records are a tenet of good medical practice and provide one method of communicating individual follow-up arrangements, informing research data, and documenting medical intervention. The objective of this review was to look at one source (the published literature) of medical records used by foreign medical teams (FMTs) in sudden onset disasters (SODs). The published literature was searched systematically for evidence of what medical records have been used by FMTs in SODs. Findings The style and content of medical records kept by FMTs in SODs varied widely according to the published literature. Similarly, there was great variability in practice as to what happens to the record and/or the data from the record following its use during a patient encounter. However, there was a paucity of published work comprehensively detailing the exact content of records used. Interpretation Without standardization of the content of medical records kept by FMTs in SODs, it is difficult to ensure robust follow-up arrangements are documented. This may hinder communication between different FMTs and local medical teams (LMTs)/other FMTs who may then need to provide follow-up care for an individual. Furthermore, without a standard method of reporting data, there is an inaccurate picture of the work carried out. Therefore, there is not a solid evidence base for improving the quality of future response to SODs. Further research targeting FMTs and LMTs directly is essential to inform any development of an internationally agreed minimum data set (MDS), for both recording and reporting, in order that FMTs can reach the World Health Organization (WHO) standards for FMT practice.

  10. Search of medical literature for indoor carbon monoxide exposure

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, T.; Ivanovich, M.

    1995-12-01

    This report documents a literature search on carbon monoxide. The search was limited to the medical and toxicological databases at the National Library of Medicine (MEDLARS). The databases searched were Medline, Toxline and TOXNET. Searches were performed using a variety of strategies. Combinations of the following keywords were used: carbon, monoxide, accidental, residential, occult, diagnosis, misdiagnosis, heating, furnace, and indoor. The literature was searched from 1966 to the present. Over 1000 references were identified and summarized using the following abbreviations: The major findings of the search are: (1) Acute and subacute carbon monoxide exposures result in a large number of symptoms affecting the brain, kidneys, respiratory system, retina, and motor functions. (2) Acute and subacute carbon monoxide (CO) poisonings have been misdiagnosed on many occasions. (3) Very few systematic investigations have been made into the frequency and consequences of carbon monoxide poisonings.

  11. Medical Application Using Multi Agent System - A Literature Survey

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    Sougata Chakraborty

    2014-02-01

    Full Text Available In this paper we have projected on the involvement of multi-agent system in medical or health care domain. The objective of this study is to provide future researchers more resourceful and focused review of various research papers in this domain. Multi-agent system is most suitable for healthcare paradigm, as the properties of agent based systems deals with heterogeneous multiple agents. Data distribution and data management in a dynamic and distributed environment with multi-user cooperation, made multi-agent system more significant in this field. The disposition of this paper is classified on the basis of theoretical and application approach. We have tried to cover few relevant papers published on last decade. The main aim of this literature survey is to provide a complete road map on multi agent system based research on medical health care platform.

  12. Grynfelt hernia: case report and literature review.

    Science.gov (United States)

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

    2012-02-01

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

  13. Neurobrucellosis: three case reports and literature review

    Directory of Open Access Journals (Sweden)

    WANG Jia-wei

    2013-01-01

    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.

  14. Sturge Weber Syndrome: review of literature with case illustration

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    Satyarthee Guru Dutta

    2017-03-01

    Full Text Available Sturge-Weber syndrome (SWS also called as encephalotrigeminal angiomatosis, is a sporadically occurring rare neuro-cutaneous syndrome, characterized by vascular malformation with capillary venous angiomas involving face, choroidal layer of eye globe and leptomeninges responsible for ophthamological as well as neurological signs and symptoms. Authors report an interesting case, a six year old girl, who presented with seizures, facial port wine stain and normal psychomotor development. CT scan showed left cerebral hemiatrophy, left frontal and parieto occipital calcification with cortical calcification in left high frontal convexity. Cranial MRI scan also confirmed finding of left cerebral hemiatrophy and also revealed presence of gyriform cortical calcification, prominent flow voids seen in left basal ganglia. Her seizure is well controlled with antiepileptic medication. The pertinent literature is reviewed and management of such cases is discussed briefly.

  15. Metabolic and infectious pathologies in Brazilian medical literature: a review

    Directory of Open Access Journals (Sweden)

    Mauricio Rocha-e-Silva

    2010-06-01

    Full Text Available OBJECTIVE: This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. METHODS: I conducted a search in PubMed for original research articles (clinical or basic research recently published (2008-2009 by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. RESULTS: This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.

  16. Metabolic and infectious pathologies in Brazilian medical literature: a review.

    Science.gov (United States)

    Rocha-e-Silva, Mauricio

    2010-06-01

    This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. I conducted a search in PubMed for original research articles (clinical or basic research) recently published (2008-2009) by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.

  17. Twelfth nerve paresis induced by an unusual posterior fossa arachnoid cyst: case report and literature review.

    Science.gov (United States)

    Tarantino, Roberto; Marruzzo, Daniele; Colistra, Davide; Mancarella, Cristina; Delfini, Roberto

    2014-08-01

    There are only three cases of arachnoid cysts inducing twelfth nerve paresis described in English medical literature. We herein report one more instance. Six weeks after surgery, the patient has almost fully recovered. This case underlines the importance of considering the arachnoid cyst as a possible cause of twelfth nerve paresis.

  18. Otomastoiditis caused by Sphingomonas paucimobilis: case report and literature review

    Directory of Open Access Journals (Sweden)

    Gabriel Nuncio Benevides

    2014-09-01

    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.

  19. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    OpenAIRE

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p

  20. Medical Literature Evaluation Education at US Schools of Pharmacy.

    Science.gov (United States)

    O'Sullivan, Teresa A; Phillips, Jennifer; Demaris, Kendra

    2016-02-25

    To determine how medical literature evaluation (MLE) is being taught across the United States and to summarize methods for teaching and assessing MLE. An 18-question survey was administered to faculty members whose primary responsibility was teaching MLE at schools and colleges of pharmacy. Responses were received from 90 (71%) US schools of pharmacy. The most common method of integrating MLE into the curriculum was as a stand-alone course (49%). The most common placement was during the second professional year (43%) or integrated throughout the curriculum (25%). The majority (77%) of schools used a team-based approach. The use of active-learning strategies was common as was the use of multiple methods of evaluation. Responses varied regarding what role the course director played in incorporating MLE into advanced pharmacy practice experiences (APPEs). There is a trend toward incorporating MLE education components throughout the pre-APPE curriculum and placement of literature review/evaluation exercises into therapeutics practice skills laboratories to help students see how this skill integrates into other patient care skills. Several pre-APPE educational standards for MLE education exist, including journal club activities, a team-based approach to teaching and evaluation, and use of active-learning techniques.

  1. Forensic Medical Examination in Civil Cases: Status, Problems, Perspectives

    Directory of Open Access Journals (Sweden)

    E. Kh. Barinov

    2011-01-01

    Full Text Available The state of forensic medical examinations in civil cases related to health harm while rendering medical services is not shown to meet the need for a legal procedure. Key words: forensic medical examination, civil procedure, medical cases.

  2. Bedside teaching in medical education: a literature review.

    Science.gov (United States)

    Peters, Max; Ten Cate, Olle

    2014-04-01

    Bedside teaching is seen as one of the most important modalities in teaching a variety of skills important for the medical profession, but its use is declining. A literature review was conducted to reveal its strengths, the causes of its decline and future perspectives, the evidence with regard to learning clinical skills and patient/student/teacher satisfaction. PubMed, Embase and the Cochrane library were systematically searched with regard to terms related to bedside teaching. Articles regarding the above-mentioned subjects were included. Bedside teaching has shown to improve certain clinical diagnostic skills in medical students and residents. Patients, students/residents and teachers all seem to favour bedside teaching, for varying reasons. Despite this, the practice of bedside teaching is declining. Reasons to explain this decline include the increased patient turnover in hospitals, the assumed violation of patients' privacy and an increased reliance on technology in the diagnostic process. Solutions vary from increasingly using residents and interns as bedside teachers to actively educating staff members regarding the importance of bedside teaching and providing them with practical essentials. Impediments to bedside teaching need to be overcome if this teaching modality is to remain a valuable educational method for durable clinical skills.

  3. Interventional tools to improve medication adherence: review of literature

    Directory of Open Access Journals (Sweden)

    Costa E

    2015-09-01

    Full Text Available Elísio Costa,1 Anna Giardini,2 Magda Savin,3 Enrica Menditto,4 Elaine Lehane,5 Olga Laosa,6 Sergio Pecorelli,7,8 Alessandro Monaco,7 Alessandra Marengoni9On behalf of the A1 Action group “Prescription and Adherence to Medical Plans”, European Innovation Partnership on Active and Healthy Ageing1UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, Porto, Portugal; 2Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Montescano (PV, Pavia, Italy; 3European Association of Pharmaceutical Full-line Wholesalers, Brussels, Belgium; 4CIRFF/Center of Pharmacoeconomics, School of Pharmacy, University of Naples FedericoII, Nápoles, Italy; 5Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland; 6Centro de Investigación Clínica del Anciano Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Madrid, Spain; 7Italian Medicines Agency – AIFA, Rome, Italy; 8University of Brescia, Brescia, Italy; 9Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy Abstract: Medication adherence and persistence is recognized as a worldwide public health problem, particularly important in the management of chronic diseases. Nonadherence to medical plans affects every level of the population, but particularly older adults due to the high number of coexisting diseases they are affected by and the consequent polypharmacy. Chronic disease management requires a continuous psychological adaptation and behavioral reorganization. In literature, many interventions to improve medication adherence have been described for different clinical conditions, however, most interventions seem to fail in their aims. Moreover, most interventions associated with adherence improvements are not associated with improvements in other outcomes. Indeed, in the last decades, the degree of nonadherence remained unchanged. In this work, we

  4. Academic genres in EFL medical educational contexts: The medical case-report

    Directory of Open Access Journals (Sweden)

    Eugenio Cianflone

    2015-11-01

    Full Text Available In genre analysis literature medical case-reports can be said to be almost underrepresented when compared to other scholarly specimens that have been thoroughly researched, like the research article, the master’s thesis or the doctoral dissertation. As a written academic variety little is known to English as a foreign language practitioners about the medical case report’s format and about its use in language for specific purposes classes. The aim of this note is to offer a preliminary description of the case-report’s main sections and to suggest some activities to be exploited in English as a foreign language classes. The hope is that these insights can call genre analysts’ attention on this medical genre to develop appropriate research that will result in new educational texts.

  5. Medical literature search practice in paediatric junior medical staff: a questionnaire survey.

    Science.gov (United States)

    Shirkhedkar, P; Day, A S

    2008-03-01

    With increasing medical knowledge and emphasis upon evidence-based medicine, it is essential for practitioners to have optimal literature searching skills. There are limited data regarding the use of online information retrieval (IR) systems by paediatric junior medical officers (JMO). The aims of this questionnaire-based study of a group of JMO were to assess the accessibility, frequency of use and preferences for electronic information resources, and to ascertain their perceived adequacy of training and expertise in online searching. Questionnaires were distributed to 319 JMO at two Australian children's hospitals. A total of 106 questionnaires were returned (33.2% response rate). Twenty-four-hour access to electronic medical databases was available to almost 90% of respondents at work or home. Five or less online searches per month were performed by 53.7% of respondents. Previous formal training in database searching was reported by 72.4% of respondents, but over half felt it had been inadequate. Most JMO (91.5%) acknowledged a need for further training in search skills. In spite of widespread availability of online resources, use of these resources was sub-optimal in this group of trainee doctors. Most respondents reported a need for further training in electronic searching. Continuing targeted education in electronic database searching is required to ensure that future doctors develop skills to ensure optimal use of medical literature.

  6. Beer potomania: two cases and review of the literature.

    Science.gov (United States)

    Fenves, A Z; Thomas, S; Knochel, J P

    1996-01-01

    The association of severe hyponatremia and the ingestion of large quantities of beer, termed beer potomania, has been known for several years. We report two new cases, and review 20 others from the medical literature. These patients usually have a history of binge beer drinking, poor dietary intake, and then present with severe hyponatremia and various mental status changes or seizures. Typical laboratory findings include hyponatremia, hypokalemia, and a very dilute urine. The patients respond quickly to the administration of sodium chloride containing i.v. fluids. We propose that the pivotal pathophysiologic mechanism in beer potomania syndrome is the minimal intake of solute and the hypoosmolality of the beer ingested. This will lead to the inability to excrete sufficient amounts of free water to keep up with the ingestion of large quantities of the hyposmolar beer. Treatment with isotonic sodium chloride results in the rapid clearance of the accumulated excess free water.

  7. Liposuction for chronic medical diseases and noncosmetic conditions: review of the literature

    Directory of Open Access Journals (Sweden)

    Hamdy Abuelhassan El-Khatib

    2015-03-01

    Full Text Available The purpose of this systematic literature review was to evaluate the safety of liposuction techniques and to identify the cosmetic and noncosmetic application of liposuction. Liposuction can be used to improve the quality-of-life in patients with disabling medical conditions in addition to its use for cosmetic rejuvenation. An online search of the Cochrane Library, MEDLINE, Embase, and SciELO were conducted. Forty-seven original articles reported from 1982 to February 2014 were included in this review. The articles reported on the use as well as the limitations of liposuction for treatment of noncosmetic and disabling medical conditions. The criteria used for selection of articles were: large sample size and originality. The case reports were excluded. There was a broad agreement about the applicability and the efficacy of the liposuction for treatment of these chronic medical conditions, such as multiple systemic lipomatosis, dercum's disease, chronic lymphedema, and axillary hyperhidrosis. Literatures review confirmed that Liposuction technique has provided significant and stable cure for these chronic medical conditions. Liposuction is the most frequent esthetic procedure for adipose tissue reduction and treatment of lipedema worldwide. Apart from esthetic indications, liposuction can also be used to treat chronic medical diseases and noncosmetic conditions.

  8. Improving medical literature sourcing by first-year medical students in problem-based learning: outcomes of early interventions.

    Science.gov (United States)

    Krasne, Sally; Stevens, Carl D; Wilkerson, LuAnn

    2014-07-01

    To describe and report outcomes of interventions implemented in the preclerkship curriculum at the David Geffen School of Medicine at UCLA to guide students toward use of high-quality information sources and build a foundation for developing fluency in applying primary medical literature to answer clinical questions. The authors introduced three phases of change to instruction in literature searching and sourcing for beginning medical students writing learning issue essays: in phase 1 (2003-2006), students were introduced to online resources during orientation week and received a lecture on high-yield literature searching midway through their first curricular block; in phase 2 (2007-2008), the high-yield lecture shifted to orientation week, and a resource matrix and librarian-guided workshop on locating authoritative sources were added; and in phase 3 (2009), peer evaluation and collaboration were implemented. To track changes in sourcing skills, the authors analyzed 3,199 references from 665 essays written by 465 first-year students for two problem-based learning (PBL) cases during the first block of one representative year per phase (2006, 2008, 2009). Over the study period, the authors found significantly increased citations to peer-reviewed journal articles and guidelines and decreased citations to general public Web sites and highly abstracted resources. Peer feedback and collaboration in phase 3 were associated with maintenance of these gains. Early introduction of instruction on medical literature searching and sourcing, a librarian-guided workshop, and peer collaboration and feedback improved the quality of references cited by students in PBL essays during their first curricular block.

  9. [Forensic-medical diagnostics of doping cases in sports].

    Science.gov (United States)

    Khodasevich, L S; Kuzin, S G; Khodasevich, A L

    2013-01-01

    The present review of the literature is focused on the problem of forensic-medical diagnostics of doping cases in sports, with special reference to the main classes of pharmaceutical products forbidden for use by the International Olympic Committee. The main causes of death among the athletes as a result of using doping substances are considered. Much attention is given to adverse reactions induced by long-time intake of anabolic steroids many of which can be identified at autopsy.

  10. Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature.

    Science.gov (United States)

    Thompson, Julian; Rehn, Marius; Lossius, Hans Morten; Lockey, David

    2014-09-24

    As the threat of international terrorism rises, there is an increasing requirement to provide evidence-based information and training for the emergency personnel who will respond to terrorist incidents. Current major incident training advises that emergency responders prioritize their own personal safety above that of the 'scene and survivors'. However, there is limited information available on the nature of these threats and how they may be accurately evaluated. This study reviews the published medical literature to identify the hazards experienced by emergency responders who have attended previous terrorist incidents. A PubMed literature search identified 10,894 articles on the subject of 'terrorism', and there was a dramatic increase in publications after the 9/11 attacks in 2001. There is heterogeneity in the focus and quality of this literature, and 307 articles addressing the subject of scene safety were assessed for information regarding the threats encountered at terrorist incidents. These articles demonstrate that emergency responders have been exposed to both direct terrorist threats and environmental scene hazards, including airborne particles, structural collapse, fire, and psychological stress. The emphasis of training and preparedness for terrorist incidents has been primarily on the direct threats, but the published literature suggests that the dominant causes of mortality and morbidity in responders after such incidents are the indirect environmental hazards. If the medical response to terrorist incidents is to be based on evidence rather than anecdote, analysis of the current literature should be incorporated into major incident training, and consistent collection of key data from future incidents is required.

  11. Bilateral simultaneous rupture of the infrapatellar tendon: a case report and literature review.

    Science.gov (United States)

    Goodrich, A; Difiore, R J; Tippens, J K

    1983-11-01

    Bilateral simultaneous patellar tendon rupture is a rare entity. Most case studies in the literature have been reported in patients with an underlying systemic condition, i.e. systemic lupus erythematosus, rheumatoid arthritis, or associated with a history of steroid injections about the infrapatellar tendon. A recent case report treated at Dwight David Eisenhower Army Medical Center without a predisposing underlying systemic condition or history of injection is presented. Our patient is the youngest to be reported in the literature. The literature is reviewed on this subject, and the mechanism of injury presented. Copyright 2013, SLACK Incorporated.

  12. Literature and disability: the medical interface in Borges and Beckett.

    Science.gov (United States)

    Novillo-Corvalán, Patricia

    2011-06-01

    Samuel Beckett and Jorge Luis Borges have presented 20th century literature with a distinctive gallery of solitary figures who suffer from a series of physiological ailments: invalidism, decrepitude, infirmity and blindness, as well as neurological conditions such as amnesia and autism spectrum disorders. Beckett and Borges were concerned with the dynamics between illness and creativity, the literary representation of physical and mental disabilities, the processes of remembering and forgetting, and the inevitability of death. This article explores the depiction of physically and mentally disabled characters in Borges' Funes the Memorious (1942)--a story about an Uruguayan gaucho who has been left paralysed after a fall from a horse which simultaneously endowed him with an infallible memory and perception--and Beckett's Trilogy: Molloy (1951), Malone Dies (1951) and The Unnamable (1953). It examines the prodigious memory of Funes and the forgetful minds of Molloy and Malone with reference to influential neuropsychological studies such as Alexander Luria's twofold exploration of memory and forgetfulness in The Mind of a Mnemonist (1968) and The Man with a Shattered World (1972). The article demonstrates that in contrast to Beckett's amnesiacs and Luria's brain-damaged patient, who are able to transcend their circumstances through cathartic writing, Borges' and Luria's mnemonic prodigies fail to achieve anything significant with their unlimited memories and remain imprisoned within their cognitive disabilities. It reveals that medical discourses can provide invaluable insights and lead to a deeper understanding of the minds and bodily afflictions of literary characters.

  13. Time to detoxify medical literature from guideline overdose

    Institute of Scientific and Technical Information of China (English)

    Dinesh Vyas; Arpita K Vyas

    2012-01-01

    The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product (GDP)in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.

  14. New journals for publishing medical case reports.

    Science.gov (United States)

    Akers, Katherine G

    2016-04-01

    Because they do not rank highly in the hierarchy of evidence and are not frequently cited, case reports describing the clinical circumstances of single patients are seldom published by medical journals. However, many clinicians argue that case reports have significant educational value, advance medical knowledge, and complement evidence-based medicine. Over the last several years, a vast number (∼160) of new peer-reviewed journals have emerged that focus on publishing case reports. These journals are typically open access and have relatively high acceptance rates. However, approximately half of the publishers of case reports journals engage in questionable or "predatory" publishing practices. Authors of case reports may benefit from greater awareness of these new publication venues as well as an ability to discriminate between reputable and non-reputable journal publishers.

  15. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients. PMID:23102495

  16. Exophiala jeanselmei infection in solid organ transplant recipients: report of two cases and review of the literature.

    Science.gov (United States)

    Lief, M H; Caplivski, D; Bottone, E J; Lerner, S; Vidal, C; Huprikar, S

    2011-02-01

    Dematiaceous fungi are an opportunistic pathogen seen in solid organ transplant recipients. We report 2 cases of Exophiala infection and review the medical literature to summarize the spectrum of disease this pathogen can cause in this patient population.

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

    Science.gov (United States)

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

    2015-09-01

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

  18. Idiopathic Harlequin Syndrome Manifesting during Exercise: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hussein Algahtani

    2017-01-01

    Full Text Available Harlequin syndrome is a rare autonomic disorder characterized by unilateral facial flushing and sweating with contralateral anhidrosis induced by exercise, heat, and emotion. It is usually idiopathic but could be the first manifestation of several serious underlying medical conditions. Medical or surgical treatments are not required for idiopathic Harlequin syndrome, but social and psychological factors may indicate sympathectomy or botulinum toxin injection. In this article, we report a case of idiopathic Harlequin syndrome and review the literature.

  19. Mastoid osteoma: consideration on two cases and literature review

    Directory of Open Access Journals (Sweden)

    Dantas, Rafaela Nunes

    2009-09-01

    Full Text Available Introduction/Objective: The mastoid osteoma is a benign osteogenic tumor, considered to be uncommon in such location. By 2006, there were about 150 cases reported in the medical literature. Its etiopathogenesis includes factors relating to embryogenesis, metaplasia, trauma and inflammation. They are generally asymptomatic and appear through tumoration protrusion from the retroauricular region. Computed tomography has been useful for its diagnosis and surgical planning. Its surgical results are good from a aesthetic and curative point of view. Method: We studied two cases of mastoid osteoma and analyzed them as for their clinical state, imaging exams, treatment and results. Results: Both locating in the right mastoid region. Absence of a previous trauma in this region. Normal neurological exam. The cranial computed tomography revealed a hyperdense lesion involving the cortex of the temporal bone in the mastoid region, radiologically compatible with osteoma. They were submitted to complete exeresis of the lesion. Anatomopathological exam: osteoma. They had excellent aesthetic and curative results. There was no recurrence or malignant transformation. Conclusions: The osteoma located in the mastoid region is an uncommon benign tumor. It provokes local aesthetic deformity and is generally asymptomatic. The choice exam is computed tomography. It has a differential diagnosis with hemangioma, fibrous dysplasia, osteosarcoma and osteoblastic metastasis. The exam does not present malignant transformation. The treatment is surgical and with excellent aesthetic and curative results.

  20. Epidural hematoma secondary to sinusitis: a case report and review of the literature.

    Science.gov (United States)

    Aviner, Shraga; Olshinka, Noam; Cherniavsky, Evgenia; Forer, Boaz; Bibi, Haim

    2014-02-01

    Epidural hematoma is a potentially life threatening event that demands prompt diagnosis and surgical treatment, usually following head trauma. We present a case of a 9-year-old boy with no history of head trauma, and who was diagnosed with epidural hematoma secondary to frontal sinusitis; and the medical literature was reviewed.

  1. Thigh infection and subcutaneous emphysema: an emergency, review of literature and case discussion.

    LENUS (Irish Health Repository)

    Thakral, R

    2011-06-01

    Thigh infection associated with local emphysematous signs on presentation to the emergency room should alert the medical staff at once of potential complication associated with it. The infection may be associated with underlying bowel pathology and has a high mortality rate. Hence, emergency treatment should be instituted. We discuss a case with this uncommon presentation, treatment administered and relevant literature.

  2. Metronidazole associated seizures: a case report and review of the pharmacovigilance literature

    Directory of Open Access Journals (Sweden)

    Olayinka A. Ogundipe

    2014-02-01

    A brief review of the medical pharmacovigilance literature in relation to metronidazole and seizures is presented. Two causality assessment systems are applied to the index case report, to illustrate their potential use in supporting increased objectivity when reporting suspected ADRs in clinical practice. [Int J Basic Clin Pharmacol 2014; 3(1.000: 235-238

  3. Medication Adherence With Diabetes Medication: A Systematic Review of the Literature.

    Science.gov (United States)

    Capoccia, Kam; Odegard, Peggy S; Letassy, Nancy

    2016-02-01

    The primary purpose of this systematic review is to synthesize the evidence regarding risk factors associated with nonadherence to prescribed glucose-lowering agents, the impact of nonadherence on glycemic control and the economics of diabetes care, and the interventions designed to improve adherence. Medline, EMBASE, the Cochrane Collaborative, BIOSIS, and the Health and Psychosocial Instruments databases were searched for studies of medication adherence for the period from May 2007 to December 2014. Inclusion criteria were study design and primary outcome measuring or characterizing adherence. Published evidence was graded according to the American Association of Clinical Endocrinologists protocol for standardized production of clinical practice guidelines. One hundred ninety-six published articles were reviewed; 98 met inclusion criteria. Factors including age, race, health beliefs, medication cost, co-pays, Medicare Part D coverage gap, insulin use, health literacy, primary nonadherence, and early nonpersistence significantly affect adherence. Higher adherence was associated with improved glycemic control, fewer emergency department visits, decreased hospitalizations, and lower medical costs. Adherence was lower when medications were not tolerated or were taken more than twice daily, with concomitant depression, and with skepticism about the importance of medication. Intervention trials show the use of phone interventions, integrative health coaching, case managers, pharmacists, education, and point-of-care testing improve adherence. Medication adherence remains an important consideration in diabetes care. Health professionals working with individuals with diabetes (eg, diabetes educators) are in a key position to assess risks for nonadherence, to develop strategies to facilitate medication taking, and to provide ongoing support and assessment of adherence at each visit. © 2015 The Author(s).

  4. Primary pancreatic lymphoma: two case reports and a literature review

    Directory of Open Access Journals (Sweden)

    Yu L

    2017-03-01

    Full Text Available Lili Yu,1,2,* Yajun Chen,1,2,* Ligang Xing2 1School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, 2Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, People’s Republic of China *These authors contributed equally to this work Abstract: Primary pancreatic lymphoma (PPL is an extremely rare disease, with only a few cases reported in the literature. Clinical manifestations of PPL are often nonspecific and may mimic other pancreatic diseases. Because of the limited experience of PPL, clinicopathological features, differential diagnosis, optimal therapy, and outcomes are not well defined. We described two cases diagnosed as PPL and confirmed by histological examination and immunohistochemical analysis. Case 1 was a young man with obstructive jaundice and upper abdominal malaise mimicking a pancreatic adenocarcinoma. A computed tomography (CT scan revealed a diffuse heterogeneous mass in the head of the pancreas along with dilated bile ducts, no dilated pancreatic duct, no liver or splenic involvement, or evident retroperitoneal adenopathies. The patient underwent a pancreatico-duodenectomy, and the postoperative histopathology confirmed diffuse large B-cell non-Hodgkin lymphoma. Postoperatively, he received six courses of the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisolone. Case 2 was an older man with left flank pain. A CT confirmed a mass with irregular margins at the tail of the pancreas and the hilum of the spleen. The mass was heterogeneous, with no clear boundary between lesions, spleen, stomach, and pancreas, with nearby blood vessels wrapped around it, and multiple enlarged lymph nodes in the abdominal cavity. A CT-guided biopsy was performed. The immunohistological findings of the specimen revealed a diffuse large B-cell lymphoma. The size of the tumor was significantly reduced after four cycles of the CHOP chemotherapy

  5. The use of Facebook in medical education – A literature review

    Science.gov (United States)

    Pander, Tanja; Pinilla, Severin; Dimitriadis, Konstantinos; Fischer, Martin R.

    2014-01-01

    Background: The vogue of social media has changed interpersonal communication as well as learning and teaching opportunities in medical education. The most popular social media tool is Facebook. Its features provide potentially useful support for the education of medical students but it also means that some new challenges will have to be faced. Aims: This review aimed to find out how Facebook has been integrated into medical education. A systematical review of the current literature and grade of evidence is provided, research gaps are identified, links to prior reviews are drawn and implications for the future are discussed. Method: The authors searched six databases. Inclusion criteria were defined and the authors independently reviewed the search results. The key information of the articles included was methodically abstracted and coded, synthesized and discussed in the categories study design, study participants’phase of medical education and study content. Results: 16 articles met all inclusion criteria. 45-96% of health care professionals in all phases of their medical education have a Facebook profile. Most studies focused on Facebook and digital professionalism. Unprofessional behavior and privacy violations occurred in 0.02% to 16%. In terms of learning and teaching environment, Facebook is well accepted by medical students. It is used to prepare for exams, share online material, discuss clinical cases, organize face-to-face sessions and exchange information on clerkships. A few educational materials to teach Facebook professionalism were positively evaluated. There seems to be no conclusive evidence as to whether medical students benefit from Facebook as a learning environment on higher competence levels. Discussion: Facebook influences a myriad of aspects of health care professionals, particularly at undergraduate and graduate level in medical education. Despite an increasing number of interventions, there is a lack of conclusive evidence in terms of

  6. The Scrotum in Pancreatitis: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Perakath B

    2004-09-01

    Full Text Available CONTEXT: An acute inguinoscrotal swelling appearing during the course of acute pancreatitis is rare. There are only three case reports of this in the English literature. CASE REPORT: We report a case of right inguinoscrotal swelling appearing during an attack of acute pancreatitis. CONCLUSIONS: A correct diagnosis and appropriate management will prevent unnecessary surgical intervention.

  7. Eosinophilic myocarditis: case series and literature review.

    Science.gov (United States)

    Sohn, Kyoung-Hee; Song, Woo-Jung; Kim, Byung-Keun; Kang, Min-Koo; Lee, Suh-Young; Suh, Jung-Won; Yoon, Yeonyee E; Kim, Sae-Hoon; Youn, Tae-Jin; Cho, Sang-Heon; Chang, Yoon-Seok

    2015-04-01

    Eosinophilic myocarditis is a condition resulting from various eosinophilic diseases, including helminth infection, drug hypersensitivity, systemic vasculitis or idiopathic hypereosinophilic syndromes. Clinical manifestations of eosinophilic myocarditis may vary from early necrosis to endomyocardial fibrosis. Eosinophilic myocarditis is one of the most fatal complications of hypereosinophilia. However, eosinophilic myocarditis has been rarely reported in the literature, particularly in Asia Pacific regions, reflecting the under-recognition of the disease among clinicians. Early recognition is crucial for improving clinical outcomes of eosinophilic myocarditis. Early administration of systemic corticosteroid is necessary in eosinophilic myocarditis regardless of underlying causes, as delayed treatment may result in fatal outcomes. In addition, differential diagnoses of underlying causes for eosinophilia are necessary to improve long-term outcomes.

  8. Tracheobronchopathia osteochondroplastica: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Junping Sun

    2015-01-01

    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. Systemic mastocytosis: Case report with literature review

    Directory of Open Access Journals (Sweden)

    Mitrović Mirjana

    2012-01-01

    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.

  10. YEYUNAL DIVERTICULAE: CASE REPORT AND LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    D. A. Ferreyra

    2014-11-01

    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

  11. Suicide pacts: six cases and literature review.

    Science.gov (United States)

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

    2013-07-01

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

  12. 2000-2009年中国李斯特菌病文献报告病例分析%Listeriosis cases reported in medical literatures in China,2000-2009

    Institute of Scientific and Technical Information of China (English)

    冯延芳; 冉陆; 张立实

    2011-01-01

    Objective To describe the clinical and epidemiological features of listeriosis in China from 2000 to 2009 and provide evidence for improvement of listeriosis prevention and control. Methods The literatures about listeriosis in China from 2000 to 2009 were collected through electronic and manual search to conduct clinical and epidemiological analysis of listeriosis were included. Results A total of 92 clinical cases of listeriosis, including 54 cases in perinatal stage and 63 cases in non-perinatal stage. The main clinical manifestation of listeriosis was septicemia (39%). The patients in pregnancy were more likely (91% ) to have fever (37.5 -40 ℃). The average case fatality among the cases analyzed was 21% (19/89), but the case fatality in the neonates was as high as 56% (14/25). Cases were reported in half of the provinces in China, but most often (57%) in Shanghai and Beijing. Conclusion The clinical and epidemiological features and case fatality of listeriosis in China were similar to those in European and American countries.%目的 描述中国(未包括香港、澳门和台湾地区,下同)近10年(2000.1-2009.12)来李斯特菌病的临床特征并简述其分布情况,为我国李斯特菌病的防治提供参考依据.方法 计算机检索与手工检索结合收集我国2000.1-2009.12李斯特菌病的文献报告资料,从中提取各李斯特菌病例的临床与流行病学信息并进行统计分析.结果 本文共纳入92例李斯特菌病例,其中,围生期病例54例,非围生期病例38例.李斯特菌病患者的临床表现以败血症(39%)最为多见,孕妇患者约91%有发热症状(37.5~40℃).纳入病例平均病死率为21%(19/89),其中,新生儿的病死率高达56%(14/25).我国16个省(约50%)已有李斯特菌病例报告,报告病例多集中于北京、上海两地(57%).结论 2000-2009年的10年,全国16个省在中文科技杂志上报告了92例李斯特菌病例.病例临床特征、报告病死率等与欧美国家类似.

  13. 76 FR 59407 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

    Science.gov (United States)

    2011-09-26

    ... ``Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... HUMAN SERVICES Food and Drug Administration Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information on Non-Standardized Allergenic Extracts in the Diagnosis...

  14. Patient participation in medication reviews is desirable but not evidence-based: a systematic literature review.

    NARCIS (Netherlands)

    Willeboordse, F.; Hugtenburg, J.G.; Schellevis, F.G.; Elders, P.J.M.

    2014-01-01

    Aim: The aim of this systematic literature review is to investigate which types of patient participation in medication reviews have been practiced and what is known about the effects of patient participation within the medication review process. Methods: A systematic literature review was performed

  15. Patient participation in medication reviews is desirable but not evidence-based: a systematic literature review.

    NARCIS (Netherlands)

    Willeboordse, F.; Hugtenburg, J.G.; Schellevis, F.G.; Elders, P.J.M.

    2014-01-01

    Aim: The aim of this systematic literature review is to investigate which types of patient participation in medication reviews have been practiced and what is known about the effects of patient participation within the medication review process. Methods: A systematic literature review was performed

  16. Medical managers in contemporary healthcare organisations: a consideration of the literature.

    Science.gov (United States)

    Dwyer, Alison J

    2010-11-01

    To consider the literature supporting the evolution of the roles of a Medical Manager within contemporary healthcare organisations. Consideration of available literature. Limited dedicated literature available. Consideration of available studies and expert opinion reveals benefit of doctors in management positions within healthcare organisations. The roles of Medical Managers arise from: organisational structure-theory of healthcare's 'professional bureaucracy'; clinical directorate models; clinical governance, legislative and public health requirements; and the duality of combining medical knowledge with business and healthcare management training. Roles identified are: (1) leadership and management of medical staff including appointments and credentialing, and mentoring of medical staff in Clinical Directorate roles; (2) strategy development including Medical Advisory Role to Executive; (3) clinical governance including quality and risk management and legislative requirements; and (4) operational areas that benefit from clinical and management skills. Strengths of this review include considering contexts of Medical Managers in medical and healthcare management literature. Weaknesses include drawing inferences from theory. Future recommendations include formal studies and systematic reviews of available literature of the subject. In light of falling Medical Management trainee numbers, this study highlights the value to the health system of a dwindling Medical Management profession, the urgent need to encourage more medical practitioners into management and for organisations to further embrace Medical Managers in key leadership roles.

  17. Anaesthetic technique during awake craniotomy. Case report and literature review

    Directory of Open Access Journals (Sweden)

    M.M. Madriz-Godoy

    2016-07-01

    Results: This case was managed with a scalp nerve block as local anaesthesia plus intravenous sedation without airway instrumentation. We reviewed the literature about patient management during awake craniotomy.

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

    Directory of Open Access Journals (Sweden)

    Jitender Aneja

    2015-01-01

    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.

  19. Osteopetrosis: A Case Report and Review of the Literature ...

    African Journals Online (AJOL)

    Osteopetrosis: A Case Report and Review of the Literature. ... Thus the result is increased bone density on radiographs. Presented here is a 25 years-old ... No specific laboratory abnormalities found in the initial evaluation. On physical ...

  20. Nephrogenic systemic fibrosis associated with gadolinium based contrast agents: A summary of the medical literature reporting

    Energy Technology Data Exchange (ETDEWEB)

    Broome, Dale R. [Department of Radiology, Loma Loma University Medical Center, 11234 Anderson Street, Room 2606, Loma Linda, CA 92354 (United States)], E-mail: dbroome@ahs.llumc.edu

    2008-05-15

    Nephrogenic systemic fibrosis (NSF) is a systemic fibrosing disorder that principally affects the skin, but can involve virtually any tissue in the human body and result in significant disability and even death. Since 2006 numerous retrospective case reports and case series have reported a very strong association of this disease with exposure to gadolinium-based contrast agents (Gd-CA) for MR imaging in the setting of severe or end-stage renal disease. The purpose of this report is to summarize the medical literature reporting of biopsy-proven NSF cases in which the authors specifically investigated patient exposure to Gd-CA. A Pub Med MEDLINE search was performed using the key words-nephrogenic systemic fibrosis and nephrogenic fibrosing dermopathy. All case reports and case series of NSF were reviewed to determine if patients had a preceding exposure to Gd-CA and which specific Gd-CA was involved. If the original reports did not clarify the specific Gd-CA, I reviewed follow-up letters to the editors or contacted the authors to clarify which specific Gd-CA were linked to the NSF cases. If several reports originated from the same institution, clarification was also obtained to avoid redundant reporting. As of February 1, 2008 there have been 190 biopsy-proven cases of NSF published in the peer-reviewed literature with the following associations: 157 gadodiamide (Omniscan, GE Healthcare), 8 gadopentetate (Magnevist, Bayer Healthcare), 3 gadoversetamide (OptiMARK, Covidien), and 18 unspecified Gd-CA, and 4 confounded cases with more than one Gd-CA. Five cases of NSF were unassociated with Gd-CA.

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

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1993-01-01

    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....

  2. Splenic vein leiomyosarcoma: case report and review of the literature.

    Science.gov (United States)

    Patrono, Damiano; Molinaro, Luca; Mazza, Elena; Romagnoli, Renato; Salizzoni, Mauro

    2014-09-28

    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%. 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. We report a case of primary venous LMS arising from the splenic vein and we briefly review the relevant literature.

  3. Sarcoidosis: Case Presentation and Literature Review

    Directory of Open Access Journals (Sweden)

    Dayana Alomá Fortún

    2016-09-01

    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.

  4. Case report and review of literatures:

    Directory of Open Access Journals (Sweden)

    Megahed Mohamed Abdl Fatah

    2016-07-01

    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.

  5. Biperiden Dependence: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fernando Espi Martinez

    2012-01-01

    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.

  6. 3D-printing techniques in a medical setting: a systematic literature review.

    Science.gov (United States)

    Tack, Philip; Victor, Jan; Gemmel, Paul; Annemans, Lieven

    2016-10-21

    Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.

  7. A Rare Case of Nonsecretory Multiple Myeloma in Lagos, Nigeria: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ebele Uche

    2015-01-01

    Full Text Available Multiple myeloma (MM is a plasma cell disorder associated with clonal proliferation of plasma cells. Nonsecretory multiple myeloma (NSMM is a rare variant of MM and accounts for approximately 1% to 5% of all cases. It is defined as symptomatic myeloma without detectable monoclonal immunoglobulin on serum or urine electrophoresis. This variant usually poses a diagnostic challenge to the clinician. We present a 60-year-old Nigerian man who was investigated extensively for bone pain, weight loss, and anaemia. He was eventually diagnosed as having nonsecretory multiple myeloma based on histology and immunohistochemistry results of bone marrow trephine biopsy. He is currently being managed with bortezomib, doxorubicin, and thalidomide, as well as zoledronic acid. He is also on anticoagulation. He continues to show remarkable clinical improvement. We describe this case report and literature review for better awareness amongst medical practitioners and pathologists.

  8. 76 FR 71045 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

    Science.gov (United States)

    2011-11-16

    ... Scientific and Medical Literature and Information on Non-Standardized Allergenic Extracts in the Diagnosis... literature and information concerning the use of non- standardized allergenic extracts in the diagnosis and... Literature and Information on Non-Standardized Allergenic Extracts in the Diagnosis and Treatment of...

  9. Hidradenitis suppurativa: literature review and case report

    Directory of Open Access Journals (Sweden)

    Mônica Mourthé de Alvim Andrade

    2012-06-01

    Full Text Available Hidradenitis suppurativa (HS is a chronic, recurrent and debilitating disease, affecting mainly women, especially in their second and third decades of life. Its most common incidence is in the axillary, inguinal, perianal and inframammary regions. Its complications include chronic fistulizing processes, with involvement of important adjacent structures, such as the sacrum and coccyx, the anal sphincter, urethra and great-caliber vessels, such as the groin vessels. The proportions of some cases of HS requiring extensive surgical procedures at several moments and the application of flaps and grafts, justify unusual cases reports, like this one. The authors present a case of extensive involvement of the perianal and gluteal regions, which required extended resection with flap in the first approach and fistulectomy in a second surgical moment, with good result for the patient.A hidradenite supurativa (HS é uma doença crônica, recorrente e debilitante, que afeta principalmente mulheres, sobretudo na segunda e terceira décadas de vida. Incide mais nas regiões axilar, inguinal, perianal e inframamária. Dentre suas complicações crônicas, são descritos processos fistulizantes com comprometimento de estruturas importantes, como o sacro e o cóccix, aparelho esfincteriano, uretra e vasos calibrosos, como os inguinais. As proporções de alguns casos de HS, exigindo intervenções alargadas, em vários tempos e com aplicação de retalhos e enxertos justificam relatos de casos que fogem da rotina, como o atual. Os autores apresentam um caso de comprometimento extenso da região glútea e perianal, que exigiu ressecção alargada com retalho e fistulectomia em um segundo tempo cirúrgico, com bom resultado para a paciente.

  10. Meningeal melanocytoma: case report and literature review.

    Science.gov (United States)

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

    2014-01-01

    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.

