WorldWideScience

Sample records for prospective case series

  1. Supratrochlear Neuralgia: A Prospective Case Series of 15 Patients.

    Science.gov (United States)

    Pareja, Juan A; López-Ruiz, Pedro; Mayo, Diego; Villar-Quiles, Rocío-Nur; Cárcamo, Alba; Gutiérrez-Viedma, Álvaro; Lastarria, Carlo P; Romeral, María; Yangüela, Julio; Cuadrado, María-Luz

    2017-10-01

    The aim of this study was to describe clinical features unique to supratrochlear neuralgia. The supratrochlear nerve supplies the medial aspect of the forehead. Due to the intricate relationship between supraorbital and supratrochlear nerves, neuralgic pain in this region has been traditionally attributed to supraorbital neuralgia. No cases of supratrochlear neuralgia have been reported so far. From 2009 through 2016, we prospectively recruited patients with pain confined to the territory of the supratrochlear nerve. Fifteen patients (13 women, 2 men; mean age 51.4 years, standard deviation 14.9) presented with pain in the lower paramedian forehead, extending to the eyebrow in two patients and to the internal angle of the orbit in another. Pain was unilateral in 11 patients (six on the right, five on the left), and bilateral in four. Six patients had continuous pain and nine described intermittent pain. Palpation of the supratrochlear nerve at the medial third of the supraorbital rim resulted in hypersensitivity in all cases. All but one patient exhibited sensory disturbances within the painful area. Fourteen patients underwent anesthetic blockades of the supratrochlear nerve, with immediate relief in all cases and long-term remission in three. Six of them had received unsuccessful anesthetic blocks of the supraorbital nerve. Five patients were treated successfully with oral drugs and one patient was treated with radiofrequency. Supratrochlear neuralgia is an uncommon disorder causing pain in the medial region of the forehead. It may be differentiated from supraorbital neuralgia and other similar headaches and neuralgias based on the topography of the pain and the response to anesthetic blockade. © 2017 American Headache Society.

  2. case series

    African Journals Online (AJOL)

    Administrator

    Key words: Case report, case series, concept analysis, research design. African Health Sciences 2012; (4): 557 - 562 http://dx.doi.org/10.4314/ahs.v12i4.25. PO Box 17666 .... According to the latest version of the Dictionary of. Epidemiology ...

  3. Case series

    African Journals Online (AJOL)

    abp

    2014-01-20

    Jan 20, 2014 ... Page number not for citation purposes. 1. Stroke in young adults: about 128 cases ... hypercholesterolemia, history of cigarette smoking, contraceptive intake treatment, alcohol intake, sexual ..... Carolei A, Marini C, Ferranti E, Frontoni M, Prencipe M, Fieschi. C. A prospective study of cerebral ischemia in ...

  4. Manchester iStent study: early results from a prospective UK case series.

    Science.gov (United States)

    Patel, Ilesh; de Klerk, Timothy A; Au, Leon

    2013-01-01

    To evaluate the 6-month efficacy and safety of the iStent microtrabecular bypass stent in patients with open-angle glaucoma. A prospective, uncontrolled, interventional case series. Forty-four eyes with open-angle glaucoma were reported. All subjects underwent ab interno implantation of a single iStent together with (n = 40) or without (n = 4) cataract surgery. Patients were assessed at postoperative week 1, months 1 and 3, and quarterly, thereafter. Data collected included visual acuity, intraocular pressure measurement using Goldmann tonometry, number of glaucoma medications, and number and type of complications. The mean age of the sample was 76.8 years. The mean duration since glaucoma diagnosis was 5.3 years (standard deviation 2.9 years). The mean visual acuity was 0.53 logMAR at baseline that improved to 0.23 at 6 months postoperatively. The mean baseline intraocular pressure was 21.1 mmHg, and this decreased significantly to 16.7 mmHg at 6 months (P control. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

  5. OnabotulinumtoxinA in urinary incontinence: Prospective Study of a Case Series.

    Science.gov (United States)

    Martín-Martínez, A; Fernández-Mederos, A; García-Hernández, J Á

    2017-09-01

    To assess the safety and efficacy of a single intravesical injection of onabotulinumtoxinA (OnaBTA) for treating urge urinary incontinence (UUI) in women. We performed a prospective case-series study of consecutive patients with refractory UUI treated with an intravesical injection of OnaBTA. The patients were administered 100 units of OnaBTA injected into the bladder wall following 4 weeks of flushing with anticholinergic agents or beta 3 agonists. The urodynamic and clinical endpoints were evaluated before and 6 months after the injection of OnaBTA. The primary study endpoint was the number of episodes of urinary leakage. A total of 204 of the 210 selected patients conducted a valid visit 6 months after the therapeutic application. At 6 months of treatment with OnaBTA, 110 (53.9%) patients remained continent and were considered a success. However, 57 (27.9%) patients experienced one episode of urinary leakage per day, and 37 (18.2%) had 2 or more. In terms of the urodynamic parameters, we observed the following changes: increase in maximum bladder capacity (P<.0001) and reduced maximum pressure of the detrusor (P<.0001). In terms of the safety profile, 8 (3.9%) patients had self-limiting haematuria during the procedure, which resolved spontaneously, and 9 (4.4%) patients had acute urinary retention that required intermittent catheterisation. This study supports the use of OnabotulinumtoxinA in patients with urge urinary incontinence that does not respond to medical treatment. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Low virulence bacterial infections in cervical intervertebral discs: a prospective case series.

    Science.gov (United States)

    Chen, Yilei; Wang, Xianjun; Zhang, Xuyang; Ren, Hong; Huang, Bao; Chen, Jian; Liu, Junhui; Shan, Zhi; Zhu, Zhihai; Zhao, Fengdong

    2018-04-19

    A prospective cross-sectional case series study. To investigate the prevalence of low virulence disc infection and its associations with characteristics of patients or discs in the cervical spine. Low virulence bacterial infections could be a possible cause of intervertebral disc degeneration and/or back pain. Controversies are continuing over whether these bacteria, predominantly Propionibacterium acnes (P. acnes), represent infection or contamination. However, the current studies mainly focus on the lumbar spine, with very limited data on the cervical spine. Thirty-two patients (20 men and 12 women) who underwent anterior cervical fusion for degenerative cervical spondylosis or traumatic cervical cord injury were enrolled. Radiological assessments included X-ray, CT, and MRI of the cervical spine. Endplate Modic changes, intervertebral range of motion, and disc herniation type were evaluated. Disc and muscle tissues were collected under strict sterile conditions. Samples were enriched in tryptone soy broth and subcultured under anaerobic conditions, followed by identification of the resulting colonies by the PCR method. Sixty-six intervertebral discs were excised from thirty-two patients. Positive disc cultures were noted in eight patients (25%) and in nine discs (13.6%). The muscle biopsy (control) cultures were negative in 28 patients and positive in 4 patients (12.5%); three of whom had a negative disc culture. Seven discs (10.6%) were positive for coagulase-negative Staphylococci (CNS) and two discs were positive for P. acnes (3.0%). A younger patient age and the extrusion or sequestration type of disc herniation, which represented a complete annulus fibrous failure, were associated with positive disc culture. Our data show that CNS is more prevalent than P. acnes in degenerative cervical discs. The infection route in cervical discs may be predominantly through an annulus fissure. Correlation between these infections and clinical symptoms is uncertain

  7. Case Series.

    Science.gov (United States)

    Vetrayan, Jayachandran; Othman, Suhana; Victor Paulraj, Smily Jesu Priya

    2017-01-01

    To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD. Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children's sleep. For all six children, significant decrease was found in the severity of children's sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful. Based on the initial data, this intervention shows promise as an effective and feasible treatment.

  8. Case series

    African Journals Online (AJOL)

    abp

    12 oct. 2015 ... term results of a prospective study on the treatment of medulloblastoma in adults. Cancer. 2007 Nov;110(9):2035-. 41. PubMed | Google Scholar. 6. Abacioglu U, Uzel O, Sengoz M, Turkan S, Ober A. Medulloblastoma in adults: treatment results and prognostic factors. Int J Radiat Oncol Biol Phys. 2002 Nov ...

  9. Case series

    African Journals Online (AJOL)

    abp

    2013-06-20

    Jun 20, 2013 ... ... by a persistent neurological deficit in 2 cases, and infection in 2 cases controlled ... Upper cervical spine injuries are frequent due to increasing number .... the patient; it also takes more time for fracture healing and expose.

  10. Case Series

    African Journals Online (AJOL)

    calciphylaxis is prevention through rigorous control of phosphate and calcium balance. We here present two ... The authors declared no conflict of interest. Introduction. Calciphylaxis is a rare but serious disorder .... were reported to resolve the calciphylaxis lesions in a chronic renal failure patient [20]. In a series of five.

  11. Case series

    African Journals Online (AJOL)

    abp

    13 oct. 2017 ... This is an Open Access article distributed under the terms of the Creative Commons Attribution ... Bifocal leg fractures pose many challenges for the surgeon due to .... Dans notre serie, le taux d'infection est reste dans un.

  12. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-01-29

    Jan 29, 2015 ... for tinnitus (Table 1). The otomicroscopic examination shows: central non marginal perforation in 29 patients, posterior perforation in 17 patients and anterior perforation in 14 patients. The tympanic cavity was dry in 27 cases, wet in 18 cases and inflammatory in the. 15 remaining cases. The conralateral ear ...

  13. Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: A Prospective Series of 16 New Cases.

    Science.gov (United States)

    Pareja, Juan A; Montojo, Teresa; Guerrero, Ángel L; Álvarez, Mónica; Porta-Etessam, Jesús; Cuadrado, María L

    2015-01-01

    Idiopathic ophthalmodynia and idiopathic rhinalgia were described a few years ago. These conditions seem specific pain syndromes with a distinctive location in the eye or in the nose. We aimed to present a new prospective series in order to verify the consistency of these syndromes. We performed a descriptive study of all patients referred to our regional neurologic clinics from 2010 to 2014 because of facial pain exclusively felt in the eye or in the nose fulfilling the proposed diagnostic criteria for idiopathic ophthalmodynia and idiopathic rhinalgia. There were 9 patients with idiopathic ophthalmodynia and 7 patients with idiopathic rhinalgia, with a clear female preponderance, and a mean age at onset in the fifth decade. The pain was usually moderate and the temporal pattern was generally chronic. Only one patient reported accompaniments (hypersensitivity to the light and to the flow of air in the symptomatic eye). Preventive treatment with amitriptyline, pregabalin, or gabapentin was partially or totally effective. The clinical features of this new series parallels those of the original description, thus indicating that both idiopathic ophthalmodynia and idiopathic rhinalgia have clear-cut clinical pictures with excellent consistency both inter- and intra-individually. © 2015 American Headache Society.

  14. Case series

    African Journals Online (AJOL)

    abp

    14 déc. 2015 ... s'agissait d'une étude prospective de base réalisée au Burkina Faso portant sur la chirurgie de la cataracte par la technique de tunnélisation. L'âge moyen de nos ... charge sur place ou d'une référence vers le service d'ophtalmologie du CHR .... trou sténopéique selon les critères de l'OMS. Ces résultats ...

  15. Case series

    African Journals Online (AJOL)

    ebutamanya

    2016-04-27

    Apr 27, 2016 ... Laparoscopic surgery for groin hernia in a third world country: a report of 9 cases of ... Concerning mesh repair, the (open) LICHENSTEIN and laparoscopic inguinal hernia techniques are ... Two cases were bilateral, 5 unilateral and all of them primary. ... In Africa, This approach is still marginal; few studies.

  16. Case series

    African Journals Online (AJOL)

    abp

    2017-07-13

    Jul 13, 2017 ... Its purpose is to assess the clinical and ... Other circumstances of discovery were atrial fibrillation, ... ventricular pacing (9.1%) and blood pressure intolerance to stress ... The mitral flow was a ... anterior mitral valve's pillar was found in one case with a left ... with a stop at the first level in another case.

  17. Case series

    African Journals Online (AJOL)

    abp

    30 mai 2017 ... All patients underwent systematic plaster immobilization for a period of ... On average, nails were removed after about 6 ... cases), osteitis associated with material (2 cases), refracture (3 ... Although intramedullary nailing ideally is an osteosynthesis ..... intramedullary fixation of pediatric forearm fractures.

  18. Case series

    African Journals Online (AJOL)

    abp

    2017-05-16

    May 16, 2017 ... Hepatocellular carcinoma: a clinicopathological study of 64 cases ... The presenting clinical symptoms were dominated by abdominal pain (n=34), followed by .... malaise, anorexia or weight loss and nausea or vomiting [4].

  19. Case series

    African Journals Online (AJOL)

    ebutamanya

    2016-06-02

    Jun 2, 2016 ... Epidemiological aspects of suicide attempts among Moroccan children .... Poorly drug intoxication was found in 25% of cases and included over 10 tablets in ... factors have been identified such as maltreatment, sexual abuse.

  20. Case series

    African Journals Online (AJOL)

    abp

    7 avr. 2016 ... HTA were complicated by heart disease in 24% of cases and by renal disease in 20% of cases ... of clinical specificity. It is not unusual for HTA to be the only manifestation of the disease. In our study we .... Le syndrome de Cushing reste une cause rare d'HTA, sa prévalence dans des centres spécialisés en ...

  1. Paracetamol in therapeutic dosages and acute liver injury: causality assessment in a prospective case series

    Directory of Open Access Journals (Sweden)

    Castellote José

    2011-07-01

    Full Text Available Abstract Background Acute liver injury (ALI induced by paracetamol overdose is a well known cause of emergency hospital admission and death. However, there is debate regarding the risk of ALI after therapeutic dosages of the drug. The aim is to describe the characteristics of patients admitted to hospital with jaundice who had previous exposure to therapeutic doses of paracetamol. An assessment of the causality role of paracetamol was performed in each case. Methods Based on the evaluation of prospectively gathered cases of ALI with detailed clinical information, thirty-two cases of ALI in non-alcoholic patients exposed to therapeutic doses of paracetamol were identified. Two authors assessed all drug exposures by using the CIOMS/RUCAM scale. Each case was classified into one of five categories based on the causality score for paracetamol. Results In four cases the role of paracetamol was judged to be unrelated, in two unlikely, and these were excluded from evaluation. In seven of the remaining 26 cases, the RUCAM score associated with paracetamol was higher than that associated with other concomitant medications. The estimated incidence of ALI related to the use of paracetamol in therapeutic dosages was 0.4 per million inhabitants older than 15 years of age and per year (99%CI, 0.2-0.8 and of 10 per million paracetamol users-year (95% CI 4.3-19.4. Conclusions Our results indicate that paracetamol in therapeutic dosages may be considered in the causality assessment in non-alcoholic patients with liver injury, even if the estimated incidence of ALI related to paracetamol appears to be low.

  2. Case series

    African Journals Online (AJOL)

    ebutamanya

    10 déc. 2015 ... 5. Chandler JR, Langenbrunner DJ, Stevens ER. The Pathogenesis. Of Orbital complications in acute sinusitis. Laryngoscope. 1970. Sep; 80(9): 1414-28. PubMed | Google Scholar. 6. Hodges E, Tabbara KF. Orbital cellulitis: review of 23 cases from Saudi Arabia. Br J Ophthalmol. 1989 Mar; 73(3): 205-8.

  3. Case series

    African Journals Online (AJOL)

    abp

    14 oct. 2013 ... Nagamine N, Nohara Y, Ito E. Elastofibroma in Okinawa - A clinicopathologic study of 170 cases. Cancer. 1982;50(9):1794-. 805. PubMed | Google Scholar. 12. Schafmayer C, Kahlke V, Leuschner I, Pai M, Tepel J. Elastofibroma dorsi as differential diagnosis in tumors of the thoracic wall. Ann Thorac Surg.

  4. Case series

    African Journals Online (AJOL)

    abp

    2017-07-14

    Jul 14, 2017 ... complications. Various methods have been used to treat these injuries, with variable results. The aim ... Soft tissue healing occurred without need for plastic surgery in all cases. ... Under general anesthesia, patients were placed in the supine .... of the ankle joint is another advantage of the ILIZAROV device.

  5. Case series

    African Journals Online (AJOL)

    abp

    4 déc. 2017 ... modify initial tumor stage in 60% of cases: upstaging in 23 patients (46%) and downstaging in ... (FDG) est injecté chez nos patients à la dose de 4 à 5 MBq/kg par ..... positron emission tomography in patients with lung cancer.

  6. Case series

    African Journals Online (AJOL)

    abp

    19 oct. 2017 ... Traitement des amyloses AL systémiques: à propos de 25 cas. Treatment of systemic AL amyloidosis: about 25 cases. Hicham Eddou1,&, Ali Zinebi1, Hicham El Maaroufi2, Mohammed Karim Moudden1, Kamal Doghmi2, Mohammed Mikdame2,. Mohammed El Baaj1. 1Service de Médecine Interne, Hôpital ...

  7. Case series

    African Journals Online (AJOL)

    abp

    2017-09-15

    15 Ebola Virus Disease (EVD) outbreak in West Africa infected more than 28,000 persons out of which 11,000 died [20]. At the height of this outbreak, the huge load of cases and their contacts overwhelmed the response ...

  8. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-01-20

    Jan 20, 2015 ... The brainstem, cerebral white matter, basal ganglia, internal capsule, thalamus and spinal cord were involved in forty four, thirty one, thirty, twenty nine, seventeen and four patients, respectively. The cerebral peduncle was the brainstem structure mainly involved with thirty cases followed by the pons with, ...

  9. Case series

    African Journals Online (AJOL)

    abp

    1 juin 2012 ... ... Ren- Xuan Guo, and Ke-Jian Guo. Adult intussusception: A retrospective review of 41 cases. World J Gastroenterol. 2009 Jul 14;15(26):3303-8. This article on PubMed. 14. Abou-Nukta F, Gutweiler J, Khaw J, Yavorek G. Giant lipoma causing a colo-colonic intussusception. Am Surg. 2007;73(4):417. This.

  10. Case series

    African Journals Online (AJOL)

    abp

    2015-01-19

    Jan 19, 2015 ... Child sexual abuse: report of 311 cases with review of literature. Laila Essabar1, Abdenbi Khalqallah2, Badr Sououd Benjelloun Dakhama1,&. 1Department of Paediatric Medical Emergencies of Rabat children's Hospital, Morocco, 2Laboratory of Clinical and Pathological Psychology,. Mohammed V ...

  11. Case series

    African Journals Online (AJOL)

    raoul

    3 mars 2011 ... Martin RG. Malignant tumors of the small intestine. Surg Clin North Am. 1986; 66: 779-785. This article on PubMed. 5. Hatzaras I, Palesty JA, Abir F, Sullivan P, Kozol RA, Dudrick SJ, Longo WE. Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry.

  12. Diode laser to treat small oral vascular malformations: A prospective case series study.

    Science.gov (United States)

    Bacci, Christian; Sacchetto, Luca; Zanette, Gastone; Sivolella, Stefano

    2018-02-01

    The current work examined a consecutive series of patients presenting vascular malformations (VMs) and venous lakes (VLs) of the lip and oral mucosa who were treated with transmucosal diode laser applications and assessed over a 1 year period. Fifty-nine patients (31 males and 28 females) presenting low-flow VMs or VLs of the oral cavity were treated transmucosally using a diode laser (with an 830 nm operating wavelength and 1.6 W output power) with a 320 µm diameter flexible fiber. All the lesions were assessed 7 days, 30 days, and 1 year after the laser treatment, and the lesion reduction percentage was scored on a one to five scale. The patients were also asked to assess their pain perception daily during the 7 days following the treatment using a visual analog scale (VAS). There were no procedure-related intra- or post-operative complications; only modest pain intensity was reported. Thirty days after the treatment, lesion reduction was described as excellent or good in 52 cases; it was fair or poor in 7. Six patients (F:M ratio 2:4) required a second diode laser application. At the 1 year follow-up, volume reduction was complete in 48 out of 59 patients; there were five recurrences (F:M ratio 3:2). No relevant gender-related differences were noted. The use of diode laser application to treat small oral VMs and VLs was associated to shorter operating times and fewer postoperative complications with respect to the scapel surgery approach. More than one session may nevertheless be required if the anomaly is larger than 10 mm. Lasers Surg. Med. 50:111-116, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  13. Autism Spectrum Disorder Symptoms in Infants with Fragile X Syndrome: A Prospective Case Series

    Science.gov (United States)

    Hogan, Abigail L.; Caravella, Kelly E.; Ezell, Jordan; Rague, Lisa; Hills, Kimberly; Roberts, Jane E.

    2017-01-01

    No studies to date have prospectively examined early autism spectrum disorder (ASD) markers in infants with fragile X syndrome (FXS), who are at elevated risk for ASD. This paper describes the developmental profiles of eight infants with FXS from 9 to 24 months of age. Four meet diagnostic criteria for ASD at 24 months of age, and four do not.…

  14. Multimodal physiotherapy treatment based on a biobehavioral approach for patients with chronic cervico-craniofacial pain: a prospective case series.

    Science.gov (United States)

    Marcos-Martín, Fernando; González-Ferrero, Luis; Martín-Alcocer, Noelia; Paris-Alemany, Alba; La Touche, Roy

    2018-01-17

    The purpose of this prospective case series was to observe and describe changes in patients with chronic cervico-craniofacial pain of muscular origin treated with multimodal physiotherapy based on a biobehavioral approach. Nine patients diagnosed with chronic myofascial temporomandibular disorder and neck pain were treated with 6 sessions over the course of 2 weeks including: (1) orthopedic manual physiotherapy (joint mobilizations, neurodynamic mobilization, and dynamic soft tissue mobilizations); (2) therapeutic exercises (motor control and muscular endurance exercises); and (3) patient education. The outcome measures of craniofacial (CF-PDI) and neck disability (NDI), kinesiophobia (TSK-11) and catastrophizing (PCS), and range of cervical and mandibular motion (ROM) and posture were collected at baseline, and at 2 and 14 weeks post-baseline. Compared to baseline, statistically significant (p posture were observed following a multimodal physiotherapy treatment based on a biobehavioral approach.

  15. Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series.

    Science.gov (United States)

    Ecker, J; Perera, N; Ebert, J

    2015-02-01

    Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques. © The Author(s) 2014.

  16. Headache in 25 consecutive patients with atrial septal defects before and after percutaneous closure--a prospective case series.

    Science.gov (United States)

    Riederer, Franz; Baumgartner, Helmut; Sándor, Peter S; Wessely, Peter; Wöber, Christian

    2011-09-01

    In contrast to patent foramen ovale that is highly prevalent in the general population, atrial septal defect (ASD) is a rare congenital heart defect. The effect of ASD closure on headache and migraine remains a matter of controversy. The objectives of our study were (1) to determine headache prevalence in consecutive patients with ASD scheduled for percutaneous closure for cardiologic indications, using the International Classification of Headache Disorders and (2) to compare headache characteristics before and after closure of ASD. In this observational case series no a priori power analysis was performed. Twenty-five consecutive patients were prospectively included over 27 months. Median duration of follow-up was 12 months [interquartile range 0]. Prevalence of active headache seemed to be higher compared with the general population: any headaches 88% (95% confidence interval 70-96), migraine without aura 28% (14-48), migraine with aura 16% (6-35). After ASD closure, we observed a slightly lower headache frequency (median frequency 1.0 [2.6] vs. 0.3 [1.5] headaches per month; P = .067). In patients with ongoing headaches, a significant decrease in headache intensity (median VAS 7 [3] vs. 5 [4]; P = .036) was reported. Three patients reporting migraine with aura before the intervention noted no migraine with aura attacks at follow-up, 2 of them reported ongoing tension-type headache, 1 migraine without aura. In summary, this prospective observational study confirms the high prevalence of headache, particularly migraine, in ASD patients and suggests a possible small beneficial effect of ASD closure. © 2011 American Headache Society.

  17. Maxillary Overdentures Supported by Anteriorly or Posteriorly Placed Implants Opposed by a Natural Dentition in the Mandible : A 1-Year Prospective Case Series Study

    NARCIS (Netherlands)

    Slot, Jan; Raghoebar, Gerry M.; Vissink, Arjan; Meijer, Henny J. A.

    Background: For maxillary overdenture therapy, treatment guidelines are missing. There is a need for longitudinal studies. Purpose: The purpose of this 1-year prospective case series study was to assess the treatment outcome of maxillary overdentures supported by six dental implants opposed by

  18. Mechanism-based classification and physical therapy management of persons with cancer pain: A prospective case series

    Directory of Open Access Journals (Sweden)

    Senthil P Kumar

    2013-01-01

    Full Text Available Context: Mechanism-based classification (MBC was established with current evidence and physical therapy (PT management methods for both cancer and for noncancer pain. Aims: This study aims to describe the efficacy of MBC-based PT in persons with primary complaints of cancer pain. Settings and Design: A prospective case series of patients who attended the physiotherapy department of a multispecialty university-affiliated teaching hospital. Material and Methods: A total of 24 adults (18 female, 6 male aged 47.5 ± 10.6 years, with primary diagnosis of heterogeneous group of cancer, chief complaints of chronic disabling pain were included in the study on their consent for participation The patients were evaluated and classified on the basis of five predominant mechanisms for pain. Physical therapy interventions were recommended based on mechanisms identified and home program was prescribed with a patient log to ensure compliance. Treatments were given in five consecutive weekly sessions for five weeks each of 30 min duration. Statistical Analysis Used: Pre-post comparisons for pain severity (PS and pain interference (PI subscales of Brief pain inventory-Cancer pain (BPI-CP and, European organization for research and treatment in cancer-quality of life questionnaire (EORTC-QLQ-C30 were done using Wilcoxon signed-rank test at 95% confidence interval using SPSS for Windows version 16.0 (SPSS Inc, Chicago, IL. Results: There were statistically significant ( P < 0.05 reduction in pain severity, pain interference and total BPI-CP scores, and the EORTC-QLQ-C30. Conclusion: MBC-PT was effective for improving BPI-CP and EORTC-QLQ-C30 scores in people with cancer pain.

  19. Cionni ring and in-the-bag intraocular lens implantation for subluxated lenses: a prospective case series.

    Science.gov (United States)

    Vasavada, Abhay R; Praveen, Mamidipudi R; Vasavada, Viraj A; Yeh, Ru-Yin; Srivastava, Samaresh; Koul, Archana; Trivedi, Rupal H

    2012-06-01

    To report the intraoperative performance and postoperative outcomes of the Cionni-modified capsule tension ring (CTR) implantation in eyes with subluxated lenses. Prospective, observational case series. This study was carried out at Iladevi Cataract & IOL Research Centre, Ahmedabad, India. The study population comprised 41 eyes with subluxated lenses that underwent lens extraction, capsular bag fixation with modified CTR, and in-the-bag single-piece AcrySof intraocular lens (IOL) implantation. Main outcome measures were intraoperative performance and postoperative best-corrected visual acuity (BCVA), IOL centration, and complications. The mean age was 29.46 ± 16.16 years (3-68 years). Mean extent of subluxation was 6.1 ± 1.0 clock hours. Preoperatively, vitreous was detected in the anterior chambers of 5 eyes (12.2%). Two-port anterior chamber vitrectomy was performed in 2 eyes. Mean follow-up was 45.8 ± 2.9 months. Mean preoperative BCVA was 0.66 ± 0.22 logMAR (35 eyes). Mean postoperative BCVA at final follow-up was 0.33 ± 0.21 logMAR (41 eyes) (P IOL decentration was noted and repositioning was required in 2 eyes. Posterior capsule opacification developed in 14 eyes (34.2%); 12 eyes (29.3%) required Nd:YAG capsulotomy. Other complications included cystoid macular edema in 1 eye (2.4%), posterior synechiae in 1 eye (2.4%), and retinal detachment in 1 eye (2.4%). In-the-bag implantation of a Cionni-modified CTR with IOL appears to be a safe option in eyes with subluxated cataract, ensuring a stable IOL with few complications. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Prospective case series on trabecular-iris angle status after an acute episode of phacomorphic angle closure

    Directory of Open Access Journals (Sweden)

    Jacky Lee

    2013-02-01

    Full Text Available AIM:To investigate the trabecular-iris angle with ultrasound biomicroscopy (UBM post cataract extraction after an acute attack of phacomorphic angle closure.METHODS: This prospective study involved 10 cases of phacomorphic angle closure that underwent cataract extraction and intraocular lens insertion after intraocular pressure (IOP lowering. Apart from visual acuity and IOP, the trabecular-iris angle was measured by gonioscopy and UBM at 3 months post attack.RESULTS: In 10 consecutive cases of acute phacomorphic angle closure from December 2009 to December 2010, gonioscopic findings showed peripheral anterior synechiae (PAS ≤ 90° in 30% of phacomorphic patients and a mean Shaffer grading of (3.1±1.0. UBM showed a mean angle of (37.1°±4.5° in the phacomorphic eye with the temporal quadrant being the most opened and (37.1°±8.0° in the contralateral uninvolved eye. The mean time from consultation to cataract extraction was (1.4±0.7 days and the mean total duration of phacomorphic angle closure was (3.6±2.8 days but there was no correlation to the degree of angle closure on UBM (Spearman correlation P=0.7. The presenting mean IOP was (50.5±7.4 mmHg and the mean IOP at 3 months was (10.5±3.4 mmHg but there were no correlations with the degree of angle closure (Spearman correlations P=0.9.CONCLUSION:An open trabecular-iris angle and normal IOP can be achieved after an acute attack of phacomorphic angle closure if cataract extraction is performed within 1 day - 2 days after IOP control. Gonioscopic findings were in agreement with UBM, which provided a more specific and object angle measurement. The superior angle is relatively more narrowed compared to the other quadrants. All contralateral eyes in this series had open angles.

  1. Horizontal stability of connective tissue grafts at the buccal aspect of single implants: a 1-year prospective case series.

    Science.gov (United States)

    De Bruyckere, Thomas; Eghbali, Aryan; Younes, Faris; De Bruyn, Hugo; Cosyn, Jan

    2015-09-01

    To clinically evaluate the horizontal stability of a connective tissue graft (CTG) at the buccal aspect of single implants (1); to compare actual gingival thickness between thin and thick gingival biotype (2). Periodontally healthy non-smoking patients with a single implant in the anterior maxilla (15-25) were selected for a prospective case series. All demonstrated a horizontal alveolar defect and were in need of contour augmentation by means of CTG for aesthetic reasons. Patients were enrolled 3 months after implant surgery and had been provided with a provisional screw-retained crown. CTG was inserted in the buccal mucosa via the envelope technique using one intrasulcular incision. An ultrasonic device was used to evaluate mucosal thickness (MT) at the buccal aspect. MT was assessed at t0 (before CTG), t1 (immediately after CTG), t2 (2 weeks after CTG = suture removal), t3 (3 months after CTG = permanent crown installation) and t4 (1 year after implant placement). The gingival biotype was categorized as thin or thick based on the transparency of a periodontal probe through the soft tissues while probing the buccal sulcus of the contra-lateral tooth. Gingival thickness (GT) was measured at the contra-lateral tooth using the same ultrasonic device. Thirty-seven patients (19 men, 18 women; mean age 38) met the selection criteria and consented to the treatment. Mean soft tissue gain immediately after CTG was on average 1.07 mm (SD 0.49). What remained of this tissue gain after 1 year was on average 0.97 mm (SD 0.48; 90.5%). Hence, mean soft tissue loss amounted to 0.10 mm (SD 0.23; 9.5%; p = 0.015) with no significant difference between patients with a thin or thick biotype (p ≥ 0.290). Patients with a thin biotype had a mean GT of 1.02 mm (SD 0.21), whereas GT was on average 1.32 mm (SD 0.31) in subjects with a thick biotype (p = 0.004). Connective tissue graft substantially thickens the peri-implant mucosa with acceptable stability over a 1-year period. © 2015

  2. Surgical outcomes for perforated peptic ulcer: A prospective case series at an academic hospital in Monrovia, Liberia

    Directory of Open Access Journals (Sweden)

    J. Fallah Moses

    2015-06-01

    Conclusion: Peptic ulcer disease and its treatment represent a potentially substantial source of morbidity and mortality in limited-resource settings. In this case series, surgical treatment for perforated peptic ulcer disease carried a high mortality, and the results highlight the potential for public health systems strengthening to prevent poor health outcomes. Peptic ulcer disease in low- and middle-income countries presents unique epidemiology and treatment challenges that may differ significantly from evidence-based guidelines in high-income countries.

  3. A 3-year prospective study on ocular injuries with tennis or cricket ball while playing cricket: A case series

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Mahapatra

    2018-01-01

    Full Text Available Purpose: The purpose of this study is to study the clinical features, visual outcome, management, and ocular complications of ocular injury, following trauma with tennis or cricket ball. Methods: A prospective, noncomparative case study of patients having injury with tennis/cricket ball while playing cricket was conducted between January 2013 and April 2016. Seventy-six eyes of 76 patients were studied. Presenting vision, age, gender, time since injury, general and ocular examination, intraocular pressure, indirect ophthalmoscopy, B scan, and X-ray/computed tomography scan findings were noted. Patients were managed medically or surgically as per the need and followed up at least for 6 months. Results: Seventy-six eyes of 76 patients were studied. All cases were male, except two. Majority (80.2% were <25 years. Median presenting visual acuity (VA was 6/36 and median final VA was 6/18. Significant findings in the decreasing order of frequency were sphincter tear (26.3%, retinal detachment (23.6%, angle recession (18.4%, choroidal rupture (17.1%, and Berlin's edema (15.7%. Most of the cases (69.7% were managed medically. Only 30.2% cases needed surgical intervention. Final visual outcome in our study was depended on initial VA (P = 0.000. It was also correlating with presenting clinical feature (P = 0.010 and type of intervention (medical/surgical (P = 0.001. Conclusion: Cricket-related ocular injury generally has a poor prognosis with most cases being closed globe injury; retinal detachment is the most common vision-threatening presentation. In spite of being a common event, cricket-related injury is sparingly documented and hence needs further studies for proper documentation, prognostication, and formulation of definitive management plan.

  4. A prospective case series evaluating the safety and efficacy of the Klox BioPhotonic System in venous leg ulcers

    Directory of Open Access Journals (Sweden)

    Nikolis A

    2016-09-01

    Full Text Available Andreas Nikolis,1 Doria Grimard,2 Yves Pesant,3 Giovanni Scapagnini,4 Denis Vézina5 1Division of Plastic Surgery, Victoria Park Research Centre, Montreal, 2Q&T Research Chicoutimi, Chicoutimi, 3St-Jerome Medical Research Inc., St-Jerome, Quebec, Canada; 4Department of Medicine and Health Sciences, School of Medicine, University of Molise, Campobasso, Italy; 5Klox Technologies, Laval, Quebec, Canada Purpose: To investigate the safety and efficacy of the BioPhotonic System developed by Klox Technologies in a case series of ten patients with venous leg ulcers.Patients and methods: Ten patients with chronic venous leg ulcers, having failed on at least one previous therapy, were enrolled into this case series.Results: Nine patients were evaluable for efficacy. A response (defined as decrease in wound surface area was observed in seven patients (77.8%. Of these, four patients (44.4% achieved wound closure on average 4 months (127.5 days following the beginning of the treatment. Two patients did not respond to the investigational treatment. Quality of life improved over time throughout the study. Compliance was excellent, with 93.2% of visits completed as per protocol. Safety was unremarkable, with only four treatment-emergent-related adverse events, for which no specific intervention was required.Conclusion: The BioPhotonic System was shown to be safe and extremely well tolerated. It also demonstrated potential in terms of wound closure, wound surface area decrease, and wound bed preparation. Keywords: biophotonics, light, photobiomodulation, venous leg ulcers

  5. Tattoo reaction: Case series

    Directory of Open Access Journals (Sweden)

    Muneer Mohamed

    2018-04-01

    Full Text Available Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous potential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most common skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and medical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis, granulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, and morphea. In this series we present three cases of tattoo reaction.

  6. Enhanced physical health screening for people with severe mental illness in Hong Kong: results from a one-year prospective case series study.

    Science.gov (United States)

    Bressington, Daniel; Mui, Jolene; Hulbert, Sabina; Cheung, Eric; Bradford, Stephen; Gray, Richard

    2014-02-27

    People with severe mental illness have significantly poorer physical health compared to the general population; previous health screening studies conducted outside Asian countries have demonstrated the potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong. This study utilises a consecutive prospective case series design. The serious mental illness Health Improvement Profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up. A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period. The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP. ISRCTN12582470.

  7. Surgical outcomes for perforated peptic ulcer: A prospective case series at an academic hospital in Monrovia, Liberia

    OpenAIRE

    Moses, J. Fallah; Hughes, Christopher D.; Patel, Pratik B.; Chao, Tiffany E.; Konneh, Solomane A.; Jallabah, Torsou Y.; Kikubaire, Michael Kiiza; Meara, John G.; Hagander, Lars

    2015-01-01

    Introduction The incidence of perforated peptic ulcer remains high in low and middle-income countries. Mortality can be significant, and early surgical management with careful evaluation of pre-operative risk factors is essential. The purpose of this study was to describe the clinical outcomes of surgical treatment for perforated peptic ulcer disease in Liberia and to explore risk factors for adverse outcomes. Methods This study prospectively examined 20 consecutive patients undergoing primar...

  8. Immediate provisionalization of immediate implants in the esthetic zone: a prospective case series evaluating implant survival, esthetics, and bone maintenance.

    Science.gov (United States)

    Levin, Barry P; Wilk, Brian L

    2013-05-01

    This prospective study evaluates immediately placed and immediately provisionalized implants in the esthetic zone. All implants were TiO2-blasted, fluoride-modified, grade 4 titanium, with a coronal microthread design. Bone grafting and guided bone regeneration (GBR) was performed at all sites, and screw-retained temporary restorations were delivered on the day of surgery. All of the provisional crown(s) were out of occlusal function and remained in place for at least 8 weeks prior to initiation of definitive restorative therapy. Bone maintenance (BM) was considered successful if radiographs demonstrated proximal bone levels even or coronal to the implant platform. Of the 29 implants placed, 25 (86 percent) achieved bone maintenance at least 12 months post-loading with the final restorations. This study was considered successful, with 100 percent implant survival after at least 1 year loading of the final restoration, and 100 percent of patients were satisfied with the esthetics of their implant treatment.

  9. Severe Upper Gastrointestinal Hemorrhage from Linear Gastric Ulcers in Large Hiatal Hernias: a Large Prospective Case Series of Cameron Ulcers

    Science.gov (United States)

    Camus, Marine; Jensen, Dennis M.; Ohning, Gordon V.; Kovacs, Thomas O.; Ghassemi, Kevin A.; Jutabha, Rome; Machicado, Gustavo A.; Dulai, Gareth S.; Hines, Joel O.

    2013-01-01

    Background and study aims Cameron ulcers are a rare but clinically significant cause of severe upper gastrointestinal hemorrhage (SUGIH). Our aims were to describe (1) the diagnosis, treatment and outcomes of patients with Cameron ulcers causing hospitalization for SUGIH, (2) the differences between patients with occult vs. overt bleeding and (3) between patients treated surgically and medically. Patients and methods Over the past 17 years, all consecutive patients hospitalized in our two tertiary referral medical centers for severe UGIH or severe obscure GIH and entered into our large prospective databasis were screened for Cameron ulcer diagnosis. Results Cameron ulcers were diagnosed in 25 patients of 3960 patients with SUGIH (0.6%). 21 patients had follow-up (median [IQR] time of 20.4 months [8.5–31.8]). Patients were more often elderly females with chronic anemia, always had large hiatal hernias, and were usually referred for obscure SUGIH. Twelve (57.2%) patients were referred to surgery for rebleeding and recurrent blood loss while treated with high dose of proton pump inhibitors (PPI). 9 (42.8%) other patients continued PPI without any rebleeding during the follow-up. Patients with overt bleeding had significantly more prior hospitalizations for SUGIH, more often stigmata of hemorrhage on ulcers, and more red blood cell transfusions than patients with occult bleeding. However, there was no difference in rebleeding and mortality rates between the two groups. Conclusions Cameron ulcers in large hiatal hernias are an uncommon cause of SUGIH. Most of patients are referred for obscure GIH. The choice of medical vs. surgical therapy should be individualized. PMID:23616128

  10. Maxillary overdentures supported by anteriorly or posteriorly placed implants opposed by a natural dentition in the mandible: a 1-year prospective case series study.

    Science.gov (United States)

    Slot, Wim; Raghoebar, Gerry M; Vissink, Arjan; Meijer, Henny J A

    2014-02-01

    For maxillary overdenture therapy, treatment guidelines are missing. There is a need for longitudinal studies. The purpose of this 1-year prospective case series study was to assess the treatment outcome of maxillary overdentures supported by six dental implants opposed by natural antagonistic teeth in the mandible. Fifty patients were treated with a maxillary overdenture supported by six dental implants, either placed in the anterior region (n = 25 patients) or in the posterior region (n = 25 patients). Items of evaluation were the following: survival of implants, condition of hard and soft peri-implant tissues, and patients' satisfaction. One-year implant survival rate was 98% in the anterior group and 99.3% in the posterior group. Mean radiographic bone loss in the anterior and posterior groups after 1 year of loading was 0.22 and 0.50 mm, respectively. Mean scores for plaque, calculus, gingiva, bleeding, and pocket probing depth were low, and patients' satisfaction was high, with no differences between the groups. Six dental implants placed in either the anterior region or the posterior region of the edentulous maxilla, connected with a bar, and opposed by antagonistic teeth in the mandible supply a proper base for the support of an overdenture. © 2012 Wiley Periodicals, Inc.

  11. Bronchoscopic intratumoral injection of tranexamic acid to prevent excessive bleeding during multiple forceps biopsies of lesions with a high risk of bleeding: a prospective case series

    International Nuclear Information System (INIS)

    Zamani, Adil

    2014-01-01

    Significant bleeding may occur following endobronchial forceps biopsy or brushing of necrotic or hypervascular tumors in the airways. In some cases, methods such as endobronchial instillation of iced saline lavage and epinephrine may fail to control bleeding. The present study evaluated the efficacy and safety of a new bronchoscopic technique using intratumoral injection of tranexamic acid (IIT) for control of bleeding during forceps biopsy in patients with endobronchial tumors with a high risk of bleeding. The study was a prospective case series carried out in a single center. Bronchoscopic IIT was performed in those patients who had endoscopically visible tumoral lesions with persistent active bleeding following the first attempt at bronchoscopic sampling. Tranexamic acid (TEA) was injected through a 22-gauge Wang cytology needle into the lesion in nominal doses of 250–500 mg. After 2–3 minutes, multiple forceps biopsy specimens were obtained from the lesion. Of the 57 consecutive patients included in the study, 20 patients (35.1%) underwent bronchoscopic IIT. The first attempt in 18 patients was endobronchial forceps biopsy (EBB), and because of a high risk of bleeding, the first attempt for the remaining two patients, who were on continuous dual antiplatelet therapy (aspirin and clopidogrel), employed endobronchial needle aspiration (EBNA) as a precautionary measure. Following IIT, subsequent specimens were obtained using EBB in all patients. Multiple forceps biopsy specimens (3–10) were obtained from the lesions (8 necrotic and 12 hypervascular) without incurring active bleeding. The following histopathologic diagnoses were made: squamous cell carcinoma (n = 14), adenocarcinoma (n = 2), small-cell lung cancer (n = 3), and malignant mesenchymal tumor (n = 1). No side effects of TEA were observed. Bronchoscopic IIT is a useful and safe technique for controlling significant bleeding from a forceps biopsy procedure and can be considered as a pre

  12. Multiple meningiomas CASE SERIES

    African Journals Online (AJOL)

    masses in the right parietal and parasagittal region (Figs 1a and b). Case 2: A ... scan showed hyperdense parasagittal and left cerebellopontine angle meningiomas (Figs ... Meningiomas are the most common primary non-glial brain tumours.

  13. Cheilitis granulomatosa: Case series

    Directory of Open Access Journals (Sweden)

    Sudha Rani Chintagunta

    2017-01-01

    Full Text Available Granulomatous cheilitis is an idiopathic inflammatory disorder characterized by persistent, asymptomatic, diffuse swelling of one or both lips. It is also considered as an oligosymptomatic or monosymptomatic form of Melkersson–Rosenthal syndrome. We herewith report five cases of granulomatous cheilitis of which three cases were females and two were males. The mean age was 41 years. The average duration of symptoms was 2.5 years (2–3 years. Four patients presented with asymptomatic persistent swelling of the upper lip and one patient with lower lip. Two cases showed associated fissuring and angular cheilitis. One case also showed involvement of the left cheek. All the patients showed moderate improvement with combination of minocycline and intralesional triamcinolone therapy.

  14. High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study.

    Science.gov (United States)

    Jaeger, Filipe; Chiavaioli, Gustavo Marques; de Toledo, Guilherme Lacerda; Freire-Maia, Belini; Amaral, Marcio Bruno Figueiredo; Mesquita, Ricardo Alves

    2018-01-01

    The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 μm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.

  15. Tinea incognito: Case series

    Directory of Open Access Journals (Sweden)

    Mikail Yılmaz

    2015-09-01

    Full Text Available Tinea incognito is a dermatophytic infection which has lost its typical clinical appearance because of inappropriate use of topical or systemic corticosteroids. The clinical manifestations of tinea incognito can mimic many dermatoses such as eczema, psoriasis, allergic contact dermatitis, rosacea, seborrheic dermatitis and atopic dermatitis. The diagnosis of tinea incognito is confirmed by direct KOH (potassium hydroxide examination ( native preparation, making the fungal cultures from the lesion and histopathological examination in some cases. Systemic antifungal therapy is recommended in the treatment of tinea incognito. Herein, 10 cases of tinea incognito which mimicking various dermatoses were diagnosed and treated in our clinic in 2014 is presented.

  16. Kleptomania: a case series

    Science.gov (United States)

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

    2014-01-01

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

  17. Kleptomania: a case series.

    Science.gov (United States)

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

    2014-12-01

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

  18. Kleptomania: a case series

    OpenAIRE

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

    2014-01-01

    Kleptomania is an enigmatic condition and is among the very few psychiatric disorders in which crime is medicalised and used as a legal defence. The scientific literature on kleptomania is scarce. Early literature and recent studies have shown a female preponderance, with an early age of onset of stealing in people with comorbid personality disorder(s). In a retrospective review of the case notes of theft offenders who had forensic psychiatric evaluations performed in a one-year period in 201...

