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Sample records for tracheomegaly a case

  1. Tracheomegaly Secondary to Tracheotomy Tube Cuff in Amyotrophic Lateral Sclerosis: A Case Report.

    Science.gov (United States)

    Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

    2015-10-01

    Tracheomegaly has not been reported in amyotrophic lateral sclerosis (ALS). Herein, the authors report a case of tracheomegaly secondary to tracheotomy tube cuff in a patient with ALS. To our knowledge, this is the first report of an ALS patient with tracheomegaly and of tracheomegaly being associated with tracheotomy tube cuff and home tracheotomy mechanical ventilator.The clinician should consider the possibility of tracheomegaly in the differential diagnosis, if a patient with ALS develops repeat air leakage around the tracheotomy tube or rupture of tracheotomy tube cuff.

  2. Tracheomegaly Secondary to Tracheotomy Tube Cuff in Amyotrophic Lateral Sclerosis

    OpenAIRE

    Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

    2015-01-01

    Abstract Tracheomegaly has not been reported in amyotrophic lateral sclerosis (ALS). Herein, the authors report a case of tracheomegaly secondary to tracheotomy tube cuff in a patient with ALS. To our knowledge, this is the first report of an ALS patient with tracheomegaly and of tracheomegaly being associated with tracheotomy tube cuff and home tracheotomy mechanical ventilator. The clinician should consider the possibility of tracheomegaly in the differential diagnosis, if a patient with AL...

  3. Tracheomegaly in association with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Celenk, C.; Selcuk, M.B.; Oezyazici, B.; Celenk, P.; Kuru, Oe.

    2000-01-01

    Herein we present a case of tracheomegaly seen in a patient with rheumatoid arthritis. To the authors' knowledge, and from a review of the literature, this combination has not been previously described. (orig.)

  4. Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    McHugh, Kieran; Afaq, Asim; Roebuck, Derek J. [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom); Broderick, Nigel [Nottingham University Hospitals, Radiology Department, Nottingham (United Kingdom); Gabra, Hany O.; Elliott, Martin J. [Great Ormond Street Hospital for Children, Department of Cardiothoracic Surgery, London (United Kingdom)

    2010-05-15

    Fetal endoscopic tracheal occlusion (FETO) is a promising treatment for severe congenital diaphragmatic hernia, a condition that carries significant morbidity and mortality. It is hypothesised that balloon occlusion of the fetal trachea leads to an improvement in lung growth and development. The major documented complications of FETO to date are related to preterm delivery. To report a series of five infants who developed tracheomegaly following FETO. Review of all children referred with tracheomegaly to the paediatric intensive care and tracheal service at two referral centres. Five neonates presented with features of respiratory distress shortly after birth and were subsequently found to have marked tracheomegaly. Two neonates had tracheomalacia in addition. There are no previous reports in the literature describing tracheomalacia, or more specifically, tracheomegaly, as a consequence of FETO. We propose that the particularly compliant fetal airway is at risk of mechanical damage from in utero balloon occlusion. This observation of a new problem in this cohort suggests a thorough evaluation of the trachea should be performed in children who have had FETO in utero. It may be that balloon occlusion of the trachea earlier in utero (before 26 weeks' gestation) predisposes to this condition. (orig.)

  5. Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia

    International Nuclear Information System (INIS)

    McHugh, Kieran; Afaq, Asim; Roebuck, Derek J.; Broderick, Nigel; Gabra, Hany O.; Elliott, Martin J.

    2010-01-01

    Fetal endoscopic tracheal occlusion (FETO) is a promising treatment for severe congenital diaphragmatic hernia, a condition that carries significant morbidity and mortality. It is hypothesised that balloon occlusion of the fetal trachea leads to an improvement in lung growth and development. The major documented complications of FETO to date are related to preterm delivery. To report a series of five infants who developed tracheomegaly following FETO. Review of all children referred with tracheomegaly to the paediatric intensive care and tracheal service at two referral centres. Five neonates presented with features of respiratory distress shortly after birth and were subsequently found to have marked tracheomegaly. Two neonates had tracheomalacia in addition. There are no previous reports in the literature describing tracheomalacia, or more specifically, tracheomegaly, as a consequence of FETO. We propose that the particularly compliant fetal airway is at risk of mechanical damage from in utero balloon occlusion. This observation of a new problem in this cohort suggests a thorough evaluation of the trachea should be performed in children who have had FETO in utero. It may be that balloon occlusion of the trachea earlier in utero (before 26 weeks' gestation) predisposes to this condition. (orig.)

  6. Tracheomegaly: a complication of fetal endoscopic tracheal occlusion in the treatment of congenital diaphragmatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    McHugh, Kieran; Afaq, Asim; Roebuck, Derek J [Great Ormond Street Hospital for Children, Radiology Department, London (United Kingdom); Broderick, Nigel [Nottingham University Hospitals, Radiology Department, Nottingham (United Kingdom); Gabra, Hany O; Elliott, Martin J [Great Ormond Street Hospital for Children, Department of Cardiothoracic Surgery, London (United Kingdom)

    2010-05-15

    Fetal endoscopic tracheal occlusion (FETO) is a promising treatment for severe congenital diaphragmatic hernia, a condition that carries significant morbidity and mortality. It is hypothesised that balloon occlusion of the fetal trachea leads to an improvement in lung growth and development. The major documented complications of FETO to date are related to preterm delivery. To report a series of five infants who developed tracheomegaly following FETO. Review of all children referred with tracheomegaly to the paediatric intensive care and tracheal service at two referral centres. Five neonates presented with features of respiratory distress shortly after birth and were subsequently found to have marked tracheomegaly. Two neonates had tracheomalacia in addition. There are no previous reports in the literature describing tracheomalacia, or more specifically, tracheomegaly, as a consequence of FETO. We propose that the particularly compliant fetal airway is at risk of mechanical damage from in utero balloon occlusion. This observation of a new problem in this cohort suggests a thorough evaluation of the trachea should be performed in children who have had FETO in utero. It may be that balloon occlusion of the trachea earlier in utero (before 26 weeks' gestation) predisposes to this condition. (orig.)

  7. Tracheomalacia Treatment Using a Large-Diameter, Custom-Made Airway Stent in a Case with Mounier-Kuhn Syndrome

    OpenAIRE

    Özdemir, Cengiz; Sökücü, Sinem Nedime; Karasulu, Levent; Altın, Sedat; Dalar, Levent

    2014-01-01

    Mounier-Kuhn Syndrome (MKS) is a rare congenital disease that presents with abnormal enlargement in the central airways. In MKS, tracheomegaly is accompanied by difficulty in expelling recurrent lung infections and bronchiectasia. We presented a patient with MKS where commercially made stents were inadequate for stabilization and a custom-made, self-expandable metallic stent with a diameter of 28 mm and length of 100 mm was used. Chest pain that was thought to develop due to the stent and tha...

  8. Tracheomalacia treatment using a large-diameter, custom-made airway stent in a case with mounier-kuhn syndrome.

    Science.gov (United States)

    Ozdemir, Cengiz; Sökücü, Sinem Nedime; Karasulu, Levent; Altın, Sedat; Dalar, Levent

    2014-01-01

    Mounier-Kuhn Syndrome (MKS) is a rare congenital disease that presents with abnormal enlargement in the central airways. In MKS, tracheomegaly is accompanied by difficulty in expelling recurrent lung infections and bronchiectasia. We presented a patient with MKS where commercially made stents were inadequate for stabilization and a custom-made, self-expandable metallic stent with a diameter of 28 mm and length of 100 mm was used. Chest pain that was thought to develop due to the stent and that disappeared after stent removal may be considered the main complication leading to stent removal. Continuous positive airway pressure therapy (CPAP) therapy was planned for the control of symptoms, which re-emerged after stent removal. This case is presented as an example that complications developing due to the stent as well as patient noncompliance may lead to stent removal, even when useful results are obtained from treatment of MKS.

  9. Tracheomalacia Treatment Using a Large-Diameter, Custom-Made Airway Stent in a Case with Mounier-Kuhn Syndrome

    Directory of Open Access Journals (Sweden)

    Cengiz Özdemir

    2014-01-01

    Full Text Available Mounier-Kuhn Syndrome (MKS is a rare congenital disease that presents with abnormal enlargement in the central airways. In MKS, tracheomegaly is accompanied by difficulty in expelling recurrent lung infections and bronchiectasia. We presented a patient with MKS where commercially made stents were inadequate for stabilization and a custom-made, self-expandable metallic stent with a diameter of 28 mm and length of 100 mm was used. Chest pain that was thought to develop due to the stent and that disappeared after stent removal may be considered the main complication leading to stent removal. Continuous positive airway pressure therapy (CPAP therapy was planned for the control of symptoms, which re-emerged after stent removal. This case is presented as an example that complications developing due to the stent as well as patient noncompliance may lead to stent removal, even when useful results are obtained from treatment of MKS.

  10. Tracheobronchomegaly and rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rua Marin, Catalina; Diaz Betancur, James Samir; Cardona, Alejandro; Ramirez Gomez, Luis Alberto

    2008-01-01

    Tracheobronchomegaly is a rare condition of unknown etiology that has been described in association with connective tissue diseases. We present a case of tracheomegaly in a patient with a long evolution rheumatoid arthritis. This is the second case reported in the medical literature until now. Association between these pathologies is uncertain and we can not establish a clear pathophysiological link due to the rarity of its occurrence and the late onset of symptoms

  11. CASE REPORT CASE CASE Post-traumatic cholesteatoma … a ...

    African Journals Online (AJOL)

    CASE REPORT. CASE. 46. SA JOURNAL OF RADIOLOGY • July 2008. CASE. Abstract. Temporal bone fractures and their acute complications have been well described in radiology and ENT journals; this is in contrast to ... post-traumatic cholesteatomas and made postulations on their origin. Since then, there have been ...