  11. Pachydermodactyly: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Paravina Mirjana

    2014-12-01

    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.

  12. Gallstone ileus: case report and literature review.

    Science.gov (United States)

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

    2013-09-07

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

  13. Stiff person syndrome (SPS): Literature review and case report

    African Journals Online (AJOL)

    Recognition of a case of SPS is important because early initiation of therapy prevents ... Spasms were often triggered by emotional distress and unexpected external stimuli. ..... been started on GABA-ergic medication and the EMG recorded.

  14. Takotsubo Cardiomyopathy: Case Series and Literature Review

    Science.gov (United States)

    Cavayero, Chase; Kar, Pran; Kar, Sunny

    2016-01-01

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

  15. Personality and Medical Specialty Choice: A Literature Review and Integration.

    Science.gov (United States)

    Borges, Nicole J.; Savickas, Mark L.

    2002-01-01

    Synthesizes studies categorized by medical specialties and using the following instruments into the Five Factor Model of personality: Adjective Check List, California Psychological Inventory, 16 Personality Factor Questionnaire, and Myers-Briggs Type Indicator. Suggests a loose association between personalty factors and medical specialties and…

  16. One health, one literature: Weaving together veterinary and medical research.

    Science.gov (United States)

    Christopher, Mary M

    2015-09-02

    Translating veterinary research to humans will require a "one literature" approach to break through species barriers in how we organize, retrieve, cite, and publish in biomedicine. Copyright © 2015, American Association for the Advancement of Science.

  17. Erupted complex odontoma: a case report and literature review.

    Science.gov (United States)

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

    2004-01-01

    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.

  18. Adult Pancreatic Hemangioma: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Gerhard S. Mundinger

    2009-01-01

    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.

  19. Bilateral peritonsillar abscess: A case report and pertinent literature review

    Directory of Open Access Journals (Sweden)

    Ibrahim AlAwadh

    2017-01-01

    Conclusion: Based on our case and literature review, we recommend airway management as the first step, followed by further examinations, especially contrast-enhanced computed tomography, in cases of bilateral PTA. This condition lacks the hallmark of unilateral disease and may mimic many conditions, which will have different management approaches.

  20. Bilateral Common Iliac Artery Endofibrosis in a Recreational Cyclist: Case Report and Review of the Literature.

    Science.gov (United States)

    Franco, Arie; Rigberg, David A; Ruehm, Stefan G

    2016-08-01

    External iliac artery endofibrosis is a rare medical condition typically encountered in young endurance athletes, mainly cyclists. Iliac endofibrosis usually develops in the external iliac artery and is rarely seen in the common iliac or in common femoral arteries. We describe a unique case of a patient who was not a professional or high-endurance cyclist. The lesions in our case appeared to be bilateral in the common iliac arteries and were not limited to the external iliac artery as most commonly described. We present an overview of the literature regarding this medical condition.

  1. Exertional rhabdomyolysis after spinning: case series and review of the literature.

    Science.gov (United States)

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

    2016-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Damiano Patrono

    2014-09-01

    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.

  3. Electroconvulsive Therapy Treatment in a Patient With Neurosyphilis and Psychotic Disorder: Case Report and Literature Review.

    Science.gov (United States)

    Pecenak, Jan; Janik, Peter; Vaseckova, Barbora; Trebulova, Kristina

    2015-12-01

    Syphilis is an infectious disease caused by Treponema pallidum that presents clinically in different ways. Over recent years, an upsurge of new cases of syphilis has been reported, often in combination with human immunodeficiency virus infection. The clinical picture is changing because of the widespread use of antibiotics, and psychiatric manifestations may be the main reason why patients seek medical help. In most cases, treatment with penicillin and psychotropic medication is effective. Electroconvulsive therapy (ECT) is rarely used for the psychiatric manifestations of neurosyphilis: we identified only 19 cases in the literature. We report here on a 40-year-old man newly diagnosed with neurosyphilis during hospitalization for a psychotic state with depression and also review the literature. He was treated with 2 courses of penicillin and several antipsychotics. The ECT was indicated because he failed to respond well to antipsychotic treatment and developed a high risk of dangerous behavior. A series of 8 sessions of ECT rapidly relieved the psychotic symptoms.

  4. Cervical synovial cyst: case report and review of literature

    Science.gov (United States)

    Menghetti, Claudia; Cardia, Andrea; Fornari, Maurizio; Ortolina, Alessandro

    2009-01-01

    Synovial cysts, typically observed in the lumbar spine eventually associated with degenerative changes of the facet joints, only rarely present in the cervical spine. Up to now, only 28 symptomatic cases are described in literature. Typically, the treatment of these cases is a decompressive laminectomy followed by complete surgical removal of the lesion. The authors present the case of an 84-year-old man with a symptomatic synovial cyst involving the space between C7 and T1. PMID:19603197

  5. Cervicofacial necrotizing fasciitis: report of three cases and literature review.

    Science.gov (United States)

    Balcerak, R J; Sisto, J M; Bosack, R C

    1988-06-01

    Three cases of cervicofacial necrotizing fasciitis have been reported, two of dental etiology, and one the result of blunt and abrasive facial trauma. All cases responded well to aggressive surgical intervention in combination with broad spectrum antibiotic coverage and supportive medical therapy. The presence of increased vascularity in the head and neck region probably minimizes the amount of overlying soft tissue that must be excised during surgical management (in comparison to extremity and trunk necrotizing fasciitis cases). The key to successful management of such infections is early diagnosis of the disease process with prompt surgical and medical intervention.

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Citation analysis in journal rankings: medical informatics in the library and information science literature.

    Science.gov (United States)

    Vishwanatham, R

    1998-10-01

    Medical informatics is an interdisciplinary field. Medical informatics articles will be found in the literature of various disciplines including library and information science publications. The purpose of this study was to provide an objectively ranked list of journals that publish medical informatics articles relevant to library and information science. Library Literature, Library and Information Science Abstracts, and Social Science Citation Index were used to identify articles published on the topic of medical informatics and to identify a ranked list of journals. This study also used citation analysis to identify the most frequently cited journals relevant to library and information science.

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

    Science.gov (United States)

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

    2010-01-01

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

  9. Subject and source trends in the Star Tribune's coverage of the medical literature.

    Science.gov (United States)

    McGuire, Lisa; Kelly, Julia Ann

    2003-04-01

    Medical developments are front-page news, and many health-related news reports are based on articles from the medical research literature. We analyzed the subjects and sources of literature-based medical news articles that appeared in Minnesota's largest newspaper, the Star Tribune, from May 1994 through December 2002. Data were collected by searching Health and Medicine in the News (http://www.biomed.lib.umn.edu/hmed), an online database that catalogues Star Tribune articles on health and medical topics. The most common topics of the 3,419 literature-based medical news articles appearing during the period were cancer, obesity/diet/exercise, and heart disease. The New England Journal of Medicine was the source cited most often, followed by the Journal of the American Medical Association, Science, and Nature. We compared the most common subjects covered in the news articles with those covered in MEDLINE and with the most common causes of death in the United States. Diet, smoking, AIDS, and Alzheimer's disease are represented much more often in the Star Tribune than in the medical literature in general, and articles on genetics and pregnancy were found much more often in the medical literature than in this sample of newspaper articles. Cancer and heart disease, which were the first and third most-often-covered topics in the Star Tribune, are 2 of the 3 top causes of death in this country.

  10. Somatoform abdominal pain in surgery: is SD worthy of surgical attention? Case reports and literature review.

    LENUS (Irish Health Repository)

    Abd Elwahab, Sami Medani

    2012-08-01

    Somatoform disorders (SD) or medically unexplained physical symptoms (MUPS) are a group of disorders that represent a group of symptoms that cannot be explained by an organic or physical pathology. These disorders are widely prevalent, and, if unrecognised, SD may lead medical professionals to embark on tests or procedures which may inflict unnecessary iatrogenic complications. Despite the high prevalence, they are only poorly included in medical training curricula, at both undergraduate and postgraduate levels. In this article, we review the literature and present two cases. The first one presented with a recurrent acute abdomen had an unnecessary CT abdomen. The second case had laparoscopy for acute right-sided abdominal pain which turned out to be normal, and was readmitted again after a short period with acute urine retention which resolved spontaneously following discussion with the patient and family. Both cases were referred for psychiatric assessment and their family doctors were informed.

  11. Wikipedia vs peer-reviewed medical literature for information about the 10 most costly medical conditions.

    Science.gov (United States)

    Hasty, Robert T; Garbalosa, Ryan C; Barbato, Vincenzo A; Valdes, Pedro J; Powers, David W; Hernandez, Emmanuel; John, Jones S; Suciu, Gabriel; Qureshi, Farheen; Popa-Radu, Matei; San Jose, Sergio; Drexler, Nathaniel; Patankar, Rohan; Paz, Jose R; King, Christopher W; Gerber, Hilary N; Valladares, Michael G; Somji, Alyaz A

    2014-05-01

    Since its launch in 2001, Wikipedia has become the most popular general reference site on the Internet and a popular source of health care information. To evaluate the accuracy of this resource, the authors compared Wikipedia articles on the most costly medical conditions with standard, evidence-based, peer-reviewed sources. The top 10 most costly conditions in terms of public and private expenditure in the United States were identified, and a Wikipedia article corresponding to each topic was chosen. In a blinded process, 2 randomly assigned investigators independently reviewed each article and identified all assertions (ie, implication or statement of fact) made in it. The reviewer then conducted a literature search to determine whether each assertion was supported by evidence. The assertions found by each reviewer were compared and analyzed to determine whether assertions made by Wikipedia for these conditions were supported by peer-reviewed sources. For commonly identified assertions, there was statistically significant discordance between 9 of the 10 selected Wikipedia articles (coronary artery disease, lung cancer, major depressive disorder, osteoarthritis, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, back pain, and hyperlipidemia) and their corresponding peer-reviewed sources (Ppeer-reviewed sources. Caution should be used when using Wikipedia to answer questions regarding patient care.

  12. Stress Management in Medical Education: A Review of the Literature.

    Science.gov (United States)

    Shapiro, Shauna L.; Shapiro, Daniel E.; Schwartz, Gary E. R.

    2000-01-01

    Review of clinical studies providing empirical data on stress management programs in medical education found that student participants in such programs demonstrated improved immunologic functioning, decreased depression and anxiety, increased spirituality and empathy, enhanced knowledge of alternative therapies, improved knowledge of stress…

  13. Systematic literature review of hospital medication administration errors in children

    Directory of Open Access Journals (Sweden)

    Ameer A

    2015-11-01

    Full Text Available Ahmed Ameer,1 Soraya Dhillon,1 Mark J Peters,2 Maisoon Ghaleb11Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; 2Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK Objective: Medication administration is the last step in the medication process. It can act as a safety net to prevent unintended harm to patients if detected. However, medication administration errors (MAEs during this process have been documented and thought to be preventable. In pediatric medicine, doses are usually administered based on the child's weight or body surface area. This in turn increases the risk of drug miscalculations and therefore MAEs. The aim of this review is to report MAEs occurring in pediatric inpatients. Methods: Twelve bibliographic databases were searched for studies published between January 2000 and February 2015 using “medication administration errors”, “hospital”, and “children” related terminologies. Handsearching of relevant publications was also carried out. A second reviewer screened articles for eligibility and quality in accordance with the inclusion/exclusion criteria. Key findings: A total of 44 studies were systematically reviewed. MAEs were generally defined as a deviation of dose given from that prescribed; this included omitted doses and administration at the wrong time. Hospital MAEs in children accounted for a mean of 50% of all reported medication error reports (n=12,588. It was also identified in a mean of 29% of doses observed (n=8,894. The most prevalent type of MAEs related to preparation, infusion rate, dose, and time. This review has identified five types of interventions to reduce hospital MAEs in children: barcode medicine administration, electronic prescribing, education, use of smart pumps, and standard concentration. Conclusion: This review has identified a wide variation in the prevalence of hospital MAEs in children. This is attributed to

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

    Directory of Open Access Journals (Sweden)

    Nagihan Koç

    2014-01-01

    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.

  15. Gallbladder small cell carcinoma: a case report and literature review.

    Science.gov (United States)

    Adachi, Toshiyuki; Haraguchi, Masashi; Irie, Junji; Yoshimoto, Tomoko; Uehara, Ryohei; Ito, Shinichiro; Tokai, Hirotaka; Noda, Kazumasa; Tada, Nobuhiro; Hirabaru, Masataka; Inoue, Keiji; Minami, Shigeki; Eguchi, Susumu

    2016-12-01

    Gallbladder small cell carcinoma (SCC) comprises only 0.5 % of all gallbladder cancer and consists of aggressive tumors with poor survival outcomes against current treatments. These tumors are most common in elderly females, particularly those with cholecystolithiasis. We report the case of a 79-year-old woman with gallbladder small cell carcinoma. The patient had intermittent right upper quadrant abdominal pain and was admitted to our hospital due to suspected acute cholecystitis. She regularly received medical treatment for diabetes, hypertension, and dyslipidemia. On initial laboratory evaluation, the levels of aspartate aminotransferase (AST), total bilirubin, and C-reactive protein (CRP) were markedly elevated. She underwent computed tomography (CT) for screening. CT images showed a thick-walled gallbladder containing multiple stones and multiple 3-cm-sized round nodular lesions, which were suggestive of metastatic lymph nodes. After percutaneous transhepatic gallbladder drainage was performed, endoscopic ultrasound-guided fine needle aspiration of enlarged lymph nodes resulted in a diagnosis of small cell carcinoma or adenocarcinoma. However, we could not identify the primary lesion before the surgery because of no decisive factors. We performed cholecystectomy because there was a possibility of cholecystitis recurrence risk and also partial liver resection because we suspected tumor invasion. The final pathological diagnosis was neuroendocrine carcinoma of the gallbladder, small cell type. The tumor stage was IVb, T3aN1M1. The patient died 13 weeks after the surgery. In the present paper, we review the current available English-language literature of gallbladder SCC.

  16. Cost of dengue outbreaks: literature review and country case studies

    Science.gov (United States)

    2013-01-01

    Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

  17. Red ear syndrome: literature review and a pediatric case report.

    Science.gov (United States)

    Moitri, Misha O; Banglawala, Sarfaraz M; Archibald, Jason

    2015-03-01

    Red ear syndrome (RES) is characterized by recurrent unilateral or bilateral painful attacks of the external ear, accompanied by ear redness, burning, or warmth. Proposed etiologies of this rare condition include dysregulation of sympathetic outflow, upper cervical pathology, glossopharyngeal and trigeminal neuralgia, TMJ dysfunction, thalamic syndrome, and primary headache syndromes. Idiopathic cases also exist in the literature. Pediatric cases are particularly rare and more commonly associated with migraine. Given the various potential etiologies, no single treatment is effective in all cases. This paper summarizes the current understanding and management of RES, and describes a case of idiopathic pediatric RES. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Cuda, Tahleesa; Prinsloo, Pieter

    2017-08-17

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

  19. Postauricular Leiomyosarcoma: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Dillip Samal

    2013-01-01

    Full Text Available Leiomyosarcoma arising in the head and neck region is a rare entity. Auricular involvement by the disease is further rarer with few cases reported in the literature. Usually auricular leiomyosarcoma is a disease of middle-old age. We report a case of leiomyosarcoma of the postauricular region in a young adolescent female. Surgery along with adjuvant radiotherapy was used for complete cure. Patient is disease-free for the last eight years and is on regular yearly followup. The aim of reporting this case is to add to the scarce existing literature regarding auricular leiomyosarcoma and its long-term outcome. Also, this is the first case report in young adolescent and second only of the post auricular region.

  20. Multifocal cutaneous melanoacanthoma with ulceration: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Shalu Jain

    2011-01-01

    Full Text Available We report a case of a 58-year-old female patient who presented with multiple, asymptomatic, slowly-growing, raised pigmented lesions all over her body for the past 10 years with ulceration in one of the lesions on the trunk for the past five months. Histopathology of the lesion revealed features consistent with melanoacanthoma. Here, we report the first case of cutaneous melanoacanthoma presenting with an ulcerated plaque and the third case of cutaneous melanoacanthoma with multiple lesions. To the best of our knowledge, ulceration has not yet been reported as a feature of cutaneous melanoacanthoma in the medical literature.

  1. Nodular Esophageal Xanthoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ahmed Dirweesh

    2017-01-01

    Full Text Available Xanthomas are localized nonneoplastic lesions within tissues that may manifest as papules, plaques, or nodules. These lesions can be found anywhere along the gastrointestinal tract, commonly in the stomach and colon, and rarely in the small intestine and esophagus. Esophagogastroduodenoscopy (EGD with biopsy is the gold standard tool for diagnosis. Here, we report a rare case of a lower solitary nodular esophageal xanthoma in an elderly black female. Correspondingly, all cases of esophageal xanthomas reported in the English medical literature were reviewed and presented with the reported case.

  2. Clinical characteristics of Raoultella ornithinolytica bacteremia: a case series and literature review.

    Science.gov (United States)

    Haruki, Yuto; Hagiya, Hideharu; Sakuma, Akiko; Murase, Tomoko; Sugiyama, Tetsuhiro; Kondo, Sachiyo

    2014-09-01

    Raoultella ornithinolytica is a rare pathogen in human infection and bacteremic cases had been scarcely reported. For further comprehension of the rare infection, we summarized clinical characteristics of 6 cases that were detected at our medical facility and 5 cases from previous literature. The most common infectious focus was biliary infection and elderly patients with a history of any biliary intervention or malignancy were considered to be at a great risk for the infection. The prognosis of the patients was quite satisfactory. Bacterial identification in this report was performed on the basis of biochemical tests alone, and further investigations by molecular analysis are required to confirm our findings.

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

    Science.gov (United States)

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

    2013-06-01

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

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

    OpenAIRE

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

    2004-01-01

    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...

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

    Science.gov (United States)

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

    2006-01-01

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

  6. Pancreatic schwannoma: Report of a case and review of literature.

    Science.gov (United States)

    Kinhal, Vidyadhar A; Ravishankar, T H S; Melapure, Ashok I; Jayaprakasha, G; Range Gowda, B C; Manjunath

    2010-07-01

    Connective tissue tumors of pancreas are uncommon, among them pancreatic schwannoma is very rare tumor, very few cases were reported in literature. Aggressive resections like whipple's procedure, or distal pancreatectomy are not necessary for pancreatic schwannoma as it rarely goes to malignant change and simple enuclation is sufficient.In our patient pancreatic schwannoma is associated with simple cyst in liver and absence of one kidney. Here, we are presenting a case of pancreatic schwannoma treated by simple enucleation.

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

    Science.gov (United States)

    Luey, Christopher; Tooley, Debbie; Briggs, Simon

    2012-03-01

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

  8. Injuries Following Segway Personal Transporter Accidents: Case Report and Review of the Literature.

    Science.gov (United States)

    Ashurst, John; Wagner, Benjamin

    2015-09-01

    The Segway® self-balancing personal transporter has been used as a means of transport for sightseeing tourists, military, police and emergency medical personnel. Only recently have reports been published about serious injuries that have been sustained while operating this device. This case describes a 67-year-old male who sustained an oblique fracture of the shaft of the femur while using the Segway® for transportation around his community. We also present a review of the literature.

  9. Pulmonary extraskeletal myxoid chondrosarcoma: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Ricardo Balanzá, MD

    2016-01-01

    Conclusion: EMC is an intermediate-grade neoplasm, characterized by a long clinical course with high potential for local recurrence and distant metastasis. Treatment for EMC is surgical and non-surgical treatment is reserved for recurrence or metastatic disease. Pulmonary extraskeletal myxoid chondrosarcoma is a rare neoplasm with only isolated case reports found in the literature.

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

    DEFF Research Database (Denmark)

    Elming, H; Køber, L

    1999-01-01

    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...

  11. Pancreatic schwannoma: Report of a case and review of literature

    OpenAIRE

    Vidyadhar A Kinhal; Ravishankar, T. H. S.; Melapure, Ashok I.; Jayaprakasha, G.; Range Gowda, B. C.; Manjunath

    2010-01-01

    Connective tissue tumors of pancreas are uncommon, among them pancreatic schwannoma is very rare tumor, very few cases were reported in literature. Aggressive resections like whipple’s procedure, or distal pancreatectomy are not necessary for pancreatic schwannoma as it rarely goes to malignant change and simple enuclation is sufficient.

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

    African Journals Online (AJOL)

    case series of five patient's along with the review of literature is presented here. Keywords: ... underwent a renal transplant biopsy to ascertain the cause of ... A 16-year-old male presented in March 2002 with a fever of unknown origin and splenomegaly. ... There was no evidence of tuft necrosis/crescent formation or.

  13. Lateral subtalar dislocation : Case report and review of the literature

    NARCIS (Netherlands)

    Veltman, Ewout S; Steller, Ernst Ja; Wittich, Philippe; Keizer, Jort

    2016-01-01

    A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis

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

    Directory of Open Access Journals (Sweden)

    Gupta V

    2002-04-01

    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.

  15. Renal Leiomyoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Noppadol Larbcharoensub

    2017-07-01

    Full Text Available Leiomyoma is an uncommon tumor of the kidney. The authors report a rare case of renal leiomyoma in a 39-year-old male patient who presented with a right flank mass. Laparoscopic nephrectomy was performed. The histopathology and immunohistochemistry confirm the diagnosis of renal leiomyoma. The review of literature in the clinicoradiopathological correlation was illustrated.

  16. Kindler Syndrome - A Case Report with Review of Literature

    Directory of Open Access Journals (Sweden)

    Antony John

    2007-01-01

    Full Text Available Kindler syndrome is a rare autosomal recessive skin fragility disorder characterized by blistering in infancy, followed by photosensitivity and progressive poikiloderma 1 . More than 70 cases have been documented in dermatologic and pediatric journals with little emphasis on dental findings 2 . Here we report a 18 year old female patient with Kindler syndrome along with a review of literature.

  17. Giant prostatic hyperplasia: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Oktay Üçer

    2011-12-01

    Full Text Available The giant hyperplasia of the prostate is an extremely rare pathology of prostate gland. We report the uncomplicated removal of the largest ever prostate from Turkey and the 3rd case exceeding 500 grams in the world literature.

  18. The Economic Impact of Medical Migration: An Overview of the Literature

    NARCIS (Netherlands)

    Rutten, M.M.

    2009-01-01

    This paper provides an overview of the evidence and applied literature on medical migration. The economic impacts of medical migration have been little researched, causing a polarisation in the debate between its critics and its proponents. The paucity of quantitative studies may be explained by the

  19. The Economic Impact of Medical Migration: An Overview of the Literature

    NARCIS (Netherlands)

    Rutten, M.M.

    2009-01-01

    This paper provides an overview of the evidence and applied literature on medical migration. The economic impacts of medical migration have been little researched, causing a polarisation in the debate between its critics and its proponents. The paucity of quantitative studies may be explained by the

  20. Medication effects on the rate of orthodontic tooth movement: a systematic literature review.

    NARCIS (Netherlands)

    Bartzela, T.; Turp, J.C.; Motschall, E.; Maltha, J.C.

    2009-01-01

    INTRODUCTION: Recently, several reviews have been published on the effects of medications on bone physiology and the clinical side effects in orthodontics. However, the effects of medications on the rate of orthodontic tooth movement have not been evaluated. METHODS: A systematic literature review o

  1. Medical deficiencies and traffic accidents : a review of the literature and a programme for research (summary).

    NARCIS (Netherlands)

    Griep, D.J.

    1965-01-01

    In 1964 a working part was established by the Dutch Government (Public Health Department) to study "Medical Deficiencies in the Prevention of Traffic Accidents. Study of the literature was directed at temporary and permanent medico-psychological disorders, and medical disorders in road users that

  2. Medication effects on the rate of orthodontic tooth movement: a systematic literature review.

    NARCIS (Netherlands)

    Bartzela, T.; Turp, J.C.; Motschall, E.; Maltha, J.C.

    2009-01-01

    INTRODUCTION: Recently, several reviews have been published on the effects of medications on bone physiology and the clinical side effects in orthodontics. However, the effects of medications on the rate of orthodontic tooth movement have not been evaluated. METHODS: A systematic literature review

  3. Malignant Catatonia Warrants Early Psychiatric-Critical Care Collaborative Management: Two Cases and Literature Review

    Directory of Open Access Journals (Sweden)

    Julia Park

    2017-01-01

    Full Text Available Malignant catatonia (MC is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS. The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management.

  4. Internal auditory canal osteoma: Case report and review of the literature.

    Science.gov (United States)

    Tamir, Sharon Ovnat; Cyna-Gorse, Francoise; Sterkers, Olivier

    2015-06-01

    We report a case of internal auditory canal osteoma and discuss this entity's etiology, natural history, and treatment options. The internal auditory canal osteoma is a rare entity with only a few reports published in the medical literature. Its diagnosis is based on two complementary imaging modalities: thin-slice computed tomography and magnetic resonance imaging. No consensus exists regarding the treatment of this entity, and treatment should be tailored to each patient depending on that patient's initial complaints, as well as his or her medical findings.

  5. Malignant Catatonia Warrants Early Psychiatric-Critical Care Collaborative Management: Two Cases and Literature Review

    Science.gov (United States)

    Tan, Josh; Krzeminski, Sylvia; Hazeghazam, Maryam; Bandlamuri, Meghana; Carlson, Richard W.

    2017-01-01

    Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management. PMID:28250995

  6. Malignant Catatonia Warrants Early Psychiatric-Critical Care Collaborative Management: Two Cases and Literature Review.

    Science.gov (United States)

    Park, Julia; Tan, Josh; Krzeminski, Sylvia; Hazeghazam, Maryam; Bandlamuri, Meghana; Carlson, Richard W

    2017-01-01

    Malignant catatonia (MC) is a life-threatening manifestation which can occur in the setting of an underlying neuropsychiatric syndrome or general medical illness and shares clinical and pathophysiological features and medical comorbidities with the Neuroleptic Malignant Syndrome (NMS). The subsequent diagnosis and definitive therapy of MC are typically delayed, which increases morbidity and mortality. We present two cases of MC and review recent literature of MC and NMS, illustrating factors which delay diagnosis and management. When clinical features suggest MC or NMS, we propose early critical care consultation and stabilization with collaborative psychiatric management.

  7. Pediatric psychotropic medication initiation and adherence: a literature review based on social exchange theory.

    Science.gov (United States)

    Hamrin, Vanya; McCarthy, Erin M; Tyson, Veda

    2010-08-01

    Psychotropic medication initiation and adherence is an identified problem. This literature review explores factors that determine families' decisions to initiate, sustain, or discontinue use of psychotropic medication in children and adolescents. Social exchange theory is used as a framework to explore decisions to initiate and adhere to psychotropic medications. Contributing factors related to psychotropic medication initiation, adherence, and discontinuation are explored. Themes in the literature encompassing costs and benefits of psychotropic medication adherence include family experiences with adverse effects, previous psychotropic medication experience, medication psychoeducation, stigma, societal views about psychotropic medication, particular diagnosis, the effect of comorbid diagnosis on adherence, attitudes and beliefs about medication by both children and parents, and relationships with the provider. The impact of family demographics including parent gender, age of the child, ethnicity, and parent educational level on psychotropic medication adherence is evaluated. International and U.S. studies from Medline, Cumulative Index for Nursing and Allied Health Literature and PsychInfo evaluating medication initiation and adherence in the pediatric psychiatric population and social exchange theory was incorporated from relevant textbook resources. Rewards experienced from medication treatment include improvement in symptoms, school performance and family relationships, and reduced level of parenting stress. Identified costs include impact of adverse side effects, social stigma, lack of response, fears of addiction, and changing the child's personality. Acceptance of the diagnosis influences adherence while medication education has varying effects. Families' attitudes, beliefs and perceptions about psychiatric illness and treatment play a large role in medication treatment decisions. A trusting provider relationship has a positive effect on adherence

  8. Metronidazole Induced Pancreatitis. A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Casey KJ

    2004-11-01

    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.

  9. The impact of open access on the medical literature: a review of current literature

    Directory of Open Access Journals (Sweden)

    Nana Turk

    2017-02-01

    Full Text Available Background: the aim of the article is to conduct an overview of the impact of OA on the medical articles based on 3-part categorization.Methods: Data were identified by a search strategy with eight combinations of keywords (open access, citation impact, citation advantage, citation count, article download, article usage, social media attention, altmetrics and searched in three different databases.Results: the analysis was conducted on 107 studies dealing with citations, downloads and social impact. Sixty-seven of them simply employed the counting citations to OA and non-OA articles; nineteen articles compared the downloads and citations counts; and twenty-one articles investigated the social impact of OA articles. Twenty-five articles investigated the citations, download counts, and social impact of medical articles.Conclusions: The studies investigating the citation impact mostly showed citation advantages. Those that employed citation and download counts of medical articles using randomized controlled trials showed that OA articles were downloaded significantly more frequently, but found no evidence of a citation advantage for open access articles. The citation advantage from open access might be caused by other factors. Results of the studies comparing the social media attention and citations/downloads of the medical articles are often diametrically opposed.

  10. Duodenal pseudolymphoma: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Yong-Heng Huang; Tian-Zhu Long; Zhi-Yu Xiao; Hua Ye; Yun-Le Wan; Jie Wang

    2011-01-01

    We report a rare case of duodenal pseudolymphoma without any symptoms. The lesion located in front of the head of the pancreas was found accidentally during a medical examination. The findings of computed tomography and positron emission tomography-computed tomography suggested a stromal tumor or malignant lymphoma. Surgical resection was performed. The lesions were pathologically diagnosed as duodenal pseudolymphoma.

  11. RISPERIDONE - INDUCED TARDIVE DYSKINESIA : CASE REPORT AND REVIEW OF LITERATURE

    OpenAIRE

    Kumar, P.N. Suresh; Andrade, Chittaranjan

    2001-01-01

    Risperidone is an atypical antipsychotic with broad spectrum of antipsychotic activity and lower potential for extrapyramidal side effects at therapeutic doses. This case report illustrates the development of tardive dyskinesia with therapeutic dose of risperidone in a paranoid schizophrenic patient who was not on any antipsychotic medication previously.

  12. Recurrent gallstone ileus: case report and literature review.

    Science.gov (United States)

    Pronio, A; Piroli, S; Caporilli, D; Ciamberlano, B; Coluzzi, M; Castellucci, G; Vestri, A; Pitasi, F; Montesani, C

    2013-01-01

    The gallstone ileus is a rare complication of cholelithiasis and it represents the 1-4% of small intestinal mechanical obstruction. Gallstone is generally wedged in the terminal ileum, even if unusual locations have been described. The literature reports a very high morbidity and mortality, often because misdiagnosis or delayed diagnosis. There is no unique opinion in literature about the choice between one-stage and two-stage surgery. We report a clinical case that summarizes the diagnostic and therapeutic difficulties of gallstone ileus.

  13. Orbitofrontal epilepsy: electroclinical analysis of surgical cases and literature review.

    Science.gov (United States)

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

    2004-01-01

    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.

  14. Management of Mycobacterium abscessus Infection After Medical Tourism in Cosmetic Surgery and a Review of Literature.

    Science.gov (United States)

    Cai, Stephen S; Chopra, Karan; Lifchez, Scott D

    2016-12-01

    Despite news reports, Food and Drug Administration disclaimers, and warnings from US plastic surgeons against the perils of cosmetic tourism, patients continue to seek care abroad and often present with infectious complications. Recent reports of Mycobacterium abscessus surgical site infection (SSI) is of particularly concern and its management, particularly surgical intervention, has been poorly documented. A retrospective review of 2 sisters who presented with M. abscessus SSI after cosmetic surgery in the Dominican Republic was performed. A comprehensive review of the literature was conducted to unveil similar cases after cosmetic tourism. Both patients presented four months after index operation after definitive diagnoses have been reached. They were counselled to undergo immediate, aggressive debridement and antibiotic therapy. Although 1 patient agreed, the other patient opted for local wound care and oral antibiotics in hopes to avoid reoperation. When unsuccessful, she agreed to the initial plan which led to rapid convalescence of her infection. However, aesthetic result was far inferior to the first patient. Review of literature revealed 14 women with an average age of 40 years (range, 19-60 years). Most frequent cosmetic operations that resulted in M. abscessus SSI were abdominoplasty (41%), liposuction (27%), breast augmentation (14%), breast reduction (9%), and rejuvenation surgery (9%). Surgical interventions were performed in all cases except one. Antibiotic therapies focused on macrolides, particularly clarithromycin or azithromycin, with average time to complete recovery of 8 months (range, 2-22 months). The 2 cases highlighted the importance of multidisciplinary approach of early aggressive surgical intervention and long-term intravenous antibiotics in treating M. abscessus SSI that is highly prevalent among those returning from medical tourism in cosmetic surgery.

  15. Candida-induced prosthetic joint infection. A literature review including 72 cases and a case report.

    Science.gov (United States)

    Cobo, Fernando; Rodríguez-Granger, Javier; López, Enrique M; Jiménez, Gemma; Sampedro, Antonio; Aliaga-Martínez, Luis; Navarro-Marí, José María

    2017-02-01

    The clinical and microbiological characteristics of prosthetic joint infection (PJI) caused by Candida species is described, including 72 cases in the literature and a case of Candida glabrata infection handled at the present centre. We describe one patient and using the key words 'fungal prosthetic joint infection' and 'candida prosthetic joint infection' we searched MEDLINE (National Library of Medicine, Bethesda, MD), Web of Science, CINAHL and Cochrane systematic review databases for case reports of this condition. Out of the 73 patients, 38 were female; mean age at diagnosis was 65.7 (± SD 18) yrs; 50 had risk factors for candidal infection such as systemic disease (e.g. rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus) and/or immunosuppressive therapy in 18 (24.6%) cases, diabetes mellitus in 14 (19.1%), immunosuppression due to malignant or chronic disease in 24 (32.8%) and long-term antibiotic use in four (5.4%) patients. Infection site was the knee in 36 patients and hip in 35; pain was present in 43 patients and swelling in 23 and the mean surgery-diagnosis interval was 32 months. The most frequent species was C. albicans, followed by C. parapsilosis. The diagnosis was obtained from joint fluid aspirate in 33 cases and intra-operative samples in 16. Susceptibility to antifungals was tested in only 21 isolates. The most frequently used antifungals were fluconazole and amphotericin B. Two-stage exchange arthroplasty was performed in 30 patients and resection arthroplasty in 31; 56 patients were cured with a combination of medical and surgical treatment; one patient died from the infection. PJI caused by Candida requires a high index of suspicion; surgery with long-term antifungal therapy is recommended.

  16. The case for medical marijuana in epilepsy.

    Science.gov (United States)

    Maa, Edward; Figi, Paige

    2014-06-01

    Charlotte, a little girl with SCN1A-confirmed Dravet syndrome, was recently featured in a special that aired on CNN. Through exhaustive personal research and assistance from a Colorado-based medical marijuana group (Realm of Caring), Charlotte's mother started adjunctive therapy with a high concentration cannabidiol/Δ(9) -tetrahydrocannabinol (CBD:THC) strain of cannabis, now known as Charlotte's Web. This extract, slowly titrated over weeks and given in conjunction with her existing antiepileptic drug regimen, reduced Charlotte's seizure frequency from nearly 50 convulsive seizures per day to now 2-3 nocturnal convulsions per month. This effect has persisted for the last 20 months, and Charlotte has been successfully weaned from her other antiepileptic drugs. We briefly review some of the history, preclinical and clinical data, and controversies surrounding the use of medical marijuana for the treatment of epilepsy, and make a case that the desire to isolate and treat with pharmaceutical grade compounds from cannabis (specifically CBD) may be inferior to therapy with whole plant extracts. Much more needs to be learned about the mechanisms of antiepileptic activity of the phytocannabinoids and other constituents of Cannabis sativa. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  17. Haunted manuscripts: ghost authorship in the medical literature.

    Science.gov (United States)

    Ngai, Stephanie; Gold, Jennifer L; Gill, Sudeep S; Rochon, Paula A

    2005-01-01

    Ghost authorship occurs when an individual who contributed substantially to a manuscript is not named in the byline or acknowledgments. Ghost authors may be employed by industry to prepare clinical trial results for publication. An expert is then "hired" as author so as to lend an air of credibility and neutrality to the manuscript. Ghost authorship is difficult to detect, and most articles that have been identified as ghostwritten were revealed as such only after investigative work by lawyers, journalists, or scientists. Ghost authorship is ethically questionable in that it may be used to mask conflicts of interest with industry. As it has been demonstrated that industry sponsorship of clinical trials may be associated with outcomes favorable to industry, this is problematic. Evidence-based medicine requires that clinical decisions be based on empirical evidence published in peer-reviewed medical journals. If physicians base their decisions on dubious research data, this can have negative consequences for patients. Ghost authorship also compromises academic integrity. A "film credit" concept of authority is one solution to the problems posed by ghost authorship. Other approaches have been taken by the United Kingdom and Denmark. A solution is necessary, as the relationship between authorship and accountability must be maintained.

  18. Factors associated with dropping out of medical school: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research......  Presenter: Lotte D. O'Neill, MMedEd, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark. Co-authors: Birgitta Wallstedt, MSc, Unit for Educational Development, University of Southern Denmark; Berit Eika, MD, MHPE, MI, PhD, Unit for Medical Education, University...

  19. Medication errors in the intensive care unit: literature review using the SEIPS model.

    Science.gov (United States)

    Frith, Karen H

    2013-01-01

    Medication errors in intensive care units put patients at risk for injury or death every day. Safety requires an organized and systematic approach to improving the tasks, technology, environment, and organizational culture associated with medication systems. The Systems Engineering Initiative for Patient Safety model can help leaders and health care providers understand the complicated and high-risk work associated with critical care. Using this model, the author combines a human factors approach with the well-known structure-process-outcome model of quality improvement to examine research literature. The literature review reveals that human factors, including stress, high workloads, knowledge deficits, and performance deficits, are associated with medication errors. Factors contributing to medication errors are frequent interruptions, communication problems, and poor fit of health information technology to the workflow of providers. Multifaceted medication safety interventions are needed so that human factors and system problems can be addressed simultaneously.

  20. Primary peripheral nerve sheath tumors of the thyroid gland: A case report and literature review.

    Science.gov (United States)

    Chen, Guang; Liu, Zengguang; Su, Chang; Guan, Qiang; Wan, Fang; Dong, Bingfei; Bao, Liang; Zhang, Wenxin; Wang, Yinping; Wang, Guimin

    2016-02-01

    Primary peripheral nerve sheath tumors (PNSTs) of the thyroid gland are rare, with fewer than 30 cases reported in the medical literature to date. Primary PNSTs of the thyroid gland are classified into malignant and benign PNSTs. The benign PNSTs may be further subclassified into neurofibromas and Schwannomas. This is the case report of a 51-year-old male patient presenting with multiple primary PNSTs involving the left lobe of the thyroid gland. The patient underwent total excision of the thyroid gland and the pathological results indicated a Schwannoma with Antoni type A and B cells. The literature was reviewed briefly and, to the best of our knowledge, this is the first case report of multiple primary PNSTs of the thyroid gland.

  1. Podcasts from the journal Medical Education. Personality factors and medical training: a review of the literature

    OpenAIRE

    Doherty, Eva M; Eva, Kevin

    2011-01-01

    It has been acknowledged that certain personality characteristics influence both medical students’ and doctors’ performance. With regard to medical students, studies have been concerned with the role of personality, and performance indicators such as academic results and clinical competence. Eva Doherty (Director of human factors and patient safety, National Surgical Training Centre, The Royal College of Surgeons in Ireland, Dublin, Ireland) speaks to Kevin Eva, Editor in Chief of Medical Edu...

  2. Intraosseous pleomorphic adenoma: case report and review of the literature.

    Science.gov (United States)

    Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A

    2002-01-01

    Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

  3. Jaguar attack on a child: case report and literature review.

    Science.gov (United States)

    Iserson, Kenneth V; Francis, Adama M

    2015-03-01

    Jaguar attacks on humans rarely occur in the wild. When they do, they are often fatal. We describe a jaguar attack on a three-year-old girl near her home deep in a remote area of the Guyanese jungle. The patient had a complex but, relatively, rapid transport to a medical treatment facility for her life-threatening injuries. The child, who suffered typical jaguar-inflicted injury patterns and survived, is highlighted. We review jaguar anatomy, environmental status, hunting and killing behaviors, and discuss optimal medical management, given the resource-limited treatment environment of this international emergency medicine case.

  4. Subdural Hematoma: An Adverse Event of Electroconvulsive Therapy—Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ranganath R. Kulkarni

    2012-01-01

    Full Text Available Electroconvulsive therapy (ECT is commonly used in the management of medication nonresponsive depressive disorder, with proven efficacy in psychiatric practice since many decades. A rare complication of intracranial bleed following this therapeutic procedure has been reported in sporadic case reports in the English literature. We report a case of such a complication in a 42-year-old male, a known case of nonorganic medication nonresponsive depressive disorder for the last two years who required ECT application. Presenting symptoms included altered mental state, urinary incontinence, and repeated episodes of vomiting; following ECT procedure with magnetic resonance imaging (MRI of the brain suggestive of bilateral acute subdural hematoma. Despite the view that it may be used in neurological conditions without raised intracranial tension, it will be worthwhile to be vigilant during post-ECT recovery for any emergent complications.

  5. Can CanMEDS competencies be developed in medical school anatomy laboratories? A literature review

    Science.gov (United States)

    Ramnanan, Christopher J.

    2017-01-01

    Objectives The purpose of this literature review was to identify potential ways in which undergraduate medical anatomy education may be relevant to the CanMEDS Roles, a competency-based framework used throughout Canadian medical training. Methods A scoping review of medical education literature was conducted in March 2017 for English language publications that included key words related to anatomy education and to key competencies formally described for each of the Roles in the CanMEDS 2015 framework. Indicated benefits were then collated, characterized, and synthesized for each CanMEDS Role. Results There were 71 studies identified describing original findings. Perceived benefits of anatomy education were most often identified for competencies related to the Medical Expert Role. Multiple studies also cited benefits related to the Scholar, Professional and Collaborator Roles. There was a lack of literature related to the Health Advocate, Communicator, and Leader Roles. The majority of benefits defined in the literature were limited to student perceptions rather than objectively measured outcomes. Conclusions There is some evidence to suggest that anatomy education can facilitate the development of core competencies related to several CanMEDS Roles, outside of simply developing medical knowledge in the Medical Expert Role. Future studies need to develop methods to objectively assess outcomes related to these competencies. PMID:28650843

  6. Calcification of vestibular schwannoma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang Yang

    2012-10-01

    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.