  19. Protostylid: A case series

    Directory of Open Access Journals (Sweden)

    S. V. S. G. Nirmala

    2013-01-01

    Full Text Available Human jaws and teeth display a high degree of morphological individuality as they represent personal, family and population characteristics. A protostylid is a supernumerary or accessory cusp located on the mesial half of the buccal surface on the molars that may seldom pose problems while its presence may not be a cause for alarm in most instances. This case report presents a rare finding of protostylid on the buccal surface of the primary molars in 4 children. From the perspective of forensic dentistry, this morphological feature, though uncommon, may be useful for classification and identification of victims in mass causalities and bite marks on bodies or inanimate objects.

  20. Safety and efficacy of vertebroplasty: Early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center

    Directory of Open Access Journals (Sweden)

    Diel Peter

    2009-01-01

    Full Text Available Background: Vertebroplasty (VP is a cost-efficient alternative to kyphoplasty. However, it is considered inferior when it comes to maintaining safety and in vertebral body (VB height restoration. We assess the safety and efficacy of VP in alleviating pain, improving quality of life (QoL, and restoring alignment. Materials and Methods: In a prospective monocenter case series, from April 2007 until July 2008, 1,422 vertebroplasties were performed, during 307 interventions, in 279 patients with traumatic, lytic, and osteoporotic fractures with 28 repeat interventions, for new fractures after the primary surgery, in 28 patients. The 226 interventions (n=203 patients done for osteoporotic fractures were analyzed for demographics, treatment and radiographic details, pain alleviation, QoL improvement [NASS and Euroqol (EQ-5D] and complications. Results: Osteoporotic patient sample consisted of 77.8% (n=158 females with a median age of 78 years and 45 males who had the same median age. Around 69% of these patients were ASA (American Society of Anesthesiologists grade 3 and above. On an average there were 1.8 VBs fractured and five VBs treated,whereas the most frequently performed cementations were in six (35.6%, n=80 or five (19.6%, n=44 levels. About 36.5%, (n=414 of the interventions were localized at the thoraco-lumbar junction (Th12-L2. On applying the Genant classification, there was a slight height reduction in 13.1% (n=29, a medium loss in 34.3% (n=78, and a severe loss of height in 52.6% (n=119. The pre-operative pain was assessed by the visual analog scale (VAS and decreased from 56.7 to 41.4 pts after two months. Accordingly, the QoL on the EQ-5D measure (0.6 to 1 improved from 0.32 pts before surgery to 0.58 pts after two months. The pre-operative Beck index (anterior height/posterior height improved from a mean of 0.66 preoperative to 0.80 post-operative and remained stable at two months post-operatively. There were cement leakages in 33% of

  1. Treatment of trochanteric fractures with the gamma3 nail - methodology and early results of a prospective consecutive monitored clinical case series.

    Science.gov (United States)

    A C, Unger; E, Wilde; B, Kienast; C, Jürgens; A P, Schulz

    2014-01-01

    There is only sparse data on clinical results and complications of the third-generation Gamma nailing system (Gamma3, Stryker). Therefore, we started a large multi-centre case series in 2008. The aim of this paper is to present the study design and early results of a single arm of a prospective, consecutive, monitored, post-market follow-up evaluation of Gamma3 nails. From September 2009 to January 2012, 154 consecutive patients with an average age of 80 ± 1.43 years (50-99 years) and a trochanteric femoral fracture were included in the local arm of the trial. All patients that fulfilled the inclusion criteria were treated with a Gamma3 nail. Preoperative variables included age, gender, fracture classification, walking ability (Merle d'Aubigné score), daily activity level (retrospective Zuckerman score), ASA rating of operative risk, waiting time for operation, use of walker or crutches and body mass index (BMI). Skin-to-skin time, fluoroscopy time, blood loss, intraoperative complications and device information were recorded for each patient. Follow-up postoperative assessment was undertaken at 4, 12 and 24 months. Hip range of motion, pain around the hip and the tight, walking ability (Merle d'Aubigné score, Sahlgrenska mobility score) and management of daily life (Zuckerman score) were used to evaluate the outcome. The descriptive data of age, gender, BMI, ASA classification, fracture type and skin-to-skin time is similar to other studies. Median fluoroscopy time was 62 seconds (range: 4-225 seconds) and significantly shorter in closed reductions. No intraoperative implant-related complication was recorded. A cut-out of the leg-screw during assessment period occurred in 2.6% patients (n = 4). At the 12-month assessment two (1.8%) non-unions were identified and two patients (1.8%) had broken the femoral shaft below the 180 mm nail after a fall. Analysis of the scores showed significantly declined mobility and activity in daily life four months after operation

  2. Intra-patient comparison of parietal pleural biopsies by rigid forceps, flexible forceps and cryoprobe obtained during medical thoracoscopy: a prospective series of 80 cases with pleural effusion.

    Science.gov (United States)

    Wurps, H; Schönfeld, N; Bauer, T T; Bock, M; Duve, C; Sauer, R; Mairinger, T; Griff, S

    2016-07-07

    There is only few data available on the use of cryotechnique during medical thoracoscopy. Medical thoracoscopy was performed in consecutive patients with pleural effusion. Prospectively, biopsies were taken by rigid forceps, flexible forceps and cryoprobe. Specimen size, depth and diagnostic yield were compared. 80 Patients were included. 408 biopsies were taken (205 rigid biopsies, 104 flexible biopsies, 99 cryobiopsies). Mean surface area of rigid biopsies was 22.6 ± 20.4 mm(2) (flexible biopsies: 7.1 ± 9.3 mm(2), cryobiopsies: 14.4 ± 12.8 mm(2)). Rigid biopsies were significantly larger than cryobiopsies (p < 0.001) and flexible biopsies (p < 0.001), crybiopsies were significantly larger than flexible biopsies (p < 0.01). A deep biopsy containing fatty tissue was harvested in 63 % of rigid biopsies (cryobiopsy: 49.5 % flexible biopsy: 39.5 %). In 79/80 cases (98.7 % 95 % CI cannot be calculated) a diagnosis was obtained by rigid biopsy (cryobiopsy: 73/80 cases (91.3 % 95 % CI 86.0 - 96.5 %), flexible biopsy: 74/80 cases (92.5 % 95 % CI 88.6 - 97.4 %)). Diagnostic yield achieved with cryobiopsies was inferior to the yield of rigid biopsies (Difference: 12.7 %), but non-inferior to flexible biopsies (Difference: 6.5 %). Cryobiopsies in medical thoracoscopy are safe with high diagnostic yield, non-inferior to flexible biopsies with increased tissue quantity and quality. Cryotechnique can develop an important role in medical thoracoscopy in the near future when rigid thoracoscopy is not available.

  3. Robotic repair of retrocaval ureter: A case series | Nayak | African ...

    African Journals Online (AJOL)

    Subjects and methods: This is a prospective case series of five consecutive patients who underwent robotic retrocaval ureter repair at our institute from August 2006 to September 2009. Pre-operative imaging included intravenous urogram, contrast enhanced CT scan and diuretic renography. All cases were done through a ...

  4. Prospective study of the reproducibility of X-rays and CT scans for assessing trochanteric fracture comminution in the elderly: a series of 110 cases.

    Science.gov (United States)

    Isida, Ronald; Bariatinsky, Varenka; Kern, Gregory; Dereudre, Gregoire; Demondion, Xavier; Chantelot, Christophe

    2015-10-01

    found in 65 patients based on X-rays, 80 patients based on CT scan and 83 patients based on intraoperative findings. Comminution was mainly identified during surgery; it was medial in 34 % of cases, posterior in 22 % and posteromedial in 21.8 %. In the current study, 75.4 % of fractures were complex and unstable, with medial and/or posterior comminution present in three-quarters of these fractures. X-ray assessment underestimates posterior comminution and the complexity of the fracture line and was not very reproducible. The current results of this study suggest that comminution contributes to instability and that this finding is not taken into account in the AO classification, which is not well suited for this type of fracture and raises the question of how to best evaluate and treat these fractures. Prospective diagnostic study, Level III.

  5. [Scimitar syndrome: a case series].

    Science.gov (United States)

    Jaramillo González, Carlos; Karam Bechara, José; Sáenz Gómez, Jessica; Siegert Olivares, Augusto; Jamaica Balderas, Lourdes

    Scimitar syndrome is a rare and complex congenital anomaly of the lung with multiple variables and is named for its resemblance to the classical radiological crooked sword. Its defining feature is the anomalous pulmonary drainage. It is associated with various cardiothoracic malformations and a wide spectrum of clinical manifestations. Nine patients diagnosed with scimitar syndrome found in the database of Hospital Infantil de México between 2009 and 2013 were reviewed. Demographic records, clinical status and hemodynamic parameters reported were collected. This case series called attention to certain differences between our group of patients and those reported in the international literature. Patients were predominantly female and were diagnosed between 1 and 20 months of life. All were asymptomatic at the time of the study. Half of the patients had a history of respiratory disease and all patients had with pulmonary hypertension. Surgical management was required in on-third of the patient group. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  6. Osseous genioplasty: A case series

    Science.gov (United States)

    Deshpande, Sanjeev N.; Munoli, Amarnath V.

    2011-01-01

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

  7. Osseous genioplasty: A case series

    Directory of Open Access Journals (Sweden)

    Sanjeev N Deshpande

    2011-01-01

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

  8. Prospective Case Series of a Novel Minimally Invasive Bipolar Coagulation System in the Treatment of Grade I and II Internal Hemorrhoids.

    Science.gov (United States)

    Crawshaw, Benjamin P; Russ, Andrew J; Ermlich, Bridget O; Delaney, Conor P; Champagne, Bradley J

    2016-12-01

    Background Existing nonsurgical procedures for the treatment of grade I and II internal hemorrhoids are often painful, technically demanding, and often necessitate multiple applications. This study prospectively assessed the safety and efficacy of the HET Bipolar System, a novel minimally invasive device, in the treatment of symptomatic grade I and II internal hemorrhoids. Methods Patients with symptomatic grade I or II internal hemorrhoids despite medical management underwent hemorrhoidal ligation with the HET Bipolar System. Endpoints included resolution or improvement of hemorrhoidal bleeding and/or prolapse from baseline, recurrent or refractory symptoms, and pain. Results Twenty patients were treated with the HET Bipolar System. Two were lost to follow-up. Refractory or recurrent bleeding was present in 8 of 18 (44.4%), 4 of 11 (36.4%), and 4 of 8 (50.0%) patients, and prolapse was reported by 1 of 18 (5.6%), 4 of 11 (36.4%), and 1/7 (14.3%) of patients at 1, 3, and 6 months, respectively. Bleeding improved from baseline in 88.2%, 81.8%, and 87.5% of patients, and resolution of baseline prolapse was seen in 11 of 11 (100%), 4 of 7 (57.1%), and 5 of 5 (100%) patients at the same intervals. Thirteen of 18 (72.2%) patients did not require additional treatment for their symptoms. Conclusions The HET Bipolar System is safe and easy to use with short-term effectiveness comparable to that of currently used techniques for the treatment of symptomatic grade I and II internal hemorrhoids. It may be an effective alternative to rubber band ligation in patients with larger internal hemorrhoids and those with hemorrhoids close to the dentate line in which banding may produce debilitating pain. © The Author(s) 2016.

  9. Prospective assessment of nocturnal awakenings in a case series of treatment-seeking chronic insomnia patients: a pilot study of subjective and objective causes.

    Science.gov (United States)

    Krakow, Barry; Romero, Edward; Ulibarri, Victor A; Kikta, Shara

    2012-12-01

    The cause of nocturnal awakenings in patients with chronic insomnia is rarely researched. This study prospectively assessed the etiology of nocturnal awakenings (subjectively and objectively) among patients with insomnia at a private, community-based sleep medical center. Twenty adult patients with chronic insomnia enrolled between April 2008 and February 2010 met diagnostic criteria for an insomnia disorder, never previously visited a sleep specialist or underwent sleep testing, and reported no classic sleep disordered breathing symptoms. Patients completed validated scales for insomnia, sleepiness, impairment, anxiety, depression, and quality of life, a qualitative interview to assess subjective reasons for awakenings, and a diagnostic sleep study to objectively assess awakenings and their precipitants. Subjective and objective data showed clinically meaningful insomnia, primarily sleep maintenance insomnia. The most common self-reported reasons for awakenings were: uncertain cause (50%), nightmares (45%), nocturia (35%), bedroom distractions (20%), or pain (15%). No patient identified breathing symptoms as a cause. Objectively, 531 awakenings were observed in the total sample, and 478 (90%) were preceded by sleep breathing events (apnea, hypopnea, or respiratory effort-related event). Fifty-three awakenings were caused by other factors (independent leg jerks [7], spontaneous [14], and sleep that was laboratory-induced [32]). Thirty awakenings ≥ 5 min-a duration sufficient to predispose toward an insomnia episode-were each preceded by a breathing event. Among patients with insomnia with no classic sleep breathing symptoms and therefore low probability of a sleep breathing disorder, most of their awakenings were precipitated by a medical condition (sleep disordered breathing), which contrasted sharply with their perceptions about their awakenings

  10. Novel hybrid cryo‐radial method: an emerging alternative to CT‐guided biopsy in suspected lung cancer. A prospective case series and description of technique

    Science.gov (United States)

    Yap, Elaine

    2017-01-01

    In diagnosing peripheral pulmonary lesions (PPL), radial endobronchial ultrasound (R‐EBUS) is emerging as a safer method in comparison to CT‐guided biopsy. Despite the better safety profile, the yield of R‐EBUS remains lower (73%) than CT‐guided biopsy (90%) due to the smaller size of samples. We adopted a hybrid method by adding cryobiopsy via the R‐EBUS Guide Sheath (GS) to produce larger, non‐crushed samples to improve diagnostic capability and enhance molecular testing. We report six prospective patients who underwent this procedure in our institution. R‐EBUS samples were obtained via conventional sampling methods (needle aspiration, forceps biopsy, and cytology brush), followed by a cryobiopsy. An endobronchial blocker was placed near the planned area of biopsy in advance and inflated post‐biopsy to minimize the risk of bleeding in all patients. A chest X‐ray was performed 1 h post‐procedure. All the PPLs were visualized with R‐EBUS. The mean diameter of cryobiopsy samples was twice the size of forceps biopsy samples. In four patients, cryobiopsy samples were superior in size and the number of malignant cells per high power filed and was the preferred sample selected for mutation analysis and molecular testing. There was no pneumothorax or significant bleeding to report. Cryobiopsy samples were consistently larger and were the preferred samples for molecular testing, with an increase in the diagnostic yield and reduction in the need for repeat procedures, without hindering the marked safety profile of R‐EBUS. Using an endobronchial blocker improves the safety of this procedure. PMID:29321931

  11. Membranous Dysmenorrhea: A Case Series

    Science.gov (United States)

    Omar, Hatim A.; Smith, Shawn J.

    2007-01-01

    The purpose was to illustrate the variability of hormonal contraception of patients that presented with membranous dysmenorrheal. A case analysis chart review was completed on six patients referred to a Pediatric Gynecologist in an academic setting. In each case the patient underwent a thorough pelvic and bimanual exam. Following the initial presentation, each patient continued to be followed on a regular visits. Cases: Two were using the transdermal contraceptive patch and oral contraceptive, but following the expulsion of decidual cast, they were both placed on depot medroxyprogesterone acetate (DMPA) without further complications. Three of the six cases were on DMPA prior to the similar occurrence of membranous dysmenorrheal and following this incident, continued on DMPA without further problems. The final case was on the transdermal patch prior to decidual cast expulsion and remained on this form of hormonal contraception without further complications. These cases indicate that membranous dysmenorrheal is not limited to the use of DMPA. PMID:18060329

  12. Delusional Parasitosis : Series Of 25 Cases

    Directory of Open Access Journals (Sweden)

    Bhatia M S

    1996-01-01

    Full Text Available A series 25 cases of delusional parasitosis is being reported. There were three cases below 45 years, 12 cases between 46-45 years and 11 cases above 55 years of age, 64% cases were females. A majority of cases (92% had insidious onset. The duration of symptoms in all the cases (except one was 6 months or more. 13 cases presented with infestation with insects over body and 10 cases with insects crawling over scalp. There were three cases each with diabetes mellitus and leprosy. Three cased had dementia, 2 cases had depression and one case presented with trichotillomania. Pimozide was used in22 cases, amitriptyline in 2 cases and fluoxetine in one. 14 cases (52% showed complete remission while receiving drug, 8 cases showed partial improvement and 3 cases did not respond.

  13. Bi-layered zirconia/fluor-apatite bridges supported by ceramic dental implants: a prospective case series after thirty months of observation.

    Science.gov (United States)

    Spies, Benedikt Christopher; Witkowski, Siegbert; Butz, Frank; Vach, Kirstin; Kohal, Ralf-Joachim

    2016-10-01

    The aim of this study was to determine the success and survival rate of all-ceramic bi-layered implant-supported three-unit fixed dental prostheses (IS-FDPs) 3 years after implant placement. Thirteen patients (seven males, six females; age: 41-78 years) received two one-piece ceramic implants (alumina-toughened zirconia) each in the region of the premolars or the first molar and were finally restored with adhesively cemented bi-layered zirconia-based IS-FDPs (3 in the maxilla, 10 in the mandible) composed of CAD/CAM-fabricated zirconia frameworks pressed-over with fluor-apatite glass-ceramic ingots. At prosthetic delivery and the follow-ups after 1, 2 and 3 years, the restorations were evaluated using modified United States Public Health Service (USPHS) criteria. Restorations with minor veneer chippings, a small-area occlusal roughness, slightly soundable restoration margins, minimal contour deficiencies and tolerable color deviations were regarded as success. In case of more distinct defects that could, however, be repaired to a clinically acceptable level, IS-FDPs were regarded as surviving. Kaplan-Meier plots were used for the success/survival analyses. To verify an impact on subjective patients' perceptions, satisfaction was evaluated by visual analog scales (VAS). All patients were seen 3 years after implant installation. No IS-FDP had to be replaced, resulting in 100% survival after a mean observation period of 29.5 months (median: 30.7). At the 3-year follow-up, 7/13 IS-FDPs showed a veneer chipping, 13/13 an occlusal roughness and 12/13 minimal deficiencies of contour/color. Since six restorations showed a major chipping and/or a major occlusal roughness, the Kaplan-Meier success rate was 53.8%. However, patients' significantly improved perceptions of function, esthetics, sense, and speech at prosthetic delivery remained stable over time. Bi-layered zirconia/fluor-apatite IS-FDPs entirely survived the observation period but showed a high frequency of

  14. Case Series Investigations in Cognitive Neuropsychology

    Science.gov (United States)

    Schwartz, Myrna F.; Dell, Gary S.

    2011-01-01

    Case series methodology involves the systematic assessment of a sample of related patients, with the goal of understanding how and why they differ from one another. This method has become increasingly important in cognitive neuropsychology, which has long been identified with single-subject research. We review case series studies dealing with impaired semantic memory, reading, and language production, and draw attention to the affinity of this methodology for testing theories that are expressed as computational models and for addressing questions about neuroanatomy. It is concluded that case series methods usefully complement single-subject techniques. PMID:21714756

  15. Transvestism as a Symptom: A Case Series

    OpenAIRE

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

    2016-01-01

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

  16. Profilin desensitization: A case series

    Science.gov (United States)

    Nucera, Eleonora; Aruanno, Arianna; Rizzi, Angela; Pecora, Valentina; Patriarca, Giampiero; Buonomo, Alessandro; Mezzacappa, Simona; Schiavino, Domenico

    2016-01-01

    The role of profilin as an allergen has long been questioned. The capacity of profilin to induce respiratory symptoms has recently been demonstrated; moreover, over 50% of patients sensitized to profilin experienced symptoms after the ingestion of plant-derived foods, suggesting that profilin should be considered as a clinically relevant food allergen. We describe the cases of seven allergic patients with oral allergy syndrome and other adverse reactions after eating plant-derived food, that have been undergone to profilin desensitization treatment. The protocol started with a drop of profilin solution (50 µg/mL) diluted 1:1018 in water until the highest dose of 10 drops of undiluted solution three times a week. At the end of the treatment we observed a decreased mean diameter of profilin wheal in skin prick test (SPT) in five of the seven participants and in profilin specific IgE values in six patients that repeated the test. Regarding basophil activation test (BAT) and the detection of IgG4, we do not have significant results because the tests have to be repeated in some patients. Regarding the double-blind placebo-controlled challenges, after about 10 months of induction phase all the patients showed tolerance to several foods that they previously did not tolerate. Moreover, the immunotherapy with profilin has proved to be safe because no serious adverse events have been reported in our patients. In summary, the results of this exploratory study of sublingual immunotherapy (SLIT) for profilin allergy show that it can be a promising therapeutic option that could modify the clinical reactivity of the patients to the intake of plant-derived food. PMID:26684620

  17. Pyogenic Tenosynovitis in Infants: A Case Series.

    Science.gov (United States)

    Lironi, Céline; Steiger, Christina; Juchler, Céline; Spyropoulou, Vasiliki; Samara, Eleftheria; Ceroni, Dimitri

    2017-11-01

    Pyogenic tenosynovitis is an uncommon condition in children, and there are few published case reports. We present a series of 11 cases who were treated in the Geneva Children Hospital in the last 10 years. Kingella kingae was the main pathogen, and the characteristics of infection (inflammatory indices, clinical findings and severity) are similar to other osteoarticular K. kingae infections in infants.

  18. A CASE SERIES ON FISH BILE TOXICITY

    Directory of Open Access Journals (Sweden)

    Dwijen

    2015-08-01

    Full Text Available A case series of 3 cases of fish bile poisoning are reported. After ingestion of gall bladder of Labeo rohita for alleged vision improvement, generally presented with gastrointestinal symptoms such as cramping pain abdomen, nausea and vomiting within 12 hours after ingestion. Subsequently rena l and hepatic dysfunctions were found in all the three cases. The patient recovered fully with conservative treatment and supportive haemodialysis.

  19. Analysis of the learning curve for pre-cut corneal specimens in preparation for lamellar transplantation: a prospective, single-centre, consecutive case series prepared at the Lions New South Wales Eye Bank.

    Science.gov (United States)

    Martin, Aifric Isabel; Devasahayam, Rajnesh; Hodge, Christopher; Cooper, Simon; Sutton, Gerard L

    2017-09-01

    This study is the first paper to establish a learning curve by a single technician. Preparation of pre-cut corneal endothelial grafts commenced at Lions New South Wales Eye Bank in December 2014. The primary objective of this study was to review the safety and reliability of the preparation method during the first year of production. This is a hospital-based, prospective case series. There were 234 consecutive donor corneal lenticules. Donor lenticules were prepared by a single operator using a linear cutting microkeratome. Immediately prior to cutting, central corneal thickness values were recorded. Measurements of the corneal bed were taken immediately following lenticule preparation. Outcomes were separated by blade sizes, and intended thickness was compared to actual thickness for each setting. Early specimens were compared to later ones to assess for a learning curve within the technique. The main parameter measured is the mean difference from intended lamellar cut thickness. The mean final cut thickness was 122.36 ± 20.35 μm, and the mean difference from intended cut was 30.17 ± 37.45 μm. No significant difference was found between results achieved with early specimens versus those achieved with later specimens (P = 0.425). Thin, reproducible endothelial grafts can routinely be produced by trained technicians at their respective eye banks without significant concerns for an extended learning curve. This service can reduce perioperative surgical complexity, required surgical paraphernalia and theatre times. The consistent preparation of single-pass, ultrathin pre-cut corneas may have additional advantages for surgeons seeking to introduce lamellar techniques. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  20. Transvestism as a Symptom: A Case Series.

    Science.gov (United States)

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

    2016-01-01

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

  1. 5. CASE SERIES OF MANIA SECONDARY

    African Journals Online (AJOL)

    Esem

    meeting the criteria for DSM IV- TR is increasing. What is not clear with this increase is whether it is primary mania or secondary mania linked with HIV. METHODS. This study design was a case series in which patients with acute manic episodes were admitted to. Chainama Hills College Hospital and University. Teaching ...

  2. Unilateral nodular adrenal hyperplasia: Case series

    African Journals Online (AJOL)

    A.F. Kotb

    2016-07-26

    Jul 26, 2016 ... Abstract. Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 ...

  3. Hybrid natural orifice transluminal endoscopic cholecystectomy: prospective human series.

    Science.gov (United States)

    Cuadrado-Garcia, Angel; Noguera, Jose F; Olea-Martinez, Jose M; Morales, Rafael; Dolz, Carlos; Lozano, Luis; Vicens, Jose-Carlos; Pujol, Juan José

    2011-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) makes it possible to perform intraperitoneal surgical procedures with a minimal number of access points in the abdominal wall. Currently, it is not possible to perform these interventions without the help of abdominal wall entryways, so these procedures are hybrids fusing minilaparoscopy and transluminal endoscopic surgery. This report presents a prospective clinical series of 25 patients who underwent transvaginal hybrid cholecystectomy for cholelithiasis. The study comprised a clinical series of 25 consecutive nonrandomized women who underwent a fusion transvaginal NOTES and minilaparoscopy procedure with two trocars for cholelithiasis: one 5-mm umbilical trocar and one 3-mm trocar in the upper left quadrant. The study had no control group. The scheduled surgical intervention was performed for all 25 women. No intraoperative complications occurred. One patient had mild hematuria that resolved in less than 12 h, but no other complications occurred during an average follow-up period of 140 days. Of the 25 women, 20 were discharged in 24 h, and 5 were discharged less than 12 h after the procedure. Hybrid transvaginal cholecystectomy, combining NOTES and minilaparoscopy, is a good surgical model for minimally invasive surgery. It can be performed in surgical settings where laparoscopy is practiced regularly using the instruments normally used for endoscopy and laparoscopic surgery. Due to the reproducibility of the intervention and the ease of vaginal closure, hybrid transvaginal cholecystectomy will permit further development of NOTES in the future.

  4. Case-Mix, Care Processes, and Outcomes in Medically-Ill Patients Receiving Mechanical Ventilation in a Low-Resource Setting from Southern India: A Prospective Clinical Case Series.

    Science.gov (United States)

    Karthikeyan, Balasubramanian; Kadhiravan, Tamilarasu; Deepanjali, Surendran; Swaminathan, Rathinam Palamalai

    2015-01-01

    Mechanical ventilation is a resource intensive organ support treatment, and historical studies from low-resource settings had reported a high mortality. We aimed to study the outcomes in patients receiving mechanical ventilation in a contemporary low-resource setting. We prospectively studied the characteristics and outcomes (disease-related, mechanical ventilation-related, and process of care-related) in 237 adults mechanically ventilated for a medical illness at a teaching hospital in southern India during February 2011 to August 2012. Vital status of patients discharged from hospital was ascertained on Day 90 or later. Mean age of the patients was 40 ± 17 years; 140 (51%) were men. Poisoning and envenomation accounted for 98 (41%) of 237 admissions. In total, 87 (37%) patients died in-hospital; 16 (7%) died after discharge; 115 (49%) were alive at 90-day assessment; and 19 (8%) were lost to follow-up. Weaning was attempted in 171 (72%) patients; most patients (78 of 99 [79%]) failing the first attempt could be weaned off. Prolonged mechanical ventilation was required in 20 (8%) patients. Adherence to head-end elevation and deep vein thrombosis prophylaxis were 164 (69%) and 147 (62%) respectively. Risk of nosocomial infections particularly ventilator-associated pneumonia was high (57.2 per 1,000 ventilator-days). Higher APACHE II score quartiles (adjusted HR [95% CI] quartile 2, 2.65 [1.19-5.89]; quartile 3, 2.98 [1.24-7.15]; quartile 4, 5.78 [2.45-13.60]), and new-onset organ failure (2.98 [1.94-4.56]) were independently associated with the risk of death. Patients with poisoning had higher risk of reintubation (43% vs. 20%; P = 0.001) and ventilator-associated pneumonia (75% vs. 53%; P = 0.001). But, their mortality was significantly lower compared to the rest (24% vs. 44%; P = 0.002). The case-mix considerably differs from other settings. Mortality in this low-resource setting is similar to high-resource settings. But, further improvements in care processes

  5. Case-Mix, Care Processes, and Outcomes in Medically-Ill Patients Receiving Mechanical Ventilation in a Low-Resource Setting from Southern India: A Prospective Clinical Case Series.

    Directory of Open Access Journals (Sweden)

    Balasubramanian Karthikeyan

    Full Text Available Mechanical ventilation is a resource intensive organ support treatment, and historical studies from low-resource settings had reported a high mortality. We aimed to study the outcomes in patients receiving mechanical ventilation in a contemporary low-resource setting.We prospectively studied the characteristics and outcomes (disease-related, mechanical ventilation-related, and process of care-related in 237 adults mechanically ventilated for a medical illness at a teaching hospital in southern India during February 2011 to August 2012. Vital status of patients discharged from hospital was ascertained on Day 90 or later.Mean age of the patients was 40 ± 17 years; 140 (51% were men. Poisoning and envenomation accounted for 98 (41% of 237 admissions. In total, 87 (37% patients died in-hospital; 16 (7% died after discharge; 115 (49% were alive at 90-day assessment; and 19 (8% were lost to follow-up. Weaning was attempted in 171 (72% patients; most patients (78 of 99 [79%] failing the first attempt could be weaned off. Prolonged mechanical ventilation was required in 20 (8% patients. Adherence to head-end elevation and deep vein thrombosis prophylaxis were 164 (69% and 147 (62% respectively. Risk of nosocomial infections particularly ventilator-associated pneumonia was high (57.2 per 1,000 ventilator-days. Higher APACHE II score quartiles (adjusted HR [95% CI] quartile 2, 2.65 [1.19-5.89]; quartile 3, 2.98 [1.24-7.15]; quartile 4, 5.78 [2.45-13.60], and new-onset organ failure (2.98 [1.94-4.56] were independently associated with the risk of death. Patients with poisoning had higher risk of reintubation (43% vs. 20%; P = 0.001 and ventilator-associated pneumonia (75% vs. 53%; P = 0.001. But, their mortality was significantly lower compared to the rest (24% vs. 44%; P = 0.002.The case-mix considerably differs from other settings. Mortality in this low-resource setting is similar to high-resource settings. But, further improvements in care processes

  6. Adult intussusception: A case series and review

    OpenAIRE

    Shenoy, Santosh

    2017-01-01

    AIM To identify factors differentiating pathologic adult intussusception (AI) from benign causes and the need for an operative intervention. Current evidence available from the literature is discussed. METHODS This is a case series of eleven patients over the age of 18 and a surgical consultation for ?Intussusception? at a single veteran?s hospital over a five-year period (2011-2016). AI was diagnosed on computed tomography (CT) scan and or flexible endoscopy (colonoscopy). Surgical referrals...

  7. Acute sirolimus overdose: a multicenter case series.

    Directory of Open Access Journals (Sweden)

    Alessandro Ceschi

    Full Text Available There are few data relating to sirolimus overdose in the medical literature. Our objectives were to describe all cases of overdose with sirolimus reported to Swiss, German and Austrian Poisons Centres between 2002-2013.An observational case-series analysis was performed to determine circumstances, magnitude, management and outcome of sirolimus overdose.Five cases of acute sirolimus overdose were reported--three in young children and two in adults. Four were accidental and one was with suicidal intent. Two patients developed symptoms probably related to sirolimus overdose: mild elevation of alkaline phosphatase, fever and gastroenteritis in a 2.5-year-old male who ingested 3 mg, and mild changes in total cholesterol in an 18-year-old female after ingestion of 103 mg. None of these events were life-threatening. Serial blood concentration measurements were performed starting 24 h after ingestion of 103 mg in a single case, and these followed a similar pharmacokinetic time-course to measurements taken after dosing in the therapeutic range.Acute sirolimus overdose occurred accidentally in the majority of cases. Even large overdoses appeared to be well-tolerated, however children might be at greater risk of developing complications. Further study of sirolimus overdose is needed.

  8. Ortner's syndrome: case series and literature review.

    Science.gov (United States)

    Subramaniam, Vijayalakshmi; Herle, Adarsha; Mohammed, Navisha; Thahir, Muhammad

    2011-01-01

    More than a century ago, Ortner described a case of cardiovocal syndrome wherein he attributed a case of left vocal fold immobility to compression of the recurrent laryngeal nerve by a dilated left atrium in a patient with mitral valve stenosis. Since then, the term Ortner's syndrome has come to encompass any nonmalignant, cardiac, intrathoracic process that results in embarrassment of either recurrent laryngeal nerve-usually by stretching, pulling, or compression; and causes vocal fold paralysis. Not surprisingly, the left recurrent laryngeal nerve, with its longer course around the aortic arch, is more frequently involved than the right nerve, which passes around the subclavian artery. To discuss the pathogenesis of hoarseness resulting from cardiovascular disorders involving the recurrent laryngeal nerve along with the findings of literature review. This paper reports a series of four cases of Ortner's syndrome occurring due to different causes. Case study. Ortner's syndrome could be a cause of hoarseness of voice in patients with cardiovascular diseases. Although hoarseness of voice is frequently encountered in the Otolaryngology outpatient department, cardiovascular- related hoarseness is an unusual presentation. Indirect laryngoscopy should be routinely performed in all cases of heart disease.

  9. Medicaid prospective payment: Case-mix increase

    Science.gov (United States)

    Baker, Samuel L.; Kronenfeld, Jennie J.

    1990-01-01

    South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced. PMID:10113463

  10. Temporal fossa hemangiopericytoma: a case series.

    Science.gov (United States)

    Heiser, Marc A; Waldron, James S; Tihan, Tarik; Parsa, Andrew T; Cheung, Steven W

    2009-10-01

    Review clinical experience with temporal fossa hemangiopericytomas (HPCs). Retrospective case series review. Tertiary referral center. Intracranial HPCs within the temporal fossa. Craniotomy for either subtotal or gross total tumor excision. Determination of clinical outcome (alive with no evidence of disease, alive with disease, and died of disease). Five cases of HPC involving the temporal fossa were treated at our tertiary referral center for the period from 1995 to 2008. All but 1 patient were men. The age of presentation ranged from 31 to 62 years, and duration of follow-up ranged from 8 to 153 months. Clinical presentation was protean; headache was the most common symptom. Gross total tumor excision was achieved in 2 patients, whereas subtotal tumor excision was achieved in 3 patients. Reasons for subtotal resection included excessive intraoperative blood loss and inextricable tumor. Histologically, all tumors were composed of tightly packed, randomly oriented (jumbled-up) tumor cells with little intervening collagen. CD34 staining mostly highlighted the vascular background. One patient died of disease, 2 patients were alive with disease, and 2 patients had no evidence of disease. Management of temporal fossa HPC is challenging because clinical presentation is often late, and extent of tumor excision is constrained by vital structures in the cranial base and intracranial contents. A multidisciplinary approach with neurosurgery and neurotology undertaken to achieve the most complete tumor resection possible, whereas minimizing morbidity are likely to confer a longer period of symptom-free survival and improves curability of these difficult lesions.

  11. Cutaneous leishmaniasis in children: A case series

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    Mrinal Gupta

    2018-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is a protozoal disease usually caused by Leishmania major and Leishmania tropica and transmitted by the bite of a sandfly. It is usually characterized by a single, polymorphous lesion located in an uncovered area. Aims: This study aimed to evaluate the clinico-epidemiological characteristics of CL among children. Materials and Methods: It was a retro-prospective study carried out over a period of 18 months in our center, in which the clinico-epidemiological features of children presenting with CL were assessed. Results: A total of 10 children (male:female - 7:3 were included in the study with the age range of 1–15 years, with a mean age of 8.8 years. Face was the most commonly affected site (n = 8, followed by neck and hands (1 each, and nodulo-ulcerative was the most common clinical type seen in nine patients. Skin smears for Leishman–Donovan (LD bodies were positive in five patients while the skin biopsy, which was done in four cases, showed the presence of LD bodies in only one patient. Conclusion: CL is a common presentation among children, especially in the endemic areas, and the clinical features are similar to the adult onset disease.

  12. Safety of Combination of a Tetravalent Meningococcal Conjugate Vaccine Against Serogroups A, C, Y, W-135 With Other Vaccine Preparations: a Prospective Study of a Series of Cases Among Healthy Children and Children With Various Health Abnormalities

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    Leyla S. Namazova-Baranova

    2017-01-01

    Full Text Available Meningococcal infection is an acute disease caused by Neisseria meningitidis, which proceeds with a diverse clinical aspect from nasopharyngitis to meningococcal meningitis and meningococcemia. Since 2014, a tetravalent meningococcal conjugate vaccine has been registered in Russia. This vaccine creates protection against serogroups A, C, W-135, Y and can be used from the age of nine months to 55 years. The actual issue is a vaccine tolerability, including when combined with other vaccine preparations.Objective: Our aim was to evaluate the safety of a tetravalent meningococcal conjugate vaccine against serogroups A, C, Y and W-135 when it is combined with other vaccine preparations.Methods. A prospective full-design study assessed the tolerability of immunization with a meningococcal conjugate vaccine, both in case of monovaccination and in combination with a pneumococcal 13-valent conjugate vaccine, measles-mumps-rubella, viral hepatitis A, influenza, and chicken pox vaccines.Results. 97 children aged from 9 months to 18 years were vaccinated, 20 of them were healthy and 77 had medical issues (with allergic pathology, ENT diseases, cardiovascular and nervous system diseases, lung diseases as well as orphan diseases. Among vaccinated children, general reactions were observed in 3/97 (3.1% children, local reactions — in 5 (5.2%. The post-vaccination period passed asymptomatically and uneventfully in the prevailing majority of children vaccinated with a tetravalent meningococcal conjugate vaccine (in 91, 93.8%.Conclusion. The immunization with a tetravalent meningococcal conjugate vaccine against serogroups A, C, Y, W-135 is well tolerated, both in case of monovaccination and in combination with other vaccine preparations, in healthy children of different age groups and in patients with different health status.

  13. Treatment of gingival pigmentation : A case series

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    Prasad Deepak

    2005-01-01

    Full Text Available A smile expresses a feeling of joy, success, sensuality, affection and courtesy, and reveals self confidence and kindness. The harmony of the smile is determined not only by the shape, the position and the color of the teeth but also by the gingival tissues. Gingival health and appearance are essential components of an attractive smile. Gingival pigmentation results from melanin granules, which are produced by melanoblasts. The degree of pigmentation depends on melanoblastic activity. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of ′black gums′ are common particularly in patients having a very high smile line (gummy smile. For depigmentation of gingiva different treatment modalities have been reported like- Bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery and laser. In the present case series bur abrasion, scraping, partial thickness flap (epithelial excision cryotherapy and electrosurgery have been tried for depigmentation, which are simple, effective and yield good results, along with good patient satisfaction. The problems encountered with some of these techniques have also been discussed.

  14. Facial firework injury: a case series.

    Science.gov (United States)

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

    2014-07-01

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

  15. Facial Firework Injury: A Case Series

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    Kashyap Tadisina

    2014-07-01

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

  16. Surgery or radiotherapy for the treatment of bone hydatid disease: a retrospective case series

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    Zengru Xie

    2015-04-01

    Conclusion: This retrospective case series describes, for the first time, the clinical outcomes in a series of patients treated with radiotherapy for bone hydatid disease. Although no direct comparison between the treatment groups could be made due to methodological limitations of the study design, this study indicates that well-designed prospective randomized controlled clinical trials assessing radiotherapy may be warranted in patients with inoperable hydatid disease of the bones.

  17. Intramuscular Olanzapine – a UK case series of early cases

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    Taylor Mark

    2007-04-01

    Full Text Available Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy and safety of IM olanzapine. The PANSS-EC scale used in the clinical studies may represent a tool that could be used in routine clinical practice. Case presentation We report on an early unselected case series of 7 patients who received IM olanzapine in routine clinical practice settings in the UK. In this case series, olanzapine IM was generally effective, and no adverse events were reported. Adjunctive benzodiazepines were given concomitantly in 1 of the 7 subjects. This is relevant as concomitant benzodiazepines are not recommended for a minimum of 1 hour post IM olanzapine administration. PANSS-EC data was collected in 2 of the 7 subjects. Conclusion Although patients had greater severity of psychosis than clinical trial patients there were no unexpected findings. In addition the PANSS-EC scale is a scale that may be useful in assessing the efficacy of IM antipsychotics in routine clinical practice.

  18. [Dental agenesis. Results of a prospective study of 30 cases].

    Science.gov (United States)

    Romieux, G; Bonin, B; Laure, B; Van Hove, A; Goga, D

    2000-11-01

    We conducted a prospective study to determine the types of bone anomalies observed in different types of dental agenesia. This prospective series included 30 patients who attended our pluridisciplinary clinic since 1988. There were 22 cases of non syndromal agenesia and 8 cases of syndromal agenesia. Patients consulted for a variety of reasons, no specific sign was found. The diagnosis was based on the panoramic x-ray and confirmed at the genetic consultation. Results were systemized by localization of the agenesia. In all cases, the height of the bone crest was preserved compared with the adjacent teeth. In the anterior part of the maxillary, the bone crest was thin showing a water drop aspect. In the posterior maxillary, there was a decrease in the subsinusal height due to invagination of the floor of the sinus. In the anterior part of the mandible, the crest had a knife blade aspect but no loss of height and in the posterior part, a preserved distance between the residual crest rim and the dental canal. In 60% of the solitary agenesias in the anterior part of the maxillary, augmentation was not required. A sinus graft was required in all cases involving the posterior maxillary. Multiple anterior or lateral agenesias were treated with a parietal graft.

  19. Healthcare-Associated Infective Endocarditis: a Case Series in a Referral Hospital from 2006 to 2011

    OpenAIRE

    Francischetto, Oslan; Silva, Luciana Almenara Pereira da; Senna, Katia Marie Simões e; Vasques, Marcia Regina; Barbosa, Giovanna Ferraiuoli; Weksler, Clara; Ramos, Rosana Grandelle; Golebiovski, Wilma Felix; Lamas, Cristiane da Cruz

    2014-01-01

    Background: Healthcare-associated infective endocarditis (HCA-IE), a severe complication of medical care, shows a growing incidence in literature. Objective: To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods: Observational prospective case series study (2006-2011) in a public hospital in Rio de Janeiro. Results: Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE) were ...

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

    Science.gov (United States)

    Rapp, Brenda

    2011-10-01

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

  1. Case Series in Cognitive Neuropsychology: Promise, Perils and Proper Perspective

    Science.gov (United States)

    Rapp, Brenda

    2012-01-01

    Schwartz & Dell (2010) advocated for a major role for case series investigations in cognitive neuropsychology. They defined the key features of this approach and presented a number of arguments and examples illustrating the benefits of case series studies and their contribution to computational cognitive neuropsychology. In the Special Issue on “Case Series in Cognitive Neuropsychology” there are six commentaries on Schwartz and Dell (2010) as well as a response to the six commentaries by Dell and Schwartz. In this paper, I provide a brief summary of the key points made in Schwartz and Dell (2010) and I review the promise and perils of case series design as revealed by the six commentaries. I conclude by placing the set of papers within a broader perspective, providing some clarification of the historical record on case series and single case approaches, raising some cautionary notes for case series studies and situating both case series and single case approaches within the larger context of theory development in the cognitive sciences. PMID:22746685

  2. Case series of Stargardt's disease: Our experience

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    Syed Abdul Wadud

    2016-08-01

    Full Text Available Stargardt disease is the most common form of juvenile macular degeneration. Clinically, it is characterized by pisciform flecks at lhe level of the retinal pigment epithelium and a bull's-eye maculopathy. Inheritance is usually autosomal recessive, although dominantly inherited case have been described. Both sexes are affected equally. We reported here three cases of Stargardt's macular dystrophy, who are siblings and daughters of non consanguineous parents. In case-1,2 and 3 we found the typical presentation with almost same findings.

  3. Pulmonary Artery Agenesis: A Case Series

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    Meltem Ağca

    2015-04-01

    Full Text Available Pulmonary artery agenesis is a rare congenital abnormality in which atresia was encountered in the short segment of the right or left pulmonary arteries. It can be isolated or associated with cardiac abnormalities such as tetralogy of Fallot, septal defects or pulmonary stenosis.The majority of cases are diagnosed in childhood whereas some cases yield no symptoms until adulthood. We evaluated retrospectively 5 pulmonary artery agenesis cases diagnosed in our clinics between 1998-2010 with respect to the literature.

  4. Surgical management of palatine Torus - case series

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    Thaís Sumie Nozu Imada

    Full Text Available INTRODUCTION: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. OBJECTIVE: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. CASE REPORT: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients' quality of life. FINAL CONSIDERATION: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications.

  5. Complicated infective endocarditis: a case series.

    Science.gov (United States)

    Kim, Joo Seop; Kang, Min-Kyung; Cho, A Jin; Seo, Yu Bin; Kim, Kun Il

    2017-05-08

    Infective endocarditis is associated with not only cardiac complications but also neurologic, renal, musculoskeletal, and systemic complications related to the infection, such as embolization, metastatic infection, and mycotic aneurysm. We report three cases (the first patient is Chinese and the other two are Koreans) of complicated infective endocarditis; two of the cases were associated with a mycotic aneurysm, and one case was associated with a splenic abscess. One case of a patient with prosthetic valve endocarditis was complicated by intracerebral hemorrhage caused by mycotic aneurysm rupture. A second case of a patient with right-sided valve endocarditis associated with a central catheter was complicated by an abdominal aortic mycotic aneurysm. The third patient had a splenic infarction and abscess associated with infected cardiac thrombi. Complicated infective endocarditis is rare and is associated with cardiac, neurologic, renal, musculoskeletal, and systemic complications related to infection, such as embolization, metastatic infection, and mycotic aneurysm. Infective endocarditis caused by Staphylococcus aureus is more frequently associated with complications. Because the mortality rate increases when complications develop, aggressive antibiotic therapy and surgery, combined with specific treatments for the complications, are necessary.

  6. Acute Lidocaine Toxicity: a Case Series

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    Mitra Rahimi

    2018-06-01

    Full Text Available Introduction: Parenteral form of lidocaine is the best-known source of lidocaine poisoning. This study aimed to evaluate the characteristics of acute lidocaine toxicity.Methods: In this retrospective cross-sectional study, demographics, clinical presentation, laboratory findings, and outcome of patients intoxicated with lidocaine (based on  ICD10 codes admitted to Loghman Hakim Hospital, during April 2007 to March 2014 were analyzed.Results: 30 cases with the mean age of 21.83 ± 6.57 year were studied (60% male. All subjects had used either 6.5% lidocaine spray or 2% topical formulations of lidocaine. The mean consumed dose of lidocaine was 465 ± 318.17 milligrams. The most frequent clinical presentations were nausea and vomiting (50%, seizure (33.3%, and loss of consciousness (16.7%. 22 (73.3% cases had normal sinus rhythm, 4 (13.3% bradycardia, 2 (6.7% ventricular tachycardia, and 2 (6.7% had left axis deviation. 11 (36.6% cases were intubated and admitted to intensive care unit (ICU for 6.91 ± 7.16 days. Three patients experienced status epilepticus that led to cardiac arrest, and death (all cases with suicidal intention.Conclusion: Based on the results of this study, most cases of topical lidocaine toxicity were among < 40-year-old patients with a male to female ratio of 1.2, with suicidal attempt in 90%, need for intensive care in 36.6%, and  mortality rate of 10%.