  12. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    Science.gov (United States)

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  13. Defining a periodontitis case

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Lopez, Rodrigo

    2012-01-01

    . Conclusions The results indicate that it should be feasible for the periodontal community to reach an agreement over the distinction between a case and a non-case. The classification system proposed by van der Velden is better suited for providing clinicians with a clear image of the case....

  14. Location of gliomas in relation to mobile telephone use: a case-case and case-specular analysis

    DEFF Research Database (Denmark)

    Larjavaara, Suvi; Schüz, Joachim; Swerdlow, Anthony

    2011-01-01

    approaches: In a case-case analysis, tumor locations were compared with varying exposure levels; in a case-specular analysis, a hypothetical reference location was assigned for each glioma, and the distances from the actual and specular locations to the handset were compared. The study included 888 gliomas......The energy absorbed from the radio-frequency fields of mobile telephones depends strongly on distance from the source. The authors' objective in this study was to evaluate whether gliomas occur preferentially in the areas of the brain having the highest radio-frequency exposure. The authors used 2...... from 7 European countries (2000-2004), with tumor midpoints defined on a 3-dimensional grid based on radiologic images. The case-case analyses were carried out using unconditional logistic regression, whereas in the case-specular analysis, conditional logistic regression was used. In the case-case...

  15. Case Report: A Unique Case Of Cystic Echinococcosis in a Sahiwal ...

    African Journals Online (AJOL)

    Case Report: A Unique Case Of Cystic Echinococcosis in a Sahiwal Cow in Narok County, Kenya. JA Omega, PK Koskei. Abstract. A three and a half year old pregnant Sahiwal cow born and reared just outside the Maasai Mara National Game Reserve in Narok County, Kenya was noticed to walk slowly, cough occasionally ...

  16. Writing a case report: polishing a gem?

    Science.gov (United States)

    Papanas, N; Lazarides, M K

    2008-08-01

    Case reports describe patient cases which are of particular interest due to their novelty and their potential message for clinical practice. While there are several types of case reports, originality and clinical implications constitute the main virtues by which case reports are judged. Defining the educational message and choosing the right audience are vital steps in the process of writing. Generally, a case report is structured, its main components being the abstract, the introduction, the case description and the discussion. Guidelines and tips for writing case reports are not enough for making a successful author, but they help, especially less experienced doctors, to exercise and improve their writing. If properly prepared, case reports can still communicate new observations in an interesting and pleasant way, thereby enriching our knowledge, even in the era of evidence-based medicine.

  17. Teaching Business French through Case Studies: Presentation of a Marketing Case.

    Science.gov (United States)

    Federico, Salvatore; Moore, Catherine

    The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

  18. 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

  19. Urachal endometrioma: a case report.

    LENUS (Irish Health Repository)

    Browne, Katherine M

    2009-01-01

    INTRODUCTION: We discuss a rare presentation of an unusual case of endometrioma. CASE PRESENTATION: A 40-year-old Caucasian woman presented with subacute abdominal pain and a suprapubic mass. A final diagnosis was made after the mass was resected and histopathology confirmed an endometrioma originating from an urachal remnant. Select imaging studies and histopathology are presented in this case report. CONCLUSION: While endometriomata are well known to arise from abdominal scars, the condition described in this case report is a rare example of an endometrioma arising from the urachus. A review of the pathological complications of the urachus is also included.

  20. A challenging case of invasive pulmonary aspergillosis after near-drowning: a case report and literature review.

    Science.gov (United States)

    Jenks, Jeffrey D; Preziosi, Michael

    2015-09-01

    Near-drowning, a relatively common event, is often complicated by subsequent pneumonia. While endogenous and exogenous bacteria are typical pathogens, rarely fungi are as well. We report a complicated case of invasive pulmonary aspergillosis in a 30-year-old man after a near-drowning event. We also review the medical literature for similar cases. All cases of invasive pulmonary aspergillosis after near-drowning reported in the literature involve Aspergillus fumigatus . The majority of cases involved submersion in stagnant water after a motor vehicle accident (MVA). Treatment varied considerably, with amphotericin B used in the majority of cases. Morbidity was considerable with prolonged hospitalization occurring in every case, and mortality occurring in fifty percent of the reported cases. Although a rare complication of near-drowning, invasive pulmonary aspergillosis can occur and lead to significant morbidity and mortality. After near-drowning A. fumigatus isolated from the respiratory tract should be assumed to be a true pathogen and treated accordingly.

  1. 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...

  2. A case of unilateral dysmenorrhea

    Directory of Open Access Journals (Sweden)

    Tulon Borah

    2010-01-01

    Full Text Available Unilateral dysmenorrhea in an adolescent may be associated with uterine malformation. Relevant investigations in suspected cases and timely intervention can prevent future complications in such cases. Here, we present a case of unicornuate uterus with rudimentary horn in an adolescent complaining of unilateral dysmenorrhea.

  3. Dioctophymiasis: A Rare Case Report.

    Science.gov (United States)

    Chauhan, Sapna; Kaval, Sunil; Tewari, Swati

    2016-02-01

    Dioctophyma renale commonly known as "giant kidney worm' is found in the kidney of carnivorous mammals. Human infestation is rare, but results in destruction of the kidneys. Very few cases have been reported worldwide. We are here reporting a case of Dioctophymiasis in a 35-year-old male patient who presented with retention of urine and subsequent passage of worm and blood in urine. The worm was confirmed as Dioctophyma renale based on its morphology and clinical presentation. This is a very rare case report and to best of our knowledge only two cases have been reported from India.

  4. Contemplating case mix: A primer on case mix classification and management.

    Science.gov (United States)

    Costa, Andrew P; Poss, Jeffery W; McKillop, Ian

    2015-01-01

    Case mix classifications are the frameworks that underlie many healthcare funding schemes, including the so-called activity-based funding. Now more than ever, Canadian healthcare administrators are evaluating case mix-based funding and deciphering how they will influence their organization. Case mix is a topic fraught with technical jargon and largely relegated to government agencies or private industries. This article provides an abridged review of case mix classification as well as its implications for management in healthcare. © 2015 The Canadian College of Health Leaders.

  5. 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).

  6. Breast cancer case using tamoxifen during pregnancy: a case report ...

    African Journals Online (AJOL)

    This is a case of 32 years old nulliparous female who was diagnosed in November 2004 as a case of carcinoma of the right breast , luminal A , (Estrogen Receptor positive Progesterone receptor negative, Her 2 negative, Ki67 10 %), poorly differentiated invasive ductal cancer, TNM stage,T2 N0 MO. She had a wide local ...

  7. Trichotillomania in a dementia case

    OpenAIRE

    Caixeta, Leonardo; Lopes, Danielly Bandeira

    2011-01-01

    Abstract We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger's disease). Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-s...

  8. Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie

    2017-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

  9. Intrahepatic splenosis: a case report

    International Nuclear Information System (INIS)

    Pekkafali, Zekai; Karsli, Fevzi A.; Silit, Emir; Basekim, Cinar C.; Mutlu, Hakan; Kizilkaya, Esref; Narin, Yavuz

    2002-01-01

    Splenosis is heterotopic autotransplantation and seeding of splenic tissue. In the literature, only a few cases of splenosis involving the liver and the radiologic characteristics of these lesions have been reported. We report a case of intrahepatic splenosis diagnosed by ultrasound, computed tomography, magnetic resonance imaging and scintigraphic features. To our knowledge, our patient is the first case diagnosed only by radiologic and radionuclide examination without any intervention. (orig.)

  10. Treatment phases in management of a comprehensive restorative case. A case report

    International Nuclear Information System (INIS)

    AlSamh, Duaa Abo; Endo, Cert End

    2008-01-01

    The aim of this case report was to emphasize the value of preforming patient's treatment plan into phases of treatment and encouraging colleagues to apply such phases in the clinical practice for the management of complex restorative cases. Traditional approach to treatment planning has certain merits. However, new treatment approach should improve oral health rather than react to presenting problems and therefore, dentists should aim to convert their irregular attendee to a regular attendee with treatment plan directed to enhance oral health, prevent disease, improve esthetic and free the patient from pain and discomfort. In this report, a complex restorative case of a 16-year-old female patient was managed for comprehensive dental therapy in the form of treatment plan which was divided into phases by way of a ''staircase'' approach with one clinical step being dependent on the previous step. The whole treatment was completed in three months and the results were satisfactory and patient became a highly motivated person with more self-confidence. (author)

  11. A case of pancreatolithiasis

    International Nuclear Information System (INIS)

    Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira

    1982-01-01

    During 3-year follow-up of a case of pancreatolithiasis localized in the pancreatic head, CT showed sudden new appearance of calculi over an extensive area of the body and tail of the pancreas after acute exacerbation of chronic pancreatitis. This case and the etiology and mechanism of pancreatolithiasis were discussed on the basis of literature. (Chiba, N.)

  12. Trichotillomania in a dementia case

    Directory of Open Access Journals (Sweden)

    Leonardo Caixeta

    Full Text Available Abstract We report an 87-year-old male case of hair pulling associated with a white-matter vascular dementia (Binswanger's disease. Trichotillomania in our case did not resolve using mirtazapine or anticholinesterasic medication. Trichotillomania seems to be related to a form of perseveration associated with dementia. The findings in this case suggest the abnormality involving white matter in the pathogenesis of trichotillomania, may constitute a defect in connectivity in the right frontal-subcortical circuit.