  7. Transitional cell carcinoma of the ovary-A case report with review of literature

    Institute of Scientific and Technical Information of China (English)

    Sheikh Aijaz Aziz; Abdul Rashid Lone; Mohmad Hussain Mir; Sumyra Khursheed Qadri; Arif Nabi Bhat; Farhana Siraj Bagdadi; Mir Muzaffar Bashir; Sanjeed Ahmed

    2013-01-01

    Transitional cel carcinoma (TCC) of the ovary is a rare and recently recognized subtype of ovarian epithelial cancer. We presented the first case report from our Institute (Sheri Kashmir Instiute of Medical Sciences, Srinagar, India), which was initial y misdiagnosed as stromal cel carcinoma (granulosa cel tumour), and on review of histopathology with immunohistochemistry, the diagnosis of TCC of the ovary was established. The aim of this article was to describe the typical case of primary TCC of the ovary and to review the literature for information on TCC management.

  8. Vulval Fibroadenoma — A Report of Two Cases with Review of Literature

    OpenAIRE

    Kalyani, R; Srinivas, Murthy V.; Veda, P.

    2014-01-01

    Vulval fibroadenoma is rare benign tumours arising from ectopic breast tissue or mammary like anogenital glands tissue. Only a few cases are reported in medical literature. It is usually seen between 20 – 80 years of age. Excision usually has good prognosis and rarely recurs. We present two cases of vulval fibroadenoma, one in a 26 years woman as a well defined soft tissue mass in right labia major and other in a 45 years woman as a pedunculated soft tissue mass in left labia major.

  9. Solitary Endobronchial Papilloma with Malignant Transformation and Concomitant TB Infection: Case Report and Literature Review

    Science.gov (United States)

    2017-01-01

    We are reporting a case of solitary endobronchial papilloma located in posterior segment of the left upper lobe of the lung with malignant transformation and negative human papilloma virus (HPV) strains in a 40-year-old Saudi nonsmoker man. The patient had a concomitant tuberculosis (TB) infection. The patient received appropriate treatment in the form of anti-TB medication and surgical resection of the squamous cell carcinoma followed by chemotherapy. There was no evidence of tumor recurrence, resulting in a complete cure. We are reporting the case as well as a literature review related to the topic.

  10. Recurrent pneumothorax as a presenting manifestation of active sarcoidosis: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    LIU Yan; DAI Hua-ping; XU Li-li; LI Xue

    2010-01-01

    @@ Sarcoidosis is a systemic granulomatous disease of unknown cause. It commonly affects young to middle-aged adults and frequently presents with bilateral hilar lymphadenopathy, pulmonary infiltration, and ocular and skin lesions. Pleural involvement is relatively uncommon. Pneumothorax is a rare complication of sarcoidosis, occurring usually in the late fibrotic stages of the disease with associated bullous changes. There are only scattered case reports on pneumothorax as the first manifestation of sarcoidosis in medical literature. The present case study reports a young man who presented first with recurrent spontaneous pneumothorax during the early stage and relapse of sarcoidosis.

  11. Acquired Ichthyosis Triggered by an Osseous Hemangiopericytoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Aikaterini Patsatsi

    2014-01-01

    Full Text Available Ichthyoses are a heterogeneous group of cutaneous keratinization disorders that can be congenital or acquired. Apart from neoplastic disorders, the acquired form of ichthyosis (AI has been associated with a variety of diseases including infections, autoimmune/inflammatory and endocrine/metabolic diseases as well as nutritional conditions, medications and others. However, malignancy accounts for half of the reported cases, most commonly including lymphoproliferative disorders. We present a case of AI as a paraneoplastic skin manifestation of a primary, osseous hemangiopericytoma (HP accompanied by multiple liver metastases. We also review the literature and discuss the necessity of investigating underlying diseases, especially malignancy, when adult-onset ichthyosis arises.

  12. Spinning-induced Rhabdomyolysis: Eleven Case Reports and Review of the Literature.

    Science.gov (United States)

    Kim, Daejin; Ko, Eun-Jung; Cho, HyeJeong; Park, Su Hyung; Lee, Sang Hwan; Cho, Nam-Gil; Lee, So-Young; Jeong, Hye Yun; Yang, Dong Ho

    2015-12-01

    Non-traumatic exertional rhabdomyolysis (exRML) occurs in individuals with normal muscles when the energy supplied to the muscle is insufficient. Here, we report 11 cases of spinning-induced rhabdomyolysis and review related literature. Spinning is a kind of indoor bicycle sport. The 11 patients who were diagnosed with exRML and admitted to CHA Bundang Medical Center were female and their ages ranged from 15 to 46 years. Two to three days prior to the presentation, the patients had attended a spinning class for the first time. All the patients had been otherwise healthy without any known medical illnesses. They were successfully treated without any complications, except mild non-symptomatic hypocalcemia. However, in the literature, severe complications such as compartment syndrome or acute kidney injury had been reported in relation to exRML including spinning-induced rhabdomyolysis. This spinning exercise needs prior guidelines and specific warnings to prevent exertional rhabdomyolysis.

  13. Clinical-decision support based on medical literature: A complex network approach

    Science.gov (United States)

    Jiang, Jingchi; Zheng, Jichuan; Zhao, Chao; Su, Jia; Guan, Yi; Yu, Qiubin

    2016-10-01

    In making clinical decisions, clinicians often review medical literature to ensure the reliability of diagnosis, test, and treatment because the medical literature can answer clinical questions and assist clinicians making clinical decisions. Therefore, finding the appropriate literature is a critical problem for clinical-decision support (CDS). First, the present study employs search engines to retrieve relevant literature about patient records. However, the result of the traditional method is usually unsatisfactory. To improve the relevance of the retrieval result, a medical literature network (MLN) based on these retrieved papers is constructed. Then, we show that this MLN has small-world and scale-free properties of a complex network. According to the structural characteristics of the MLN, we adopt two methods to further identify the potential relevant literature in addition to the retrieved literature. By integrating these potential papers into the MLN, a more comprehensive MLN is built to answer the question of actual patient records. Furthermore, we propose a re-ranking model to sort all papers by relevance. We experimentally find that the re-ranking model can improve the normalized discounted cumulative gain of the results. As participants of the Text Retrieval Conference 2015, our clinical-decision method based on the MLN also yields higher scores than the medians in most topics and achieves the best scores for topics: #11 and #12. These research results indicate that our study can be used to effectively assist clinicians in making clinical decisions, and the MLN can facilitate the investigation of CDS.

  14. 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: giuseppe_dr@uol.com.br [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)

    2014-05-15

    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)

  15. Extraskeletal Osteosarcoma: A case report and review of the literature

    Science.gov (United States)

    Hoch, Michael; Ali, Sayed; Agrawal, Shefali; Wang, Congli; Khurana, Jasvir S.

    2013-01-01

    We report an instructive case of extraskeletal osteosarcoma in a 63-year-old African American male who presented after an episode of recent trauma, with clinical and radiological features characteristic of this neoplasm. Osteosarcoma is the most common primary malignant tumor of bone in young adults, but the extraskeletal variety is very uncommon. The radiological and pathological features of this neoplasm will be discussed, along with a review of the literature. PMID:24421944

  16. Maxillary double lip: A case series with review of literature

    Directory of Open Access Journals (Sweden)

    Vela D Desai

    2015-01-01

    Full Text Available Double lip is a rare dental anomaly affecting either upper or lower lip or concurrently. It may be congenital or acquired. This deformity can affect the facial esthetics as it gets exaggerated while speaking, smiling, or chewing food. When it interferes with speech, double lip may cause potential functional problems. The purpose of this article is to review the literature on double lip and present a case series of maxillary double lip.

  17. 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

    2009-01-01

    @@ 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.

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

    Directory of Open Access Journals (Sweden)

    Singh Shikha

    2015-11-01

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

  19. Teratoma tongue: Case report and review of literature

    OpenAIRE

    Gupta, Manish; Chaudhary, Neena; Rai, A. K.

    2007-01-01

    Teratomas are true neoplasms composed of tissues from all three germinal layers and may exhibit variable levels of maturity. They have an unknown origin and eccentric microscopic appearance. Teratomas arising from the oral cavity are rare in the newborn; only 22 cases have been reported in the literature. We describe a female neonate with an oral teratoma originating from the tongue that was successfully treated with surgery.

  20. Sororicide in preteen girls. A case report and literature review.

    Science.gov (United States)

    Adam, B S; Livingston, R

    1993-01-01

    All means of exploring the psychological and environmental antecedents of murder by a child should be used toward preventing lethal outcomes in future. The authors present the case of a ten year old girl who killed her sister with details of the sisters' relationship, the perpetrator's psychological characteristics and the family situation. Sibling-rivalry, family stressors, and the perpetrator's compulsive and narcissistic traits and preoccupation with a violent television fantasy are discussed. A literature review and suggestions for future research are provided.

  1. Unilateral condylar hyperplasia: A case report and review of literature

    OpenAIRE

    Bharathi, Saravana C.; Senthilnathan, S.; Kumar, Lokesh D.; Mohan, Anand C. S.; Taranath, M.

    2014-01-01

    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle ‘differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature.

  2. Unilateral condylar hyperplasia: A case report and review of literature.

    Science.gov (United States)

    Bharathi, Saravana C; Senthilnathan, S; Kumar, Lokesh D; Mohan, Anand C S; Taranath, M

    2014-01-01

    Condylar hyperplasia is (CH) an uncommon malformation of the mandible involving change in size and morphology of the condylar neck and head. CH is an anomaly that usually occurs unilaterally and equally affects in both men and women. Hyperplasia of the condyle 'differentiated into hemimandibular hyperplasia, hemimandibular elongation and CH. Here, we are presenting a case of 17-year-old male patient with unilateral CH and its review of the literature.

  3. Clostridium ramosum bacteremia: case report and literature review.

    Science.gov (United States)

    Forrester, Joseph D; Spain, David A

    2014-06-01

    Clostridium ramosum is a common enteric anaerobe but infrequently also a cause of pathologic infection. Case report and literature review. We reviewed 12 case reports describing infection with C. ramosum. When pathogenic, C. ramosum is cultured most commonly from the inner ear, anaerobic blood samples, or abscesses. Patients with such infections fall into two demographic groups, consisting of young children with ear infections or immunocompromised adults with bacteremia. Resistance of C. ramosum to antibiotics is uncommon. Clostridium ramosum is a common but generally commensal bacterial species. Rarely, it becomes pathogenic in young children or immunosuppressed adults.

  4. Presacral ganglioneuroma: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Guido Cerullo; Daniele Marrelli; Bernardino Rampone; Clelia Miracco; Stefano Caruso; Di Martino Marianna; Maria Antonietta Mazzei; Franco Roviello

    2007-01-01

    Presacral ganglioneuromas are so rare benign tumors that only 17 cases have been reported in the literature.They are abdominal masses growing slowly and differential diagnoses have to be considered. Surgical resection is important for definitive diagnosis because it represents the only therapeutic choice. Because of the benign nature of ganglioneuroma, adjuvant chemoor radiotherapy is not indicated but regular follow-up is necessary for an early diagnosis of potential local recurrence. We report a case of a 64-year-old man with a presacral ganglioneuroma.

  5. 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

    2011-01-01

    Blastomycosis is a fungal disease that is endemic in parts of North America.It is very rare in China and also commonly misdiagnosed,often as cancer or other infectious diseases.The clinical profile of a case of disseminated blastomycosis with pulmonary changes and skin ulcers was described.He had been misdiagnosed with tuberculosis,after adequate therapy with a lipid formulation of amphotericin B,followed by itraconazole,the lung and skin lesions improved.Then the five cases reported in China and literatures were reviewed.The aim of this report was to improve the knowledge regarding blastomycosis for physicians in China to avoid delaying adequate therapy.

  6. The Case For Corporate Responsibility: Arguments From The Literature

    Directory of Open Access Journals (Sweden)

    Lucy da Piedade

    2006-11-01

    Full Text Available Heightened scrutiny of organisations and ever increasing stakeholder demands for organisations to respond to issues within broader society, make it imperative that organisational leaders understand why they should undertake corporate responsibility initiatives. This literature review (part one of a two part study investigates the issues that should be addressed by organisations under the banner of corporate responsibility, including the definition of corporate responsibility, its extent and boundaries and the business case for corporate responsibility. This background provides a basis for an exploratory study (part two of how South African organisations should frame the case for corporate responsibility and how investment in this area can be assessed.

  7. Fetal-Maternal Hemorrhage: A Case and Literature Review

    Directory of Open Access Journals (Sweden)

    Nino Solomonia

    2012-11-01

    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.

  8. Schwannoma base tongue: Case report and review of literature.

    Science.gov (United States)

    George, N A; Wagh, M; Balagopal, P G; Gupta, S; Sukumaran, R; Sebastian, P

    2014-07-01

    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.

  9. The Trend of Smoking Behavior and its Relation to Health Knowledge among Medical and Literature Colleges

    Directory of Open Access Journals (Sweden)

    Wijdan Akram

    2011-01-01

    Full Text Available Problem statement: Smoking is a major public health problem all around the world, especially in developing countries when smoking behavior among college students is a major concern to the society. Object of this study to estimate the prevalence of smoking among university students of medical and literature colleges and to assess the students’ knowledge about the health effects of smoking and attitudes towards public action against smoking. Design: cross sectional study. Setting: Al-Kindy Medical College, Baghdad Medical College and Baghdad literature collage/University of Baghdad for the period from first of March till 1st of April 2010. Approach: A random sample of 252 students of 1st and 2nd stages at the above colleges, 124 Literature students and 128 students in two Medical colleges, had been selected and subjected to the modified Arabic version of the World Health Organization (WHO, standard questionnaire for young people, to study their knowledge, attitudes and practices of smoking. All the information elicited from the questionnaire was collected and analyzed. The statistical differences between literature students and medical students were estimated. Results: The prevalence of current smoking was 58, 60% for cigarettes, 65, 56% for sheesha for Medical and Literature students respectively. Friends were the main source of the first cigarette (69%, (62% among students of the literature college and those of the medical college, respectively. followed by parents. Level of awareness of the injurious nature of smoking found to be very high among both medical 100% and literature students 94%, while (74% of medical student and only (51.3% of Literature student Agree with prevention of smoking advertising activity. Conclusion/Recommendations: Smoking still constitutes a major problem among Baghdad university students, in spite of high level of awareness to it’s hazards. This may call for an urgent action to be undertaken by health sectors in

  10. Cutaneous Metaplastic Synovial Cyst: A Case Report and Literature Review.

    Science.gov (United States)

    Kermani, Hamed; Dehghani, Nima; Dehghani, Siavash; Behnia, Hossein; Pourdanesh, Fereydoun; Mohajerani, Hassan

    2015-12-01

    Cutaneous metaplastic synovial cyst (CMSC) is a rare cutaneous lesion characterized by a tender subcutaneous nodule, which usually occurs at the site of previous surgical or local trauma. Histologically, the lesion includes a cystic structure with villous-like projections and a lining mimicking hyperplastic synovium. We reported the first case of CMSC which developed at the surgical incision site of treatment of a maxillofacial fracture. In addition, we reviewed English literature to evaluate all previously reported CMSC cases and discussed its clinical and histopathological features and etiology. From 1987 to now, reviewing the English literature about CMSC includes 17 studies that described 28 cases, and our presented case was the 29th. There was no sex predilection and age of patients ranged from 7 to 82 years, but most of them were over 40 years. We can see this lesion in any site of the body and hand/arm is the most prevalent involved region (28% cases). Most of the patients had a history of previous local trauma or operation in the involved area. Although the actual etiology of CMSC remains unclear, trauma, as the most probable etiologic factor, plays a role in development of CMSC. Surgical excision of the lesion is the preferable treatment choice and rate of recurrence is low.

  11. Littoral cell angioma: review of the literature and case report.

    Science.gov (United States)

    Mokhtari, Navid; Hamidian Jahromi, Alireza; Dela Cruz, Nestora; Woodward, Aaron; Do, Daniel; Thomas-Ogunniyi, Jaiyeola O; Sangster, Guillermo

    2013-01-01

    Littoral cell angioma (LCA), a primary vascular neoplasm originating from splenic red pulp littoral cells, was initially thought to be an extremely rare pathology. There have been an increasing number of cases reported in the literature. However, the etiology and prevalence of LCA is still unclear, partly due to the rarity of cases. The association of LCA with internal organ cancers, specifically lymphoma, has also been reported. In the patients with a history of cancer/lymphoma, the accurate diagnosis of LCA as the cause of the splenomegaly is challenging. Here we present a case of LCA in a patient with non-Hodgkin B-cell lymphoma and alpha-thalassemia trait. To our knowledge, this is the first report of the coexistence of LCA and thalassemia and only the second report of LCA and marginal-zone non-Hodgkin B-cell lymphoma. We review the literature and discuss the radiologic and pathologic findings of this case compared with the previously reported cases.

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

    Science.gov (United States)

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

    2016-03-01

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

  13. TASER® conducted electrical weapons: misconceptions in the scientific/medical and other literature.

    Science.gov (United States)

    Jauchem, James R

    2015-03-01

    TASER(®) conducted electrical weapons (CEWs) have become an important law-enforcement tool. Controversial questions are often raised during discussion of some incidents in which the devices have been used. The main purpose of this paper is to point out some misconceptions about CEWs that have been published in the scientific/medical and other literature. This is a narrative review, using a multidisciplinary approach of analyzing reports from scientific/medical and other literature sources. In previous reports, durations of incapacitating effects and possible associations of CEWs with deaths-in-custody have often been overstated or exaggerated. Comparisons of CEW effects with "electrocution" are misleading. Clarification of these misconceptions may be important during policymaker decisions, practitioner operations, expert witness testimonies, and court proceedings. Despite misconceptions in the literature, CEWs can still be a valuable tool for law enforcement activities. Scientists, medical professionals, legal advisors, and investigators of police tactics should be aware of these misconceptions.

  14. Television Medical Dramas as Case Studies in Biochemistry

    Science.gov (United States)

    Millard, Julie T.

    2009-01-01

    Several case studies from popular television medical dramas are described for use in an undergraduate biochemistry course. These cases, which illustrate fundamental principles of biochemistry, are used as the basis for problems that can be discussed further in small groups. Medical cases provide an interesting context for biochemistry with video…

  15. Rethinking agency and medical adherence technology: applying Actor Network Theory to the case study of Digital Pills.

    Science.gov (United States)

    Hurtado-de-Mendoza, Alejandra; Cabling, Mark L; Sheppard, Vanessa B

    2015-12-01

    Much literature surrounding medical technology and adherence posits that technology is a mechanism for social control. This assumes that the medical establishment can take away patients' agency. Although power relationships and social control can play a key role, medical technology can also serve as an agentive tool to be utilized. We (1) offer the alternative framework of Actor Network Theory to view medical technology, (2) discuss the literature on medication adherence and technology, (3) delve into the ramifications of looking at adherence as a network and (4) use Digital Pills as a case study of dispersed agency.

  16. Levodropropizine-Induced Anaphylaxis: Case Series and Literature Review

    OpenAIRE

    Song, Jae-Won; Jang, Young-Sook; Jung, Moon-Chan; Kim, Joo-Hee; Choi, Jeong-Hee; Park, Sunghoon; Hwang, Yong Il; Jang, Seung Hun; Jung, Ki-Suck

    2017-01-01

    Levodropropizine is commonly used as an antitussive drug for acute and chronic cough. It is a non-opioid agent with peripheral antitussive action via the modulation of sensory neuropeptide levels in the airways. Thus, levodropropizine has a more tolerable profile than opioid antitussives. However, we experienced 3 cases of levodropropizine-induced anaphylaxis. Three patients commonly presented with generalized urticaria, dyspnea, and collapse after taking cold medication including levodroprop...

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

    Science.gov (United States)

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

    2011-07-01

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

  18. The reading, writing, and arithmetic of the medical literature, part 1.

    Science.gov (United States)

    Mansfield, Lyndon

    2005-08-01

    To offer suggestions that will help clinicians improve their scrutiny of the medical literature and apply these suggestions to their own medical writings. Literature searches began at the National Library of Medicine's online database and were traced to primary sources. All referenced information in this article was cited from primary sources. Objective criteria should be used when assessing the quality of clinical research reports and writing accurate, substantive reports. When reading or writing a journal article, authors should ask themselves if it meets the following standards of high quality: Is the topic or problem important and relevant to current practice? Is the stated reason for the study design valid? Is the description of the study methods clear enough to allow for replication by other researchers? What interventions are being compared, and is the comparison reasonable? Is the number of patients in the study sufficient to show a statistically significant difference? Do the study results have clinical relevance? Are new findings described in relation to the literature? Are both positive and negative aspects of the study addressed? Is the existing literature cited sufficiently? Do the results support the conclusions? Reading and interpreting the medical literature require a set of skills that can be learned. Similarly, good medical writing skills can be developed. Achieving these skills should enhance the clinician's practice of medicine.

  19. [A bibliometrics study of literature on medical image processing for the past ten years].

    Science.gov (United States)

    Chen, Wei; Wang, Yanbin; Ouyang, Zhaolian; Guo, Wenjiao; Chi, Hui

    2014-02-01

    We searched and retrieved literature on the topic of medical image processing published on SCI journals in the past 10 years. We then imported the retrieved literature into TDA for data cleanup before data analysis and pro cessing by EXCLE and UCINET to generate tables and figures that could indicate disciplinary correlation and research hotspots from the perspective of bibliometrics. The results indicated that people in Europe and USA were leading researchers on medical image processing with close international cooperation. Many disciplines contributed to the fast development of medical image processing with intense interdisciplinary researches. The papers that we found show recent research hotspots of the algorithm, system, model, image and segmentation in the field of medical image processing. Cluster analysis on key words of high frequency demonstrated complicated clustering relationship.

  20. Longus colli tendinitis. A review of literature and case series

    Directory of Open Access Journals (Sweden)

    Shawky Ahmed

    2017-01-01

    Full Text Available Purpose: To increase the awareness of longus colli tendinitis (LCT among spine specialists and to present a practical overview of diagnostic and treatment options, so that unnecessary interventions are avoided. Five sample cases from a German spine center will also be presented. Methods: Literature review and case series. A PubMed search was performed in May 2015, and the articles found were reviewed for clinical presentation, investigations, and treatment. The frequency of publication of LCT cases and the specialty of journals were also noted. Recent cases treated in our institution were also reviewed. The clinical findings, investigations, and therapeutic interventions were summarized. Results: The PubMed search from May 2015 found 104 articles, published over 51 years, on the topic of LCT. Only four were published in spine journals. A review of this literature yielded a total of 242 cases. The classic clinical triad included neck pain, limitation of movements, and swallowing complaints. C-reactive Protein (CRP values were available in 21 cases (mean 23.66 mg/dL. A contrast-enhanced computed tomography (CT scan was the best diagnostic modality. LCT is usually a self-limiting condition, but non-steroidal anti-inflammatory drugs (NSAIDs may help alleviate discomfort. Five cases of LCT were diagnosed and treated in our center over the past three years. Conclusions: LCT, which is uncommon and has non-specific symptoms, is often referred to spine centers. Spine specialists should be aware of its clinical presentation and radiographic findings in order to avoid unnecessary interventions. The condition is self-limiting and can be treated conservatively.

  1. Motivation as an independent and a dependent variable in medical education: a review of the literature.

    Science.gov (United States)

    Kusurkar, R A; Ten Cate, Th J; van Asperen, M; Croiset, G

    2011-01-01

    Motivation in learning behaviour and education is well-researched in general education, but less in medical education. To answer two research questions, 'How has the literature studied motivation as either an independent or dependent variable? How is motivation useful in predicting and understanding processes and outcomes in medical education?' in the light of the Self-determination Theory (SDT) of motivation. A literature search performed using the PubMed, PsycINFO and ERIC databases resulted in 460 articles. The inclusion criteria were empirical research, specific measurement of motivation and qualitative research studies which had well-designed methodology. Only studies related to medical students/school were included. Findings of 56 articles were included in the review. Motivation as an independent variable appears to affect learning and study behaviour, academic performance, choice of medicine and specialty within medicine and intention to continue medical study. Motivation as a dependent variable appears to be affected by age, gender, ethnicity, socioeconomic status, personality, year of medical curriculum and teacher and peer support, all of which cannot be manipulated by medical educators. Motivation is also affected by factors that can be influenced, among which are, autonomy, competence and relatedness, which have been described as the basic psychological needs important for intrinsic motivation according to SDT. Motivation is an independent variable in medical education influencing important outcomes and is also a dependent variable influenced by autonomy, competence and relatedness. This review finds some evidence in support of the validity of SDT in medical education.

  2. Mycetoma (Madura Foot) in Israel: Recent Cases and a Systematic Review of the Literature.

    Science.gov (United States)

    Bitan, Ohad; Wiener-Well, Yonit; Segal, Rina; Schwartz, Eli

    2017-06-01

    AbstractMycetoma is a chronic soft tissue infection caused by fungal or bacterial pathogens, and is endemic in tropical and subtropical regions. Cases in developed countries outside the mycetoma belt are rare and usually imported by immigrants. Sporadic cases have been reported in Israel. Unpublished cases in the participating medical centers are reported. In addition, a systematic review of the literature was performed. All published mycetoma cases diagnosed in Israel were included with relevant variables collected. Twenty-one cases of mycetoma were diagnosed in Israel between 1942 and 2015, including four unpublished cases and 17 published cases. The mean age at diagnosis was 42 years (range 23-73), and 16 of the patients were male. The foot was the primary involved organ. Fifteen patients were immigrants from Yemen, Ethiopia, and Sudan. Five cases were autochthonous. One case was travel related. Among patients who developed symptoms after immigration, the mean time from exposure to symptom onset was 5.6 years (range 1-10 years). The mean time from symptom onset to diagnosis was 6.6 years (range 0.2-35 years). The autochthonous cases demonstrate that Israel is endemic of mycetoma. The immigrant population represents two distinct waves of immigration to Israel in the past century. Two unpublished cases of Ethiopian immigrants are the first reported cases of mycetoma acquired in Ethiopia. The diagnostic and therapeutic challenges along with the epidemiological data emphasize the need of raising the awareness of physicians to this devastating condition even in developed countries.

  3. Eruption cyst: A literature review and four case reports

    Directory of Open Access Journals (Sweden)

    N B Nagaveni

    2011-01-01

    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.

  4. Acute disseminated encephalomyelitis following meningoencephalitis: case report and literature review.

    Science.gov (United States)

    Elias, Matthew D; Narula, Sona; Chu, Andrew S

    2014-04-01

    Meningoencephalitis and acute disseminated encephalomyelitis (ADEM) are both neurological disease processes, but there have been few cases of meningoencephalitis progressing to ADEM in the pediatric population. A case of a 4-year-old girl with an initial diagnosis of meningoencephalitis is presented here, whose initial presentation was manifested by prolonged fever, gray matter signal abnormality on brain magnetic resonance imaging, cerebrospinal fluid pleocytosis, and a markedly irritable mental status. As her neurological examination changed with focal abnormalities, a repeat magnetic resonance imaging demonstrated new areas of both gray and white matter signal abnormality, consistent with ADEM. Her symptoms and imaging findings completely resolved with a course of methylprednisolone. Based on the literature and this current case, it is our recommendation to consider ADEM as a diagnosis if meningoencephalitis is not improving.

  5. Mycobacterium fortuitum complex endocarditis-case report and literature review.

    Science.gov (United States)

    Olalla, J; Pombo, M; Aguado, J M; Rodríguez, E; Palenque, E; Costa, J R; Riopérez, E

    2002-02-01

    Endocarditis due to Mycobacterium fortuitum complex is a rare entity generally linked to the hospital environment. Only 18 cases have been published since 1966. Here we present a case of a female who developed an endocarditis due to Mycobacterium chelonae after valve replacement as well as a review of the literature. The course of this kind of endocarditis is generally subacute and the outcome is usually fatal. Blood cultures were positive in 75% of cases of metallic valve endocarditis, versus 20% in bioprostheses. The treatment must include antibiotics that have shown activity against these mycobacteria, such as amikacin, imipenem, cefoxitin, fluorinated quinolones and macrolides (especially clarithromycin). Surgical removal is recommended. Although the prognosis for the patient is poor, we should expect better outcomes with the use of new antibiotic regimens.

  6. Dextromethorphan, chlorphenamine and serotonin toxicity: case report and systematic literature review

    Science.gov (United States)

    Monte, Andrew A; Chuang, Ryan; Bodmer, Michael

    2010-01-01

    The aim of this review was to describe a patient with serotonin toxicity after an overdose of dextromethorphan and chlorphenamine and to perform a systematic literature review exploring whether dextromethorphan and chlorphenamine may be equally contributory in the development of serotonin toxicity in overdose. A Medline literature review was undertaken to identify cases of serotonin toxicity due to dextromethorphan and/or chlorphenamine. Case reports were included if they included information on the ingested dose or plasma concentrations of dextromethorphan and/or chlorphenamine, information about co-ingestions and detailed clinical information to evaluate for serotonin toxicity. Cases were reviewed by two toxicologists and serotonin toxicity, defined by the Hunter criteria, was diagnosed when appropriate. The literature was then reviewed to evaluate whether chlorphenamine may be a serotonergic agent. One hundred and fifty-five articles of dextromethorphan or chlorphenamine poisoning were identified. There were 23 case reports of dextromethorphan, of which 18 were excluded for lack of serotonin toxicity. No cases were identified in which serotonin toxicity could be solely attributed to chlorphenamine. This left six cases of dextrometorphane and/or chlorphenamine overdose, including our own, in which serotonin toxicity could be diagnosed based on the presented clinical information. In three of the six eligible cases dextromethorphan and chlorphenamine were the only overdosed drugs. There is substantial evidence from the literature that chlorphenamine is a similarly potent serotonin re-uptake inhibitor when compared with dextrometorphan. Chlorphenamine is a serotonergic medication and combinations of chlorphenamine and dextromethorphan may be dangerous in overdose due to an increased risk of serotonin toxicity. PMID:21175434

  7. Medication errors in the Middle East countries: a systematic review of the literature.

    Science.gov (United States)

    Alsulami, Zayed; Conroy, Sharon; Choonara, Imti

    2013-04-01

    Medication errors are a significant global concern and can cause serious medical consequences for patients. Little is known about medication errors in Middle Eastern countries. The objectives of this systematic review were to review studies of the incidence and types of medication errors in Middle Eastern countries and to identify the main contributory factors involved. A systematic review of the literature related to medication errors in Middle Eastern countries was conducted in October 2011 using the following databases: Embase, Medline, Pubmed, the British Nursing Index and the Cumulative Index to Nursing & Allied Health Literature. The search strategy included all ages and languages. Inclusion criteria were that the studies assessed or discussed the incidence of medication errors and contributory factors to medication errors during the medication treatment process in adults or in children. Forty-five studies from 10 of the 15 Middle Eastern countries met the inclusion criteria. Nine (20 %) studies focused on medication errors in paediatric patients. Twenty-one focused on prescribing errors, 11 measured administration errors, 12 were interventional studies and one assessed transcribing errors. Dispensing and documentation errors were inadequately evaluated. Error rates varied from 7.1 % to 90.5 % for prescribing and from 9.4 % to 80 % for administration. The most common types of prescribing errors reported were incorrect dose (with an incidence rate from 0.15 % to 34.8 % of prescriptions), wrong frequency and wrong strength. Computerised physician rder entry and clinical pharmacist input were the main interventions evaluated. Poor knowledge of medicines was identified as a contributory factor for errors by both doctors (prescribers) and nurses (when administering drugs). Most studies did not assess the clinical severity of the medication errors. Studies related to medication errors in the Middle Eastern countries were relatively few in number and of poor quality

  8. Literature searching in medical education: online tutorial development from idea to creation.

    Science.gov (United States)

    Maggio, Lauren A; Davies, Kathy J; Allee, Nancy; Beattie, Jim; Berryman, Donna; Littleton, Dawn; Tannery, Nancy H; O'Rourke, Kerry

    2012-01-01

    The medical education literature is growing, and the result is not only greater knowledge, but an increasing complexity in locating quality evidence-based information. In 2008, eight librarians partnered with the Association of American Medical Colleges to research, conceptualize, and build an online module to develop medical educators' search skills. Developing an online instructional module is a time-consuming, multi-stage process requiring the expertise of content, technical, and design specialists working in concert. Many lessons were learned, including the power of collaborative tools; the benefits of including specialists, such as graphic designers; the benefit of thoroughly surveying existing resources; and the importance of choosing technology wisely.

  9. #DDOD Use Case: Consolidated reporting of medical device recalls

    Data.gov (United States)

    U.S. Department of Health & Human Services — SUMMARY DDOD use case request for consolidated, consistent reporting of medical device recalls. WHAT IS A USE CASE? A “Use Case” is a request that was made by the...

  10. Medical and psychiatric comorbidities among elderly individuals with bipolar disorder: a literature review.

    Science.gov (United States)

    Lala, Sonali V; Sajatovic, Martha

    2012-03-01

    The common comorbid conditions that accompany late-life bipolar disorder (BD) have not been well studied. This is a literature review on psychiatric and medical comorbidities among elderly individuals with BD. A focused literature review searched PubMed. Inclusion criteria were original research reports, in English, until June 2009, specifically focused on medical and psychiatric comorbidities in BD individuals over the age of 50. A limited number of studies were identified. Most involved small samples (n < 100). Metabolic syndrome, respiratory and cardiovascular conditions, and endocrine abnormalities are common, with patients having an average of 3 to 4 medical comorbid conditions. Approximately 4.5% to 19% of elderly individuals with BD have dementia. Rates of psychiatric comorbidity appear lower than in younger BD populations, with the most common concurrent psychiatric illnesses being anxiety and substance use disorders. Rates of comorbid medical conditions appear similar to rates among geriatric patients without BD. Elderly individuals with BD are burdened by multiple concomitant medical disorders. In contrast to the elevated rates of medical comorbidity, rates of psychiatric comorbidity appear lower in elderly individuals with BD than in younger populations with BD. Greater awareness of concurrent medical conditions might help inform coordinated care that considers both mental and physical health among geriatric patients with BD.

  11. Clinical and laboratory features of Streptococcus salivarius meningitis: a case report and literature review.

    Science.gov (United States)

    Wilson, Megan; Martin, Ryan; Walk, Seth T; Young, Carol; Grossman, Sylvia; McKean, Erin Lin; Aronoff, David M

    2012-02-01

    Streptococcus salivarius is a normal member of the human oral microbiome that is an uncommon cause of invasive infections. Meningitis is a rare but increasingly reported infection caused by S. salivarius. Despite the growing number of reported cases, a comprehensive review of the literature on S. salivarius meningitis is lacking. We sought to gain a better understanding of the clinical presentation, evaluation, management, and outcome of S. salivarius meningitis by analyzing previously reported cases. In addition to a single case reported here, 64 previously published cases of meningitis were identified for this review. The collected data confirm that most patients presented with classical signs and symptoms of bacterial meningitis with a predominance of neutrophils in the cerebrospinal fluid (CSF) and hypoglycorrhachia. The majority of cases followed iatrogenic or traumatic CSF contamination. Most cases were diagnosed by CSF culture within one day of symptom onset. There was no clear evidence of predisposing co-morbid conditions in patients with meningitis, although in most case reports, limited information was given on the medical history of each patient. Outcomes were generally favorable with antibiotic management. Clinicians should suspect S. salivarius meningitis in patients presenting acutely after medical or surgical procedures involving the meninges.

  12. Beyond Sensitivity. LGBT Healthcare Training in U.S. Medical Schools: A Review of the Literature

    Science.gov (United States)

    Utamsingh, Pooja Dushyant; Kenya, Sonjia; Lebron, Cynthia N.; Carrasquillo, Olveen

    2017-01-01

    Purpose: Training future physicians to address the health needs of the lesbian, gay, bisexual, and transgender (LGBT) population can potentially decrease health disparities faced by such individuals. In this literature review, we examine the characteristics and impact of current LGBT healthcare training at U.S. medical schools. Methods: We…

  13. Primary pancreatic lymphoma: two case reports and a literature review

    Science.gov (United States)

    Yu, Lili; Chen, Yajun; Xing, Ligang

    2017-01-01

    Primary pancreatic lymphoma (PPL) is an extremely rare disease, with only a few cases reported in the literature. Clinical manifestations of PPL are often nonspecific and may mimic other pancreatic diseases. Because of the limited experience of PPL, clinicopathological features, differential diagnosis, optimal therapy, and outcomes are not well defined. We described two cases diagnosed as PPL and confirmed by histological examination and immunohistochemical analysis. Case 1 was a young man with obstructive jaundice and upper abdominal malaise mimicking a pancreatic adenocarcinoma. A computed tomography (CT) scan revealed a diffuse heterogeneous mass in the head of the pancreas along with dilated bile ducts, no dilated pancreatic duct, no liver or splenic involvement, or evident retroperitoneal adenopathies. The patient underwent a pancreatico-duodenectomy, and the postoperative histopathology confirmed diffuse large B-cell non-Hodgkin lymphoma. Postoperatively, he received six courses of the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisolone). Case 2 was an older man with left flank pain. A CT confirmed a mass with irregular margins at the tail of the pancreas and the hilum of the spleen. The mass was heterogeneous, with no clear boundary between lesions, spleen, stomach, and pancreas, with nearby blood vessels wrapped around it, and multiple enlarged lymph nodes in the abdominal cavity. A CT-guided biopsy was performed. The immunohistological findings of the specimen revealed a diffuse large B-cell lymphoma. The size of the tumor was significantly reduced after four cycles of the CHOP chemotherapy regimen. These two cases were different in clinical manifestation, location, and treatment. We reviewed the literature and discussed the clinicopathological features, differential diagnosis, optimal therapy, and outcomes of this neoplasm. PMID:28356755

  14. Tungiasis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Chieh-Wen Chen

    2011-03-01

    Full Text Available Tungiasis is a cutaneous parasitic infection caused by the sand flea Tunga penetrans. This infection is endemic to Central and South America, the Caribbean, and sub-Saharan Africa and is more prevalent in resource-poor communities. Increased air travel, emigration from, and immigration to these countries can lead to the import of T. penetrans to travelers’ hometowns. In recent times, dermatologists have encountered many such tropical cutaneous infections, and they should promptly diagnose the condition to prevent complications. We report a case of tungiasis imported from Brazil and review the related literature.

  15. A Case of Primary Hepatic Lymphoma and Related Literature Review

    Directory of Open Access Journals (Sweden)

    Yonghua Liu

    2016-01-01

    Full Text Available Objective. Primary hepatic lymphoma is a rare disease. And the clinical manifestations of this disease are nonspecific. The objective of this paper is to improve clinicians’ understanding of this disease. Methods. We analyzed the clinical characteristics of a case of primary hepatic lymphoma in association with hepatitis B virus infection and reviewed the literature. Conclusion. The clinical manifestations of primary hepatic lymphoma are nonspecific. And it is easily misdiagnosed. Postoperative radiotherapy of patients with early stage was previously speculated to achieve favorable improvement. The application of targeted therapeutic drugs, chemotherapy, or combined local radiotherapy has become the first-line treatment strategy.

  16. Schizencephaly: A case report and review of literature.

    Science.gov (United States)

    Ugboma, Enighe W; Agi, C E

    2016-01-01

    Schizencephaly is a congenital condition characterized by cerebrospinal fluid-filled clefts that extend from the pia surface of the cerebral hemisphere to the ependymal surface of the ventricle. Magnetic resonance imaging is the modality of choice for its diagnosis. Very few cases have been described in the literature in this environment. Here, we present an 18-month-old male child who presented in a tertiary hospital in Port Harcourt, Rivers State in Nigeria with 6 months history of recurrent seizures. A cranial MRI done revealed that he had right unilateral opened lip schizencephaly.

  17. Superficial cervicovaginal myofibroblastoma: report of four cases and literature review

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-feng; WU Yu-yu; WANG Jian

    2010-01-01

    @@ In 2001, Laskin et al~1 firstly described a series of 14 seemly distinctive mesenchymal tumors that occurred exclusively in the superficial lamina propria of the vagina and cervix of middle to old-aged women. They proposed the term "superficial cervicovaginal myofibroblastoma (SCVM)" to highlight the unique features of this tumor: the superficial subepithelial location and myofibroblastic differentiation of the tumor cells. SCVM appears less well recognized with only three additional reports have been documented in the English literatures.~(2-4) In this study, we described four new cases of SCVM to further characterize the clinical and pathological features of this rare entity.

  18. 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

    2005-01-01

    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.

  19. Morbihan syndrome: a case report and literature review*

    Science.gov (United States)

    de Vasconcelos, Rossana Cantanhede Farias; Eid, Natália Trefiglio; Eid, Renata Trefiglio; Moriya, Fabíolla Sih; Braga, Bruna Backsmann; Michalany, Alexandre Ozores

    2016-01-01

    Morbihan syndrome is a rare entity that more commonly affects women in the third or fourth decade of life. It is considered a special form of rosacea and its pathogenesis is not fully known. It is clinically characterized by the slow appearance of erythema and solid edemas on the upper portion of the face, with accentuation in the periorbital region, forehead, glabella, nose, and cheeks. We report the case of a patient presented with edema on the upper eyelid for a year. These findings suggested the diagnosis of Morbihan syndrome. We aim to report a rare, particularly refractory and chronic form of rosacea, which has received little attention in the literature.

  20. Brown Tumors: A Case Report and Review of the Literature

    Science.gov (United States)

    Can, Özgür; Boynueğri, Başak; Gökçe, Ali Murat; Özdemir, Ebru; Ferhatoğlu, Ferhat; Canbakan, Mustafa; Şahin, Gülizar Manga; Titiz, Mesut İzzet; Apaydın, Süheyla

    2016-01-01

    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

  1. 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

    2011-01-01

    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.

  2. Brain abscess by Kocuria rosea: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Juan Esteban Muñoz Montoya

    2017-03-01

    Full Text Available Brain abscess is one of the most serious complications of head and neck infections (Tunkel, 2010 [1]. Defined as a focal intracranial infection that is initiated as an area of cerebritis and evolves into a collection of pus surrounded by a vascularized capsule (Tunkel and Scheld, 2011 [2]. The infectious agents depend on the pathogenesis of the infection and the presence of various predisposing conditions, however, in general: Streptococcus sp. is the most frequent microorganism (Tunkel and Scheld, 2011 [2]: Greenberg, 2010 [3]. In this article we report a case of brain abscess caused by Kocuria rosea, an entity that has not been reported previously in literature.