  7. Kartagener′s syndrome: A case series

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    Mayank Mishra

    2012-01-01

    Full Text Available Kartagener′s syndrome is a rare, autosomal recessive genetic ciliary disorder comprising the triad of situs inversus, chronic sinusitis, and bronchiectasis. The basic problem lies in the defective movement of cilia, leading to recurrent chest infections, ear/nose/throat symptoms, and infertility. We hereby report three unusual cases of this rare entity - an infertile male with azoospermia in whom Bochdalek′s diaphragmatic hernia coexisted, another case of an infertile female, and a third of an infertile male with oligospermia. The need for a high index of suspicion to make an early diagnosis cannot be overemphasized in such patients so that wherever possible, options for timely treatment of infertility may be offered and unnecessary evaluation of symptoms is avoided.

  8. Gastrojejunocolic fistula after gastrojejunostomy: a case series

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    Wu Jin-Ming

    2008-06-01

    Full Text Available Abstract Introduction Gastrojejunocolic (GJC fistulae represent a significant post-surgical cause of morbidity and mortality. GJC fistulae represent rare post-surgical complications, and most are associated with gastric surgery. In the past, this complication has been under-recognized because a fistula may form years after surgery. Case presentation We describe two cases of gastrojejunocolic fistula in men aged 67 and 60 who both initially presented with watery diarrhea and weight loss. Upper GI studies with small bowel follow-through or barium contrast enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course was uneventful. Conclusion With surgery, this condition is entirely correctable. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery, and total parenteral nutrition plays a major role in the provision of bowel rest to allow recovery in malnourished patients.

  9. Zolpidem (Ambien): a pediatric case series.

    Science.gov (United States)

    Kurta, D L; Myers, L B; Krenzelok, E P

    1997-01-01

    In 1993, the nonbenzodiazepine sedative-hypnotic zolpidem tartrate (Ambien) was approved for use in the US. Zolpidem has an imidazopyridine structure and possesses a rapid onset of action and a short half-life. The toxic threshold and profile have not been well established in the pediatric population. All pediatric zolpidem exposures reported to a regional poison information center over 24 months were reviewed retrospectively from the American Association of Poison Control Centers Toxic Exposure Surveillance System data collection forms. Twelve pediatric zolpidem exposures were reported. Seven were unintentional (ages 20 mon-5 y) and five were intentional misuse/suicide (ages 12-16 y). The regional poison information center was contacted within 1 h in ten cases with onset of symptoms within 10 to 60 min (mean 31.6 min). One child had no effect with 2.5 mg. As little as 5 mg caused symptoms with minor outcome in six unintentional ingestions (5-30 mg). Minor to moderate symptoms were reported 1-4 h after intentional ingestions (12.5-150 mg). The duration of symptoms in the unintentional cases ranged from less than 60 min up to 4 h (mean 2.4 h) and 6-10 h (mean 7.5 h) in the intentional exposures. Treatment consisted of observation (4), syrup of ipecac (1), lavage and activated charcoal (1), activated charcoal alone (5), and unknown (1). Due to the very rapid onset of central nervous system symptoms in children, emesis is not a treatment option. Supportive care, activated charcoal in large ingestions, and observation until symptoms resolve may be sufficient in most pediatric cases.

  10. The sweet Christmas rash (case series)

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Nepper-Christensen, Steen; Thyssen, Jacob P

    2013-01-01

    Christmas tree hypersensitivity is a rare condition, which has so far obtained scarce attention in the medical literature. We present two clinical cases of hypersensitivity associated with Christmas tree exposure, a 51-year-old woman with allergic contact dermatitis and a 41-year-old man...... with allergic rhinitis. The female patient had a positive patch test reaction to colophony, and the male patient had a positive skin prick test reaction to alternaria mould. Both were successfully advised to avoid prolonged exposure to Christmas trees and buy artificial trees for Christmas....

  11. Etanercept and venous thromboembolism: a case series

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    Guggenheim Carla

    2010-01-01

    Full Text Available Abstract Introduction The treatment with antitumor necrosis factor agents has often been associated with the induction of autoantibodies (antinuclear antibodies, anti-double stranded DNA antibodies and antiphospholipid antibodies. The clinical significance of these antibodies remains unclear, but they may predispose to antiphospholipid syndrome with thromboembolic complications. The association of etanercept with thromboembolic events has not been reported previously in the literature. Case presentation We describe the cases of three patients with rheumatoid arthritis, psoriatic arthritis and seronegative inflammatory arthritis who were treated with etanercept. They developed deep vein thrombosis and/or pulmonary embolism one to three years after the initiation of etanercept therapy. All three patients had a prolonged activated partial thromboplastin time with a positive lupus anticoagulant that persisted even after 12 weeks. Conclusion Although the clinical significance of antiphospholipid antibodies during treatment with antitumor necrosis factor agents remains unclear, they may predispose patients to develop antiphospholipid syndrome when associated with prolonged activated partial thromboplastin time, lupus anticoagulant positivity, or the presence of anti-β2 glycoprotein I. Clinicians must keep this in mind during therapy with antitumor necrosis factor agents in order to prevent, detect and treat potential consequences such as deep vein thrombosis and pulmonary embolism.

  12. Doxycyclin induced esophageal injury: A Case series

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    İsmail Demiryılmaz

    2013-01-01

    Full Text Available Some drugs have been known to damage to esophagusfor a long time. Half of the cases reported are of tetracyclineand its derivatives. The damage caused by thesedrugs is depends on the drug itself and the patient.In this paper we present 5 patients having diagnosedesophageal damage endoscopically after due to doxycyclinuse. The mean age of the patients was 26 years.Three of them for acne and 2 for heir complaints gynecologicalinfection were taking these drugs. Lesions werelocated at the middle in 4 cases and lover part in 1 patient.The common complaint was retrosternal pain and heartburnafter taking the drug with insufficient water or withoutwater. All the patients were relieved by symtomatic teratment.Esophageal damage is to be remembered in patientscomplaning sudden pain and difficult swallowing on doxycyclintreatment and endoscopic procedure should beemployed for definition of diagnosis and evaluation of theseverity of the damage. After treatment, endoscopic controlis not necessary. Physicians must not forget to advicethe patients to take these drugs with splendid amount ofwater.Key words: Doxycycline, esophagus damage, endoscopy

  13. Global aphasia without hemiparesis: A case series

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    Aparna R Pai

    2011-01-01

    Full Text Available Background: Global aphasia without hemiparesis (GAWH is a rare stroke syndrome characterized by the unusual dissociation of motor and language functions. Issues regarding its etio-pathogenesis, lesion sites, and recovery patterns are extensively being debated in contemporary neuroscience literature. Materials and Methods: Four patients admitted in our hospital between 2005 and 2009 with GAWH caused by ischemic stroke were studied retrospectively with emphasis on number and site of lesions, etiology, and recovery patterns. Results: The clinical findings from our subjects showed that GAWH could result from either single/multiple lesions including subcortical lesions. The recovery was rapid, although not complete. One case evolved into Wernicke′s aphasia as seen in earlier studies. Two subjects revealed evolution to transcortical sensory aphasia and one to Broca′s aphasia which is distinct from previous proposals. Two cases showed lack of clinico-anatomic correlation during recovery. Conclusions: GAWH could result from both embolic and large vessel strokes and single or multiple lesions. The recovery pattern may be variable and may show lack of clinico-anatomical correlation indicating anomalous cerebral functional reorganization, questioning the conventional teaching of language representation in the brain.

  14. PLATEAU IRIS SYNDROME--CASE SERIES.

    Science.gov (United States)

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

    2015-01-01

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

  15. Fourth branchial complex anomalies: a case series.

    Science.gov (United States)

    Shrime, Mark; Kacker, Ashutosh; Bent, John; Ward, Robert F

    2003-11-01

    Anomalies of the fourth branchial arch complex are exceedingly rare, with approximately forty cases reported in the literature since 1972. The authors report experience with six fourth arch anomalies. Retrospective chart review of six consecutive patients presenting to the pediatric otolaryngology service at a tertiary care center with anomalies referable to the fourth branchial arch. All six patients presented within the first or second decade of life. All six had left-sided disease. Four patients presented with recurrent neck infection, one with asymptomatic cervical masses, and one with a neck mass and respiratory compromise. One patient had prior surgery presented with a recurrence. Diagnosis of fourth arch anomalies was suggested or confirmed by computed tomography and flexible laryngoscopy. Treatment was surgical in five patients; one patient is awaiting surgery. Surgical procedures included resection of the mass and endoscopic cauterization of the inner opening of the cyst. The presentation of a cervical mass, especially with recurrent infections and especially on the left side, in a child in the first or second decade of life heightens suspicion for an anomaly of the fourth branchial arch. Diagnosis can be difficult, but is aided by the use of flexible laryngoscopy, Computed tomography (CT) scanning and ultrasonography. Surgical resection of the cyst and cauterization of its pyriform sinus opening should be undertaken to minimize recurrence.

  16. Neonatal hemochromatosis. Case series from Bahrain.

    Science.gov (United States)

    Isa, Hasan M; Mohamed, Afaf M

    2013-12-01

    To review clinical presentations, diagnosis, response to treatment, and outcome of infants with neonatal hemochromatosis (NH). This is a retrospective review of all cases admitted to the Pediatric Department at Salmaniya Medical Center, Manama, Bahrain between March 2008 and May 2011. The diagnosis was based on serum iron and ferritin, alpha-fetoprotein levels (AFP), liver and buccal biopsies, and abdominal MRI scan. Ten patients (8 males and 2 females) were diagnosed with NH. Two patients were intrauterine growth restriction (IUGR) and 6 were preterm. The median birth weight was 1.700 grams. The median age at presentation was 16 days, and at diagnosis was 23 days. Two patients had positive consanguinity. Clinical presentations of the infants were hepatosplenomegaly (n=5), ascites (n=3), and hypoglycemia (n=6). All patients had raised ferritin levels, prolonged prothrombin time, and 9 patients had high serum iron and serum AFP. Abdominal MRI showed iron overload in the liver (n=8). Liver biopsies showed evidence of hemochromatosis (n=3). Buccal biopsies stained positive for iron (n=1). Eight patients received antioxidant therapy and survived. Two patients passed away. Neonatal hemochromatosis is a rare liver disease of newborns with a spectrum of clinical severity. Elevated serum ferritin and AFP support the diagnosis after excluding other causes of neonatal liver failure. The use of antioxidant therapy helps to improve the outcome.

  17. Pancreatico-pleural Fistula: Case Series

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    Manoj Munirathinam

    2018-01-01

    Full Text Available Pancreatico-pleural fistula is a rare but serious complication of acute and chronic pancreatitis. The pleural effusion caused by pancreatico-pleural fistula is usually massive and recurrent. It is predominately left-sided but right-sided and bilateral effusion does occur. We report four cases of pancreatico-pleural fistula admitted to our hospital. Their clinical presentation and management aspects are discussed. Two patients were managed by pancreatic endotherapy and two patients were managed conservatively. All four patients improved symptomatically and were discharged and are on regular follow-up. Most of these patients would be evaluated for their breathlessness and pleural effusion delaying the diagnosis of pancreatic pathology and management. Hence, earlier recognition and prompt treatment would help the patients to recover from their illnesses. Pancreatic pleural fistula diagnosis requires a high index of suspicion in patients presenting with chest symptoms or pleural effusion. Extremely high pleural fluid amylase levels are usual but not universally present. A chest X-ray, pleural fluid analysis, and abdominal imaging (magnetic resonance cholangiopancreatography/magnetic resonance imaging abdomen more useful than contrast-enhanced computed tomography abdomen would clinch the diagnosis. Endoscopic retrograde cholangiopancreatography with stent or sphincterotomy should be considered when pancreatic duct (PD reveals a stricture or when medical management fails in patients with dilated or irregular PD. Surgical intervention may be indicated in patients with complete disruption of PD or multiple strictures.

  18. Pituitary gigantism: a retrospective case series.

    Science.gov (United States)

    Creo, Ana L; Lteif, Aida N

    2016-05-01

    Pituitary gigantism (PG) is a rare pediatric disease with poorly defined long-term outcomes. Our aim is to describe the longitudinal clinical course in PG patients using a single-center, retrospective cohort study. Patients younger than 19 years diagnosed with PG were identified. Thirteen cases were confirmed based on histopathology of a GH secreting adenoma or hyperplasia and a height >2 SD for age and gender. Laboratory studies, initial pathology, and imaging were abstracted. Average age at diagnosis was 13 years with an average initial tumor size of 7.4×3.8 mm. Initial transsphenoidal surgery was curative in 3/12 patients. Four of the nine patients who failed the initial surgery required a repeat procedure. Octreotide successfully normalized GH levels in 1/6 patients with disease refractory to surgery (1/6). Two out of five patients received pegvisomant after failing octreotide but only one patient responded to treatment. Five patients were ultimately treated with radiosurgery or radiation patients were followed for an average of 10 years. PG is difficult to treat. In most patients, the initial transsphenoidal surgery failed to normalize GH levels. If the initial surgery was unsuccessful, repeat surgery was unlikely to control GH secretion. Treatment with octreotide or pegvisomant was successful in less than half the patients failing surgery. Radiosurgery was curative, but is not an optimal treatment for pediatric patients. Despite the small sample, our study suggests that the treatment outcome of pediatric PG may be different than adults.

  19. Pica in iron deficiency: a case series

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    Tisman Glenn

    2010-03-01

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

  20. Granulomatous lobular mastitis ,A case series.

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    Ali Pourzand

    2014-05-01

    Full Text Available BACKGROUND: Granulomatous lobular mastitis (GLM is an inflammatory disease of the breast, which can mimic breast cancer in clinical and radiological findings. We conducted the present study in order to determine the diagnostic and other important aspects of this disease. METHODS: In this study, we reviewed the records of 38 patients with granulomatous lobular mastitis in order to describe the clinical, imaging, laboratory, pathologic, and treatment aspects of this disease. RESULTS: All of the patients’ ages were in the range of 22-62 years (mean age: 42 years. All of them had children, history of oral contraceptive pill (OCP usage, antibiotic therapy and mammoplasty. In physical examination, dimpling, edema, inflammation, ulcer, abscess, and firm mass were detected. Size of masses was in the range of 2 × 2 to 8 × 6 cm and their location, in most cases, was in the superior lateral quadrant or central region. In Ultrasonography, a hypoechoic fibroglandular mass and collection, and in pathologic findings, granulomatous reaction was reported. These patients were treated by antibiotics, corticosteroids, and surgery. CONCLUSIONS: GLM is a chronic inflammatory lesion of the breast which can mimic breast cancer. A history of child bearing, lactation, and OCP drug usage have suspicious roles in the formation of GLM. The most common clinical sign in these patients is a painful mass in the breast. We uncovered that clinical and radiological findings are not specific and sufficient for diagnosis of GLM. Therefore, for better diagnosis of this disease, usage of core, incisional, or excisional biopsy are recommended.

  1. Unilateral nodular adrenal hyperplasia: Case series | Kot | African ...

    African Journals Online (AJOL)

    Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 cases of radiologically ...

  2. Oral lichen planus in childhood: a case series.

    Science.gov (United States)

    Cascone, Marco; Celentano, Antonio; Adamo, Daniela; Leuci, Stefania; Ruoppo, Elvira; Mignogna, Michele D

    2017-06-01

    Although the exact incidence of pediatric oral lichen planus (OLP) is unknown, the oral mucosa seems to be less commonly involved, and the clinical presentation is often atypical. The aim of the study is to present a case series of OLP in childhood. From our database, we retrospectively selected and analyzed the clinical data of OLP patients under the age of 18 where the diagnosis had been confirmed by histopathological analysis. The case series from our database shows eight patients, four males and four females. The mean (±SD) age at the time of diagnosis of the disease was 13.5 (±2.73) years, ranging in age from 9 to 17. Clinically, a reticular pattern was present in six patients (75%), and the tongue was the most commonly involved oral site (six cases, 75%). We also report the first case of OLP in a 9-year-old girl affected by autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. We report the largest case series of pediatric OLP published in literature thus far. Differences in the disease between adults and pediatric patients have been detected, but further investigation and a larger case series are needed to establish any detailed differences in clinical outcomes. © 2017 The International Society of Dermatology.

  3. Risk factors, organ weight deviation and associated anomalies in neural tube defects: A prospective fetal and perinatal autopsy series

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    Asaranti Kar

    2015-01-01

    Full Text Available Introduction: Neural tube defects (NTD are a group of serious birth defects occurring due to defective closure of neural tube during embryonic development. It comprises of anencephaly, encephalocele and spina bifida. We conducted this prospective fetal autopsy series to study the rate and distribution of NTD, analyze the reproductive factors and risk factors, note any associated anomalies and evaluate the organ weights and their deviation from normal. Materials and Methods: This was a prospective study done over a period of 6 years from August, 2007 to July, 2013. All cases of NTDs delivered as abortion, still born and live born were included. The reproductive and risk factors like age, parity, multiple births, previous miscarriage, obesity, diabetes mellitus, socioeconomic status and use of folic acid during pregnancy were collected.Autopsy was performed according to Virchow′s technique. Detail external and internal examination were carried out to detect any associated anomalies. Gross and microscopic examination of organs were done. Results: Out of 210 cases of fetal and perinatal autopsy done, 72 (34.28% had NTD constituting 49 cases of anencephaly, 16 spina bifida and 7 cases of encephalocele. The mothers in these cases predominantly were within 25-29 years (P = 0.02 and primy (P = 0.01. Female sex was more commonly affected than males (M:F = 25:47, P = 0.0005 There was no history of folate use in majority of cases. Organ weight deviations were >2 standard deviation low in most of the cases. Most common associated anomalies were adrenal hypoplasia and thymic hyperplasia. Conclusion: The authors have made an attempt to study NTD cases in respect to maternal reproductive and risk factors and their association with NTD along with the organ weight deviation and associated anomalies. This so far in our knowledge is an innovative study which was not found in literature even after extensive search.

  4. A single centre case series of gallstone sigmoid ileus management

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    Nicholas Farkas

    2017-01-01

    Conclusions: This is the first case series highlighting the differing strategies and challenges faced by clinicians managing gallstone sigmoid ileus. Conservative measures (including manual evacuation, endoscopy, lithotripsy and surgery all play important roles in relieving large bowel obstruction. It is essential to tailor care to individual patients’ needs given the complexities of this potentially life threatening condition.

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

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    Kumar Ravi

    2010-01-01

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

  6. Ossiculoplasty: A Prospective Study of 80 Cases

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    Shrinivas Shripatrao Chavan

    2014-07-01

    Full Text Available Introduction: The use of ossicular graft material in ossicular chain reconstruction has significantly improved hearing results hearing after tympanoplasty and tympanomastoid surgery for chronic otitis media. Today, otologists have a wide array of tools from which to choose, but may find it difficult to know which middle ear implant works best.   Materials and Methods: A prospective study of 80 patients who underwent ossiculoplasty was performed in the ear, nose, and throat (ENT department at a tertiary health care facility from 2011 to 2013. Patients with chronic suppurative otitis media with an air-bone gap (ABG of >25 dB with ossicular involvement were included in the study. Total ossicular replacement prosthesis (TORP, partial ossicular replacement prosthesis (PORP, and refashioned incus were used. Success was defined as ABG   Results: The majority patients were of middle age with moderate conductive hearing loss. Incus was the most susceptible ossicle. Overall success rate in this study was 80.0% with an average change of 15.76 dB in ABG.   Conclusion:  With continuing advances in our understanding of middle ear mechanics, the results of ossiculoplasty are improving and results can be very rewarding in experienced hands. Severity of preoperative ear discharge, preoperative mastoid cellularity, presence of disease, and surgical procedure proved to be significant prognostic factors. Autograft incus and PORP fared better when the malleus handle was present while TORP gave better results when the malleus handle was eroded.  

  7. AngioCT in the management of neurointerventional patients: a prospective, consecutive series with associated dosimetry and resolution data

    International Nuclear Information System (INIS)

    White, Philip M.; Innes, Brian; Sellar, Robin J.; Gilmour, John N.; Weir, Nicholas W.

    2008-01-01

    Endovascular coiling of intracranial aneurysms carries a risk of complications. Early detection and management of complications can improve clinical outcomes. AngioCT is a new imaging technology enabling CT-like images to be generated on a flat-panel digital subtraction angiography system, which can provide immediate ''on angio table'' identification and thorough assessment of such complications. We prospectively audited its utility during aneurysm coiling in patients following subarachnoid haemorrhage (SAH). A prospective series of 44 patients with SAH undergoing endovascular coiling with AngioCT was audited for image quality and the influence of the AngioCT on patient management. In a parallel experimental study, radiation doses were measured and image quality parameters on standard phantoms were established. In all patients, AngioCT provided adequate diagnostic information. In 40.9% of patients, AngioCT was a substantial or major factor in determining the management immediately after coiling. Using a 10-s high-dose acquisition technique, acceptable image quality could be obtained rapidly with a radiation dose just over half that for a conventional CT scan of the head (35 mGy versus approximately 60 mGy). No patient in this series required conventional CT to clarify the AngioCT appearance. AngioCT has many applications in the neurointerventional setting. In particular during coiling, AngioCT provides a rapid way to clarify concerns or identify complications and in some cases was the major factor influencing further patient management immediately after coiling. AngioCT images were judged of adequate quality to be clinically useful in all patients in this series. (orig.)

  8. Endodontic Periodontic Lesions and Host Modulation – Case Series

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    Afaf Zia

    2015-07-01

    Full Text Available Host modulation, includes inhibition of matrix metalloproteinases, blocking production of proinflammatory cytokines and inhibition of osteoclastic activity, has therapeutic value as adjunctive therapy in treating chronic periodontitis. This case series presented three patients with chief complaint of teeth mobility where endo perio involvement was diagnosed. The endo perio combined lesions generally shows the communication between pulp and periodontal tissues with the same origin of dental infection. Diagnosis in such cases is difficult and generally raising problem in the management. All of the cases were managed by non surgical endodontic therapy combined with host modulation. All local factors causing the lesion were removed. Clinical outcome after six and nine months were quite satisfactory. Combined endo perio cases are challenging to the dentists and involve multidisciplinary involvement. To manage such cases, dentists have to rely on the unconventional techniques.DOI: 10.14693/jdi.v22i1.378

  9. The effect of nabilone on neuropsychological functions related to driving ability: an extended case series.

    Science.gov (United States)

    Kurzthaler, Ilsemarie; Bodner, Thomas; Kemmler, Georg; Entner, Tanja; Wissel, Joerg; Berger, Thomas; Fleischhacker, W Wolfgang

    2005-06-01

    The primary goal of this prospective extended case series was to obtain the first data about the potential influence of nabilone intake on driving ability related neuropsychological functions. Six patients were investigated within a placebo controlled, double-blind crossover study of this synthetic cannabinoid (2 mg/day) in patients with multiple sclerosis and spasticity associated pain. Five neuropsychological functions (reaction time, working memory, divided attention, psychomotor speed and mental flexibility) were assessed. No indication was found of a deterioration of any of the five investigated neuropsychological functions during the 4-week treatment period with nabilone. Copyright 2005 John Wiley & Sons, Ltd.

  10. A case series of Osteoid Osteoma: 7 cases

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    Farzan M

    1997-08-01

    Full Text Available Osteoid osteoma is a unique benign primary bone tumor that may present in the metaphyseal diaphyseal areas of the short tubular bones and has also been reported in the carpal bones. It occurs in the first two decades of life. The classic history is bone pain, often relieved by aspirin. The clinical appearance is local swelling and tenderness. The typical radiographic appearance is very characteristic: an eccentric area of cortical sclerosis, frequently with a radiolucent nidus. The lesion does not exceed 1 cm in diameter. The use of a bone scan may be helpful diagnostically, as are the CAT scan and tomography. Doyle et al described seven cases of osteoid osteoma with a prolonged delay in diagnosis, but reported an excellent cure rate following excision. The carpus is not unusual as a site for this tumor, especially the scaphoid. Treatment is windowing with curettage of the tumor nidus. The use of a dental drill to window the phalanx and expose the nidus is very helpful. Removal of the entire nidus is permanently curative, but if a portion of the tumor is missed, prompt recurrence of the symptoms is the rule.

  11. Methodology Series Module 2: Case-control Studies.

    Science.gov (United States)

    Setia, Maninder Singh

    2016-01-01

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

  12. DISK BATTERIES IN THE ESOPHAGUS OF NIGERIAN CHILDREN: CASE SERIES

    OpenAIRE

    LUCKY OBUKOWHO ONOTAI; ADAOBI ELIZABETH OSUJI

    2015-01-01

    Foreign body (FB) ingestion is common in clinical practice especially in children. Its impaction in the esophagus constitutes an important cause of morbidity and mortality in our environment. Due to technological advancement and increase use of disk batteries to power children toys and remote control gadgets, ingestion of disk batteries is now commonplace. In our environment there is paucity of information on disk batteries hence we decided to present case series of disk batteries in the esop...

  13. Transsellar transsphenoidal encephalocele: A series of four cases

    OpenAIRE

    Yashpal S Rathore; Sumit Sinha; A K Mahapatra

    2011-01-01

    Transsellar transsphenoidal encephalocele is the least common type of basal encephalocele. We present a series of four cases of transsellar transsphenoidal encephalocele. Clinical findings, imaging reviews, surgical repair techniques and postoperative morbidity are discussed with the relevant literature. Non contrast CT scan head with 3D reconstruction and magnetic resonance imaging should be done in all patients of transsphenoidal encephalocele. Endocrine assessment is also essential. Repair...

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

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    Pierangela Rubino

    2015-01-01

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

  15. Barium peritonitis following upper gastrointestinal series: A case report

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    Ko, Su Jin; Hwang, Ji Young; Kim, Yong Jin; Hong, Seong Sook [Soonchunhyang University College of Medicine, Seoul Hospital, Seoul (Korea, Republic of)

    2017-06-15

    We report a rare case of barium peritonitis following an upper gastrointestinal (GI) series and its imaging findings in a 74-year-old female. Barium peritonitis is a rare but life-threatening complication of GI contrast investigation. Therefore, clinical awareness of barium peritonitis as a complication of GI tract contrast investigation would help to prevent such a complication and manage the patients properly.

  16. Barium peritonitis following upper gastrointestinal series: A case report

    International Nuclear Information System (INIS)

    Ko, Su Jin; Hwang, Ji Young; Kim, Yong Jin; Hong, Seong Sook

    2017-01-01

    We report a rare case of barium peritonitis following an upper gastrointestinal (GI) series and its imaging findings in a 74-year-old female. Barium peritonitis is a rare but life-threatening complication of GI contrast investigation. Therefore, clinical awareness of barium peritonitis as a complication of GI tract contrast investigation would help to prevent such a complication and manage the patients properly

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

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    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.

  18. Isolated gingival overgrowths: A review of case series

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    Shruti Raizada

    2016-01-01

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

  19. Gilles De La Tourette′s Syndrome : A Case Series Of 14 Patients From India

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    Anil Gurtoo

    2005-01-01

    Full Text Available Background: Gilles de la Tourette′s Syndrome (GTS is a neuropsychiatric disorder characterized by motor and vocal tics associated with obsessive compulsive disorder (OCD and attention deficit hyperactivity disorder (ADHD. This syndrome is often misdiagnosed as psychiatric disorder, therefore neuropsychiatric evaluation in patients suffering from it is very essential to make the correct diagnosis. Few reports, mostly single case reports of GTS from India have been published, this series attempts to define the clinical spectrum of patients from India. Aim : To study the clinical profile of patients with GTS in India. Setting and Design : Prospective hospital based study. Material and Methods : Ct scan of the head and EEG were done in all the 14 cases in addition to clinical history and detailed neurological examination. The diagnosis of GTS was made according to Tourette Syndrome Classification Study Criteria Group. Findings were statistically analyzed. Results : In all a total of 101 simple motor tics and 21 complex motor tics were observed in 14 cases. Most common site of simple motor tics was the facio-nuchal region (70% and type was eyebrow raising seen in 10 cases (71%. Commonest type of complex motor tics nose blowing (35%. Vocal tics were found in all 14 cases, simple (56%, being more common than complex vocal tics i.e, coprolalia (42%. Throat clearing was found in (50% cases and was the most positive in 28%. OCD was seen in 64% and ADHD in 28%. All the 14 cases Responded well to treatment. Conclusion : The clinical profile of patients in our case series is similar to those reported from the western countries with the exception of coprolalia, and ADHD, the incidence of which is higher in this case series.

  20. [Brucellosis in Chile: Description of a series of 13 cases].

    Science.gov (United States)

    Olivares, Roberto; Vidal, Pamela; Sotomayor, Camila; Norambuena, Mackarenna; Luppi, Mario; Silva, Francisco; Cifuentes, Marcela

    2017-06-01

    Brucellosis is a zoonosis caused by Brucella spp. It may be acquired by consuming unpasteurized dairy products. Brucellosis has a low incidence in Chile, thus, we have a scarce data. To report and to characterize the first series of clinical cases of adult patients diagnosed with brucellosis in Chile. We describe a series of 13 clinical cases in patients diagnosed between 2000 and 2016 in three different centers in the Metropolitan Region, Chile. A retrospective analysis was performed on clinical presentation, laboratory, antibiotic treatment, morbidity and mortality. The mean age was 50 years old. Eight cases had a record of consumption of unpasteurized dairy products. The most frequently reported complaints were fever. The most frequent focal point involved was the spine. Only one patient had a positive blood culture, while the diagnosis was made using serological techniques in the other part of the group. The most indicated antibiotic regimens were doxycycline-rifampicin and doxycycline-gentamicin. The hospital stay was 20 days approximately as an average. Clinical cure was achieved in all cases. Brucellosis is an infrequent zoonosis in Chile, and it produces a nonspecific clinical picture, so it is necessary to have high suspicion to make the diagnosis based in the antecedent of consumption of unpasteurized dairy or raw meat.

  1. Pediatric Digital Necrosis Secondary to Dressing Application: A Case Series.

    Science.gov (United States)

    Bjorklund, Kim A; Rice, Dahlia M; Amalfi, Ashley N

    2018-04-01

    Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury. All 4 children suffered digital necrosis secondary to Coban dressings and ultimately required revision amputation. We discuss risks factors, application practices, and strategies to minimize complications with digital dressings in the pediatric population with the intent of creating awareness among hand surgeons to help promote safe practices and improve patient outcomes.

  2. Surgical management of generalized gingival enlargement - a case series

    International Nuclear Information System (INIS)

    Akhtar, M.U.; Nazir, A.; Montmorency College of Dentistry, Lahore; Kiran, S.; Montmorency College of Dentistry, Lahore

    2014-01-01

    Generalized gingival enlargement is characterized by massive and exuberant gingival overgrowth that poses social, aesthetic, phonetic and functional problems for the patient. Therefore, it requires meticulous management. Objective: To describe the surgical management of generalized gingival enlargement by electrosurgical excision of patients presenting to a tertiary care centre. Study Design: Case series. Materials and Methods: The study was conducted at the Department of Oral and Maxillofacial Surgery, de'Montmorency College of Dentistry, Lahore, from January 2010 to December 2012. A total of sixteen patients were operated by using electrosurgical approach under general anaesthesia for surgical excision of generalized gingival enlargement. Results: All of the sixteen patients, 11 males and 5 females, showed excellent healing postoperatively without any recurrent gingival overgrowth. Discussion: To the best of our knowledge, the current study presents the largest case series of generalized gingival enlargement. Most of these cases were with massive disease due to lack of information of the study population about their disease, delay in referral by the general dental practitioners, painless and innocent nature of the problem. Early referral of such patients to tertiary care centers can prevent the patients from social and psychological embarrassment. Conclusion: Electrosurgical excision is an excellent surgical technique for management of generalized gingival enlargement. Moreover, cross comparative studies are required to establish some diagnostic and therapeutic standards for such patients. (author)

  3. Gastroparesis in patients with inactive Crohn's disease: a case series

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    Oyen Wim JG

    2007-03-01

    Full Text Available Abstract Background Few studies have described patients with foregut dysmotility in inflammatory bowel disease. The aim of this case series was to evaluate clinical characteristics of 5 patients with inflammatory bowel disease and symptoms and signs of upper gut dysmotility. Case presentations We describe a series of four patients with Crohn's disease and one with indeterminate colitis who presented with severe symptoms and signs of gastroparesis. We reviewed medical records of all cases. Gastric emptying of a solid meal was assessed by scintigraphy. Small bowel enteroclysis, gastroduodenoscopy and colonoscopy with biopsies were performed to estimate the activity of the disease and to exclude organic obstruction. None of the patients had any signs of active inflammation or stricture. All of the patients had markedly delayed gastric emptying with a mean t 1/2 of 234 minutes (range 110–380 minutes; normal values 54–94 minutes. Conclusion Clinicians should consider impaired gastric emptying when evaluating patients with Crohn's disease and severe symptoms of upper gut dysmotility, which cannot be attributed to active inflammation or organic obstruction of the digestive tract. Symptoms in these patients are refractory to various therapeutic interventions including tube feeding and gastric surgery.

  4. Boxing training for patients with Parkinson disease: a case series.

    Science.gov (United States)

    Combs, Stephanie A; Diehl, M Dyer; Staples, William H; Conn, Lindsay; Davis, Kendra; Lewis, Nicole; Schaneman, Katie

    2011-01-01

    A nontraditional form of exercise recently applied for patients with Parkinson disease (PD) is boxing training. The primary purpose of this case series is to describe the effects of disease severity and duration of boxing training (short term and long term) on changes in balance, mobility, and quality of life for patients with mild or moderate to severe PD. The feasibility and safety of the boxing training program also were assessed. Six patients with idiopathic PD attended 24 to 36 boxing training sessions for 12 weeks, with the option of continuing the training for an additional 24 weeks (a seventh patient attended sessions for only 4 weeks). The 90-minute sessions included boxing drills and traditional stretching, strengthening, and endurance exercises. Outcomes were tested at the baseline and after 12, 24, and 36 weeks of boxing sessions (12-, 24-, and 36-week tests). The outcome measures were the Functional Reach Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Timed "Up & Go" Test, Six-Minute Walk Test, gait speed, cadence, stride length, step width, activities of daily living and motor examination subscales of the Unified Parkinson Disease Rating Scale, and Parkinson Disease Quality of Life Scale. Six patients completed all phases of the case series, showed improvements on at least 5 of the 12 outcome measures over the baseline at the 12-week test, and showed continued improvements at the 24- and 36-week tests. Patients with mild PD typically showed improvements earlier than those with moderate to severe PD. Despite the progressive nature of PD, the patients in this case series showed short-term and long-term improvements in balance, gait, activities of daily living, and quality of life after the boxing training program. A longer duration of training was necessary for patients with moderate to severe PD to show maximal training outcomes. The boxing training program was feasible and safe for these patients with PD.

  5. Brucella endocarditis – A series of five case reports

    Directory of Open Access Journals (Sweden)

    I. Tammi Raju

    2013-01-01

    Full Text Available Endocarditis due to brucellosis is considered a rare occurrence involving native, congenital and prosthetic valves. The diagnosis needs high degree of suspicion in culture negative endocarditis especially in those with history of exposure to farm animals. A positive culture in a susceptible patient confirms the diagnosis with 91% sensitivity. An early diagnosis and prompt treatment with appropriate antibiotics can restore the valve structural integrity with minimal damage. Here we present a series of five cases of culture proven Brucella endocarditis (four native valves, one prosthetic valve and this report discusses the diagnostic and management issues involved.

  6. Congenital esophageal stenosis in 3 children: A case series

    Directory of Open Access Journals (Sweden)

    Mackenzie C. Lees

    2017-08-01

    Full Text Available Congenital esophageal stenosis (CES is rare condition found in 1 per 25,000 to 50,000 live births. It is characterized by intrinsic narrowing of the esophagus secondary to congenital malformation of the esophageal wall architecture. Diagnosis is often difficult to definitively establish as the symptoms are often initially attributed to esophageal strictures secondary to reflux, or occur within the context of a tracheo-esophageal fistula (TEF in the newborn. Endoscopic dilation and surgical repair are the mainstays of treatment. We report a series of three cases seen recently at our institution, the University of Alberta/Stollery Children's Hospital.

  7. Gorlin-Goltz syndrome: A series of three cases.

    Science.gov (United States)

    Patankar, Amod P; Kshirsagar, Rajesh A; Dugal, Arun; Mishra, Akshay; Ram, Hari

    2014-01-01

    The Gorlin-Goltz syndrome (GGS) is also known as nevoid basal cell carcinoma syndrome. It is characterized by multiple keratocystic odontogenic tumors (KCOTs) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. The syndrome may be diagnosed early by a dentist during the routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article reports the series of 3 cases, emphasizing its clinical and radiographic manifestations of GGS.

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

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    Kenneth D. Katz

    2016-05-01

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

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

    OpenAIRE

    LA?TOVKOV?, Andrea; KLUS??KOV?, Pavlina; FENCLOV?, Zdenka; BONNETERRE, Vincent; PELCLOV?, Daniela

    2015-01-01

    The objective of this study is to describe a case-series of potassium aluminium tetrafluoride (KAlF4)-induced occupational asthma (OA) and/or occupational rhinitis (OR). The study involves five patients from a heat-exchanger production line who were examined (including specific inhalation challenge tests) for suspected OA and/or OR caused by a flux containing almost 100% KAlF4 ? with fluorides? workplace air concentrations ranging between 1.7 and 2.8?mg/m3. No subject had a previous history o...

  10. Transsellar transsphenoidal encephalocele: a series of four cases.

    Science.gov (United States)

    Rathore, Yashpal S; Sinha, Sumit; Mahapatra, A K

    2011-01-01

    Transsellar transsphenoidal encephalocele is the least common type of basal encephalocele. We present a series of four cases of transsellar transsphenoidal encephalocele. Clinical findings, imaging reviews, surgical repair techniques and postoperative morbidity are discussed with the relevant literature. Non contrast CT scan head with 3D reconstruction and magnetic resonance imaging should be done in all patients of transsphenoidal encephalocele. Endocrine assessment is also essential. Repair of a transsphenoidal encephalocele should be coordinated between a team of neurosurgeons and ENT surgeon. Our surgical outcome supports the transpalatal/ transnasal approach over the transcranial approach.

  11. Phenobarbital-responsive sialadenosis in dogs: case series.

    Science.gov (United States)

    Alcoverro, Emili; Tabar, Maria Dolores; Lloret, Albert; Roura, Xavier; Pastor, Josep; Planellas, Marta

    2014-12-01

    Phenobarbital-responsive sialadenosis (PRS) is a rare idiopathic disease in dogs. Vomiting, retching, and gulping with bilateral enlargement of the submandibular salivary glands are the more frequent clinical signs. A thorough diagnostic examination must be performed to rule out the most important systemic etiologies involved with chronic vomiting, as there is no specific test to diagnose PRS. Diagnosis is confirmed clinically by a rapid and dramatic improvement of clinical signs after instauration of phenobarbital treatment. The aim of this article is to describe the clinical presentation, diagnostic findings, and outcome of a case series of 4 dogs with presumptive PRS. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Hypothalamic-pituitary sarcoidosis with vision loss and hypopituitarism: case series and literature review.

    Science.gov (United States)

    Anthony, Jeremy; Esper, Gregory J; Ioachimescu, Adriana

    2016-02-01

    Hypothalamic-pituitary (HP) neurosarcoidosis (NS) accounts for 0.5 % cases of sarcoidosis and 1 % of HP masses. Correlative data on endocrine and neurological outcomes is lacking. Retrospective case series and literature review of presentation, treatment and outcome of HP NS. Our series includes 4 men, ages 34-59, followed for a median of 7.3 years (range 1.5-17). All had optic neuropathy, multiple pituitary hormone abnormalities (PHAs) and other organ involvement by sarcoidosis (lung, sino-nasal, brain/spine and facial nerve). Two patients had central diabetes insipidus and one impaired thirst with polydipsia. After treatment with high-dose glucocorticoids, optic neuropathy improved in one case and stabilized in the others. After treatment, HP lesions improved radiologically, but PHAs persisted in all cases. Review of four published series on HP NS in addition to ours yielded 46 patients, age 37 ± 11.8 years, 65 % male. PHAs consisted of anterior hypopituitarism (LH/FSH 88.8 %, TSH 67.4 %, GH 50.0 %, ACTH 48.8 %), hyperprolactinemia (48.8 %) and diabetes insipidus (65.2 %). PHAs were the first sign of disease in 54.3 % patients. Vision problems occurred in 28.3 % patients, but optic neuropathy was not well documented in previous series. Most patients (93.5 %) received high-dose glucocorticoids followed by taper; 50 % also received other immunomodulators, including methotrexate, mycophenolate mofetil, cyclosporine, azathioprine, infliximab and hydrochloroquine. Only 13 % patients showed improvement in PHAs. All-cause mortality was 8.7 %. HP NS is a serious disease requiring multidisciplinary treatment and lifelong follow-up. Prospective multicentric studies are needed to determine a more standardized approach to HP NS and outline predictors of disease outcome.

  13. Acute sterile endophthalmitis following intravitreal bevacizumab: case series

    Science.gov (United States)

    Orozco-Hernández, Axel; Ortega-Larrocea, Ximena; Sánchez-Bermúdez, Gustavo; García-Aguirre, Gerardo; Cantón, Virgilio Morales; Velez-Montoya, Raul

    2014-01-01

    Background Since the ophthalmological community adopted the use of intravitreal bevacizumab as an accepted off-label treatment for neovascular diseases, the amount of knowledge regarding its effects and properties has been increasing continually. In the last few years, there have been an increasing number of reports about sterile intraocular inflammation and intraocular pressure elevations after intravitreal bevacizumab. In the following case series, we describe the clinical presentation and outcomes of ten consecutive cases of patients developing mild-to-severe sterile intraocular inflammation after intravitreal bevacizumab and their management. Methods This report presents a retrospective case series. We reviewed the medical records of ten consecutive patients from a group of 46, in whom repackaged bevacizumab in individual aliquots from two vials from the same batch were used. All surgical procedures were performed using standard sterile techniques in the operating room. At each follow-up visit, patients underwent a complete ophthalmological examination including visual acuity assessment, intraocular pressure, biomicroscopy, and posterior fundus examination. Results Ten patients presented sterile endophthalmitis with an onset time of 3.5±1.95 days. The clinical characteristics were mild pain, slight visual loss, conjunctival hyperemia, and various degrees of intraocular inflammation with microhypopyon. All cultures were negative. All patients were managed with topical steroids and antibiotics, except two, in whom, due to severe vitreous cells, intravitreal antibiotics were used. Three patients showed a transient elevation of intraocular pressure. Only 50% of the patients regained a visual acuity equal or better to the baseline visual acuity on file. Conclusion The increasing number of intravitreal injections of bevacizumab applied every day, due to its widespread acceptance, might be one reason why the number of cases of sterile endophthalmitis is rising. Fast

  14. Was molar incisor hypomineralisation (MIH) present in archaeological case series?

    Science.gov (United States)

    Kühnisch, Jan; Lauenstein, Anne; Pitchika, Vinay; McGlynn, George; Staskiewicz, Anja; Hickel, Reinhard; Grupe, Gisela

    2016-12-01

    With respect to the unknown aetiology of molar incisor hypomineralisation (MIH), it is unclear whether this phenomenon was overlooked in the last century as a result of a high number of caries in children or if this developmental disorder was not present until then. Therefore, this study determined the presence of MIH in historical dentitions and teeth. Dental remains from late medieval (n = 191, twelfth-sixteenth century, Regensburg, Germany), post-medieval (n = 33, sixteenth-eighteenth century, Passau, Germany) and modern age archaeological skeletal series (n = 99, nineteenth-twentieth century, Altdorf, Germany) were examined for MIH. In addition, linear enamel hypoplasia (LEH), diffuse opacities, hypoplasia and Turner's teeth were documented. MIH-related demarcated opacities or enamel breakdowns were found in only 15 (0.4 %) of the 3891 examined permanent teeth. Ten cases (3.1 %) from a total of 323 dentitions were classified as having MIH. In contrast, 98 individuals (30.3 %) showed LEH. Other enamel disorders were recorded in 64 individuals (19.8 %). With respect to the low number of affected dentitions and teeth, MIH most likely did not exist or was at least rarely present in the investigated archaeological case series. This study supports the hypothesis that MIH may be linked to contemporary living conditions or other health-related factors.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Shamanic Healing for Veterans with PTSD: A Case Series.

    Science.gov (United States)

    Wahbeh, Helané; Shainsky, Lauri; Weaver, Angela; Engels-Smith, Jan

    Posttraumatic stress disorder (PTSD) is a serious health concern. Current evidence-based treatments for PTSD are efficacious; however, they are not appropriate or tolerated by everyone who needs them. Alternative treatment approaches are needed. Shamanic healing is one such therapy that may potentially be beneficial but no systematic research has been conducted on it for PTSD. The objectives of the case series are to (1) develop a structured replicable shamanic treatment plan for veterans with posttraumatic stress disorder (PTSD); (2) collect preliminary data on PTSD-related outcomes, and (3) explore the feasibility and potential for adverse events of the plan. Case series. Clinical. Veterans with PTSD. Shamanic healing. PTSD symptoms, quality of life, and piritual wellness. A semi-structured shamanic healing protocol was created with the following components: rapport building, power animal retrieval, extraction, compassionate spirit release, curse unraveling, soul retrieval, forgiveness/cord-cutting, aspect maturing/soul rematrixing, and divination. Six veterans enrolled in the study (mean age = 49.3 ± 13.1). Qualitative descriptions of the participants, their histories, and effects from the intervention are reported. Preliminary data was collected on PTSD-related outcomes. The protocol was found feasible and acceptable and recommendations for its future use are suggested. Future research is warranted and needed to evaluate the efficacy of shamanic healing as a potential therapy for veterans with PTSD. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Rapidly destructive osteoarthritis of the hip joint: a case series

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    McMurtrie A

    2008-01-01

    Full Text Available Abstract Background Rapidly destructive arthrosis of the hip is a rare and incompletely understood disorder with scarce literature about variations in natural history within a population. Methods A series of cases from North Wales with rapid progressive joint destruction and extensive subchondral bone loss in the femoral head and acetabulum are presented. Radiographic findings mimicked those of other disorders such as septic arthritis, rheumatoid and seronegative arthritis, primary osteonecrosis with secondary osteoarthritis, or neuropathic osteoarthropathy, but none of the patients had clinical, pathologic, or laboratory evidence of these entities. Results Rapid progression of hip pain and disability was a consistent clinical feature. The average duration of symptoms was 1.4 years. Radiographs obtained at various intervals before surgery (average 14 months in 18 patients documented rapid hip destruction, involvement being unilateral in 13 cases. All patients underwent total hip arthroplasty, and osteoarthritis was confirmed at pathologic examination. Conclusion The authors postulate that these cases represent an uncommon subset of osteoarthritis and regular review, both clinically and radiologically, are required to assess speed of progression and prevent rapid loss of bone stock without the surgeon being aware. These cases are unsuitable for being placed on long waiting list due to technical difficulties in delayed surgery and compromised outcome following surgery.