  13. PHAKOMATOSIS PIGMENTOVASCULARIS: REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    Mostafa Mirshams-Shahshahani

    1995-06-01

    Full Text Available The present study introduces a rare case of phakomatosispigmenJovascularis, which is charaderiud by the existence ofpigmentary naevus ond vascular naevus. Until 1985, 63 cases ofthis syndrome have been reported, mostly in Japon (56 cases. This is the first case of phakomatosis pigmentovascularis, reported in Iran.

  14. CASE REPORT CASE A super 'lead pipe' colon: radio-pathological ...

    African Journals Online (AJOL)

    2008-10-15

    Oct 15, 2008 ... cancer in UC. Clearly, correct diagnosis is crucial. Our case not only had severe findings and a diagnosis that predated her surgery, but also had no clinical, radiological or histological features of the other alternative diagnoses. The case demonstrates an unusually severe form of 'lead pipe' colon occurring ...

  15. [Amyand's hernia--a clinical case].

    Science.gov (United States)

    Savlovschi, C; Brănescu, C; Serban, D; Tudor, C; Găvan, C; Shanabli, A; Comandaşu, M; Vasilescu, L; Borcan, R; Dumitrescu, D; Sandolache, B; Sajin, M; Grădinaru, S; Munteanu, R; Kraft, A; Oprescu, S

    2010-01-01

    Amyand's hernia, a rare entity in the surgical pathology, presupposes the presence of the vermiform appendix inside a inguinal hernia sac (1). The hernia sac peritonitis by appendix swelling is even more rare, very few cases being presented in the surgical literature (1). The preoperatory diagnosis of Amyand's hernia is therefore very difficult. We herein present the case of a 71-year old male patient, operated on an emergency basis for hernia, which eventually turned out to be Amyand's hernia, a case which determined us to research the literature dedicated to this topic.

  16. Human babesiosis - A case report

    Directory of Open Access Journals (Sweden)

    Marathe A

    2005-01-01

    Full Text Available Babesiosis is an emerging, tick-transmitted, zoonotic disease caused by hematotropic parasites of the genus Babesia. Most cases of Babesial infections in humans have been acquired in temperate regions of the United States, Europe, France and England. A few cases of Babesiosis have been described in other parts of the world, including China, Taiwan, Egypt, South Africa, and Mexico.1,2 We report the first case of human Babesiosis, in a normosplenic, previously healthy individual from India.

  17. What is in a Business Case? Business Cases as a Tool‐in‐Use for Promoting Water Stewardship

    DEFF Research Database (Denmark)

    Pedersen, Esben Rahbek Gjerdrum; Lauesen, Linne Marie; Rosati, Francesco

    This paper explores the role of business cases as a tool‐in‐use for decision‐making processes on Water management. The literature is rich on generic discussions of the business case for corporate sustainability, whereas there have been less efforts to examine the concrete use of business cases...... in everyday organisational life. Drawing on the practice‐based management literature, it is concluded that the business case tool has a decisive influence on water management activities among European food companies. However, the analysis also show the business case tool are not set in stone but can...

  18. TA Treatment of Depression - A Hermeneutic Single-Case Efficacy Design Study - ‘Linda’ - a mixed outcome case

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2013-07-01

    Full Text Available Hermeneutic Single-Case EfficacyDesign (HSCED is a systematic case study research method involving the cross-examination of mixed method data to generate both plausible arguments that the client changed due to therapy and alternative explanations. The present study is the fourth article of a case series which has investigated the process and outcome of transactional analysis psychotherapy using Hermeneutic Single-Case Efficacy Design (Elliott 2002. The client, Linda, was a 45 yearold white British woman with mild depression who attended nine sessions of therapy. The conclusion of the judges was that this was a mixed-outcome case:whilst the client improved over the course of therapy and was positive about her experience of therapy, her changes did not last when she experienced considerable stressful events during follow-up. Linda provided a detailed and idiosyncratic description of the aspects of the therapy which were most helpful for her. A cross-case comparison with other cases in this series suggests several interesting features which are worthy of further investigation. Specifically, the use of a shared theoretical framework and an egalitarian therapeutic relationship were helpful. As with other cases in this series, the client experienced positive changes in her interpersonal relationships suggesting that this outcome of TA therapy warrants further investigation

  19. The wavefield of acoustic logging in a cased-hole with a single casing - Part I: a monopole tool

    Science.gov (United States)

    Wang, Hua; Fehler, Michael

    2018-01-01

    The bonding quality of the seal formed by the cement or collapse material between casing and formation rock is critical for the hydraulic isolation of reservoir layers with shallow aquifers, production and environmental safety, and plug and abandonment issues. Acoustic logging is a very good tool for evaluating the condition of the bond between different interfaces. The understanding of the acoustic logging wavefields in wells with single casing is still incomplete. We use a 3-D finite difference method to simulate wireline monopole wavefields in a single cased borehole with different bonding conditions at two locations: (1) between the cement and casing and (2) between the cement and formation. Pressure snapshots and waveforms for different models are shown, which allow us to better understand the wave propagation. Modal dispersion curves and data processing methods such as velocity-time semblance and dispersion analysis facilitate the identification of propagation modes in the different models. We find that the P wave is submerged in the casing modes and the S wave has poor coherency when the cement is replaced with fluid. The casing modes are strong when cement next to the casing is partially or fully replaced with fluid. The amplitude of these casing modes can be used to determine the bonding condition of the interface between casing and cement. However, the limited variation of the amplitude with fluid thickness means that amplitude measurements may lead to an ambiguous interpretation. When the cement next to the formation is partially replaced with fluid, the modes propagate in the combination of steel casing and cement and the velocities are highly dependent on the cement thickness. However, if the cement thickness is large (more than 2/3 of the annulus between casing and rock), the arrival time of the first arrival approximates that of the formation compressional wave when cement is good. It would highly likely that an analyst could misjudge cement quality

  20. Patterned genital injury in cases of rape - A case-control study

    DEFF Research Database (Denmark)

    Astrup, Birgitte Schmidt; Ravn, Pernille; Thomsen, Jørgen Lange

    2013-01-01

    A pattern of genital injury that separates trauma seen in sexual assault cases from trauma seen following consensual sexual intercourse has been a matter of debate. This study aimed at clarifying the question by eliminating as many confounders as possible in a prospective, case-control setup. A t...

  1. An unusual case of neonatal mastocytoma: A case report

    Directory of Open Access Journals (Sweden)

    Guglielmo Pranteda

    2017-08-01

    Full Text Available Mastocytosis is a group of disorders characterized by the accumulation of mast cells in various tissues. In this article we report an interesting case of cutaneous mastocytoma in a 3-month-old infant. We describe two episodes characterized by an exacerbation of the skin lesion with the typical Darier’s sign. Both of them occurred after breastfeeding. In both episodes, the mother had eaten shrimps before the breastfeeding. This peculiar case, difficult to understand regarding its pathogenesis, was successful resolved just with dietary prescription given to the breast feeding mother.

  2. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru

    2013-01-01

    articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing...

  3. No case for Case in locality: Case does not help interpretation when intervention blocks A-bar chains

    Directory of Open Access Journals (Sweden)

    Naama Friedmann

    2017-04-01

    Full Text Available We discuss a robust yet at first sight surprising fact: individuals who have problems understanding sentences with object A-bar movement cannot use overt Case marking of the object to interpret these sentences and to associate the DPs with thematic roles. We tested the effect of overt Case marking of the object in typically developing Hebrew-speaking children by comparing their comprehension of 'which 'object questions with and without the object Case marker 'et', and found that there was no difference in comprehension between the two. A similar pattern was found in an adolescent with syntactic SLI. We then tested the comprehension of object topicalized structures in the order OVS, where the only element identifying these sentences as object-first sentences and distinguishing them from simple SVO sentences was the object marker. We tested this in three populations with object A-bar movement problems: individuals with agrammatism, adolescents with syntactic SLI, and orally-trained children with hearing impairment, as well as in analysis of previous data on typically-developing children acquiring Hebrew. All populations failed to understand the sentence, but did not consistently reverse the thematic roles of the two noun phrases. This suggests that they were sensitive to the presence of the Case marker but could not use it for interpretation. We argue that these findings immediately follow from the way intervention and locality are computed, under the featural Relativized Minimality approach. Case is not among the features triggering movement, therefore a Case difference is not taken into account in trying to build a movement chain across an intervener. As a result, the object chain cannot be built across the intervening subject in the relevant cases, and overt Case marking of the object cannot help rescue the structure. Thematic role assignment in complex movement configurations requires the building of movement chains; if chain formation fails

  4. Hepatopulmonary syndrome: a case report

    NARCIS (Netherlands)

    Huurnink, Arnold

    2015-01-01

    Huurnink A, Van den Berg CHSB, Booij J. Hepatopulmonary syndrome: a case report. Hepatopulmonary syndrome is characterised by a lowered oxygenation caused by intrapulmonary vascular dilatation in the setting of a liver disease. We present a case of a 42-year old woman with a Budd-Chiari syndrome,

  5. Sirenomelia: a case report.

    Science.gov (United States)

    Mandal, Subinay; Bandyopadhyay, Anjali; Ray, Sumit

    2009-01-01

    Sirenomelia (Mermaid syndrome) is a rare anomaly of caudal region of the body, presented with fusion of the lower limbs. Genito-urinary, gastro-intestinal, neural tube and vertebral anomalies are found in most cases. Here a case of sirenomelia born of a 5th gravida mother is reported. The body had fusion of both lower limbs, absent genitalia, absent anal orifice and single umbilical artery. It died 2 1/2 hours after birth. Autopsy was undertaken to verify various anomalies.