  3. Familial isolated congenital asplenia: case report and literature review.

    Science.gov (United States)

    Ahmed, Syed Ather; Zengeya, Stanley; Kini, Usha; Pollard, Andrew J

    2010-03-01

    Congenital asplenia is a rare life-threatening condition, often presenting with pneumococcal sepsis. It may arise as part of situs abnormalities or result from an unrelated specific defect of spleen development. The mode of inheritance is usually autosomal dominant, though sporadic cases are also reported. In affected individuals, the use of appropriate antibiotic prophylaxis and immunisations could save lives. In our report, we describe a family of three siblings with isolated congenital asplenia and unaffected parents, suggestive of recessive inheritance. The diagnosis in the proband was made post mortem following overwhelming pneumococcal sepsis. We also review the literature and compare the eight families previously reported with congenital isolated asplenia.

  4. Jaguar Attack on a Child: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Iserson, Kenneth V.

    2015-02-01

    Full Text Available 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. [West J Emerg Med. 2015;16(2:303–309.

  5. Update in medical education for pediatrics: insights and directions from the 2010 literature

    Directory of Open Access Journals (Sweden)

    Helen Barrett Fromme

    2012-05-01

    Full Text Available Background: While most would agree that utilizing the literature to enhance individual educational practice and/or institutional success is the ideal method for improving medical education, methods to focus attention on the most relevant and valuable information have been heretofore lacking in the pediatric medical education literature. Methods : We performed a review of the medical education literature for the year 2010. Utilizing a similar strategy employed by others in Internal Medicine, we selected 12 high-yield education journals and manually reviewed the table of contents to select titles that would have grassroots applicability for medical educators. A broad search through PubMed was then completed using search terms adopted from prior studies, and titles from this search were similarly selected. The abstracts of selected titles (n=147 were each reviewed by two of the authors, then all authors reached consensus on articles for full review (n=34. The articles were then discussed and scored to achieve consensus for the 11 articles for inclusion in this paper. Results : Several themes emerged from reviewing these publications. We did not select topics or sections of interest a priori. The themes, grouped into four areas: supervision and leadership, hand-off communication, core competencies: teaching and assessment, and educational potpourri, reflect our community's current concerns, challenges, and engagement in addressing these topics. Each article is summarized below and begins with a brief statement of what the study adds to the practice of pediatric medical education. Discussion : This review highlights multiple ‘articles of value’ for all medical educators. We believe the value of these articles and the information they contain for improving the methods used to educate medical students, residents, and fellows are significant. The organically derived thematic areas of the representative articles offer a view of the landscape of

  6. Intracranial epithelioid hemangioendothelioma: two cases report and literature review

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    Jun-chao FANG

    2015-09-01

    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

  7. Paranormal phenomena in the medical literature sufficient smoke to warrant a search for fire.

    Science.gov (United States)

    Bobrow, Robert S

    2003-06-01

    Paranormal phenomena - events that cannot be explained by existing science - are regularly reported in medicine. Surveys have shown that a majority of the population of the United States and Great Britain hold at least one paranormal belief. Information was retrieved by MEDLINE searches using keywords 'paranormal' and 'psychic', and from the author's own collection. Reports are predominantly by physicians, and from peer-reviewed, MEDLINE-indexed literature. This is a representative sample, as there is no database for paranormal medical phenomena. Presented and discussed are: a case of systemic lupus erythematosis ameliorated by witchcraft; an analysis of studies on distant healing; acupuncture, as a bridge between what is now accepted but recently would have been deemed paranormal; a carefully-done study of a psychic; auditory hallucinations informing a patient, correctly, that she had a brain tumor; two nearly-identical lay press reports of self-predicted death; lycanthropy (the delusion of being an animal); the development of Carl Jung's collective unconscious; hypnosis - still questioned despite documented therapeutic benefit, and a well-researched report of a person speaking a foreign language, apparently unlearned (xenoglossy) while hypnotized; and multiple examples of children who spout the details of the life of an unknown, deceased person. The inability of existing paradigms to explain these observations does not negate them; rather, it elucidates a need for more research.

  8. Prosthetic Tricuspid Valve Thrombosis: Three Case Reports and Literature Review

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    Ahmad Yaminisharif

    2015-10-01

    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.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Holocord spinal epidural abscess: Case report and literature review.

    Science.gov (United States)

    Xiang, H; Ma, X; Shen, N; Yue, B; Zhang, G; Chen, B

    2016-10-01

    Holocord spinal epidural abscess (SEA) is a rare condition. To our knowledge, five cases of SEA have been reported so far, and no consensus has been made on the treatment yet. In this article, we report a case of holocord SEA and review literature to further understanding of SEA. The advent of antibiotic treatment and the recognition of surgical debridement have been important in searching for alternatives to recovery, so the patient was treated surgically together with systemic antibiotics. The patient remained neurologically stable and continued to be clinically in good condition without any low back pain after 1 year. Surgical drainage, together with systemic antibiotics, is the main treatment choice for extensive SEAs. Although treatment should be considered that highlights the importance of examining the factors related to the health and condition of the patients and the anatomy and extent of the abscess, early surgical treatment associated with prolonged antibiotic treatment is necessary.

  11. Spontaneous coronary artery dissection: case report and literature review.

    Science.gov (United States)

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

    2015-05-01

    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.

  12. Congenital defects of pericardium: case reports and review of literature.

    Science.gov (United States)

    Cuccuini, Matteo; Lisi, Francesca; Consoli, Arturo; Mancini, Sara; Bellino, Valentina; Galanti, Giorgio; Capaccioli, Leonardo

    2013-01-01

    Pericardial defects are a rare condition, generally asymptomatic, due to failure in development of pericardial sac. They are difficult to detect, particularly the complete absence of the pericardium. At present magnetic resonance imaging (MRI) is considered the best performing exam and it could be the first choice in the diagnosis of agenesia of the pericardium. A comprehensive review of dedicated books and PubMed literature was performed and three clinical cases have been analyzed. We report three cases, one with partial and two with total agenesia of the left pericardium, seen at our Institute and diagnosed at MRI as unexpected findings. The diagnosis of a congenital defect of the pericardium is challenging, even for expert radiologists, because this kind of deformity does not provide specific clinical nor conventional radiology findings. Nowadays, the most effective instrument for a certain diagnosis is MRI, interlocked with electrocardiography.

  13. Dorsal extradural meningioma: Case report and literature review

    Science.gov (United States)

    Dehcordi, Soheila Raysi; Ricci, Alessandro; Chiominto, Alessandro; De Paulis, Danilo; Di Vitantonio, Hambra; Galzio, Renato J.

    2016-01-01

    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

  14. Mesonephric adenocarcinoma of the cervix: Case report and literature review

    Directory of Open Access Journals (Sweden)

    A. Dierickx

    2016-08-01

    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.

  15. Herpes Simplex Mastitis: Case Report and Review of the Literature

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    Holly Brown

    1996-01-01

    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. Scedosporium prolificans Endocarditis: Case Report and Literature Review.

    Science.gov (United States)

    Wakabayashi, Yoshitaka; Okugawa, Shu; Tatsuno, Keita; Ikeda, Mahoko; Misawa, Yoshiki; Koyano, Saho; Tsuji, Eiichi; Yanagimoto, Shintaro; Hatakeyama, Shuji; Moriya, Kyoji; Yotsuyanagi, Hiroshi

    2016-01-01

    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.

  17. A rare case of infantile myofibromatosis and review of literature.

    Science.gov (United States)

    Hausbrandt, Peter A; Leithner, Andreas; Beham, Alfred; Bodo, Koppany; Raith, Johannes; Windhager, Reinhard

    2010-01-01

    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

  18. Surgical Management of Malignant Tumors of the Trachea: Report of Two Cases and Review of Literature

    Directory of Open Access Journals (Sweden)

    Ryuji Yasumatsu

    2012-06-01

    Full Text Available Malignant neoplasms occurring from the trachea are extremely rare. Therefore, their clinical characteristics and surgical results have not been thoroughly discussed. These tumors are often misdiagnosed and treated as bronchial asthma or chronic obstructive pulmonary disease. It is critically important to probe the cause-effect relationship between the medical presentations and the clinical diagnosis. In this report, two cases of tracheal malignancy suffering from dyspnea due to obstruction of the proximal trachea are described, and a review of the literature is presented.

  19. The anatomy of a shark attack: a case report and review of the literature.

    Science.gov (United States)

    Caldicott, D G; Mahajani, R; Kuhn, M

    2001-07-01

    Shark attacks are rare but are associated with a high morbidity and significant mortality. We report the case of a patient's survival from a shark attack and their subsequent emergency medical and surgical management. Using data from the International Shark Attack File, we review the worldwide distribution and incidence of shark attack. A review of the world literature examines the features which make shark attacks unique pathological processes. We offer suggestions for strategies of management of shark attack, and techniques for avoiding adverse outcomes in human encounters with these endangered creatures.

  20. Injuries Following Segway Personal Transporter Accidents: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    John Ashurst

    2015-10-01

    Full Text Available The Segway® self-balancing personal transporter has been used as a means of transport for sightseeing tourists, military, police and emergency medical personnel. Only recently have reports been published about serious injuries that have been sustained while operating this device. This case describes a 67-year-old male who sustained an oblique fracture of the shaft of the femur while using the Segway® for transportation around his community. We also present a review of the literature.

  1. Laugier-Hunziker syndrome: A case report and review of the literature.

    Science.gov (United States)

    Rangwala, Sophia; Doherty, Christy B; Katta, Rajani

    2010-12-15

    Laugier-Hunziker syndrome (LHS) is a rare acquired disorder characterized by diffuse macular hyperpigmentation of the oral mucosa and, at times, longitudinal melanonychia. Although LHS is considered a benign disease with no systemic manifestations or malignant potential, it is important to rule out other mucocutaneous pigmentary disorders that do require medical management. Prompt clinical recognition also averts the need for excessive and invasive procedures and treatments. To date, only four cases have been reported in the United States. We present a 77-year-old man who had clinical features typical of LHS and we then provide a review of the literature on LHS and its mimickers.

  2. Propafenone hepatotoxicity: Report of a new case and review of the literature

    Directory of Open Access Journals (Sweden)

    Lara B Younan

    2013-01-01

    Full Text Available Propafenone is a class Ic antiarrhythmic drug. It is a beta-adrenergic blocker that causes bradycardia and bronchospasm. It is metabolized primarily in the liver. Its bioavailability and plasma concentration differ among patients under long-term therapy. They are genetically determined by the hepatic cytochrome P-450 2D6. Hepatic toxicity is highly uncommon. To date, only eight patients were reported in the reviewed world literature. In this article, one new case will be reported emphasizing the importance of medication history taking in patients presenting with new-onset liver enzymes abnormalities.

  3. Temporal lobe epilepsy and aura with happiness and pleasure: report of two cases and literature revision

    OpenAIRE

    1994-01-01

    The authors present two cases of temporal lobe epilepsy with happiness and pleasure during the seizure. Discussing the rarity of these clinical findings, the concept of epileptic aura is historically reviewed with special attention to Dostoievski's epilepsy and its descriptions by the medical literature. São apresentados 2 casos de epilepsia do lobo temporal nos quais os pacientes apresentam sensações de alegria e prazer durante a crise. Os autores analisam a evolução do conceito de aura e...

  4. Educational strategies aimed at improving student nurse's medication calculation skills: a review of the research literature.

    Science.gov (United States)

    Stolic, Snezana

    2014-09-01

    Medication administration is an important and essential nursing function with the potential for dangerous consequences if errors occur. Not only must nurses understand the use and outcomes of administering medications they must be able to calculate correct dosages. Medication administration and dosage calculation education occurs across the undergraduate program for student nurses. Research highlights inconsistencies in the approaches used by academics to enhance the student nurse's medication calculation abilities. The aim of this integrative review was to examine the literature available on effective education strategies for undergraduate student nurses on medication dosage calculations. A literature search of five health care databases: Sciencedirect, Cinahl, Pubmed, Proquest, Medline to identify journal articles between 1990 and 2012 was conducted. Research articles on medication calculation educational strategies were considered for inclusion in this review. The search yielded 266 papers of which 20 meet the inclusion criteria. A total of 5206 student nurse were included in the final review. The review revealed educational strategies fell into four types of strategies; traditional pedagogy, technology, psychomotor skills and blended learning. The results suggested student nurses showed some benefit from the different strategies; however more improvements could be made. More rigorous research into this area is needed.

  5. [Anal abscess with a tuberculous origin: report of two cases and review of the literature].

    Science.gov (United States)

    Romelaer, Charlotte; Abramowitz, Laurent

    2007-01-01

    Gastrointestinal tuberculosis represents 1% of extrapulmonary tuberculoses and only sporadic cases of anal tuberculosis have been reported in the literature. We report two cases of tuberculous anal abscess and a review of the literature for diagnosis and treatment.

  6. Atypical pityriasis rosea: a case report and a review of literature

    Directory of Open Access Journals (Sweden)

    Iqbal A. Bukhari

    2015-02-01

    Full Text Available Aim: Pityriasis rosea (PR is a common acute inflammatory skin disease characterized by pruritic erythematous papulosquamous eruption that is self-limited which can rarely pose a diagnostic challenge. In this report, we present a rare presentation of PR.Method: the case was completely evaluated including laboratory works and a final diagnosis of erythema multiforme-like PR was reached. Besides, we reviewed all atypical presentations of PR that are reported in the medical literature.Results: our patient has a morphological variant of PR which is erythema multiforme-like. The presence of a herald patch and  the rapid resolution of the symptoms supports our diagnosis. This variant is considered rare and to our knowledge, this is the seventh case of erythema multiforme-like PR reported in the medical literature.In conclusion: we report a case of erythema multiforme-like PR. It is important that physicians recognize the wide spectrum of PR variants so that appropriate management can be arranged. 

  7. Orthopedic Considerations with Eosinophilic Fasciitis: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Jason Samona

    2012-01-01

    Full Text Available Eosinophilic fasciitis (EF or Shulman's disease is a very rare condition first described in 1974 by Dr. Shulman in patients with diffuse fasciitis and eosinophilia. Fewer than 300 cases have been reported worldwide in the past 35 years. The current understanding of the disease in the medical community relies only on a few large case series and multiple case reports. The proposed etiology, pathological mechanisms, and consensus for therapy are obscure or lacking. The presentation of the disease is variable, but certain signs and symptoms have been associated with EF. The extreme rarity of the disease, the large constellation of signs and symptoms, as well as the lack of knowledge about eosinophilic fasciitis and make this disease difficult to recognize and treat. Through the review of the literature, there is only one other case by Yamanishi where recurrent asthma has been seen to be associated with eosinophilic fasciitis. To the knowledge of the authors of this paper this patient represents the second recorded incident. The case described by the authors of this paper demonstrated an initial biopsy of mixed cell fasciitis including eosinophils, compared to the eosinophil-rich sample taken at a later date. This could be a unique aspect to the pathology of the disease not previously discovered. Similar scenarios were not noted in a review of the literature. A change in the pathological findings as shown in this case from non-eosinophil-rich sample to one rich in eosinophils is unique in a patient actively suffering from EF. The authors of this paper propose that an allergic reaction (at the patient's puncture site occurred, which initially caused the left hand symptoms that led to the patient’s first presentation to the hospital. This is a unique causative agent, not found in the review of the literature. Through a review of the literature and the presentation of this patient, the authors propose an underlying dysregulation of the immune system

  8. A case of HAPE on K2 and literature review.

    Science.gov (United States)

    Sasao, Gen; Nagai, Asuka; Iwamoto, Tokuzen; Ichiwata, Toshio; Kuwahira, Ichiro

    2010-01-01

    HAPE (High Altitude Pulmonary Edema) is a serious and fatal disease in mountains. Early diagnosis and immediate descent are important for successful treatment. One of the authors (GS), who was healthy and a well trained climber, participated in the expedition to K2 (8611 m) in 2006 and developed HAPE. Under the severe environmental condition, it was difficult to evaluate his condition in its early stage. The earliest symptoms were nonspecific for HAPE as reported in many papers. Neither had he suffered from HAPE on the previous expeditions. These facts probably delayed the diagnosis in spite of its typical onset. This is a rare case report by a medical doctor who suffered from HAPE. The present case may remind the climbers of the difficulties in diagnosing HAPE on a mountain.

  9. Manic depression in literature: the case of Virginia Woolf.

    Science.gov (United States)

    Koutsantoni, Katerina

    2012-06-01

    The steady growth of the discipline of medical humanities has facilitated better understanding of the symptoms and signs of mental health conditions and the feelings of the humans experiencing them. In this project, the arts have been seen as enabling re-engagement of the practitioner with the patient's own perceptions and feelings. With respect to the association between creativity and bipolar disorder in particular, work within medical humanities has meant that mentally ill creative individuals have been subject to scientific scrutiny and investigation, rather than continuing to be viewed as naively romanticised cases of mental illness. This paper is an attempt to supplement traditional literary criticism by examining Virginia Woolf's history of bipolar disorder through a medical humanities lens. I will provide an overview of Woolf's history of manic-depressive episodes, their symptoms and manifestation, look back on her circumstances during their occurrence, and observe the author's losing battle to salvage her identity in the throes of the disease. The aim is to offer further insight into Woolf's psychopathology and to gain some understanding of the causes and progression of the condition that led to her death by suicide.

  10. Creating a classification of image types in the medical literature for visual categorization

    Science.gov (United States)

    Müller, Henning; Kalpathy-Cramer, Jayashree; Demner-Fushman, Dina; Antani, Sameer

    2012-02-01

    Content-based image retrieval (CBIR) from specialized collections has often been proposed for use in such areas as diagnostic aid, clinical decision support, and teaching. The visual retrieval from broad image collections such as teaching files, the medical literature or web images, by contrast, has not yet reached a high maturity level compared to textual information retrieval. Visual image classification into a relatively small number of classes (20-100) on the other hand, has shown to deliver good results in several benchmarks. It is, however, currently underused as a basic technology for retrieval tasks, for example, to limit the search space. Most classification schemes for medical images are focused on specific areas and consider mainly the medical image types (modalities), imaged anatomy, and view, and merge them into a single descriptor or classification hierarchy. Furthermore, they often ignore other important image types such as biological images, statistical figures, flowcharts, and diagrams that frequently occur in the biomedical literature. Most of the current classifications have also been created for radiology images, which are not the only types to be taken into account. With Open Access becoming increasingly widespread particularly in medicine, images from the biomedical literature are more easily available for use. Visual information from these images and knowledge that an image is of a specific type or medical modality could enrich retrieval. This enrichment is hampered by the lack of a commonly agreed image classification scheme. This paper presents a hierarchy for classification of biomedical illustrations with the goal of using it for visual classification and thus as a basis for retrieval. The proposed hierarchy is based on relevant parts of existing terminologies, such as the IRMA-code (Image Retrieval in Medical Applications), ad hoc classifications and hierarchies used in imageCLEF (Image retrieval task at the Cross-Language Evaluation

  11. Primary retroperitoneal Merkel cell carcinoma: Case report and literature review

    Science.gov (United States)

    Quiroz-Sandoval, Osvaldo A.; Cuellar-Hubbe, Mario; Lino-Silva, Leonardo S.; Salcedo-Hernández, Rosa A.; López-Basave, Horacio N.; Padilla-Rosciano, Alejandro E.; León-Takahashi, Alberto M.; Herrera-Gómez, Ángel

    2015-01-01

    Background Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma that affects elderly patients and typically arises in sun-exposed skin. The disease is very rare and only few cases present with no apparent skin lesion. In the retroperitoneum there are only two cases reported in the literature. Case presentation We report a case of a 54-year-old Mexican male with MCC, which presented as a large retroperitoneal mass. Pathological and immunohistochemical analysis of the transabdominal CT-guided biopsy specimen revealed a MCC. The patient underwent preoperative chemotherapy followed by a laparotomy and the mass was successfully excised. Discussion There are two possible explanations for what occurred in our patient. The most plausible theory is the retroperitoneal mass could be a massively enlarged lymph node where precursor cells became neoplastic. This would be consistent with a presumptive diagnosis of primary nodal disease. Moreover, metastasis to the retroperitoneal lymph nodes has been reported as relatively common when compared to other sites such as liver, bone, brain and skin. The less probable theory is the non-described “regression” phenomena of a cutaneous MCC, but we are not found a primary skin lesion. Conclusion Preoperative chemotherapy and excision of the primary tumor is the surgical treatment of choice for retroperitoneal MCC. We propose that further studies are needed to elucidate the true efficacy of chemotherapy in conventional and unconventional patients with MCC. PMID:26708276

  12. BILATERAL MENIERE’S DISEASE IN THE YOUNG, DILEMMA’S IN MEDICAL MANAGEMENT: A CRITICAL REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Sahoo Kumar Anjan

    2015-04-01

    Full Text Available It is not very unusual for the ENT personnel to encounter cases of Meniere’s disease with bilateral ear involvement. As compared to unilateral cases the patient with bilateral involvement has more significant morbidity and emotional disturbance, particularly in young individuals. The present ambiguity in aetiology of the disease process has leaked to the management too and no definitive treatment options are described till date. The medical management at present is successful in controlling vertigo in the majority of the patients. But the symptoms of hearing loss and tinnitus are relatively less rehabilitated. The options of management like Aminoglycoside infusion and surgery have a limited role in cases with bilateral involvement and this drastically cripples the management protocol. The present review aims to evaluate the efficacy of individual agents and suggest a beneficial protocol based on the current literature.

  13. Levodropropizine-Induced Anaphylaxis: Case Series and Literature Review.

    Science.gov (United States)

    Song, Jae Won; Jang, Young Sook; Jung, Moon Chan; Kim, Joo Hee; Choi, Jeong Hee; Park, Sunghoon; Hwang, Yong Il; Jang, Seung Hun; Jung, Ki Suck

    2017-05-01

    Levodropropizine is commonly used as an antitussive drug for acute and chronic cough. It is a non-opioid agent with peripheral antitussive action via the modulation of sensory neuropeptide levels in the airways. Thus, levodropropizine has a more tolerable profile than opioid antitussives. However, we experienced 3 cases of levodropropizine-induced anaphylaxis. Three patients commonly presented with generalized urticaria, dyspnea, and collapse after taking cold medication including levodropropizine. To find out the culprit drug, we performed skin tests, oral provocation tests (OPTs), and basophil activation tests (BATs). Two patients were confirmed as having levodropropizine-induced anaphylaxis by OPTs, and one of them showed positive to skin prick tests (SPTs). The other patient was confirmed by skin tests and BATs. When we analyzed pharmacovigilance data related to levodropropizine collected for 5 years, most cases (78.9%) had allergic reactions, such as rash, urticaria, angioedema, and anaphylaxis. Therefore, physicians should consider that levodropropizine can be a culprit drug, when anaphylaxis occurs after taking anti-cough or common cold medication.

  14. Primary melanoma of the gallbladder: Does it exist? Report of a case and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Michail Safioleas; Emmanouil Agapitos; Konstantinos Kontzoglou; Michail Stamatakos; Panagiotis Safioleas; George Mouzopoulos; Alkiviadis Kostakis

    2006-01-01

    With the occasion of a case of malignant melanoma of the gallbladder, which appeared to be primary, we have reviewed the literature and the result of this research was that primary melanoma of the gallbladder remains a questionable medical entity. Only few cases of both primary and metastatic gallbladder melanoma have been reported so far, and the only agreement is that surgery is the mainstaytreatment. The role of adjuvant chemotherapy, hormonotherapy or immunotherapy for both primary and metastatic disease remains undefined.

  15. Infection-related mental and inferior alveolar nerve paresthesia: literature review and presentation of two cases.

    Science.gov (United States)

    Morse, D R

    1997-07-01

    A review of the literature on infection-related mental and inferior alveolar nerve paresthesia is given. This is followed by 2 case reports. The first case is of a mandibular left second molar in which a chloropercha overfill puff occurred in the vicinity of the inferior alveolar canal. The tooth remained asymptomatic until 2 and 1/2 yr later, when the periapical lesion enlarged and swelling, pain, and paresthesia developed. The paresthesia resolved 2 weeks following periapical surgery. The second case is of a mandibular right first premolar in which paresthesia began 1 day after the initial endodontic treatment. The intracanal medication was formocresol on a cotton pellet that was squeezed dry. The paresthesia was treated by irrigation, antibiotics, and dexamethasone. The paresthesia lasted 7 weeks, and when it resolved the root canal was filled with gutta-percha/eucapercha. Almost 9 months later, the tooth remained asymptomatic.

  16. Esophagogastric fistula: a complication of Crohn's disease--case report and review of the literature.

    Science.gov (United States)

    Rholl, J C; Yavorski, R T; Cheney, C P; Wong, R K

    1998-08-01

    Esophagogastric fistula formation as a complication of esophageal Crohn's has been reported in only one case in the literature. In addition, only eight cases of esophageal fistulae of any type have been reported in the setting of Crohn's disease. Unlike the more often described superficial, aphthous disease of the esophagus, response of fistulae to medical therapy has been disappointing, and recurrence and progression are likely. Surgery remains the primary modality for refractory disease. The roles of salicylates, antibiotics, immunosuppressive agents, sealants, and intralesional steroid injections have not been well defined. We present a case of severe, refractory Crohn's disease with fistula formation between the esophagus and stomach, and concomitant involvement of the oropharynx, duodenum, terminal ileum, and cecum.

  17. Diagnosis of acanthamoeba keratitis-A report of four cases and review of literature

    Directory of Open Access Journals (Sweden)

    Sharma Savitri

    1990-01-01

    Full Text Available Acanthamoeba keratitis is not reported often in India. We reported the first case diagnosed in this country a year back. In this communication, four more cases of Acanthamoeba keratitis diagnosed since then are being reported along with a brief review of literature. Diagnosis in all these patients was based on observation of acanthamoeba cysts in 10% KOH wet mount of corneal ulcer scrapings and subsequent culture. The characteristic ring infiltration of cornea was seen in all of them. All cases were treated medically with the available antiamoebic drugs (Miconazole, Neosporin, Ketoconazole and Metronidazole in different combinations. Only one out of four, responded with complete healing of the ulcer. Acanthamoeba keratitis is probably not as uncommon in India as it is thought to be. With increased awareness and performance of minimal laboratory tests the condition may be diagnosed more often.

  18. A Case of Pyomyoma following Uterine Fibroid Embolization and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Chika C. Obele

    2016-01-01

    Full Text Available Background. Since its introduction in 1996, uterine fibroid embolization (UFE has become standard medical practice in the management of symptomatic uterine fibroids. An extremely rare complication, pyomyoma, has been reported only 5 times previously in the literature following UFE. Case. A 37-year-old woman underwent UFE for symptomatic leiomyomas of the uterus. Signs and symptoms of uterine infection ensued, beginning at 6 days following the procedure. Recurrent fevers and increasing leukocytosis despite the intravenous administration of appropriate antibiotics eventually necessitated surgical intervention on postprocedure day #18. Conclusion. An extremely rare complication of UFE is herein presented, pyomyoma, with a review of other reported cases. Commonalities are sought among these few reported cases with the hope of increasing diagnostic acumen in the detection of this disease.

  19. Giant Cardiac Hydatid Cyst in Children: Case Report and Review of the Literature

    Science.gov (United States)

    Fiengo, Leslie; Bucci, Federico; Giannotti, Domenico; Patrizi, Gregorio; Redler, Adriano; Kucukaksu, Denis Suha

    2014-01-01

    Cardiac echinococcus is a rare affliction of the heart caused by the tapeworm Echinococcus granulosus. Primary echinococcosis of the heart represents 0.5–2% of all hydatid disease cases in endemic regions. It evolves slowly, explaining its rarity in children. We report the case of a 11-year-old child affected by a giant cardiac cyst of the left ventricle (LV). The patient underwent cardiac surgery and medical treatment. A retrospective review of the current literature was realized. We found 18 cases: the mean age was 11-years old. Nine cysts were localized in the LV, four in the interventricular septum, three in the right ventricle, and two in the right atrium. All underwent surgery except six patients. Routine echocardiographic screening may be useful in endemic regions where infestation is common. Cardiac echinococcus should be diagnosed in the early and uncomplicated stages and be removed surgically even in asymptomatic patients. PMID:25249763

  20. Gigantomastia and Macroprolactinemia Responding to Cabergoline Treatment: A Case Report and Minireview of the Literature

    Science.gov (United States)

    Dellal, Fatma Dilek; Ozdemir, Didem; Aydin, Cevdet; Kaya, Gulfem; Ersoy, Reyhan; Cakir, Bekir

    2016-01-01

    Background. Macroprolactinemia is defined as predominance of high molecular weight prolactin forms in the circulation. Although macroprolactin is considered as a biologically inactive molecule, some authorities suggest treatment in symptomatic cases. Gigantomastia is defined as excess breast tissue and most cases in the literature were treated by surgical intervention. Case. A 44-year-old woman was admitted to our clinic with gigantomastia and galactorrhea. The patient had a demand for surgical therapy. In laboratory examination, she had hyperprolactinemia and macroprolactinemia. Pituitary imaging revealed 6 mm microadenoma in right side of the hypophysis. Since she was symptomatic, cabergolin treatment was started. Macroprolactin became negative, breast circumference decreased significantly, and galactorrhea resolved after treatment. Conclusion. Gigantomastia might be the presenting symptom in patients with macroprolactinemia. In these patients medical treatment with cabergoline may be used initially as an alternative to surgical approach. PMID:27195157

  1. Gigantomastia and Macroprolactinemia Responding to Cabergoline Treatment: A Case Report and Minireview of the Literature

    Directory of Open Access Journals (Sweden)

    Fatma Dilek Dellal

    2016-01-01

    Full Text Available Background. Macroprolactinemia is defined as predominance of high molecular weight prolactin forms in the circulation. Although macroprolactin is considered as a biologically inactive molecule, some authorities suggest treatment in symptomatic cases. Gigantomastia is defined as excess breast tissue and most cases in the literature were treated by surgical intervention. Case. A 44-year-old woman was admitted to our clinic with gigantomastia and galactorrhea. The patient had a demand for surgical therapy. In laboratory examination, she had hyperprolactinemia and macroprolactinemia. Pituitary imaging revealed 6 mm microadenoma in right side of the hypophysis. Since she was symptomatic, cabergolin treatment was started. Macroprolactin became negative, breast circumference decreased significantly, and galactorrhea resolved after treatment. Conclusion. Gigantomastia might be the presenting symptom in patients with macroprolactinemia. In these patients medical treatment with cabergoline may be used initially as an alternative to surgical approach.

  2. Proximal dup(10q): Case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Barritt, J.A.; Teague, K.E.; Bodurtha, J.N. [Virginia Commonwealth Univ., Richmond, VA (United States)] [and others

    1994-09-01

    We report a case of a proximal dir dup(10q) in a female with multiple congenital anomalies. During infancy she was noted to gave growth retardation, microcephaly, microphthalmia, coloboma, a long, beaked nose, posteriorly rotated ears with simple helices, full bowed lips, widely-spaced nipples, broad first toes, hypermobile and proximally placed thumbs, a heart murmur, PDA, and coarctation of the aorta. Additional findings at age 13 included a full columella, short philtrum, thin limbs, bilateral blindness, and mental retardation, as well as continued growth retardation. Her medical history included precocious puberty at age 8 and a diagnosis of hyperactivity. Using FISH with multiple probes combined with GTG-banding, the aberrant chromosome was determined to be a dir dup(10)(q21{r_arrow}q22). Parental chromosomes were normal and the family history was unremarkable. The parental origin of the dir dup(10) is being assessed using DNA markers. Five similar cases of proximal dup(10q) have been reported previously. Consistent characteristics include low birth weight, developmental and psychomotor delay, growth retardation, and microcephaly. Also found in most cases were short prominent philtrum, bowed mouth, PDA, thin limbs, coloboma, micropthalmia, deep set eyes, and other ocular anomalies. Our case is unique in that she has a long, beaked nose, precocious puberty, and hyperactivity. Future studies such as this, using molecular cytogenetic techniques to better define the chromatin involved in proximal dup(10q), may lead to its recognition as a distinct clinical phenotype.

  3. Atraumatic tooth extraction in patients taking bisphosphonates: a review of literature and experience with three cases.

    Science.gov (United States)

    Hoefert, Sebastian; Grimm, Martin; Sharghi, Feraydoon; Geist, Andreas; Krimmel, Michael; Reinert, Siegmar

    2014-09-01

    Regev et al. first re-introduced the method of atraumatic tooth extraction with orthodontic elastics in 2008. Since then, the method has been mentioned regularly in literature. Nevertheless, the need for additional more detailed information remains. We present a review of literature and a retrospective analysis of our three patients receiving bisphosphonate medication. Two of our patients suffered from bisphosphonate-related osteonecrosis of the jaw (BRONJ). All three patients underwent atraumatic tooth extraction, which we describe in detail. Regev et al. reported satisfactory results using the novel method. We removed six teeth in two patients with continued chemotherapy or bisphosphonate therapy in a time span of 26.2 ± 16.4 weeks successfully. None of the patients developed exposed bone in the follow-up (7.4 ± 0.2 months). In one case, the technique had to be discontinued due to increasing tooth soreness. Atraumatic tooth extraction seems to be a safe method to prevent bone exposure, even in cases with BRONJ. The time required of our patients for exfoliation exceeded the time mentioned in literature considerably. This proved to be a major limitation. Our cases showed that patients with good compliance, no sore teeth, or painful BRONJ lesions, benefited from atraumatic tooth extraction. One of the method's major advantages might be the possibility to continue chemotherapy and bisphosphonate therapy throughout the treatment.

  4. Streptococcus intermedius Causing Necrotizing Pneumonia in an Immune Competent Female: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Faris Hannoodi

    2016-01-01

    Full Text Available We report a case of a 52-year-old immunocompetent Caucasian female treated for necrotizing Streptococcus intermedius pneumonia and review available literature of similar cases. Our patient presented with respiratory failure and required hospitalization and treatment in the intensive care unit. Moreover, she required surgical drainage of right lung empyema as well as decortication and resection. The review of literature revealed three cases of S. intermedius pneumonia, one of which was a mortality. Comparison of the published cases showed a highly varied prehospital course and radiological presentations, with a symptomatic phase ranging from 10 days to five months. Radiological findings varied from an isolated pleural effusion to systemic disease with the presence of brain abscesses. Immunocompetence appears to correlate well with the overall prognosis. In addition, smoking appears to be an important risk factor for S. intermedius pneumonia. In 2 (50% of cases, pleural fluid analysis identified S. intermedius. In contrast, no organism was found in our patient, necessitating the acquisition of lung tissue sample for the diagnosis. In conclusion, both medical and surgical management are necessary for effective treatment of S. intermedius pneumonia. The outcome of treatment is good in immunocompetent individuals.

  5. Medical care epidemiology and unwarranted variation: the Israeli case.

    Science.gov (United States)

    Goodman, David C; Goodman, Andrew A

    2017-01-01

    In an article in this Journal, Mendlovic and colleagues report on regional variation in medical care across Israeli regions. This study joins a growing literature demonstrating generally high variation in the provision of health care services within developed countries. This commentary summarizes the status of medical care epidemiology and its studies of unwarranted variation in health care, and provides a conceptual framework to guide future studies. Recommendations are offered for advancing studies in Israel that could guide policy development and clinical improvement.

  6. A unique case of urinary bladder simple melanosis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hollowell Christopher

    2009-07-01

    Full Text Available Abstract Melanosis refers to abnormal or excessive deposition of melanin pigment in the cells and/or tissue, which can be seen in any organ but commonly in skin and oral mucosa. Melanosis of the urinary bladder is an extremely rare benign condition and only a handful of cases been reported in the English literature before. In this article, we report a new case of urinary melanosis, describe the differential diagnostic features from pseudomelanosis and offer clues for correct diagnosis. We also provide comprehensive review of the literature on the subject.

  7. [Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

    Science.gov (United States)

    Mehrmann, Lena; Ollenschläger, Günter

    2014-01-01

    Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care.

  8. Isolated pulmonary vasculitis: case report and literature review.

    Science.gov (United States)

    Riancho-Zarrabeitia, Leyre; Zurbano, Felipe; Gómez-Román, Javier; Martínez-Meñaca, Amaya; López, Marta; Hernández, Miguel A; Pina, Trinitario; González-Gay, Miguel A

    2015-04-01

    Single-organ vasculitis has been reported to affect the skin, kidneys, central nervous system, peripheral nerves, genitourinary tract, calf muscles, aorta, coronary arteries, retina, or gastrointestinal tract. However, isolated pulmonary vasculitis is a very rare entity. Our aims were to describe a case of localized pulmonary vasculitis affecting medium-sized vessels and review the literature. A patient with localized pulmonary vasculitis affecting medium-sized vessels that presented as pulmonary arterial hypertension is described. A MEDLINE database search of cases with localized pulmonary vasculitis was also conducted. A 30-year-old man presented with pulmonary hypertension due to isolated pulmonary medium-sized vessel vasculitis that was confirmed histologically. Initially he responded to corticosteroids and vasodilator treatment, but therapy eventually lost efficacy. Treatment with rituximab was not effective, and as the clinical situation worsened, lung transplant was performed. Isolated large pulmonary vessel disease, often related to Takayasu disease or giant cell arteritis, may present as pulmonary artery hypertension, thus mimicking chronic thromboembolic disease. Medium- and small-vessel pulmonary vasculitis usually develops in the context of a systemic disease. Some cases of isolated small-vessel vasculitis have been reported presenting as diffuse alveolar hemorrhage. In contrast, our case developed pulmonary artery hypertension secondary to medium-sized vessels vasculitis. To our knowledge, this is the first case of lung transplantation in isolated pulmonary vasculitis. Pulmonary isolated vasculitis is a rare cause of pulmonary hypertension but it must be taken into consideration after more common disorders are excluded. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. A Case of Postsurgical Necrotizing Fasciitis Invading the Rectus Abdominis Muscle and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Francesco Carbonetti

    2014-01-01

    Full Text Available Necrotizing fasciitis is a life-threatening, soft tissue infection and an early diagnosis is needed to permit a prompt surgical and medical intervention. Due to the high fatal potential of the disease complications, the radiologist should distinguish necrotizing fasciitis from the most common soft tissue infections, in order to permit a prompt surgical and medical treatment. We present a case of a wide necrotizing fasciitis who presented at our emergency department and we also provide the basic tools, through a review of the literature, for the general radiologist to distinguish, with computed tomography and magnetic resonance imaging, necrotizing fasciitis from the most common infections that could present during our routine practice.

  10. Adrenal incidentaloma in thalassemia: a case report and literature review.

    Science.gov (United States)

    Gamberini, Maria Rita; Prandini, Napoleone; Chiodi, Elisabetta; Farneti, Carlotta; Garani, Maria Chiara

    2011-03-01

    In the last 30 years the development and widespread use of modern imaging techniques has caused a 20-time increase in the diagnosis of adrenal incidentaloma (AI). Among AIs myelolipoma (ML) is reported with a frequency up to 10%. In the literature 8 patients with adrenal masses in thalassaemia or chronic haemolytic anaemia have been reported: five cases were shown to have extramedullary haematopoiesis (EH) and 3 ML. We describe here a case of an adult male affected by beta thalassaemia intermedia and large bilateral lipomatous adrenal masses. The patient was referred to our ward at the age of 55 and underwent hormonal testing, MRI, and SPECT/CT scans. Adrenal masses were hormonally inactive, and fat-containing on MRI and CT scans. SPECT/CT examination with 99mTccolloid demonstrated the presence of marrow tissue. ML and EH are the only two tumours with marrow tissue among lipomatous adrenal masses. In our patient a brown nodular mass was resected and histologically classified as ML. In benign adrenal masses, radiological follow-up is indicated; in case of large bilateral masses adrenal function tests are suggested periodically in order to detect possible adrenal hypofunction.

  11. Primary nasopharyngeal Hodgkin's disease: case report and literature review

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    Benjaafar Nourredine

    2010-04-01

    Full Text Available Abstract Introduction Primary Hodgkin's disease of the nasopharynx is a rare and uncommon event. It has a relatively favorable prognosis and represents less than 1% of all documented cases of Hodgkin's disease. Case presentation A 40-year-old Arabic man presented initially with bilateral nasal obstruction, which was then followed by a significant involvement of his bilateral cervical lymph nodes. His nasopharyngeal biopsy together with immunohistochemistry analysis showed negative expressions of CD15, CD20 and CD3, but positive expressions of CD30 and epithelial membrane antigen. This confirmed the diagnosis of nasopharyngeal Hodgkin's disease of a mixed cellularity subtype. The disease was at stage IIEA. Our patient received four cycles of chemotherapy, which yielded a 75% response. This was followed by irradiation of his Waldeyer's ring and supraclavicular lymph nodes. He remains in good local control after 30 months of follow-up. Conclusion The literature review and our case report discuss the optimal management of this rare and atypical localization of Hodgkin's disease, which should be differentiated from lymphoproliferations associated with Epstein-Barr virus and non-Hodgkin's lymphoma.

  12. Urinothorax: Case report and systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Alexander Casallas

    2016-01-01

    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.

  13. Paratesticular Liposarcoma: A Case Report and Review of the Literature

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    Haider Alyousef

    2013-01-01

    Full Text Available Introduction. Liposarcoma is a rare pathological entity. By far it is the most common histological subtype of genitourinary sarcomas in adults. Approximately two hundred cases were reported in the literature. We are hereby presenting a case with a typical clinical scenario of paratesticular liposarcoma. Case report. A 75-year-old gentleman presented with a painless right hemiscrotal swelling that was progressively increasing in size over the last 6 years. Testicular tumour markers were negative. Imaging showed a heterogenous mass with fat component. Subsequently he underwent wide local excision that included the paratesticular mass along with the right testicle and all right inguinal canal contents up to the deep inguinal ring with the sparing of right illioinguinal nerve. Histopathological examination showed a well differentiated liposarcoma of the spermatic cord. He remained recurrence-free so far after 18 months of followup. Conclusion. Radical orchidectomy with wide local excision comprises the cornerstone of treatment of paratesticular liposarcoma. Due to the rarity of the disease there is no definite universal consensus of opinion as regards the role of radiotherapy and chemotherapy.