  18. Paediatric nasopharyngeal rhabdomyosarcoma: a case series and literature review

    International Nuclear Information System (INIS)

    Healy, J.N.; Borg, M.F.

    2010-01-01

    Full text: Rhabdomyosarcoma (RMS) is the most common soft tissue tumour in children, with the head and neck region accounting for 35-40% of cases. Nasopharyngeal RMSs tend to grow rapidly and invade adjacent structures. Both the intergroup Rhabdomyosarcoma studies and the European Studies have established that the ideal management of this disease is multimodal, using a combination of surgery, chemotherapy and radiotherapy. This case series examines the role of radiotherapy in the management of paediatric nasopharyngeal RMSs, with particular reference to long-term morbidity and disease-free survival. The cases of five children with nasopharyngeal RMS were reviewed and a systematic review of the literature contained in the PubMed databases was conducted to establish 24 individually detailed cases. Management in all patients was multimodal, using a combination of chemotherapy, radiotherapy as well as surgery. External beam radiotherapy is an integral component of treatment for nasopharyngeal RMSs. With more patients surviving for longer periods, more long-term sequelae of radiotherapy have been reported. Complications include sensorineural deafness, endocrine manifestations following radiation of the pituitary gland, cranial nerve palsies, second malignancies within the radiation field, cataract formation, retinopathy and growth disturbance. Morbidity from radiotherapy may be considerable and depends on the field and dose of radiation. Current advances in radiotherapy are aimed at improving the rate of tumour control and reducing such complications. Recent improvements in imaging and conformal techniques have the potential to reduce the morbidity associated with radiotherapy in this cohort.

  19. Congenital asymptomatic diaphragmatic hernias in adults: a case series.

    Science.gov (United States)

    Bianchi, Enrica; Mancini, Paola; De Vito, Stefania; Pompili, Elena; Taurone, Samanta; Guerrisi, Isabella; Guerrisi, Antonino; D'Andrea, Vito; Cantisani, Vito; Artico, Marco

    2013-05-13

    Congenital diaphragmatic hernia is a major malformation occasionally found in newborns and babies. Congenital diaphragmatic hernia is defined by the presence of an orifice in the diaphragm, more often to the left and posterolateral, that permits the herniation of abdominal contents into the thorax. The aim of this case series is to provide information on the presentation, diagnosis and outcome of three patients with late-presenting congenital diaphragmatic hernias. The diagnosis of congenital diaphragmatic hernia is based on clinical investigation and is confirmed by plain X-ray films and computed tomography scans. In the present report three cases of asymptomatic abdominal viscera herniation within the thorax are described. The first case concerns herniation of some loops of the large intestine into the left hemi-thorax in a 75-year-old Caucasian Italian woman. The second case concerns a rare type of herniation in the right side of the thorax of the right kidney with a part of the liver parenchyma in a 57-year-old Caucasian Italian woman. The third case concerns herniation of the stomach and bowel into the left side of the chest with compression of the left lung in a 32-year-old Caucasian Italian man. This type of hernia may appear later in life, because of concomitant respiratory or gastrointestinal disease, or it may be an incidental finding in asymptomatic adults, such as in the three cases featured here. Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms, and diagnosis may be difficult. Additional investigation and research appear necessary to better explain the development and progression of this type of disease.

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

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    Mohammad Reza Razeghinejad

    2016-09-01

    Full Text Available 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.

  1. Gingival fibromatosis with hypertrichosis syndrome: Case series of rare syndrome

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    Preetha Balaji

    2017-01-01

    Full Text Available Gingival fibromatosis with hypertrichosis syndrome is an extremely rare genetic condition characterized by profound overgrowth of hair and gums, as well as other variable features. Gingival fibromatosis is characterized by a large increase in the gingival dimension which extends above the dental crowns, covering them partially or completely. They were found to have a genetic origin, may also occur in isolation or be part of a syndrome, or acquired origin, due to specific drugs administered systemically. Congenital generalized hypertrichosis is a heterogeneous group of diseases with continuing excessive growth of terminal hair without androgenic stimulation. It has informally been called werewolf syndrome because the appearance is similar to that of a werewolf. Various syndromes have been associated with these features such as epilepsy, mental retardation, cardiomegaly, or osteochondrodysplasia. As so far very few cases have been reported in literature, we are reporting a series of three cases with management of the same. The excess gingival tissues, in these cases, were removed by conventional gingivectomy under general anesthesia. The postoperative result was uneventful and the patient's appearance improved significantly. Good esthetic result was achieved to allow patient to practice oral hygiene measures. Though this is not a serious condition clinically, psychosocial trauma cannot be neglected owing to the cosmetic disfigurement it produces.

  2. Operative management of acute pavement burns: a case series.

    Science.gov (United States)

    Silver, A G; Zamboni, W A; Baynosa, R C

    2014-11-01

    Acute burns suffered from contact with environmentally heated roadways and walkways are a rare entity. The aim of this report is to assess the information gained from the treatment of a series of patients. A retrospective review of a consecutive series of cases, where operative treatment was necessary, that occurred during July 2010 in southern Arizona. Seven patients were included, with an average total body surface area burn of 10.2%. Direct fascial excision and tangential excision were carried out on three and four patients, respectively. Although tangential excision was carried out to normal endpoints, there was commonly a need for repetitive debridement. The total hospital costs were over $4,400,000 (£2,730,000). Burns suffered from contact with roadways/walkways are often deeper than suggested by their appearance. Direct fascial excision minimises the number of debridement sessions. We hypothesise that the failure to offload pressure on these wounds may be a causative factor in their observed deepening.

  3. Serous endometrial intraepithelial carcinoma: a case series and literature review

    International Nuclear Information System (INIS)

    Pathiraja, P; Dhar, S; Haldar, K

    2013-01-01

    Minimal uterine serous cancer (MUSC) or serous endometrial intraepithelial carcinoma (EIC) has been described by many different names since 1998. There have been very few cases reported in literature since EIC/MUSC was recognized as a separate entity. The World health Organization (WHO) Classification favors the term serous EIC. Although serous EIC is confined to the uterine endometrium at initial histology diagnosis, a significant number of patients could have distal metastasis at diagnosis, without symptoms. Serous EIC is considered as being the precursor of uterine serous cancer (USC), but pure serous EIC also has an aggressive behavior similar to USC. It is therefore prudent to have an accurate diagnosis and appropriate surgical staging. There are very few published articles in literature that discuss the pure form of serous EIC. The aim of this series is to share our experience and review evidence for optimum management of serous EIC. We report a series of five women treated in our institute in the last 3 years. We reviewed the relevant literature on serous EIC and various management strategies, to recommend best clinical practice. Pure serous EIC is a difficult histopathological diagnosis, which requires ancillary immunohistochemical staining. It can have an aggressive clinical behavior with early recurrence and poor survival. Optimum surgical staging, with appropriate adjuvant treatment, should be discussed when treating these patients

  4. 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.

  5. Cannabis Intoxication Case Series: The Dangers of Edibles Containing Tetrahydrocannabinol.

    Science.gov (United States)

    Vo, Kathy T; Horng, Howard; Li, Kai; Ho, Raymond Y; Wu, Alan H B; Lynch, Kara L; Smollin, Craig G

    2018-03-01

    Cannabis and its principal active constituent, Δ9-tetrahydrocannabinol (THC), are increasingly available as edibles resembling commercially available food products. In this case series, we describe a population of predominantly pediatric patients who were inadvertently exposed to a THC-containing product in San Francisco. Twelve children and 9 adults were identified, with 16 patients having detectable serum THC and THC metabolites. All patients presented to hospitals with a variety of constitutional symptoms and all were discharged home within 12 hours. In general, pediatric patients had more severe symptoms and longer hospital length of stay, and, uniquely, a majority presented with leukocytosis and elevated lactic acid levels. We recommend that efforts be made to increase general public awareness in regard to the potential hazards of THC-containing edibles resembling commercially available food products. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  6. Snus (nass and oral cancer: A case series report

    Directory of Open Access Journals (Sweden)

    Maryam Alsadat Hashemipour

    2013-01-01

    Full Text Available Snus (nass is a form of snuff used in a similar manner to American dipping tobacco, but it does not typically result in a need for spitting. Possible hazards associated with this material include malignant and premalignant lesions in the oral cavity and gastrointestinal tract. The use of smokeless tobacco has increased in the Middle East in recent decades, particularly among teenagers and young adults. Therefore, practitioners must be able to recognize malignant and premalignant lesions. Although, an estimated 10-25% of the world′s population uses smokeless tobacco, this practice is virtually unknown in Iran. The aim of this study is to report a series of cases of squamous cell carcinoma and verrucous carcinoma occurring in the users of snus, who referred to the Department of Oral Medicine in Kerman Dental School.

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

    Directory of Open Access Journals (Sweden)

    Arthiie Thangavelu

    2012-01-01

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

  8. Adult Craniopharyngioma: Case Series, Systematic Review, and Meta-Analysis.

    Science.gov (United States)

    Dandurand, Charlotte; Sepehry, Amir Ali; Asadi Lari, Mohammad Hossein; Akagami, Ryojo; Gooderham, Peter

    2017-12-18

    The optimal therapeutic approach for adult craniopharyngioma remains controversial. Some advocate for gross total resection (GTR), while others advocate for subtotal resection followed by adjuvant radiotherapy (STR + XRT). To conduct a systematic review and meta-analysis assessing the rate of recurrence in the follow-up of 3 yr in adult craniopharyngioma stratified by extent of resection and presence of adjuvant radiotherapy. MEDLINE (1946-July 1, 2016) and EMBASE (1980-June 30, 2016) were systematically reviewed. From1975 to 2013, 33 patients were treated with initial surgical resection for adult onset craniopharyngioma at our center and were reviewed for inclusion in this study. Data from 22 patients were available for inclusion as a case series in the systematic review. Eligible studies (n = 21) were identified from the literature in addition to a case series of our institutional experience. Three groups were available for analysis: GTR, STR + XRT, and STR. The rates of recurrence were 17%, 27%, and 45%, respectively. The risk of developing recurrence was significant for GTR vs STR (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.15-0.38) and STR + XRT vs STR (OR: 0.20, 95% CI: 0.10-0.41). Risk of recurrence after GTR vs STR + XRT did not reach significance (OR: 0.63, 95% CI: 0.33-1.24, P = .18). This is the first and largest systematic review focusing on the rate of recurrence in adult craniopharyngioma. Although the rates of recurrence are favoring GTR, difference in risk of recurrence did not reach significance. This study provides guidance to clinicians and directions for future research with the need to stratify outcomes per treatment modalities. Copyright © 2017 by the Congress of Neurological Surgeons

  9. BISPHOSPHONATES IN LANGERHANS CELL HISTIOCYTOSIS: AN INTERNATIONAL RETROSPECTIVE CASE SERIES

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    Deepak Chellapandian

    2016-07-01

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

  10. Acute sterile endophthalmitis following intravitreal bevacizumab: case series

    Directory of Open Access Journals (Sweden)

    Orozco-Hernández A

    2014-09-01

    Full Text Available Axel Orozco-Hernández,1 Ximena Ortega-Larrocea,1 Gustavo Sánchez-Bermúdez,1 Gerardo García-Aguirre,1 Virgilio Morales Cantón,1 Raul Velez-Montoya2 1Retina Department, Asociación para Evitar la Ceguera en México IAP, Mexico City, Mexico; 2Department of Ophthalmology, University of Colorado School of Medicine, Rocky Mountain Lions Eye Institute, Aurora, CO, USA Background: Since the ophthalmological community adopted the use of intravitreal bevacizumab as an accepted off-label treatment for neovascular diseases, the amount of knowledge regarding its effects and properties has been increasing continually. In the last few years, there have been an increasing number of reports about sterile intraocular inflammation and intraocular pressure elevations after intravitreal bevacizumab. In the following case series, we describe the clinical presentation and outcomes of ten consecutive cases of patients developing mild-to-severe sterile intraocular inflammation after intravitreal bevacizumab and their management. Methods: This report presents a retrospective case series. We reviewed the medical records of ten consecutive patients from a group of 46, in whom repackaged bevacizumab in individual aliquots from two vials from the same batch were used. All surgical procedures were performed using standard sterile techniques in the operating room. At each follow-up visit, patients underwent a complete ophthalmological examination including visual acuity assessment, intraocular pressure, biomicroscopy, and posterior fundus examination. Results: Ten patients presented sterile endophthalmitis with an onset time of 3.5±1.95 days. The clinical characteristics were mild pain, slight visual loss, conjunctival hyperemia, and various degrees of intraocular inflammation with microhypopyon. All cultures were negative. All patients were managed with topical steroids and antibiotics, except two, in whom, due to severe vitreous cells, intravitreal antibiotics were

  11. Psychosocial reactions to upper extremity limb salvage: A case series.

    Science.gov (United States)

    Sposato, Lindsay; Yancosek, Kathleen; Cancio, Jill

    2017-11-30

    Case series. A salvaged limb is one that has undergone a major traumatic injury, followed by repeated surgical attempts in order to avoid amputation. Psychological recovery for individuals with lower extremity limb salvage has been examined in a number of studies. However, psychosocial reactions for individuals with upper extremity (UE) limb salvage are understudied in the literature. The purpose of this study was to explore the process of psychosocial adaptation for 3 trauma cases after UE limb salvage. The Reactions to Impairment and Disability Inventory was used to assess psychosocial adaptation. Physical function outcomes (pain, range of motion, edema, sensation, and dexterity) are presented. The Disabilities of the Arm, Shoulder, and Hand measure was used to assess perceived disability. Medical and rehabilitation history are discussed for each case, in order to provide in-depth understanding of the impact of these injuries. Reactions to injury varied across the cases; however, outcomes suggest that psychosocial adaptation may be influenced by the experience of pain, the ability to participate in valued roles and activities, and having a supportive social network. For this population, therapists may consider emphasizing pain management, focusing on client-centered goals and interventions, and facilitating peer support. Providers should closely monitor patients for signs of poor adaptation, such as hand-hiding behaviors. This study is among the first to examine psychological outcomes for the UE limb salvage population. Future research would be beneficial to provide deeper understanding of the psychosocial challenges for these individuals. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  12. Drug-induced gingival enlargement: Series of cases

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    Isabella Manzur-Villalobos

    2018-01-01

    Full Text Available Introduction: Gingival enlargement (GA is a benign condition of the oral cavity that is characterized by the excessive growth of the gingiva in mass and volume. This lesion is not only caused by hereditary factors or poor oral hygiene, but also by the intake of medications, including antihypertensive, anticonvulsant and immunosuppressive drugs. Objective: To sensitize the prevention or early care in patients with pathologies that merit the use of antihypertensive and anticonvulsants in conjunction with the dentist, to treat or avoid the drug-induced gingival enlargement (DIGE. Materials and methods: A series of clinical cases of patients with gingival enlargement by various drugs are reported, including Phenytoin, Amlodipine and Nifedipine. Periodontal and gingivectomy hygienic phase measures were applied to obtain better effects. Results: Satisfactory results were obtained with a considerable decrease in DIGE. Conclusions: The integral management is important in conjunction with the treating physician to follow up the drug that can be generating gingival enlargement. It is necessary to employ an initial approach with strategies of periodontal hygiene, and in severe cases and, as last resort, the periodontal surgery with gingivectomy and gingivoplasty.

  13. "Spice" (Synthetic Marijuana) Induced Acute Myocardial Infarction: A Case Series.

    Science.gov (United States)

    Ul Haq, E; Shafiq, A; Khan, A A; Awan, A A; Ezad, S; Minteer, W J; Omar, B

    2017-01-01

    Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI. Spice refers to herbal mixture with composition and effects similar to that of marijuana and therefore is referred to as "synthetic marijuana." Herein, we report 3 cases of spice induced ST-segment elevation myocardial infarction. All patients were relatively young and had few or absolutely no risk factors for cardiovascular disease. All patients underwent emergent coronary angiography, with two needing stent placement and the third requiring only aspiration thrombectomy. Our case series emphasizes the importance of suspecting and investigating synthetic marijuana use in low risk young adults presenting with AMI.

  14. Myofascial trigger points in cluster headache patients: a case series

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    Rico-Villademoros Fernando

    2008-12-01

    Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

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

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    Vinay Marla

    2016-01-01

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

  16. Short-term retrospective case series of implant-assisted removable partial dentures with locator abutments.

    Science.gov (United States)

    Ortiz-Puigpelat, Octavi; Gargallo-Albiol, Jordi; Hernández-Alfaro, Federico; Cabratosa-Termes, Josep

    2014-01-01

    The purpose of this retrospective case series was to report on the clinical performance of implant-assisted removable partial dentures (IARPDs) with Locator abutments in different partial edentulism situations, with a mean follow-up period of 28.6 months. Twelve consecutive patients were treated with IARPDs. A total of 24 implants were placed in the edentulous area. Minimum follow-up period was 12 months. Overall patient satisfaction, health of peri-implant tissues, survival of implants and abutments, and prosthetic complications were reported. Overall implant survival was 91.6%; two implants failed. No major complications were reported-only one IARPD metal framework broke. No Locator abutment loosening was reported. Within the limitations of this retrospective study, treatment with IARPDs can improve the patient's function, phonetics, and esthetics without the need for extensive bone regeneration surgeries and prosthodontic rehabilitations. However, well-designed prospective clinical studies on IARPDs are needed to support their long-term use.

  17. Tracheobronchial Mycosis in a Retrospective Case-Series Study of Five Status Asthmaticus Patients

    Science.gov (United States)

    Mak, Garbo; Porter, Paul C.; Bandi, Venkata; Kheradmand, Farrah; Corry, David B.

    2013-01-01

    The aetiology of status asthmaticus (SA), a complication of severe asthma, is unknown. Fungal exposure, as measured by fungal atopy, is a major risk factor for developing asthma, but the relationship of fungi in SA per se has not previously been reported. In this five patient retrospective case series study, lower respiratory tract cultures were performed on bronchoalveolar lavage or tracheal aspirate fluid, comparing standard clinical laboratory cultures with a specialized technique in which respiratory mucus was removed prior to culture. We show mucolytic treatment allows increased detection of fungal growth, especially yeast, from the lower airways of all SA patients. We also demonstrate that the yeast Candida albicans inhalation readily induces asthma-like disease in mice. Our observations suggest, SA may represent a fungal infectious process, and supports additional prospective studies utilizing anti-fungal therapy to supplement conventional therapy, broad-spectrum antibiotics and high-dose glucocorticoids, which can promote fungal overgrowth. PMID:23280490

  18. Regression of Ophthalmopathic Exophthalmos in Graves' Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series.

    Science.gov (United States)

    Bhargav, P R K; Sabaretnam, M; Kumar, S Chandra; Zwalitha, S; Devi, N Vimala

    2017-12-01

    Autoimmune ophthalmopathy is one of the salient clinical features associated with Graves' disease. Exophthalmos is one of the commonest manifestations of Graves' associated ophthalmopathy. It is reported to regress after thyroidectomy favourably compared to radioiodine or antithyroid drug therapy. In this context, we present our experience based on a surgical series of Graves' disease. This is a prospective study of 15 patients of Graves' disease associated with ophthalmopathic exophthalmos. Preoperative and monthly postoperative evaluation of exophthalmos was done with Hertel's exophthalmometer, apart from documenting lid, extra-ocular muscle and orbital involvement. The minimum follow-up of the cohort was 12 months. The female to male ratio was 12:3 and the mean age of the subjects was 33.4 years (18-55). Exophthalmos was bilateral in 13 and unilateral in 2 patients. All the 15 patients underwent total thyroidectomy without any major morbidity. Exophthalmos regressed in 12 patients at a mean follow-up of 15.6 ± 6.4 months (14-38) and was static in 3. None of the cases had worsened ophthalmopathy at the final follow-up. Mean regression of exophthalmos was 2.1 mm (1-5). The regression was statistically significant at P value = 0.035. Surgery has a positive impact on the regression of ophthalmopathic exophthalmos associated with Graves' disease.

  19. [Pediatric case series in an ophthalmic camp in Turkana (Kenya)].

    Science.gov (United States)

    Noval, S; Cabrejas, L; Jarrín, E; Ruiz-Guerrero, M; Ciancas, E

    2013-12-01

    Turkana is the largest district in Kenya, situated in the Northwest of the country. It features a semi-nomadic population of 850,000. Around 60% of population lives below the poverty threshold. The ratio of doctors is 1:75,000 inhabitants. Five ophthalmologists took part in the last deployment in November. Local staff had previously selected the patients from the rural areas, as well as in Lodwar, the capital of the district. Of the 371 patients who attended the clinic, 128 required surgery. To describe the pediatric population attended to in the last «Turkana Eye Project» Camp. Description of the ophthalmic pathologies of the children seen in the clinic in this surgical camp, and the diagnostic and therapeutic options according to the limitations of the environment. Of the 371 patients, 54 were younger than 15 years old (14.5%). Four children had surgery (3.25% of the 128 patients). In 2 more cases surgery was the indicated but not performed. Therefore, of the total of 54 cases, 6 could be considered as surgical (11.1%), and 17 suffered ophthalmic problems other than refraction defects, or mild ocular surface pathologies: traumatic cataracts, neuropathies, impetigo, exophthalmos, retinal dystrophies, dermoid cysts, or nyctalopia. The etiology was traumatic in four of the 17 children (23.5%). Surgical camps are increasing in the developing countries. They are usually focused on particular pathologies, such as cataracts or trachoma. Our case series shows the importance of pediatric teams and the need to be prepared to face complex pediatric pathologies. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  20. Case series of eosinophilic meningoencephalitis from South India

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    Parameswaran K

    2006-01-01

    Full Text Available Eosinophilic meningoencephalitis (EM is a rare type of meningoencephalitis. The objective of this report is to describe a series of EM identified in a specific geographic area over a short period of time. Materials and Methods: This series of cases are described from a neurological center in Central Kerala occuring in the period between February 2004 and June 2006. Results: During this period we had identified ten patients (eight males and two females with EM. Their mean age was 37.1 years (range 15-60 years. Main symptomatologies were fever, severe headache, body pain, abdominal pain and arthralgia. One patient was in akinetic rigid state with coma. All patients had peripheral eosinophilia. The cerebrospinal fluid (CSF of all patients showed eosinophilic pleocytosis. The mean CSF white cell count was 588 cells. CSF differential count showed 50-70% eosinophils. CSF glucose levels were normal but proteins were markedly raised (mean CSF protein was 180 mg/dl. MRI brain showed T2 hyperintensities diffusely in periventricular white matter in the comatose patient. Contrast enhanced CT scan of the brain was normal in others. All eight male patients gave history of eating "raw flesh of Monitor Lizard" (Iguana some three to fourteen days prior to the onset of symptoms. There was no such history for the female patients. Considering the history of exposure and eosinophilic meningitis we suspected a meningoencephalitis with Angiostrongylus cantonensis and treated them with albendazole, steroid and other supportive measures. All of them recovered. Conclusion: Eosinophilic meningitis (EM is a rare condition and in this locality, a CNS infection with Agiostrongylus cantonensis is highly likely. AC is a parasite in monitor lizard. Human infection occurs from consumption of uncooked flesh or blood of infected lizards. Physicians need to maintain a high index of suspicion and enquire for any exposure to uncooked meat or blood of monitor lizard when faced with EM

  1. Clinical Usage of an Extracellular, Collagen-rich Matrix: A Case Series.

    Science.gov (United States)

    AbouIssa, Abdelfatah; Mari, Walid; Simman, Richard

    2015-11-01

    OASIS Ultra (Smith and Nephew, St. Petersburg, FL) is an extracellular, collagen-rich matrix derived from submucosa of porcine intestine. It is composed of collagen type I, glycosaminoglycan, and proteoglycans. This extracellular matrix (ECM) differs from the single layer in thickness and offers ease of handling and application. It also stimulates cell migration and structural support, provides moisture environment, decreases inflammation, and induces cell proliferation and cellular attachments. In this case series, the authors present their experience with this product in various clinical scenarios. The authors used the product in a variety of wounds with different etiologies to test the clinical outcome of the ECM. This was an observational case series with prospective review of 6 different patients with different types of wounds who received treatment with the ECM during their treatment. The product was applied on the following types of wounds: chronic venous ulcer, nonhealing Achilles tendon vasculitic wound, Marjolin's ulcer, posttraumatic wound, stage IV sacral-coccygeal pressure wound, and complicated transmetatarsal amputation of gangrenous left forefoot diabetic wound. All of these wounds healed within the expected time periods and without complications. In general, healing was achieved in 4-16 weeks using 1-12 applications of the ECM. Wounds with different etiologies were successfully treated with an extracellular, collagen-rich matrix. By replacing the lost ECM to guide cellular growth and migration, this product did ultimately hasten the healing process.

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Initial primary endovascular treatment in the management of ruptured intracranial aneurysms: a prospective consecutive series

    International Nuclear Information System (INIS)

    Mejdoubi, Mehdi; Cognard, Christophe; Gigaud, Michel; Tremoulet, Michel; Albucher, Jean-Francois

    2006-01-01

    From January 1998 to December 2002, endovascular treatment (EVT) was used as first intention in all patients with ruptured aneurysms. The objective of this study was to analyze the results of this therapeutic strategy. Among 401 patients admitted with a subarachnoid hemorrhage (SAH), 73 (18%) had a nonaneurysmal perimesencephalic SAH, 28 were not explored by angiography due to very poor clinical status, and 28 with aneurysmal SAH were not treated due to poor clinical status. Thus, of the 300 patients with a proven aneurysmal SAH, 272 (83%) were treated. EVT was attempted in 230 patients and was successful in 222 (82%), and clipping was performed in 50 (18%). Finally, EVT was successful in 234 aneurysms (96.7%) in 222 patients out of 242 aneurysms in 230 patients (some of the patients were treated for more than one aneurysm in the same procedure). EVT-related morbidity occurred in ten patients (4.5%) and mortality in eight (3.6%). Rate of dependency or death (modified Rankin scale 3-5) was 24.5% at 26 months. Initially, complete aneurysm occlusion was obtained in 81%, a dog ear in 3.4%, a neck remnant in 8% and incomplete occlusion in 8.1% of the patients. At follow-up (mean 26 months), the occlusion rate remained stable at 75%. This consecutive prospective series shows that EVT can be performed routinely as first-intention treatment in most aneurysmal SAH. Using this therapeutic strategy, EVT was performed in 82% of patients with long-term clinical results similar to those of the ISAT study. (orig.)

  4. Modified rib pivot lateral thoracotomy: a case series.

    Science.gov (United States)

    Appelgrein, C; Hosgood, G

    2018-01-01

    To describe a modified rib pivot thoracotomy and its clinical application in client-owned dogs and cats. Case series of 24 dogs and 1 cat requiring a thoracotomy. A lateral thoracic incision over the required thoracic segment was made. The latissimus dorsi muscle was reflected dorsally. The predetermined rib was identified and the periosteum overlying the rib was elevated circumferentially, avoiding the intercostal neurovascular structures. Holes were pre-placed above and below the proposed osteotomy site. The rib was osteotomised and pivoted cranially. The pleura was incised and the required intrathoracic procedure was then performed. The thoracic cavity was closed by pre-placement of a suture through the pre-placed holes within the osteotomised rib. The pleura and intercostal musculature were closed, avoiding the intercostal neurovascular structures. The rib was re-apposed and the lateral approach was closed. The cases included were reviewed for both the rib pivoted as per the procedure required and postoperative complications. The study group comprised 8 Staffordshire Bull Terriers, 2 Poodles, 2 German Shepherd Dogs, 1 each of Basset Hound, Rhodesian Ridgeback, Golden Retriever, Australian Shepherd, Vizsla, Bull Mastiff, Schnauzer, Jack Russell Terrier, Bulldog, Deerhound, Labrador Retriever and Australian Terrier, and 1 cat. A modified rib pivot thoracotomy was performed for lung lobectomy (n = 11), oesophagectomy (7), subtotal pericardectomy (5), patent ductus arteriosus ligation (1) and thoracic duct ligation (1). Follow-up ranged from 2 to 40 weeks postoperatively. Postoperative complications included seroma formation in two dogs. A modified rib pivot thoracotomy should be considered as an alternative lateral thoracic approach with good exposure, minimal complications and low morbidity. © 2018 Australian Veterinary Association.

  5. Video Game Rehabilitation of Velopharyngeal Dysfunction: A Case Series.

    Science.gov (United States)

    Cler, Gabriel J; Mittelman, Talia; Braden, Maia N; Woodnorth, Geralyn Harvey; Stepp, Cara E

    2017-06-22

    Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Results suggest that video game-based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. https://doi.org/10.23641/asha.5116828.

  6. Inhaled Loxapine for Agitation in Intoxicated Patients: A Case Series.

    Science.gov (United States)

    Roncero, Carlos; Ros-Cucurull, Elena; Palma-Álvarez, Raúl Felipe; Abad, Alfonso Carlos; Fadeuilhe, Christian; Casas, Miquel; Grau-López, Lara

    Episodes of agitation are frequent in intoxicated patients who have a substance use disorder, a psychiatric disorder or both (dual diagnosis). For managing the agitation, it is necessary to act promptly in a safe environment and addressing any underlying etiology. Inhaled loxapine improves symptoms of agitation in adults with psychiatric disorders (eg, schizophrenia) within 10 minutes of administration. Recently, some reports have documented the usefulness of loxapine in dual diagnoses patients with agitation. However, the efficacy of loxapine in intoxicated patients has not been deeply addressed. This report describes a case series of 12 patients (with addiction or dual disorder) who received inhaled loxapine for symptoms of psychomotor agitation during intoxication with different substances (eg, alcohol, cannabis, or cocaine) at 1 center in Spain. Data from 12 patients were reviewed, 5 patients were attended at the emergency room, 4 at the addiction and dual diagnosis unit, and 3 were treated during hospitalization for detoxification. All patients were under effects of substances. They had substance use disorder (including cannabis, cocaine, alcohol, hypnotics, and hallucinogens), and almost all (90%) presented 1 or more psychiatric disorders. One dose of inhaled loxapine was effective in 9 patients (75%), and in 3 patients, a second dose was required. Only mild dizziness was reported in 1 patient after the second dose. The acute agitation was effectively and quickly managed with inhaled loxapine in all intoxicated patients and enabled the appropriate clinical evaluation of the agitated state and the patient's management.

  7. Ayurvedic therapy (shirodhara) for insomnia: a case series.

    Science.gov (United States)

    Vinjamury, Sivarama Prasad; Vinjamury, Manjusha; der Martirosian, Claudia; Miller, Judith

    2014-01-01

    Insomnia is one of the most common complaints faced by primary care practitioners after pain. Non-pharmacological management of Insomnia that is noninvasive is gaining interest among patients with insomnia. To determine the feasibility of recruiting and retaining participants in a clinical trial on shirodhara, Ayurvedic oil dripping therapy, for insomnia in the United States and also to investigate the therapeutic usefulness of Shirodhara for insomnia using standardized outcome measures. Case series. Shirodhara with Brahmi oil was done for 45 minutes on each participant for 5 consecutive days. Insomnia Severity Index (ISI) was used to evaluate the severity of insomnia as well as to determine the response to Shirodhara therapy. Data were collected at baseline, end of the treatment (day 5) and 1 week after the treatment ended (follow-up). Two males and eight females with a mean age of 40 years (range 23 to 72), SD ± 14.2, were enrolled in the study. One dropped out of the study, but all remaining nine participants experienced improvement at the end of treatment. The percentage of improvement range varied from 3.85% to 69.57%. At follow-up, most participants continued to improve. Comparison of means between baseline and day 5 indicated an overall significant improvement (P insomnia. It is feasible to recruit and retain participants for such therapies in the United States. It is important to validate these findings and investigate the mechanism of action using a larger sample and rigorous research design.

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

    Science.gov (United States)

    2009-01-01

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

  9. Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community

    Directory of Open Access Journals (Sweden)

    Basilious Alfred

    2011-05-01

    Full Text Available Abstract Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin prick tests reduced the eosinophil counts to normal levels in all three children. Food items which tested positive were then reintroduced while symptoms and eosinophil counts were monitored. Nutritional management of eosinophilic esophagitis and eosinophilic colitis was found to be effective in reducing symptoms. However, obstacles facing patients who choose this type of therapy include limitations due to the cost of repeated endoscopies, palatability of elimination/elemental diets and the availability of subspecialists trained in management (e.g. Allergy, Gastroenterology, and Pathology. It may be a worthwhile endeavour to overcome these obstacles as nutritional management minimizes the potential long-term effects of chronic steroid therapy.

  10. Liquid nitrogen cryotherapy for conjunctival lymphangiectasia: a case series.

    Science.gov (United States)

    Fraunfelder, Frederick W

    2009-12-01

    To report a case series of conjunctival lymphangiectasia treated with liquid nitrogen cryotherapy. A 1.5-mm Brymill cryoprobe was applied in a double freeze-thaw method after an incisional biopsy of a portion of the conjunctiva in patients with conjunctival lymphangiectasia. Freeze times were 1 to 2 seconds with thawing of 5 to 10 seconds between treatments. Patients were reexamined at 1 day, 2 weeks, 3 months, 6 months, and yearly following cryotherapy. Five eyes of 4 patients (3 male and 1 female) with biopsy-proven conjunctival lymphangiectasia underwent liquid nitrogen cryotherapy. The average patient age was 53 years. Ocular examination revealed large lymphatic vessels that were translucent and without conjunctival injection. Subjective symptoms included epiphora, ocular irritation, eye redness, and occasional blurred vision. After treatment with liquid nitrogen cryotherapy, the patients' symptoms and signs resolved within 2 weeks. Lymphangiectasia recurred twice in one patient, at 1 and 3 years postoperatively. In another patient, lymphangiectasia recurred at 6 months. The average time to recurrence in these 3 eyes was 18 months. Average length of follow-up was 24.5 months for all subjects. Liquid nitrogen cryotherapy may be an effective surgical alternative in the treatment of conjunctival lymphangiectasia. Cryotherapy may need to be repeated in some instances.

  11. Cerebral Venous Thrombosis and Headache--A Case-Series.

    Science.gov (United States)

    Sparaco, Marco; Feleppa, Michele; Bigal, Marcelo E

    2015-06-01

    Headache happens in the majority of patients with Cerebral Venous Thrombosis (CVT) being sometimes the sole manifestation of the disease. Herein we report a case-series of CVT, focusing on headache characteristics. Etiological, clinical, and radiological features of 25 consecutive adult patients with CVT were compiled from August 2005 to December 2013. Diagnosis of CVT was confirmed by brain magnetic resonance imaging and magnetic resonance venography. All patients underwent extensive systematic etiological and genetic work-up at admission. A structured questionnaire about the characteristics of headache was responded by all participants. Headache was reported by 23 out of 25 (92%) of participants, being by far the most frequent symptom. It was the sole manifestation in nearly one third of the patients (8/25, 32.0%). Headache was typically severe (19/23, 82.6%) and throbbing (16/23, 69.5%), with sudden onset (13/23, 56.5%) and non-remitting (20/23, 86.9%) characteristics. The sinus most frequently involved was the transverse sinus (24/25, 96.0%), either alone or in association with other sinuses. Headache is the most frequent symptom and sometimes the sole presentation of CVT. © 2015 American Headache Society.

  12. Symptomatic thoracic spinal cord herniation: case series and technical report.

    Science.gov (United States)

    Hawasli, Ammar H; Ray, Wilson Z; Wright, Neill M

    2014-09-01

    Idiopathic spinal cord herniation (ISCH) is an uncommon condition located predominantly in the thoracic spine and often associated with a remote history of a major traumatic injury. ISCH has an incompletely described presentation and unknown etiology. There is no consensus on the treatment algorithm and surgical technique, and there are few data on clinical outcomes. In this case series and technical report, we describe the atypical myelopathy presentation, remote history of traumatic injury, radiographic progression, treatment, and outcomes of 5 patients treated at Washington University for symptomatic ISCH. A video showing surgical repair is presented. In contrast to classic compressive myelopathy symptomatology, ISCH patients presented with an atypical myelopathy, characterized by asymmetric motor and sensory deficits and early-onset urinary incontinence. Clinical deterioration correlated with progressive spinal cord displacement and herniation observed on yearly spinal imaging in a patient imaged serially because of multiple sclerosis. Finally, compared with compressive myelopathy in the thoracic spine, surgical treatment of ISCH led to rapid improvement despite a long duration of symptoms. Symptomatic ISCH presents with atypical myelopathy and slow temporal progression and can be successfully managed with surgical repair.

  13. Video Game Rehabilitation of Velopharyngeal Dysfunction: A Case Series

    Science.gov (United States)

    Mittelman, Talia; Braden, Maia N.; Woodnorth, Geralyn Harvey; Stepp, Cara E.

    2017-01-01

    Purpose Video games provide a promising platform for rehabilitation of speech disorders. Although video games have been used to train speech perception in foreign language learners and have been proposed for aural rehabilitation, their use in speech therapy has been limited thus far. We present feasibility results from at-home use in a case series of children with velopharyngeal dysfunction (VPD) using an interactive video game that provided real-time biofeedback to facilitate appropriate nasalization. Method Five participants were recruited across a range of ages, VPD severities, and VPD etiologies. Participants completed multiple weeks of individual game play with a video game that provides feedback on nasalization measured via nasal accelerometry. Nasalization was assessed before and after training by using nasometry, aerodynamic measures, and expert perceptual judgments. Results Four participants used the game at home or school, with the remaining participant unwilling to have the nasal accelerometer secured to his nasal skin, perhaps due to his young age. The remaining participants showed a tendency toward decreased nasalization after training, particularly for the words explicitly trained in the video game. Conclusion Results suggest that video game–based systems may provide a useful rehabilitation platform for providing real-time feedback of speech nasalization in VPD. Supplemental Material https://doi.org/10.23641/asha.5116828 PMID:28655049

  14. Vitamin B6 in Health Supplements and Neuropathy: Case Series Assessment of Spontaneously Reported Cases.

    Science.gov (United States)

    van Hunsel, Florence; van de Koppel, Sonja; van Puijenbroek, Eugène; Kant, Agnes

    2018-05-08

    In the literature, vitamin B 6 has been linked to the development of polyneuropathy. Most often, these complaints were seen when taking high doses of vitamin B 6 for a long time. Evidence as to whether a lower dosage range of vitamin B 6 (< 50 mg/day) can also induce neuropathy is scarce. We aim to comprehensively describe the cases of neuropathy associated with vitamin B 6 received by the Netherlands Pharmacovigilance Centre Lareb and to assess the case series concerning the use of vitamin B 6 and neuropathic complaints. We describe the number and nature of the reported cases, including suspect product, dosage, duration of use, and vitamin B 6 serum levels. In addition, we describe the causality for the individual cases (Naranjo Probability Scale) and for the entire case series (Bradford Hill criteria). In total, 90 reports on products containing vitamin B 6 included at least one adverse drug reaction in the standardized Medical Dictionary for Regulatory Activities (MedDRA ® ) query (SMQ; broad) 'peripheral neuropathy'. The amount of vitamin B 6 in the products varied between 1.4 and 100 mg per tablet. The serum vitamin B 6 level was known in 36 cases (88-4338 nmol/l), and the mean serum vitamin B 6 level was 907 nmol/l. However, no statistical correlation between dosage and vitamin B 6 blood levels was found. Causality assessment of the case series of 90 reports to Lareb shows it is plausible for the vitamin B 6 supplements to have caused complaints such as neuropathies. This is especially the case with higher dosages and prolonged use, but dosages < 50 mg/day also cannot be excluded.

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

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    Xiang Lei

    2015-01-01

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

  16. Biomarkers in differentiating clinical dengue cases: A prospective cohort study

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    Gary Kim Kuan Low

    2015-12-01

    Full Text Available Objective: To evaluate five biomarkers (neopterin, vascular endothelial growth factor-A, thrombomodulin, soluble vascular cell adhesion molecule 1 and pentraxin 3 in differentiating clinical dengue cases. Methods: A prospective cohort study was conducted whereby the blood samples were obtained at day of presentation and the final diagnosis were obtained at the end of patients’ follow-up. All patients included in the study were 15 years old or older, not pregnant, not infected by dengue previously and did not have cancer, autoimmune or haematological disorder. Median test was performed to compare the biomarker levels. A subgroup Mann-Whitney U test was analysed between severe dengue and non-severe dengue cases. Monte Carlo method was used to estimate the 2-tailed probability (P value for independent variables with unequal number of patients. Results: All biomarkers except thrombomodulin has P value < 0.001 in differentiating among the healthy subjects, non-dengue fever, dengue without warning signs and dengue with warning signs/severe dengue. Subgroup analysis for all the biomarkers between severe dengue and non-severe dengue cases was not statistically significant except vascular endothelial growth factor-A (P < 0.05. Conclusions: Certain biomarkers were able to differentiate the clinical dengue cases. This could be potentially useful in classifying and determining the severity of dengue infected patients in the hospital.

  17. Phenytoin Cream for the Treatment of Neuropathic Pain: Case Series

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    David J. Kopsky

    2018-05-01

    Full Text Available BACKGROUND: Neuropathic pain can be disabling, and is often difficult to treat. Within a year, over half of all patients stop taking their prescribed neuropathic pain medication, which is most probably due to side effects or disappointing analgesic results. Therefore, new therapies are needed to alleviate neuropathic pain. As such, topical analgesics could be a new inroad in the treatment of neuropathic pain. In 2014, we developed a new topical formulation containing either phenytoin or sodium phenytoin. After optimization of the formulation, we were able to reach a 10% concentration and combine phenytoin with other co-analgesics in the same base cream. OBJECTIVE: To describe a series of 70 neuropathic pain patients who were treated with phenytoin cream. MATERIAL AND METHODS: Cases treated with phenytoin 5% or 10% creams were gathered. The mean onset of pain relief, the duration of effect, and reduction in pain intensity measured on the 11-point numerical rating scale (NRS were all studied. A single-blind response test with phenytoin 10% and placebo creams was conducted on 12 patients in order to select responders prior to prescribing the active cream. Plasma phenytoin concentrations were measured in 16 patients. RESULTS: Nine patients applied phenytoin 5% cream, and 61 patients used phenytoin 10% cream. After grouping the effects of all of the patients, the mean onset of pain relief was 16.3 min (SD: 14.8, the mean duration of analgesia was 8.1 h (SD: 9.1, and the mean pain reduction on the NRS was 61.2% (SD: 25.0. The mean pain reduction on the NRS while using phenytoin cream was statistically significant compared with the baseline, with a reduction of 4.5 (CI: 4.0 to 5.0, p < 0.01. The 12 patients on whom a single-blind response test was performed experienced a statistically significant reduction in pain in the area where the phenytoin 10% cream was applied in comparison to the area where the placebo cream was applied (p < 0.01. Thirty

  18. Case series of females charged with murder or attempted murder of ...

    African Journals Online (AJOL)

    Case series of females charged with murder or attempted murder of minors and referred to Weskoppies Hospital in terms of the Criminal Procedure Act over a ... The aim of describing this case series was to attempt to find a psychiatric profile of such cases, as well as to find other information for example, demographics.

  19. Churg–Strauss syndrome: Case series

    Directory of Open Access Journals (Sweden)

    T.M. Alfaro

    2012-03-01

    : Churg–Strauss syndrome, Vasculitis, Review, Case series, Palavras-chave: Síndrome de Churg-Strauss, Vasculite, Revisão, Casuística

  20. Surgical staging identified false HPV-negative cases in a large series of invasive cervical cancers.

    Science.gov (United States)

    Petry, Karl Ulrich; Liebrich, Clemens; Luyten, Alexander; Zander, Martina; Iftner, Thomas

    2017-12-01

    We examined a large series of biopsy-proven invasive cervical cancers with surgical staging and HPV re-testing to estimate the relevance of HPV-negative cervical cancers in a Caucasian population. We prospectively collected smears from 371 patients with a biopsy-proven diagnosis of cervical cancer for HC2 testing of high-risk HPV (HR-HPV). In HC2-negative cases, smears and paraffin embedded tissue blocks underwent additional HPV genotyping. HC2 tests showed 31/371 cases (8.8%) had negative findings. Surgical staging showed that 21/31 HC2-negative cases (68%) were not cervical cancer. Overall, 340/350 cases of primary cervical cancer confirmed by surgical staging tested HC2 positive (97.2%). Non-high-risk HPV subtypes were detected in five cases (one HPV-53, one HPV-70, and three HPV-73) and high-risk subtypes in four patients with HC2-negative cervical cancer (two HPV 16 and two HPV-18). The remaining case, a primary undifferentiated carcinoma of the uterine cervix, tested negative for HPV-DNA with all tests. The main explanation for HPV-negative cervical cancer was a false diagnosis, followed by cancers associated with non-HR-HPV types, and false-negative HR-HPV results. Truly HPV negative seem to be very rare in Caucasian populations. Retrospective analyses without surgical staging may overestimate the proportion of HPV negative cervical cancers. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Adjuvant radiotherapy after extrapleural pneumonectomy for mesothelioma. Prospective analysis of a multi-institutional series

    International Nuclear Information System (INIS)

    Tonoli, Sandro; Vitali, Paola; Scotti, Vieri; Bertoni, Filippo; Spiazzi, Luigi; Ghedi, Barbara; Buonamici, Fabrizio Banci; Marrazzo, Livia; Guidi, Gabriele; Meattini, Icro; Bastiani, Paolo; Amichetti, Maurizio; Schwarz, Marco; Magrini, Stefano Maria

    2011-01-01

    Background and purpose: To evaluate survival, locoregional control and toxicity in a series of 56 mesothelioma patients treated from May 2005 to May 2010 with post-operative radiotherapy after extrapleural pneumonectomy (EPP) in three Italian Institutions (Brescia, Florence, and Modena). Material and methods: Fifty-six patients treated with adjuvant radiotherapy (RT) after EPP were analyzed. Four patients were treated with 3DCRT, 50 with IMRT and two with helical tomotherapy. Forty-five to 50 Gy in 25 fractions were given to the affected hemithorax and to ipsilateral mediastinum, with a simultaneous integrated boost to the sites of microscopically involved margins up to 60 Gy in 20/56 cases. Results: Three year locoregional control (LRC), distant metastasis free (DMF), disease free (DF), disease specific (DSS) and overall survival (OS) rates are 90%, 66%, 57%, 62%, and 60%, respectively. Conclusion: Postoperative RT with modern techniques is an effective method to obtain excellent local control and cure rates in mesothelioma patients submitted to EPP.