  6. SIRENOMELIA: A CASE REPORT

    OpenAIRE

    Wankhede; Shrivastava

    2016-01-01

    The incidence of Sirenomelia is thought to be about 1 in 65,000 live births (Oxford Medical database, Dysmorphology). In Sirenomelia, lower limbs are fused together. Common associated malformations include absent genitalia, imperforate anus, lumbosacral vertebral pelvic abnormalities and renal agenesis. Sirenomelia with craniorachischisis totalis (CT) is a rare fetal malformation, only six cases have been reported in English literature (1-5) and none yet from Asia. Our case is of ...

  7. Periosteal osteosarcoma: A case report

    Directory of Open Access Journals (Sweden)

    Errol U. Hutagalung

    2003-09-01

    Full Text Available Periosteal osteosarcoma is a rare type of malignant bone neoplasm, with predominantly cartilaginous component and arising on the bone surface. Reports of the case in the literature were rare. Last case was reported by Mayo Clinic in 1999. We report a case of periosteal osteosarcoma in a 17-year-old male, who was treated surgically with a limb salvage procedure, neoadjuvant and adjuvant chemotherapy were also given to the patient. There was no local recurrence and lung metastases up to 14 months after surgery. (Med J Indones 2003; 12: 166-70 Keywords: osteosarcoma, periosteal osteosarcoma, limb salvage

  8. The Analysis of a Murder, a Case Study

    Science.gov (United States)

    Dinan, Frank J.; Szczepankiewicz, Steven H.; Carnaham, Melinda; Colvin, Michael T.

    2007-01-01

    The analysis of a Murder case study can be used in general chemistry or nonscience major chemistry courses to teach data handling and analysis in a non-laboratory context. This case study will help students to respond more enthusiastically and with more interest to a set of material placed before them related to a real case rather than…

  9. Writing a Case Report: A Work of Art

    Directory of Open Access Journals (Sweden)

    Christian Ortega-Loubon

    2015-10-01

    Full Text Available Case reports are a time-honored, important, integral, accepted part firmly established within the medical literature, and represent a growing importance of valuable clinical medical information. Parkinson´s disease, and Kaposi´s Sarcoma are only a few examples of famous diseases first described in the case report format, and making us acknowledge the value of case reports to the scientific literature. Case reports are valuable resources of new and unusual information that may lead to vital research and advances in clinical practice that improve patient outcomes.

  10. [A case of lingual agenesis].

    Science.gov (United States)

    Carinci, F; Felisatti, P; Curioni, C

    1996-01-01

    Lingual agenesis is a rare anomaly caused by failed morphogenesis of the lateral lingual swellings during embriogenesis. Most reported cases have been part of oromandibular limb hypogenesis syndrome (OLHS). A case of lingual agenesis associated with micrognathia and alteration of the hands is reported.

  11. Renal myxoma: a case report

    Directory of Open Access Journals (Sweden)

    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  12. A case of inflammatory ascites

    Directory of Open Access Journals (Sweden)

    Marco Biolato

    2008-03-01

    Full Text Available Even ascites appears mainly as sign of portal hypertension in patiens with liver cirrhosis, in some case depends on a different lying condition such as right congestive heart failure, peritoneal carcinomatosis or tuberculosis. In these cases, paracentesis represents the key tool for diagnosis. We report a case of cardiac ascites in a 71-years-old woman who developed in four-month an abdominal distension. Preliminary exams showed exudative ascites related to portal hypertension, a pelvic mass with caseous apparence, and inflammatory status ad an elevation of CA-125. Successive evaluation exluded peritoneal carcinomatosis or tuberculosis, underlyng a tricuspidal regurgitation. The literature on ascites has also been reviewed.

  13. Case Study: What Makes a Good Case, Revisited: The Survey Monkey Tells All

    Science.gov (United States)

    Herried, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

    2016-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. In this month's issue the authors provide a more definitive answer to the "What Makes a Good Case?" question based on a just-completed Survey Monkey survey given to NCCSTS teachers.

  14. A Case: Eight-and-A-Half Syndrome

    Directory of Open Access Journals (Sweden)

    Cennet Nalan Kuş

    2007-12-01

    Full Text Available Scientific BACKGROUND: The combination of clinical one-and-a-half syndrome together with cranial nerve VII palsy is known to as eight-and-a-half syndrome. It localized the pathology to the pons. OBJECTIVE: To report a case having clinical and radiologic findings typical of eight-and-a-half syndrome. CASE: 65 year old man with hypertension presented with sudden onset of binocular diplopia left facial weakness. Magnetic resonance imaging demostrated a small lesion in the left paramedian pontine tegmentum. CONCLUSION: To our knowledge, this is the first report of a case of eight-and-a-half syndrome in Turkish literature

  15. Case-based reasoning a concise introduction

    CERN Document Server

    López, Beatriz

    2013-01-01

    Case-based reasoning is a methodology with a long tradition in artificial intelligence that brings together reasoning and machine learning techniques to solve problems based on past experiences or cases. Given a problem to be solved, reasoning involves the use of methods to retrieve similar past cases in order to reuse their solution for the problem at hand. Once the problem has been solved, learning methods can be applied to improve the knowledge based on past experiences. In spite of being a broad methodology applied in industry and services, case-based reasoning has often been forgotten in

  16. Asynchronous asymmetric form of heterogeneous osteopetrosis: initial case expanded and a new case

    International Nuclear Information System (INIS)

    Young, L.W.; Lachman, R.S.

    2001-01-01

    We have discovered additional serial radiographs and clinical information on the initial case of ''regional osteopetrosis tarda'' that has been included in several editions of Caffey's Pediatric X-Ray Diagnosis. A definite second case was found after a search of radiology teaching files of other selected medical centers and the International Skeletal Dysplasia Registry. Analysis of the sequential unusual radiographic findings of the initial case and the equivalent compelling findings of the second case justifies renewed attention to an asynchronous asymmetric form of heterogeneous osteopetrosis. (orig.)

  17. A severe case of erythrodermic psoriasis associated with advanced nail and joint manifestations: a case report

    Directory of Open Access Journals (Sweden)

    Balderrama Carola

    2010-06-01

    Full Text Available Abstract Introduction Erythrodermic psoriasis is a rare generalized clinical presentation of psoriasis in children and adults. Its systemic involvement and a diverse range of clinical findings in the joint and nails are commonly described. A high index of suspicion and an exhaustive differential diagnosis involving other causes of erythroderma should be initially considered. Case presentation We present the case of a 9-year-old native Hispanic girl with severe erythrodermic psoriasis associated with uncommon advanced nail and joint manifestations. Our patient showed an excellent response to methotrexate medication. Conclusion This case shows clinical features not commonly described or reported in severe cases of erythrodermic psoriasis, including severe and rare nail and arthritic findings in a pediatric scenario.

  18. A case study of a Cuban government institution

    International Nuclear Information System (INIS)

    Nunez, A.L.; Vazquez, A.; Cruz Cabrera, L.

    2004-01-01

    The aim of this contribution is to present a case study on the partial implementation of a knowledge management system in an institution. In this case the knowledge management has been directed toward the best performance of the organization. The tool used in case study can be implemented at any institution, including institutions of nuclear or radiological profiles. (author)

  19. CASE REPORT A recurrent gestational choriocarcinoma case ...

    African Journals Online (AJOL)

    Admin

    molar pregnancy (Luna Russo et al., 2015). To our knowledge recurrence resulting in rupture 14 month following a live pregnancy is an extremely rare event. Management of gestational trophoblastic disease in our setup poses multiple challenges as seen in this particular case. Serum β-HCG follow up for these patients ...

  20. A Case of Traumatic Proptosis

    Directory of Open Access Journals (Sweden)

    Bobby Desai

    2013-01-01

    Full Text Available We present a case of traumatic proptosis in a competitive football player. This entity can occur with a significant decrease in vision, but in this case it did not. Some other causes of this condition are also discussed. A review of some traumatic conditions that may cause proptosis is provided as well.

  1. Associative visual agnosia: a case study.

    Science.gov (United States)

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  2. Case Report Writing in a Doctor of Physical Therapy Education Program: A Case Study

    Science.gov (United States)

    Fillyaw, Michael J.

    2011-01-01

    Case reports are an established form of scholarship used for teaching and learning in medicine and health care, but there are few examples of the teaching and learning activities used to prepare students to write a case report. This report describes the implementation of two courses that prepare physical therapy students to write and disseminate a…

  3. Associative Visual Agnosia: A Case Study

    Directory of Open Access Journals (Sweden)

    A. Charnallet

    2008-01-01

    Full Text Available We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive episodic models of memory [4].

  4. Associative Visual Agnosia: A Case Study

    OpenAIRE

    Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

    2008-01-01

    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4].

  5. A technology-enhanced patient case workshop.

    Science.gov (United States)

    Pai, Vinita B; Kelley, Katherine A; Bellebaum, Katherine L

    2009-08-28

    To assess the impact of technology-based changes on student learning, skill development, and satisfaction in a patient-case workshop. A new workshop format for a course was adopted over a 3-year period. Students received and completed patient cases and obtained immediate performance feedback in class instead of preparing the case prior to class and waiting for instructors to grade and return their cases. The cases were designed and accessed via an online course management system. Student satisfaction was measured using end-of-course surveys. The impact of the technology-based changes on student learning, problem-solving, and critical-thinking skills was measured and compared between the 2 different course formats by assessing changes in examination responses. Three advantages to the new format were reported: real-life format in terms of time constraint for responses, a team learning environment, and expedient grading and feedback. Students overwhelmingly agreed that the new format should be continued. Students' examination scores improved significantly under the new format. The change in delivery of patient-case workshops to an online, real-time system was well accepted and resulted in enhanced learning, critical thinking, and problem-solving skills.