  14. Gallstone ileus: a case report and review of the literature.

    Science.gov (United States)

    Gasparrini, Marcello; Liverani, Andrea; Catracchia, Valeria; Conte, Stefano; Leonardo, Giacomo; Marino, Graziella; Milillo, Andrea; Mari, Francesco Saverio; Pezzatini, Massimo; Favi, Francesco

    2008-01-01

    Gallstone ileus is a rare complication of gallstone disease, accounting for 1-4% of all bowel obstructions. The phisiopathology is related to the presence of a bilio-enteric fistula. Cholecistoenteric fistulae occur in fewer than 1% of patients with gallstone. We present the case of an 83-years-old woman, complaining of acute abdominal pain, vomiting and mechanical obstruction at admission. She reported a past history of hypertension, recent miocardial ischaemia, diverticular disease and cholelithiasis. A CT scan revealed aerobilia, gastric and duodenal dilatation and a gallstone impacted just beyond the duodeno-jejunal junction. An exploratory supraumbilical laparotomy was performed: revealing a 4-cm gallstone impacted just caudal to the Treitz ligament. We then performed an enterolithotomy. According to the literature, enterolithotomy is the most commonly used surgical technique, whereas enterolithotomy combined with cholecistectomy and fistulectomy is indicated only in selected cases. The clinical presentation depends on impaction site and generally includes abdominal pain, nausea and vomiting. Some cases may present haematemesis due to mucosal erosion. The gold-standard investigation technique is CT scan.

  15. [Clinical cases and historical-medical didactics].

    Science.gov (United States)

    Berti, Giuseppina Bock

    2004-01-01

    The discovery of remarkable documents dating back to the thirties and coming from the Policlinico Surgical Clinic of Milan, offers the possibility to be read in a historical clue too and to compare the constant discordances with the clinical contemporary practice. The aim is to point out the relationship between yesterday knowledges and critical today interpretations. The analysis can be suggested because certainly instructive and formative, also within the historical-medical didactics students of the courses of degree in Medicine and Nursing since the first match with the Medical Faculty.

  16. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

    Science.gov (United States)

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-02-09

    This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ryan Chin Taw Cheong

    2016-01-01

    Full Text Available Congenital temporomandibular joint (TMJ ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1 much earlier insult to the TMJ, (2 reduced opportunity for neuromuscular development of the muscles of mastication, and (3 reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients.

  18. Fulminant musculoskeletal and neurologic sarcoidosis: case report and literature update

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    Sweeney, Ashley; Hammer, Richard; Evenski, Andrea; Crim, Julia [University of Missouri at Columbia, Columbia, MO (United States)

    2016-11-15

    We report a case of fulminant sarcoidosis in a 28-year-old man presenting with skin nodules, multifocal small and large joint arthralgias, and blurred vision. Characteristic bone, soft tissue, articular, and CNS findings were evident on multimodality imaging. Bony abnormalities included near-complete destruction of a distal phalanx, ''lace-like'' lucent lesions, erosive arthritis, lytic lesions with and without sclerotic margins, and bone marrow replacement visible only on MRI. The extent of bony disease at time of presentation was unusual. We review the widely varying reported prevalence of imaging findings of bony sarcoidosis in the literature, and discuss reasons for this variability. We found that musculoskeletal findings at US and MRI were less specific than radiographic and CT findings, but were useful in quantifying extent of disease. (orig.)

  19. [Laryngeal amyloidosis: a clinical case and review of literature].

    Science.gov (United States)

    Fries, S; Pasche, P; Brunel, C; Schweizer, V

    2015-09-30

    Amyloidosis consists of different forms of systemic or isolated organ lesions characterised by fibrillary protein deposits in extra-cellular tissue. The isolated involvement of the larynx is the most frequent form in the ENT sphere. We present a clinical case of a 67 year-old woman addressed for a sub-acute laryngitis resistant to conservative treatment, and finally diagnosed with laryngeal amyloidosis. We reviewed its physiopathology, the scientific literature as well as the different possibilities of management. Laryngeal amyloidosis is rare. A thorough additional work-up for the research of multifocal or systemic forms is highly recommended. The treatment aims at a minimal invasive endoscopic surgery with functional organ preservation.

  20. Autoscopic phenomena: case report and review of literature

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    Thomas Astrid

    2011-01-01

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

  1. Achromobacter species endocarditis: A Case Report and Literature Review

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    Catherine Derber

    2011-01-01

    Full Text Available Endocarditis due to Achromobacter species is a rare, yet serious, endovascular infection. Achromobacter species infective endocarditis is associated with underlying immunodeficiencies or prosthetic heart valves and devices. A case of prosthetic pulmonary valve endocarditis secondary to Achromobacter xylosoxidans subspecies denitrificans is described in the present report. This life-threatening infection was successfully treated with combined valve replacement and prolonged antibiotic therapy. A Medline/PubMed literature review of Achromobacter endocarditis was also performed. Achromobacter species are an uncommon, yet important, cause of nosocomial endocarditis. Given the significant associated morbidity and mortality, along with a high degree of intrinsic antibiotic resistance, Achromobacter species infective endocarditis remains a clinical treatment challenge.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  4. [Abdominal ectopic pregnancy. A case report and literature review].

    Science.gov (United States)

    Puch-Ceballos, Eduardo Erik; Vázquez-Castro, Rosbel; Osorio-Pérez, Ana Isabel; Ramos-Ayala, Montserrat; Villarreal-Sosa, Conrado Otoniel; Ruvalcaba-Rivera, Everardo

    2015-07-01

    Abdominal ectopic pregnancy is an extremely rare entity, which represents 1% of all ectopic pregnancies and is associated with high maternal and fetal morbidity and mortality. The maternal mortality risk of an abdominal ectopic pregnancy is seven to eight times greater than the risk of a tubal ectopic pregnancy and is 90 times greater than the risk of intrauterine pregnancy. This is a disease of difficult diagnosis that often takes place late. We report the case of a patient with an abdominal ectopic pregnancy, which was diagnosed by abdominal ultrasound in the second trimester; the patient was suc- cessfully treated with exploratory laparotomy with complete removal of the fetus and placenta. We provide a review of the literature on the risk factors for abdominal ectopic pregnancy, diagnostic tests and therapeutic options.

  5. Nasolacrimal Duct Mucocele: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Britto, Fernanda Carneiro Corujeira de

    2014-02-01

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

  6. Facial hemiatrophy: Review of literature and a case report

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    Manisha S Tijare

    2011-01-01

    Full Text Available A case report of hemifacial atrophy is presented in this paper. It is also known as Parry-Romberg syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by progressive atrophy of the skin, subcutaneous tissue, muscle, cartilage or bone; the condition can leave a marked deformity on one side of the face. The incidence and the cause of this alteration is debatable. The most common complications that appear in association to this health disorder are: trigeminal neuritis, facial paresthesia, severe headache and epilepsy. Now, plastic surgery with graft of autogenous fat can be performed, after stabilization of the disease, to correct the deformity. Orthodontic treatment can help in the correction of any associated malformation. This presentation gives a review of concern literature about the etiology, physiopathology, differential diagnosis and treatment of hemifacial atrophy.

  7. Ladybug hypersensitivity: report of a case and review of literature.

    Science.gov (United States)

    Ray, Jonathan N; Pence, Hobert L

    2004-01-01

    For years, allergists have known that inhalant allergens arise from insects such as flies, beetles, moths, cockroaches, and mites. Now, it is becoming evident that the Asian ladybeetle Harmonia axyridis possibly should be added to this list. Several cases have been reported recently in the literature describing patients suffering from allergic respiratory symptoms including rhinitis, conjunctivitis, and asthma related to exposure to ladybugs. These patients reveal positive skin-prick testing with ladybug extract and immunoglobulin E immunoblotting with the sera showing at least two distinct allergenic proteins. This species infests homes in very large numbers in the fall and winter months and stay there in a hibernation-like state until the warm weather arrives with early spring. We discuss avoidance measures, which are the key to successful treatment.

  8. Cutaneous pancreatic metastasis: a case report and review of literature.

    Science.gov (United States)

    Hafez, Hza

    2007-01-01

    Pancreatic cancer is one of the most lethal human cancers and continues to be a major unsolved health problem as we enter the 21st century. This is the case despite advances in imaging technology and surgical management. Indeed, 80-90% of pancreatic cancers are diagnosed either at the locally advanced stage or metastatic stage. Cutaneous metastases originating from pancreatic cancer are relatively rare. The most common site of cutaneous metastasis is the umbilicus, and it is known as the Sister Joseph's nodule. Very few patients have been reported with cutaneous lesions disclosing pancreatic carcinoma at sites other than the umbilical area. To our knowledge, there were no previous reports on cutaneous pancreatic metastasis in Egypt. This is a report of a patient with cutaneous pancreatic metastases at the neck, followed by a review of reported non-umbilical cutaneous metastases from pancreatic carcinoma in the literature.

  9. Adult Wilms' tumour: a case report with review of literature

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    Gowda KM Srinivasa

    2006-12-01

    Full Text Available Abstract Background Wilms' tumor is the commonest primary malignant renal tumor in childhood. Rarely, it may present in the adult age group. Case presentation We report a 48-year-old male presenting with flank pain and haematuria. Abdominal ultrasound revealed a right renal mass measuring 11 × 10 cms, and a clinical diagnosis of renal cell carcinoma was made. Nephrectomy was performed, and a final diagnosis of adult Wilms' tumor was made based on the criteria proposed by Kilton et al. Conclusion The possibility of an adult Wilms' tumor should be considered when a patient presents with pain in the flank and a renal mass. Rarity of the tumor favors documentation in literature.

  10. Plunging ranula in children: case report and literature review

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    Veronica Carlini

    2016-12-01

    Full Text Available Few cases of plunging ranulas (PRs occur during childhood and the lesions are frequently misdiagnosed. Here, a PR in a child is reported along with a literature review. A seven-year-old female complaining of swelling in the midline neck, left-submandibular region, was evaluated. No oral cavity or major salivary glands abnormalities were detected. On palpation, a soft, painless, and fluid-containing mass was observed. The suspicion PR was performed by ultrasound. The diagnosis was confirmed with a histopathological examination. The lesion was removed with a cervical approach, without recurrence. PR is an uncommon condition in children under 10 years of age. Differential diagnosis depends on clinical examination and ultrasonography. A computed tomography-scan and magnetic resonance imaging can be performed if the diagnosis remains uncertain. In pediatrics, the key to success of the treatment may rely on the radical excision of the cyst and sublingual gland, via an intraoral or submandibular approach.

  11. Plunging Ranula in Children: Case Report and Literature Review.

    Science.gov (United States)

    Carlini, Veronica; Calcaterra, Valeria; Pasqua, Noemi; Guazzotti, Marinella; Fusillo, Mario; Pelizzo, Gloria

    2016-11-17

    Few cases of plunging ranulas (PRs) occur during childhood and the lesions are frequently misdiagnosed. Here, a PR in a child is reported along with a literature review. A seven-year-old female complaining of swelling in the midline neck, left-submandibular region, was evaluated. No oral cavity or major salivary glands abnormalities were detected. On palpation, a soft, painless, and fluid-containing mass was observed. The suspicion PR was performed by ultrasound. The diagnosis was confirmed with a histopathological examination. The lesion was removed with a cervical approach, without recurrence. PR is an uncommon condition in children under 10 years of age. Differential diagnosis depends on clinical examination and ultrasonography. A computed tomography-scan and magnetic resonance imaging can be performed if the diagnosis remains uncertain. In pediatrics, the key to success of the treatment may rely on the radical excision of the cyst and sublingual gland, via an intraoral or submandibular approach.

  12. Modern negligence law: Contribution of the medical cases.

    Science.gov (United States)

    Hodgson, John

    The law on medical negligence is part of the law of negligence generally. It has played a significant part in developing two key aspects of the law. There are special rules to determine the standard of care expected of experts when advising and solving problems, and medical cases have largely shaped the law. Although cases on causation may arise in any area, several of the key cases happen to be medical ones. They are particularly likely to assist where there are alternative causes, as it is often difficult to distinguish the effects of disease from those of inappropriate treatment.

  13. PRIMARY TUBERCULOSIS OTITIS MEDIA: CASE PRESENTATION AND REVIEW OF LITERATURE

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    Shankar

    2014-12-01

    Full Text Available : INTRODUCTION: Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. The incidence of tuberculosis in the middle ear is very low and accounts for only 0.04% of all cases of chronic Suppurative otitis media. Its diagnosis is often delayed because it can easily be confused with other acute or chronic middle ear conditions, still the treatment of tuberculous otitis media is medical treatment with anti -tuberculous drugs and mastoid exploration if the temporal bone is involved and also to clear the disease from the middle ear cavity to avoid further complications. CASE PRESENTATION: A 21 year male patient presented with ear discharge, deafness and headache, diagnosed as primary tuberculous otitis media, treated with mastoidectomy and anti-tuberculous treatment. DISCUSSION: Primary tuberculous otitis media is very rare condition in adults, it is commonly seen in children which is also secondary to pulmonary tuberculosis / extra pulmonary tuberculosis the treatment of choice is anti tuberculous treatment for 06 months, surgery indicated to clear the disease from middle ear, temporal bone and to avoid further complications. CONCLUSION: Even though primary tuberculosis in middle ear and mastoid is very rare, the diagnosis is possible only with histological findings. In our case there was no signs of pulmonary / extra pulmonary tuberculosis, treated with mastoidectomy followed by anti - tuberculous treatment.

  14. Primary intramedullary neurocytoma: Case report and literature analysis

    Science.gov (United States)

    Montano, Nicola; Di Bonaventura, Rina; Coli, Antonella; Fernandez, Eduardo; Meglio, Mario

    2015-01-01

    Background: Primary intramedullary neurocytoma is extremely rare. Due to its rarity, it is difficult to collect a wide series in a single institution to perform a survival analysis and give indications about prognosis and treatment. Case Description: Here, we report on a case of a 37-year-old woman with primary intramedullary neurocytoma and perform a systematic statistical analysis of cases reported in the literature. Of 21 articles found, 15 studies and the present case (22 patients) were eligible for the analysis. We studied the impact of age, sex, number of involved levels (≤2 vs. >2), entity of resection, postoperative radiotherapy (RT), proliferation index (Ki67) on the neurological outcome of patients, and on the recurrence of the tumor. Comparison of categorical variables was performed by the χ2 statistic. The Kaplan–Meier curves were plotted to calculate the progression-free survival (PFS) of these patients. P < 0.05 was considered as statistically significant. The 1-year PFS was 95.45% and the 2-year PFS was 86.36%. A gross total resection was associated to a worsening of the neurological function with no impact on the tumor recurrence. Adjuvant RT significantly improved the neurological function. A lower Ki67 was strongly associated with a lower tumor recurrence. Conclusions: We think that the goal of the surgery should be to preserve a good neurological function even if a residual tumor has to be left. Ki67 should be always evaluated due to its impact on the prognosis. Although adjuvant RT significantly improved the neurological function, its role in preventing the tumor recurrence is not clearly defined. PMID:26673057

  15. Bilateral desmoid tumor of the breast: case seriesand literature review

    Science.gov (United States)

    Wongmaneerung, Phanchaporn; Somwangprasert, Areewan; Watcharachan, Kirati; Ditsatham, Chagkrit

    2016-01-01

    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

  16. Giant Pericardial Cyst: A Case Report and Review of Literature

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    Hekmat

    2016-01-01

    Full Text Available Pericardial cysts are rare lesions. These benign anomalies are located in the middle mediastinum. In this article, we present a 24-year-old man who was referred to the emergency department with dyspnea and persistent cough. In physical exam, no abnormality was found. His past medical history was normal. His trans-thoracic echocardiogram showed an echo-lucent space next to the right atrium at the right cardiophrenic angle. No pericardial effusion was found. The patient underwent surgery. After midsternotomy, a huge cyst measuring approximately 13 × 8 × 5 cm in diameters was found on the right side and outside the pericardium that was totally excised. After 5 days, the patient was discharged and pathologic report confirmed preoperative diagnosis of pericardial cyst. Giant pericardial cysts are not common and in this report, we will review published case reports.

  17. Giant ovarian tumour: case report and literature review

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    Shazwani Adnan

    2016-10-01

    Full Text Available A case of giant ovarian tumour containing total of 53 liters of serous fluid is reported here. A 61 year old postmenopausal lady presented with shortness of breath to the Casualty Department with underlying history of progressive abdominal distension for 10 years. Clinical assessment and abdominal ultrasound suggest diagnosis of giant ovarian tumour with concurrent pneumonia. Stabilization of her medical condition took priority before surgery. Both pre- and intraoperative drainage of the tumour were performed. Postoperative period was stormy but patient recovered well and was discharged on day 42 post-surgery. Histopathological examination confirmed benign papillary serous cystadenoma of the ovaries. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3601-3604

  18. Dual Ectopic Thyroid: A Case Report with Review of Literature

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    A. Sood

    2011-06-01

    Full Text Available The ectopic thyroid gland is a rare entity which is mostly found along the line of descent of"nthe thyroid gland. Most of the patients present with midline swelling and usually seek medical"nattention. Dual ectopic thyroid gland is even rarer. The clinical examination and different imaging"nmodalities establish its diagnosis. Radionuclide studies are highly sensitive and specific in"ndemonstrating the functional tissues in patients with ectopic thyroid, thereby guiding further"nmanagement. The authors reported a case of ectopic thyroid gland in a girl with midline neck"nswelling initially, subsequently lost to follow-up. She again presented with enlarged swelling after"na period of three years with dual ectopic thyroid in the neck region on thyroid scan. Thyroid"nscintigraphy demonstrated that progression in the size of ectopic glands was due to neglect in"ntreatment.

  19. Sporotrichosis as an unusual case of osteomyelitis: A case report and review of the literature

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    Henry T. Lederer

    2016-03-01

    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.

  20. Sertraline-Induced Rhabdomyolysis: A Case Report and Literature Review.

    Science.gov (United States)

    Snyder, Mitchell; Kish, Troy

    2016-01-01

    The objective of this study is to report a case of sertraline-induced rhabdomyolysis in a female patient with a history of depression. A 25-year-old Hispanic woman with a history of depression reported to the emergency department (ED) with a chief complaint of muscle swelling and soreness and dark urine. The patient's creatine phosphokinase was 15,103 U/L. Despite treatment with IV normal saline, the patient's symptoms persisted and the creatine phosphokinase continued to rise to a peak of 16,778 U/L on day 2. The patient reported completing a strenuous, although routine, exercise the day before arriving at the ED, and her medication history was only significant for sertraline. Of note, 6 weeks before her visit to the ED, sertraline was increased from 100 mg daily to 150 mg daily. The patient's rhabdomyolysis was attributed to sertraline in conjunction with recent exercise. Selective serotonin reuptake inhibitor (SSRI)-induced rhabdomyolysis has been documented in 5 case reports. Similar to most reports, our patient presented with rhabdomyolysis in the presence of both SSRI use and exercise. Unlike the majority of previous reports, our patient was not taking other medications with documented association to rhabdomyolysis and had performed routine exercise before presenting with rhabdomyolysis. Although the mechanism of SSRI-induced rhabdomyolysis is not known, a theory posits that sertraline may have a role in muscle contraction and relaxation, leading to shorter time to contracture and longer time of contraction. The use of sertraline and other SSRIs may be associated with development of rhabdomyolysis, especially in the presence of strenuous exercise.

  1. Empathy in medical education: A case for social construction.

    Science.gov (United States)

    Hirshfield, Laura E; Underman, Kelly

    2017-04-01

    In this brief review, we build upon suggestions in Pedersen's [1] excellent critical review of empathy research in medical education and make the case for an increase in social constructivist scholarship related to emotions and empathy within medical education contexts. In the process, we define social construction, as well as provide several key opportunities in which these types of theories could provide insights for medical educators. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Ulnar Nerve Injury as a Result of Galeazzi Fracture: A Case Report and Literature Review.

    Science.gov (United States)

    Roettges, Paul; Turker, Tolga

    2017-09-01

    Sparse documentation of Galeazzi fracture with associated nerve injury exists in the medical literature. The purpose of this report is to review the available literature in regard to incidence, nerve injury type, treatment strategies, and expected outcomes. We present a classic Galeazzi fracture dislocation with associated complete ulnar nerve transection injury at the level of the wrist. After rigid internal bony stabilization, allograft nerve repair was performed. The patient's presentation, operative management, recovery, and a thorough literature review are discussed. Fracture union was attained with near full wrist and elbow range of motion. Despite lack of ulnar nerve function return, the patient was able to resume manual labor occupation. Despite its close proximity to the dislocating distal radioulnar joint (DRUJ), thorough review reveals rare associated ulnar nerve palsy. If there is suspicion for nerve injury in the setting of open DRUJ dislocation, the nerve should be explored to identify possible entrapment or transection. Literature supports likely return of nerve function in cases of intact nerve; however, management of nerve transection remains debatable.

  3. Rhinocerebral mucormycosis in patients without predisposing medical conditions: a review of the literature.

    Science.gov (United States)

    Elinav, H; Zimhony, O; Cohen, M J; Marcovich, A L; Benenson, S

    2009-07-01

    Rhinocerebral mucormycosis is a rare disease, affecting almost exclusively patients with known predisposing conditions such as diabetes mellitus, immunocompromised status, haemochromatosis or major trauma. Subsequent to a case of rhinocerebral mucormycosis in a 78-year-old woman without any known risk factor, we reviewed the published English-language literature and found an additional 72 cases. Reviewing all the published case series of mucormycosis involving any site, the proportion of apparently normal hosts among cases of rhinocerebral mucormycosis was found to be 9.06% (95% confidence interval 6.7-11.8). These findings suggest that rhinocerebral mucormycosis in patients without known predisposing factors is more prevalent than was previously believed.

  4. Adolescent Vicissitudes and Medical Judgment: A Case Study.

    Science.gov (United States)

    Gallagher, Eugene B.; Farrall, Michael G.

    1987-01-01

    Notes usual presumption that pregnant adolescents are in good health but suffer from socioeconomic and cultural disadvantages, which the pregnancy will exacerbate. Presents case study to illustrate how problems of pregnant adolescent are more complex when she also has a severe medical handicap and when medical problems interact with the…

  5. Catatonia Secondary to Sudden Clozapine Withdrawal: A Case with Three Repeated Episodes and a Literature Review

    Directory of Open Access Journals (Sweden)

    John Bilbily

    2017-01-01

    Full Text Available A literature search identified 9 previously published cases that were considered as possible cases of catatonia secondary to sudden clozapine withdrawal. Two of these 9 cases did not provide enough information to make a diagnosis of catatonia according to the Diagnostic and Statistical Manual, 5th Edition (DSM-5. The Liverpool Adverse Drug Reaction (ADR Causality Scale was modified to assess ADRs secondary to drug withdrawal. From the 7 published cases which met DSM-5 catatonia criteria, using the modified scale, we established that 3 were definitive and 4 were probable cases of catatonia secondary to clozapine withdrawal. A new definitive case is described with three catatonic episodes which (1 occurred after sudden discontinuation of clozapine in the context of decades of follow-up, (2 had ≥3 of 12 DSM-5 catatonic symptoms and serum creatinine kinase elevation, and (3 required medical hospitalization and intravenous fluids. Clozapine may be a gamma-aminobutyric acid (GABA receptor agonist; sudden clozapine withdrawal may explain a sudden decrease in GABA activity that may contribute to the development of catatonic symptoms in vulnerable patients. Based on the limited information from these cases, the pharmacological treatment for catatonia secondary to sudden clozapine withdrawal can include benzodiazepines and/or restarting clozapine.

  6. Clostridium difficile associated reactive arthritis: Case report and literature review.

    Science.gov (United States)

    Legendre, Paul; Lalande, Valérie; Eckert, Catherine; Barbut, Fréderic; Fardet, Laurence; Meynard, Jean-Luc; Surgers, Laure

    2016-04-01

    Extra-gastro-intestinal tract manifestations associated with Clostridium difficile infection (CDI), including reactive arthritis (ReA), are uncommon. We report a case of ReA associated with a relapse of CDI in a 46-year-old woman. A toxigenic C. difficile strain was isolated from stools and characterized as PCR-ribotype 014/020/077. We conducted a comprehensive literature review of ReA associated with CDI (ReA-CDI). Diagnostic criteria for ReA-CDI were: (i) evidence of aseptic synovitis (confirmed by culture) developing during or immediately after colitis, (ii) presence of a toxigenic C. difficile strain in stool samples, and (iii) absence of other causes of colitis and arthritis. Forty-nine cases of ReA-CDI (excluding the present report) have already been described since 1976. Of these reports, Mean age of patients was 38 years (SD: 18.5), 46% were male, and 68% had HLA B27 genotype. Sixty-nine percent of patients received a β-lactamin treatment before CDI. ReA-CDI occurred a median 10 days (range 0-55 days) after CDI. Outcome was favorable in 90% of patients and oral non anti-inflammatory drugs were required for 55%. ReA-CDI remains uncommon. Compared to the general population, it is more likely observed in younger patients with HLA B27-positive genotype. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. [Case report and literature review: elbow fracture dislocation in children].

    Science.gov (United States)

    Guzmdn, R; Rincón, D; Camacho, J

    2015-01-01

    Elbow dislocation in children is a very infrequent traumatic event which was first described by Stimson in 1900 and then by Tachdjian in 1990. Its estimated incidence ranges from 3% to 6% of all elbow injuries, peaking at 13-14 years. Elbow trauma is classified considering the direction in which the proximal radioulnar joint shifts with respect to the humerus, into posterior and anterior dislocation. The former is the most frequent and accounts for 95% of cases. Elbow fracture dislocation is an even rarer event. The incidence rate of avulsion fracture of the medial epicondyle is 25-36%, of the lateral condyle 4%, of the olecranon 1.7%, of the radial head 8%, of the coronoid process 3.5%, and others, 3.5%. At present there is no consensus in the literature on how to treat this type of lesions, particularly because some authors advocate nonsurgical management, while others propose surgical management as the definitive treatment. What is clear, however, is that a late diagnosis or untimely treatment may affect the child's growth and lead to serious complications. The purpose of this study is to share our experience and good results with the surgical management of these infrequent cases.

  8. Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Annika Chadee

    2016-01-01

    Full Text Available Introduction. Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID, tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. Case. This paper represents two cases of heterotopic pregnancies as well as a literature review. Conclusion. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome.

  9. "Burn catatonia": a case report and literature review.

    Science.gov (United States)

    Quinn, Davin Kenneth

    2014-01-01

    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.

  10. Ear replanatation: a case report and literature review

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    Krešimir Božikov

    2013-10-01

    Full Text Available Background: Total ear amputation is a rare accident. The most common causes are traffic accidents (33 %, followed by fights (28 %. In 1980, Pennington et al. reported the first successful microsurgical ear replantation in a 29-year old man.Methods: An English literature review of trauma cases of total ear amputation showed only 13 successful replantations with arterial and venous microanastomoses. We present a case report of successful total ear replantation with arterial and vein microanastomoses in a 17-year old boy.Results: Our ear replantation with both arterial and venous anastomoses performed was successful and we achieved an excellent aesthetic outcome.Conclusion: The reason for such a low number of successful ear replantations is technical challenge due to small vessel diameter, difficult vessel identification, vessel approach and concomitant avulsion injury. The best aesthetic result in ear reconstruction is achieved by microsurgical replantation. The surgical technique depends on the intraoperative findings. Since ear replantation is a very challenging procedure, a microsurgeon needs to discuss with the patient the risk of partial/total necrosis of the replanted ear and the possibilities of other reconstructive options.

  11. Analyses of Medical Malpractice in Judicial Appraisal: 505 Cases

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    Meng You

    2015-01-01

    Full Text Available The purpose of this paper is to investigate and analyze the current situation of medical malpractice and make suggestions for preventative measures from a judicial appraisal standpoint. From 2002 to 2011, we conducted and analyzed 505 medicolegal malpractice experiments at the Fada Institute of Forensic Medicine and Science (FIFMS in Beijing, People′s Republic of China (PRC. We found that the occurrence of medical disputes in surgical and obstetrical/gynecological cases seemed more frequent. The main causes of medical disputes included issues regarding medical ethics, poor quality of the medical staff, equipment malfunctions, and dereliction of duty by the medical personnel. The reasons for dissatisfaction varied among the different levels of medical service. Basic medical services garnered the most complaints. If we can work to improve the moral and professional standards of the medical staff members, intensify their ethics, and foster good relationships between patients and medical professionals, the quality of medical care would improve and the number of disputes regarding medical services would be reduced.

  12. The framing effect in medical decision-making: a review of the literature.

    Science.gov (United States)

    Gong, Jingjing; Zhang, Yan; Yang, Zheng; Huang, Yonghua; Feng, Jun; Zhang, Weiwei

    2013-01-01

    The framing effect, identified by Tversky and Kahneman, is one of the most striking cognitive biases, in which people react differently to a particular choice depending whether it is presented as a loss or as a gain. Numerous studies have subsequently demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision-making. Compared to daily decisions, medical decisions are of low frequency but of paramount importance. The framing effect is a well-documented bias in a variety of studies, but research is inconsistent regarding whether and how variables influence framing effects in medical decision-making. To clarify the discrepancy in the previous literature, published literature in the English language concerning the framing effect was retrieved using electronic and bibliographic searches. Two reviewers examined each article for inclusion and evaluated the articles' methodological quality. The framing effect in medical decision-making was reviewed in these papers. No studies identified an influence of framing information upon compliance with health recommendations, and different studies demonstrate different orientations of the framing effect. Because so many variables influence the presence or absence of the framing effect, the unexplained heterogeneity between studies suggests the possibility of a framing effect under specific conditions. Further research is needed to determine why the framing effect is induced and how it can be precluded.

  13. Families, nurses and organisations contributing factors to medication administration error in paediatrics: a literature review

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    Albara Alomari

    2015-05-01

    Full Text Available Background: Medication error is the most common adverse event for hospitalised children and can lead to significant harm. Despite decades of research and implementation of a number of initiatives, the error rates continue to rise, particularly those associated with administration. Objectives: The objective of this literature review is to explore the factors involving nurses, families and healthcare systems that impact on medication administration errors in paediatric patients. Design: A review was undertaken of studies that reported on factors that contribute to a rise or fall in medication administration errors, from family, nurse and organisational perspectives. The following databases were searched: Medline, Embase, CINAHL and the Cochrane library. The title, abstract and full article were reviewed for relevance. Articles were excluded if they were not research studies, they related to medications and not medication administration errors or they referred to medical errors rather than medication errors. Results: A total of 15 studies met the inclusion criteria. The factors contributing to medication administration errors are communication failure between the parents and healthcare professionals, nurse workload, failure to adhere to policy and guidelines, interruptions, inexperience and insufficient nurse education from organisations. Strategies that were reported to reduce errors were doublechecking by two nurses, implementing educational sessions, use of computerised prescribing and barcoding administration systems. Yet despite such interventions, errors persist. The review highlighted families that have a central role in caring for the child and therefore are key to the administration process, but have largely been ignored in research studies relating to medication administration. Conclusions: While there is a consensus about the factors that contribute to errors, sustainable and effective solutions remain elusive. To date, families have not

  14. Obturator hernia: A case report and review of the literature.

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    Hodgins, Nicholas; Cieplucha, Krzysztof; Conneally, Padhraic; Ghareeb, Essam

    2013-01-01

    An obturator hernia is a rare condition but is associated with the highest mortality of all abdominal wall hernias. Early surgical intervention is often hindered by clinical and radiological diagnostic difficulty. The following case report highlights these diagnostic difficulties, and reviews the current literature on management of such cases. We present the case of an 86-year-old lady who presented with intermittent small bowel obstruction, clear hernial orifices, and right medial thigh pain. Pre-operative CT imaging was suggestive of an obstructed right femoral hernia. However, intra-operatively the femoral canal was clear and an obstructed hernia was found passing through the obturator foramen lying between the pectineus and obturator muscles in the obturator canal. Obturator hernias are notorious for diagnostic difficulty. Patients often present with intermittent bowel obstruction symptoms due to a high proportion exhibiting Richter's herniation of the bowel. Hernial sacs can irritate the obturator nerve within the canal, manifesting as medial thigh pain, and often no hernial masses can be detected on clinical examination. Increasing speed of diagnosis through early CT imaging has been shown to reduce the morbidity and mortality associated with obturator hernias. However, over-reliance on CT findings should be cautioned, as imaging and operative findings may not always correlate. A high suspicion for obturator hernia should be maintained when assessing a patient presenting with bowel obstruction particularly where intermittent symptoms or medial thigh pain are present. Rapid clinical and appropriate radiological assessment, followed by early surgery is critical to successful treatment. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Surgical Management of Calciphylaxis Associated with Primary Hyperparathyroidism: A Case Report and Review of the Literature

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    Jennifer Bishop

    2010-01-01

    Full Text Available Calciphylaxis, or calcific uremic arteriolopathy, commonly affects people with end-stage renal disease and carries with it a high rate of morbidity and mortality. Here, we present the unusual case of a 56-year-old woman, with extensive medical problems, who developed calciphylaxis in the presence of primary hyperparathyroidism. Our patient initially presented with bilateral, exquisitely tender thigh lesions. The diagnosis of calciphylaxis was rendered histologically by extensive calcification of the subcutaneous blood vessels. Subsequent parathyroidectomy identified the presence of a hyperactive mediastinal parathyroid adenoma, weighing 0.62 grams. Postoperatively, the patient had normalization of hypercalcemia and parathyroid hormone levels, with subsequent healing of her thigh wounds. Currently, there have been sixteen cases described in the English literature, with only nine being offered a potentially therapeutic parathyroidectomy. It is contingent upon the vigilant physician to diagnose and properly manage this difficult yet treatable condition.

  16. Malignant priapism due to penile metastases: Case series and literature review

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    Francesco De Luca

    2016-07-01

    Full Text Available Malignant priapism secondary to penile metastases is a rare condition. This term was originally used by Peacock in 1938 to describe a condition of painful induration and erection of the penis due to metastatic infiltration by a neoplasm. In the current literature there are 512 case reports. The primary tumor sites are bladder, prostate and rectum. The treatment has only palliative intent and consists of local tumor excision, penectomy, radiotherapy and chemotherapy. We present one case of malignant priapism originated from prostate cancer, and two from urothelial carcinoma of the bladder. Different approaches in diagnosis and therapy were performed. The entire three patient reported a relief of the pain following the treatment, with an improvement of their quality of life, even though it was only temporary as a palliative. Malignant priapism is a rare medical emergency. Penile/pelvis magnetic resonance imaging (MRI scan and corporal biopsies are considered an effective method of diagnosis of the primary organ site.

  17. Cataracts and Dupuytren disease: a case report and review of the literature.

    Science.gov (United States)

    Cutolo, Carlo A; Lombardo, Sara; Verticchio Vercellin, Alice C; Bertone, Chiara; De Amici, Mara; Antoniazzi, Elena; Milano, Giovanni

    2012-11-08

    Purpose. Dupuytren disease is an inherited proliferative and progressive connective disease. Ectopic disease may, however, be located distant from the palmar fascia. 
Methods. Case report and review of the literature. 
Results. We describe a case of symmetric bilateral posterior subcapsular cataracts associated with symmetric bilateral Dupuytren disease and symmetric bilateral Ledderhose disease in a 56-year-old Caucasian man. His medical history was negative for glucocorticoids intake, diabetes, and exposure to radiation. Serum transforming growth factor β (TGF-β)1 concentration has been evaluated and was found to be almost double compared to the controls. 
Conclusions. We speculate that the TGF-β plays an important role for ocular and connective tissue disorders.

  18. Twin Pregnancy with Hydatidiform Mole and Coexisting Fetus: Report of Three Cases and Review of Literature

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    Fariba Yarandi

    2009-03-01

    Full Text Available A twin pregnancy with a coexisting complete hydatidiform mole and a healthy fetus (CMCF is rare. Here we report three cases of CMCF with different clinical courses but similar outcome without a surviving neonate. Two women required uterine evacuation before 20 weeks of gestational age because of vaginal bleeding and medical complications and the other patient underwent termination of her pregnancy at 24 weeks of gestation due to severe pre-eclampsia. The pathologic diagnosis of complete hydatidiform mole was confirmed in each case and the chromosome complement was 46XX in two molar gestations and 46XY in one gestation. One of the three women required chemotherapy for treatment of low-risk gestational trophoblastic disease. The hCG level was normalized after 4 cycles and the patient was free of disease at 1 year follow-up. Review of the literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with CMCF are presented.

  19. Compartment syndrome after viper-bite in toddler: case report and review of literature.

    Science.gov (United States)

    Pietrangiolillo, Zaira; Frassoldati, Rossella; Leonelli, Virginia; Freschi, Rachele; Russomando, Antonia; Lucaccioni, Laura; Iughetti, Lorenzo

    2012-04-01

    Snakebites in Italy are a rare source of severe medical condition, except in case of venomous snakes. The venom causes both local and/or systemic complication which may determine death in 6-60 hours, particularly in children and the elderly. In fact, the same amount of venom affects children more severely than adults because of the reduced total dilution volume in children. The only specific and conflicting therapy for venomous snakebite is to administer the appropriate anti-venom; the remaining therapy is symptomatic and supportive. We describe the case of a 22-month-old child who, despite appropriate symptomatic treatment, developed severe signs and an acute compartment syndrome of the right upper limb, a rare complication of venom snakebite. Administration of antivenom and fasciotomy were needed to resolve the acute episode permitting a positive outcome. On the basis of literature review and our experience we hypothesize an algorithm for the treatment of these patients.

  20. Xanthogranulomatous Appendicitis in a Child: Report of a Case and Review of the Literature

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    Sura M. Al-Rawabdeh

    2013-01-01

    Full Text Available Xanthogranulomatous inflammation is a well-described inflammatory process, which may involve any organ but is most frequently encountered in the gall bladder and the kidney. There are rare reports of xanthogranulomatous appendicitis (XA in the adult population, but only one brief mention of such a diagnosis in a child. In this report, we describe the case of an 11-year-old boy who presented with clinical signs and symptoms of acute appendicitis necessitating appendectomy. Upon microscopic examination, the appendix showed the typical features of XA. To the best of our knowledge, this is the first well-described case XA in a noninterval appendix in a child. We also reviewed the limited medical literature on the subject.

  1. Post-traumatic pituitary apoplexy: Case presentation and review of literature

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    Domenico Billeci, M.D.

    2017-03-01

    Full Text Available Pituitary apoplexy is a dramatic condition that can occur spontaneously or triggered by various precipitating factors. Head trauma is a rare but well-recognized cause of apoplectics events. We present the case of an 81-year-old woman, with negative past medical history and under antiplatelet agents, who experienced an isolated VI cranial nerve palsy 24 h after a mild head trauma. Early brain CT revealed an unknown pituitary lesion without signs of intralesional bleeding. Only late brain MRI imaging revealed pituitary apoplexy together with a subarachnoid hemorrhage. After aggravation of neurological condition the patient, undergo endoscopic transsphenoidal decompression of cranial nerves with rapid deficits improvement. Our aim is to share our experience and to propose the first critical review of all cases of post-traumatic pituitary apoplexy described in literature. We also try to suggest some management advice for post traumatic pituitary apoplexy.

  2. Groove Pancreatitis: A Case Report and Review of Literature

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    Vallath Balakrishnan

    2007-09-01

    Full Text Available Context Groove pancreatitis is a rare type of segmental pancreatitis characterized by fibrous scars of the anatomic space between the dorsocranial part of the head of the pancreas, the duodenum, and the common bile duct. Case report A 40-year-old man, with a past history of chronic alcohol consumption presented with epigastric pain radiating to the back and intermittent vomiting and a weight loss of 9 kg. A CT of the abdomen revealed swelling of the pancreatic head, a hypodense mass and duodenal wall thickening with luminal narrowing. Peripancreatic fluid and dense strands were also seen. Upper gastrointestinal endoscopy revealed an edematous, shiny, reddish raised mucosa having a polypoid appearance with narrowing of the second portion of the duodenum. Histological examination of the duodenal biopsy specimens showed preservation of the crypt-villus ratio, and the submucosa showed Brunner gland hyperplasia. These findings appeared consistent with the diagnosis of groove pancreatitis. Presently, the patient is on conservative medical management with analgesics, proton pump inhibitors and a pancreatic enzyme supplement. Conclusions Groove pancreatitis often masquerades as pancreatic head carcinoma. This condition should be kept in mind when making the differential diagnosis between pancreatic masses and duodenal stenosis. In all cases of focal pancreatitis involving the head or uncinate process of the pancreas with involvement of the adjacent duodenum, the possibility of groove pancreatitis should be considered.

  3. Congenital Unilateral Agenesis of the Parotid Gland: A Case Report and Review of the Literature

    Science.gov (United States)

    Teymoortash, Afshin

    2016-01-01

    Congenital unilateral agenesis of the parotid gland is a rare condition with only few cases reported in the literature. A review of 21 cases in the available literature is presented in this article. We report on a further case of a 34-year-old woman with agenesis of the left parotid gland and lipoma of the right cheek. Clinicopathological characteristics of described cases in the literature were discussed. PMID:27895943

  4. Do calculation errors by nurses cause medication errors in clinical practice? A literature review.

    Science.gov (United States)

    Wright, Kerri

    2010-01-01

    This review aims to examine the literature available to ascertain whether medication errors in clinical practice are the result of nurses' miscalculating drug dosages. The research studies highlighting poor calculation skills of nurses and student nurses have been tested using written drug calculation tests in formal classroom settings [Kapborg, I., 1994. Calculation and administration of drug dosage by Swedish nurses, student nurses and physicians. International Journal for Quality in Health Care 6(4): 389 -395; Hutton, M., 1998. Nursing Mathematics: the importance of application Nursing Standard 13(11): 35-38; Weeks, K., Lynne, P., Torrance, C., 2000. Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach. Clinical Effectiveness in Nursing 4, 20-29]; Wright, K., 2004. Investigation to find strategies to improve student nurses' maths skills. British Journal Nursing 13(21) 1280-1287; Wright, K., 2005. An exploration into the most effective way to teach drug calculation skills to nursing students. Nurse Education Today 25, 430-436], but there have been no reviews of the literature on medication errors in practice that specifically look to see whether the medication errors are caused by nurses' poor calculation skills. The databases Medline, CINAHL, British Nursing Index (BNI), Journal of American Medical Association (JAMA) and Archives and Cochrane reviews were searched for research studies or systematic reviews which reported on the incidence or causes of drug errors in clinical practice. In total 33 articles met the criteria for this review. There were no studies that examined nurses' drug calculation errors in practice. As a result studies and systematic reviews that investigated the types and causes of drug errors were examined to establish whether miscalculations by nurses were the causes of errors. The review found insufficient evidence to suggest that medication errors are caused by nurses' poor

  5. Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

    Science.gov (United States)

    Paredes Saenz, Carmen; Raju, Rubin; Cuthpert, Sierra; Kanzy, Abed; Abhari, Sina; Hebert III, John; Rocha, Frederico G.