  2. Healthcare-Associated Infective Endocarditis: a Case Series in a Referral Hospital from 2006 to 2011

    Directory of Open Access Journals (Sweden)

    Oslan Francischetto

    2014-10-01

    Full Text Available Background: Healthcare-associated infective endocarditis (HCA-IE, a severe complication of medical care, shows a growing incidence in literature. Objective: To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods: Observational prospective case series study (2006-2011 in a public hospital in Rio de Janeiro. Results: Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE were included. There were 26 (49% males (mean age of 47 ± 18.7 years, 27 (51% females (mean age of 42 ± 20.1 years. IE was acute in 37 (70% cases and subacute in 16 (30% cases. The mitral valve was affected in 19 (36% patients and the aortic valve in 12 (36%; prosthetic valves were affected in 23 (43% patients and native valves in 30 (57%. Deep intravenous access was used in 43 (81% cases. Negative blood cultures were observed in 11 (21% patients, Enterococcus faecalis in 10 (19%, Staphylococcus aureus in 9 (17%, and Candida sp. in 7 (13%. Fever was present in 49 (92% patients, splenomegaly in 12 (23%, new regurgitation murmur in 31 (58%, and elevated C-reactive protein in 44/53 (83%. Echocardiograms showed major criteria in 46 (87% patients, and 34 (64% patients were submitted to cardiac surgery. Overall mortality was 17/53 (32%. Conclusion: In Brazil HCA-IE affected young subjects. Patients with prosthetic and native valves were affected in a similar proportion, and non-cardiac surgery was an infrequent predisposing factor, whereas intravenous access was a common one. S. aureus was significantly frequent in native valve HCA-IE, and overall mortality was high.

  3. Healthcare-Associated Infective Endocarditis: a Case Series in a Referral Hospital from 2006 to 2011

    Science.gov (United States)

    Francischetto, Oslan; da Silva, Luciana Almenara Pereira; Senna, Katia Marie Simões e; Vasques, Marcia Regina; Barbosa, Giovanna Ferraiuoli; Weksler, Clara; Ramos, Rosana Grandelle; Golebiovski, Wilma Felix; Lamas, Cristiane da Cruz

    2014-01-01

    Background Healthcare-associated infective endocarditis (HCA-IE), a severe complication of medical care, shows a growing incidence in literature. Objective To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods Observational prospective case series study (2006-2011) in a public hospital in Rio de Janeiro. Results Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE) were included. There were 26 (49%) males (mean age of 47 ± 18.7 years), 27 (51%) females (mean age of 42 ± 20.1 years). IE was acute in 37 (70%) cases and subacute in 16 (30%) cases. The mitral valve was affected in 19 (36%) patients and the aortic valve in 12 (36%); prosthetic valves were affected in 23 (43%) patients and native valves in 30 (57%). Deep intravenous access was used in 43 (81%) cases. Negative blood cultures were observed in 11 (21%) patients, Enterococcus faecalis in 10 (19%), Staphylococcus aureus in 9 (17%), and Candida sp. in 7 (13%). Fever was present in 49 (92%) patients, splenomegaly in 12 (23%), new regurgitation murmur in 31 (58%), and elevated C-reactive protein in 44/53 (83%). Echocardiograms showed major criteria in 46 (87%) patients, and 34 (64%) patients were submitted to cardiac surgery. Overall mortality was 17/53 (32%). Conclusion In Brazil HCA-IE affected young subjects. Patients with prosthetic and native valves were affected in a similar proportion, and non-cardiac surgery was an infrequent predisposing factor, whereas intravenous access was a common one. S. aureus was significantly frequent in native valve HCA-IE, and overall mortality was high. PMID:25352503

  4. Awake tracheal intubation using Pentax airway scope in 30 patients: A Case series

    Directory of Open Access Journals (Sweden)

    Payal Kajekar

    2014-01-01

    Full Text Available Background and Aims: Pentax airway scope (AWS has been successfully used for managing difficult intubations. In this case series, we aimed to evaluate the success rate and time taken to complete intubation, when AWS was used for awake tracheal intubation. Methods: We prospectively evaluated the use of AWS for awake tracheal intubation in 30 patients. Indication for awake intubation, intubation time, total time to complete tracheal intubation, laryngoscopic view (Cormack and Lehane grade, total dose of local anaesthetic used, anaesthetists rating and patient′s tolerance of the procedure were recorded. Results: The procedure was successful in 25 out of the 30 patients (83%. The mean (standard deviation intubation time and total time to complete the tracheal intubation was 5.4 (2.4 and 13.9 (3.7 min, respectively in successful cases. The laryngeal view was grade 1 in 24 and grade 2 in one of 25 successful intubations. In three out of the five patients where the AWS failed, awake tracheal intubation was successfully completed with the assistance of flexible fibre optic scope (FOS. Conclusion: Awake tracheal intubation using AWS was successful in 83% of patients. Success rate can be further improved using a combination of AWS and FOS. Anaesthesiologists who do not routinely use FOS may find AWS easier to use for awake tracheal intubation using an oral route.

  5. Conversion (dissociative) symptoms as a presenting feature in early onset bipolar disorder: a case series

    OpenAIRE

    Ghosal, Malay Kumar; Guha, Prathama; Sinha, Mausumi; Majumdar, Debabrata; Sengupta, Payel

    2009-01-01

    We present three cases of early onset bipolar disorder where dissociative (conversion) symptoms preceded the onset of mania. This case series underscores the significance of dissociative/conversion symptoms as an early atypical presentation in juvenile bipolar disorder.

  6. Combined clear corneal phacoemulsification and ab interno trabeculectomy: three-year case series.

    Science.gov (United States)

    Ferrari, Ettore; Bandello, Francesco; Roman-Pognuz, Derri; Menchini, Francesca

    2005-09-01

    To evaluate the efficacy and safety of a novel surgical approach, ab interno trabeculectomy, in a combined procedure (clear corneal phacoemulsification + ab interno trabeculectomy) for the management of concurrent cataract and glaucoma with prognostic factors for filtration failure. Department of Ophthalmology, Palmanova Hospital, Udine, Italy. A prospective noncomparative case series of 11 eyes of 11 consecutive cataract patients with medically uncontrolled primary open-angle glaucoma or pseudoexfoliation glaucoma was performed. Each patient had phacoemulsification + intraocular lens implantation + ab interno trabeculectomy, which consisted of a gonioscopically controlled ab interno removal of a quadrant (3 clock hours) of the trabecular meshwork. The main outcome measures were intraocular pressure (IOP), the number of antiglaucomatous medications used, and complications. Ten patients completed a 3-year follow-up. One patient had further surgery because of poor IOP control; in this case, the last valid observation was carried forward for IOP calculation. Mean preoperative IOP and IOPs measured 1, 3, 6, 12, 24, and 36 months after surgery were 25.0, 15.8, 15.4, 15.4, 15.2, 15.0, and 15.3 (-38.56%) mm Hg respectively. The number of medications averaged 2.4 before surgery and dropped to 0.8 at the end of follow-up. No major complications occurred during the follow-up period. The new surgical procedure combining phacoemulsification with ab interno trabeculectomy can induce a clinically relevant decrease in IOP in eyes with cataract and glaucoma with poor prognosis for filtering surgery. However, a randomized controlled clinical trial with a more extended follow-up and a larger series of patients is needed to ascertain the actual effectiveness and safety of this procedure.

  7. Nifurtimox plus Eflornithine for late-stage sleeping sickness in Uganda: a case series.

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    Francesco Checchi

    2007-11-01

    Full Text Available We report efficacy and safety outcomes from a prospective case series of 31 late-stage T.b. gambiense sleeping sickness (Human African Trypanosomiasis, HAT patients treated with a combination of nifurtimox and eflornithine (N+E in Yumbe, northwest Uganda in 2002-2003, following on a previously reported terminated trial in nearby Omugo, in which 17 patients received the combination under the same conditions.Eligible sequential late-stage patients received 400 mg/Kg/day eflornithine (Ornidyl, Sanofi-Aventis for seven days plus 15 mg/Kg/day (20 mg for children <15 years old nifurtimox (Lampit, Bayer AG for ten days. Efficacy (primary outcome was monitored for 24 months post discharge. Clinical and laboratory adverse events (secondary outcome were monitored during treatment. All 31 patients were discharged alive, but two died post-discharge of non-HAT and non-treatment causes, and one was lost to follow-up. Efficacy ranged from 90.3% to 100.0% according to analysis approach. Five patients experienced major adverse events during treatment, and neutropenia was common (9/31 patients.Combined with the previous group of 17 trial patients, this case series yields a group of 48 patients treated with N+E, among whom no deaths judged to be treatment- or HAT-related, no treatment terminations and no relapses have been noted, a very favourable outcome in the context of late-stage disease. N+E could be the most promising combination regimen available for sleeping sickness, and deserves further evaluation.

  8. Acute hypopituitarism complicating Russell's viper envenomation: case series and systematic review.

    Science.gov (United States)

    Rajagopala, S; Thabah, M M; Ariga, K K; Gopalakrishnan, M

    2015-09-01

    Chronic hypopituitarism following Russell viper envenomation (RVE) is a rare but well-recognized syndrome. The clinical features, associations, management and outcomes of RVE associated-acute hypopituitarism (AHP) are not well described. To describe the clinical features, intensive care unit (ICU) management and outcomes of a series of patients with RVE-AHP and identify the clinical associations of RVE-AHP. We describe a series of patients with prospectively identified AHP related to RVE and describe our findings comparing RVE with and without AHP and a systematic search of literature on AHP related to RVE. We identified nine cases of AHP related to RVE. Unexplained hypoglycemia (100%) and hypotension (66.7%) were the most common findings at presentation. AHP occurred after a median of 9 (range, 2-14) days after severe envenomation and was associated with multi-organ dysfunction, lower platelet counts, more bleeding and transfusions when compared to patients with RVE alone. The presence of clinically defined capillary leak syndrome, disseminated intravascular coagulation and mortality were not different from those without AHP. Our systematic search yielded 12 cases of AHP related to RVE; data on associated clinical manifestations, therapy and ASV administration were not available in most reports. AHP is a very rare complication of RVE. Unexplained hypoglycemia and hypotension should prompt evaluation for AHP in RVE. AHP is associated with severe RVE, multi-organ dysfunction, bleeding and need for transfusion. Prompt treatment with steroids may reduce mortality related to AHP in RVE. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

    OpenAIRE

    Chao, Chia-Ter; Lee, Szu-Ying; Yang, Wei-Shun; Chen, Huei-Wen; Fang, Cheng-Chung; Yen, Chung-Jen; Chiang, Chih-Kang; Hung, Kuan-Yu; Huang, Jenq-Wen

    2013-01-01

    Background Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis. Methods We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patient...

  10. Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

    Science.gov (United States)

    Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

    2017-08-07

    Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

  11. Case series and descriptive cohort studies in neurosurgery: the confusion and solution.

    Science.gov (United States)

    Esene, Ignatius N; Ngu, Julius; El Zoghby, Mohamed; Solaroglu, Ihsan; Sikod, Anna M; Kotb, Ali; Dechambenoit, Gilbert; El Husseiny, Hossam

    2014-08-01

    Case series (CS) are well-known designs in contemporary use in neurosurgery but are sometimes used in contexts that are incompatible with their true meaning as defined by epidemiologists. This inconsistent, inappropriate and incorrect use, and mislabeling impairs the appropriate indexing and sorting of evidence. Using PubMed, we systematically identified published articles that had "case series" in the "title" in 15 top-ranked neurosurgical journals from January 2008 to December 2012. The abstracts and/or full articles were scanned to identify those with descriptions of the principal method as being "case series" and then classified as "true case series" or "non-case series" by two independent investigators with 100 % inter-rater agreement. Sixty-four articles had the label "case series" in their "titles." Based on the definition of "case series" and our appraisal of the articles using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, 18 articles (28.13 %) were true case series, while 46 (71.87 %) were mislabeled. Thirty-five articles (54.69 %) mistook retrospective (descriptive) cohorts for CS. CS are descriptive with an outcome-based sampling, while "descriptive cohorts" have an exposure-based sampling of patients, followed over time to assess outcome(s). A comparison group is not a defining feature of a cohort study and distinguishes descriptive from analytic cohorts. A distinction between a case report, case series, and descriptive cohorts is absolutely necessary to enable the appropriate indexing, sorting, and application of evidence. Researchers need better training in methods and terminology, and editors and reviewers should scrutinize more carefully manuscripts claiming to be "case series" studies.

  12. The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014.

    Science.gov (United States)

    Ng, Colin; Mifsud, Max; Borg, Joseph N; Mizzi, Colin

    2015-11-20

    The purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries. Our aims were to assess acute outcomes and short term mortality of surgery within the perspective of a damage control orthopaedic strategy whereby aggressive wound management, early fixation using relative stability principles, antibiotic cover with adequate soft tissue cover are paramount. We also aim to describe the variety of war injuries we came across, with a goal for future improvement in regards to service providing. Prospective collection of six interesting cases with severe limb and spinal injuries sustained in Libya during the Libyan civil war between June and November 2014. We applied current trends in the treatment of war injuries, specifically in damage control orthopaedic strategy and converting to definitive treatment where permissible. The majority of our cases were classified as most severe (Type IIIB/C) according to the Gustilo-Anderson classification of open fractures. The injuries treated reflected the type of standard and improved weaponry available in modern warfare affecting both militants and civilians alike with increasing severity and extent of damage. Due to this fact, multidisciplinary team approach to patient centred care was utilised with an ultimate aim of swift recovery and early mobilisation. It also highlighted the difficulties and complex issues required on a hospital management level as a neighbouring country to war zone countries in transforming care of civil trauma to military trauma.

  13. Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study.

    Science.gov (United States)

    Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

    2017-01-01

    Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.

  14. Eosinophilic Gastroenteritis Presenting as Intestinal Obstruction - A Case Series

    Directory of Open Access Journals (Sweden)

    Amita Krishnappa

    2011-07-01

    Full Text Available Eosinophilic Gastroenteritis is a rare disease characterized by infiltration of the gastrointestinal tract by an increased number of eosinophils as compared to the normal. The anatomic location and intensity of the infiltrate decides the varied clinical symptomatology with which these patients present. The present report deals with four cases, all presenting with clinical signs of intestinal obstruction A laparotomy performed revealed a stricture in the first case, superficial ulcers and adhesions in the second case, an ileocaecal mass in the third case and volvulus formation in the fourth case. Eosinophilic gastroenteritis was confirmed on histopathology in all the four cases. All the four patients experienced relief of symptoms after resection. It is essential to diagnose the disease to differentiate it from other conditions presenting as intestinal obstruction. The cases are presented because of the rarity of occurrence and presentation. Relevant literature has been reviewed.

  15. Adverse effects of aromatherapy: a systematic review of case reports and case series.

    Science.gov (United States)

    Posadzki, Paul; Alotaibi, Amani; Ernst, Edzard

    2012-01-01

    This systematic review was aimed at critically evaluating the evidence regarding the adverse effects associated with aromatherapy. Five electronic databases were searched to identify all relevant case reports and case series. Forty two primary reports met our inclusion criteria. In total, 71 patients experienced adverse effects of aromatherapy. Adverse effects ranged from mild to severe and included one fatality. The most common adverse effect was dermatitis. Lavender, peppermint, tea tree oil and ylang-ylang were the most common essential oils responsible for adverse effects. Aromatherapy has the potential to cause adverse effects some of which are serious. Their frequency remains unknown. Lack of sufficiently convincing evidence regarding the effectiveness of aromatherapy combined with its potential to cause adverse effects questions the usefulness of this modality in any condition.

  16. Snapshots of Student Thinking: An Exploration of Video Cases for Extending Prospective Teachers' Knowledge

    Science.gov (United States)

    Pitts Bannister, Vanessa R.; Mariano, Gina J.

    2013-01-01

    The purpose of this article is to explore the relationships between prospective teachers' content knowledge, student understanding, and pedagogy using video cases. The emphasis was on the extent to which the participants utilized constructs of Technology Pedagogy And Content Knowledge. Ten prospective teachers viewed video cases of students…

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

    Science.gov (United States)

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

    2005-01-01

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

  18. Imported brucellosis: A case series and literature review.

    Science.gov (United States)

    Norman, Francesca F; Monge-Maillo, Begoña; Chamorro-Tojeiro, Sandra; Pérez-Molina, Jose-Antonio; López-Vélez, Rogelio

    2016-01-01

    Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported. Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed. Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays. Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Lithological and petrophysical properties and prospects of oil and gas presence of Kalinsky series in Absheron

    International Nuclear Information System (INIS)

    Kheirov, M.B; Dilbazi, Z.H; Askerov, F.H; Imanov, A.D.

    2002-01-01

    Full text:The presentation is is dedicated to summarizing the results of studying lithological and petrographic peculiarities and petrophysical properties of relatively scarcely studied rocks of lower Pliocene Kalinsky Series in Absheron, particularly its lower horizons, as well as to determining the regularities of these properties change about the area, as well as along the geological section. These generalisation cover the areas of Gala, Turkany, Gala-Dubendy, Govsany, Garachukhur, Bina, Zykh, Peschany island, Chilov, Khali, Gryazevaya sopka, Pirallakhy, and they are necessary for determining the direction of exploration and increasing the efficiency of productive horizons development. Kalinsky series is represented mostly by the alternation of siltstones, sandstones and shale and subjected to lithofacial changes along the section and about the area. In the reservoir sections studied Kalinsky series is mostly of polymetallic composition and is represented by badly sorted rocks. The sorting coefficient is within the range 2.5-4.7. Sands and sandstones occur relatively seldom. Thus, Kalinsky series, and its lower horizons in particular are scarcely studied. In some areas these horizons in particular are scarcely studied. In some areas horizons are not exposed. That is why for the purpose of oil and gas presence degree clarification it is necessary to resume exploration in Absheron oil and gas bearing region Kalinsky series, and in particular in its lower horizons

  20. Perinatal asphyxia and medical professional liability: A case series

    Directory of Open Access Journals (Sweden)

    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.

  1. Prospective application of advanced series compensation to improve transmission system performance

    Energy Technology Data Exchange (ETDEWEB)

    Gama, C A; Scavassa, J L; Silva, W.M. da; Silva, J M.M. da; Ponte, J R [ELETRONORTE, Brasilia, DF (Brazil)

    1994-12-31

    This paper describes the main aspects and results of the planning studies undertaken to evaluate the technical benefits of using Thyristor Controlled Series Compensation (TCSC), in a large 500 kV transmission system (Brazilian North-Northeast system). TCSC controllers design and simplified models for digital non-linear time domain simulations are discussed. The proposed controllers are tuned and used to support the comparative analysis between controlled and fixed series compensation. The relevant conclusions concerning this comparison are highlighted. (author) 2 refs., 14 figs., 3 tabs.

  2. Chorangioma of Placenta with High Risk Pregnancy: A Case Series

    African Journals Online (AJOL)

    Case 4 was associated with maternal rheumatic heart disease and polyhydramnios. ... proliferation of fetal blood vessels, usually supported by scant connective ... mass with similar or higher echogenicity to the surrounding tissue, and a clearly ...

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

    Directory of Open Access Journals (Sweden)

    Eun-A Kim

    2011-06-01

    Conclusion: Considering the possibility of exposure to carcinogenic agents, we could not find any convincing evidence for occupational exposure in all investigated cases. However, further study is needed because the semiconductor industry is a newly developing one.

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

    Science.gov (United States)

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

    2009-01-01

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

  5. "Spiritual starvation?": a case series concerning christianity and eating disorders.

    Science.gov (United States)

    Morgan, J F; Marsden, P; Lacey, J H

    2000-12-01

    We describe the cases of four patients with eating disorders in whom complex interactions occurred among religious faith, pathogenesis of the eating disorder, and clinical management. In some of the cases, religious beliefs seemed to provide a containment of maladaptive behaviors, partly through prayer and through a sense of belonging to the religious community. In other cases, it proved difficult to separate the concept of a punitive God from the illness process. The cases are discussed with reference to a limited empirical literature. Similarities are noted between some religious institutions and eating disorder treatment regimes. This paper explores management issues, including the use of pastoral counseling and the ethics of addressing religious beliefs in therapy. We note the benefits of a rapprochement between psychiatry and religion. Copyright 2000 by John Wiley & Sons, Inc.

  6. Invasive pulmonary aspergillosis in patients with decompensated cirrhosis: case series

    Directory of Open Access Journals (Sweden)

    Poynard Thierry

    2007-01-01

    Full Text Available Abstract Background Opportunistic invasive fungal infections are increasingly frequent in intensive care patients. Their clinical spectrum goes beyond the patients with malignancies, and for example invasive pulmonary aspergillosis has recently been described in critically ill patients without such condition. Liver failure has been suspected to be a risk factor for aspergillosis. Case presentation We describe three cases of adult respiratory distress syndrome with sepsis, shock and multiple organ failure in patients with severe liver failure among whom two had positive Aspergillus antigenemia and one had a positive Aspergillus serology. In all cases bronchoalveolar lavage fluid was positive for Aspergillus fumigatus. Outcome was fatal in all cases despite treatment with voriconazole and agressive symptomatic treatment. Conclusion Invasive aspergillosis should be among rapidly raised hypothesis in cirrhotic patients developing acute respiratory symptoms and alveolar opacities.

  7. Case series of unusual causes intestinal obstruction in infants and ...

    African Journals Online (AJOL)

    Introduction Many of the causes of intestinal obstruction arise from ... In this work, we report eight unusual cases of intestinal ..... lymph is considered to be the result of an imbalance ... During fetal life, midgut communicates with the yolk sac.

  8. Medium-density fibreboard and occupational asthma. A case series.

    Science.gov (United States)

    Burton, C; Bradshaw, L; Agius, R; Burge, S; Huggins, V; Fishwick, D

    2011-08-01

    Medium-density fibreboard (MDF) is a wood composite material, composed primarily of softwood, bonded with a synthetic formaldehyde-based resin. It is increasingly used, as it has various advantages over natural woods. Enquiry of the national reporting scheme data and three case reports were used to further the evidence base linking this exposure to occupational asthma (OA). From 1991 to 2007, 21 cases of occupational sensitization to MDF were reported to the UK voluntary reporting scheme, Surveillance of Work Related Occupational Respiratory Disease (SWORD): 18 reported as occupational asthma (OA) and 3 as occupational rhinitis. All workers were male, with a mean age of 48 years, working in education, furniture manufacturing or joinery among other employments. Whilst reporting scheme data identified relatively small numbers of cases of OA likely to be due to MDF, the evidence base supporting this link is generally lacking. The three cases presented, where OA was attributed to MDF exposure, add to this evidence.

  9. Sudden Death Following Exercise; a Case Series Study

    Directory of Open Access Journals (Sweden)

    Fares Najari

    2016-04-01

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

  10. Endophthalmitis caused by Acinetobacter baumanni: a case series.

    Science.gov (United States)

    Roy, R; Panigrahi, P; Malathi, J; Pal, S S; Nandi, K; Patil, A; Nigam, E; Arora, V

    2013-03-01

    To profile the etiology, clinical outcomes and drug sensitivity patterns in endophthalmitis caused by Acinetobacter baumanni. Retrospective analysis of all the cases of Acinetobacter baumanni endophthalmitis presenting to tertiary referral care ophthalmic hospital in Eastern India from January 2009 to December 2011 were done. A total of four cases were included in the study. Out of the four cases one was post traumatic and the rest were post cataract surgery. All the cases underwent vitreoretinal surgical intervention followed by intravitreal antibiotics. A. Baumanni was isolated from vitreous in all the cases. Among all the drugs tested bacteria were found sensitive to ciprofloxacin (100 %) whereas all tested resistant to ceftazidime. Out of the four cases one had to be eviscerated, another developed retinal detachment post vitrectomy, one was phthisical at final followup, and only one patient achieved a vision of 20/200 with clear media and attached retina at final visit. A. Baumanni is a very rare cause of endophthalmitis with poor visual and anatomical outcomes. Ciprofloxacin should be considered as first the line intravitreal antibiotic.

  11. Cysticercosis of the eye in south India - A case series

    Directory of Open Access Journals (Sweden)

    Kaliaperumal S

    2005-01-01

    Full Text Available Purpose: To study the clinical presentation and treatment outcome of patients with ocular cysticercosis in southern India. Methods: This study included 10 patients who were diagnosed to have ocular or adnexal cysticercosis over a period of one year in Pondicherry, India. The clinical presentation, results of investigation and treatment outcome of the cases were analysed retrospectively. Results: Age of these patients ranged from 12 to 55 years. Four presented with loss of vision, two with a swelling in the eyelid, one with proptosis, one with diplopia and two with conjunctival involvement. ELISA for cysticercus antibodies in serum was positive in all cases. Albendazole and prednisolone were given for the treatment of these cases. Two patients responded well to treatment and were completely cured of the disease. There was partial improvement in 6 cases. Surgery in the form of excision was performed in two cases following a course of medical therapy. There was no significant change in visual acuity in eyes with intraocular cysticercosis following treatment. Conclusion: Ultrasonography B scan and ELISA for anticysticercal antibodies help to establish the diagnosis of ocular cysticercosis. A combination of oral albendazole and corticosteroids is found to be effective in confirmed cases. Intraocular cysticercosis is associated with a poor prognosis for vision.

  12. Lithological and petrophysical properties and prospects of oil and gas presence of Kalinsky series in Absheron

    International Nuclear Information System (INIS)

    Kheirov, M.B; Dilbazi, Z.H; Askerov, F.H; Imanov, A.D

    2002-01-01

    Full text: The presentation is dedicated to summarizing the results of studying lithological and petrographic peculiarities and petrophysical properties of relatively scarcely studied rocks of lower Pliocene Kalinsky Series in Absheron, particularly its lower horizons, as well as to determining the regularities of these properties change about the area, as well as along the geological section.These generalizations cover the areas of Gala, Turkany,Gala-Dubendy,Govsany,Garachukhur, Bina, Zykh, Peschany island, Chilov, Khali, Gryazevaya sopka, Pirallakhy, and they are necessary for determining the direction of exploration and increasing the efficiently of productive horizons development.Kalinsky series (KaS) is represented mostly by the alternation of siltstones,sandstones and shale and subjected to lithofacial changes along the section and about the area.Within the area under analysis the Kalinsky series thickness is changeable and decreases towards north-west (the crest), besides it pinches out, thus promoting lithostratigraphical traps occurrence. In this direction the arenosity of reservoir rocks increases.The The exposure of the 4-th and 5-th horizons of Kalinsky series in Peschany Island, Zyrya and Gryazevaya sopka gives us an opportunity to expect the occurrence of the corresponding formations in other areas as well. In the reservoir sections studied Kalinsky series is mostly of polymictic composition and is represented by badly sorted rocks.the sorting coefficient is within the range 2,5-4,7.Sands and sandstones occur relatively seldom.Silt fraction mostly prevails in their granulometric composition.The sand fraction content is close to the content of silt fraction in Surakhany, Garachukhur, Gum adasy, Zykh and Govsany (Fig.1).The reservoir rocks clayiness ranges within 12%-35%.Pelite fraction is the smallest in Surakhany, Peschany Island and Bina, while in Turkany, Gala, Gala-dubendy, Turkany-deniz and Gryazevaya sopka this fraction increases, attaining 28

  13. Work-related olfactory disorder: a case series and review.

    Science.gov (United States)

    Park, Soon Woo; Kang, Young Joong; Eom, Huisu; Cho, Hyun-Jin; Ahn, Jungho; Lee, Sang-Gil

    2018-01-01

    The olfactory bulb is anatomically exposed and thus can be directly damaged by external stimulation. This can occur as an occupational injury owing to contact with organic solvents or other causes. We present cases of eight patients who sustained occupation-related exposure to potentially toxic substances and later presented with signs and symptoms of anosmia. We examined the occupational and medical characteristics of the patients and evaluated their work-relatedness. Case 1: A 50-year-old man performed high-frequency heat treatments for approximately 11 years. He experienced decreased senses for olfaction and taste during the later years culminating in the diagnosis of anosmia after 3 years (high work-relatedness). Case 2: A 54-year-old man whose work involved exposure to various organic solvents, such as spray painting and application of paint and thinners for approximately 4 years, was subsequently diagnosed with anosmia based on rhinorrhea, headache, and loss of olfaction (high work-relatedness). Case 3: A 44-year-old-man who performed spray painting for approximately 17 years developed anosmia (high work-relatedness). Case 4: A 44-year-old man was involved in ship engine cleaning once a month, for approximately 7 h per cleaning session; he was diagnosed with anosmia based on loss of olfaction (low work-relatedness). Case 5: A 41-year-old man worked in ship building block construction for approximately 13 years; anosmia diagnosis was based on loss of olfaction (low work-relatedness). Case 6: A 47-year-old woman performed product inspection and labeling at a plant manufacturing automobile parts; anosmia diagnosis was based on decreased olfaction and taste (low work-relatedness). Case 7: A 50-year-old woman performed epoxy coating in a plant manufacturing automobile parts; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). Case 8: A 57-year-old woman performed cleaning of the area where mobile phone parts were manufactured

  14. Treatment of epidermoid tumors with gamma knife radiosurgery: Case series.

    Science.gov (United States)

    Vasquez, Javier A Jacobo; Fonnegra, Julio R; Diez, Juan C; Fonnegra, Andres

    2016-01-01

    Epidermoid tumors (ETs) are benign lesions that are treated mainly by means of surgical resection, with overall good results. External beam radiotherapy is an alternative treatment for those recurrent tumors, in which a second surgery might not be the best choice for the patient. A little information exists about the effectiveness of gamma knife radiosurgery for the treatment of newly diagnosed and recurrent ETs. We present three cases of ETs treated with gamma knife radiosurgery. Case 1 is a 21-year-old female with an ET located in the left cerebellopontine angle (CPA) with symptoms related to VIII cranial nerve dysfunction. Symptom control was achieved and maintained after single session radiosurgery with gamma knife. Case 2 is a 59-year-old female patient with the history of trigeminal neuralgia secondary to a recurrent ET located in the left CPA. Significant pain improvement was achieved after treatment with gamma knife radiosurgery. Case 3 is a 29-year-old male patient with a CPA ET causing long lasting trigeminal neuralgia, pain relief was achieved in this patient after gamma knife radiosurgery. Long-term symptom relief was achieved in all three cases proving that gamma knife radiosurgery is a good and safe alternative for patients with recurrent or nonsurgically treated ETs.

  15. Saving Natural Teeth: Intentional Replantation-Protocol and Case Series.

    Science.gov (United States)

    Grzanich, Derek; Rizzo, Gabriella; Silva, Renato Menezes

    2017-12-01

    Intentional replantation is a reliable and predictable treatment for cases in which nonsurgical endodontic retreatment failed or is impractical and endodontic surgery is hampered because of anatomic limitations. This article presents a protocol for intentional replantation illustrated with some interesting cases. The cases presented here are from patients (average age, 61 years) with no contributing medical history. The cases are molars with previous failed endodontic treatment/retreatment and diagnosed with apical periodontitis. Treatment procedures included atraumatic extractions with minimal manipulations of the periodontal ligament, followed by root-end resection, root-end preparation with ultrasonic tips, root-end fill with bioceramic cement, and rapid tooth replacement into the socket. Granulomatous tissue was gently curetted when applicable. All procedures were performed under the microscope. Intentional replantation with careful case selection may be considered as a last option for preserving hopeless teeth. Atraumatic extraction by using state-of-the-art equipment, instruments, and materials, minimal extra-alveolar time, and maintaining an aseptic technique are key factors for success. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. [Analysis of a case series of workers with mobbing syndrome].

    Science.gov (United States)

    Marinoni, B; Minelli, C M; Franzina, B; Martellosio, V; Scafa, F; Giorgi, I; Mazzacane, F; Stancanelli, M; Mennoia, N V; Candura, S M

    2007-01-01

    Mobbing represents nowadays a major challenge for Occupational Medicine. We examined, during the last seven years, 253 patients who asked medical assistance for psychopathological problems by them ascribed to mobbing in the working environment. All patients underwent occupational health visit, psychological counselling (including personality tests administration), and psychiatric evaluation. A clinical picture probably due to mobbing was diagnosed in 37 workers: 2 cases of Post-Traumatic Stress Disorder (PTSD), 33 of Adjustment Disorder (AD), and 2 of anxiety disorder. Regarding mobbing typology, we found 19 cases of vertical mobbing (by an employer/manager to employees), 14 cases of strategic mobbing, 3 cases of horizontal mobbing (among colleagues), and one non intentional mobbing. In conclusion, a pure mobbing syndrome was diagnosed in a lower proportion than that reported by other investigators. The described interdisciplinary approach appears useful for the diagnostic assessment of suspect mobbing cases, that in turn is crucial for prognosis and treatment, as well as in relation to medico-legal issues and work-related compensation claims.

  17. Management of paediatric spontaneous pneumothorax: a multicentre retrospective case series.

    Science.gov (United States)

    Robinson, Paul D; Blackburn, Carol; Babl, Franz E; Gamage, Lalith; Schutz, Jacquie; Nogajski, Rebecca; Dalziel, Stuart; Donald, Colin B; Druda, Dino; Krieser, David; Neutze, Jocelyn; Acworth, Jason; Lee, Mark; Ngo, Peter K

    2015-10-01

    Paediatric guidelines are lacking for management of spontaneous pneumothorax. Adult patient-focused guidelines (British Thoracic Society 2003 and 2010) introduced aspiration as first-line intervention for primary spontaneous pneumothorax (PSP) and small secondary spontaneous pneumothoraces (SSP). Paediatric practice is unclear, and evidence for aspiration success rates is urgently required to develop paediatric-specific recommendations. Retrospective analysis of PSP and SSP management at nine paediatric emergency departments across Australia and New Zealand (2003-2010) to compare PSP and SSP management. 219 episodes of spontaneous pneumothorax occurred in 162 children (median age 15 years, 71% male); 155 PSP episodes in 120 children and 64 SSP episodes in 42 children. Intervention in PSP vs SSP episodes occurred in 55% (95% CI 47% to 62%) vs 70% (60% to 79%), pmanagement, PSP and SSP management did not differ and ICC insertion was the continuing preferred intervention. Overall success of aspiration was lower than reported results for adults, although success was greater for small than for large pneumothoraces. Paediatric prospective studies are urgently required to determine optimal paediatric interventional management strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Benzodiazepine maintenance for alcohol dependence: A case series

    Directory of Open Access Journals (Sweden)

    Shivanand Kattimani

    2017-01-01

    Full Text Available Alcohol addiction is a chronic relapsing syndrome. Benzodiazepines remain as the mainstay for detoxification, taking care of the acute withdrawal syndrome. There is fear of dependence and abuse of benzodiazepines on prolonged use. Here, we selectively interviewed ten cases who were on longer duration of benzodiazepines to elicit their potential perceived benefits, attitudes, and any adverse effect. Three patients experienced adverse effects. None of them had features of benzodiazepine dependence. We opine that in select cases, benzodiazepine use should persist beyond detox period, and its benefits continue beyond the acute withdrawal phase while monitoring their safety/adverse effects.

  19. Maxillary First Molars with 2 Distobuccal Canals: A Case Series.

    Science.gov (United States)

    Fogel, Howard M; Cunha, Rodrigo Sanches

    2017-11-01

    An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Acute Disseminated Encephalomyelitis: A case series and review of literatures

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2013-05-01

    Full Text Available Acute disseminated encephalomyelitis is a rare immune mediated and demyelinating disease of the central nervous system that usually affects children. It is a monophasic disorder related with multifocal neurologic symptoms. In this paper, we report seven cases of Acute disseminated encephalomyelitis in pediatrics in addition; a review of literatures is presented.

  1. Eye and rare genetic diseases: Case series and literature review ...

    African Journals Online (AJOL)

    Genetic diseases are generally characterised by a multi visceral pathogenesis. Although orphan, these diseases interest many disciplines due to their clinical expression. Eye is sometimes part of the clinical polymorphism of some rare genetic diseases. Ocular signs are in some cases leading to the diagnosis of these ...

  2. Transverse facial cleft: A series of 17 cases

    Directory of Open Access Journals (Sweden)

    L K Makhija

    2011-01-01

    Full Text Available Introduction: Transverse facial cleft (Tessier type 7 or congenital macrostomia is a rare congenital anomaly seldom occurring alone and is frequently associated with deformities of the structures developing from the first and second branchial arches. The reported incidence of No. 7 cleft varies from 1 in 60,000 to 1 in 300,000 live births. Material and Methods: Seventeen patients of transeverse facial cleft who presented to us in last 5 years were included in the study. Their history regarding familial and environmental predispositions was recorded. The cases were analysed on basis of sex, laterality, severity, associated anomalies and were graded according to severity. They were operated by z plasty technique and were followed up for 2 years to look for effectiveness of the technique and its complications. Result: Out of the seventeen patients of transverse cleft, none had familial predilection or any environmental etiology like antenatal radiological exposure or intake of drugs of teratogenic potential. Most of the patients (9/17 were associated with hemifacial microsomia and 1 patient was associated with Treacher Colin′s Syndrome. Out of the 6 cases of Grade I clefts, 4 were isolated transverse clefts and of the 10 patients of Grade II clefts, 7 were associated with hemifacial microsomia. We encountered only one case of Grade III Transverse Cleft which was not only associated with hemifacial microsomia but also had cardiac anomaly. Out of the17 cases, 15 were operated and in most of them the outcome was satisfactory.

  3. Spontaneous haemoperitoneum in pregnancy and endometriosis: a case series

    NARCIS (Netherlands)

    Lier, M. van; Malik, R.F.; Waesberghe, J. van; Maas, J.W.; Rumpt-van de Geest, D.A. van; Coppus, S.F.P.J.; Berger, J.P.; Rijn, B.B. van; Janssen, P.F.; Boer, M.A. de; Vries, J.I.P. de; Jansen, F.W.; Brosens, I.A.; Lambalk, C.B.; Mijatovic, V.

    2017-01-01

    OBJECTIVE: To report pregnancy outcomes of SHiP (spontaneous haemoperitoneum in pregnancy) and the association with endometriosis. DESIGN: Retrospective case note review. SETTING: Dutch referral hospitals for endometriosis. SAMPLE: Eleven women presenting with 15 events of SHiP. METHODS: In

  4. Spontaneous haemoperitoneum in pregnancy and endometriosis : a case series

    NARCIS (Netherlands)

    Lier, McI; Malik, R F; van Waesberghe, Jhtm; Maas, J W; van Rumpt-van de Geest, D A; Coppus, S F; Berger, J P; van Rijn, B B; Janssen, P F; de Boer, M. A; de Vries, Jip; Jansen, F. W.; Brosens, I A; Lambalk, C B; Mijatovic, V

    OBJECTIVE: To report pregnancy outcomes of SHiP (spontaneous haemoperitoneum in pregnancy) and the association with endometriosis. DESIGN: Retrospective case note review. SETTING: Dutch referral hospitals for endometriosis. SAMPLE: Eleven women presenting with 15 events of SHiP. METHODS: In

  5. [Eye and cat scratch disease: A case series].

    Science.gov (United States)

    Deschasse, C; Bielefeld, P; Muselier, A; Bour, J B; Besancenot, J F; Garcher, C C; Bron, A M

    2016-02-01

    Cat scratch disease is a pleiomorphic condition, sometimes with isolated ophthalmic involvement. We report the clinical observations of seven cases with ophthalmologic manifestations of cat scratch disease. There were seven patients, with a median age of 52 years, of whom five were women and three had unilateral involvement. Six exhibited Leber's stellate neuroretinitis, an incomplete syndrome in two cases, and one associated with chorioretinal foci. One patient had isolated retinal infiltrates. The diagnosis of cat scratch disease was confirmed by Bartonella henselae serology, positive in all cases. All patients received treatment with doxycycline. Ocular complications (with optic atrophy and macular retinal pigment epithelial changes) were noted in five cases. Ocular bartonellosis is an atypical clinical form. It requires a directed ancillary work-up with serology or PCR, which has the peculiarity of being highly specific if not very sensitive. Treatment is above all preventive. Antibiotics may be initiated. Cat scratch disease must be excluded in the work-up of posterior uveitis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  6. Travel-related leptospirosis: a series of 15 imported cases.

    Science.gov (United States)

    van de Werve, Charlotte; Perignon, Alice; Jauréguiberry, Stéphane; Bricaire, François; Bourhy, Pascal; Caumes, Eric

    2013-01-01

    Leptospirosis belongs to the spectrum of travel-related infections. We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100. Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered. Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis. © 2013 International Society of Travel Medicine.

  7. Parkinsonism caused by adverse drug reactions: a case series

    Directory of Open Access Journals (Sweden)

    Agaba Emmanuel I

    2011-03-01

    Full Text Available Abstract Introduction Parkinsonism puts a high direct cost burden on both patient and caregiver. Several reports of drug-induced parkinsonism have been published, but to the best of our knowledge, there has not been any report of quinine or halothane inducing parkinsonism. Case presentation We describe two cases of parkinsonism possibly caused by adverse drug reaction to quinine in a 29-year-old black Nigerian woman and to halothane in a 36-year-old black Hausa (Nigerian man who received it as general anaesthesia for appendicectomy in our teaching hospital. Conclusion These are two unusual cases of parkinsonism caused by adverse drug reactions to high-dose quinine and to halothane as general anaesthesia. We consider that these two cases are important in bringing this potential side-effect to the attention of both pharmacologists and primary care physicians as these are two of the most commonly used medications in our clinics. We conclude that parkinsonism should be included among the adverse drug reactions to high-dose quinine and halothane general anaesthetic.

  8. Cases series of malignant lymphohematopoietic disorder in korean semiconductor industry.

    Science.gov (United States)

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

    2011-06-01

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

  9. Demyelinating disease masquerading as a surgical problem: a case series

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    Awang Saufi M

    2009-08-01

    Full Text Available Abstract Introduction We report three cases of demyelinating disease with tumor-like presentation. This information is particularly important to both neurosurgeons and neurologists who should be aware that inflammatory demyelinating diseases can present as a mass lesion, which is indistinguishable from a tumor, both clinically and radiologically, especially when there is no evidence of temporal dissemination of this disease. Case presentation The first patient was a 42-year-old Malay woman who developed subacute onset of progressive quadriparesis with urinary incontinence. Magnetic resonance imaging of her spine showed an intramedullary lesion at the C5-C7 level. She was operated on and biopsy was suggestive of a demyelinating disease. Retrospective history discovered two episodes of acute onset of neurological deficits with partial recovery and magnetic resonance imaging of her brain revealed demyelinating plaques in the centrum semiovale. The second patient was a 16-year-old Malay boy who presented with symptoms of raised intracranial pressure. A computed tomography brain scan revealed obstructive hydrocephalus with a lesion adjacent to the fourth ventricle. An external ventricular drainage was inserted. Subsequently, a stereotactic biopsy was taken and histopathology was reported as demyelination. Retrospective history revealed similar episodes with full recovery in between episodes. The third case was a 28-year-old Malay man who presented with acute bilateral visual loss and confusion. Magnetic resonance imaging of his brain showed a large mass lesion in the right temporoparietal region. Biopsy was consistent with demyelinating disease. Reexamination of the patient revealed bilateral papillitis and not papilledema. Visual evoked potential was prolonged bilaterally. In all three cases, lumbar puncture for cerebrospinal fluid study was not carried out due to lack of patient consent. Conclusions These cases illustrate the importance of

  10. Ketogenic diet therapy for epilepsy during pregnancy: A case series.

    Science.gov (United States)

    van der Louw, Elles J T M; Williams, Tanya J; Henry-Barron, Bobbie J; Olieman, Joanne F; Duvekot, Johannes J; Vermeulen, Marijn J; Bannink, Natalja; Williams, Monique; Neuteboom, Rinze F; Kossoff, Eric H; Catsman-Berrevoets, Coriene E; Cervenka, Mackenzie C

    2017-02-01

    Evaluation of ketogenic diet (KD) therapies for seizure control during pregnancy when safety and appropriate management become considerations. Until now, no information has been available on seizure reduction and human pregnancy related outcomes in women treated with KD therapies. We describe two cases of pregnant women with epilepsy treated with KD therapy either as monotherapy (Case 1) or as adjunctive therapy (Case 2). Case 1: A 27 year old woman, gravida1, started the classic KD with medium chain triglyceride (MCT) emulsion and 75g carbohydrate-restriction, later reduced to 47g. Glucose levels were 4-6mmol/L and blood ketone levels ranged from 0.2 to 1.4mmol/L. Seizure frequency decreased and seizure-free days increased. Mild side effects included intolerance to MCT, reduced serum carnitine and vitamin levels, and mild hyperlipidemia. Fetal and neonatal growth was normal as was growth and development at 12 months. Case 2: A 36 year-old nulliparous woman was treated with a 20 gram carbohydrate-restricted Modified Atkins Diet (MAD) and lamotrigine, resulting in reduction of seizure frequency to once per month prior to pregnancy. Once pregnant, carbohydrates were increased to 30g. When seizures increased, lamotrigine dose was doubled. Urine ketones trended down during second trimester. A male was born with bilateral ear deformities of unknown significance. The child had a normal neurodevelopment at eight months. Non-pharmacological epilepsy therapies like KD and MAD may be effective during human pregnancy. However, safety still has to be established. Further monitoring to identify potential long term side effects is warranted. Copyright © 2017 British Epilepsy Association. All rights reserved.