  6. A Case of Lymphomatoid Keratosis

    Science.gov (United States)

    Choi, Min Jee; Kim, Hei Sung; Kim, Hyung Ok; Song, Kye Yong

    2010-01-01

    Lymphomatoid keratosis (LK) is considered to be a rare variant of cutaneous lymphoid hyperplasia, with epidermotropism. We herein report a case of LK which developed on the abdomen of an elderly Korean woman. A 60-year-old woman presented with a 10-year history of a pruritic, solitary, brown to black plaque on the abdomen. Histopathologically, the specimen showed hyperkeratosis, parakeratosis, acanthosis and Pautrier's micro-abscess in the epidermis, and a lichenoid infiltration of lymphocytes in the dermis, which expressed both B cell and T cell lineage on the immune-histochemical staining. Based on these clinical and histopathological findings, our case was diagnosed as LK. To our knowledge, this is the first case report of LK in the Korean dermatologic literature. PMID:20548920

  7. Vascular colitis: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Il; Han, Chang Yul; Han, Man Chung; Choo, Dong Woon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1973-04-15

    The authors report two cases of vascular colitis in Korean with a review of literature. Case I, 20 years old male had severe abdominal pain and bloody diarrhea. Case II was 57 years old male and complained severe abdominal pain. Barium enema colon study on each cases disclosed typical thumbprinting appearance of involved segment. Predisposing factor in case I appeared to be anaphylactoid purpura, and in case II distal obstruction due to adenocarcinoma. The mechanism of vascular was briefly discussed.

  8. A case of granulomatous rosacea

    African Journals Online (AJOL)

    Case Study: A case of granulomatous rosacea. 133. Vol 52 No 2. SA Fam Pract 2010. Clinical Quiz. A 49-year-old housewife had complained of an itchy facial rash for four years. She denied using steroid creams and skin lighteners. On examination, dark grey papules were found on her face, with some coalescing into ...

  9. A case of triple volvulus

    Science.gov (United States)

    Basu, I; Phillips, D

    2012-01-01

    Situs inversus is a rare congenital anomaly that has reportedly been associated with caecal volvulus. We describe a case of partial situs inversus complicated by intestinal obstruction secondary to three simultaneously occurring volvuli of the stomach, caecum and sigmoid colon. To our knowledge, this is the first documented case in the literature of multiple, simultaneously occurring volvuli. PMID:22391352

  10. Ruptured gastroepiploic artery aneurysm: A case report

    Directory of Open Access Journals (Sweden)

    Ahmad S. Ashrafi

    Full Text Available Introduction: Gastroepiploic artery aneurysms are extremely rare, with few reported cases in the literature. The risk of rupture however, is high and thus warrants attention. Presentation of case: Here we present a rare case of a women who presented to the emergency department in shock and was found to have a ruptured gastroepiploic artery aneurysm during surgical exploration. Suture ligation of the aneurysm was completed. Discussion: Although rare, gastroepiploic artery aneurysms have up to a 90% rate of rupture and therefore require intervention. A laparoscopic approach has been described however, in cases where rupture has occurred, urgent laparotomy and control of hemorrhage is needed. Conclusion: We describe a rare case of a ruptured gastroepiploic aneurysm that was successfully managed with urgent laparotomy and aneurysmal resection. Keywords: Gastroepiploic, Aneurysm, Hemorrhage, Case report

  11. Obsessive Jealousy: A Case Report

    Directory of Open Access Journals (Sweden)

    João Miguel Ferreira Perestrelo

    2017-03-01

    Full Text Available Background: Jealousy is common between humans but can assume pathological characteristics. Aims: To report a case of obsessive jealousy and to review the concept and clinical features of the condition. Methods: A clinical cases of obsessive jealousy was obtained and a literature review of the theme was shortly surveyed. Results and Conclusions: The clinical case presents a man with morbid jealousy with obsessive features who was hospitalized after a  suicide  attempted.  During  his  hospitalization he was medicated with fluvoxamine and clonazepam reporting a decrease of the ruminative thoughts and anxiety. A correct diagnosis  of  obsessive-compulsive  disorder (OCD and its differentiation from a delusion,  obsessive  or  overvalued  idea  are  essential for an adequate approach and treatment.

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

    Science.gov (United States)

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

    2009-01-01

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

  13. Chronic eosinophilic pneumonia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Tae Haeng; Park, Jeong Hee; Lim, Jong Nam; Shin, Hyun Jun; Jeon, Hae Jeong [College of Medicine, Kon-Kuk University, Seoul (Korea, Republic of)

    1995-05-15

    Chronic eosinophilic pneumonia is a rare disease characterized by chronic infiltration of the lung with eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest radiograph shows typical nonsegmental air-space consolidation confined to the outer third of the lung, and in 25% of cases, the 'photographic negative of pulmonary edema' Typical lung manifestations with peripheral eosinophilia are characteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We report a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.

  14. Case management after long-term absence from work in China: a case report.

    Science.gov (United States)

    Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

    2011-03-01

    Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

  15. Congenital mesoblastic nephroma in a premature neonate: A case ...

    African Journals Online (AJOL)

    2013-06-11

    Jun 11, 2013 ... We report a case of CMN in a 30 week old premature female neonate seen at autopsy who was born ... is very good and in most cases, surgery alone may effect a .... CMN with intratumoral hemorrhage and all cases with large.

  16. Intestinal actinomycosis: a case report

    International Nuclear Information System (INIS)

    Loureiro, C.M.; Labrunie, E.; Pannaim, V.L.N.; Santos, A.A.S. dos; Pereira, A.A.

    1989-01-01

    Intestinal actinomycosis: a case report. The authors describe a case of intestinal actinomycosis, which was manisfestated by abdominal mass and suggested, clinical and radiologically, a bowel carcinoma. They discuss the pathogenesis, and the clinical and radiological manisfestations of this disease, and its differential diagnosis. This is an infrequent disease which must be considered whenever suggestive clinical aspects are associated with a radiological ''malignant pattern'' of a bowel lesion. (author) [pt

  17. Collodion Baby - a Case Report

    Directory of Open Access Journals (Sweden)

    Stojanović Vesna

    2014-12-01

    Full Text Available Colloidon baby describes a highly characteristic clinical entity in newborns encased in a yellowish translucent membrane resembling collodion. In most cases the condition either precedes the development of one of a variety of ichthyoses, the commonest of which are lamellar ichthyosis and non-bullous ichthyosiform erythroderma, or occasionally represents an initial phase of other ichthyoses such as ichthyosis vulgaris. In at least 10% of all cases of collodion baby, the condition is followed by a mild ichthyosis of lamellar type, so mild as to be considered more or less normal, so-called self-healing collodion baby or ‘lamellar ichthyosis of the newborn’. In this report we present a rare case of collodion baby in whom, after collodion membrane peeled-off, the skin retained normal appearance.

  18. Infected Complex Odontoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Shanthala Damodar

    2015-06-01

    Full Text Available Odontoma represent a hamartomatous malformation. They are usually asymptomatic and are diagnosed on routine radiological examination. Infection of an odontome is very uncommon. Few cases of infected odontoma are reported in the literature. We report a special case of infected complex odontoma and perforation of the cheeks with a tooth impacted upon along with computed tomographic (CT image. Thus, making the present case unusual. [Cukurova Med J 2015; 40(2.000: 379-383

  19. Case-control studies in diabetes. Do they really use a case-control design?

    Science.gov (United States)

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  20. Primary breast tuberculosis. A case report

    International Nuclear Information System (INIS)

    Filippou, D.C.; Rizos, S.; Nissiotis, A.

    2003-01-01

    Background. The differential diagnosis of primary breast tuberculosis with other benign or malignant conditions can be difficult with the current imaging techniques that used to recognize breast pathologies. In many cases mammographic and ultrasound characteristics of breast tuberculosis are similar to those of breast cancer. Case report. We present a case of primary breast tuberculosis, with no previous history of the disease, which was diagnosed during the operation. Conclusions. Primary breast tuberculosis can be misdiagnosed. In these cases a tuberculosis infection history is negative, the mammographic and radiological findings obscure and the mass can be misdiagnosed as carcinoma. The diagnosis is achieved after the surgical removal of the mass and histological examination of the specimen. (author)

  1. Intracortical chondrosarcoma: a case report.

    OpenAIRE

    Khodamorad Jamshidi; Reza Razavi; Homan Yahyazadeh

    2014-01-01

    Chondrosarcoma is the second most common primary mesenchymal malignant tumor of the bone. The most common form is central chondrosarcoma and the rarest is intracortical chondrosarcoma. Here, we describe the clinical, pathological, and imaging features of a case of intracortical chondrosarcoma as well as the outcome of surgical treatment. This is the third case reported in the literature.

  2. A psychological profile of a serial killer: a case report.

    Science.gov (United States)

    Dogra, T D; Leenaars, Antoon A; Chadha, R K; Manju, Mehta; Lalwani, Sanjeev; Sood, Mamta; Lester, David; Raina, Anupuma; Behera, C

    2012-01-01

    Serial killers have always fascinated society. A serial killer is typically defined as a perpetrator who murders three or more people over a period of time. Most reported cases of serial killers come from the United States and Canada. In India, there are few reported cases. We present, to the best of our knowledge, the first Indian case in the literature. The present case is of a 28-year-old man, Surinder Koli. The Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, New Delphi handled the forensic study. We present a most unique psychological investigation into the mind of a serial killer.