    2016-01-01

    Introduction. Uterine leiomyomas, also called uterine fibroids or myomas, are the most common pelvic tumors in women. They are very rarely the cause of acute complications. However, when complications occur they cause significant morbidity and mortality. Thromboembolic disease has been described as a rare complication of uterine leiomyomas. DVT is a serious illness, sometimes causing death due to acute PE. Cases. We report a case series of 3 patients with thromboembolic disease associated with uterine leiomyoma at Hurley Medical Center, Flint, Michigan, during 2015 and conduct a literature review on the topic. A literature search was conducted using Medline, PubMed, and PMC databases from 1966 to 2015. Conclusion. The uterine leiomyoma is a very rare cause of PE and only few cases have been reported. DVT secondary to uterine leiomyoma should be considered in a female presenting with abdominal mass and pelvic pressure, if there is no clear common cause for her symptoms. Thromboembolic disease secondary to large uterine leiomyoma should be treated with acute stabilization and then hysterectomy. Prophylactic anticoagulation would be beneficial for lowering the risk of VTE in patients with large uterine leiomyoma. PMID:27885348

  6. A critical analysis of the hepatotoxicity cases described in the literature related to Herbalife (r products

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    Flávio Ailton Duque Zambrone

    2015-12-01

    Full Text Available Abstract The aim of this study was to assess the hepatotoxicity cases described in the literature, attributed to the consumption of Herbalife(r products, and to determine whether a causal relationship exists between the reported cases of liver injury and the use of these products. A literature search was performed on the PubMed, LILACS and PAHO databases. Seven publications reporting a total of 53 cases of hepatotoxicity linked to the use of Herbalife(r products were retrieved. All of the studies lacked sufficient information to some degree, whether related to patients' history, concomitant use of medication and/or other compounds (including alcohol, observations on interrupted use (dechallenge, results found with markers, viral serology and autoantibodies or observations concerning re-exposure to the products. In addition to these items, the lack of clear information on the type of products evaluated and their respective composition is an important factor to be considered. Furthermore, data quality was also questionable due to the presence of confounding factors, absence of proper exclusion of alternative explanations, and the use of questionable methods for attributing causality. Hence, an association between hepatotoxicity and consumption of these products cannot be proven based on the data collected and rigorous scientific analysis.

  7. Gastric femoral hernia in a male cadaver with gastroptosis: case report and review of the literature.

    Science.gov (United States)

    Natsis, K; Apostolidis, S; Papadopoulou, A L; Vlasis, K; Totlis, T; Skandalakis, P

    2008-04-01

    The shape and the position of the stomach and its anatomic relations to the round viscera vary from individual to individual, but they also vary in the same subject depending on many factors. The downward displacement of the stomach is called gastroptosis. In the literature, there are only five case reports where the stomach constituted the content of a femoral hernia. The current study presents a case of a gastric femoral hernia in a cadaver along with a review of the relevant literature. During routine dissection of a 67-year-old male cadaver with a very large stomach and gastroptosis, a femoral hernia containing a part of the great curvature of the stomach was found. The length of the hernia sac was 5 cm, and its width was 3.5 cm. There was a disposition of the intestinal coils to the posterior wall and the lesser pelvis. The cadaver's former medical history and skin observation before dissection excluded any previous abdominal surgery. This is the second case of stomach herniation through the femoral ring in a male subject ever reported. The symptoms in this pathology vary from complete absence to symptoms due to high stenosis of the digestive tract, stomach strangulation and stomach wall necrosis.

  8. Class 1 devices case studies in medical devices design

    CERN Document Server

    Ogrodnik, Peter J

    2014-01-01

    The Case Studies in Medical Devices Design series consists of practical, applied case studies relating to medical device design in industry. These titles complement Ogrodnik's Medical Device Design and will assist engineers with applying the theory in practice. The case studies presented directly relate to Class I, Class IIa, Class IIb and Class III medical devices. Designers and companies who wish to extend their knowledge in a specific discipline related to their respective class of operation will find any or all of these titles a great addition to their library. Class 1 Devices is a companion text to Medical Devices Design: Innovation from Concept to Market. The intention of this book, and its sister books in the series, is to support the concepts presented in Medical Devices Design through case studies. In the context of this book the case studies consider Class I (EU) and 510(k) exempt (FDA) . This book covers classifications, the conceptual and embodiment phase, plus design from idea to PDS. These title...

  9. Global health competencies and approaches in medical education: a literature review.

    Science.gov (United States)

    Battat, Robert; Seidman, Gillian; Chadi, Nicholas; Chanda, Mohammed Y; Nehme, Jessica; Hulme, Jennifer; Li, Annie; Faridi, Nazlie; Brewer, Timothy F

    2010-12-22

    Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training. A literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools. Using a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches. This review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

  10. Global health competencies and approaches in medical education: a literature review

    Directory of Open Access Journals (Sweden)

    Hulme Jennifer

    2010-12-01

    Full Text Available Abstract Background Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training. Methods A literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools. Results Using a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches. Conclusions This review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

  11. Case report medical eponyms: an applied clinical informatics opportunity.

    Science.gov (United States)

    Baskaran, L N Guptha Munugoor; Greco, P J; Kaelber, D C

    2012-01-01

    Medical eponyms are medical words derived from people's names. Eponyms, especially similar sounding eponyms, may be confusing to people trying to use them because the terms themselves do not contain physiologically descriptive words about the condition they refer to. Through the use of electronic health records (EHRs), embedded applied clinical informatics tools including synonyms and pick lists that include physiologically descriptive terms associated with any eponym appearing in the EHR can significantly enhance the correct use of medical eponyms. Here we describe a case example of two similar sounding medical eponyms--Wegener's disease and Wegner's disease-- which were confused in our EHR. We describe our solution to address this specific example and our suggestions and accomplishments developing more generalized approaches to dealing with medical eponyms in EHRs. Integrating brief physiologically descriptive terms with medical eponyms provides an applied clinical informatics opportunity to improve patient care.

  12. Ophthalmic Timolol Hallucinations: A Case Series and Review of the Literature.

    Science.gov (United States)

    Nanda, Tavish; Rasool, Nailyn; Callahan, Alison B; Stamper, Robert L; Odel, Jeffrey G

    2017-09-01

    Systemic absorption and central nervous system (CNS) penetration of timolol drops are a well-studied phenomenon, resulting in common side effects such as bradycardia, bronchospasm, fatigue, and confusion. More serious CNS side effects, such as psychosis and depression, however, are rarely attributed to eye drops. We report a case series in which patients developed visual hallucinations secondary to topical ocular timolol use. This study is a case series and review of the literature. Four patients with glaucoma developed visual hallucinations while using topical timolol. The patients were all elderly, caucasian females with associated CNS pathology. All patients had resolution of symptoms upon discontinuation and a positive retrial test to confirm the association. The rarity of this side effect and its anecdotal predilection for elderly, caucasian females with underlying neurological dysfunction, may involve a yet unknown predisposition or hypersensitivity to beta blocker action, such as blood brain barrier disruption leading to increased susceptibility to the medication. This case series highlights an important, although rare, side effect of this medication which clinicians should be aware of especially when using it in elderly patients who may have coexisting CNS pathology. It is important that this side effect be recognized and appropriately managed to prevent otherwise unnecessary investigations and treatment.

  13. Survey of Medical Literature Borrowed from the National Lending Library for Science and Technology *

    Science.gov (United States)

    Wood, David N.; Bower, Cathryn A.

    1969-01-01

    This paper reports the results of a four-week questionnaire survey carried out at the National Lending Library (N.L.L.), Great Britian, to discover which types of organizations were the principal users of medical literature, what types of literature were used, and which were the main sources of references to medical publications. Industrial organizations and universities accounted for the majority (62 percent) of the loans, most of which were English-language periodicals published since 1960. For the whole sample, citation lists in periodical articles were the principal sources of references, although for literature published in the last fifteen months, abstracting and indexing journals were the main sources. Of the latter, Index Medicus proved to be the most fruitful source of references. By asking whether the item requested was really useful to their work, a measure of the reliability of the different sources of references was obtained. Appendixes include the questionnaire, a list of the most frequently borrowed journals, and a list of abstracting and indexing journals used as sources of references. PMID:5782264

  14. Hepatopulmonary hydatidosis: pediatric case report and literature review

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    Sebastián Paredes

    2014-12-01

    Full Text Available Hydatidosis is a parasitic zoonosis of the genus Echinococcus that infects herbivores and humans in its larvae stage (hydatid. Pediatric hydatidosis usually presents with involvement of the lung, in contrast to the adult clinical picture. Therefore, hepatopulmonary hydatidosis is an unusual entity in children. A clinical case is presented, along with a short review of available literature. A thirteen-year-old male child, who lives in Cauquenes, a rural area of Central Chile, presents with three months of cough, fever, malaise, and an abdominal mass. Imaging reveals multiple cystic images, located mostly in the right lung and the liver. The patient is started on albendazole (15 mg/kg/day and transferred to the Pediatric Surgery Unit in Hospital de Talca. He underwent thoracotomy and laparotomy for the removal of the hydatid cysts. He recovered from surgery and continued his pharmacological treatment. Hydatidosis is a public healthcare problem, and a major cause of morbidity and mortality. It can be asymptomatic; thus, its diagnosis requires a high level of suspicion.

  15. Intranodal palisaded myofibroblastoma - a rare case report and literature review.

    Science.gov (United States)

    Karabulut, Yasemin Yuyucu; Kara, Tuba; Berkeşoğlu, Mustafa

    2016-10-01

    Intranodal palisaded myofibroblastoma (IPM) is a benign mesenchymal neoplasm originating from smooth muscle cells and myofibroblasts. The inguinal region is the most common site of this rare tumor. As there are only about 89 such cases reported in the literature, the precise etiology and pathogenesis have yet to be explained adequately. It is characterized by spindle cells, amianthoid fibers, and by the proliferation of hemosiderin-containing histiocytes in the lymph node. A nodular lesion was excised from the inguinal region of a 47-year-old female patient with the clinical diagnosis of lymphoma and/or metastase. Macroscopic examination of a section of the lesion demonstrated a solid appearance. Microscopic examination revealed spindle-cell proliferation, amianthoid fibers, hemosiderin pigment, and extravasated erythrocytes. Nuclei of the spindle cells displayed a palisaded appearance. Compressed lymphoid tissue was observed around the lesion. Neoplastic cells were identified by the presence of vimentin, SMA, Cyclin D1, and beta-catenin. The Ki67 index was less than 1%. Histological examination confirmed the diagnosis of IPM. Although IPM is benign, it is frequently confused with metastatic lesions and lymphomas.

  16. Onodi cell mucocele: Case report and review of the literature.

    Science.gov (United States)

    Lee, John M; Au, Michael

    2016-09-01

    Onodi cell mucoceles are rare entities that can cause devastating ocular complications if not treated promptly. Delays in the diagnosis are possible because of the wide range of differential diagnoses of unilateral retrobulbar optic neuropathy. We describe a new case of Onodi cell mucocele in a 39-year-old woman, and we present a comprehensive review of the literature on this entity. To the best of our knowledge, no review of Onodi cell mucoceles has been previously published. Our review found that 69% of patients with an Onodi cell mucocele experienced an improvement in vision after surgical decompression. The vast majority of these patients underwent endoscopic decompression; the timing of surgical decompression did not appear to affect outcomes in terms of vision. Onodi cell mucocele requires a high degree of clinical suspicion for diagnosis and a multidisciplinary approach to management that involves primary care physicians, ophthalmologists, and otolaryngologists. Early surgical treatment via an endoscopic approach is recommended for most patients, regardless of the duration of their ophthalmologic signs and symptoms.

  17. Recessive omodysplasia: five new cases and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Elcioglu, Nursel H. [Department of Pediatric Genetics, Marmara University Hospital, Tophanelioglu cad 15, Altunizade, 34660 Istanbul (Turkey); Gustavson, Karl H. [Department of Clinical Genetics, Uppsala University Children' s Hospital, Uppsala (Sweden); Wilkie, Andrew O.M. [Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford (United Kingdom); Yueksel-Apak, Memune [Institute of Child Health, University of Istanbul, Istanbul (Turkey); Spranger, Juergen W. [Universitaets-Kinderklinik Mainz, Mainz (Germany); Greenwood Genetic Center, Greenwood, South Carolina (United States)

    2004-01-01

    Autosomal recessive omodysplasia (MIM 258315) is a rare skeletal dysplasia characterized by severe congenital micromelia with shortening and distal tapering of the humeri and femora to give a club-like appearance. Fewer than 20 cases have been reported in the literature so far. The purpose of this study was to more clearly describe the clinical and radiographic phenotypes and their changes with age. Five new patients, including two sibs, with autosomal recessive omodysplasia are presented. Clinical features are rhizomelic dwarfism with limited extension of elbows and knees and a distinct face with a short nose, depressed nasal bridge, long philtrum, midline haemangiomas in infants and cryptorchidism in males. Radiological findings are distal hypoplasia of the short humerus and femur with characteristic radial dislocation and radioulnar diastasis. Based on a review of these and 16 previously reported patients, the regressive nature of the humerofemoral changes and the obvious male predominance are stressed. Phenotypic similarities with the atelosteogenesis group of disorders and with diastrophic dysplasia suggest common pathogenetic mechanisms. (orig.)

  18. Solitary subdural osteoma: A case report and literature review

    Science.gov (United States)

    Cao, Lei; Hong, Lichuan; Li, Chuzhong; Zhang, Yazhuo; Gui, Songbai

    2016-01-01

    Osteomas attached to the meninges unrelated to bone are extremely rare and their etiology has not been discussed previously in the English literature. Here, we report the case of a 54-year-old male patient with a right frontal subdural osteoma. The patient presented with a ~5-month history of intermittent dizziness. Non-contrasted computerized tomography demonstrated a densely calcified mass attached to the inner surface of the right frontal skull. Magnetic resonance imaging (MRI) revealed this mass could be enhanced by contrast MRI. Intraoperatively, the hard mass was noted to be attached to the inner layer of the dura mater, and not associated with the bone. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue, which contributed to the MRI enhancement. It was speculated that subdural osteomas arose from ectopic osteoblasts derived from the embryological neural crest cells. The context of intertrabecular bone marrow contributed to the enhancement on MRI. Simple excision is the treatment of choice for symptomatic lesions. PMID:27446388

  19. Spinal angiolipoma: case report and review of literature.

    Science.gov (United States)

    Oge, H K; Söylemezoglu, F; Rousan, N; Ozcan, O E

    1999-08-01

    Spinal extradural angiolipomas are distinct, benign, and rare lesions composed of mature lipocytes admixed with abnormal blood vessels. They account for 0.14% of all spinal axis tumors. The case described here was a 72-year-old patient presenting with a history of paraparesis, hypoesthesia under the T2 level, hyperreflexia, and urinary overflow incontinence that appeared within 7 days after the administration of a coronary vasodilator drug regimen. The spinal magnetic resonance scan showed a lipomatous mass with signal void lesions, suggesting a vascular component of the tumor. The patient improved rapidly after surgical resection of the epidural tumor and decompression of the cord. According to the present literature, the duration of neurological symptoms ranges from 1 to 180 months (mean 28 months). But this patient's neurological deterioration took place 4 days before hospitalization. We believe that this can be explained by the increased tumor blood volume caused by vasodilator drugs, which in turn exerted a pulsatile compressive effect on the cord.

  20. Occipital condyle fractures: report of five cases and literature review.

    Science.gov (United States)

    Caroli, Emanuela; Rocchi, Giovanni; Orlando, Epimenio Ramundo; Delfini, Roberto

    2005-06-01

    Occipital condyle fractures (OCFs) are uncommon and potentially fatal lesions. After the advent of CT, prompt diagnosis can be readily made and consequently better prognosis of these patients is expected. Early recognition of some types of OCF is imperative to avoid fatal results. We analyzed 121 cases of OCF (116 from the literature and five of our own). Rarely patients with a deficit of the lower cranial nerves make a complete recovery. However, quoad vitam prognosis of patients with "pure OCFs" remains good. Immobilization provides good recovery of most OCFs, but delay of treatment can lead to serious morbidity. We want to emphasize that not only an OCF with instability of O-C1-C2 can be a fatal injury unless prompt surgical intervention, but a displacement and migration of the fractured condylar fragment can also result in a fatal outcome. A high level of suspicion is fundamental for the early diagnosis of these fractures, so that when a posterior basal cranial or occipital squama fracture occurs, a CT study of the occipital condyles becomes imperative.

  1. Diagonal ear lobe crease and atherosclerosis: a review of the medical literature and dental implications.

    Science.gov (United States)

    Friedlander, Arthur H; López-López, José; Velasco-Ortega, Eugenio

    2012-01-01

    In Spain a significant number of individuals die from atherosclerotic disease of the coronary and carotid arteries without having classic risk factors and prodomal symptoms. The diagonal ear lobe crease (DELC) has been characterized in the medical literature as a surrogate marker which can identify high risk patients having occult atherosclerosis. This topic however has not been examined in either the medical or dental literature emanating from Spain. The majority of clinical, angiography and postmortem reports support the premise that DELC is a valuable extravascular physical sign able to distinguish some patients at risk of succumbing to atherosclerosis of the coronary arteries. A minority of studies have however failed to support this hypothesis. More recently reports using B mode ultrasound have also linked DELC to atherosclerosis of the carotid artery and another report has related DELC to the presence of calcified carotid artery atheromas on panoramic radiographs. DELC is readily visible during head and neck cancer screening examinations. In conjunction with the patient's medical history, vital signs, and panoramic radiograph, the DELC may assist in atherosclerotic risk.

  2. From Cases to Projects in Problem-Based Medical Education

    Science.gov (United States)

    Stentoft, Diana; Duroux, Meg; Fink, Trine; Emmersen, Jeppe

    2014-01-01

    Problem-based learning (PBL) based on patient cases has become a well-established worldwide educational approach in medical education. Recent studies indicate that case-based PBL when used throughout an entire curriculum may develop into a counter-productive routine for students as well as teachers. Consequently, there is a need to develop PBL…

  3. The application of heterogeneous cluster grouping to reflective writing for medical humanities literature study to enhance students' empathy, critical thinking, and reflective writing

    National Research Council Canada - National Science Library

    Liao, Hung-Chang; Wang, Ya-Huei

    2016-01-01

    ... grouping in reflective writing for medical humanities literature acquisition could have positive effects on medical university students in terms of empathy, critical thinking, and reflective writing...

  4. From cases to projects in problem-based medical education

    Directory of Open Access Journals (Sweden)

    Diana Stentoft

    2014-06-01

    Full Text Available Problem-based learning (PBL based on patient cases has become a well-established worldwide educational approach in medical education. Recent studies indicate that case-based PBL when used throughout an entire curriculum may develop into a counter-productive routine for students as well as teachers. Consequently, there is a need to develop PBL approaches further allowing students to work with more ill-defined problems and alternative learning structures. In this paper, we argue that this can be realised by introducing project-PBL into the medical curriculum, as in the medical education at Aalborg University, Denmark. We outline organisations of case- and project- PBL in the medical curriculum and present an explorative study of 116 first and second year students’ experiences working in the two settings of PBL. Results reveal that students generally rate their PBL experiences positively however, project-PBL is rated more positively than case-PBL on all parameters studied. These results invite further consideration of the differences in working with cases and projects. Two central differences are discussed; the nature of the problem as the trigger of learning and students' possibilities for directing their own learning processes. The study demonstrates that introducing project-PBL may contribute significantly in problem-based medical education. However, the need for extensive research into advantages and limitations of the combined use of case- and project-PBL is also emphasised.

  5. Atypical Proliferating Trichilemmal Cyst with Malignant Breast Skin Transformation: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Marino Antonio Capurso-García

    2016-01-01

    Full Text Available Proliferating trichilemmal tumors (PTTs are benign adnexal skin neoplasms that arise from the outer root sheath of the hair follicle. These tumors are most commonly observed on the scalp and occur, most of the time, in elderly women. Malignant transformation of these neoplasms is a rare event; less than 50 cases have been reported in the English medical literature. We present the case of a 39-year-old Hispanic woman with a tumor located on the skin of one of her breasts that in her third surgical procedure the histologic examination revealed the presence of a malignant proliferating trichilemmal tumor (MPTT. Furthermore, a review of the medical literature and a discussion of the clinical and pathologic features of this rare entity are provided.

  6. Non-nosocomial healthcare-associated left-sided Pseudomonas aeruginosa endocarditis: a case report and literature review.

    Science.gov (United States)

    Hagiya, Hideharu; Tanaka, Takeshi; Takimoto, Kohei; Yoshida, Hisao; Yamamoto, Norihisa; Akeda, Yukihiro; Tomono, Kazunori

    2016-08-20

    With the development of invasive medical procedures, an increasing number of healthcare-associated infective endocarditis cases have been reported. In particular, non-nosocomial healthcare-associated infective endocarditis in outpatients with recent medical intervention has been increasingly identified. A 66-year-old man with diabetes mellitus and a recent history of intermittent urethral self-catheterization was admitted due to a high fever. Repeated blood cultures identified Pseudomonas aeruginosa, and transesophageal echocardiography uncovered a new-onset severe aortic regurgitation along with a vegetative valvular structure. The patient underwent emergency aortic valve replacement surgery and was successfully treated with 6 weeks of high-dose meropenem and tobramycin. Historically, most cases of P. aeruginosa endocarditis have occurred in the right side of the heart and in outpatients with a history of intravenous drug abuse. In the case presented, the repeated manipulations of the urethra may have triggered the infection. Our literature review for left-sided P. aeruginosa endocarditis showed that non-nosocomial infection accounted for nearly half of the cases and resulted in fatal outcomes as often as nosocomial cases. A combination therapy with anti-pseudomonal beta-lactams or carbapenems and aminoglycosides may be the preferable treatment. Medical treatment alone may be effective, and surgical treatment should be carefully considered. We presented a rare case of native aortic valve endocarditis caused by P. aeruginosa. This case illustrates the importance of identifying the causative pathogen(s), especially for outpatients with a recent history of medical procedures.

  7. Cerebellar Hemangioblastoma: Four Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sevgi Bakaris

    2015-03-01

    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

  8. Necrotizing Fasciitis Complicating Pregnancy: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Marinos Nikolaou

    2014-01-01

    Full Text Available Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. A 15-year-old primigravid woman, at 28 weeks of gestation with no significant previous medical history, was admitted to our hospital complaining of severe left lower extremity pain and high fever the last 72 hours. During clinical examination, she had a swollen, erythematous and tender to palpation inflamed skin over the medial aspect of the upper thigh without any evidence of injury. Incision drainage was performed immediately and she received broad spectrum antibiotics. During initial laboratory examinations, diabetes mellitus was diagnosed. There was no clinical improvement over the following days. Magnetic resonance imaging (MRI revealed subcutaneous tissue inflammation and edema of infected tissues confirming the disease entity. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intensive care monitoring was performed successfully. The patient’s postoperative course was uncomplicated and skin defect was closed with split thickness skin grafting. Our case emphasized the potential immunosuppressive role of pregnancy state in conjunction with diabetes mellitus in the development of severe necrotizing soft tissue infections.

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

    Directory of Open Access Journals (Sweden)

    Rashmi Mishra

    2016-01-01

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

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

    Science.gov (United States)

    Reddy, Pavithra; Khaja, Misbahuddin

    2016-01-01

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

  11. Current concepts in hypophosphatasia: case report and literature review.

    Science.gov (United States)

    Hollis, Amy; Arundel, Paul; High, Alec; Balmer, Richard

    2013-05-01

    BACKGROUND.  Hypophosphatasia (HP) is characterized by defective mineralization of bone and teeth because of deficient alkaline phosphatase activity. There are generally six recognized clinical forms, of which the most severe is often lethal prenatally or early in life. In milder forms, such as odontohypophosphatasia (OHP), premature exfoliation of primary teeth may be the only clinical manifestation. CASE REPORT.  A 20-month-old girl was referred to the Specialist Paediatric Salaried Dental Service within the Harrogate and District NHS Foundation Trust with mobility of tooth numbers 71 and 81. Clinical examination revealed grade III mobile 71 and 81, with minimal gingival inflammation and plaque deposits. There were no other dental findings and no significant medical history. Tooth numbers 71 and 81 exfoliated prematurely with no evidence of root resorption, shortly after presentation. Haematological and urinary investigations showed no abnormalities. Histological examination showed a complete absence of cementum. A diagnosis of OHP was made. After 10 months of dental follow-up, no further teeth have increased mobility. CONCLUSION.  Odontohypophosphatasia should be included as a differential diagnosis in children presenting with early loss of primary teeth. The dentist may be the first health care professional to whom the patient presents.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dora Buonfrate

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

  14. Long-term effects of forgotten biliary stents: a case series and literature review

    Science.gov (United States)

    Odabasi, Mehmet; Arslan, Cem; Akbulut, Sami; Abuoglu, Haci Hasan; Ozkan, Erkan; Yildiz, Mehmet Kamil; Eris, Cengiz; Gunay, Emre; Tekesin, Kemal; Muftuoglu, Tolga

    2014-01-01

    There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. Past history and medical documents submitted by the patient did not indicate a replacement of the biliary stent in 3 patients. Two patients knew that they had biliary stents. We also conducted a literature review via the PubMed and Google Scholar databases of English language studies published until March 2014 on forgotten biliary stent. There were 3 men and 2 women ranging in age from 22 to 68 years (mean age 41.6 years). Patients presented with pain in the upper abdomen, jaundice, fever, abnormal liver function tests or dilatation of the biliary tract alone or in combination. Patients’ demographic findings are presented in Table 1. A review of three cases reported in the English medical literature also discussed. The mean duration of the patency of the stent is about 12 months. The biliary stenting is performed either with plastic or metal stents, studies recommending their replacement after 3-6 months. Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient. PMID:25232385

  15. Long-term effects of forgotten biliary stents: a case series and literature review.

    Science.gov (United States)

    Odabasi, Mehmet; Arslan, Cem; Akbulut, Sami; Abuoglu, Haci Hasan; Ozkan, Erkan; Yildiz, Mehmet Kamil; Eris, Cengiz; Gunay, Emre; Tekesin, Kemal; Muftuoglu, Tolga

    2014-01-01

    There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. Past history and medical documents submitted by the patient did not indicate a replacement of the biliary stent in 3 patients. Two patients knew that they had biliary stents. We also conducted a literature review via the PubMed and Google Scholar databases of English language studies published until March 2014 on forgotten biliary stent. There were 3 men and 2 women ranging in age from 22 to 68 years (mean age 41.6 years). Patients presented with pain in the upper abdomen, jaundice, fever, abnormal liver function tests or dilatation of the biliary tract alone or in combination. Patients' demographic findings are presented in Table 1. A review of three cases reported in the English medical literature also discussed. The mean duration of the patency of the stent is about 12 months. The biliary stenting is performed either with plastic or metal stents, studies recommending their replacement after 3-6 months. Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient.

  16. A clear cell adenocarcinoma of the gallbladder with hepatoid differentiation: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Zhang C

    2016-09-01

    Full Text Available Chengsheng Zhang,1,2 Wei Zhang,1,2 Dianbin Mu,1 Xuetao Shi,1 Lei Zhao1,2 1Department of Hepatobiliary Surgery, Shandong Cancer Hospital affiliated to Shandong University, Shandong Academy of Medical Science, 2School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong Province, People’s Republic of China Abstract: An 80-year-old male was referred to our department for a gallbladder mass. He denied any history of alcohol consumption or cholecystitis and smoking. Hepatitis B surface antigen test and antihepatitis C antibody test were found to be negative. Serum carbohydrate antigen 19-9 (CA19-9 and carcinoembryonic antigen were elevated (CA19-9 was 59.92 U/mL and carcinoembryonic antigen was 12.64 ng/mL, whereas alpha-fetoprotein was below the normal limit (2.46 ng/mL. Computed tomography scan revealed a solid mass with measurements of 4.6×5.6×7.1 cm, which nearly filled the whole gallbladder space. Radical cholecystectomy, including segments IV B and V of the liver and lymphadenectomy, was performed. The neoplasm in gallbladder was completely resected, and the patient obtained a negative margin. Histological and immunohistochemical profile suggested a clear cell adenocarcinoma of the gallbladder with hepatoid differentiation. After reviewing the literature, we reported that this case is the first identified case of cell adenocarcinoma of the gallbladder with extensive hepatoid differentiation. However, clinical features of clear cell adenocarcinoma with hepatoid differentiation remain unclear due to the extremely rare incidence. There was no indication of adjuvant chemotherapy and no literature has been reported on the application of chemotherapy. This case showed a promising clinical outcome after curative resection, which indicated that surgical treatment could be potentially considered for suitable patients. Keywords: gallbladder, clear cell adenocarcinoma, hepatoid differentiation 

  17. [Follicular bronchiolitis: report of 3 cases and literature review].

    Science.gov (United States)

    Dai, J; Cai, H R; Li, Y; Meng, F Q; Wu, J Q

    2017-06-12

    Objective: To improve understanding of the characteristics of follicular bronchiolitis(FB). Methods: The clinical data of 3 patients with FB confirmed by thoracoscopic lung biopsy were retrospectively analyzed. A literature search was performed with "follicular bronchiolitis" as the key word in China Knowledge Resource Integrated Database, Wanfang and PubMed, Ovid Database. The time interval was from January 1947 to December 2015. Related articles of FB were retrieved and the clinical, radiographic characteristics and prognosis were analyzed. Results: Among the 3 patients, 1 was male and 2 were female, aging 32-55 years. Two patients were asymptomatic, and 1 patient presented with fever, cough and dyspnea. Two patients showed normal pulmonary ventilatory function with decreased diffusive function, and 1 patient showed normal pulmonary function. The predominant HRCT findings were bilateral multiple small nodules and cystic opacities, patchy ground-glass opacities, reticular opacities and traction bronchiectasis. The pathological examination by thoracoscopic biopsy revealed bronchiolar and peribronchiolar lymphoid follicles. All patients were treated with corticosteroids, with 2 patients receiving immunosuppressants. Follow-up HRCT after 1-2 months showed no improvement, and further follow-up HRCT after 2-4 years revealed no change in 2 patients while the other patient had increased pulmonary nodules and cystic opacities. Seventeen articles concerning FB with complete records were included in the literature review. A total of 64 patients were reported in these articles. The typical images were bilateral multiple small nodules and ground-glass opacities, reticular opacities, and cystic opacities. The majority of patients improved after treatment of corticosteroids and (or) immunosuppressants. But our 3 cases showed no improvement. Conclusions: FB is a rare small airway disease which has non-specific clinical manifestations and pulmonary function. The most common

  18. Myroides odoratimimus soft tissue infection in an immunocompetent child following a pig bite: case report and literature review

    Directory of Open Access Journals (Sweden)

    Sofia Maraki

    2012-08-01

    Full Text Available Members of the genus Myroides are aerobic Gram-negative bacteria that are common in environmental sources, but are not components of the normal human microflora. Myroides organisms behave as low-grade opportunistic pathogens, causing infections in severely immunocompromised patients and rarely, in immunocompetent hosts. A case of Myroides odoratimimus cellulitis following a pig bite in an immunocompetent child is presented, and the medical literature on Myroides spp. soft tissue infections is reviewed.

  19. Instruments for evaluating shared medical decision making: a structured literature review.

    Science.gov (United States)

    Dy, Sydney Morss

    2007-12-01

    The author conducted a structured literature review of instruments for evaluating shared medical decision making. She included relevant instruments that were generalizable beyond specific situations and had been formally evaluated and organized them by domains of values or preferences, information and communication in decision making, and other aspects of decision making. For values or preferences, the author identified 11 instruments, mostly on preferences for roles and information. For information and communication, she found a systematic review of instruments for observational assessment of decision making, 3 additional observational instruments, and 3 questionnaires. For other aspects of decision making, the author identified 3 instruments in domains such as decision self-efficacy and 4 multidimensional instruments. Although instrument development tended to cluster in several areas and there were clear gaps in the literature, the diversity of instruments demonstrates the broad range of constructs involved in assessing shared decision making.

  20. A new case of cervical intramedullary sinus histiocytosis causing paraplegia and review of the literature

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    Rocha-Maguey, Jesús; Felix-Torrontegui, José-Angel; Cabrera-López, Myriam; Gutiérrez-Castro, Macrina; Montante-Montes de Oca, Daniel

    2016-01-01

    Background: Rosai–Dorfman disease (RDD) is an uncommon, benign histiocytic proliferative disorder of unknown origin. It predominantly affects the lymph nodes, but can also be found extranodal in different organs. Nervous system involvement is rare, and the most cases are intracranial. Surgical treatment is indicated when the central nervous system (CNS) in compromised. Case Description: We herein describe the management of a 27-year-old woman who presented progressive spinal cord symptoms, secondary to an isolated intramedullary lesion, which had a histological confirmation of RDD. To our knowledge, this is the 6th case reported in English written manuscripts. We review these cases and analyze some of the literature concerning the disease. Conclusions: RDD shows some variability in the involvement of the entire neuraxis, and because its ability to mimic meningeal and primary brain tumors, it is essential to be aware of this entity and consider RDD in the differential diagnosis of various lesions of the CNS. The conclusive diagnosis must be obtained by histological methods, so surgical approaches have to be discussed. Although it is not considered as a malignancy, options for postoperative medical treatment are variable and include radiation, chemotherapy or maybe monoclonal antibodies for refractory or recurrent cases. PMID:26862448

  1. Transient lingual papillitis: A retrospective study of 11 cases and review of the literature

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

    2017-01-01

    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

  2. MEDICAL MYSTERY: ECTRODACTYLY A CASE REPORT

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    Subhra Mandal

    2015-03-01

    Full Text Available Congenital absence of all or part of one or more fingers or toes is defined as Ectrodactyly. It is the word derived from Greek ektroma meaning “abortion” and dactyly meaning digits. Also called split hand or foot malformation (SHFM, Ectrodactyly is a rare limb malformation with median cleft of hand and foot and aplasia or hypoplasia of the phalanges, metacarpals and metatarsals. Irregular pattern of inheritance exists for ectrodactyly; may be autosomal dominant, autosomal recessive or X linked. In this condition, the median cleft of the hand gives the hand, the appearance of lobster claws- so also called ‘Lobster Claw Hand”. Ectrodactyly may be very commonly associated with other anomalies of face, eyes and skeletal system. We report a rare case of unilateral ectrodactyly of right hand .The present case is not associated with any other anomaly as described in various textbooks and reference articles. The details of etiology, diagnosis, genetic causes, association with other anomalies and treatment will be discussed.

  3. [Recognition of flavor in non-medical literatures of pre-Qin dynasty].

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    Zhang, Ruixian; Zhang, Wei

    2010-02-01

    By systemically sorting of non-medical literatures of pre-Qin dynasty such as the Thirteen Confucian Classics, etc, this article made an analysis on the meaning and content of flavor in that period with the Genesis and Epistemology, and pointed out that there were two meanings of the flavor: the first is the flavor or taste obtained by tasting, and the other is the five-elements flavor, a abstract flavor. The former flavor should be originated early than the later one. Besides, the article made a brief view on the functions of flavors in the health keeping and medicine.

  4. Isolated Splenic Metastasis from Non-Small-Cell Lung Cancer: A Case Report and Review of the Literature

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    Nikolaos Mitsimponas

    2017-07-01

    Full Text Available Metastases to the spleen are rare but have been reported for different tumor entities, including breast cancer, lung cancer, colorectal cancer, ovarian cancer, and melanoma. As an isolated event, splenic metastasis from non-small-cell lung cancer (NSCLC is exceedingly rare. Until now, only 28 cases have been reported in the medical literature. We report the case of a 66-year-old woman with NSCLC (adenocarcinoma who presented with a synchronous, isolated splenic metastasis. Operative removal of both primary tumor and metastasis was not possible due to multiple comorbidities. Therefore, treatment was limited to combined systemic chemotherapy and simultaneous radiation of the primary tumor, which led to partial remission of the disease. Isolated metastasis to the spleen in NSCLC has been reported only 28 times in the medical literature, most often in male patients with right-sided lung tumors, most of which were adenocarcinomas. The majority of patients were asymptomatic with respect to splenic metastasis. About half of the reported cases were isolated metachronous splenic metastases. Splenectomy seems to confer a survival advantage. We review the pertinent medical literature.

  5. Multi-Modal Treatment Approach to Painful Rib Syndrome: Case Series and Review of the Literature.

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    Germanovich, Andrew; Ferrante, Francis Michael

    2016-03-01

    Mechanical chest wall pain is a common presenting complaint in the primary care office, emergency room, and specialty clinic. Diagnostic testing is often expensive due to similar presenting symptoms that may involve the heart or lungs. Since the chest wall biomechanics are poorly understood by many clinicians, few effective treatments are offered to patients with rib-related acute pain, which may lead to chronic pain. This case series and literature review illustrates biomechanics involved in the pathogenesis of rib-related chest wall pain and suggests an effective multi-modal treatment plan using interventional techniques with emphasis on manual manipulative techniques. Case series and literature review. Pain clinic in an academic medical center. This is a case series of 3 patients diagnosed with painful rib syndrome using osteopathic palpatory physical examination techniques. Ultrasound-guided intercostal nerve blocks were followed by manual manipulation of mechanically displaced ribs as a part of our multi-modal treatment plan. A review of the literature was undertaken to clarify nomenclature used in the description of rib-related pain, to describe the biomechanics involved in the pathogenesis of mechanical rib pain, and to illustrate the use of effective manual manipulation techniques. This review is introductory and not a complete review of all manual or interventional pain management techniques applicable to the treatment of mechanical rib-related pain. Manual diagnostic and therapeutic skills can be learned by physicians to treat biomechanically complex rib-related chest wall pain in combination with interventional image-guided techniques. Pain physicians should learn certain basic manual manipulation skills both for diagnostic and therapeutic purposes.

  6. Unintentional Complications After Uneventful Rhinoplasty Operations: Case Reports and a Review of the Literature.

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    Keleş, Musa Kemal; Aksakal, İbrahim Alper; Park, Tae Hwan; Yağmur, Çağlayan; Küçüker, İsmail

    2016-02-01

    No surgical procedure is free of complications; however, some of these complications are unintentional. Plastic surgeons may be unfamiliar with certain complications after rhinoplasty operations. In this study, we aimed to present four unintentional complications that have occurred in our patients and review the literature related to these complications. In this study, we conducted a review of 1400 patients who were operated on from 2007 to 2015. The medical recordings of all patients were investigated. Four patients with unintentional complications after rhinoplasty operations are presented and the related literature was reviewed. Cases 1 and 2: These patients included a 26-year-old woman and a 30-year-old man who developed herpes simplex virus (HSV) infections after a primary septorhinoplasty. Case 3: This was a 25-year-old woman who developed periorbital emphysema after a primary rhinoplasty operation. Case 4: This was a 22-year-old woman who developed a second-degree burn on the nasal dorsum. All patients healed without sequel or scars. Many unexpected complications have been reported in the literature. Some of these complications include bleeding disorders, allergic reactions, dermatitis, visual loss, gastric bleeding, benign paroxysmal positional vertigo, false aneurysm after rhinoplasty, pneumocephalus, Tapia's syndrome, cavernous sinus syndrome, and skin reactions to prolene. Meticulous patient histories, consistent surgical routines, careful radiologic examinations, and frequent patient visits can help surgeons control these types of complications. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online

  7. Third ventricle liponeurocytoma: one case report and review of literature

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    Wu-wu DING

    2014-09-01

    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

  8. Metastatic pituitary carcinoma: a case report and review of literature

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    ZHANG Shang-fu

    2013-02-01

    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.

  9. Anterior mediastinal synovial sarcoma: A case report and literature review

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    Wen-xiang YUE

    2015-01-01

    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

  10. Catatonia in disulfiram intoxication - a case report and a brief overview of the literature.

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    Takacs, Rozalia; Milan, Flora; Ungvari, Gabor S; Faludi, Gabor; Gazdag, Gabor

    2016-06-01

    Catatonic syndromes could accompany a variety of psychiatric and medical conditions. The most common conditions underlying catatonia are affective disorders followed by schizophrenia, but several medical conditions including intoxications affecting the central nervous system can also present with catatonic signs and symptoms. Therapeutic doses of disulfiram could induce catatonia with or without accompanying psychosis or mood disorder. A case of disulfiram intoxication manifesting with catatonia is reported here together with a brief overview of the literature. A patient was admitted to the toxicology ward after a suicide attempt with approximately 20 g of disulfiram. On transfer to the psychiatric ward, she was sitting still, in a semi-stuporous state and displayed motiveless resistance to instructions or attempts to move (active negativism). She was unresponsive to most of the questions (mutism), occasionally verbigerated 1-2 words and stared for more than 20 seconds between shifting attention. After developing a comatosus state her treatment continued at the toxicology ward, where a contrast-enhanced computer tomography scan revealed bilateral emollition of 1.5 cm diameter in both nucleus lentiformis at the level of the third ventricle. Following treatment her condition improved and she benefited of rehabilitation facility and a second psychiatric treatment. She was discharged free of neurological and psychiatric symptoms. In conclusion, we underscore the importance of accurate diagnosis of the underlying psychiatric or medical condition when encountering a fast emerging catatonic syndrome and focus first on treating the causative condition while simultaneously attempting symptomatic treatment of catatonia.