  11. Chemotherapy-associated paronychia treated with 2% povidone–iodine: a series of cases

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    Capriotti K

    2017-06-01

    Full Text Available Kara Capriotti,1,2 Joseph Capriotti,1,3 Jesse Pelletier,1,3 Kevin Stewart1,3 1Veloce BioPharma LLC, Fort Lauderdale, FL, 2Bryn Mawr Skin and Cancer Institute, Rosemont, PA, 3Plessen Ophthalmology Consultants, Christiansted, VI, USA Background: Nail changes are known to occur during the use of chemotherapy for a variety of malignancies, particularly those treated with taxanes and EGFR inhibitors. There are currently no actively recruiting prospective clinical trials investigating potential treatments. There are also no US Food and Drug Administration-approved medical treatments for chemotherapy-associated paronychia and no consensus on the best way to treat these common chemotherapy-induced events. Methods: A retrospective review of all cases presenting to a single dermatology private practice from June 2016 to January 2017 identified nine patients with chemotherapy-associated paronychia seeking treatment. Each patient was prescribed a topical solution comprised of 2% povidone–iodine in a dimethylsulfoxide vehicle that was prepared by a licensed compounding pharmacy. Patients were seen at 3 week and 6 week follow-up visits. Results: All 9/9 patients demonstrated complete or partial resolution. The number of nails involved for each patient ranged from 4–12. There were a total of 58 nails affected in the case series, and 44/58 (76% resolved overall. The treatment was well tolerated. Conclusion: The topical povidone–iodine/dimethylsufoxide solution described is very effective in alleviating the signs and symptoms of paronychia associated with chemotherapy. This novel combination warrants further investigation in randomized, controlled trials to further elucidate its clinical utility. Keywords: paronychia, chemotherapy, taxanes, epidermal growth factor receptor inhibitor, povidone–iodine, dimethylsulfoxide

  12. Experience of managing complicated diverticulitis of colon: a retrospective case series from south asian country

    International Nuclear Information System (INIS)

    Gala, T.; Alvi, A.R.; Sheikh, G.M.; Habib, H.Y.; Ghafoor, Z.

    2014-01-01

    To assess the morbidity and mortality associated with complicated diverticulitis in Pakistan. Methods: The retrospective case series was conducted at an urban tertiary care university hospital of Karachi, Pakistan, comprising data from December 1989 to November 2010. International Classification of Diseases codes for diverticular disease and diverticulitis with abscess, fistula, stricture, bowel obstruction and perforation were obtained from the medical record department. SPSS 19 was used for statistical analysis. Results: A total of 60 (1.9%) cases with complicated diverticulitis were located from among 3170 records reviewed. Mean age was 62.7+-13 years with male-to-female ratio being 36:24. In 37 (62%) patients, the diagnosis was established on computed tomography scan of the abdomen, followed by barium enema in 12 (20%) and colonoscopy in 11 (18%). Post-operative morbidity was observed in 24 (40%) and 7 (16%) expired within 28 days of surgery. Post-operative intra-abdominal sepsis, wound dehiscence and incisional hernia were significantly associated with generalised peritonitis (p <0.05), while admission to intensive care unit was associated with age over 60 years and faecal peritonitis. Post-operative mortality was significantly associated with high American Society of Anaesthesiologists-score III and IV and age above 60 years. Conclusion: Complicated diverticulitis carries significant morbidity and mortality in Pakistani population. Since the trend is on the rise, therefore we propose a prospective multi-centre cohort study to understand the spectrum of disease, management and identification of risk factors to achieve the best possible outcomes in patients with complicated diverticulitis. (author)

  13. Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series

    Science.gov (United States)

    2013-01-01

    Background Bacterial infections account for most peritoneal dialysis (PD)-associated peritonitis episodes. However, anaerobic PD peritonitis is extremely rare and intuitively associated with intra-abdominal lesions. In this study, we examined the clinical characteristics of PD patients who developed anaerobic peritonitis. Methods We retrospectively identified all anaerobic PD peritonitis episodes from a prospectively collected PD registry at a single center between 1990 and 2010. Only patients receiving more than 3 months of PD were enrolled. We analyzed clinical features as well as outcomes of anaerobic PD peritonitis patients. Results Among 6 patients, 10 episodes of PD-associated peritonitis were caused by anaerobic pathogens (1.59% of all peritonitis episodes during study the period), in which the cultures from 5 episodes had mixed growth. Bacteroides fragilis was the most common species identified (4 isolates). Only 3 episodes were associated with gastrointestinal lesions, and 4 episodes were related to a break in sterility during exchange procedures. All anaerobic pathogens were susceptible to clindamycin and metronidazole, but penicillin resistance was noted in 4 isolates. Ampicillin/sulbactam resistance was found in 2 isolates. In 5 episodes, a primary response was achieved using the first-generation cephalosporin and ceftazidime or aminoglycoside. In 3 episodes, the first-generation cephalosporin was replaced with aminoglycosides. Tenckhoff catheter removal was necessary in 2 episodes. Only one episode ended with mortality (due to a perforated bowel). Conclusion Anaerobic PD-associated peritonitis might be predominantly caused by contamination, rather than intra-abdominal events. Half of anaerobic PD-associated peritonitis episodes had polymicrobial growth. The overall outcome of anaerobic peritonitis is fair, with a high catheter survival rate. PMID:23705895

  14. The electronic structure of the antimony chalcogenide series: Prospects for optoelectronic applications

    Energy Technology Data Exchange (ETDEWEB)

    Carey, John J.; Allen, Jeremy P. [School of Chemistry and CRANN, Trinity College Dublin, Dublin 2 (Ireland); Scanlon, David O. [University College London, Kathleen Lonsdale Materials Chemistry, 20 Gordon Street, London WC1H 0AJ (United Kingdom); Diamond Light Source Ltd., Diamond House, Harwell Science and Innovation Campus, Didcot, Oxfordshire OX11 0DE (United Kingdom); Watson, Graeme W., E-mail: watsong@tcd.ie [School of Chemistry and CRANN, Trinity College Dublin, Dublin 2 (Ireland)

    2014-05-01

    In this study, density functional theory is used to evaluate the electronic structure of the antimony chalcogenide series. Analysis of the electronic density of states and charge density shows that asymmetric density, or ‘lone pairs’, forms on the Sb{sup III} cations in the distorted oxide, sulphide and selenide materials. The asymmetric density progressively weakens down the series, due to the increase in energy of valence p states from O to Te, and is absent for Sb{sub 2}Te{sub 3}. The fundamental and optical band gaps were calculated and Sb{sub 2}O{sub 3}, Sb{sub 2}S{sub 3} and Sb{sub 2}Se{sub 3} have indirect band gaps, while Sb{sub 2}Te{sub 3} was calculated to have a direct band gap at Γ. The band gaps are also seen to reduce from Sb{sub 2}O{sub 3} to Sb{sub 2}Te{sub 3}. The optical band gap for Sb{sub 2}O{sub 3} makes it a candidate as a transparent conducting oxide, while Sb{sub 2}S{sub 3} and Sb{sub 2}Se{sub 3} have suitable band gaps for thin film solar cell absorbers. - Graphical abstract: A schematic illustrating the interaction between the Sb{sup III} cations and the chalcogenide anions and the change in their respective energy levels down the series. - Highlights: • The electronic structure of the antimony chalcogenide series is modelled using DFT. • Asymmetric density is present on distorted systems and absent on the symmetric telluride system. • Asymmetric density is formed from the mixing of Sb 5s and anion p states, where the anti-bonding combination is stabilised by the Sb 5p states. • The asymmetric density weakens down the series due to the increase in energy of chalcogenide p states. • The increase in energy of the anion p states reduces the fundamental and optical band gaps.

  15. Hookworm infestation in children presenting with melena-case series

    International Nuclear Information System (INIS)

    Saeed, A.; Cheema, H.A.; Alvi, A; Suleman, H.

    2008-01-01

    Hookworm infection is common in children and can present with symptoms of upper gastrointestinal bleeding and severe anemia. Ten children below 5 years presenting with me lena and severe pallor were seen from December 2006 to May 2007 in the gastroenterology and hepatology department of children's hospital, Lahore. All patients had history of transfusion. Complete blood picture, eosinophil count with peripheral smear, stool complete examination for ova and cysts were performed in all cases while upper and lower gastrointestinal Endoscopies were performed in three patients to locate the source of bleeding. Stool routine examination in all these cases confirmed hook worm ova. These patients were managed with Antihelmenthic and stool complete examination was done three days after the medicine. There was no mortality. Though upper gastrointestinal bleeding with hookworm infestation is very rare but in the developing Countries it should be considered when other causes of upper gastrointestinal bleeding are ruled out. (author)

  16. Hidradenitis Suppurativa and Crohn’s Disease: A Case Series

    LENUS (Irish Health Repository)

    Kirthi, S

    2017-09-01

    Hidradenitis Suppurativa (HS) is characterized by chronic recurrent abscesses, nodules and draining sinus tracts with scar formation. Cutaneous Crohn’s Disease (CD) may also present similarly. We wished to identify and describe an Irish cohort with combined HS and CD, with a view to a better recognition of clinical manifestations and understanding of the pathophysiology underlying these two overlapping conditions. Cases were identified using the HIPE Code at Tallaght Hospital from 1990-2014 and retrospective review was performed. Seven patients with both HS and CD were identified, 5(71%) female. The median age of diagnosis with both conditions was 37 years. In all cases, CD had preceded the diagnosis of HS. All patients smoked. Six had an increased BMI and 43% had additional autoimmune conditions. All patients required treatment with a TNF-alpha inhibitor for HS with 5 of 6 subjects having reduced frequency of flare ups and clinically less active HS on follow up

  17. Cutaneous Leishmaniasis – A Case Series from Dresden

    Directory of Open Access Journals (Sweden)

    Uwe Wollina

    2018-01-01

    Full Text Available Leishmaniasis is world-wide one of the most common infectious disorders caused by protozoa. Due to the climate change, there is a risk of further spread of the disease to central and northern Europe. Another important issue is the high number of refugees from Syria since Syria is one of the hot spots of Old World leishmaniasis. We report on single-centre experience with leishmaniasis in the capital of Saxony, Dresden, during the years 2001 to 2017. We noted a substantial increase in the last five years. Once a very rare exotic disorder in Germany, cutaneous leishmaniasis has become a reality and physicians should be aware of it. A significant number of cases are from Syrian refugees; other cases had been acquired by tourists in the Mediterranean region!

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

    Science.gov (United States)

    Gola, Mateusz; Potenza, Marc N

    2016-09-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

    Raza, Shahzad; Mahmood, Khalid; Hakeem, Abdul; Polsky, Sylvie; Haemel, Anna; Rai, Soniya; Ali Baig, Mahadi

    2009-01-23

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

  1. CLINICAL CHARACTERISTICS OF GOUT: A HOSPITAL CASE SERIES

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    GUN SC

    2011-01-01

    Full Text Available Introduction: Gout is an increasingly common medical problem. The traditional risk factors of male sex and high red meat or alcohol consumption have been joined with newer risks such as increased life expectancy, and the metabolic syndrome (hypertension, diabetes, dyslipidaemia, truncal obesity. Methods: This was a retrospective study to determine the epidemiology, clinical features, associated conditions as well as renal related conditions in existing gout patients followed-up in Rheumatology outpatient clinic, Hospital Tuanku Ja’afar, Seremban. Results: Over a three month period, we identified 54 gouty patients on our follow-up, the majority being male, Malay ethnicity, withthe age of onset in the third and fourth decades of life. Commonly associated risk factors were hypertension, hyperlipidaemia and obesity. However, underlying history of diabetes mellitus, alcohol consumption, and family history were not commonly associated with gout in our group of patients. Half of our patients had at least two or more joints involvement. About half of the patients with tophaceous gout had renal impairment. Conclusion: Our series of gout patients highlight the high prevalence of cardiovascular risk factors. The high prevalence of tophi and renal impairment is a cause for concern.

  2. Scleroderma in the Caribbean: characteristics in a Dominican case series.

    Science.gov (United States)

    Gottschalk, Paola; Vásquez, Ricardo; López, Persio David; Then, Jossiell; Tineo, Carmen; Loyo, Esthela

    2014-01-01

    Scleroderma is a rare disease with limited data in Latin America. Preliminary genetic studies suggest a strong African ascendance in the Dominican Republic, which could modulate the expression of the disease. The objective of this study is to describe the clinical and demographic characteristics of scleroderma in a series of 26 Dominican patients. Patients who fulfilled the EULAR/ACR criteria for scleroderma were selected from the Rheumatology Department of a tertiary health center; systemic sclerosis subtypes were defined according to the EULAR classification. Clinical and demographic information was obtained retrospectively from clinical records. Mean age at time of onset was 32.6±15 years; 68% of patients had 40 years of age or less. 73% of patients was feminine, with a female:male ratio of 2.7:1. The most affected systems were pulmonary and gastrointestinal; renal affection was scarce. Anti-Scl-70 antibodies were positive in 64% of patients, sometimes in coexistence with anti-centromere antibodies. The prevalence of systemic sclerosis is lower in the Dominican population than the reported elsewhere. The age of onset of the disease seems to be lower in the Dominican population than that reported in literature. A different pattern of autoantibodies is observed in this population. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

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

    OpenAIRE

    Talih, Farid; Ajaltouni, Jean

    2015-01-01

    The misuse of nootropics—any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters—may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects. We describe four cases of probable nootropic-induced psychiatric adverse effects to illustrate this theory. To the best of ou...

  4. Flatfoot in Müller-Weiss syndrome: a case series

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    Wang Xu

    2012-08-01

    Full Text Available Abstract Introduction Spontaneous osteonecrosis of the navicular bone in adults is a rare entity, known as Müller-Weiss syndrome. We report here on our experience with six patients with Müller-Weiss syndrome accompanied by flatfoot deformity, but on a literature search found no reports on this phenomenon. Because the natural history and treatment are controversial, an understanding of how to manage this deformity may be helpful for surgeons when choosing the most appropriate operative procedure. Case presentation Six patients (five women, one man; average age, 54 years with flatfoot caused by osteonecrosis of the navicular bone were followed up between January 2005 and December 2008 (mean follow-up period, 23.2 months. Conservative treatment, such as physical therapy, and non-steroidal anti-inflammatory drugs were used, but failed. Physical examinations revealed flattening of the medial arch of the involved foot and mild tenderness at the mid-tarsal joint. Weight-bearing X-rays (anterior-posterior and lateral views, computed tomography, and MRI scans were performed for each case. Talonavicular joint arthrodesis was performed in cases of single talonavicular joint arthritis. Triple arthrodesis was performed in cases of triple joint arthritis to reconstruct the medial arch. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale; the scores were 63.0 pre-operatively and 89.8 post-operatively. All patients developed bony fusion. Conclusions The reason for the development of flatfoot in patients with Müller-Weiss syndrome is unknown. Surgical treatment may achieve favorable outcomes in terms of deformity correction, pain relief, and functional restoration. The choice of operative procedure may differ in patients with both flatfoot and posterior tibial tendon dysfunction.

  5. Infective endocarditis associated with Bartonella henselae: A case series

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    Akio Nakasu

    Full Text Available Organisms in the genus Bartonella are cause of blood culture-negative endocarditis. Bartonella infective endocarditis is being increasingly reported worldwide; however, reports from Japan are limited. Here, we report five cases of infective endocarditis associated with Bartonella henselae. All patients had a history of contact with cats or fleas; this information helped achieve an appropriate diagnosis. Keywords: Infective endocarditis, Blood culture-negative endocarditis, Bartonella henselae, Infection, Bartonella, Endocarditis

  6. Incremental short daily home hemodialysis: a case series

    OpenAIRE

    Toth-Manikowski, Stephanie M.; Mullangi, Surekha; Hwang, Seungyoung; Shafi, Tariq

    2017-01-01

    Background Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients? residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. Case presentation From 2011 to 2015, we initiated 5 incident hemodialysis patients on an ...

  7. Cleft lip and palate: series of unusual clinical cases.

    Science.gov (United States)

    Paranaíba, Lívia Máris Ribeiro; Miranda, Roseli Teixeira de; Martelli, Daniella Reis Barbosa; Bonan, Paulo Rogério Ferreti; Almeida, Hudson de; Orsi Júnior, Julian Miranda; Martelli Júnior, Hercílio

    2010-01-01

    Cleft lip and/or palate (CL/P) represent the most common congenital anomalies of the face, corresponding to approximately 65% of all malformations of the craniofacial region. to describe unusual clinical cases of non-syndromic CL/P (CL/PNS), diagnosed in a reference service in Minas Gerais, Brazil, and correlate these alterations with possible risk factors. we carried out a retrospective study, between the years of 1992 and the 1st half of 2009, from medical records. Among the 778 cases of CL/PNS diagnosed in the period of 17 years, 5 (0.64%) were unusual CL/PNS, and all patients were male. It was found that among the 5 patients, 2 had incomplete right cleft lip with incomplete cleft palate, 2 were affected by left incomplete cleft lip and incomplete cleft palate, and 1 had a cleft lip and palate associated with complete right cleft palate. Risk factors such as consanguinity, maternal smoking and alcohol consumption, medication usage during pregnancy, history of abortion and/or stillbirths and maternal diseases were not associated with unusual CL/PNS. This study described 5 unusual cases of CL/PNS in a Brazilian population; no associations with the risk factors analyzed were seen. It also confirmed the unusualness of the prevalence of such alterations.

  8. Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

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    Weijun Wang

    2016-01-01

    Full Text Available Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL; postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes; no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n=1, 41–60 (n=1, and >60 (n=55; scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy.

  9. Hip disarticulation - case series analysis and literature review

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT OBJECTIVE: To present a retrospective study of 16 patients submitted to hip disarticulation. METHODS: During the period of 16 years, 16 patients who underwent hip disarticulation were identified. All of them were studied based on clinical records regarding the gender, age at surgery, disarticulation cause, postoperative complications, mortality rates and functional status after hip disarticulation. RESULTS: Hip disarticulation was performed electively in most cases and urgently in only three cases. The indications had the following origins: infection (n = 6, tumor (n = 6, trauma (n = 3, and ischemia (n = 2. The mean post-surgery survival was 200.5 days. The survival rates were 6875% after six months, 5625% after one year, and 50% after three years. The mortality rates were higher in disarticulations with traumatic (66.7% and tumoral (60% causes. Regarding the eight patients who survived, half of them ambulate with crutches and without prosthesis, 25% walk with limb prosthesis, and 25% are bedridden. Complications and mortality were higher in the cases of urgent surgery, and in those with traumatic and tumoral causes. CONCLUSION: Hip disarticulation is a major ablative surgery with obvious implications for limb functionality, as well as high rates of complications and mortality. However, when performed at the correct time and with proper indication, this procedure can be life-saving and can ensure the return to the home environment with a certain degree of quality of life.

  10. Acetabular fractures following rugby tackles: a case series

    Directory of Open Access Journals (Sweden)

    Morris Seamus

    2011-10-01

    Full Text Available Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting 'the tackle' to only two players may well reduce the likelihood of this life-altering injury.

  11. Acetabular fractures following rugby tackles: a case series

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-10-05

    Abstract Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting \\'the tackle\\' to only two players may well reduce the likelihood of this life-altering injury.

  12. Cerebral venous sinus thrombosis on MRI: A case series analysis

    Directory of Open Access Journals (Sweden)

    Sanjay M Khaladkar

    2014-01-01

    Full Text Available Background: Cerebral venous sinus thrombosis (CVST is a rare form of stroke seen in young and middle aged group, especially in women due to thrombus of dural venous sinuses and can cause acute neurological deterioration with increased morbidity and mortality if not diagnosed in early stage. Neurological deficit occurs due to focal or diffuse cerebral edema and venous non-hemorrhagic or hemorrhagic infarct. Aim and Objectives: To assess/evaluate the role of Magnetic Resonance Imaging (MRI and Magnetic Resonance Venography (MRV as an imaging modality for early diagnosis of CVST and to study patterns of venous thrombosis, in detecting changes in brain parenchyma and residual effects of CVST using MRI. Materials and Methods: Retrospective descriptive analysis of 40 patients of CVST diagnosed on MRI brain and MRV was done. Results: 29/40 (72.5% were males and 11/40 (27.5% were females. Most of the patients were in the age group of 21-40 years (23/40-57.5%. Most of the patients 16/40 (40% presented within 7 days. No definite cause of CVST was found in 24 (60% patients in spite of detailed history. In 36/40 (90% of cases major sinuses were involved, deep venous system were involved in 7/40 (17.5% cases, superficial cortical vein was involved in 1/40 (2.5% cases. Analysis of stage of thrombus (acute, subacute, chronic was done based on its appearance on T1 and T2WI. 31/40 (77.5% patients showed complete absence of flow on MRV, while 9/40 (22.5% cases showed partial flow on MR venogram. Brain parenchyma was normal in 20/40 (50% patients while 6/40 (15% cases had non-hemorrhagic infarct and 14/40 (35% patients presented with hemorrhagic infarct. Conclusion: Our study concluded that MRI brain with MRV is sensitive in diagnosing both direct signs (evidence of thrombus inside the affected veins and indirect signs (parenchymal changes of CVST and their follow up.

  13. Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases

    International Nuclear Information System (INIS)

    Bagla, Sandeep; Sayed, Dawood; Smirniotopoulos, John; Brower, Jayson; Neal Rutledge, J.; Dick, Bradley; Carlisle, James; Lekht, Ilya; Georgy, Bassem

    2016-01-01

    BackgroundRadiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.MethodsFifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval.ResultsTwenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported.ConclusionRFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

  14. Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases.

    Science.gov (United States)

    Bagla, Sandeep; Sayed, Dawood; Smirniotopoulos, John; Brower, Jayson; Neal Rutledge, J; Dick, Bradley; Carlisle, James; Lekht, Ilya; Georgy, Bassem

    2016-09-01

    Radiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM. Fifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval. Twenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported. RFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

  15. Multicenter Prospective Clinical Series Evaluating Radiofrequency Ablation in the Treatment of Painful Spine Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Bagla, Sandeep, E-mail: sandeep.bagla@gmail.com [Vascular Institute of Virginia, LLC (United States); Sayed, Dawood [University of Kansas Medical Center (United States); Smirniotopoulos, John [New York Presbyterian Hospital/Weill Cornell Medical Center (United States); Brower, Jayson [Providence Sacred Heart Medical Center and Children’s Hospital (United States); Neal Rutledge, J. [Seton Medical Center (United States); Dick, Bradley [Suburban Hospital (United States); Carlisle, James [St. Mark’s Hospital (United States); Lekht, Ilya [University of Southern California (United States); Georgy, Bassem [San Diego Imaging (United States)

    2016-09-15

    BackgroundRadiofrequency ablation (RFA) of vertebral body metastases (VBM) has been reported as safe and effective in retrospective studies. This single-arm prospective multicenter clinical study evaluates RFA in the treatment of painful VBM.MethodsFifty patients with VBM were prospectively enrolled during a 13-month period at eight US centers under an IRB-approved study. Percutaneous RFA was performed under imaging guidance with cement augmentation at the discretion of the operator. Pain, disability and quality of life were evaluated at baseline, prior to discharge, days 3, 7, 30 and 90 using the Numerical Pain Rating Scale, Oswestry Disability Index (ODI), the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) and Functional Assessment of Cancer Therapy Quality-of-Life Measurement in Patients with Bone Pain (FACT-BP). Adverse events were monitored throughout this time interval.ResultsTwenty-six male and 24 female patients (mean age 61.0) underwent 69 treatments (30 thoracic and 39 lumbar). Cement augmentation was performed in 96 % of reported levels. Significant improvement in mean scores for pain, disability and cancer-specific health-related quality of life from baseline to all time intervals was seen. NRPS improved from 5.9 to 2.1 (p < 0.0001). ODI improved from 52.9 to 37.0 (p < 0.08). FACT-G7 improved form 10.9 to 16.2 (p = 0.0001). FACT-BP improved from 22.6 to 38.9 (p < 0.001). No complications related to the procedure were reported.ConclusionRFA with cement augmentation safely and effectively reduces pain and disability rapidly, while increasing quality of life in patients suffering from vertebral body metastases.

  16. Management of pediatric mandibular fracture: a case series.

    Science.gov (United States)

    Agarwal, Ravi M; Yeluri, Ramakrishna; Singh, Chanchal; Chaudhry, Kalpna; Munshi, Autar K

    2014-09-01

    A pediatric mandibular fracture can cause a child severe pain and the parent or caregiver extreme worry. While the pattern of fractures and associated injuries in children is similar to adults, the incidence is low. Due to a number of factors, including the anatomical complexity of the developing mandible in a child, management of such fractures differs from that of adults and can greatly challenge the pediatric dentist. Various treatment modalities of managing mandibular fracture are available, such as closed/open cap splint with circummandibular wiring, arch-bar fixation, and cementation of the cap splint. This article reviews 19 cases in the management of pediatric facial fracture using varied treatment methods.

  17. Metoprolol-induced visual hallucinations: a case series

    Directory of Open Access Journals (Sweden)

    Goldner Jonathan A

    2012-02-01

    Full Text Available Abstract Introduction Metoprolol is a widely used beta-adrenergic blocker that is commonly prescribed for a variety of cardiovascular syndromes and conditions. While central nervous system adverse effects have been well-described with most beta-blockers (especially lipophilic agents such as propranolol, visual hallucinations have been only rarely described with metoprolol. Case presentations Case 1 was an 84-year-old Caucasian woman with a history of hypertension and osteoarthritis, who suffered from visual hallucinations which she described as people in her bedroom at night. They would be standing in front of the bed or sitting on chairs watching her when she slept. Numerous medications were stopped before her physician realized the metoprolol was the causative agent. The hallucinations resolved only after discontinuation of this medication. Case 2 was a 62-year-old Caucasian man with an inferior wall myocardial infarction complicated by cardiac arrest, who was successfully resuscitated and discharged from the hospital on metoprolol. About 18 months after discharge, he related to his physician that he had been seeing dead people at night. He related his belief that since he 'had died and was brought back to life', he was now seeing people from the after-life. Upon discontinuation of the metoprolol the visual disturbances resolved within several days. Case 3 was a 68 year-old Caucasian woman with a history of severe hypertension and depression, who reported visual hallucinations at night for years while taking metoprolol. These included awakening during the night with people in her bedroom and seeing objects in her room turn into animals. After a new physician switched her from metoprolol to atenolol, the visual hallucinations ceased within four days. Conclusion We suspect that metoprolol-induced visual hallucinations may be under-recognized and under-reported. Patients may frequently fail to acknowledge this adverse effect believing that they

  18. Head and neck squamous cell carcinoma in chronic areca nut chewing Indian women: Case series and review of literature.

    Science.gov (United States)

    Muttagi, Sidramesh Shivanand; Chaturvedi, Pankaj; Gaikwad, Rohith; Singh, Bikramjit; Pawar, Prashant

    2012-01-01

    Head and neck squamous cell carcinoma (HNSCC) is an important public health problem in India. Several risk factors such as tobacco, human papilloma virus, alcohol, areca nut usage have been extensively studied as causative agents. Though Areca nut chewing is known cause of oral cancer, its association with hypopharynx cancer has not been previously reported. Since areca nut is mostly consumed along with tobacco, it is uncommon to find patients who consume the areca nut alone. This is a prospective case series of ten women who presented to us with HNSCC with history of chewing of areca nut alone for several years. We have excluded all those cases where areca nut was consumed along with tobacco in any form. The data were prospectively collected with regard to clinical parameters, duration and frequency of areca nut usage, the socio-economic status and education level. All ten females had varying degree of submucous fibrosis and coexisting squamous cell carcinoma either in the oral cavity or hypopharynx. Submucous fibrosis was characterized by burning mouth, unhealthy oral mucosa, buried third molars, trismus, poor oral hygiene, etc. The disease presented in an advanced stage in majority of the cases. All patients were unaware of areca nut's deleterious effects. Areca nut chewing is an important risk factor for HNSCC in females. Despite plethora of information, little importance is given to areca nut control in cancer prevention campaigns in India.

  19. Hemophagocytic lymphohistiocytosis: a case series of a Brazilian institution

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    Daniela Guimarães Rocha Ferreira

    2014-12-01

    Full Text Available Objective:To describe the clinical and laboratory presentation of hemophagocytic lymphohistiocytosis in children treated at a referral institution.Methods:A retrospective descriptive study was carried out of seven children diagnosed with hemophagocytic lymphohistiocytosis between 2010 and 2012. The criteria for diagnosis were those proposed by the Histiocyte Society. When indicated, immunochemotherapy was prescribed according to the HLH94 and HLH2004 protocols of the Histiocyte Society.Results:The patients' ages at diagnosis ranged from one month to nine years. All patients had splenomegaly, fever, anemia, thrombocytopenia, hyperferritinemia and hypertriglyceridemia. Bone marrow hemophagocytosis was detected in six patients. In six cases, infectious diseases triggered the syndrome. In two cases, associated with visceral leishmaniasis, remission was achieved after treatment of the underlying infection. Three patients, who had Epstein–Barr-related hemophagocytic lymphohistiocytosis, required treatment with immunochemotherapy. They are alive and in remission; one patient had symptoms of juvenile rheumatoid arthritis and another, who was suspected of having primary hemophagocytic lymphohistiocytosis, entered into remission after bone marrow transplantation. Two deaths (28.6% occurred in patients with suspected primary hemophagocytic lymphohistiocytosis; one whose clinical picture was triggered by cytomegalovirus infection did not respond to immunochemotherapy and the other died before any specific treatment was provided.Conclusion:As reported before, hemophagocytic lymphohistiocytosis has a multifaceted presentation with nonspecific signs and symptoms. In secondary forms, remission may be achieved by treating the underlying disease. In the primary forms, remission may be achieved with immunochemotherapy, but bone marrow transplantation is required for cure.

  20. Safety of escitalopram in pregnancy: a case series.

    Science.gov (United States)

    Bellantuono, Cesario; Bozzi, Francesca; Orsolini, Laura

    2013-01-01

    The aim of this paper is to report maternal and neonatal outcomes in pregnant women treated with escitalopram during pregnancy and breastfeeding. Women enrolled in the DEGRA Database at the Clinic of Affective Disorders in Pregnancy and Postpartum in Italy, treated during pregnancy with escitalopram and followed up throughout pregnancy, were included in this study. All patients provided written informed consent and the study was approved by the local ethics committee. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition) Axis I Disorders and symptoms were assessed using the Hamilton Rating Scale for Depression (17 items) and Hamilton Rating Scale for Anxiety (14 items). Clinical and sociodemographic characteristics as well as maternal and neonatal outcomes were recorded. The case histories of seven pregnant women treated for depression and/or anxiety disorders with escitalopram were reported. Four women were also treated with benzodiazepines. All pregnancies were full-term and all newborns had normal Apgar scores. There were no major malformations or miscarriages following exposure to escitalopram. Mild withdrawal syndrome was reported only in a newborn who was also exposed to a benzodiazepine. Two infants exposed to escitalopram during breastfeeding did not show any health problems. Our experience with use of escitalopram in pregnant women did not reveal any maternal or neonatal concerns. However, considering the few cases analyzed and the paucity of published literature, no conclusions can be drawn on its safety profile in pregnancy and breastfeeding.

  1. Congenital portosystemic shunts with and without gastrointestinal bleeding - case series

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ying; Chen, Jun; Chen, Qi; Ji, Min; Pa, Mier; Qiao, Zhongwei [Children' s Hospital of Fudan University, Department of Radiology, Shanghai (China); Zhu, Hui [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Zheng, Shan [Children' s Hospital of Fudan University, Department of Surgery, Shanghai (China)

    2015-12-15

    The clinical presentation of congenital portosystemic shunt is variable and gastrointestinal bleeding is an uncommon presentation. To describe the imaging features of congenital portosystemic shunt as it presented in 11 children with (n = 6) and without gastrointestinal bleeding (n = 5). We performed a retrospective study on a clinical and imaging dataset of 11 children diagnosed with congenital portosystemic shunt. A total of 11 children with congenital portosystemic shunt were included in this study, 7 with extrahepatic portosystemic shunts and 4 with intrahepatic portosystemic shunts. Six patients with gastrointestinal bleeding had an extrahepatic portosystemic shunt, and the imaging results showed that the shunts originated from the splenomesenteric junction (n = 5) or splenic vein (n = 1) and connected to the internal iliac vein. Among the five cases of congenital portosystemic shunt without gastrointestinal bleeding, one case was an extrahepatic portosystemic shunt and the other four were intrahepatic portosystemic shunts. Most congenital portosystemic shunt patients with gastrointestinal bleeding had a shunt that drained portal blood into the iliac vein via an inferior mesenteric vein. This type of shunt was uncommon, but the concomitant rate of gastrointestinal bleeding with this type of shunt was high. (orig.)

  2. Pleuroperitoneal leak complicating peritoneal dialysis: a case series.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

  3. Complications during pharmacological stress echocardiography: a video-case series

    Directory of Open Access Journals (Sweden)

    Bigi Riccardo

    2005-09-01

    Full Text Available Abstract Background Stress echocardiography is a cost-effective tool for the modern noninvasive diagnosis of coronary artery disease. Several physical and pharmacological stresses are used in combination with echocardiographic imaging, usually exercise, dobutamine and dipyridamole. The safety of a stress is (or should be a major determinant in the choice of testing. Although large scale single center experiences and multicenter trial information are available for both dobutamine and dipyridamole stress echo testing, complications or side effects still can occur even in the most experienced laboratories with the most skilled operators. Case presentation We decided to present a case collection of severe complications during pharmacological stress echo testing, including a ventricular tachycardia, cardiogenic shock, transient ischemic attack, torsade de pointe, fatal ventricular fibrillation, and free wall rupture. Conclusion We believe that, in this field, every past complication described is a future complication avoided; what happens in your lab is more true of what you read in journals; and Good Clinical Practice is not "not having complications", but to describe the complications you had.

  4. Regression Discontinuity in Prospective Evaluations: The Case of the FFVP Evaluation

    Science.gov (United States)

    Klerman, Jacob Alex; Olsho, Lauren E. W.; Bartlett, Susan

    2015-01-01

    While regression discontinuity has usually been applied retrospectively to secondary data, it is even more attractive when applied prospectively. In a prospective design, data collection can be focused on cases near the discontinuity, thereby improving internal validity and substantially increasing precision. Furthermore, such prospective…

  5. A Case Study on Mathematical Literacy of Prospective Elementary School Teachers

    Science.gov (United States)

    Suharta, I. Gusti Putu; Suarjana, I. Made

    2018-01-01

    The purpose of this study is to describe Mathematical Literacy (ML) of Prospective Elementary School Teachers with attention to aspects of mathematical skills and gender. The type of research is qualitative with the research design of Case Study. Respondents are assigned 12 Prospective Elementary School Teachers, consisting of 6 men and 6 women.…

  6. Primary adenocarcinoma of the fallopian tube: a case series

    Directory of Open Access Journals (Sweden)

    Kemal Güngördük

    2007-09-01

    Full Text Available Primary fallopian tube carcinoma is a rare tumor that histologically and clinically resembles primary ovarian carcinoma. In this article, seven patients with primary fallopian tube carcinoma who were managed at our clinic between 2002 and 2007 were evaluated. All cases were treated by total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy,appendectomy and lymph node dissection followed by chemotherapy. Fallopian tube carcinoma is rarely suspected preoperatively. The symptom complex of ‘hydrops tubae profluence’, said to be pathognomonic for this tumor, is rarely encountered. Appropriate therapy for each stage of the disease should be defined, and further studies are required to better depict the clinical course and; prognostic factors.

  7. AKI associated with synthetic cannabinoids: a case series.

    Science.gov (United States)

    Bhanushali, Gautam Kantilal; Jain, Gaurav; Fatima, Huma; Leisch, Leah J; Thornley-Brown, Denyse

    2013-04-01

    SPICE, or K2, encompasses preparations of synthetic cannabinoids marketed as incense products, bath additives, and air fresheners and used for recreational purposes. These preparations are usually smoked for their cannabis-like effects and do not appear on routine urine toxicology screens. We report four cases of oliguric AKI associated with SPICE use in previously healthy men. All showed improvement in renal function without need for renal replacement therapy. Renal biopsy, performed in three of the patients, revealed acute tubular necrosis. The close temporal and geographic associations between the clinical presentation and the development of AKI strongly suggest an association between these SPICE preparations and AKI. Further investigations are required to identify the potential nephrotoxic agent(s). Nephrotoxicity from designer drugs should be included in the differential diagnosis of AKI, especially in young adults with negative urine drug screens.

  8. Sever hepatitis induced by Epstein-Barr virus: case series

    Directory of Open Access Journals (Sweden)

    Roushan Mohammad Reza Hasanjani

    2018-03-01

    Full Text Available Epstein-Barr virus (EBV is a causative agent of infectious mononucleosis syndrome. This infection often resolves over a period of several months without outcomes, but may occasionally be complicated by a great variety of neurologic, hepatic, hematologic and respiratory complications. In the current report, we present the case histories of three patients with acute hepatitis following EBV infection when previously healthy. The patients showed fever, nausea, weakness, as well as yellowing of the skin, and then in the course of examination, sore throat. They were managed supportively and their clinical condition improved. Liver function tests such as ALT, AST, ALP, were undertaken and bilirubin were elevated. The serological tests for EBV infection were consistent with the acute phase of infection. The monospot test was also positive. The patients were managed supportively, and their critical condition was improved.

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

    Science.gov (United States)

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

    2013-12-01

    Until lately warfarin was the only valuable oral anticoagulant in stroke reduction in high risk cases with non valvular atrial fibrillation (NVAF). Although with warfarin the rate of stroke reduced notably, the major concern is the risk of serious bleeding and difficulty of establishing and maintaining the international normalised ratio (INR) within the therapeutic range. With the development of the novel anticoagulants we now have for the first time since the innovation of Warfarin feasible alternatives to it to decrease stroke rates in high risk patients with NVAF. To diminish adverse bleeding events with the novel anticoagulant proper selection of patients prior starting treatment is essential. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  10. Marfan Syndrome in an Iranian Family: A Case Series

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Davari

    2015-07-01

    Full Text Available Marfan syndrome (MFS is a genetic disorder which is inherited by autosomal dominant traits. In MFS, lens displacement and cardiovascular involvement are important causes of morbidity and mortality in the clinical course of the disease. In this case study, the ocular involvement in a family with severe penetration of MFS is reported. Twelve members of a family (father, two daughters, three sons, and six grandchildren had MFS. Lens ectopia was the most common ophthalmic involvement among the family (100%. Other ocular involvements were as follows; Hypoplastic iris or ciliary’s muscle hypoplasia (50%, on gated eyeball (42%, flat cornea (30%, glaucoma and cataract (25%, retinal detachment (16%. Three members of the family underwent eye surgery including lens extraction, glaucoma surgery and retinal surgery.

  11. Electrical storm: case series and review of management.

    Science.gov (United States)

    Srivatsa, Uma N; Ebrahimi, Ramin; El-Bialy, Adel; Wachsner, Robin Y

    2003-09-01

    Electrical storm is defined as a recurrent episode of hemodynamically destabilizing ventricular tachyarrhythmia that usually requires electrical cardioversion or defibrillation. We describe three cases presenting with electrical storm under differing circumstances: (1) a 57-year-old man with ST-elevation myocardial infarction within 1 week of a posterior circulation stroke who developed refractory sustained ventricular tachycardia 10 days after an acute myocardial infarction; (2) a 65-year-old man who developed polymorphic ventricular tachycardia and ventricular fibrillation following dobutamine echocardiography; and (3) a 20-year-old woman who developed intractable ventricular fibrillation following an overdose of a weight-reduction pill. The management of electrical storm is discussed, and evolving literature supporting the routine use of intravenous amiodarone and beta-blockers in place of intravenous lidocaine is critically examined.

  12. Necrotising otitis externa in the immunocompetent patient: case series.

    Science.gov (United States)

    Unadkat, S; Kanzara, T; Watters, G

    2018-01-01

    Necrotising otitis externa can be a devastating form of otitis externa. It typically tends to affect patients who are immunocompromised or diabetic. To date, there is very little in the literature about necrotising otitis externa in the immunocompetent patient population. The present paper discusses both the clinical and radiological findings in three cases of necrotising otitis externa in an immunocompetent patient cohort. The common factor among all three patients was their advanced age. Diagnosing necrotising otitis externa can be challenging because of the potentially non-specific symptoms and the absence of early radiological signs, particularly if patients are neither immunocompromised nor diabetic. Elderly patients should be considered in the same light as immunocompromised and diabetic patients in the context of necrotising otitis externa.

  13. Case studies in rural recycling. Public service report series

    Energy Technology Data Exchange (ETDEWEB)

    Cosper, S.D.; Hallenbeck, W.H.; Brenniman, G.R.

    1994-02-01

    Due to state planning requirements and federal landfill regulations, solid waste management in rural areas (particularly recycling) has received much attention in recent years. The growth of recycling during the 1980s occurred mainly in urban and suburban areas. Therefore, rural recycling is still a relatively new enterprise. This report presents several rural recycling case studies from Colorado, Illinois, Indiana, Iowa, Minnesota, Tennessee, and Ontario, Canada to provide examples of successes and problems. This report also discusses the current issues of cooperative marketing of recyclables and municipal solid waste flow control. With respect to recycling, a rural region does not have ready access to markets for collected materials and has difficulty in generating easily marketable quantities of recyclables. (Copyright (c) 1994 The Board of Trustees of the University of Illinois.)

  14. Case series: Endoscopic management of fourth branchial arch anomalies.

    Science.gov (United States)

    Watson, G J; Nichani, J R; Rothera, M P; Bruce, I A

    2013-05-01

    Fourth branchial arch anomalies represent branchial anomalies and present as recurrent neck infections or suppurative thyroiditis. Traditionally, management has consisted of treatment of the acute infection followed by hemithyroidectomy, surgical excision of the tract and obliteration of the opening in the pyriform fossa. Recently, it has been suggested that endoscopic obliteration of the sinus tract alone using laser, chemo or electrocautery is a viable alternative to open surgery. To determine the results of endoscopic obliteration of fourth branchial arch fistulae in children in our institute. Retrospective case note review of all children undergoing endoscopic treatment of fourth branchial arch anomalies in the last 7 years at the Royal Manchester Children's Hospital. Patient demographics, presenting symptoms, investigations and surgical technique were analysed. The primary and secondary outcome measures were resolution of recurrent infections and incidence of surgical complications, respectively. In total 5 cases were identified (4 females and 1 male) aged between 3 and 12 years. All presented with recurrent left sided neck abscesses. All children underwent a diagnostic laryngo-tracheo-bronchoscopy which identified a sinus in the apex of the left pyriform fossa. This was obliterated using electrocautery in 1 patient, CO₂ laser/Silver Nitrate chemocautery in 2 patients and Silver Nitrate chemocautery in a further 2 patients. There were no complications and no recurrences over a mean follow-up period of 25 months (range 11-41 months). Endoscopic obliteration of pyriform fossa sinus is a safe method for treating fourth branchial arch anomalies with no recurrence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Safety of escitalopram in pregnancy: a case series

    Directory of Open Access Journals (Sweden)

    Bellantuono C

    2013-09-01

    Full Text Available Cesario Bellantuono, Francesca Bozzi, Laura Orsolini Psychiatric Unit and DEGRA Center, United Hospital and Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy Background: The aim of this paper is to report maternal and neonatal outcomes in pregnant women treated with escitalopram during pregnancy and breastfeeding. Methods: Women enrolled in the DEGRA Database at the Clinic of Affective Disorders in Pregnancy and Postpartum in Italy, treated during pregnancy with escitalopram and followed up throughout pregnancy, were included in this study. All patients provided written informed consent and the study was approved by the local ethics committee. Psychiatric diagnoses were assessed using the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition Axis I Disorders and symptoms were assessed using the Hamilton Rating Scale for Depression (17 items and Hamilton Rating Scale for Anxiety (14 items. Clinical and sociodemographic characteristics as well as maternal and neonatal outcomes were recorded. Results: The case histories of seven pregnant women treated for depression and/or anxiety disorders with escitalopram were reported. Four women were also treated with benzodiazepines. All pregnancies were full-term and all newborns had normal Apgar scores. There were no major malformations or miscarriages following exposure to escitalopram. Mild withdrawal syndrome was reported only in a newborn who was also exposed to a benzodiazepine. Two infants exposed to escitalopram during breastfeeding did not show any health problems. Conclusion: Our experience with use of escitalopram in pregnant women did not reveal any maternal or neonatal concerns. However, considering the few cases analyzed and the paucity of published literature, no conclusions can be drawn on its safety profile in pregnancy and breastfeeding. Keywords: escitalopram, pregnancy

  16. A Change of Heart: Case Series of Peripartum Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Sean Martin

    2013-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is an uncommon disease of pregnancy, occurring in about 1 in 2000 live births, and is characterized by the development of heart failure, due to left ventricular systolic dysfunction. It is associated with high rates of maternal and neonatal mortality. Cardiac disease is the leading cause of maternal death in the UK: PPCM accounts for about 17% of these. Clinical findings of decompensated heart failure (HF are often masked by the normal physiological changes seen in pregnancy making the diagnosis challenging. A high index of suspicion is essential—prompting referral for echocardiogram, which is crucial for diagnosis. Favourable prognosis is dependent on the early initiation of HF medications. Although full recovery occurs in around half of cases, left ventricular systolic dysfunction persists in a significant proportion of patients with PPCM and the risk of recurrence in subsequent pregnancies is high. The pathophysiology of PPCM is under intense research. We present four patients with PPCM and a review of the literature. Owing to the diagnostic challenge of PPCM and decompensated HF in pregnant mothers and its high mortality rate without treatment, prompt investigation and referral are key to improving maternal survival.

  17. Anaesthesia for parturients with severe cystic fibrosis: a case series.

    LENUS (Irish Health Repository)

    Deighan, M

    2014-02-01

    Cystic fibrosis affects 1 in 1600-2500 live births and is inherited in an autosomal recessive manner. It primarily involves the respiratory, gastrointestinal and reproductive tracts, with impaired clearance of, and obstruction by, increasingly viscous secretions. Severe respiratory disease, diabetes and gastro-oesophageal reflux may result. Improvements in medical management and survival of cystic fibrosis patients means more are committing to pregnancies. Although guidance for anaesthesia in this patient group is available, management and outcome data associated with more severe cases are sparse. Patients with severe cystic fibrosis require multidisciplinary input and should be managed in a tertiary referral centre. Close monitoring of respiratory function and preoperative optimisation during pregnancy are mandatory. The risk of preterm labour and delivery is increased. Pregnancy and delivery can be managed successfully, even in patients with FEV1 <40% predicted. Neuraxial anaesthesia and analgesia should be the technique of choice for delivery. Postoperative care should be carried out in a critical care setting with the provision of postoperative ventilation if necessary.

  18. 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.

  19. Light weight hollow maxillary complete denture: A case series

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    Laxman Singh Kaira

    2012-01-01

    Full Text Available Retention, stability and support are the basic principles on which the success of a complete denture relies on. The skill lies in applying these principles efficiently in critical situations. Residual ridge resorption occurs at a three times faster rate in mandibular arch than in the maxillary arch. The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased interarch space provide decreased support, retention and stability. The consequent weight of the processed complete denture only compromises them further. The severely resorbed jaw can have various treatment options. Extreme resorption of the maxillary denture-bearing area may lead to problems with prosthetic rehabilitation. The advantage of a hollow maxillary or mandibular denture is the reduction of excessive weight of acrylic resin, which normally replaces lost alveolar ridge in the interridge space of the denture wearer. This clinical report describes two case reports of edentulous patients with resorbed ridges where a simplified technique of fabricating a light weight hollow maxillary complete denture was used for the preservation of denture bearing areas.