  3. A Case of Familial Polydactyly From Turkey

    Directory of Open Access Journals (Sweden)

    Billur Sezgin

    2016-06-01

    Full Text Available Polydactyly is among the most frequently encountered congenital anomalies of the extremities. Although it is usually presented in an isolated and sporadic manner, familial cases can also be rarely encountered. Such familial polydactyly cases usually follow an autosomal dominant inheritance with variable genetic penetration and are usually bilateral and symmetric. A case of rare familial polydactyly from Turkey is presented. Four siblings, two girls and two boys, presented with bilateral, symmetric preaxial polydactyly affecting both hands and feet. These siblings also had four other unaffected siblings along with an affected father and grandmother (the father’s mother. Although the cases portrayed duplication at different levels, the general definition of familial polydactyly with bilateral, symmetric inheritance is observed in these cases. Other rare familial polydactyly cases have been reported in the literature as well, and this case serves as a typical example of this rare entity from Turkey.

  4. A case of dapsone induced methaemoglobinaemia.

    LENUS (Irish Health Repository)

    O'Dwyer, D

    2008-09-01

    We present a case of dapsone induced methaemoglobinaemia that occurred in a patient who presented to the Emergency Department of a University Hospital. It is an uncommon condition that requires specific and urgent treatment in severe cases.

  5. Testicular calculus: A rare case.

    Science.gov (United States)

    Sen, Volkan; Bozkurt, Ozan; Demır, Omer; Tuna, Burcin; Yorukoglu, Kutsal; Esen, Adil

    2015-01-01

    Testicular calculus is an extremely rare case with unknown etiology and pathogenesis. To our knowledge, here we report the third case of testicular calculus. A 31-year-old man was admitted to our clinic with painful solid mass in left testis. After diagnostic work-up for a possible testicular tumour, he underwent inguinal orchiectomy and histopathologic examination showed a testicular calculus. Case hypothesis: Solid testicular lesions in young adults generally correspond to testicular cancer. Differential diagnosis should be done carefully. Future implications: In young adults with painful and solid testicular mass with hyperechogenic appearance on scrotal ultrasonography, testicular calculus must be kept in mind in differential diagnosis. Further reports on this topic may let us do more clear recommendations about the etiology and treatment of this rare disease.

  6. CASE REPORT CASE Assessing cervical stability: a reminder

    African Journals Online (AJOL)

    modality for excluding instability,2 as the following case illustrates. The patient, an underground mine worker, sustained an injury to his neck in a rock fall accident. Cervical spine radiographs and a CT scan demonstrate bilateral fractures which have resulted in disruption of the bony ring of C2. This constitutes a hangman's ...

  7. 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.

  8. Intracortical chondrosarcoma: a case report.

    Directory of Open Access Journals (Sweden)

    Khodamorad Jamshidi

    2014-02-01

    Full Text Available Chondrosarcoma is the second most common primary mesenchymal malignant tumor of the bone. The most common form is central chondrosarcoma and the rarest is intracortical chondrosarcoma. Here, we describe the clinical, pathological, and imaging features of a case of intracortical chondrosarcoma as well as the outcome of surgical treatment. This is the third case reported in the literature.

  9. Implementing Product Platforms: A Case Study

    DEFF Research Database (Denmark)

    Nielsen, Ole Fiil; Mortensen, Niels Henrik

    2006-01-01

    The paper describes a case study dealing with the process of creating and implementing a product platform. The paper espessially deals with the fact that to obtain the benefits of platforms a permanent change in behaviour in product development must be ensured. This change in behaviour requires...... acceptance and approval from the organisation in general and the commitment from management to enforce agreed-upon decisions. The case study itself was performed in the Danish company LEGO Group. The case study had two objectives: To create a technical architecture and align this architecture...

  10. A rare case of vulvar squamous cell carcinoma; case presentation

    Directory of Open Access Journals (Sweden)

    Cristina N. Cozma

    2018-05-01

    Full Text Available Objectives. Vulvar cancer is a rare gynecological malignancy, with an incidence of 1.5 per 100 000 women/year. The most common vulvar cancer is developed in squamous cells, the most encountered type of skin cells. Case report. We report a case of a 72-year-old female admitted in the Department of Plastic Surgery of Emergency Clinical Hospital “Prof. Dr. Agrippa Ionescu” with a 5/4.2 cm painful ulcerated tumoral mass located in the vulvar area. The lesion slowly increased in size over the past 12 months. The tumour was surgically removed with oncological safety margins and sent for histopathological evaluation. The histopathological examination revealed an ulcerated squamous carcinoma with lymphovascular and perineural invasion, but with negative margins. Postoperative results were favorable, and no local or general complications were observed. Conclusion. We highlight this case due to its unusual presentation in the clitoral area. Moreover, considering the potential for recurrence we point out the importance of the radical vulvectomy with regional lymphadenectomy and histopathological examination, in order to put a precise diagnosis and ensure the best possible treatment for the patient.

  11. Aluminium phosphide poising: a case report

    International Nuclear Information System (INIS)

    Hirani, S.A.A.; Rahman, A.

    2010-01-01

    This paper reports the case of a family in which three children were presented at Emergency Room (ER) with poisoning after the use of a pesticide at home. Initially, the cases were managed as routine cases of organophosphorus poisoning; however, the death of two children made the health team members realise that the poison's effects were delayed and devastating. Later, the compound was identified as Aluminium Phosphide (ALP), and the life of the last surviving child in the family was saved. (author)

  12. Desmoplastic Ameloblastoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Soheyl Sheikh

    2011-03-01

    Full Text Available Desmoplastic ameloblastoma is a rare variant of ameloblastoma. Up until now, less than 150 patients have been reported in the literature. We report a case of desmoplastic ameloblastoma in a 45-year-old female with a painless swelling in the left anterior maxillary region. Fine needle aspiration yielded no fluid. Periapical and panoramic radiographs as well as computer tomography scan showed a mixed lesion with multilocular appearance. The present case deserves special importance because of its unfamiliar appearance, potentially aggressive nature and high chances of misdiagnosis. Moreover, the radiographic features of this lesion rarely point towards ameloblastoma. A partial maxillectomy for tumor resection was performed and the involved teeth were removed. This report is an attempt to help the dental community in developing familiarity with the clinical presentation and at the same time advocating to develop a high index of suspicion in recognizing such cases.

  13. High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

    Science.gov (United States)

    Dunbar, R; Naidoo, P; Beyers, N; Langley, I

    2017-09-01

    Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

  14. Case Report: A Rare Case Report of Frontal Lobe Syndrome

    Directory of Open Access Journals (Sweden)

    Morteza Nouri- Khajavi

    2003-04-01

    Full Text Available The frontal lobe syndrome is a permanent personality change disorder with characteristic clinical pictures, which followed by frontal lobes damage. Clinical picture include: Affective instability, recurrent aggressive behavior, impaired social judgment, apathy and undifferentiating or suspiciousness and paranoid ideations. According DSM-IV classification frontal lobe syndrome named personality change due to head trauma on Axis I. Herein we report a case of 46 years-old man, who has developed behavioral disturbances following head trauma, about 10 years ago. Main clinical figures in this case are apathy, avolition and, undifferentiating. Clinical pictures are constant during these 10 years. The diagnostic approach has been based on patient’s problems history which, has taken from his family, mental status examination, Neurological examination, Brain imaging and Neuropsychological assessments which related to frontal lobes function. Because of rarity & neglection due to mysterious function of frontal lobes, and also considering that personality change from previous level is prominent figure of this syndrome and also brain imaging findings, which compatible with clinical findings, with this aim, we have reported this case.

  15. [Writing and publication of a clinical case report].

    Science.gov (United States)

    Târcoveanu, E; Roca, M; Mihăescu, T

    2011-01-01

    A case report represents a collection of detailed information about an individual patient, written with the purpose to disseminate clinical outcomes, not previously reported. Case reports provide a rich resource for teaching and research in medicine. Despite the limitation of case reports, these are useful to generate new hypothesis for future large scale clinical trials. A clinical case report should be well structured and convey a clear message. Elements of a case report are similar to all forms of medical scientific articles: title, structured abstract, introduction, case report, discussion, conclusion and references. A well written case report with literature support and a detailed description of management of the case has the greatest chances to be published. "Uniform Requirements for Manuscripts to Biomedical Journals" form the basis for most journal instructions regarding content and formatting and should be consulted when journal's instructions don't answer to author's questions. In this paper we present a case report check sheet to use as a form of self-evaluation, prior to submitting the articles.

  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. A Japanese case of autoimmune autonomic ganglionopathy (AAG) and a review of AAG cases in Japan.

    Science.gov (United States)

    Hayashi, Michiyuki; Ishii, Yuko

    2009-03-12

    A 29-year-old woman presented with acute, pure autonomic (both sympathetic and parasympathetic) failure and positive antibody to ganglionic nicotinic acetylcholine receptor; the diagnosis was autoimmune autonomic ganglionopathy (AAG). She had typical symptoms of AAG, although the patient also had coughing episodes and psychiatric symptoms, which are not typical of AAG in Western countries but are common in AAG cases in Japan. In a review of the Japanese literature, 29 cases of AAG had been reported. AAG patients in Japan were younger and more male predominant than in Western countries. Of the patients in these 29 cases, 10 (34.5%) had coughing episodes and 12 (41.4%) had psychiatric symptoms.