  11. Mitochondrial encephalopathy: a case report and review of the literature

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    XU Yu-qiao

    2013-06-01

    Full Text Available Objective To investigate the clinical, imaging and pathological characteristics of one case of mitochondrial encephalopathy. Methods The data of physical examination, electromyopraphy(EMG, cranial CT and MRI, electroencephalography (EEG, serologic examination, and light microscopy and electron microscopy of muscle biopsy specimens of one case of mitochondrial encephalopathy were collected. The related literatures were reviewed. Results A 52-year-old female patient was admitted with an 8-month of seizures, numbness of the limbs for three times. The clinical manifestations were mainly focal seizures with intelligence disturbance and positive bilateral pyramidal tract sign. The imaging examination was considered to be ischemic stroke and cerebral atrophy. EEG revealed moderate and severe abmormal brain wave. In cerebrospinal fluid (CSF examination, the intracranial pressure (ICP was initially 2.01 kPa and finally 1.03 kPa, red blood cell count 1.04 × 10 6/L, white blood cell count 5 × 10 6/L (with an increase in neutrophilic granulocyte proportion, protein 0.70 g/L, chlorides 103.30 mmol/L and IgG 51.90 mg/L. Serum high-sensitivity C-reactive protein (hsCRP was 15.40 mg/L, and erythrocyte sedimentation rate (ESR 23 mm/h. Brain biopsy revealed cortical neuron swelling, loss of natural conical shape. The number of capillary increased and astrocytes proliferated reactively. Immunohistochemical examination showed that there were positive Mito granular materials inside the swelling and normal cytoplasm of neurons. The proliferative astrocytes were positive for glial fibrillany acid protein (GFAP. The electronic microscopic examination revealed that a large number of abnormal mitochondria various in shape and size were accumulated between subsarcolemma and myofibrilla. The mitochondrial cristae were flattened or prolonged and twining in concentricity. Osmiophilic bodies and crystalloid inclusion bodies were found in mitochondria. Conclusion

  12. Morning Report Presentation with Literature Search Associated with Decreased Length of Hospital Stay. A Review of: Banks, Daniel E., Runhus Shi, Donna F. Timm, Kerri Ann Christopher, David Charles Duggar, Marianne Comegys, and Jerry McLarty. “Decreased Hospital Length of Stay Associated with Presentation of Cases at Morning Report with Librarian Support.” Journal of the Medical Library Association 95.4 (Oct. 2007: 381-87.

    Directory of Open Access Journals (Sweden)

    Jennie Kelson

    2008-09-01

    Full Text Available Objective – To determine whether hospital charges, length of stay or 30-day readmission rates were affected by case discussion at residents’ morning report (MR, accompanied by librarian-provided literature search results, within 24 hours of admission. Design – Case-control study and survey.Setting – Louisiana State University School of Medicine.Subjects – MR cases presented during the study period August 2004 to March 2005 matched with one to three cases (controls of patients who were hospitalised in the period January 2000 to July 2005. House officers who presented the MR cases during the study period were the subjects for the survey.Methods – MR cases were presented between 8:00am and 9:00am, five days a week, and only one case was presented at each MR. During the study period, August 2004 to March 2005, the presenting house officer selected independently a case for presentation at MR from patients admitted during the previous 24 hours. The selection was made without guidance as to which cases or illnesses to choose and without the knowledge or involvement of the attending physician or investigators. The term “house officer” is not defined in the article so it is not clear whether this refers to medical residents only, or if it includes interns. The faculty librarian, with clinical input from the chief resident or the chair of the Department of Medicine, conducted a search of the medical literature immediately following the MR to identify articles or citations that would answer two questions posed at the end of the presentation. The chair of the department or chief resident selected the articles that provided the most clinically sound answers to the questions. By 10:00 am, copies of the selected articles were hand-delivered to the presenting house officer and shared with members of the ward team.For the case-control component, the MR cases presented during the study period were matched against a comparison group of patients who

  13. Noncompliance with Medical Regimen in Haemodialysis Treatment: A Case Study

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    Paraskevi Theofilou

    2011-01-01

    Full Text Available Patients undergoing haemodialysis treatment have a high burden of disease (particularly cardiovascular comorbidities affecting their quality of life and dramatically shortening life expectancy. Effective chronic kidney disease (CKD control requires regular preventive medication and a response to that medication. Poor receptiveness to CKD medication can be related to individual variability in the dose needed to achieve a response, as well as to low-adherent behaviour in relation to the CKD medication regimen. Some patients, though not many, according to studies' findings, abuse the medical regimen as a result of suicidal tendencies. The present case gave us the opportunity to consider the causes and clinical findings and review the specific psychological interventions for patients with CKD.

  14. Lipomas of the oral cavity: clinicopathological and immunohistochemical study of 24 cases and review of the literature.

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    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

    2015-03-01

    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.

  15. Thrombocytopenia associated with olanzapine: A case report and review of literature

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    Swapnajeet Sahoo

    2016-01-01

    Full Text Available There is limited literature on olanzapine-associated thrombocytopenia. In this report, we present a case of a 32-year-old female, suffering from persistent delusional disorder who had thrombocytopenia (46,000/mm3 with the use of olanzapine 25 mg/day, 6 weeks after starting medication. Blood film did not reveal any evidence of any dysplastic cells, disturbance in the count of other cell lines, and autoimmune workup including antinuclear antibodies and anti-neutrophil cytoplasmic antibodies were found to be negative. Given no other etiology, olanzapine was gradually tapered, and platelet counts were monitored. Reduction in the dose of olanzapine led to an improvement in platelet counts which reached the normal range after complete stoppage of olanzapine. In view of continued psychotic symptoms, she was started on clozapine and which was gradually increased to 200 mg/day with biweekly monitoring of total platelet counts before each increment in the dose of clozapine. Thrombocytopenia did not recur with use of clozapine. With clozapine, her psychosis improved by nearly 60%. A review of literature revealed only eight case reports supporting the association of olanzapine and thrombocytopenia.

  16. Profits and plagiarism: the case of medical ghostwriting.

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    Anekwe, Tobenna D

    2010-07-01

    This paper focuses on medical ghostwriting in the United States. I argue that medical ghostwriting often involves plagiarism and, in those cases, can be treated as an act of research misconduct by both the federal government and research institutions. I also propose several anti-ghostwriting measures, including: 1) journals should implement guarantor policies so that researchers may be better held accountable for their work; 2) research institutions and the federal government should explicitly prohibit medical ghostwriting and outline appropriate penalties; and 3) a publicly available database should be created to record researchers' ethics violations.

  17. Isolated cases? The history and historiography of Australian medical research.

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    Hobbins, Peter; Hillier, Kathryn

    2010-01-01

    For over two hundred years, Australia has been portrayed as a terminus rather than a hub for scientific exchange. Alongside narratives valorising the struggle for a distinct national identity, the motif of isolation abounds in the historiography of Australian medical research. Yet these orthodoxies are ripe for rescripting, as illustrated by a symposium held in Sydney in 2010: Isolated Cases? 100 Years of Australian Medical Research. Weaving together several historical themes from this conference with wider historiographic threads, this article questions many prevailing representations. In particular the authors argue that rather than isolation or dependency, Australian medical science has been characterised by a profound interdependence across two centuries of antipodean endeavour.

  18. Gestational Breast Cancer: Report of A Case and Literature Review

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    Filipa Paixão-Barradas

    2016-03-01

    Full Text Available Background: Gestational or pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy, within the first postpartum year, or during lactation. Breast cancer is one of the most common cancers in nonpregnant and pregnant women. Case presentation: A 29-year-old pregnant woman presented at eight weeks gestational age with a palpable breast nodule. On breast ultrasound evaluation, only probably benign findings were detected. The pregnancy was uneventful until the third trimester when she started to have a severe back pain which became gradually resistant to medical therapy. Therefore, at 33 weeks, she was assisted at an emergency care facility and a highly suspicious breast mass was detected. A core biopsy was performed that revealed an invasive ductal carcinoma grade 3 with lymph node metastasis. After several imaging studies, it was diagnosed as a stage 4 breast cancer with bone, liver, and pulmonary metastasis. At thirty four weeks gestation, the pregnancy was terminated by C-section and she started to receive palliative radiation therapy one week later. She also received several cycles of palliative chemotherapy. Nineteenth months after C-section, progression of the disease was observed and a cerebellar metastasis was found. Unfortunately, two months later, her clinical condition deteriorated and the patient died.Conclusion: Gestational breast cancer represents a clinical situation of utmost important in which the health of both the mother and the fetus should be taken into account. Diagnosis is difficult due to the physiological changes of the mammary glands during pregnancy and lactation, and it usually occurs at an advanced stage.

  19. Primary hepatic carcinoid: A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Luigi Maria Fenoglio; Sara Severini; Domenico Ferrigno; Giovanni Gollè; Cristina Serraino; Christian Bracco; Elisabetta Castagna; Chiara Brignone; Fulvio Pomero; Elena Migliore; Ezio David; Mauro Salizzoni

    2009-01-01

    Carcinoids are tumors derived from neuroendocrine cells and often produce functional peptide hormones.Approximately 54.5% arise in the gastrointestinal tract and frequently metastasize to the liver. Primary hepatic carcinoid tumors (PHCT) are extremely rare;only 95 cases have been reported. A 65-year-old man came to our attention due to occasional ultrasound findings in absence of clinical manifestations. His previous medical history, since 2003, included an echotomography of the dishomogeneous parenchymal area but no focal lesions. A computed tomography scan per formed in 2005 showed an enhanced pseudonodular-like lesion of about 2 cm. Cholangiomagnetic resonance imaging identified the lesion as a possible cholangiocarcinoma. No positive findings were obtained with positron emission tomography. Histology suggested a secondary localization in the liver caused by a low-grade malignant neuroendocrine tumor. Immunohistochemistry was positive for anti chromogranin antibodies, Ki67 antibodies and synaptophysin. Octreoscan scintigraphy indicated intense activity in the lesion. Endoscopic investigations were performed to exclude the presence of extrahepatic neoplasms. Diagnosis of PHCT was established. The patient underwent left hepatectomy, followed by hormone therapy with sandostatine LAR. Two months after surgery he had a lymph nodal relapse along the celiac trunk and caudate lobe, which was histologically confirmed. The postoperative clinical course was uneventful, with a negative follow-up for hematochemical, clinical and radiological investigations at 18 mo post-surgery. Diagnosis of PHCT is based principally on the histopathological confirmation of a carcinoid tumor and the exclusion of a non-hepatic primary tumor. Surgical resection is the recommended primary treatment for PHCT. Recurrence rate and survival rate in patients treated with resection were 18% and 74%, respectively.

  20. Chronic shoulder pain referred from thymic carcinoma: a case report and review of literature

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    Dee SW

    2012-09-01

    Full Text Available Shu-Wei Dee,1 Mu-Jung Kao,2,3 Chang-Zern Hong,4 Li-Wei Chou,1,5 Henry L Lew6,71Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, 2Department of Physical Medicine and Rehabilitation, Yangming Branch, Taipei City Hospital, Taipei, 3Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, 4Department of Physical Therapy, Hungkuang University, Taichung, 5School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 6Defense and Veterans Brain Injury Center, Virginia Commonwealth University, Richmond, Virginia, 7University of Hawaii at Manoa, John A Burns School of Medicine, Honolulu, Hawaii, USAAbstract: We report a case of thymic carcinoma presenting as unilateral shoulder pain for 13 months. Before an accurate diagnosis was made, the patient received conservative treatment, cervical discectomies, and myofascial trigger point injection, none of which relieved his pain. When thymic carcinoma was eventually diagnosed, he received total resection of the tumor and the shoulder pain subsided completely. Thymic carcinoma is a rare carcinoma, and our review of the literature did not show shoulder pain as its initial presentation except for one case report. The purpose of this report is to document our clinical experience so that other physiatrists can include thymic carcinoma in their differential diagnosis of shoulder pain.Keywords: referred pain, shoulder pain, thymic carcinoma

  1. HaNDL Syndrome Presenting During Pregnancy: A Case Report and Review of the Literature

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    Yüksel Kaplan

    2014-09-01

    Full Text Available Headache associated with neurological deficits and cerebrospinal fluid lymphocytosis (HaNDL is a self-limited syndrome characterized by sudden-onset headache with a temporary neurological deficit and cerebrospinal fluid (CSF lymphocytosis. We aimed to disscus a case of HaNDL syndrome presenting during pregnancy with relevant literature. A 20-year-old female presented with a 5-day history of severe, bilateral throbbing headache accompanied by nausea, vomiting, and phonophobia. Approximately 2 days after the pain developed, she became acutely confused for less than 90 minutes. 2 days after this episode, she experienced again confusional state and left hemiparesis. There were no symptoms consistent with meningoencephalitis. She was pregnant and at 11 weeks gestation. A neurologic examination showed confusional state, bilateral papilledema, and mild left hemiparesis. The neuroradiological examination was normal. The cerebrospinal fluid revealed lymphocytic pleocytosis, mildly elevated protein, and increased opening pressure. She recovered completely after 8 days. The precise etiology of HaNDL is unknown, although an inflammatory or infectious origin and autoimmune factors have been proposed. Moreover, the risk factors and medical conditions associated with HaNDL are unknown. It is obviously difficult to determine whether the pregnancy was coincidental or associated in this case. We believe that comprehensive studies are needed to clarify the risk factors and medical conditions associated with HaNDL.

  2. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    Science.gov (United States)

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  3. Bupivacaine drug-induced liver injury: a case series and brief review of the literature.

    Science.gov (United States)

    Chintamaneni, Preethi; Stevenson, Heather L; Malik, Shahid M

    2016-08-01

    Bupivacaine is an established and efficacious anesthetic that has become increasingly popular in postoperative pain management. However, there is limited literature regarding the potential for bupivacaine-induced delayed liver toxicity. Describe cholestasis as a potential adverse reaction of bupivacaine infusion into a surgical wound. Retrospective review of patients' medical records. We report the cases of 3 patients with new onset of cholestatic injury after receiving bupivacaine infusion for postoperative herniorrhaphy pain management. All patients had negative serologic workups for other causes of liver injury. All patients achieved eventual resolution of their liver injury. Bupivacaine-induced liver injury should be on the differential of individuals presenting with jaundice and cholestasis within a month of infusion via a surgically placed catheter of this commonly used anesthetic.

  4. Severe fungal sclerokeratitis caused by Metarhizium anisopliae: a case report and literature review.

    Science.gov (United States)

    Eguchi, Hiroshi; Toibana, Toshi; Hotta, Fumika; Miyamoto, Tatsuro; Mitamura, Yoshinori; Yaguchi, Takashi

    2015-02-01

    To date, there has been only one published report on the infectious sclerokeratitis caused by Metarhizium anisopliae, which is an entomopathogenic fungus. Regarding corneal infection, three reports have been published to date. Although the prognoses of the corneal infections are favourable, prognosis when scleral infection is involved is very poor. A 76-year-old patient presented with foreign body sensation in the left eye. Microscopic examination with Fungi Flora Y staining of the corneal scraping revealed fungal infection. The conjunctiva was melted by the infection over a wide area. Although intensive medications were administered, an emergency surgery was necessary because scleral thinning, corneal perforation and lens prolapse occurred. The fungal isolate was identified as M. anisopliae by sequencing the internal transcribed spacer region. Herein, we report the second known case worldwide of M. anisopliae sclerokeratitis, and we review the literature related to the ocular infections.

  5. Diagnosis and management of sacral Tarlov cysts. Case report and review of the literature.

    Science.gov (United States)

    Acosta, Frank L; Quinones-Hinojosa, Alfredo; Schmidt, Meic H; Weinstein, Philip R

    2003-08-15

    Perineurial (Tarlov) cysts are meningeal dilations of the posterior spinal nerve root sheath that most often affect sacral roots and can cause a progressive painful radiculopathy. Tarlov cysts are most commonly diagnosed by lumbosacral magnetic resonance imaging and can often be demonstrated by computerized tomography myelography to communicate with the spinal subarachnoid space. The cyst can enlarge via a net inflow of cerebrospinal fluid, eventually causing symptoms by distorting, compressing, or stretching adjacent nerve roots. It is generally agreed that asymptomatic Tarlov cysts do not require treatment. When symptomatic, the potential surgery-related benefit and the specific surgical intervention remain controversial. The authors describe the clinical presentation, treatment, and results of surgical cyst fenestration, partial cyst wall resection, and myofascial flap repair and closure in a case of a symptomatic sacral Tarlov cyst. They review the medical literature, describe various theories on the origin and pathogenesis of Tarlov cysts, and assess alternative treatment strategies.

  6. Autoimmune progesterone dermatitis in a patient with endometriosis: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Baldwin James L

    2004-08-01

    Full Text Available Abstract Autoimmune progesterone dermatitis (APD is a condition in which the menstrual cycle is associated with a number of skin findings such as urticaria, eczema, angioedema, and others. In affected women, it occurs 3–10 days prior to the onset of menstrual flow, and resolves 2 days into menses. Women with irregular menses may not have this clear correlation, and therefore may be missed. We present a case of APD in a woman with irregular menses and urticaria/angioedema for over 20 years, who had not been diagnosed or correctly treated due to the variable timing of skin manifestations and menses. In addition, we review the medical literature in regards to clinical features, pathogenesis, diagnosis, and treatment options.

  7. Scar endometriosis after caesarean section: a case series and review of literature

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    Sandeep S. Nanaware

    2016-04-01

    Full Text Available Endometriosis is defined as extra-uterine localization of ectopic functional endometrial gland and stroma. Cystic or solid tumoral masses caused by endometriosis are named as endometrioma. Although these pathologic conditions mostly encountered in ligaments of uterus, ovaries, pouch of douglos and pelvic peritoneum; endometriosis has also been reported in nose, breast, lung, spleen, gastrointestinal tract, kidney, abdominal wall, but scar endometriomais extremely rare. Scar endometriosis is rare and difficult to diagnose. This condition can be confused with other surgical conditions, however imaging techniques and FNAC are indicated towards better diagnostic approach. Medical treatment is helpful in selected cases but wide excision is the treatment of choice. By presenting this paper, and conducting a review of the literature, we intend to increase the awareness of this rather, rare condition. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 948-952

  8. Rare case study of a primary carcinoma of the petrous bone and a brief literature review.

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    Atallah, Ihab; Karkas, Alexandre; Righini, Christian Adrien; Lantuejoul, Sylvie; Schmerber, Sébastien

    2015-04-01

    Temporal bone carcinoma is an aggressive tumor with multiple unconfirmed risk factors. Herein, we present a rare case of a primary petrous bone carcinoma in a female patient (65 years old) with an irrelevant medical history. She presented a postauricular swelling that revealed a multilocular osteolytic cystic lesion of the mastoid portion of the temporal bone on the CT scan. The patient underwent resection of the lesion and pathological analysis revealed moderately to well-differentiated squamous cell carcinoma. Postoperative radiotherapy was carried out. Until the present time, the patient shows complete remission on regular clinical and radiological follow-up. Although no widely accepted strategy for managing temporal bone tumors exists, a review of the literature showed that surgery with or without radiotherapy is the treatment of choice. Preoperative assessment and accurate staging are vital in ensuring that the treatment is adequate for each disease stage. © 2014 Wiley Periodicals, Inc.

  9. Seizures caused by pyridoxine (vitamin B6) deficiency in adults: A case report and literature review.

    Science.gov (United States)

    Tong, Yisha

    2014-05-01

    Pyridoxine (vitamin B6) deficiency is a recognised cause of intractable seizures in neonates. However, pyridoxine deficiency related seizures in adults were rarely reported. This article reports a case of a 79 year old lady who suffered from new-onset seizures and was successfully treated with vitamin B6. The patient had chronic renal disease and weight loss due to anepithymia following a pelvic fracture. This article also reviews literatures of seizures caused by pyridoxine deficiency in adults. Seizures caused by vitamin B6 deficiency in adults may result from dietary deficiency, liver disease, pregnancy and certain medications and can be easily treated by vitamin B6 with excellent outcome. Clinicians should consider vitamin B6 deficiency as a potential aetiology of seizures, even in patients who suffer from other underlying diseases which can cause seizures.

  10. Laser therapy for Hailey-Hailey Disease: review of the literature and a case report

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    Arisa E. Ortiz

    2011-10-01

    Full Text Available Medical therapy for Hailey-Hailey disease (HHD generally only provides temporary suppression. Surgical intervention has been shown to prolong remission, but may lead to significant morbidity. Laser therapy is becoming the preferred method of treatment because of its successful results and lower risk of complications compared to surgical modalities. We report a case of fractional ablative carbon dioxide (CO2 laser treatment for HHD and review the relevant literature. Fractional CO2 laser therapy was performed in our patient with a 14-year history of HHD. No recurrence was observed 5 months after laser therapy in right inframammary and axillary regions. Symptomatic recurrence was noted after treatment of inguinal areas. In conclusion, traditional laser ablation remains the treatment of choice for prolonged remission of recalcitrant plaques in HHD.

  11. MYOSITIS OSSIFICANS TRAUMATICA OF THE MASSETER MUSCLE- review of the literature and case report.

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    Elitsa G. Deliverska

    2013-11-01

    Full Text Available Introduction: Myositis ossificans traumatica (MOT is known mostly in the orthopedic literature as non-neoplastic, heterotopic bone formation within muscle or fascia, presumably due to acute trauma or repeated injury. Myositis ossificans traumatica of the masseter muscle is uncommon disease producing limitation of opening of the jaws. Purpose: To present a case of MOT of the masseter muscle in patient with history of facial trauma. Material and methods: The medical history of a 53 years patient with complaint of decreasing ability to open his mouth over the past 10 years after a blow to face. CT revealed enlarged calcification in the left masseter muscle.Conclusion: Treatment of MOT of the masseter muscle is surgical- total extirpation of the ossified muscle but also surgical techniques including osteotomy that involve the muscle attachment region should be considered and after that appropriate physical therapy.

  12. Emphysematous pyelonephritis in failed renal allograft: Case report and review of literature.

    Science.gov (United States)

    Bansal, Rahul Kumar; Lambe, Shahid; Kapoor, Anil

    2016-01-01

    Emphysematous pyelonephritis (EPN) in renal allograft is rare but potentially lethal complication and requires aggressive medical and/or surgical therapy to achieve cure. We report a case of 60-year-old diabetic male with poor cardiac function on maintenance hemodialysis, who underwent delayed allograft nephrectomy for EPN in failed renal allograft. Blood culture grew Bacteroides. He was stable in the postoperative period but passed away on day 4 due to myocardial infarction likely secondary to poor baseline cardiac function. Delay in diagnosis and treatment could have contributed to this unfavorable outcome. There is a paucity of published literature regarding EPN in the transplant population, such that management decisions (percutaneous conservative versus urgent surgical) are challenging. Further studies are required to establish treatment guidelines.

  13. Plasmapheresis for Preventing Complication of Hypertriglyceridemia: A Case Report and Review of Literature.

    Science.gov (United States)

    Costantini, Nicoletta; Mameli, Antonella; Marongiu, Francesco

    2016-01-01

    Severe hypertriglyceridemia is a common indication for the need of plasma exchange in treatment of hypertriglyceridemic-induced pancreatitis when normal therapies fail to garner a response. Application of plasmapheresis to prevent complication of hypertriglyceridemia is limited because of its cost and availability. We present a case of a 44-year-old man with metabolic syndrome and a medical history of secondary polycythemia in obesity hypoventilation syndrome, whose laboratory tests revealed a triglycerides value of 3965 mg/dL. To prevent the complication of pancreatitis due to hypertriglyceridemia, we performed plasma exchange 3 times when conventional treatments did not sufficiently reduce the high level of triglycerides. A review of the current available literature was therefore conducted to provide an overview of the present data on apheretic treatment for patients with severe hypertriglyceridemia. Several case reports and case series have used plasmapheresis in acute treatment of hypertriglyceridemia pancreatitis related. In our case, the choice of plasmapheresis was applied in prevention of possible complications of hypertriglyceridemia.

  14. Two Fatal Intoxications Due to Tramadol Alone: Autopsy Case Reports and Review of the Literature.

    Science.gov (United States)

    Gioia, Sara; Lancia, Massimo; Bacci, Mauro; Suadoni, Fabio

    2017-08-01

    Since tramadol was marketed, it has been widely prescribed as a pain killer because of its relatively safe profile among opioids.Nevertheless, intoxication can occur: overdose can lead to fatal outcomes mostly in association with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased central nervous system (CNS) depression.Fatal outcomes only attributable to tramadol are a rare entity. In this case report, 2 fatal cases are described due to tramadol stand-alone intoxication with peculiar characteristics.In case 1, gas chromatography - mass spectrometry analysis detected tramadol in all specimens (32 μg/mL in the heart blood, 23.9 μg/mL in the femoral blood, 3.3 μg/mL in the bile, and 1.4 μg/mL in the urine). No other CNS depressants were detected by toxicological analysis.In case 2, gas chromatography - mass spectrometry analysis detected tramadol in all specimens (7.5 μg/mL in the heart blood, 5.8 μg/mL in the femoral blood, and 18 μg/mL in the urine). No other CNS depressants were detected by toxicological analysis.Review of the literature was performed to clarify the actual knowledge on this topic.

  15. Diffuse idiopathic intracranial fusiform aneurysm development. Case report and literature review

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    Eric S Nussbaum

    2014-01-01

    Full Text Available Background: Fusiform intracranial aneurysms (FIAs are uncommon lesions representing less than 15% of all intracranial aneurysms in most large series. Their etiology has been linked to a variety of causes including atherosclerosis, fibromuscular dysplasia, cystic medial necrosis, connective tissue disease, hypertension, diabetes, hyperlipidemia, infection, cardiac myxoma, oral contraceptive use, vasculitis, and lymphoproliferative disorders. The finding of numerous lesions in a single patient is distinctly uncommon. Case Description: We describe the unique case of a 47-year-old female who developed multiple FIAs over a 6-year period without an obvious underlying pathology. The patient′s medical history was significant for obesity, migraine headaches, insomnia, breast cancer, and chronic skin rash. Various diagnoses were explored including infectious etiologies, autoimmune vasculopathies, malignancy-related causes, connective tissue disorders, and underlying genetic conditions. However, all investigations, including aneurysm wall and skin biopsies were negative or deemed noncontributory toward making a definitive diagnosis. Conclusion: We report an unusual case of a patient with a normal cerebral angiogram developing numerous, FIAs without obvious underlying etiology over a 6-year period. Close clinical and radiological follow-up is recommended in this case because the natural history of the disease is unclear at this point. The literature regarding potential causes of multiple fusiform intracranial aneuryms is reviewed.

  16. Primary melanoma of the adrenal gland: a case report and review of the literature

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    Machuca-Santacruz José

    2011-07-01

    Full Text Available Abstract Background Primary melanoma of the adrenal gland is exceptionally rare as demonstrated by the few cases reported in the medical literature, and it has a high fatality rate. We present the case of a patient with two relapses and survival to date. Case report We describe the case of a 58-year-old Caucasian woman who consulted her doctor with symptoms of asthenia, anorexia and weight loss. A mass was palpated in her abdomen at the height of the left hypochondrium. A computed tomographic scan revealed a retroperitoneal mass measuring 10 cm × 15 cm originating in the left adrenal gland. A left nephroadrenalectomy and splenectomy were performed. Histopathologically, the retroperitoneal mass corresponded to a melanoma, and no primary melanoma was found in any other location. The patient was treated with interferon-α-2b. Three years after her diagnosis the patient presented with a retroperitoneal relapse of the mass measuring 7.2 cm, which was removed. Five years after the first relapse a new retroperitoneal relapse mass was diagnosed, which was also removed. Since then the patient has been healthy and free from illness. Conclusion Histological and immunohistochemical studies, together with the criteria described by Ainsworth et al. and Carstens et al., allowed us to diagnose primary melanoma of the adrenal gland.

  17. Mangled extremity--case report, literature review and borderline cases guidelines proposal.

    Science.gov (United States)

    Bakota, Bore; Kopljar, Mario; Jurjević, Zoran; Staresinić, Mario; Cvjetko, Ivan; Dobrić, Ivan; De Faoite, Diarmuid

    2012-12-01

    Treatment of a mangled lower extremity represents a major challenge. The decision whether to amputate or attempt reconstruction is currently based upon surgical evaluation. The aim of this paper is to propose a new approach to surgical evaluation based on scoring systems, local clinical status of the patient as well as comorbidities, mechanism of trauma and hospital resources. Available literature regarding this topic was evaluated and a case of patient with mangled extremity is presented. Based on current literature guidelines and evidence-based medicine, management for borderline cases is proposed to aid clinical decision making in these situations. We describe a 44-year old male patient who presented with mangled lower left leg. Despite a borderline Mangled Extremity Severity Score (MESS), due to the overall health status of the patient and local clinical status with preserved plantar sensitivity and satisfactory capillary perfusion, reconstruction was attempted. After 6 months of treatment, all wounds healed completely with no pain, and satisfactory motor and sensory function was achieved. In conclusion, the treatment of mangled extremity treatment should be based on evidence based literature along with a clinical evaluation of every individual patient. Scores are helpful, but should not be taken as the sole indication for amputation.

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Sports reporting: a comprehensive review of the medical literature regarding North American professional sports.

    Science.gov (United States)

    Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S

    2014-05-01

    The increased physical demands of professional athletes predispose this patient population to a unique set of injuries typically not seen in the general population. This systematic literature review investigates the nature of injury reporting (both orthopedic and nonorthopedic conditions) in the medical literature of professional athletes in the National Football League (NFL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Hockey League (NHL). Rigorous reporting of sports injuries helps clinicians better understand disease mechanisms relevant to specific sports. The nature of injury reporting will differ within each professional sport and reflect the anatomic emphasis of each sport. An electronic literature search of all publications addressing injuries and medical conditions among professional athletes in the NFL, MLB, NBA, and NHL was conducted using the Pubmed/Medline, Scopus, and Embase databases through January 2013. Retrieved publications were categorized by journal type, medical type, and area of focus. A total of 536 publications met all inclusion criteria. There were a higher number of articles regarding the NFL (n = 211) and MLB (n = 216) when compared with the NBA (n = 34) or NHL (n = 75). The NFL had significantly more articles addressing nonorthopedic injuries/medical issues than were found with the MLB, NBA, or NHL (109 vs 75, 14, 41, respectively). Both the NFL (33 of 109, 30%) and NHL (6 of 41, 15%) had a relatively high percentage of articles regarding concussions/neurology, and MLB had a relatively high percentage of articles dedicated to vascular medicine (13 of 65, 20%). The proportion of publications dedicated to the knee/lower leg were highest in the NFL (29 of 102, 28%) and NBA (9 of 20, 45%), those dedicated to the shoulder/elbow were highest in MLB (113 of 151, 75%), and those dedicated to the hip/pelvis were highest in the NHL (16 of 34, 47%). The number and type of publications vary among the 4

  20. "'Knowledge Growth": A Multiple Case Study of English Literature Graduates' Learning Experiences for Teaching Composition

    Science.gov (United States)

    Richards, Kathleen A.

    2013-01-01

    This multiple case study investigates the learning processes of postsecondary English literature graduates who teach composition to diverse student groups. Since the context of study in English literature graduate programs concentrates on literature and literary theory, the interest of this study examines how teachers learn to teach composition…

  1. "'Knowledge Growth": A Multiple Case Study of English Literature Graduates' Learning Experiences for Teaching Composition

    Science.gov (United States)

    Richards, Kathleen A.

    2013-01-01

    This multiple case study investigates the learning processes of postsecondary English literature graduates who teach composition to diverse student groups. Since the context of study in English literature graduate programs concentrates on literature and literary theory, the interest of this study examines how teachers learn to teach composition…

  2. Mastoid Osteoma; A Case Report and Review of Literature

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    Selcan Kesgin

    2015-11-01

    Full Text Available Osteomas of the temporal bone are rare and are usually located in the external acoustic canal, squamous part of the temporal bone, middle ear, glenoid fossa, Eustachian tube, styloid process, internal acoustic canal. A limited number of mastoid osteomas have been reported in the literature. These tumors are usually nonsymptomatic unless they are too big leading to cosmetic deformity. In this report, a young male patient diagnosed with mastoid osteom is presented with literature review.

  3. Forensic evaluation of medical liability cases in general surgery.

    Science.gov (United States)

    Moreira, H; Magalhães, T; Dinis-Oliveira, Rj; Taveira-Gomes, A

    2014-10-01

    Although medical liability (disciplinary, civil and criminal) is increasingly becoming an issue, few studies exist, particularly from the perspective of forensic science, which demonstrate the extent to which medical malpractice occurs, or when it does, the reasons for it. Our aims were to evaluate the current situation concerning medical liability in general surgery (GS) in Portugal, the reasons for claims, and the forensic evaluations and conclusions, as well as the association between these issues and the judicial outcomes. We analysed the Medico-Legal Council (CML) reports of the National Institute of Legal Medicine and Forensic Sciences of Portugal related to GS during 2001-2010. The judicial outcomes of each case were requested from the Public Prosecutor Office (PPO) and the court. Alleged cases of medical liability in GS represented 11.2% of the total cases analysed by the CML. We estimated that in Portugal, 4:100,000 surgeries are subject to litigation. The majority of complaints were due to the patient's death (75.4%), with laparoscopic cholecystectomy surgeries representing 55.2% of cases. In 76.1% of the cases, the CML believed that there was no violation of legesartis and in 55.2% of cases, no causal nexus was found between the medical practice and the alleged harm. The PPO prosecuted physicians in 6.4% of the cases and resulted in one conviction. Finally, the importance of the CML reports as a relevant technical-scientific tool for judicial decision was evident because these reports significantly (p < 0.05) influenced the prosecutor's decision, whether to prosecute or not.

  4. Kimura's disease accompanied by mediastinal lymphadenopathy misdiagnosed as lung cancer: Case report and review of literatures

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    Xi SUN

    2012-06-01

    Full Text Available Objective  To further investigate the diagnostic pitfalls of Kimura's disease(KD. Methods  We report one case of Kimura's disease accompanied with mediastinal lymphadenopathy admitted to General Hospital of Chinese PLA in the year 2010. After searching on PubMed and Chinese Medical Journal Searching Engines(Wanfang data base,Cqvip data base,we have found literatures reporting another 3 cases of Kimura's disease with mediastinal lymphadenopathy. Plus the one we presented, all four patients' clinical data were collected and analyzed thereafter. Up-to-date advancement on KD's diagnosis and therapy would also be reviewed. Results  Our case, a 61-year-old male, was initially misdiagnosed as lung cancer with mediastinal metastasis in 2008, but histopathology had confirmed only eosinophil infiltration in enlarged mediasinal lymph nodes, no malignant cells were identified. In the year 2010, he complained bilateral orbital masses, one of which was surgically removed, and was later confirmed as Kimura's disease by histopathology. Clinical features of 4 patients, including our case and the other 3 retrieved in literatures, were available, 2 of whom were misdiagnosed as lung cancer while the other 2 as lymphoma in the beginning. All the 4 patients were responsive to steroid therapy. Conclusions  Kimura's disease could be associated with mediastinal lymphadenopathy which may confuse the physicians in diagnosing. Newly developed minimal invasive approaches such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA are helpful for the differential diagnosis.

  5. Suicide case due to phosphoric acid ingestion: case report and review of literature.

    Science.gov (United States)

    Aquila, Isabella; Pepe, Francesca; Di Nunzio, Ciro; Ausania, Francesco; Serra, Arianna; Ricci, Pietrantonio

    2014-11-01

    Ingesting caustic substances represents a common event which may result in serious injuries of the gastrointestinal system. Severity of injury depends on the type of ingested substance: Caustic burns are more frequently associated with acid ingestion and their severity depends on type, concentration, time of exposure, and amount of the ingested substance. We report a case of phosphoric acid ingestion leading to death in a patient with depressive disorder. While reports ingestion of other acids and organophosphates can be found in the literature, there are no reports detailing a death due to phosphoric acid ingestion. We hope that presenting the findings in this case can aid death investigators in future cases that may involve ingestion of such a substance. After autopsy pH, phosphate and calcium ions concentration in the blood were analyzed. The cause of death was due to systemic effects: metabolic acidosis, hypophosphatemia, hypocalcemia, and hyperkalemia.

  6. Perinatal asphyxia and medical professional liability: A case series

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    Andrea Verzeletti

    2016-12-01

    Full Text Available In the context of medical professional liability, obstetrics is one of the most involved medical specialties because the unfavorable outcome of a pregnancy is difficult to accept for parents, who tend to reduce it to inappropriate care that occurred during pregnancy or birth. 32 cases of perinatal asphyxia were evaluated by the Institute of Forensic Medicine in Brescia during the period between 1999 and 2014 (13 in Civil Court and 19 in Penal Court. 9 out of the 32 pregnancies were twins, so the considerations were carried out on a total of 41 fetuses/newborns. Profiles of inadequacy were identified in 66% of cases (85% of the cases evaluated in Civil Court; 53% of the cases evaluated in Penal Court. The existence of a causal relationship between the medical conduct and the onset of asphyxia was recognized in 79% of civil cases and in 38% of penal cases. There is a “greater rigor” in the verification of causal relationship and malpractice profiles in penal cases compared to civil ones: this is in harmony with the most recent Italian Court decisions, characterized by compelling suspect’s protection in the presence of a reasonable doubt in criminal matters and by victim’s protection in civil ones.

  7. Medical literature searches: a comparison of PubMed and Google Scholar.

    Science.gov (United States)

    Nourbakhsh, Eva; Nugent, Rebecca; Wang, Helen; Cevik, Cihan; Nugent, Kenneth

    2012-09-01

    Medical literature searches provide critical information for clinicians. However, the best strategy for identifying relevant high-quality literature is unknown. We compared search results using PubMed and Google Scholar on four clinical questions and analysed these results with respect to article relevance and quality. Abstracts from the first 20 citations for each search were classified into three relevance categories. We used the weighted kappa statistic to analyse reviewer agreement and nonparametric rank tests to compare the number of citations for each article and the corresponding journals' impact factors. Reviewers ranked 67.6% of PubMed articles and 80% of Google Scholar articles as at least possibly relevant (P = 0.116) with high agreement (all kappa P-values Google Scholar articles had a higher median number of citations (34 vs. 1.5, P Google Scholar searches often identify different articles. In this study, Google Scholar articles were more likely to be classified as relevant, had higher numbers of citations and were published in higher impact factor journals. The identification of frequently cited articles using Google Scholar for searches probably has value for initial literature searches. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  8. Interventions to increase medication adherence in African-American and Latino populations: a literature review.

    Science.gov (United States)

    Hu, Daniel; Juarez, Deborah Taira; Yeboah, Michelle; Castillo, Theresa P

    2014-01-01

    The objective of this systematic review was to investigate the effectiveness of interventions to improve medication adherence in ethnic minority populations. A literature search from January 2000 to August 2012 was conducted through PubMed/Medline, Web of Science, The Cochrane Library, and Google Scholar. Search terms used included: medication (MeSH), adherence, medication adherence (MeSH), compliance (MeSH), persistence, race, ethnicity, ethnic groups (MeSH), minority, African-American, Hispanic, Latino, Asian, Pacific Islander, and intervention. Studies which did not have ≥75% of the sample population comprised of individuals of any one ethnic background were excluded, unless the authors performed sub-group analyses by race/ethnicity. Of the 36 studies identified, 20 studies showed significant post-intervention differences. Sample population sizes ranged from 10 to 520, with a median of 126.5. The studies in this review were conducted with patients of mainly African-American and Latino descent. No studies were identified which focused on Asians, Pacific Islanders, or Native Americans. Interventions demonstrating mixed results included motivational interviewing, reminder devices, community health worker (CHW) delivered interventions, and pharmacist-delivered interventions. Directly observed therapy (DOT) was a successful intervention in two studies. Interventions which did not involve human contact with patients were ineffective. In this literature review, studies varied significantly in their methods and design as well as the populations studied. There was a lack of congruence among studies in the way adherence was measured and reported. No single intervention has been seen to be universally successful, particularly for patients from ethnic minority backgrounds.

  9. Solitary intracerebral chondroma without meningeal attachment: a case report with review of the literature.

    Science.gov (United States)

    Zhan, R-Y; Pan, X-F; Wan, S; Lan, P; Zhang, Y-C; Weng, N-C; Yan, M; Zhou, Y-Q

    2011-01-01

    Intracranial chondromas are rare, benign cartilaginous tumours that account for meningeal attachment. The epidemiology, aetiology, clinical behaviour, radiological features, histological features and treatment of the case are discussed with a review of previous cases reported in the literature.

  10. Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature

    Directory of Open Access Journals (Sweden)

    Blom RM

    2016-06-01

    Full Text Available Rianne M Blom,1 Nienke C Vulink,1 Sija J van der Wal,1 Takashi Nakamae,1–3 Zhonglin Tan,1,4 Eske M Derks,1 Damiaan Denys1,5 1Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 3Department of Neural Computation for Decision-Making, ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan; 4Department of Psychiatry, Hangzhou Mental Health Center, Hangzhou, People’s Republic of China; 5Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands Abstract: Body integrity identity disorder (BIID is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only Western patients with BIID, suggesting that the disorder might be merely prevalent in the West. To scrutinize this assumption, and to extend our knowledge of the etiology of BIID, it is important to trace cases with BIID in non-Western populations. Our objective was to review Chinese and Japanese literature on BIID to learn about its presence in populations with a different genetic background. A systematic literature search was performed in databases containing Japanese and Chinese research, published in the respective languages. Five Japanese articles of BIID were identified which described two cases of BIID, whereas in the Chinese databases only BIID-related conditions were found. This article reports some preliminary evidence that BIID is also present in non-Western countries. However, making general statements about the biological background of the disorder is hampered by the extremely low number of cases found. This low number possibly resulted from the extreme secrecy

  11. Medication Reconciliation at Discharge from Hospital: A Systematic Review of the Quantitative Literature

    Directory of Open Access Journals (Sweden)

    Maja H. Michaelsen

    2015-06-01

    Full Text Available Medicines reconciliation is a way to identify and act on discrepancies in patients’ medical histories and it is found to play a key role in patient safety. This review focuses on discrepancies and medical errors that occurred at point of discharge from hospital. Studies were identified through the following electronic databases: PubMed, Sciences Direct, EMBASE, Google Scholar, Cochrane Reviews and CINAHL. Each of the six databases was screened from inception to end of January 2014. To determine eligibility of the studies; the title, abstract and full manuscript were screened to find 15 articles that meet the inclusion criteria. The median number of discrepancies across the articles was found to be 60%. In average patient had between 1.2–5.3 discrepancies when leaving the hospital. More studies also found a relation between the numbers of drugs a patient was on and the number of discrepancies. The variation in the number of discrepancies found in the 15 studies could be due to the fact that some studies excluded patient taking more than 5 drugs at admission. Medication reconciliation would be a way to avoid the high number of discrepancies that was found in this literature review and thereby increase patient safety.