  20. Familial tumoral calcinosis in two Chinese patients: a case series

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    Cheng Xiaoli

    2011-08-01

    Full Text Available Abstract Introduction Tumoral calcinosis is a rare and benign condition characterized by massive subcutaneous soft tissue deposits of calcium phosphate predominantly around large joints. Case presentation Familial tumoral calcinosis was present in two members of a Han Chinese family, namely, the son and daughter. The 14-year-old son had the first operation on his right sole of the foot at the age of six, and then experienced subsequent surgeries at a lesion in his right sole of the foot and left hip, respectively. The 16-year-old daughter underwent her first operation at the age of six in her left gluteal region, and subsequent surgeries were performed due to recurrence at the same lesion. Pathologic diagnoses of surgical specimens in both of the patients were reported as tumoral calcinosis. The laboratory results showed hyperphosphatemia with normal levels of serum calcium and alkaline phosphatase. Only surgical treatment was performed in both patients with satisfactory prognosis. Conclusion This is the first report of Chinese familial tumoral calcinosis. The etiopathogenisis and treatment are discussed.

  1. Patients with Acromegaly Presenting with Colon Cancer: A Case Series

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    Murray B. Gordon

    2016-01-01

    Full Text Available Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734. Colon cancer was identified in 2 patients (4.5%. Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon. A T1N1a carcinoma was surgically removed, and 1 of 22 lymph nodes was positive for metastatic disease, leading to a diagnosis of stage 3 colon cancer. Case  2 patient was a 50-year-old male with acromegaly who underwent transsphenoidal surgery to remove a 2 cm pituitary adenoma. The patient reported severe cramping and lower abdominal pain, and an invasive 8.1 cm3 grade 2 adenocarcinoma with signet rings was identified in the ascending colon and removed. Of the 37 lymph nodes, 34 were positive for the presence of tumor cells, and stage 3c colon cancer was confirmed. Conclusion. Current guidelines for colonoscopy screening at the time of diagnosis of acromegaly and at appropriate follow-up intervals should be followed.

  2. Remote Iliac Artery Endarterectomy: A Case Series and Systematic Review.

    Science.gov (United States)

    Bekken, Joost A; de Boer, Sanne W; van der Sluijs, Rogier; Jongsma, Hidde; de Vries, Jean-Paul P M; Fioole, Bram

    2018-02-01

    To evaluate the long-term results of remote iliac artery endarterectomy (RIAE) in 2 vascular referral centers and review existing literature. A retrospective analysis was conducted of 109 consecutive patients (mean age 64.2±10.7 years; 72 men) who underwent 113 RIAE procedures for lower limb ischemia from January 2004 to August 2015 at 2 vascular centers. The majority of limbs (82, 72.6%) had TASC II D lesions (31 TASC II C). Primary outcome measures were primary, assisted primary, and secondary patency. A comprehensive literature search was performed in the PubMed and EMBASE databases to identify all English-language studies published after 1990 reporting the results of RIAE. Technical success was achieved in 95 (84.1%) of the 113 procedures. The complication rate was 13.7%, and 30-day mortality was 0%. At 5 years, primary patency was 78.2%, assisted primary patency was 83.4%, and secondary patency was 86.7%. Hemodynamic success was obtained in 91.7% of patients, and clinical improvement was observed in 95.2%. Freedom from major amputation was 94.7% at 5 years. The systematic review comprised 6 studies including 419 RIAEs, and pooled data showed results similar to the current study. For external iliac artery occlusions extending into the common femoral artery, RIAE appears to be a valuable hybrid treatment option. It combines acceptable morbidity and low mortality with good long-term patency. It has some advantages over an open surgical iliofemoral bypass or complete endovascular revascularization and could be the best treatment option in selected cases.

  3. Improvement in hearing after chiropractic care: a case series

    Directory of Open Access Journals (Sweden)

    Di Duro Joseph O

    2006-01-01

    Full Text Available Abstract Background The first chiropractic adjustment given in 1895 was reported to have cured deafness. This study examined the effects of a single, initial chiropractic visit on the central nervous system by documenting clinical changes of audiometry in patients after chiropractic care. Case presentation Fifteen patients are presented (9 male, 6 female with a mean age of 54.3 (range 34–71. A Welch Allyn AudioScope 3 was used to screen frequencies of 1000, 2000, 4000 and 500 Hz respectively at three standard decibel levels 20 decibels (dB, 25 dB and 40 dB, respectively, before and immediately after the first chiropractic intervention. Several criteria were used to determine hearing impairment. Ventry & Weinstein criteria of missing one or more tones in either ear at 40 dB and Speech-frequency criteria of missing one or more tones in either ear at 25 dB. All patients were classified as hearing impaired though greater on the right. At 40 dB using the Ventry & Weinstein criteria, 6 had hearing restored, 7 improved and 2 had no change. At 25 dB using the Speech-frequency criteria, none were restored, 11 improved, 4 had no change and 3 missed a tone. Conclusion A percentage of patients presenting to the chiropractor have a mild to moderate hearing loss, most notably in the right ear. The clinical progress documented in this report suggests that manipulation delivered to the neuromusculoskeletal system may create central plastic changes in the auditory system.

  4. Unusual root canal morphology of mandibular second premolars: A case series and review

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    Snehal Sonarkar

    2017-01-01

    Full Text Available Mandibular second premolars (MSPs have varied anatomy ranging from 1 to 3 roots and 1–5 canals. Successful endodontic treatment is achieved by proper access opening, cleaning, and shaping and three-dimensional obturation. This case series describes five cases in which MSPs have been diagnosed with aberrant canal system. The Case 1 and 5 has one root with Vertucci's Type V canal configuration. The Case 2 has two roots with two canals, the Case 3 has one root with Vertucci's Type IV canal configuration, whereas the Case 4 has three roots with three canals. This case series also describes a classification for describing the root configuration. The clinical implications of this paper are first to reach at appropriate diagnosis of canal system using diagnostic aids (angulated radiographs and dental operating microscope. Second, to use advanced endodontic instruments for achieving successful endodontic therapy (NiTi rotary instruments.

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

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    Harvey William T

    2009-07-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  7. Hepatic Dysfunction in Asphyxiated Neonates: Prospective Case-Controlled Study

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    Mukesh Choudhary

    2015-01-01

    Full Text Available Objective This study was performed to determine the occurrence of hypoxic hepatitis in full-term neonates after perinatal asphyxia and to correlate between the rise in enzymes and severity of asphyxia with Apgar score and hypoxic ischemic encephalopathy (HIE grading of the neonates. Method and Material This prospective case-controlled study was conducted in a tertiary-level hospital in India for a period of 12 months. The study group A comprised 70 newborns suffering from birth asphyxia, while 30 healthy neonates were included in group B (control. All biochemical parameters of liver function, ie, serum alanine transferase (ALT, aspartate transferase (AST, alkaline phosphatase (ALP, lactate dehydrogenase (LDH, total protein, serum albumin, bilirubin (total and direct, and international normalized ratio (INR, were measured on postnatal days 1, 3, and 10 in both study and control groups. Results In group A, 22.8% newborns had severe (Apgar score 0–3, 47.1% had moderate (Apgar score 4–5, and 30% had mild (Apgar score 6–7 birth asphyxia at five minutes. In all, 14.28% babies were in HIE stage I, 25.73% babies were in HIE stage II, and 11.42% babies were in HIE stage III. The rest of the newborns, 48.57%, were normal. The prevalence of liver function impairment was seen in 42.85% of asphyxiated neonates. On day 1, ALT, AST, ALP, LDH, PT, and INR were significantly higher, and total protein and serum albumin were significantly lower in group A than in group B. However, ALT and AST correlated well with increasing severity of HIE score. On day 3, there was a rising trend observed in the concentration of mean LDH as HIE staging of neonates progressed from stage 0 to stage III, and among various HIE stages, the difference in LDH was statistically significant. Conclusion We concluded that AST, ALT at 24 hours, and LDH at 72 hours of animation can be a utilitarian diagnostic tool to differentiate asphyxiated neonates from non-asphyxiated neonates and

  8. Characteristics and demographics of reversible cerebral vasoconstriction syndrome: A large prospective series of Korean patients.

    Science.gov (United States)

    Choi, Hyun Ah; Lee, Mi Ji; Choi, Hanna; Chung, Chin-Sang

    2018-04-01

    Objectives To report demographics and characteristics of reversible cerebral vasoconstriction syndrome (RCVS) in the Korean cohort. Methods We prospectively recruited patients with definite (imaging-proven) RCVS and probable (imaging-negative) RCVS who visited Samsung Medical Center between June 2012 and September 2016. Clinical manifestations, neuroimaging, treatment, and clinical outcomes were evaluated in all patients. Characteristics of RCVS without typical causes ("idiopathic RCVS") were compared with those of RCVS with identifiable causes ("secondary RCVS"). International Classification of Headache Disorders (ICHD)-3 beta criteria for 6.7.3 RCVS and 6.7.3.1 probable RCVS were tested. Results A total of 138 patients (104 definite and 34 probable RCVS) were included in this study. Patients with definite RCVS were predominantly female (85.6%) and middle-aged (mean, 50.7 [range, 23-82] years). Probable RCVS was associated with less female predominance (70.6%, p = 0.049), more typical manifestations ( p < 0.001), and none of neurological complications. One-hundred and one (97.1%) patients with definite RCVS had headache, but the typical "recurrent and/or triggered" thunderclap headache was reported in only 83 (82.2%). In most patients with definite RCVS (84.6%), RCVS was idiopathic, while only 16 (15.4%) had secondary causes. Compared to those with secondary RCVS, patients with idiopathic RCVS were older (52.8 ± 11.42 vs. 39.1 ± 9.55 years, p < 0.001). Patients with secondary RCVS had more complications than those with idiopathic RCVS (40.5% vs. 12.5%, p = 0.018). Among idiopathic RCVS patients, 33 (37.5%) reported a preceding event or a change in lifestyle, environment, health, or medication within one month before onset. Conclusion In our cohort, RCVS was benign and idiopathic in most patients, and occurred frequently in middle-aged women. Manifestations of RCVS were more diverse than previously recognized, and forms without any

  9. Laboratory Computerization: The Case for a Prospective Analysis

    OpenAIRE

    Hurdle, John F.; Schwamm, Harry A.

    1982-01-01

    The argument is made that computerization of a laboratory should be preceeded by a thorough prospective analysis of laboratory operations. Points to be pondered include complementation of retrospective data, system cost justification, system performance justification, post-installation personnel adjustments, improved system utilization, improved manual performance, and insight into “how much” system to buy. A brief, general outline is offered describing how to approach such a study.

  10. Revised definition of neuropathic pain and its grading system: an open case series illustrating its use in clinical practice.

    Science.gov (United States)

    Geber, Christian; Baumgärtner, Ulf; Schwab, Rainer; Müller, Harald; Stoeter, Peter; Dieterich, Marianne; Sommer, Clemens; Birklein, Frank; Treede, Rolf-Detlef

    2009-10-01

    The definition of neuropathic pain has recently been revised by an expert committee of the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG) as "pain arising as direct consequence of a lesion or disease affecting the somatosensory system," and a grading system of "definite," "probable," and "possible" neuropathic pain has been introduced. This open case series of 5 outpatients (3 men, 2 women; mean age 48 +/- 12 years) demonstrates how the grading system can be applied, in combination with appropriate confirmatory testing, to diagnosis neuropathic conditions in clinical practice. The proposed grading system includes a dynamic algorithm that enhances the physician's ability to determine with a greater level of certainty whether a pain condition is neuropathic. Its clinical use should be further validated in prospective studies.

  11. Síndrome de Gorlin-Goltz: Serie de 7 casos Gorlin-Goltz Syndrome: A 7 cases serie

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    S. Rosón-Gómez

    2009-10-01

    Full Text Available El Síndrome Névico Basocelular (SNBC o Síndrome de Gorlin- Goltz es un trastorno autosómico dominante, caracterizado principalmente por carcinomas basocelulares, múltiples queratoquistes y anomalías esqueléticas. El presente trabajo revisa a este desconocido síndrome dada la importancia que tiene para nosotros como especialistas. Presentamos un total de siete casos recogidos por el Servicio Cirugía Oral y Maxilofacial desde 1992 al 2008, con seguimiento medio de 10 años, determinamos la frecuencia de las características clínicas en nuestra serie de SNBC y el manejo terapéutico de las mismas.Nevoid Basal Cell Carcinoma Syndrome (NBCSS or Gorlin-Goltz Syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts and skeletal anomalies. This report reviews current knowledge of this disorder that is important to us as specialists. The authors reviewed seven case files from the Department of Oral and Maxillofacial Surgery of H. U. La Princesa from 1992-2008. The average follow up was 10 years; we determine the frequency of the clinical features and treatment in our series of NBCCS.

  12. A lifestyle intervention program for successfully addressing major cardiometabolic risks in persons with SCI: a three-subject case series.

    Science.gov (United States)

    Bigford, Gregory E; Mendez, Armando J; Betancourt, Luisa; Burns-Drecq, Patricia; Backus, Deborah; Nash, Mark S

    2017-01-01

    This study is a prospective case series analyzing the effects of a comprehensive lifestyle intervention program in three patients with chronic paraplegia having major risks for the cardiometabolic syndrome (CMS). Individuals underwent an intense 6-month program of circuit resistance exercise, nutrition using a Mediterranean diet and behavioral support, followed by a 6-month extension (maintenance) phase involving minimal support. The primary goal was a 7% reduction of body mass. Other outcomes analyzed insulin resistance using the HOMA-IR model, and plasma levels of fasting triglycerides and high-density lipoprotein cholesterol. All participants achieved the goal for 7% reduction of body mass and maintained the loss after the MP. Improvements were observed in 2/3 subjects for HOMA-IR and high-density lipoprotein cholesterol. All participants improved their risk for plasma triglycerides. We conclude, in a three-person case series of persons with chronic paraplegia, a lifestyle intervention program involving circuit resistance training, a calorie-restrictive Mediterranean-style diet and behavioral support, results in clinically significant loss of body mass and effectively reduced component risks for CMS and diabetes. These results were for the most part maintained after a 6-month MP involving minimal supervision.

  13. Case series

    African Journals Online (AJOL)

    abp

    13 janv. 2015 ... Abstract. Les fractures du capitulum sont rares. Leur prise en charge initiale doit être précoce et efficace en raison des risques engendrés sur le coude : rigidité, instabilité, arthrose. De nombreux traitements ont été proposés. Notre étude décrit le vissage par vis d'Herbert pratiqué chez trois patientes ...

  14. Case series

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    abp

    3 mai 2014 ... connaissance, hormis la technique d'hémostase endoscopique, avant polypectomie, à l'aide d'une anse largable en nylon. (endoloop) décrite pour la première fois en 1989 par Hachisu [8, 9], aucune autre technique similaire n'a été rapportée dans la littérature. La décision de résection endoscopique du ...

  15. Case series

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    ebutamanya

    3 nov. 2015 ... L'hémostase était réalisée par l'application d'une colle biologique au niveau du lit de résection et des berges de section, associé à des points en U à base du vicryl 2/0 ou 0 sur le parenchyme rénal avec des pansements hémostatiques type SURGYCEL ou SPONGEL. Un drain de Redon non aspiratif était ...

  16. Case series

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    ebutamanya

    autres causes d'hémorragies ont été décrites. Il s'agit de: une blessure ou un embrochage du foie par un écarteur ou un instrument; une plaie vasculaire; un mauvais contrôle de l'artère cystique ou un mauvais décollement de la ...

  17. Case series

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    abp

    11 août 2015 ... le pronostic vital tout en encadrant l'hémostase chirurgicale. Cependant la réanimation a sa propre morbi-mortalité qui vient s'ajouter à celle de l'évènement hémorragique. L'objectif de notre étude était de décrire le profil épidémiologique des patientes qui ont été prises en charge en milieu de réanimation ...

  18. Case series

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    abp

    6 mai 2016 ... during the anatomopathological exam, giving us a 3.38% prevalence. The average age of ... basedowifié, et 1 cas de maladie de basedow. L'âge moyen des ... papillaire. Un traitement par l'iode radioactif a été indiqué chez 5.

  19. Case series

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    abp

    4 déc. 2017 ... Cancer du sein chez l'homme: à propos de 40 cas et revue de la ... age was 62 years, the mean consultation time was 12 months, self-exam of a peri- ... 7,5%) et la maladie de Paget a été retrouvé dans 1 cas (soit 2,5%).

  20. Case series

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    abp

    29 juin 2017 ... littérature pour les hémoglobinopathies [11, 12]. L'anisocytose ... protection sociale dans notre pays pour toutes les couches de la société et la .... journal of medical sciences. 2010; 8(1): 71- ... Revue Marocaine de Médecine ...

  1. Case series

    African Journals Online (AJOL)

    ebutamanya

    7 mai 2014 ... source lumineuse Heine HK 7000. La désinfection du matériel réutilisable s'est faite dans quatre bacs contenant respectivement un décontaminant (Cytéal®), de l'eau propre, du glutaraldéhyde. (Endosporine®, Stéranios® 2%) puis de l'eau propre. Résultats. Durant la période de notre étude, 645 patients ...

  2. Case series

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    abp

    28 avr. 2014 ... Yáñez-Vico RM, Iglesias-Linares A, Gómez-Mendo I, et al. A descriptive epidemiologic study of cleft lip and palate in Spain. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114 (Suppl. 5): S1-4. PubMed | Google Scholar. 25. Lilius GP. Clefts with associated anomalies and syndromes in. Finland. Scand J ...

  3. Case series

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    abp

    29 juin 2016 ... Role of biliary MRI in etiological diagnosis of cholestatic icteruses in Dakar. Nfally Badji1,& ... This is an Open Access article distributed under the terms of the Creative Commons Attribution. License .... contraste en T1 gadolinium. Elles étaient ..... Malignant perihilar biliary obstruction: magnetic resonance.

  4. Case series

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    abp

    13 oct. 2013 ... Les facteurs de mauvais pronostic retrouvés étaient l'âge tardif de la chirurgie, la densité de la cataracte et la survenue de complications (p = 0,001). ..... Comment prevenir et gérer les complications post- opératoires? ... oculaire pouvant aller de +0,4 dioptries (D) à la naissance à -0,5 D à l'âge adulte [32], ...

  5. Case series

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    abp

    21 oct. 2013 ... transversal chez six patients qui ont présenté une instabilité de la radio ulnaire distale. L'immobilisation par attelle ... Chez 07 de nos patient qui présentés des luxations de la RUD très instable on a eu recours à un ... sportive antérieure sans gène fonctionnel et les 05 autres pour la plupart non satisfait à ...

  6. Case series

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    raoul

    24 août 2011 ... Le traitement adjuvant de l'ATL et traitement de sortie : Le traitement à base des anti GP IIb IIIa a été prescrit chez 15,5% du l'ensemble de la population, avec ..... Wiviott SD, Cannon CP, Morrow DA, Murphy SA, Gibson CM, Mc- Cabe CH, Sabatine MS, Rifai N, Giugliano RP, DiBattiste PM, et al. Differential ...

  7. Case series

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    ebutamanya

    4 févr. 2015 ... articulaire renforcé par un hauban par un fils d'acier 1,4 (Figure 2). Une immobilisation par une écharpe du membre supérieur est préconisée pendant 4 semaines. Une mobilisation douce et progressive est débutée après sédation de la douleur. L'ablation de matériels est réalisée à 5 mois en moyenne ...

  8. Case series

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    abp

    26 déc. 2017 ... Peut-on améliorer la motivation des étudiants en médecine pour ... est l'une des trois composantes majeures de cette motivation. ... cours fondamental de physiologie et d'évaluer l'impact de l'intégration de quelques .... compétences requises pour l'exercice de la médecine générale. Cet .... Les recherches.

  9. Case series

    African Journals Online (AJOL)

    abp

    2015-05-07

    May 7, 2015 ... Key words: Pregnancy, maternal death, Yaoundé, Cameroon, causes, risk factors ... This is an Open Access article distributed under the terms of the .... variable and the unacceptable high rates of maternal deaths, efforts.

  10. Case series

    African Journals Online (AJOL)

    cqq1a

    4 nov. 2010 ... L'examen échographique a été réalisé à l'aide d'un échographe Logic 200 de marque General Electric muni d'une sonde de 3,5 MHZ et de 7,5 MHz. Il a consisté en une ... Les formes diffuses ou infiltrantes à limites imprécises ont été considérées d'emblée comme de grosses tumeurs. L'échogénicité des ...

  11. Case series

    African Journals Online (AJOL)

    abp

    26 mars 2014 ... Le siège de prédilection a été les plis inter-orteils, suivi par les ongles et les plantes des pieds. Le Trichophyton rubruma été le principal agent en cause des lésions mycosiques (28,23%), Il a été retrouvé sur 24 cultures parmi les 85 cultures positives. Dans cette étude, les mycoses ont été significativement ...

  12. Case series

    African Journals Online (AJOL)

    abp

    7 nov. 2017 ... and 21 years with sickle cell disease SS during the intercritical period, ... In the child, first crisis was dominated by vaso-occlusive crisis (32.6%) ... All patients had anemia with an average hemoglobin of 08,6 g/dl [05,7-11,8].

  13. Case series

    African Journals Online (AJOL)

    abp

    12 janv. 2013 ... Abstract. L'arthroplastie de la hanche est un moyen fiable dans le traitement des affections de la hanche. En lui rendant sa mobilité sa stabilité et son indolence. Cependant cette chirurgie prothétique expose au risque de la survenue des complications qui peuvent engager le pronostic fonctionnel.

  14. Case series

    African Journals Online (AJOL)

    abp

    4 déc. 2017 ... &Corresponding author: Meriem Elbachiri, Centre Mohamed VI pour le Traitement Des Cancers, Casablanca, Maroc. Mots clés: Homme, cancer du ... Abstract. Breast cancer in men is rare, accounting for approximately 1% of all breast cancers and less than 1% of all neoplasias in men. This study aimed to.

  15. Case series

    African Journals Online (AJOL)

    abp

    13 oct. 2017 ... Les traits de fracture étaient métaphyso-métaphysaire disto-proximal 3 fois, diaphyso métaphysaires proximaux 4 fois, diaphyso-diaphysaires 8 fois et diaphyso métaphysaires distaux 1 fois. La fibula était fracturée dans tous les cas. Le foyer proximal tibial était simple 11 fois, à coin ou comminutif 5 fois et le ...

  16. Case series

    African Journals Online (AJOL)

    raoul

    2011-03-22

    Mar 22, 2011 ... The thoracic x-ray found a left basal site; hence the patient was initially treated ... assessment found a hyperleukocytosis at 13000 elements/mm³. ... homogeneous or heterogeneous mass, the attenuation coefficient is not.

  17. Case Series

    African Journals Online (AJOL)

    Introduction: Therapy with vitamin D3 analogs suppress the parathyroid hormone (PTH) secretion in ... day for phosphate binding and intravenous paricalcitol. Paricalcitol was initiated at 0.01 μg/kg according to the .... Turner S, Charytan C. Cinacalcet HCl and concurrent low-dose vitamin D improves treatment of secondary.

  18. Case series

    African Journals Online (AJOL)

    cqq1a

    7 oct. 2010 ... ayant un retentissement sur l'axe hypothalamo-hypophysaire avec une TSHus élevée ont bénéficié d'un traitement substitutif hormonal à base de la L-thyroxine (LEVOTHYROX®), à doses progressives. La dose journalière initiale était de 50 µg. Pour le reste des patients en hypothyroïdie biologique (au ...

  19. Case series

    African Journals Online (AJOL)

    abp

    hémodialyse chronique en raison de sa longévité, son taux faible de complication et de mortalité par rapport aux pontages artério-veineux et aux cathéters. Cependant, il arrive assez souvent que l'on assiste à des.

  20. Case series

    African Journals Online (AJOL)

    abp

    14 janv. 2013 ... actuel, l'âge avancé à la mise en hémodialyse, le sexe féminin, l'excès pondéral, et l'abord vasculaire. Le SCC est une complication fréquente de l'hémodialyse chronique. L'amélioration de la qualité de dialyse permettrait de réduire le risque de survenue du SCC. Pan African Medical Journal. 2013 ...

  1. Case series

    African Journals Online (AJOL)

    abp

    étude. En effet de 100% à J1, le taux de patients vus en post opératoire est passé à 98,33% à J15, 95,33% à J30, et. 75% à J60. Une amélioration de l'acuité visuelle chez certains patients peut les conduire à juger inutile de ...

  2. Case series

    African Journals Online (AJOL)

    abp

    28 août 2013 ... rendez-vous a été pris pour la collecte des données. Les personnes contactées ont été les greffiers du juge d'instruction, le greffier du greffe correctionnel du tribunal de grande instance, le greffier de la cour criminelle et le greffier en chef. Seuls les dossiers ayant eu une décision de justice ont été retenu.

  3. Case series

    African Journals Online (AJOL)

    abp

    10 juin 2014 ... appliquer de la glace et à effectuer une mobilisation précoce de l'articulation dès l'arrêt de la douleur. Les hémorragies extériorisées peu graves étaient traitées par une pression locale continue. Tous les accidents étaient notés sur un cahier que le médecin consultait au cours des rendez-vous trimestriels.

  4. Case series

    African Journals Online (AJOL)

    abp

    16 déc. 2015 ... ... d'Oncologie Médicale, Institut National d'Oncologie de Rabat, CHU Ibn Sina, BP 6213 Rabat, Maroc ..... plus actif que l'administration en continue [4]. ... formation de ponts stables, par des liaisons covalentes, entre les.

  5. Case series

    African Journals Online (AJOL)

    raoul

    13 mars 2011 ... 1Service de neurochirurgie, CHU Hassan II, Fès, Maroc .... par la consolidation du foyer lésionnel et la formation du bloc vertébral dans un .... continue à être partagée entre le traitement médical exclusif et le traitement ...

  6. Case series

    African Journals Online (AJOL)

    abp

    13 sept. 2017 ... Abdellah, Fès, Maroc, 3Pôle de Biologie Médicale, Hôpital Militaire Moulay Ismail ..... augmentation de la fréquence des EBLSE dans notre formation ou .... thérapeutiques et entretient une hausse continue de la prescription.

  7. Case series

    African Journals Online (AJOL)

    abp

    14 janv. 2013 ... 1Service de néphrologie, CHU Hassan II, Fès, Maroc, 2Service de neurologie, CHU Hassan II, .... glyosaminoglycanes rentrant dans la formation des dépôts .... articulaires des patients traités par dialyse péritonéale continue.

  8. Case series

    African Journals Online (AJOL)

    abp

    7 août 2013 ... service de néphrologie et dialyse de l'hôpital militaire de Rabat, Maroc ... concernant les patients mis en hémodialyse dans notre formation entre le 01 janvier 2006 et le .... continue de constituer une cause fréquente d'IRCT.

  9. Case series

    African Journals Online (AJOL)

    ebutamanya

    10 mars 2015 ... 1Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc. &Corresponding .... particulier néonatale qui reste déficitaire dans notre formation. Ces .... être continue avec une surveillance clinique et échographique mensuelle à ...

  10. Case series

    African Journals Online (AJOL)

    ebutamanya

    5 juin 2015 ... survenant lors du jeu ou des repas. Il survient habituellement chez des personnes ayant un développement normal. Il peut être favorisé par un terrain particulier: retard mental, trisomie ou toute autre infirmité psychomotrice. Dans la majorité des publications [2-5], la localisation auriculaire prédomine entre ...

  11. Case series

    African Journals Online (AJOL)

    ebutamanya

    28 août 2015 ... Les tumeurs de l'enfant sont dominées par les tumeurs du blastème, les lymphomes et les sarcomes. Ces derniers peuvent se présenter sous forme de tumeurs à petites cellules rondes [1]. La biopsie radioguidée percutanée joue un rôle de plus en plus croissant dans le diagnostic et la prise en charge.

  12. Case series

    African Journals Online (AJOL)

    abp

    2015-02-17

    Feb 17, 2015 ... Marrakesh, from January 2004 to December 2009, were included in this retrospective study. Early seizures were defined as seizures occurring within 7 days from acute stroke according to the international league against epilepsy guidelines (1993). Patients with history of epilepsy, transient ischemic attack, ...

  13. Case series

    African Journals Online (AJOL)

    abp

    23 nov. 2015 ... tête chez les adolescentes et les jeunes femmes adultes. Celles-ci ont souvent la mauvaise habitude de tenir ces épingles dans la bouche pendant l'arrangement de leur voile. L'inhalation accidentelle de ces épingles aboutit le plus souvent à leur localisation dans l'arbre trachéo-bronchite chez ce groupe ...

  14. Case series

    African Journals Online (AJOL)

    abp

    . Une position inhabituelle permettant une pénétration particulièrement profonde de la verge (décubitus dorsal avec hyper flexion des cuisses, position assise), la brutalité ou une hâte excessive sont souvent à l'origine de ces ...

  15. Case series

    African Journals Online (AJOL)

    abp

    11 déc. 2015 ... du manuscrit. Figures. Figure 1: Obésité et vergetures abdominales chez une jeune adolescente avec maladie de cushing. Figure 2: Retard staturo-pondéral et obésité chez une patiente avec maladie de Cushing. Figure 3: Signes cliniques retrouvés chez les adolescents avec un syndrome de Cushing.

  16. Case series

    African Journals Online (AJOL)

    abp

    5 mars 2013 ... Cervical necrotizing fasciitis: clinical manifestations and management. Clin infect Dis. 1995;21: 51-6. PubMed | Google Scholar. 10. Pignat J C, Haguenauer J P, Navailles B. Les cellulites cervicales diffuses spontanées à anaérobies. Rev Laryngol. 1989;110: 141-4. PubMed | Google Scholar. 11. Ennouri A ...

  17. Case series

    African Journals Online (AJOL)

    abp

    2017-10-18

    Oct 18, 2017 ... phenytoin and phenobarbital) drugs. It is often life threatening ... Haemorrhages of gastrointestinal system, mucosal membranes and skin can ... disease, but parenteral administration of vitamin K is required for the late disease ...

  18. Case series

    African Journals Online (AJOL)

    abp

    2015-02-27

    Feb 27, 2015 ... from 2008-2012 and identified 7 patients with symptomatic Hoffa's fat pad impingement. ... physiotherapy program to strengthen the quadriceps power and ... apprehension, or antalgic block during terminal extension [1,12].

  19. Case series

    African Journals Online (AJOL)

    ebutamanya

    3 mai 2016 ... suivants: hémocultures (7 cas, 50%), examen bactériologique d'un prélèvement de l'articulation sacro-iliaque dans (4 cas, 29%), ECBU. (2 cas, 15%), examen ..... 5. 13. Malghem J, Vande Berg BC, Lecouvet FE, Simoni P, Maldague. B. Principes d'interprétation de l'imagerie des articulations sacroiliaques.

  20. Case series

    African Journals Online (AJOL)

    abp

    26 avr. 2016 ... Les gestes vitaux, les médicaments utilisés ainsi que l'évolution ont été notés. ... to describe the aspects of its management and its evolution in the short term. ..... Tonleu E C. Evaluation de la qualité des soins essentiels offerts.

  1. Case series

    African Journals Online (AJOL)

    abp

    2012-07-24

    Jul 24, 2012 ... Moreover, fine needle aspiration and biopsy are often not diagnostic due to oncocytoma .... Dechet CB, Sebo T, Farrow G, Blute ML, Engen DE, Zincke H. ... Licht MR, Novick AC, Tubbs RR, Klein EA, Levin HS, Streem SB.

  2. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-06-22

    Jun 22, 2015 ... entity, few data are available on its features and none of them involves patients in North Africa. To date, there is no explicit consensus to sets PDTC patients' management. This study intended to report the experience of a tertiary medical centre in Morocco by reporting patients' features, clinical stage at the ...

  3. Case series

    African Journals Online (AJOL)

    raoul

    18 janv. 2012 ... d'asthme, d'une affection cardiaque préexistante (valvulopathie ou une autre atteinte), de prise d'anorexigènes. Nous avons en outre apprécié les données cliniques (dont les signes fonctionnels cardio-vasculaires, dermatologiques), les signes généraux (constantes hémodynamiques, état général), les ...

  4. Case series

    African Journals Online (AJOL)

    abp

    15 avr. 2014 ... football :20, tennis :cinq ,basketball :trois, ,handball :deux, , non précisé :15) ;un traumatisme indirect .... Lansdaal JR, Goslings JC, Reichart M, Govaert GA, et al. Les résultats de 163 ruptures de tendon d'Achilles traités la chirurgie mini invasive et post traitement fonctionnel. Injury. 2007 ; 38(7) : 839-844.

  5. Case series

    African Journals Online (AJOL)

    abp

    24 juil. 2015 ... work is properly cited. Pan African Medical Journal – ISSN: 1937- 8688 .... Ceci pourrait être expliqué par les variations des habitudes tabagiques et des composants des cigarettes [6-8]. .... Thun MJ, Lally CA, Flannery JT, Calle EE, Flanders WD, Heath. CW JR. Cigarette smoking and changes in the ...

  6. Case series

    African Journals Online (AJOL)

    ebutamanya

    21 août 2015 ... Papa Adama Dieng et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons. Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, ...

  7. Case series

    African Journals Online (AJOL)

    abp

    3 janv. 2013 ... Abstract. La maladie de Wilson ou dégénérescence hépato-lenticulaire est une affection génétique autosomique récessive caractérisée par une accumulation toxique de cuivre dans l'organisme, essentiellement dans le foie, le système nerveux central et la cornée. L'objectif de ce travail était de soulever.

  8. Case series

    African Journals Online (AJOL)

    abp

    27 févr. 2015 ... Abstract. L'association pancréatite aigue et grossesse est rare mais non exceptionnelle, le diagnostic de la pancréatite au cours de la grossesse est difficile, vu la non spécificité de la symptomatologie et vu que très souvent les douleurs et les vomissements peuvent être rattachés à la grossesse elle-.

  9. Case series

    African Journals Online (AJOL)

    abp

    2 déc. 2015 ... Abstract. Les pyélonéphrites aigues gravidiques (PNAg) sont fréquentes et peuvent avoir des conséquences maternelles et fœtales graves. Le but de notre étude était de déterminer les facteurs prédictifs cliniques, biologiques et radiologiques qui permettent de se limiter au traitement médical ou d'associer ...

  10. Case series

    African Journals Online (AJOL)

    abp

    2015-11-23

    Nov 23, 2015 ... HF, TI, AI. Pneumonia. Tricuspid vegetations, TI, AI, severe PAH. BC: Negative leukocytosis. Hyperfibrinogenaemia. CRP: positive. HF. Favorable. 3. 43. F. Fever. TI. Tricuspid vegetations, TI. HC: Negative. Hyperfibrinogenaemia. CRP: positive. Pulmonary embolism. 4. 27. F. Fever. TI. Right pleural effusion.

  11. Case series

    African Journals Online (AJOL)

    ebutamanya

    14 oct. 2015 ... Leys D. Ischemic strokes in young adults. Rev Médecine. Interne Fondée Par Société Natl Francaise Médecine Interne. 2003 Sep; 24(9):585-93. PubMed | Google Scholar. 6. Razzaq AA, Khan BA, Baig SM. Ischemic stroke in young adults of South Asia. JPMA J Pak Med Assoc. 2002 Sep; 52(9):417-22.

  12. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-12-17

    Dec 17, 2015 ... Am Rev Respir Dis. 1988 Apr;137(4):969-78. PubMed. | Google Scholar. 4. Minov J, Karadzinska-Bislimovska J, Vasilevska K, Stoleski S,. Mijakoski D. Assessment of the Non-Cystic Fibrosis. Bronchiectasis Severity : The FACED Score vs the. Bronchiectasis Severity Index. Open Respir Med J. 2015 Mar.

  13. Case series

    African Journals Online (AJOL)

    2012-11-15

    Nov 15, 2012 ... L´agent pathogène est principalement le Mycobacterium tuberculosis ou le bacille de Koch secondairement le Mycobacterium bovis. Il s´agit d´un bacille acido-alcoolo-résistant à croissance lente (temps de dédoublement est de 15à 20 heures), ce qui explique l´évolution lente de la maladie. [5]. L´atteinte ...

  14. Case series

    African Journals Online (AJOL)

    abp

    28 oct. 2013 ... Key words: Cancer du sein chez l'homme, diagnostic, traitement, facteurs pronostiques. Received: ..... BRCA1 and BRCA2 genes in breast cancer families. ... breast disease: clinical, mammographic, and ultrasonographic.

  15. Case series

    African Journals Online (AJOL)

    abp

    2015-07-24

    Jul 24, 2015 ... is very high. The mechanism of postoperative hydrocephalus remains unclear; some authors proposed the common explication: that the encephalocele contains a large part of the resorption mechanism of the cerebro-spinal fluid. So the hydrocephalus must be managed in the post- operative period for all ...

  16. Case series

    African Journals Online (AJOL)

    ebutamanya

    23 oct. 2015 ... secondaires à des agressions physiques sur une durée de trois ans. Les critères d'inclusion ... morceaux de verre. Dans notre série .... contre les comportements agressifs; les médias devront éliminer la diffusion de portraits ...

  17. Case series

    African Journals Online (AJOL)

    abp

    , en Tunisie, durant une période de 7 ans (janvier 2007 à décembre 2013). Les patients avec SGSp étaient classés en deux groupes selon l'âge de début de la maladie : groupe de sujets âgés (≥ 65 ans) et groupe de sujets ...

  18. Case series

    African Journals Online (AJOL)

    ebutamanya

    25 juin 2015 ... Maghreb Document INED ; enseigner la guerre d'Algérie et le. Maghreb contemporain. Actes de la DESCO Université d'été. 2001; pp1-25. Google Scholar. 2. Benider A, Bennani Othmani M, Harif M et al. Registre des cancers de la région du Grand Casablanca, année 2004, édition. 2007. Google Scholar.

  19. Case series

    African Journals Online (AJOL)

    abp

    23 nov. 2015 ... moyenne de la ventilation des patients atteints de PN était de 10,46 j alors que celle des patients non infectés était de 6,60 j. ... facteurs de risque: l'âge, la durée de la ventilation mécanique, la durée de séjour en réanimation, l'existence d'une .... ventillacion mecanica. Med Intensiva (Spanish). 2010 Jun-.

  20. Case series

    African Journals Online (AJOL)

    abp

    8 oct. 2015 ... Les implants cochléaires sont des prothèses électro-acoustiques qui ont pour rôle de pallier une déficience bilatérale de l'oreille interne, qu'elle soit profonde ou ... Les patients ont été convoqués régulièrement pour contrôle à 1 mois, 3 ... correspondant à l'absence de performance et 5 correspondant à la.

  1. Case series

    African Journals Online (AJOL)

    raoul

    20 févr. 2012 ... complet retenus pour notre étude sont ceux qui ont été énoncés par Sibaï [3] , associant une thrombopénie de moins de 100000 plaquettes par mm³, une cytolyse hépatique marquée par une élévation des enzymes hépatiques (TGO et TGP), ainsi qu'une hémolyse intravasculaire mise en évidence par une ...

  2. Case series

    African Journals Online (AJOL)

    raoul

    31 mai 2011 ... Syndromes microdélétionnels (syndrome de Williams et syndrome de la délétion .... Pour l'observation 2 et 3 (propositus et parents): Vysis DiGeorge Region Probe- LSI TUPLE 1 SpectrumOrange .... 2010 Apr;17(4):431-4.

  3. Case series

    African Journals Online (AJOL)

    abp

    1 oct. 2013 ... conduit, 23 patients ont eu une atteinte pulmonaire rhumatoïde à type de pneumonie infiltrante diffuse, de nodules rhumatoïdes pulmonaires ou de fibrose pulmonaire, 38 patients avaient un syndrome sec, dont 7 souffraient d'un goujerot sjogren retenu selon les critères de l'American European Consensus ...

  4. Case series

    African Journals Online (AJOL)

    raoul

    21 sept. 2010 ... Nos patients étaient traités par hémodialyse, avant la greffe, dans 65 cas (97%), et dialyse péritonéale dans 2 cas. (2,9%). La durée de dialyse médiane est de 24 mois (2 – 260). Concernant le ... TR, dans un tableau d'altération de la fonction rénale avec douleurs abdominales. La rupture du greffon était.

  5. Case series

    African Journals Online (AJOL)

    abp

    12 sept. 2013 ... ... au centre d'hémodialyse de l'hôpital Al Farabi d'Oujda, incluant tous nos patients diabétiques HDC. Nous avons relevé les données démographiques, clinico-biologiques et dialytiques. Nous avons receuilli les éléments suivants : la présence ou non de douleur évalué par l'échelle visuelle analogique ...

  6. Case series

    African Journals Online (AJOL)

    abp

    19 sept. 2013 ... La durée moyenne d'hémodialyse était de 89± 54 mois. 67(80%) de nos patients étaient de bas niveau socio-économique. La néphropathie causale était diabétique dans 17.8% des cas, vasculaire dans 9.6% des cas, et indéterminée dans 53.3 %. (Figure 1). Les douleurs osseuses étaient présentes chez ...

  7. Case series

    African Journals Online (AJOL)

    abp

    4 déc. 2017 ... était toujours normo-chrome et le plus souvent macrocytaire. La biopsie médullaire et myélogramme réalisés dans ... du cycle cellulaire, elle peut porter sur des cellules non traitées ou exposées à des agents pontant l'ADN. En effet, la phase G2 du cycle cellulaire est significativement plus importante dans ...

  8. Case series

    African Journals Online (AJOL)

    abp

    15 mai 2014 ... 1Service de Chirurgie Maxillo Faciale Hôpital Militaire Avicenne, Marrakech, Maroc, 2Service de .... cependant ses contre-indications et sa disponibilité limitent son .... cervical necrotizing fasciitis with hyperbaric oxygen.

  9. Case series

    African Journals Online (AJOL)

    Raoul

    2012-03-22

    Mar 22, 2012 ... transported by police, 11% by emergency medical system, and 24% by ... points, reinforced by the pericardium, was done with non-resorbable 3/0 wire. .... Several techniques are available to achieve temporary control of the.

  10. Case series

    African Journals Online (AJOL)

    abp

    2013-01-12

    Jan 12, 2013 ... delay in surgery and the referral patterns at the point of first contact with health workers. This paper sets out to ... diagnostic rule of the thumb for communities and lower cadre health workers in low resource settings. Pan African ... commonly follows delay in providing definitive surgical intervention in form of ...

  11. Case series

    African Journals Online (AJOL)

    abp

    12 mars 2015 ... Notre objectif principal était d'évaluer les résultats préliminaires de la prise en charge des lésions précancéreuses éligibles pour .... CHU de Yaoundé. et les objectifs spécifiques, déterminer le profil sociodémographique des ... Echantillonnage: Le recrutement était consécutif et la taille de l'échantillon a été ...

  12. Case series

    African Journals Online (AJOL)

    abp

    ; 18:288 doi:10.11604/pamj.2014.18.288.3772. This article is .... Le résultat objectif de la technique était évalué par les clichés en autovarus. Nous avons observé une diminution de l'angle tibio-talien passant de 10,9° à 3,4°; ...

  13. Case series

    African Journals Online (AJOL)

    ebutamanya

    16 févr. 2015 ... 1Département de chirurgie générale, CHU Mohamed VI, Université Caddi ayyad, Marrakech, Maroc ... La disponibilité d'un plateau technique performant constitue classiquement une ... Le but de ce travail ne cherche pas à valider la méthode ... Le Traumatisme abdominal Fermé est un défi diagnostique et.

  14. Case series

    African Journals Online (AJOL)

    abp

    10 juin 2014 ... l'hémophilie, l'âge des patients, l'âge du diagnostic, l'existence d'autres membres ... infectieux a été réalisé par la technique Elisa sur un rythme de 6 mois. ... ainsi la recherche de l'antigène de surface du virus de l'hépatite B.

  15. Case series

    African Journals Online (AJOL)

    abp

    28 avr. 2014 ... C'est la technique de Millard qui a été la plus pratiquée (72/130). Les ... cliniques : type et variété de la FLP dont le diagnostic clinique s'est basé sur la .... charge des FLP se fait avant l'âge de 6 mois grâce à la recherche.

  16. Case series

    African Journals Online (AJOL)

    abp

    12 oct. 2015 ... 1Service d'Oncologie-Radiothérapie, CHU Mohamed VI, Marrakech, Maroc. &Corresponding .... irradiation était réalisée selon la technique de «jonction mobile». Le délai moyen ... L'exérèse chirurgicale est indispensable au diagnostic .... l'enfant. Bien que les progrès dans la recherche fondamentale, des.

  17. Case series

    African Journals Online (AJOL)

    abp

    7 sept. 2017 ... The average age at the time of the first treatment was 45.1 years (ranging from 20 to 78 years). There was a prevalence of male patients (n=13), with a sex ratio of. 3.3. Colorectal tumor pathologies (n=9) and volvulus of the pelvic colon (n=7) were the main indications for colectomy. The first treatment was.

  18. Case series

    African Journals Online (AJOL)

    abp

    immunocompétent. Revue des Maladies Respiratoires. 2007;. (24 ):104. Google Scholar. 4. Al Tawfik JA. Multifocal systemic tuberculosis: the many faces of an old nemesis. Med Sci Monit. 2007;(4):CS56-. 60. PubMed | Google ...

  19. Case series

    African Journals Online (AJOL)

    abp

    2015-10-06

    Oct 6, 2015 ... PubMed | Google Scholar. 6. Plöckinger U, Couvelard A, Falconi M et al. Consensus guidelines for the management of patients with digestive neuroendocrine tumours: well-differentiated tumour/carcinoma of the appendix and goblet cell carcinoma. Neuroendocrinology. 2008;87(1):20-30. PubMed | Google.

  20. Case series

    African Journals Online (AJOL)

    abp

    13 mars 2014 ... thérapeutique chez les patients ayant d'autres pathologies chroniques d'ordre ... thérapeutiques, notamment le traitement antidiabétique oral ou insulinothérapie ou ..... children with chronic asthma. Pediatr Pulmonol. 2005;.

  1. Case series

    African Journals Online (AJOL)

    abp

    15 mars 2016 ... cancer in Belarus after Chernobyl. Int Congr Ser. 2007;1299(1):27-31. PubMed | Google Scholar. 6. Wémeau JL, Caron P, Helal B et al.Thyroïde et Chernoby l. Ann. Endocrinol. 2001;62(5):435-6. PubMed| Google Scholar. 7. Damak H. Nodules thyroïdiens?: Facteurs prédictifs de malignité. 2002 Sfax.