  19. Mediastinitis after oesophagoscopy : a case report : case report

    African Journals Online (AJOL)

    Marinda

    of the mediastinal tissues and pleural cavities through digestive juices and bacteria that give rise to cellulitis and suppuration.3. We here report a case in which .... measures and surgical drainage of the retro-oesophageal space if suppuration has developed. Complete healing of the oesophagus may take as long as two ...

  20. Hermansky-Pudlak syndrome; a Case Report

    Directory of Open Access Journals (Sweden)

    Abbas Bagheri

    2010-01-01

    Full Text Available Purpose: To report a case of Hermansky-Pudlak syndrome. Case Report: A seven-year-old boy presented with marked generalized hypopigmentation, ocular exodeviation and nystagmus. He had history of easy bruising. Examination revealed green irides with marked transillumination, hypopigmented fundi and foveal hypoplasia. Further investigations disclosed platelet storage defect with adenosine diphosphate deficiency and abnormal aggregation compatible with Hermansky-Pudlak syndrome. The patient underwent strabismus surgery taking necessary precautions such as reserving platelet concentrates in case of a hemorrhagic event. Conclusion: Patients with albinism should be evaluated for Hermansky-Pudlak syndrome especially before surgery to prevent life-threatening complications.

  1. Case Study: A Step-by-Step Guide to Students Writing Case Studies (and Tools for Novice Case Authors)

    Science.gov (United States)

    Prud'homme-Genereux, Annie

    2015-01-01

    In experimenting with ways of structuring the assignment and providing guidance to students, the author developed a series of tools that may be of interest to instructors wishing to implement a case-writing assignment in their course. This assignment is more suited for instructors experienced in case writing, as their knowledge of how to design a…

  2. Pulmonary Artery Agenesis: A Case Series

    Directory of Open Access Journals (Sweden)

    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.

  3. Hemimegalencephaly. A Case Report

    International Nuclear Information System (INIS)

    Sánchez Lozano, Ada; Rojas Fuentes, Joan Omar; Rodríguez Roque, María Octavina

    2015-01-01

    Hemimegalencephaly is a disorder of neuronal proliferation that causes an overgrowth of all or part of a cerebral hemisphere. Its pathogenesis is still unknown. We present the case of an adult patient with a history of childhood-onset epilepsy, which was refractory to medical treatment and associated with moderate mental retardation. He was admitted to the hospital for seizure control. Magnetic resonance imaging showed hemispheric asymmetry with enlarged right cerebral hemisphere and poor gray-white matter differentiation. The objective of this paper is to present a rare cause of epilepsy that is usually diagnosed during childhood. Hemimegalencephaly should be suspected in cases of early onset of difficult-to-control epilepsy, especially when associated with macrocephaly and delayed psychomotor development. Timely indication for neuroimaging allows establishing the diagnosis and providing other treatment options. (author)

  4. SPOROTRICHOSIS: A CASE REPORT

    OpenAIRE

    Sudheer; Venkatakrishna; Nagaswetha; Manmohan

    2015-01-01

    Sporotrichosis is a rare disease in the Southern part of India. A sporadic case of sporotrichosis restricted to primary site of inoculation in a 11-years old student from a non–endemic region of Telangana has been described.

  5. Sirenomelia in a Nigerian triplet: a case report

    Science.gov (United States)

    2011-01-01

    Introduction Sirenomelia, also known as mermaid syndrome, is a very rare fatal congenital abnormality in which the legs are fused together, giving them the appearance of a mermaid's tail. It is commonly associated with abnormal kidney development, genital and rectal abnormalities. A handful of cases have been reported in other parts of the world, however, no cases have previously been reported in a Nigerian neonate. To the best of our knowledge, we believe that this is the first case reported from West Africa and in a triplet. Case presentation A 16-hour-old baby boy, the second of a set of Nigerian triplets, presented to our facility with fusion of the entire lower limbs, imperforate anus, indiscernible genital structures, single umbilical artery and a neural tube defect. His parents were from the Hausa ethnic group and not related. Conclusion Sirenomelia has not been previously described in a set of triplets, and it is hoped that this report from West Africa will give information about the non-racial predilection of this condition. PMID:21888626

  6. Sirenomelia in a Nigerian triplet: a case report

    Directory of Open Access Journals (Sweden)

    Wonodi Woroma

    2011-09-01

    Full Text Available Abstract Introduction Sirenomelia, also known as mermaid syndrome, is a very rare fatal congenital abnormality in which the legs are fused together, giving them the appearance of a mermaid's tail. It is commonly associated with abnormal kidney development, genital and rectal abnormalities. A handful of cases have been reported in other parts of the world, however, no cases have previously been reported in a Nigerian neonate. To the best of our knowledge, we believe that this is the first case reported from West Africa and in a triplet. Case presentation A 16-hour-old baby boy, the second of a set of Nigerian triplets, presented to our facility with fusion of the entire lower limbs, imperforate anus, indiscernible genital structures, single umbilical artery and a neural tube defect. His parents were from the Hausa ethnic group and not related. Conclusion Sirenomelia has not been previously described in a set of triplets, and it is hoped that this report from West Africa will give information about the non-racial predilection of this condition.

  7. Cardiac leiomyosarcoma, a case report

    DEFF Research Database (Denmark)

    Andersen, Rikke; Kristensen, Bjarne W; Gill, Sabine

    2013-01-01

    In this case report we present the history of a patient admitted with recurrent pulmonary edema. Transesophageal chocardiography showed a tumour in the left atrium, occluding the ostium of the mitral valve and mimicking intermittent mitral stenosis. Cardiac surgery followed by pathological...... examination revealed that the tumour was a leiomyosarcoma. Images from the echocardiography as well as the pathological findings are shown and discussed. The present case report illustrates that atrial tumors comprise also sarcomas, suggesting the use of careful, rapid diagnostic procedures and treatment...

  8. Pituitary Gigantism: A Case Report

    OpenAIRE

    Rana Bhattacharjee; Ajitesh Roy; Soumik Goswami; Chitra Selvan; Partha P Chakraborty; Sujoy Ghosh; Dibakar Biswas; Ranen Dasgupta; Satinath Mukhopadhyay; Subhankar Chowdhury

    2012-01-01

    Objective: To present a rare case of gigantism. Case Report: A 25-year-old lady presented with increased statural growth and enlarged body parts noticed since the age of 14 years, primary amenorrhea, and frontal headache for the last 2 years. She has also been suffering from non-inflammatory low back pain with progressive kyphosis and pain in the knees, ankles, and elbows for the last 5 years. There was no history of visual disturbance, vomiting, galactorrhoea, cold intolerance. She had no si...

  9. Serotonin Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Pedro Oliveira

    2018-01-01

    Full Text Available Serotonin Syndrome (SS is a potentially fatal iatrogenic condition that occurs as a result of an over-stimulation of the serotonergic receptors. Its typical presentation consists of the triad altered mental status, autonomic hyperactivity and neuromuscular alterations, although the clinical condition is highly variable. Despite being potentially treatable, many cases per year are underdiagnosed, a fact that has been mainly attributed to the lack of knowledge of this condition by the physicians. SS treatment relies on four pillars: removal of the precipitating agent and supportive therapy, antagonism of 5-HT2A receptors, and control of agitation, autonomic instability and hyperthermia. It is expected that its incidence will accompany the growth of the prescription of antidepressants, andincreasing physician’s awareness about its occurrence, could contribute to a timely diagnosis and to the success of the treatment. We present a clinical case of a patient diagnosed with Bipolar Affective Disorder, hospitalized for a depressive episode with a psychotic component, which developed a SS compatible condition. Based on this case report the authors undertake a theoretical review of this condition.

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

    Science.gov (United States)

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

    2017-02-01

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

  11. A case of tuberculous pericardial effusion

    Directory of Open Access Journals (Sweden)

    Wanjari K

    2009-01-01

    Full Text Available Tuberculosis accounts for up to 4% of acute pericarditis and 7% cases of cardiac tamponade. Prompt treatment can be life saving but requires accurate diagnosis. We report a case of 30-year-old male who presented with fever, chills, and dry nonproductive cough since one month. The case was diagnosed by radiological findings, which were suggestive of pulmonary tuberculosis, followed by acid fast staining and culture of the aspirated pericardial fluid. The patient was responding to antitubercular treatment at the last follow up.

  12. Erupted Compound Odontomas: A Case Report

    Directory of Open Access Journals (Sweden)

    Avinash Tejasvi M.L.

    2011-03-01

    Full Text Available The tumors in which odontogenic differentiation is fully expressed are the odontomas. Odontomas are considered as hamartomas rather than a true neoplasm. These tumors are composed of enamel, dentine, cementum and pulp tissue. It is most commonly associated with the eruption of the teeth. They are usually discovered on routine radiographic examination. In exceptional cases, the odontoma erupts in to the mouth. Nine cases of erupted compound odontomas are reported in the English literature, and the present paper reports another case of an erupted compound odontoma in a 22-year-old female patient.

  13. A cluster of cases of Nocardiosis

    Directory of Open Access Journals (Sweden)

    Rabindranath Misra

    2017-01-01

    Full Text Available Human Nocardiosis has become more common in last two decades due to increase in the number of immunocompromised states of patients and the availability of better detection methods. We report three cases of Nocardiosis in which one was a renal allograft recipient who had developed pneumonia due to a relatively uncommon pathogen Nocardia brasiliensis. Other two cases were seen in immunocompetent hosts where ophthalmic infection due to Nocardia farcinica and subcutaneous infection in the leg due to N. brasiliensis were reported. The patients responded well to treatment. High level of suspicion helped in the detection of these cases.