  12. Mentoring programs for medical students - a review of the PubMed literature 2000 - 2008

    Science.gov (United States)

    2010-01-01

    Background Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. Methods A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. Results The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. Conclusion Mentoring is obviously an important career advancement tool for medical students. In Europe

  13. Mentoring programs for medical students - a review of the PubMed literature 2000 - 2008

    Directory of Open Access Journals (Sweden)

    Buddeberg-Fischer Barbara

    2010-04-01

    Full Text Available Abstract Background Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. Methods A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. Results The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. Conclusion Mentoring is obviously an important career advancement tool for

  14. Acute Immunologic Reaction to Silicone Breast Implant after Mastectomy and Immediate Reconstruction: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Massoome Najafi

    2014-08-01

    Full Text Available Background: Since the introduction of silicone based medical devices in to clinical practice, several reports appeared in the medical literature regarding their adverse effects. However, there are few reports of immunologic reactions to these implants.Case presentation: A case of systemic reaction to a breast implant inserted for immediate breast reconstruction in a breast cancer patient is presented. The patient developed fever and skin rash two months after the surgery. Investigations disclosed no infectious origin for the fever and a dramatic response to steroid therapy was observed.Conclusion: Immunologic reaction should be considered in case of systemic signs and symptoms after silicone breast implant placement as a rare complication. 

  15. Breadth versus volume: Neurology outpatient clinic cases in medical education.

    Science.gov (United States)

    Albert, Dara V; Blood, Angela D; Park, Yoon Soo; Brorson, James R; Lukas, Rimas V

    2016-06-01

    This study examined how volume in certain patient case types and breadth across patient case types in the outpatient clinic setting are related to Neurology Clerkship student performance. Case logs from the outpatient clinic experience of 486 students from The University of Chicago Pritzker School of Medicine, USA, participating in the 4week Neurology Clerkship from July 2008 to June 2013 were reviewed. A total of 12,381 patient encounters were logged and then classified into 13 diagnostic categories. How volume of cases within categories and the breadth of cases across categories relate to the National Board of Medical Examiners Clinical Subject Examination for Neurology and a Neurology Clerkship Objective Structured Clinical Examination was analyzed. Volume of cases was significantly correlated with the National Board of Medical Examiners Clinical Subject Examination for Neurology (r=.290, pNeurology (r=.231, p=.017), however was not significantly correlated with any component of the Objective Structured Clinical Examination. Volume of cases correlated with higher performance on measures of specialty knowledge and clinical skill. Fewer relationships emerged correlating breadth of cases and performance on the same measures. This study provides guidance to educators who must decide how much emphasis to place on volume versus breadth of cases in outpatient clinic learning experiences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. A Recurrent Case of Pentalogy of Cantrell: A Rare Case with Sonological Findings and Review of Literature

    Science.gov (United States)

    Naren Satya, Srinivas M.; Mayilvaganan, Kamala Retnam; Prathyusha, Ivvala Sai; Gautam, Munnangi Satya; Raidu, Deepthi; Amogh, V.N.

    2017-01-01

    Summary Background Pentalogy of Cantrell (POC) is an extremely rare and complex congenital anomaly. Ultrasound is a valuable, safe, nonionizing, cost effective, widely available, and easily reproducible imaging tool and is indispensible in the diagnosis of POC. Despite the rarity of POC, it is imperative for a radiologist to be aware of its wide spectrum of presentation on ultrasound in first trimester of gestation. Most reported cases in literature till now have been sporadic. In this paper, we aimed to report for the first time in literature, a recurrent case of POC detected in the first trimester in a mother whose previous pregnancy also was terminated in the second trimester medically due to the ultrasound diagnosis of POC. We also discuss the role of ultrasound and other imaging modalities in a case of POC as well as the differential diagnoses which can mimic POC. Case Report A 23-year-old G2P0A1 (Gravida2, para0, abortion1) woman with a gestational age of around 12 weeks was referred for a routine first trimester ultrasound scan. The antenatal ultrasound scan showed a single, live, intrauterine gestation corresponding to a gestational age of 11 weeks and 5 days. The fetal heart was visualized outside the chest through a defect in the lower sternum in association with anterior diaphragmatic and ventral abdominal wall defects suggestive of thoraco-abdominal variety of ectopia cardis. There was a membrane covered, midline, abdominal wall defect at the base of the umbilical cord insertion containing the herniated abdominal organs including the liver, bowel loops and the ectopic cardia. There was a breach in the normal outline of the lower sternum indicating a sternal deficiency. The fetal pericardium was absent. The nuchal translucency was grossly increased. Pentalogy of Cantrell was diagnosed on ultrasound and the patient was explained about the poor prognosis of this condition. An informed consent was obtained after she opted for medical termination of

  17. Surgical Management of Traumatic Penile Amputation: A Case Report and Review of the World Literature

    Directory of Open Access Journals (Sweden)

    Omer A. Raheem, MD

    2015-03-01

    Conclusion: We review the literature and case reports on penile amputation and its etiology, surgical management, variables effecting outcomes, and its complications. Raheem OA, Mirheydar HS, Patel ND, Patel SH, Suliman A, and Buckley JC. Surgical management of traumatic penile amputation: A case report and review of the world literature. Sex Med 2015;3:49–53.

  18. Vulvar mucinous adenocarcinoma with neuroendocrine differentiation: A case report and review of the literature

    NARCIS (Netherlands)

    Rosmalen, M.H. Van; Reijnen, C.; Boll, D.; Pijnenborg, J.M.A.; Wurff, A.A. van der; Piek, J.M.

    2016-01-01

    BACKGROUND: There are limited cases in literature of patients with mucinous adenocarcinoma of the vulva with neuroendocrine differentiation have. With this new case, we aim to provide an overview of the existing literature and present a tool with relevant markers for the pathologist in the different

  19. Medical Clowning and Psychosis: A Case Report and Theoretical Review.

    Science.gov (United States)

    Gruber, Alex; Levin, Raz; Lichtenberg, Pesach

    2015-01-01

    The medical clown has become an accepted therapeutic figure in non-psychiatric hospital departments in recent years. However, the potential role of the clown in psychiatry, especially for the treatment of psychosis, has not been investigated. We report here on the functioning of a medical clown in an inpatient psychiatric department. A program using psychodramatic group therapy techniques with the clown serving as moderator was developed. We describe the case of one individual diagnosed with schizophrenia who in the course of four and a half months of group therapy led by the medical clown was able to adopt a succession of surprising roles. This process may have contributed to the patient's remission. We discuss the special capacity of medical clowns to encourage communication and indulge in fantasy while returning to consensual reality. We suggest that this may have particular relevance in work with psychotic individuals.

  20. Goldenhar syndrome: A case report and literature review

    African Journals Online (AJOL)

    Goldenhar syndrome is presented and the challenges of ... The aetiology in most cases is often difficult to ascertain. Some cases .... spared. An attempt to carry out an estimation of the respiratory ... for a trade that required acute sense of vision.

  1. Traumatic abdominal wall hernia: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Osama S. Al Beteddini

    2016-01-01

    Conclusion: Traumatic abdominal wall hernia presents a diagnostic as well as a therapeutic challenge. The therapeutic approach is governed by a multitude of factors emphasizing the need of a patient-tailored, case by case management plan.

  2. A rare presentation in two cases with review of literature

    African Journals Online (AJOL)

    2011-07-29

    Jul 29, 2011 ... while there was an associated mild pain in the second case. In both cases, the clinical ... scan (CECT) of the brain was done to rule out coexistent neurological ... Musculocutaneous and visceral cysticercosis: A rare disease?

  3. Brain Gains: a literature review of medical missions to low and middle-income countries

    Directory of Open Access Journals (Sweden)

    Martiniuk Alexandra LC

    2012-05-01

    Full Text Available Abstract Background Healthcare professionals’ participation in short-term medical missions to low and middle income countries (LMIC to provide healthcare has become common over the past 50 years yet little is known about the quantity and quality of these missions. The aim of this study was to review medical mission publications over 25 years to better understand missions and their potential impact on health systems in LMICs. Methods A literature review was conducted by searching Medline for articles published from 1985–2009 about medical missions to LMICs, revealing 2512 publications. Exclusion criteria such as receiving country and mission length were applied, leaving 230 relevant articles. A data extraction sheet was used to collect information, including sending/receiving countries and funding source. Results The majority of articles were descriptive and lacked contextual or theoretical analysis. Most missions were short-term (1 day – 1 month. The most common sending countries were the U.S. and Canada. The top destination country was Honduras, while regionally Africa received the highest number of missions. Health care professionals typically responded to presenting health needs, ranging from primary care to surgical relief. Cleft lip/palate surgeries were the next most common type of care provided. Conclusions Based on the articles reviewed, there is significant scope for improvement in mission planning, monitoring and evaluation as well as global and/or national policies regarding foreign medical missions. To promote optimum performance by mission staff, training in such areas as cross-cultural communication and contextual realities of mission sites should be provided. With the large number of missions conducted worldwide, efforts to ensure efficacy, harmonisation with existing government programming and transparency are needed.

  4. Extremely Rare Form of Impaction Bilateral Kissing Molars: Report of a Case and Review of the Literature.

    Science.gov (United States)

    Zerener, Tamer; Bayar, Gurkan Rasit; Altug, Hasan Ayberk; Kiran, Serkan

    2016-01-01

    Kissing molars (KM) or rosette formation is a term that is used to describe impacted teeth contacting occlusal surfaces in a single follicular space and their roots pointing in opposite directions. In some cases kissing molars can be seen but occurrence of bilateral kissing molars is extremely rare phenomenon in the dental literature and the aetiology of this phenomenon is still unknown. In this paper we describe a case and review of the literature and discuss the management of this pathology. In our case, extremely rare form of impacted bilateral kissing molars was extracted surgically. The decision of extraction of asymptomatic kissing molars represents surgical dilemma. There may be many surgical complications; on the other hand in some cases surgical intervention is unavoidable. Few treatment options were described in the literature. This phenomenon can be sign of various medical conditions that may require further investigation. In this paper, our treatment option is in agreement with the literature suggesting the surgical removal of both teeth at either side of the mandible.

  5. Francisella tularensis endocarditis: two case reports and a literature review.

    Science.gov (United States)

    Gaci, Rostane; Alauzet, Corentine; Selton-Suty, Christine; Lozniewski, Alain; Pulcini, Céline; May, Thierry; Goehringer, François

    2017-02-01

    We report the first two cases of infective endocarditis caused by Francisella tularensis in Europe (two cases have previously been reported outside Europe). We suggest clinicians should consider tularemia as a possible diagnosis in endemic regions in cases of culture-negative endocarditis.

  6. Manubrial stress fractures diagnosed on MRI: report of two cases and review of the literature

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    Baker, Jonathan C.; Demertzis, Jennifer L. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, Musculoskeletal Section, St Louis, MO (United States)

    2016-06-15

    In contrast to widely-reported sternal insufficiency fractures, stress fractures of the sternum from overuse are extremely rare. Of the 5 cases of sternal stress fracture published in the English-language medical literature, 3 were in the sternal body and only 2 were in the manubrium. We describe two cases of manubrial stress fracture related to golf and weightlifting, and present the first report of the MR findings of this injury. In each of these cases, the onset of pain was atraumatic, insidious, and associated with increased frequency of athletic activity. Imaging was obtained because of clinical diagnostic uncertainty. On MRI, each patient had a sagittally oriented stress fracture of the lateral manubrium adjacent to the first rib synchondrosis. Both patients had resolution of pain after a period of rest, with subsequent successful return to their respective activities. One patient had a follow-up MRI, which showed resolution of the manubrial marrow edema and fracture line. Based on the sternal anatomy and MR findings, we hypothesize that this rare injury might be caused by repetitive torque of the muscle forces on the first costal cartilage and manubrium, and propose that MRI might be an effective means of diagnosing manubrial stress fracture. (orig.)

  7. Xanthomatous Hypophysitis Presenting with Diabetes Insipidus Completely Cured Through Transsphenoidal Surgery: Case Report and Literature Review.

    Science.gov (United States)

    Lin, Wei; Gao, Lu; Guo, Xiaopeng; Wang, Wenze; Xing, Bing

    2017-08-01

    Xanthomatous hypophysitis (XH) is extremely rare. Only 27 cases have been reported in the literature. No XH patient presenting with diabetes insipidus (DI) has been completely cured through surgery. Here, we describe the first XH case of a DI patient whose pituitary function was normalized postoperatively, without hormone replacement therapy. A 41-year-old woman suffered from polydipsia, DI, headache, and breast discharge. Laboratory investigation revealed hyperprolactinemia. Pituitary magnetic resonance imaging showed a 2.0-cm × 1.4-cm × 1.6-cm lesion that demonstrated heterogeneous intensity on T1-weighted imaging and peripheral ring enhancement following contrast; the lesion was totally removed through transsphenoidal surgery. Histopathologic and immunohistochemical examinations confirmed the diagnosis of XH. At the 4- and 15-month follow-up visits, all pituitary-related hormones were normal, and the patient was not taking medication. A repeat pituitary magnetic resonance imaging showed no evidence of recurrence. To the best of our knowledge, this case is the first documented occurrence of XH with DI completely cured through surgery. If XH is suspected, total surgical resection of the lesion is recommended and normal pituitary tissue should be carefully protected intraoperatively. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Association of autoimmune hepatitis and systemic lupus erythematodes: a case series and review of the literature.

    Science.gov (United States)

    Beisel, Claudia; Weiler-Normann, Christina; Teufel, Andreas; Lohse, Ansgar W

    2014-09-21

    Liver test abnormalities have been described in up to 60% of patients with systemic lupus erythematodes (SLE) at some point during the course of their disease. Prior treatment with potentially hepatotoxic drugs or viral hepatitis is commonly considered to be the main cause of liver disease in SLE patients. However, in rare cases elevated liver enzymes may be due to concurrent autoimmune hepatitis (AIH). To distinguish whether the patient has primary liver disease with associated autoimmune clinical and laboratory features resembling SLE - such as AIH - or the elevation of liver enzymes is a manifestation of SLE remains a difficult challenge for the treating physician. Here, we present six female patients with complex autoimmune disorders and hepatitis. Patient charts were reviewed in order to investigate the complex relationship between SLE and AIH. All patients had coexisting autoimmune disease in their medical history. At the time of diagnosis of AIH, patients presented with arthralgia, abdominal complaints, cutaneous involvement and fatigue as common symptoms. All patients fulfilled the current diagnostic criteria of both, AIH and SLE. Remission of acute hepatitis was achieved in all cases after the initiation of immunosuppressive therapy. In addition to this case study a literature review was conducted.

  9. [Iatrogenic cervical epidural hematoma: case report and review of the literature].

    Science.gov (United States)

    Jusué-Torres, I; Ortega-Zufiria, J M; Tamarit-Degenhardt, M; Navarro Torres, R; López-Serrano, R; Riqué-Dormido, J; Aragonés-Cabrerizo, P; Gómez-Angulo, J C; Poveda-Nuñez, P; Jerez-Fernández, P; Del Pozo-García, J M

    2011-08-01

    Around 600 spinal epidural hematoma cases have been previously reported. Incidence of paraplegia after epidural anesthesia varies between 0,0005 and 0,02%. Several possible etiologies have been described in the literature, including surgery, trauma, anticoagulant therapy, arteriovenous malformations, pregnancy and lumbar puncture. Spinal and epidural anesthesic procedures represent the tenth most common cause. But in combination with anticoagulant therapy, the forementioned procedures increase its incidence until reaching the fifth most common etiological group. We report the case of an 80 year-old-man with a cervical epidural hematoma who had a good outcome with conservative management. 80 year-old-man that developed intense cervicalgia with lower limbs weakness showing complete paraplegia and arreflexia 2 hours after analgesic treatment with epidural cervical infiltration for cervicoartrosis. Cervical MRI showed epidural cervical hematoma between C4 and T1 levels. The patient is transferred to our facilities in order to perform surgery. But after showing fast recovery, medical conservative management was elected. After one month, the patient's condition has improved showing no neurological deficits and complete resorption is seen in MRI. Nowadays, trend is to perform surgery in patients with spinal hematoma and significant neurological deterioration during the first hours. However, good neurological outcomes can be achieved with conservative management, in well selected patients with non progressive, incomplete and partial deficits. Presently, we can not predict which is the best treatment for each case.

  10. Pulmonary histoplasmosis in a immunocompetent patient: A case report and literature review

    Science.gov (United States)

    Zhu, Cui; Wang, Ge; Chen, Qiong; He, Bixiu; Wang, Lijing

    2016-01-01

    In the present study, the case of a 54-year-old male patient diagnosed with pulmonary histoplasmosis is reported, with the aim to increase the understanding of the disease characteristics and thereby facilitate the diagnosis and treatment of pulmonary histoplasmosis. Clinical manifestations, diagnosis, treatment and clinical outcomes of the present case of pulmonary histoplasmosis were described. In addition, 76 histoplasmosis patients with complete clinical data were reviewed by searching the literature for relevant studies published during 1990 and 2015. The disease was mainly manifested as cough in the present case, while imaging examination detected a lump shadow in the right lung, accompanied by exudative lesions. Initially, the patient was suspected to have bacterial pneumonia, but subsequently the diagnosis of pulmonary histoplasmosis was confirmed by lung biopsy. The symptoms were alleviated following itraconazole treatment. The patient was physically stable and had no recurrence during the subsequent follow-up period. In conclusion, pulmonary histoplasmosis is characterized by non-specific clinical and imaging manifestations, and lung tissue biopsy or respiratory pathogen culture are regarded as the diagnostic gold standards. Individualized antifungal medication should be administered based upon the patients' situation in terms of dosage and duration. PMID:27882146

  11. Rhodococcus equi venous catheter infection: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Nahleh Zeina

    2011-08-01

    Full Text Available Abstract Introduction Rhodococcus equi is an animal pathogen that was initially isolated from horses and is being increasingly reported as a cause of infection in humans with impaired cellular immunity. However, this pathogen is underestimated as a challenging antagonist and is frequently considered to be a mere contaminant despite the potential for life-threatening infections. Most case reports have occurred in immunocompromised patients who have received organ transplants (for example kidney, heart, bone marrow or those with human immunodeficiency virus infection. Infections often manifest as pulmonary involvement or soft tissue abscesses. Bacteremia related to R. equi infections of tunneled central venous catheters has rarely been described. Case presentation We report the case of a 63-year-old non-transplant recipient, non-HIV infected Caucasian woman with endometrial carcinoma who developed recurrent bloodstream infections and septic shock due to R. equi and ultimately required the removal of her port catheter, a subcutaneous implantable central venous catheter. We also review the medical literature related to human infections with R. equi. Conclusion R. equi should be considered a serious pathogen, not a contaminant, particularly in an immunocompromised patient who presents with a central venous catheter-related bloodstream infection. Counseling patients with central venous catheters who participate in activities involving exposure to domesticated animals is recommended.

  12. Health economic evaluations of medical devices in the People's Republic of China: A systematic literature review

    Directory of Open Access Journals (Sweden)

    Zhang R

    2015-04-01

    Full Text Available Rongrong Zhang, Farhang Modaresi, Oleg Borisenko Synergus AB, Stockholm, Sweden Background: The objective of this study is to identify and review the methodological quality of health economic evaluations of medical devices performed in the People's Republic of China. To our knowledge, no such investigations have been performed to date. Methods: A systematic literature review involving searches of Medline, Medline In-Process, the National Health Service Economic Evaluation Database, the Cost-Effectiveness Analysis Registry of the Tufts Medical Center, and the Wanfang Database was performed. The search spanned the period from 1990 to 2013. Studies on health economic evaluations of medical devices, in-vitro diagnostics, procedures, and the use of medical devices in Chinese health care settings were included. Full-text articles and conference abstracts in English and Chinese were included. Results: Fifty-seven publications were included, 26 (46% of which were in English and 31 (54% of which were in Chinese. The included publications covered a wide range of clinical areas, such as surgery (n=23, 40%, screening (n=9, 16%, imaging use (n=6, 11%, kidney intervention (n=4, 7%, and nine other technological areas. Most of the studies (n=31, 54% were cost analyses. Among the others, 13 (50% studies used modeling, and another 13 (50% were within-trial evaluations. Among studies that used modeling, eleven (85% conducted sensitivity analyses, six of which had one-way sensitivity analysis, whereas one conducted both one-way and two-way sensitivity analyses; four of these eleven modeling-based analyses included probabilistic sensitivity analyses. The incremental cost-effectiveness ratio was reported in ten (18% studies, eight of which were screening studies. The remaining two modeling studies were in areas of imaging and oncology. Conclusion: This study indicates that there are major limitations and deficiencies in the health economic evaluations on medical

  13. Peutz-Jeguers syndrome: case report and literature review

    Directory of Open Access Journals (Sweden)

    Juvenal da Rocha Torres Neto

    2012-03-01

    Full Text Available The Peutz-Jeghers syndrome is a rare disease characterized by the presence of mucocutaneous melanic pigmentation of the lips, oral mucosa and perioral region, associated with hamartomatous intestinal polyposis. Malignization of the polyps and association with other types of cancer are also usual. Case report: 32-year-old patient, female, white, who had an intestinal occlusion by invagination, discovered during laparotomy, when an intestinal tumor was found as well. The material was sent to anotomopathological analysis. However, the results did not allow to identify the tumor nature due to tumor necrosis. Then, the patient was sent to our service because of the intestinal polyps, and during the interview, the characteristic melanic pigmentation was observed. Videocolonoscopy was performed, with excision of two rectal polyps, identified in the anatomopathological exam as hamartomatous polyps. The patient reported anal imperforation at birth, just like her brother. He had unexplained death. The authors found no correlation of the Peutz-Jeghers syndrome with anal imperforation in the literature and asked the patient if her brother also had the syndrome.A síndrome de Peutz-Jeghers é uma doença rara que tem como características a pigmentação melânica mucocutânea de lábios, regiões perioral e de mucosa bucal associada à polipose hamartomatosa do trato intestinal, com possibilidade de malignização dos pólipos digestivos e associação com outros tipos de câncer. Relato de Caso: Paciente de 32 anos, de gênero feminino, branca, apresentou um quadro de oclusão intestinal por uma invaginação, evidenciada durante laparotomia exploradora, constatando-se, ainda, a presença de uma tumoração intestinal. O material foi encaminhado para exame anatomopatológico; porém, foi inconclusivo para a natureza da tumoração em decorrência da necrose. Em função do pólipo intestinal, a paciente foi encaminhada ao nosso serviço, quando percebemos

  14. Odontomas in the primary dentition: literature review and case report.

    Science.gov (United States)

    Sheehy, Evelyn C; Odell, Edward W; Al-Jaddir, Ghaida

    2004-01-01

    Odontomas are hamartomatous developmental malformations of dental tissues. They are very rarely diagnosed in the primary dentition. The purpose of this paper was to review the literature in relation to odontomas in the primary dentition, and describe the dental management of a child, age 4 years and 8 months, who had a complex odontoma.

  15. Pulmonary tumor thromboembolism: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Aiyappan Vinod

    2007-01-01

    Full Text Available Pulmonary tumor thromoembolism is well described in literature especially in patients known to have cancer. We are presenting this report of a patient presenting with Acute Cor-pulmonale secondary to Occult Gastric carcinoma causing pulmonary tumor embolism. This is an unusual presentation of occult neoplasm.

  16. Case Disposition: An Assessment of Literature on Police Referral Practices.

    Science.gov (United States)

    Scott, Eric J.; And Others

    This report reviews the manner in which police handle citizen requests for social services. The focus is on how officers make their decisions--whether they handle such requests themselves, direct them elsewhere in the department, or refer citizens to other agencies. In their assessment of the literature on referral practices, the authors point out…

  17. Rectal angiolipoma: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Sabite Kacar; Sedef Kuran; Tulay Temucin; Bulent Odemis; Nilufer Karadeniz; Nurgul Sasmaz

    2007-01-01

    Angiolipoma is a rare vascular variant of the benign lipomatous tumors and is generally seen in subcutaneous tissues. We report a 70-year-old female with abdominal distension not related to rectal small polypoid mass with peduncule described as angiolipoma by histologically,and review the literature.

  18. Case of Lingual Cysticercosis and Review of Literature

    Science.gov (United States)

    Kinger, Arvind; Kawatra, Mallika; Chaudhary, Tej Singh

    2012-01-01

    A 30-year-old female presented with a painless solitary swelling at right lateral border of tongue of 2-month duration. Fine-needle aspiration cytology was nonconclusive. Excision biopsy was done. Histopathology revealed cysticercosis cellulosae and parasite visualized in the slide with tongue muscles. Lingual cysticercosis is rare and therefore its literature is reviewed and discussed. PMID:22923927

  19. Management of trichobezoar: case report and literature review.

    NARCIS (Netherlands)

    Gorter, R.R.; Kneepkens, C.M.; Mattens, E.C.; Aronson, D.C.; Heij, H.A.

    2010-01-01

    Trichobezoars (hair ball) are usually located in the stomach, but may extend through the pylorus into the duodenum and small bowel (Rapunzel syndrome). They are almost always associated with trichotillomania and trichophagia or other psychiatric disorders. In the literature several treatment options

  20. Management of trichobezoar: case report and literature review

    NARCIS (Netherlands)

    Gorter, R.R.; Kneepkens, C.M.F.; Mattens, E.C.J.L.; Aronson, D.C.; Heij, H.A.

    2010-01-01

    Trichobezoars (hair ball) are usually located in the stomach, but may extend through the pylorus into the duodenum and small bowel (Rapunzel syndrome). They are almost always associated with trichotillomania and trichophagia or other psychiatric disorders. In the literature several treatment options

  1. Aspirin allergy desensitization in cerebrovascular disease. A report of two cases, literature review and management guide for the neurointerventionalist.

    Science.gov (United States)

    Zuckerman, Scott L; Seder, David B; Tsujiura, Crystiana; Cushing, Deborah; Gallup, Holly; Mocco, J; Hanel, Richard A; Ecker, Robert D

    2014-01-01

    Aspirin (ASA) is the mainstay of treatment in cerebrovascular and systemic vascular disease. ASA hypersensitivity can pose a challenge to achieving optimum medical management prior to and after neurointerventional treatment. Desensitization to ASA is well described in the allergy and cardiovascular literature, but there are no similar discussions specific to neurointervention. The purpose of our study was to describe our experience with ASA hypersensitivity management and review the relevant literature. Two cases of patients with symptomatic cerebrovascular disease requiring neurointervention who were successfully desensitized to their ASA hypersensitivity prior to treatment are described. The subsequent literature is reviewed. Several ASA desensitization protocols exist and have been proven to successfully treat ASA hypersensitivity and allow for ASA therapy to be safely initiated. We describe several previously published protocols. ASA desensitization is a safe and simple way to manage ASA hypersensitivity. We provide comprehensive management guidelines for the neurointerventionalist engaging in ASA desensitization.

  2. Bartonella and intraocular inflammation: a series of cases and review of literature

    Directory of Open Access Journals (Sweden)

    Kalogeropoulos C

    2011-06-01

    Full Text Available Chris Kalogeropoulos1, Ioannis Koumpoulis1, Andreas Mentis2, Chrisavgi Pappa1, Paraskevas Zafeiropoulos1, Miltiadis Aspiotis11Department of Ophthalmology, Medical School, University of Ioannina, Greece; 2Laboratory of Medical Microbiology, Hellenic Pasteur Institute, Athens, GreecePurpose: To present various forms of uveitis and/or retinal vasculitis attributed to Bartonella infection and review the impact of this microorganism in patients with uveitis.Methods: Retrospective case series study. Review of clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2001 to 2010 in the Ocular Inflammation Department of the University Eye Clinic, Ioannina, Greece. Presentation of epidemiological and clinical data concerning Bartonella infection was provided by the international literature.Results: Eight patients with the diagnosis of Bartonella henselae and two patients with B. quintana intraocular inflammation were identified. Since four patients experienced bilateral involvement, the affected eyes totaled 14. The mean age was 36.6 years (range 12–62. Uveitic clinical entities that we found included intermediate uveitis in seven eyes (50%, vitritis in two eyes (14.2%, neuroretinitis in one eye (7.1%, focal retinochoroiditis in one eye (7.1%, branch retinal vein occlusion (BRVO due to vasculitis in one eye (7.1%, disc edema with peripapillary serous retinal detachment in one eye (7.1%, and iridocyclitis in one eye (7.1%. Most of the patients (70% did not experience systemic symptoms preceding the intraocular inflammation. Antimicrobial treatment was efficient in all cases with the exception of the case with neuroretinitis complicated by anterior ischemic optic neuropathy and tubulointerstitial nephritis.Conclusion: Intraocular involvement caused not only by B. henselae but also by B. quintana is being diagnosed with increasing frequency. A high index of suspicion is needed because the

  3. Quantitative evaluation of English-Japanese machine translation of medical literature.

    Science.gov (United States)

    Kiuchi, T; Kaihara, S

    1991-08-01

    Although many machine-translation programs are currently available, few evaluation methods of such translation exist for any given application area. It is difficult to evaluate machine-translation systems objectively because the quality of a translation depends on the combination of three factors: the translation program, the dictionary, and the original document. In this study, we developed a quantitative evaluation method for assessing machine translation, which evaluates these three factors separately. We applied this method to the translation of English to Japanese for medical literature and the method proved to be a good indicator for further system improvement. Using this method we also discovered other important points for machine translation, such as the examination of target documents for the construction of a better application dictionary.

  4. Driving licences and medical screening in old age: Review of literature and European licensing policies

    DEFF Research Database (Denmark)

    Siren, Anu Kristiina; Haustein, Sonja

    2015-01-01

    Chronological age, per se, seems to be, in the case of mature drivers, only a weak predictor of safe driving performance. However, screening policies based on chronological age are widely used. Nevertheless, lately, more evidence-based policies have been called for. In this paper we first......, investigate the evidence for and against having an age-based driver screening policy in place; second, we map and compare the current driving licensing policies in European Union (EU) member states in order to examine the variation; and third, we draw conclusions based on the literature and the policy mapping...

  5. [Thyrotoxic periodic paralysis: a case series of four patients and literature review].

    Science.gov (United States)

    Boissier, E; Georgin-Lavialle, S; Cochereau, D; Ducloux, R; Ranque, B; Aslangul, E; Pouchot, J

    2013-09-01

    Periodic thyrotoxic hypokalemic paralysis (TPP) is a neuromuscular complication of hyperthyroidism. It is more common in young Asian males than in Caucasian and African patients. We report four new cases and review the literature. Four consecutive patients were diagnosed with TPP. They were all men with a median age of 34.5 years at presentation. Two patients originated from the Philippines, one was African and one was Caucasian ethnic background. They all presented with a paresis or flaccid paralysis, without respiratory failure. Previous similar episodes in their past medical history, the presence of profound hypokalemia (mean serum potassium level of 2 mmol/L) and the presence of clinical and biological signs of hyperthyroidism led to the diagnosis of TPP. All four patients were diagnosed with Graves' disease. Outcome was favourable in all four patients with the symptomatic treatment of TPP and treatment of Graves' disease. TPP is a severe condition, due to a dysfunction of the Na(+)-K(+) ATPase pump. Initial management relies on β-blocker treatment and careful potassium supplementation. Then, medical or surgical etiological treatment of the thyrotoxicosis is essential to prevent a recurrence. The disease is probably underdiagnosed: it must be suspected when a profound hypokaliema resolves very quickly (<12hours); hyperthyroidism should always be included in the differential diagnosis of a paresis associated with hypokalemia. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  6. Misinformation in the medical literature: what role do error and fraud play?

    Science.gov (United States)

    Steen, R Grant

    2011-08-01

    Media attention to retracted research suggests that a substantial number of papers are corrupted by misinformation. In reality, every paper contains misinformation; at issue is whether the balance of correct versus incorrect information is acceptable. This paper postulates that analysis of retracted research papers can provide insight into medical misinformation, although retracted papers are not a random sample of incorrect papers. Error is the most common reason for retraction and error may be the principal cause of misinformation as well. Still, one-quarter of retracted papers are fraudulent, and misinformation may also arise through fraud. This paper hypothesises that error and fraud are the main sources of misinformation and that error is more common than fraud. Retraction removes misinformation from the literature; bias is non-retracted misinformation. Bias arises when scientific impropriety results in false research findings. Impropriety can involve experimental design, data collection, data analysis, or data presentation. Yet impropriety also arises through earnest error or statistical naiveté; not all bias is fraud. Several measures are proposed to minimise misinformation in the medical literature, including: greater detail in the clinical trial registry, with rigorous definition of inclusion and exclusion criteria and primary endpoints; clear statistical criteria for every aspect of clinical trials, especially sample size; responsibility for data integrity that accrues to all named authors; increased transparency as to how the costs of research were paid; and greater clarity as to the reasons for retraction. Misinformation can arise without malicious intent; authors of incorrect papers are owed a presumption of incompetence, not malice.

  7. Rhetorical Structure and Linguistic Features of Case Presentations in Case Reports in Taiwanese and International Medical Journals

    Science.gov (United States)

    Hung, Hsuan; Chen, Pi-Ching; Tsai, Jing-Jane

    2012-01-01

    The case presentation is the core section of a medical case report. Issues in the teaching of case report writing have recently been the subject of great interest in medical education, especially in the era of globalization. Given that Taiwanese medical students, residents and junior physicians are requested to write case reports in English and…

  8. The Terri Schiavo case: legal, ethical, and medical perspectives.

    Science.gov (United States)

    Perry, Joshua E; Churchill, Larry R; Kirshner, Howard S

    2005-11-15

    Although tragic, the plight of Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care. First, the authors review the current medical understanding of persistent vegetative state, including the requirements for patient examination, the differential diagnosis, and the practice guidelines of the American Academy of Neurology regarding artificial nutrition and hydration for patients with this diagnosis. Second, they examine the legal history, including the 2000 trial, the 2002 evidentiary hearing, and the subsequent appeals. The authors argue that the law did not fail Terri Schiavo, but produced the highest-quality evidence and provided the most judicial review of any end-of-life guardianship case in U.S. history. Third, they review alternative ethical frameworks for understanding the Terri Schiavo case and contend that the principle of respect for autonomy is paramount in this case and in similar cases. Far from being unusual, the manner in which Terri Schiavo's case was reviewed and the basis for the decision reflect a broad medical, legal, and ethical consensus. Greater clarity regarding the persistent vegetative state, less apprehension of the presumed mysteries of legal proceedings, and greater appreciation of the ethical principles at work are the chief benefits obtained from studying this provocative case.

  9. Staphylococcus intermedius infections: case report and literature review

    Directory of Open Access Journals (Sweden)

    Nancy Wang

    2013-01-01

    Full Text Available Staphylococcus intermedius is part of the normal skin and oral flora of dogs. Case reports of human infections are rare, but the true incidence is unknown because the pathogen is frequently misidentified as Staphylococcus aureus. Reported cases range from soft tissue infections to brain abscess. Most reported cases in humans have been related to dog exposure. We report a case of a 73 year old female with S. intermedius surgical wound infection one month following a left elbow total arthroplasty. This is the first reported human case of S. intermedius infection of a mechanical prosthesis. The presumed source of infection was the patient’s dog. The patient was treated with vancomycin, then switched to cefazolin and rifampin once susceptibilities were known. Case reports suggest that patients generally respond well to tailored antibiotics with complete or near-complete recovery. S. intermedius should be included in the differential diagnosis of invasive infection amongst patients with close contact with dogs.

  10. Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

    Science.gov (United States)

    Sanders, Vicki L; Flanagan, Jennifer

    2015-01-01

    The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

  11. A Case Report of Bronchobiliary Fistula and Literature Review

    Institute of Scientific and Technical Information of China (English)

    Liang; Cao; Zhao-min; Song; Quan; Liu; Jun; Sheng; Pei-li; Zhao; Xun; Peng

    2012-01-01

    Bronchobiliary fistula(BBF) is one of the very rare disease.In this report,we described a BBF case.The case was diagnosed by endoscopic retrograde cholangio-pancreatography(ERCP) and percutaneous transhepatic cholangial drainage(PTCD) examinations,and treated properly.From the diagnosis of this BBF case,a patient with cough,biliptysis,fever and pain,should be considered for diagnosis of BBF.

  12. Nonsyndromic Familial Hyperdontia: Two Case Reports and Review of Literature

    Directory of Open Access Journals (Sweden)

    Pradhuman Verma

    2010-01-01

    Early clinical and radiographic examination of the supernumerary teeth allow for optimal yet minimal treatment. This article reports two rare cases of nonsyndromic hereditary hyperdontia both in the maxillary anterior region. First case report with bilateral mesiodentes palatal to the central incisors in sister and brother and second case report with presence of fused mesiodentes in father and conical mesiodens in son. Though the exact etiology of this dental anomaly remains unclear, genetics as key factor in development of supernumerary teeth is highlighted.

  13. Lipoatrophia semicircularis: a case report and review of the literature.

    Science.gov (United States)

    Presta, Fabrizio; Del Giglio, Micol; Girolomoni, Giampiero

    2016-08-01

    The case of a 45 years old woman with lipoatrophia semicircularis is presented showing a typical semicircular depressions of the anterolateral aspects of the thighs. The lesion regressed after avoiding the pressing of the thighs against the desk edge. A PubMed search disclosed 125 cases of lipoatrophia semicircularis reported in details. More then 90% were middle aged women. Repeated external microtraumatisms was the most common cause. The few cases biopsied revealed a localized lipoatrophy. Avoiding microtraumatisms resulted in a complete remission of lipoatrophia semicircularis in most cases.

  14. Necrobiosis Lipoidica : A Case Without Diabetes And Review Of Literature

    Directory of Open Access Journals (Sweden)

    Biswas Nibir

    2002-01-01

    Full Text Available Necrobiosis lipoidica, a disorder initially thought to be a complication of diabetes, may also occur in non-diabetics. A 55 year old woman with histologically confirmed necrobiosis lipoidica, who did not have diabetes on presentation or during subsequent follow up, is reported. A good response to topical clobetasol propionate followed by betamethasone dipropionate was noted. A brief review of the literature has been included.

  15. Discovering disease associations by integrating electronic clinical data and medical literature.

    Directory of Open Access Journals (Sweden)

    Antony B Holmes

    Full Text Available Electronic health record (EHR systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

  16. Searching the seat of the soul in Ancient Greek and Byzantine medical literature.

    Science.gov (United States)

    Lykouras, Eleftherios; Poulakou-Rebelakou, Effie; Ploumpidis, Demetrios N

    2010-12-01

    The objective of this paper was to examine the ancient and medieval concepts about the seat of the mental functions, as exposed in Greek texts from Antiquity to Byzantine times. The review of the philosophical and medical literature from the original ancient Greek language from the Homeric epics to the Holy Fathers of Christianity, as the problem of the seat of the soul remained without a certain answer through the centuries. Primitive concepts attributed great significance to the soul and dictated cannibal behaviours for the possession and eating of the defeated enemy's heart. Mental functions, such as thinking, feeling and mainly those related to affective manifestations, were attributed to the heart and to some other internal organs (liver, diaphragm) from the times of Greek mythology. Philosophy and empirical medicine had underestimated the brain probably because it is a 'silent' organ, contrary to the palpitating heart, with its obvious participations in the emotional reactions. The role of the brain as the mental organ and the seat of emotions has been gradually recognized. The permanent question of the seat of the soul had been for many centuries a critical dispute and the contribution of Greek philosophical and medical thought was decisive for the contemporary transformation of the whole concept.

  17. "Mercedes-Benz" sign on CT examination: Two case reports and review of the literature

    OpenAIRE

    ÇİLEDAĞ, Nazan; Arda, Kemal; GÜMÜŞDAĞ, Pelin DEMİR; AKTAŞ, ELIF

    2009-01-01

    Centrally gas-containing gallstone in vitro is a well-known entity. The typical triradiate arrangement of gas-filled fissures of the gallstones was first described by Meyers on abdominal radiography (1, 2). Sixteen cases of "Mercedes-Benz" sign have been reported in the literature; however, only a limited number of cases have been reported in recent literature. We report two cases of "Mercedes-Benz" sign of gallstones on abdominal computerized tomography ex...

  18. Cerebral venous sinus thrombosis complicated by subdural hematomas: Case series and literature review

    OpenAIRE

    Akins, Paul T.; Axelrod, Yekaterina K; Ji, Cheng; Ciporen, Jeremy N.; Arshad, Syed T.; Hawk, Mark W.; Guppy, Kern H.

    2013-01-01

    Background: Cerebral venous sinus thrombosis (CVST) can cause elevated intracranial pressure, hemorrhagic venous infarct, and cortical subarachnoid hemorrhage. We present a case series and literature review to illustrate that CVST can also present with subdural hematoma (SDH). Case Description: Chart review was completed on a retrospective case series of CVST with spontaneous SDH. We also conducted a literature search. Over a 6 year interval, three patients with CVST and SDH were admitted to ...

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

    OpenAIRE

    2009-01-01

    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...

  20. Comparing the quality of accessing medical literature using content-based visual and textual information retrieval

    Science.gov (United States)

    Müller, Henning; Kalpathy-Cramer, Jayashree; Kahn, Charles E., Jr.; Hersh, William

    2009-02-01

    Content-based visual information (or image) retrieval (CBIR) has been an extremely active research domain within medical imaging over the past ten years, with the goal of improving the management of visual medical information. Many technical solutions have been proposed, and application scenarios for image retrieval as well as image classification have been set up. However, in contrast to medical information retrieval using textual methods, visual retrieval has only rarely been applied in clinical practice. This is despite the large amount and variety of visual information produced in hospitals every day. This information overload imposes a significant burden upon clinicians, and CBIR technologies have the potential to help the situation. However, in order for CBIR to become an accepted clinical tool, it must demonstrate a higher level of technical maturity than it has to date. Since 2004, the ImageCLEF benchmark has included a task for the comparison of visual information retrieval algorithms for medical applications. In 2005, a task for medical image classification was introduced and both tasks have been run successfully for the past four years. These benchmarks allow an annual comparison of visual retrieval techniques based on the same data sets and the same query tasks, enabling the meaningful comparison of various retrieval techniques. The datasets used from 2004-2007 contained images and annotations from medical teaching files. In 2008, however, the dataset used was made up of 67,000 images (along with their associated figure captions and the full text of their corresponding articles) from two Radiological Society of North America (RSNA) scientific journals. This article describes the results of the medical image retrieval task of the ImageCLEF 2008 evaluation campaign. We compare the retrieval results of both visual and textual information retrieval systems from 15 research groups on the aforementioned data set. The results show clearly that, currently