  2. Case series

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    abp

    25 sept. 2017 ... Chernobyl nuclear accident. Statistical data and clinicomorphologic characteristics. Cancer. 1999; 86(1): 149-. 56. PubMed | Google Scholar. 3. Jacob P, Kenigsberg Y, Zvonova I et al. Childhood exposure due to the Chernobyl accident and thyroid cancer risk in contaminated areas of Belarus and Russia.

  3. Case series

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    ebutamanya

    14 avr. 2016 ... Le dosage des marqueurs sériques du deuxième trimestre a permis le dépistage des .... Ailleurs, le geste n'a pas été réalisé suite au refus de la patiente (05 cas) ou devant la .... par le système de soin. Une telle stratégie de ...

  4. Case series

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    ebutamanya

    9 juin 2008 ... longtemps débattue, après avoir proposé initialement une origine musculaire striée les études récentes sont en faveur d'une origine neurogène schwannienne confirmées par une étude immunohistochimique. Le traitement de la tumeur à cellules granuleuses est un traitement chirurgical, il permet un ...

  5. Case series

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    abp

    4 févr. 2015 ... Abstract. La drépanocytose est une maladie génétique à transmission autosomale codominante. Les patients homozygotes ont des crises hémolytiques qui génèrent les symptômes cliniques. Il s'agit d'une maladie fréquente. En France, la plupart des cas hospitalisés sont observés en Ile de France et.

  6. Case series

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    ebutamanya

    2015-01-29

    Jan 29, 2015 ... Doppler cardiaque (121 cas sur 380) soit 39,53%. Les CIV étaient au premier plan des cardiopathies congénitales (28,26%), suivies des CIA. (23,19%), des sténoses pulmonaires (19,57%), des Tétralogie de Fallot (9,42%). Dans leur forme isolée, les CIA étaient les plus fréquentes avec. 21,95% des cas, ...

  7. Case series

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    ebutamanya

    2016-05-12

    May 12, 2016 ... based on the records of 53 children hospitalized at the pediatrics unit of Hassan II University Hospital, Fez Morocco. Thirty boys ... development of the lungs. This could ..... Figure 2: Whistle of a toy at the right main bronchus.

  8. Case series

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    ebutamanya

    'Antananarivo .... l'insuffisance rénale chronique dans la population générale car très .... soins de la MRC consistent surtout à ralentir la progression de la ... prévention primaire, il consiste à supprimer de tous facteurs de.

  9. Case series

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    ebutamanya

    22 oct. 2015 ... 1Service de Médecine Légale et Médecine du Travail, Faculté de Médecine, de Pharmacie et ... générale et contre la violence domestique en particulier préoccupe de plus en ... le niveau d'instruction (primaire, secondaire, supérieur, aucun), le ..... d?entretiens avec 19 médecins d?un réseau de soins ville.

  10. Case series

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    ebutamanya

    25 mai 2015 ... antécédents, les données de l'examen clinique général et de l'examen ... centre de soins. Les informations sur nos ... patientes ayant le niveau primaire ou secondaire représentaient ..... FES Maroc: Faculté de médecine et de.

  11. Case series

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    abp

    31 août 2015 ... 1Service de Chirurgie Générale, Centre Hospitalier Régional de Kafrrine, .... auxquels viennent s'ajouter les traumatismes primaires résultant de ... aussi aux soins médicaux prolongés et chers. ... Le congrès Médecins.

  12. Case series

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    abp

    16 oct. 2015 ... l'obtention ou le maintien du permis de conduire ou pouvant donner lieu à la délivrance du permis de conduire de durée de validité limitée. Journal officiel de la République Française du. 14 Septembre 2012, 1-12. Google Scholar. 7. Kotecha A, Spratt A, Viswanathan A. Visual function and fitness to drive.

  13. Case series

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    abp

    8 sept. 2015 ... &Corresponding author: Essodina Padja, Service d'Urologie de l'Hôpital Militaire d'Instruction Mohammed V de Rabat, Université Mohammed V-. Rabat, Maroc. Key words: calculs, haut appareil ..... Ben Saddik MA, Al-Qahtani Sejiny S, Ndoye M et al. Urétéroscopie souple dans le traitement des calculs du ...

  14. Case series

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    abp

    2012-06-01

    Jun 1, 2012 ... magnesium sulphate infusion, 2 patients had direct current shock (DCS) whilst 3 .... and required antibiotic treatment and chest drainage with an intercostal tube. .... Indian Pacing Electrophysiol J. 2003 Jul 1;3(3):143-7.

  15. Case series

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    ebutamanya

    12 oct. 2015 ... s'est modernisée devenant moins agressive (Patey en 1948, Madden en 1972, la technique du ganglion sentinelle en 1994) tout en conservant son potentiel curatif [6]. Les traitements adjuvants et néo adjuvants ont permis à la chirurgie de conforter son rôle de traitement curatif dans le cancer du sein [6].

  16. Case series

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    abp

    28 mai 2014 ... Abstract. Le mélanome malin des fosses nasales est une tumeur rare mais très agressive, de traitement complexe et de pronostic défavorable. Son traitement relève en principe d'une prise en charge essentiellement chirurgicale complétée par une radiothérapie. L'objectif de ce travail est de rapporter les ...

  17. Case series

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    ebutamanya

    2015 ... une étape fondamentale dans le traitement du cancer de l'enfant, elle doit être évaluée dès l'étape diagnostique et surveillée tout au long du traitement. Pan African ..... Mémoire et douleur chez l'enfant. Douleurs. 2004;.

  18. Case series

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    abp

    27 févr. 2015 ... survie sans métastase et en termes de récidive locale entre les plasties mammaires et les traitements usuels: mastectomie et traitement .... La verticale sous l'aréole est alors prolongée vers l'extérieur, elle permet de limiter la ... tracé des techniques en «T inversé», le trou de serrure de la clé représente ...

  19. Case series

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    abp

    1 mai 2014 ... acidocétose diabétique dans le service de Médecine Interne de l'hôpital Jason Sendwe de Lubumbashi (République Démocratique du Congo). L'échantillon était exhaustif ... métabolique à trou anionique augmenté [1,2]. Son incidence dans le .... aura évolué vers l'installation d'un coma, faute de prise en ...

  20. Case series

    African Journals Online (AJOL)

    abp

    2015-07-23

    . Due to logistical constraints its first steps occurred in Lubumbashi only in. 2008. The aim of this presentation was to report authors' ten-month experience of laparoscopic surgery at Lubumbashi Don Bosco Missionary.

  1. Case series

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    abp

    13 sept. 2017 ... Asma Ben Cheikh et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons. Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, ...

  2. Case series

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    abp

    2017-09-15

    Sep 15, 2017 ... Cholera, Yellow Fever, Zika, Dengue and Rift Valley fever [12-15] in ... the health system and public health challenges further buttresses the need for more ... management, infection prevention and control, active surveillance,.

  3. Case series

    African Journals Online (AJOL)

    5 sept. 2012 ... 2000;4(5):415-418. This article on PubMed. 24. Azim HA Jr, Peccatori FA, Pavlidis N. Treatment of the pregnant mother with cancer: a systematic review on the use of cytotoxic, endocrine, targeted agents and immunotherapy during pregnancy. Part I: Solid tumors. Cancer Treat Rev. 2010 Apr;36(2):101-9.

  4. Case series

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    abp

    17 janv. 2014 ... 11. K Cohen, G Meintjes . Management of individuals requiring ART and tuberculosis treatment. Curr Opin HIV AIDS. 2010 January;. 5(1): 61-69. PubMed | Google Scholar. 12. Harries A, Maher D, Raviglione M, Chaulet P, Nunn P, et al. Tuberculose et VIH; Manuel Clinique. OMS 1996; WHO/TB/96. 200.

  5. Case series

    African Journals Online (AJOL)

    abp

    26 mai 2015 ... La définition du goitre plongeant, la plus couramment employée, est tout goitre ne siégeant pas dans la région cervicale en position opératoire. Le but d'évaluer sa .... plusieurs auteurs ont essayé de donner leurs propres définitions. la plus part .... de compression, d'hyperthyroïdie et devant le risque de.

  6. Case series

    African Journals Online (AJOL)

    ebutamanya

    10 févr. 2015 ... Key words: Cancer du sein bilatéral synchrone, Facteurs de risque, histologie, traitement, Pronostic ... avaient six fois plus de risque de développer un cancer au niveau du sein controlatéral que les femmes âgées de plus de 40 ans. .... définition d´un cancer du sein bilatéral simultané, ce qui rend l'étude ...

  7. Case series

    African Journals Online (AJOL)

    raoul

    29 févr. 2012 ... l'administration du sérum antitétanique, du diazépam, de la pénicillinothérapie, au parage de la plaie et à l'isolement de la lumière et des bruits. ... En dehors des études menées dans certains centres hospitaliers, son épidémiologie est ... En milieu hospitalier africain il était de 38,9% à Kigali, [11].

  8. Case series

    African Journals Online (AJOL)

    abp

    20 juil. 2016 ... 1Faculté des Sciences de la Santé, Université Marien NGOUABI, Congo, 2Service de Pneumologie, CHU de .... critères d'inclusion, hospitalisés durant la période de l'étude, soit un .... Revista da SociedadeBrasileira de.

  9. Case series

    African Journals Online (AJOL)

    abp

    10 mai 2016 ... Immunity impact of pregnancy on the experience of the Obstetrics and Gynecology. Department .... 2), sur le plan biologique le syndrome inflammatoire ainsi que le ..... on outcome of pregnancy in women with antiphospholipid.

  10. Case series

    African Journals Online (AJOL)

    abp

    15 avr. 2016 ... diptère vecteur hématophage : le phlébotome femelle [5]. Selon l'espèce parasitaire en cause et ... Les dérivés de l'antimoine demeurent le traitement de référence de la leishmaniose viscérale dans de ... étude, l'évolution de nos patients traités par dérivés d'antimoine a été marquée par la survenue de la ...

  11. Case series

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    ebutamanya

    23 nov. 2015 ... générale et digestive et d'anatomie cytologie et pathologie du CHU- ... médiane à cheval sur l'ombilic chez neuf patients et une incision de ... La pathologie du diverticule de Meckel a une présentation clinique atypique rendant le diagnostic encore plus difficile d'autant plus que le patient est âgé. Ainsi en ...

  12. Case series

    African Journals Online (AJOL)

    ebutamanya

    20 nov. 2015 ... Key words: Cancer bronchopulmonaire, cliniques, Madagascar, primitif. Received: ... which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ..... cannabis.

  13. Case series

    African Journals Online (AJOL)

    abp

    23 juin 2015 ... 1Service de Chirurgie Générale, Hôpital Militaire Avicenne, Marrakech, Maroc. &Corresponding author: Ahmed El Khader, Service de Chirurgie Générale, Hôpital Militaire Avicenne, Marrakech, Maroc. Key words: Appendicite aigue, traitement conservateur, antibiotique. Received: 31/12/2014 - Accepted: ...

  14. Case series

    African Journals Online (AJOL)

    abp

    6 janv. 2013 ... 1Service de chirurgie générale, Hôpital militaire Avicenne, Marrakech, Maroc. &Corresponding author: Dr Rachid El Barni. Service de chirurgie générale. Hôpital militaire Avicenne, Marrakech, Maroc. Key words: Tuberculose, paroi thoracique, abcès, enfant. Received: 21/10/2012 - Accepted: 06/01/2013 ...

  15. Case series

    African Journals Online (AJOL)

    ebutamanya

    3 juil. 2015 ... Louaya Shamil1,&, Bennouk Youssef2, Kriet Mohamed2, Oubaaz Abdelbarre3. 1Centre Médico-chirurgical, Agadir, Maroc, 2Hopital Militaire Avicenne, Marrakech, Maroc, 3Hopital Militaire D'instruction Mohamed V, Rabat, Maroc. &Corresponding author: Louaya Shamil, Centre Médico-chirurgical, Agadir, ...

  16. Case series

    African Journals Online (AJOL)

    ebutamanya

    20 juil. 2015 ... 1Pôle de traumatologie et orthopédie, Hôpital Militaire d'Instruction Avicenne, Université Kadi Iyade, Faculté de Médecine et de Pharmacie,. Marrakech, Maroc. &Corresponding author: Nader Youssef, Pôle de traumatologie et orthopédie, Hôpital Militaire d'Instruction Avicenne, Université Kadi Iyade, ...

  17. Case series

    African Journals Online (AJOL)

    ebutamanya

    14 avr. 2016 ... C'est une étude transversale observationnelle, réalisée dans le service de Réanimation Centrale de l'Hôpital Avicenne de Rabat sur une durée de 6 mois. Ont été inclus les patients ayant présenté un événement indésirable (EI) au cours de leur hospitalisation en Réanimation, ou ayant présenté un EI à ...

  18. Case series

    African Journals Online (AJOL)

    ebutamanya

    8 mai 2015 ... 1Service d'Oto-rhino-laryngologie et Chirurgie Cervico-faciale, Hôpital Militaire Avicenne, Marrakech, Maroc. &Corresponding author: Mohamed Mliha Touati, Service d'Oto-rhino-laryngologie et Chirurgie Cervico-faciale, Hôpital Militaire Avicenne, Marrakech,. Maroc. Key words: otite moyenne chronique ...

  19. Case series

    African Journals Online (AJOL)

    raoul

    15 févr. 2012 ... réalisé une étude rétrospective portant sur 30 malades, réalisée au service de réanimation de l'hôpital militaire Avicenne de Marrakech. L'âge moyen de nos patients est de 59, 6 avec un sexe ratio de 1,5 (18 femmes et 12 femmes). On note dans notre série le terrain multi-taré des patients sous AVK avec ...

  20. Case series

    African Journals Online (AJOL)

    abp

    otospongiose colligés au service d'Oto-rhino-laryngologie de l'hôpital militaire Avicenne de Marrakech, entre Janvier 2009 et Décembre 2012. L'âge moyen des patients était de 38 ans avec une nette prédominance masculine (77%).

  1. Case series

    African Journals Online (AJOL)

    abp

    4 juin 2014 ... Neurochirurgie de l'Hôpital Avicenne du Centre Hospitalo-. Universitaire de Rabat, entre 1996 et 2009. Tous les patients ont bénéficié d'un examen clinique et scannographique à l'admission. Les choix thérapeutiques variaient selon le tableau clinique à l'admission : traitement médical seul ou associé à ...

  2. Case series

    African Journals Online (AJOL)

    abp

    26 mai 2015 ... cervico-faciale de l'hôpital militaire Avicenne de Marrakech, sur une période de 8 ans, allant de janvier 2006 à décembre 2013.Les carcinomes thyroïdiens atteignent le sujet jeune avant l'âge de 50 ans, en particulier le sexe féminin. La tendance dans les pays en voie de développement, comme dans le ...

  3. Case series

    African Journals Online (AJOL)

    ebutamanya

    28 août 2015 ... 1Service de Psychiatrie, Hôpital Militaire d'Instruction Avicenne, Marrakech, Maroc, 2Equipe de Recherche sur la Santé Mentale, CHU Mohamed IV,. Université Caddi Ayyad, Faculté de Médecine, Marrakech, Maroc. &Corresponding author: Fadoua Oueriagli Nabih, Service de Psychiatrie, Hôpital Militaire ...

  4. Case series

    African Journals Online (AJOL)

    raoul

    22 nov. 2011 ... Abstract. Etude rétrospective rapportant une série de kystes hydatiques rompus dans les voies biliaires colligés dans le service de chirurgie de l'hôpital militaire Avicenne à Marrakech. Entre 1990 à 2008, sur 536 kystes hydatiques du foie opérés dans le service, 120 étaient compliqués de rupture dans les ...

  5. Case series

    African Journals Online (AJOL)

    abp

    14 déc. 2015 ... Néanmoins certaines de ces tuméfactions restent d'origine non précisée, portant donc l'indication d'une cervicotomie exploratrice. Il s'agit d'une étude rétrospective d'une série de 300 cas de tuméfactions cervicales isolées colligées au service d'ORL de l'hôpital militaire Avicenne de Marrakech entre 2001 ...

  6. Case series

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    abp

    27 sept. 2017 ... Résumé. La synovite villonodulaire pigmentée (SVNP) est une prolifération bénigne rare de la synoviale des articulations, des bourses séreuses et des gaines tendineuses, d'étiopathogénie inconnue. Notre travail porte sur 20 cas de SVN du genou colligés à l'hôpital militaire Avicenne de Marrakech sur ...

  7. Case series

    African Journals Online (AJOL)

    ebutamanya

    16 mars 2016 ... Le but de ce travail est d'étudier les facteurs prédictifs de malignité dans les tumeurs parotidiennes à travers une étude rétrospective sur 76 cas de tumeurs de la parotide traités au service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale de l'hôpital militaire Avicenne de Marrakech entre janvier.

  8. Case series

    African Journals Online (AJOL)

    abp

    10 déc. 2015 ... Le diagnostic de ces tumeurs est difficile, nécessitant une approche multidisciplinaire, à savoir oto-rhino- laryngologique, radiologique et anatomopathologique. Notre étude rétrospective concerne 32 cas de tumeurs malignes naso-sinusiennes, colligées au service d'ORL de l'hôpital militaire Avicenne de ...

  9. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-02-17

    Feb 17, 2015 ... Therefore, the present study has been undertaken to determine ... variceal bleeding is a severe complication occurring in up to 30% of patients ... of large esophageal varices is an upper gastrointestinal endoscopy. It is now ...

  10. Case series

    African Journals Online (AJOL)

    abp

    16 janv. 2017 ... Spinal trauma is one of the most common types of injuries among victims of traffic accidents, sports accidents, domestic accidents and workplace accidents. .... Google Scholar. 5. Jackson AB, Dijkers M, Devivo MJ, Poczatek RB. A demographic profile of new traumatic spinal cord injuries: change and.

  11. Case series

    African Journals Online (AJOL)

    ebutamanya

    28 août 2015 ... 1Réanimation de Chirurgie Cardiaque, Hôpital Militaire d'instruction Mohammed V, Faculté de .... la dose de 5 'g /kg et un curare de type cisatracurium à la dose de ... temps de coagulation activée et la gazométrie artérielle.

  12. Case series

    African Journals Online (AJOL)

    ebutamanya

    24 juin 2015 ... diminution de l'oedème cérébral en cas d'absence d'une lésion intracrânienne .... selon la classification de Fain et Péri [1] (Figure 2): type I: fracture .... coagulation et excision la plus complète possible de la muqueuse, la.

  13. Case series

    African Journals Online (AJOL)

    ebutamanya

    12 oct. 2015 ... Key words: Coagulation, réanimation, transfusion, trouble de l´hémostase. Received: ... L'objectif de cette étude est d'en déterminer l'incidence, les étiologies et ... exprimés en moyenne ± écart-type ou avec les extrêmes et en.

  14. Case series

    African Journals Online (AJOL)

    abp

    3 mars 2014 ... Childs Nerv Syst. Nov 2000; 16(10-. 11):765-9. PubMed | Google Scholar. 4. Ben Becher S, Cheour M, Ben Hassine L, Hlioui S, et al. Les kystes hydatiques cerebraux chez l'enfant. Arch Péd. 1997;. 4(11):1107-1110. PubMed |Google Scholar. 5. Duishanbai S, Jiafu D, Guo H, Liu C, Liu B, et al. Intracranial.

  15. Case series

    African Journals Online (AJOL)

    ebutamanya

    2016-02-08

    Feb 8, 2016 ... 1Department of Dermatology, Ibn Rochd UHC of Casablanca, Morocco, 2Laboratory of Immunology, faculty of medicine, Casablanca, Morocco,. 3Laboratory .... Diabetes was found in 3 patients in the psoriasis group versus 2 persons in the control group. In the 165 samples (66 skin samples and 33 nasal.

  16. Case series

    African Journals Online (AJOL)

    ebutamanya

    2015-09-28

    Sep 28, 2015 ... Teeth syndrome or fight bite is a specific entity in hand surgery that is little known. It includes infectious complications of the hand following a fist ... A retrospective study was performed on 20 patients treated for teeth syndrome ...

  17. Case series

    African Journals Online (AJOL)

    abp

    26 août 2015 ... radiothérapie chez toutes les patientes à la dose unique de 24 Grays pour le bas débit de dose (LDR) et ... ce risque était aussi multiplié par 2,9 pour toute augmentation d'une journée de l'étalement au delà de 65 .... de l'article, Samir Ahid a participé à la gestion des données statistiques, Tayeb Kebdani et ...

  18. Case series

    African Journals Online (AJOL)

    ebutamanya

    4 sept. 2015 ... rapport avec la stase urinaire (infection urinaire, lithiase vésicale). [12] des complications plus rares ont été rapportées telles que la survenue d'une tumeur vésicale intraherniaire [13] ou une insuffisance rénale secondaire à la compression du trigone [5]. En cas de diagnostic pré-opératoire le traitement ...

  19. Case series

    African Journals Online (AJOL)

    abp

    2017-09-29

    Sep 29, 2017 ... European Society of Human Reproduction and Embryology (ESHRE) introduced a revised ... A pregnancy loss that occurs after a positive urinary human chorionic ..... patients with recurrent IVF/ICSI failure. Indian Journal of.

  20. Case series

    African Journals Online (AJOL)

    abp

    7 avr. 2016 ... Naima Bouznad1,&, Ghizlane El Mghari1, Nawal El Ansari1. 1Service ... des cas. L'HTA a été compliquée de cardiopathie dans 24% des cas et de néphropathie dans 20% des cas. ..... Maria Abad- Cardiel et al. ... 2004;27(3).

  1. Case series

    African Journals Online (AJOL)

    ebutamanya

    18 août 2015 ... of the meniscus for exposure of tibial plateau fractures requiring open reduction and internal fixation. J Orthop. Trauma. 1996;10(4):243-7. PubMed | Google Scholar. 15. Stevens DG, Beharry R, McKee et al. The long-term functional outcome of operatively treated tibial plateau fractures. J. Orthop Trauma.

  2. Case series

    African Journals Online (AJOL)

    Raoul

    7 mars 2012 ... Abstract. L'occlusion intestinale survient rarement au cours de la grossesse mais elle s'accompagne d'une morbidité et mortalité maternelle et fœtale élevées souvent dues au retard diagnostic et thérapeutique. Les auteurs rapportent cinq cas d'obstruction intestinale gravidique, et revoient la littérature.

  3. Case series

    African Journals Online (AJOL)

    ebutamanya

    22 juin 2015 ... grossesse et l'accouchement chez la femme cardiaque constituent un haut risque materno-foetal dépendant du type, mais surtout du stade de la cardiopathie, nécessitant ... Concernant l'accouchement, quarante patientes (71,42%) étaient .... femmes ont des enfants à un âge plus tardif et qu'elles sont plus.

  4. Case series

    African Journals Online (AJOL)

    abp

    31 mai 2016 ... Aucune récidive n'a été notée après un recul minimal de 3 ans. ... cartilagineuse avec ankylose, il persiste à long terme des séquelles ... s'est faite durant la grossesse, la patiente a été traitée après l'accouchement. Tous les patients inclus dans notre étude présentaient un stade III ET VI de Martini.

  5. Case series

    African Journals Online (AJOL)

    abp

    utilisation d'un DIU. Le germe le plus souvent ... patiente a présenté un pyosalpinx en post opératoire et a nécessité une reprise chirurgicale avec salpingectomie .... vivantes à terme [38]. Dans les cas où une FIV est d'emblée requise.

  6. Case series

    African Journals Online (AJOL)

    abp

    22 août 2013 ... Le lien avec le virus du papillome humain (VPH), quoique fortement soupçonné, n'est pas confirmé [3]. D'un point de vue clinique, le cancer de la vulve se présente sous forme d'une masse, d'une plaque, d'un ulcère, d'un nodule, du prurit, des saignements et des pertes vaginales post ménopausiques, ...

  7. Case series

    African Journals Online (AJOL)

    abp

    30 janv. 2017 ... dominés respectivement par le cancer du sein dans 27,6% des cas, les cancers digestifs dans 15,8% .... vessie, de l'utérus (corps ou col) et du sein qui métastasent au foie .... Distant metastases from head and neck cancer.

  8. Google Calendar Enhances Prospective Memory in Alzheimer's Disease: A Case Report.

    Science.gov (United States)

    El Haj, Mohamad; Gallouj, Karim; Antoine, Pascal

    2017-01-01

    We investigated whether an external memory aid (i.e., Google Calendar) would alleviate prospective memory compromise in a patient with mild Alzheimer's disease. The patient was asked in the baseline phase to perform three prospective targeted events (e.g., attending her weekly bridge game at the community club) and three prospective control events (e.g., buying her weekly magazine). The same six prospective events were assessed in the intervention phase but the targeted-events were cued by Google Calendar while the control-events were not. Results showed less omission of the targeted events in the training phase than in the baseline phase, suggesting a positive effect of Google Calendar. This case report offers a unique view into how smartphone calendars may alleviate prospective memory compromise in patients with mild Alzheimer's disease.

  9. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series.

    Science.gov (United States)

    Marr, Brendan; Yenumula, Panduranga

    2012-01-01

    Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

  10. Day case inguinal hernia surgery in Nigerian children: Prospective ...

    African Journals Online (AJOL)

    required readmission into the hospital. Conclusion: Day case inguinal hernia surgery in children is safe and well accepted by patients and parents alike. Health institutions in which children with inguinal hernias still queue for long periods for space on the operation list need to adopt day case surgery for inguinal hernia in ...

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

    Science.gov (United States)

    Shah, I; Barot, S; Madvariya, M

    2015-01-01

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

  12. A Rare Case Series of Ischemic Stroke Following Russell’s Viper Snake Bite in India

    Directory of Open Access Journals (Sweden)

    Venkata Krishna Pothukuchi

    2018-01-01

    Full Text Available Snakebite is an important medical problem in India. Among their various manifestations, cerebral complications are uncommonly found in literature. Moreover, Ischemic stroke following snake bite is quite rare. Here we report a case series of two such cases that developed neurological manifestations following Russell’s viper bite. On computerized tomography (CT scan of brain; cerebral infarcts were revealed. Their likely mechanisms are discussed in present study which include disseminated intravascular coagulation, toxin induced vasculitis and endothelial damage.

  13. Evaluating Fall Risk in People with Low Vision: A Case Series

    OpenAIRE

    Kierstyn Napier-Dovorany, OD; Victoria Graham, DPT

    2013-01-01

    Background: People with low vision have increased risk for falls and preventable health conditions due to sedentary lifestyle and reduced participation in social activities. This case series describes an interprofessional low vision, balance, and mobility evaluation of two patients referred to our low vision optometric clinic. Case Report: RM, an 82-year-old white female with diabetic retinopathy, and PC, a 55-year-old white female with retinopathy of prematurity, completed a comprehensive lo...

  14. Rare case-series of electrocautery burn following off-pump coronary artery bypass grafting

    Science.gov (United States)

    Sabzi, Feridoun; Niazi, Mojtaba; Ahmadi, Alireza

    2014-01-01

    Abstract: With an increasing number of off-pump coronary artery surgery procedures in high-risk patients with coagulopathy, including renal failure, hepatic failure and anticoagulant drug-using patients, the frequency of related complications such as repeated exploration for bleeding is also increasing. The associated co-morbidity and repeated use of electrocautery in postoperative bleeding leaves patients susceptible to electrocautery ulcers. In this case series, rare cases of cautery burn with unique causative mechanisms are described. PMID:23669602

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

    Science.gov (United States)

    Eckshtain, Dikla; Gaynor, Scott T.

    2009-01-01

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

  16. Psychosis associated with acute recreational drug toxicity: a European case series

    OpenAIRE

    Vallersnes, Odd Martin; Dines, Alison M.; Wood, David M.; Yates, Christopher; Heyerdahl, Fridtjof; Hovda, Knut Erik; Giraudon, Isabelle; Dargan, Paul I.

    2016-01-01

    Background Psychosis can be associated with acute recreational drug and novel psychoactive substance (NPS) toxicity. However, there is limited data available on how common this is and which drugs are most frequently implicated. We describe a European case series of psychosis associated with acute recreational drug toxicity, and estimate the frequency of psychosis for different recreational drugs. Methods ...

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Casey, James; Aguirre, Francisco; Yunker, Amanda

    2016-08-01

    The following presents a case series of 29 referral patients who underwent laparoscopic Essure removal for the indication of suspected Essure-related pelvic pain and to describe patient characteristics, intraoperative findings and postoperative pain outcomes. Laparoscopic removal for Essure-associated pelvic pain is a safe and effective treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A case series of pediatric seymour fractures related to hoverboards: Increasing trend with changing lifestyle

    Directory of Open Access Journals (Sweden)

    A.E. Kattan

    2017-01-01

    Conclusion: We report a case series of a fracture pattern resulting from the improper/unsafe use of a hoverboard. This type of fracture occurs with a tremendous load of energy. Although improper use was a factor, design fault also plays a role in causing the injury. Parent awareness and supervision are important to prevent such injuries.

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2005-01-01

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

  2. Risk-reducing Salpingo-Oophorectomy in Women at Higher Risk of Ovarian and Breast Cancer: A Single Institution Prospective Series.

    Science.gov (United States)

    Ricciardi, Enzo; Tomao, Federica; Aletti, Giovanni; Bazzurini, Luca; Bocciolone, Luca; Boveri, Sara; Landoni, Fabio; Lapresa, Maria Teresa; Maruccio, Matteo; Parma, Gabriella; Peccatori, Fedro; Petrella, Maria Cristina; Zanagnolo, Vanna; Colombo, Nicoletta; Maggioni, Angelo

    2017-09-01

    Occult cancers' reported rates vary from 2-12% and serous tubal intraepithelial carcinomas (STICs) have been identified in 3-12% of the prophylactically removed tubes of women carrying a BRCA mutation. The aim of this study was to evaluate the incidence of tubal minor epithelial atypia (STIL), STIC, and occult invasive cancer and to evaluate the cancer-specific mortality in a prospective series of women at higher risk of ovarian and breast cancer undergoing risk-reducing salpingo-oophorectomy (RRSO) n a tertiary cancer center. A series of RRSO specimens (including endometrial biopsy) from women carrying a BRCA mutation, BRCA-unknown and BRCA-negative were collected between January 1998 and April 2016 at the Division of Gynecology at the European Institute of Oncology. Inclusion criteria were: asymptomatic women who had a negative gynecologic screening within 3 months prior to RRSO. Exclusion criteria were: women with ovarian/tubal cancer prior to RRSO. A total of 411 women underwent RRSO. Median age at RRSO was 47.0 years (range=32-70 years); 75.2% had a history of breast cancer. Fifteen women were diagnosed with an occult cancer (7 STIC, 4 invasive cancers, 2 breast cancers metastatic to the adnexa, 2 endometrial cancer) (3.6%). Sixteen showed a STIL (3.9%). When excluding cases with preoperative positive markers, the occult invasive cancer rate drops to 1.5%. Our study, covering an 18-year period, shows a substantial low risk of occult cancer among a high-risk population of women undergoing RRSO. Our data still support the indication for RRSO in higher-risk patients. An endometrial biopsy should also be routinely obtained as it raises the chances of detecting occult endometrial cancers that may be otherwise missed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  3. [External lumbar drainage with volumetric continuing infusion pump in patients with cerebrospinal fluid leak. A case series].

    Science.gov (United States)

    Manso Melgosa, Ana Belén; García Gutiérrez, Helena; Fernández Porras, Mónica; Castrillo Manero, Ana Berta; Pérez Marijuán, Belén

    To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. Retrospective descriptive case series study. patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP. age, sex, type of intervention, variables related to the practice of the pump and complications. Average and medians were calculated for quantitative variables, frequencies and percentages for qualitative. Sample: 11 subjects. Incidence in running IP: disconnection, occlusion and acoustic alarm activation. Most frequently complication is headache; a case of pneumocephalus. The small number of subjects and the heterogeneity of these do not allow for comparison or establishing associations between variables. The resolution of the cerebrospinal fluid leak with continuous IP is lower in this study than others, and may be influenced by the small number of subjects. It should be noted the frequent activation of the pump alarm for no apparent cause. Protocol would be developed for preparing the IP team to reduce the acoustic alarm activation, and would make a prospective multicenter study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  4. Dengue infection and miscarriage: a prospective case control study.

    Directory of Open Access Journals (Sweden)

    Peng Chiong Tan

    Full Text Available BACKGROUND: Dengue is the most prevalent mosquito borne infection worldwide. Vertical transmissions after maternal dengue infection to the fetus and pregnancy losses in relation to dengue illness have been reported. The relationship of dengue to miscarriage is not known. METHOD: We aimed to establish the relationship of recent dengue infection and miscarriage. Women who presented with miscarriage (up to 22 weeks gestation to our hospital were approached to participate in the study. For each case of miscarriage, we recruited 3 controls with viable pregnancies at a similar gestation. A brief questionnaire on recent febrile illness and prior dengue infection was answered. Blood was drawn from participants, processed and the frozen serum was stored. Stored sera were thawed and then tested in batches with dengue specific IgM capture ELISA, dengue non-structural protein 1 (NS1 antigen and dengue specific IgG ELISA tests. Controls remained in the analysis if their pregnancies continued beyond 22 weeks gestation. Tests were run on 116 case and 341 control sera. One case (a misdiagnosed viable early pregnancy plus 45 controls (39 lost to follow up and six subsequent late miscarriages were excluded from analysis. FINDINGS: Dengue specific IgM or dengue NS1 antigen (indicating recent dengue infection was positive in 6/115 (5·2% cases and 5/296 (1·7% controls RR 3·1 (95% CI 1·0-10 P = 0·047. Maternal age, gestational age, parity and ethnicity were dissimilar between cases and controls. After adjustments for these factors, recent dengue infection remained significantly more frequently detected in cases than controls (AOR 4·2 95% CI 1·2-14 P = 0·023. INTERPRETATION: Recent dengue infections were more frequently detected in women presenting with miscarriage than in controls whose pregnancies were viable. After adjustments for confounders, the positive association remained.

  5. Childhood Mourning: Prospective Case Analysis of Multiple Losses

    Science.gov (United States)

    Kaufman, Kenneth R.; Kaufman, Nathaniel D.

    2005-01-01

    Multiple losses within short time periods make one question life and can exponentially influence one's coping skills. But what are the effects on a child and what should be done when the next loss occurs? This case addresses the multiple losses suffered by a child while assessing coping skills of the child and coping strategies used by the parents…

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

    Science.gov (United States)

    Calice, Ivana; Moens, Yves

    2016-01-01

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

  7. Oral Granular Cell Tumor: Report of Case Series and a Brief Review of the Literature

    Directory of Open Access Journals (Sweden)

    Karakostas Panayiotis

    2017-07-01

    Full Text Available Background/Aim: The present analysis focuses on examining a case series of eight patients diagnosed with a granular cell tumor located in the oral cavity. Case series: The patients’ clinical states were thoroughly studied, along with the histopathological and immunohistochemical examinations findings. Their surgical treatment and postoperative course are also within the scope of this analysis. Numerous histogenesis theories and the appropriate tumor treatment are mentioned within the article being always in accordance with the relative literature. Conclusions: Oral granular cell tumor is a benign oral disease of possible neural origin commonly located on the tongue. Surgical excision is the treatment of choice. In any case, histological and immunohistochemical examination confirm both the clinical diagnosis and the differential diagnosis between oral squamous cell carcinoma.

  8. (Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series.

    Science.gov (United States)

    DeKoven, Samuel; DeKoven, Joel; Holness, D Linn

    Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails. Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series. Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate. The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.

  9. Chest x-ray in Q-fever pneumonia: a series of 71 cases

    International Nuclear Information System (INIS)

    Encinas, B.; Cerezal, L.F.; Fidalgo, I.; Bustamente, M.; Lopez Calderon, M.

    1995-01-01

    Chest X ray features of 71 cases of Q-fever serologically confirmed and with clinical manifestations of acute respiratory disease were retrospectively assessed in order to evaluate the radiographic features. In 68 cases (96%) The X-ray films were abnormal. Segmental consolidation, sometimes multiple and bilateral were tue most usual findings. Nodular opacities were found in 6 cases (9%) and can mimic a tumor. Cavitacion , a very unusual findings, was found in two nodular consolidations(two patients). Laminar atelectasis was less common than proviously reported. As in other series, total resolution or with minimal scars occurs within 3 months 15 refs

  10. Combustible Cartridge Cases: Current Status and Future Prospects

    Science.gov (United States)

    1992-08-01

    and presents new models of combustible cartridge case burning . Following a summary of experimental data, it concludes with proposals for further...UNCLASSIFIED UNCLASSIFIED UNCLASSIFIED SAR NSN 7540-01-280-5500 Standard Form 298 (Rev 2-89) Precribed by ANSI Std Z39-19 IWFENTIONALLY LEFT BLANK...7 3.3 In-Depth Burning Model ........................................ 7 3.3.1 M odel A ................................................ 9 3.3.2

  11. The role of genetic factors in patients with hepatocellular carcinoma and iron overload - a prospective series of 234 patients.

    Science.gov (United States)

    Funakoshi, Natalie; Chaze, Iphigénie; Alary, Anne-Sophie; Tachon, Gaëlle; Cunat, Séverine; Giansily-Blaizot, Muriel; Bismuth, Michael; Larrey, Dominique; Pageaux, Georges-Philippe; Schved, Jean-François; Donnadieu-Rigole, Hélène; Blanc, Pierre; Aguilar-Martinez, Patricia

    2016-05-01

    Iron overload (IO) in HFE-related hereditary haemochromatosis is associated with increased risk of liver cancer. This study aimed to investigate the role of other genes involved in hereditary IO among patients with hepatocellular carcinoma (HCC). Patients with HCC diagnosed in our institution were included in this prospective study. Those with ferritin levels ≥300 μg/L (males) or ≥200 μg/L (females) and/or transferrin saturation ≥50% (males) or ≥45% (females) had liver iron concentration (LIC) evaluated by MRI. HFE C282Y and H63D mutations were screened. Genetic analyses of genes involved in hereditary IO (HFE, HJV/HFE2, HAMP, TFR2, SLC40A1, GNPAT) were performed in patients with increased LIC. A total of 234 patients were included; 215 (92%) had common acquired risk factors of HCC (mainly alcoholism or chronic viral hepatitis). 119 patients had abnormal iron parameters. Twelve (5.1%) were C282Y homozygotes, three were compound C282Y/H63D heterozygotes. LIC was measured by MRI in 100 patients. Thirteen patients with a LIC>70 μmol/g were enrolled in further genetic analyses: two unrelated patients bore the HAMP:c.-153C>T mutation at the heterozygous state, which is associated with increased risk of IO and severe haemochromatosis. Specific haplotypes of SLC40A1 were also studied. Additional genetic risk factors of IO were found in 18 patients (7.7%) among a large series of 234 HCC patients. Screening for IO and the associated at-risk genotypes in patients who have developed HCC, is useful for both determining etiologic diagnosis and enabling family screening and possibly primary prevention in relatives. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Cuthbert, Scott C; Rosner, Anthony L

    2012-03-01

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

  13. Esophageal dysmotility in scleroderma: a prospective study of 183 cases.

    Science.gov (United States)

    Lahcene, M; Oumnia, N; Matougui, N; Boudjella, M; Tebaibia, A; Touchene, B

    2009-01-01

    The goal of the study was to evaluate the prevalence and risk factors of esophageal motor disorders in systemic sclerosis. In 183 consecutive cases of scleroderma, as diagnosed by American College of Rheumatology criteria (1980). Patients' mean age was 40.6+/-13.3 years, the gender ratio was 0.13 and the average duration of disease was 6.8+/-7.5 years. A localized, cutaneous form was observed in 148 patients (81%) and a diffuse form in 35 (19%). All patients underwent upper gastrointestinal endoscopy and standard esophageal manometry. Esophageal symptoms and reflux esophagitis were found in 108 (59%) and 68 (37%) of patients, respectively. Esophageal motor disorders were present in 148 patients (81%), and were associated with a hypotensive lower esophageal sphincter in 114 (62%). The presence of these motor abnormalities was not related to age, gender, skin extension or duration of disease. Esophageal motor disorders were present in almost all patients with esophageal symptoms or esophagitis, and were also found in 48 (64%) of the asymptomatic patients. Esophageal motor disorders are frequently seen in scleroderma, especially in cases with clinical symptoms, but are not associated with a specific form of the disease.

  14. Case series of Creutzfeldt-Jakob disease in a third-level hospital in Quito.

    Science.gov (United States)

    Torres Herrán, Germaine Eleanor; Ortega Herrera, Andrés Damián; Burbano, Braulio Martinez; Serrano-Dueñas, Marcos; Ortiz Yepez, María Angélica; Barrera Madera, Raúl Alberto; Masabanda Campaña, Luis Alfredo; Baño Jiménez, Guillermo David; Santos Saltos, Denny Maritza; Correa Díaz, Edgar Patricio

    2018-04-27

    Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disorder that affects mammals and humans. The prevalence of this disease in the United States is 0.5 to 1 per million inhabitants. So far in Ecuador, we do not know what the prevalence or incidence is, and only one case report has been written. We present a case series of Creutzfeldt-Jakob disease in a third-level hospital in Quito. The average age of symptom onset in our patients was 58.8 years. The male to female ratio was 1:1. Two patients began with cognitive/behavioral symptoms, while 4 patients began with focal neurological signs; 1 case with ataxia, 2 with gait disorders and 1 with vertigo and headache. All of the patients had the clinical features established by the World Health Organization. In addition, the entire cohort was positive for the 14-3-3 protein in cerebrospinal fluid, and had high signal abnormalities in caudate and putamen nucleus in DWI and FLAIR IRM. Only in one case, did we reach a definitive diagnosis through a pathological study. All other cases had a probable diagnosis. In this series of cases, 6 out of 6 patients died. The average time from the onset of the symptoms to death in this cohort was 13 months. This is the first report of a series of cases of Creutzfeldt-Jakob disease in Quito. Although definitive diagnosis must be histopathological, there are ancillary tests currently available that have allowed us to obtain a diagnosis of the disease.

  15. Shared written case formulations and weight change in outpatient therapy for anorexia nervosa: a naturalistic single case series.

    Science.gov (United States)

    Gladwin, Alice M; Evangeli, Michael

    2013-01-01

    The therapeutic effects of written shared case formulations are underexplored and have not been examined in anorexia nervosa. This study explored the relationship between (a) the delivery (b) the quality of a shared written case formulation and weight in outpatient psychological therapy for anorexia nervosa. A naturalistic single case series approach was used to examine the case notes of women who had attended a specialist eating disorders service over a 2-year period. The case notes of 15 adult women who had undergone outpatient psychological therapy for anorexia nervosa with a shared written case formulation component were reviewed. The impact of the quality of the case formulation on weekly weight was examined for 14 of the clients where the case formulation was available. The nature of the relationship between the delivery of the written shared case formulation and weight was examined for all 15 clients. There was some evidence to support an association between delivery of the shared written case formulation and weight changes (both weight gain [five out of 15 clients] and weight loss [three out of 15 clients]) in individual cases. Higher case formulation quality was related to cases where weight change did not occur. The delivery of case formulations can be associated with important therapeutic change (both beneficial and potentially harmful) in anorexia nervosa. Future research into the causal mechanisms associated with sharing formulations will face the challenge of adopting strategies that allow for an in-depth exploration of complex therapy variables whilst overcoming methodological challenges. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Determinants of Entrepreneurial Intention among Prospective Graduates of Higher Institutions Case of Wolaita Sodo University

    Science.gov (United States)

    Tegegn, Tesfahun; Paulos, Mesfin; Desalegn, Yonatan

    2016-01-01

    This study entitled "Determinants of Entrepreneurial Intention among Prospective Graduates of Higher Institutions, Case of Wolaita Sodo University" aimed at profiling entrepreneurship among graduating class students at WSU and identify determinants of their entrepreneurial intentions. The study used survey design and collected…

  17. Solid pseudopapillary neoplasm of the pancreas in pediatric patients: A case report and institutional case series

    Directory of Open Access Journals (Sweden)

    Justin B. Mahida

    2015-04-01

    Full Text Available Solid pseudopapillary neoplasm (SPN of the pancreas is a rare tumor presenting in adolescent and young adult females. A previously healthy 13 year-old female presented to our institution with abdominal pain and emesis. Imaging revealed a pancreatic cystic mass. Endoscopic ultrasound (EUS with fine needle biopsy suggested SPN. Pathologic evaluation following resection revealed immunohistochemical (IHC staining positive for β-catenin and α-1-antitrypsin despite extensive necrosis. We discuss this patient as well as our institutional series of SPN of the pancreas, describing the evaluation, management, and histopathology of this rare tumor.

  18. Role of computed tomography of abdomen in difficult to diagnose typhoid fever: a case series.

    Science.gov (United States)

    Hafeez, Wajid; Rajalakshmi, S; Sripriya, S; Madhu Bashini, M

    2018-04-01

    Background and Aim Diagnosis of typhoid is challenging when blood cultures fail to isolate Salmonella species. We report our experience with interpreting computed tomography (CT) abdomen findings in a case series of typhoid fever. Methods The case series consisted of patients who had a CT abdomen done as part of their investigations and a final diagnosis of typhoid fever. The CT films were reviewed and findings evaluated for distinctive features. Results During 2011-2017, 11 patients met the inclusion criteria. Indication for CT was pyrexia of unknown origin in the majority of patients. Review of CT films revealed mesenteric lymphadenopathy (100%), terminal ileum thickening (85%), hepatosplenomegaly (45%), retroperitoneal lymphadenopathy (18%) and ascites (9%). Conclusions Enhancing discrete mesenteric lymphadenopathy and terminal ileum thickening are non-specific findings noted in typhoid fever. Absence of matted necrotic nodes and peritoneal thickening rule out tuberculosis and raise suspicion of typhoid fever in endemic regions.

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Testing independence between two Poisson-generated multinomial variables in case-series and cohort studies.

    Science.gov (United States)

    Hocine, Mounia; Guillemot, Didier; Tubert-Bitter, Pascale; Moreau, Thierry

    2005-12-30

    In case-series or cohort studies, we propose a test of independence between the occurrences of two types of recurrent events (such as two repeated infections) related to an intermittent exposure (such as an antibiotic treatment). The test relies upon an extension of a recent method for analysing case-series data, in the presence of one type of recurrent event. The test statistic is derived from a bivariate Poisson generated-multinomial distribution. Simulations for checking the validity of the test concerning the type I error and the power properties are presented. The test is illustrated using data from a cohort on antibiotics bacterial resistance in schoolchildren. Copyright 2005 John Wiley & Sons, Ltd.