  14. Mills’ syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Fábio Henrique de Gobbi Porto

    2009-11-01

    Full Text Available The syndrome of progressive, ascending or descending hemiplegia, with no significant sensory impairment was first describes by Mills in 1900, which several cases were reported later. However after diagnostic tests and image improvements, the number of reports has shortened. A possible explanation for this shortage is the identification of other diseases that could mimic the clinical picture. Currently, the syndrome has an uncertain nosological status, since it was described based on clinical examination only. We can find this clinical presentation (Mills syndrome in cases of amyotrophic lateral sclerosis (ALS, predominant upper motor neuron amyotrophic lateral sclerosis (UMN-ALS and primary lateral sclerosis (PLS, besides its symptomatic (secondary forms. We describe a case (initial presentation and one year follow-up of progressive ascending hemiplegia with clinical isolated upper neuron signs and normal sensory examination, discussing its nosological status, electromyographic findings, differential diagnosis and prognosis.

  15. A case of Hydrops fetalis due to Kell alloimmunization: A perinatal approach to a rare case

    Directory of Open Access Journals (Sweden)

    Arzu Akdag

    2012-03-01

    Full Text Available Introduction: While the routine administration of Rhesus immunoglobulin has significantly reduced the incidence of this type of alloimmunization, maternal alloimmunization to other red cell antigens continues to contribute to perinatal morbidity and mortality. Although the Kell antigen is found on the red cells of only 9% of the population, attention has increasingly been focused on Kell antibodies. Case Report: We present a case of fetal hydrops who was sonographically detected at 30th week of pregnancy. Antenatal tests for evaluation of fetal condition clearly showed the critical level of hemolytic disease but the baby was delivered prematurely due to fetal distress. The combination of anemia, reticulocytopenia, hydrops fetalis, and positive indirect Coombs test suggested Kell isoimmunization. The baby was treated by exchange transfusion with the Kell-negative packed red cell succesfully, and was discharged on postnatal 30th day. Conclusion: Here we describe a case of hydrops fetalis caused by Kell alloimmunization that was determined in postnatal period, and thus we plan to discuss the perinatal approach to the Kell immunization.

  16. First case of bacteremia caused by Moellerella wisconsensis: case report and a review of the literature.

    Science.gov (United States)

    Cardentey-Reyes, A; Jacobs, F; Struelens, M J; Rodriguez-Villalobos, H

    2009-12-01

    Moellerella wisconsensis, a member of the Enterobacteriaceae family, is rarely isolated in clinical specimens. We report here a case of M. wisconsensis infection in a 46-year-old cirrhotic patient with acute cholecystitis. This is the first reported case of a M. wisconsensis infection in Belgium and the first reported case of human bacteremia caused by this bacterium. Our case report is followed by a review of the literature.

  17. Trachelectomy: A Review of 15 Cases

    International Nuclear Information System (INIS)

    EL-ZOHAIRY, M.A.

    2010-01-01

    To determine the indications and complications of removal of the retained cervical stump (trachelectomy). Material and Methods: Retrospective review of the records of 15 cases of removal of the retained cervical stump performed at the Department of Surgical Oncology NCI Cairo University and Nasser Institute Cairo between January 2005 and December 2009. Results: Fifteen patients were identified with a mean age of 43.1+8.4 years. The indications for subtotal hysterectomy were uterine fibroids, 7 (46.7%), abnormal bleeding, 5 (33.3%), and ovarian mass, 3 (20%) cases. Route of trachelectomy was abdominal in all cases. The indications for trachelectomy were cervical malignancy in 8 (53.3%), residual tumor at the hysterectomy specimen in 3 (20%), and persistent bleeding in 2 (13.3%) cases. The most common concomitant procedures with the trachelectomy were pelvic lymphadenectomy in 11 (73.3%), and oophorectomy in 10 (66.6%) cases. There were no postoperative mortalities. The most common complications were wound infection, 4 (26.6%), and urinary tract infection, 3 (20%). The mean estimated blood loss was 341.0± 82.3 ml. Hospital stay was 7.915.1 days. The most common histological diagnosis was squamous carcinoma 9 cases (60%). The median follow-up period was 16 months. Conclusion: Subtotal hysterectomy carries the risk of developing a stump cancer. Patient agreement is mandatory. Subtotal hysterectomy should be avoided whenever possible in populations with restricted access to screening programs for cancer of the uterine cervix.

  18. A Case-Based Reasoning Method with Rank Aggregation

    Science.gov (United States)

    Sun, Jinhua; Du, Jiao; Hu, Jian

    2018-03-01

    In order to improve the accuracy of case-based reasoning (CBR), this paper addresses a new CBR framework with the basic principle of rank aggregation. First, the ranking methods are put forward in each attribute subspace of case. The ordering relation between cases on each attribute is got between cases. Then, a sorting matrix is got. Second, the similar case retrieval process from ranking matrix is transformed into a rank aggregation optimal problem, which uses the Kemeny optimal. On the basis, a rank aggregation case-based reasoning algorithm, named RA-CBR, is designed. The experiment result on UCI data sets shows that case retrieval accuracy of RA-CBR algorithm is higher than euclidean distance CBR and mahalanobis distance CBR testing.So we can get the conclusion that RA-CBR method can increase the performance and efficiency of CBR.

  19. A clinico-pathological study of 70 cases of pemphigus

    Directory of Open Access Journals (Sweden)

    Arya S

    1999-01-01

    Full Text Available A clinicopalhological study of 70 cases of pemphigus observed over a span of four and a half years from January 1992 to June 1996 at the Sir J.J. Group of Hospitals and Grant Medical College, Mumbai is reported. Pemphigus vulgaris constituted the single largest group of 43 cases, followed by pemphigus foliaceus (25 cases and pemphigus vegetans (2 cases. Majority of the cases were seen in the age group of 21-60 years, with a slight male predominance. The youngest patient was 14 years while the eldest was aged 75 years. Mucosal involvement was seen in 31 cases of pemphigus vulgaris, as opposed to only 5 cases of pemphigus foliaceus. Flaccid bullae were present in 100% cases. Pruritus was complained of in 14 cases, though it was more common in pemphigus vegetans and vulgaris. Salient histopathological features of pemphigus vulgaris observed were (I intraepidermal suprabasal blisters (35 cases, (2 presence of acantholytic cells (40 cases, (3 "Row of tombstone appearance" (I8 cases and (4 acantholysis involving follicular sheath (20 cases. Main histopathological features of pemphigus foliaceus were (1 subcorneal blister (15 case, (2 acantholysis (24 cases and (3 bulla cavity containing inflammatory infiltrate (12 cases. Both cases of pemphigus vegetans showed hyperkeratosis, papillomatosis and irregular acanthosis with intra-epidermal eosinophilic abscesses besides suprabasal lacunae.

  20. Abdominal elephantiasis: a case report.

    Science.gov (United States)

    Hanna, Dominique; Cloutier, Richard; Lapointe, Roch; Desgagné, Antoine

    2004-01-01

    Elephantiasis is a well-known condition in dermatology usually affecting the legs and external genitalia. It is characterized by chronic inflammation and obstruction of the lymphatic channels and by hypertrophy of the skin and subcutaneous tissues. The etiology is either idiopathic or caused by a variety of conditions such as chronic filarial disease, leprosy, leishmaniasis, and chronic recurrent cellulites. Elephantiasis of the abdominal wall is very rare. A complete review of the English and French literature showed only two cases reported in 1966 and 1973, respectively. We report a third case of abdominal elephantiasis and we briefly review this entity. We present the case of a 51-year-old woman who had progressively developed an enormous pediculated abdominal mass hanging down her knees. The skin was thickened, hyperpigmented, and fissured. She had a history of multiple abdominal cellulites. She underwent an abdominal lipectomy. Histopathology of the specimen confirmed the diagnosis of abdominal elephantiasis. Abdominal elephantiasis is a rare disease that represents end-stage failure of lymph drainage. Lipectomy should be considered in the management of this condition.

  1. A Psychobiographical Case Study

    African Journals Online (AJOL)

    man, and cancer fighter. This psychobiographical case study entailed a psychosocial-historical ... does not draw more attention as a research method, as this approach has .... of the applied Levinsonian theory to the life of Jobs against the ...

  2. A CYTOLOGICALLY DIAGNOSED CASE OF GIANT FIBROADENOMA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Metta Raja Gopal

    2015-02-01

    Full Text Available Fibroadenomas are benign solid tumors which occur most frequently in child bearing age with 68% occurrence in adolescents. Giant fibroadenomas are uncommon variants of fibroadenomas usually presenting in adolescents characterized by massive and rapid enlargement of bre ast tissue which may be quite alarming to the young girls. We present a case of giant fibroadenoma diagnosed by FNAC in the 14 yr adolescent who presented with large unilateral left breast enlargement which grew rapidly over a period of 10 months.

  3. Two cases of a fetus with sirenomelia sequence.

    Science.gov (United States)

    Horikoshi, Tsuguhiro; Kikuchi, Akihiko; Tatematsu, Mikiko; Matsumoto, Yasuhiro; Hayashi, Akiko; Unno, Nobuya

    2005-09-01

    We report two cases of a fetus with sirenomelia sequence which showed oligohydramnios and a single umbilical artery. The first case was of a single fetus with symelia apus and only one leg. Prenatal diagnosis of this case was possible. The second case was of a dichorionic-diamniotic twin pregnancy in which one fetus had symelia dipus with two fused lower extremities. Prenatal diagnosis of the condition was not made. In both cases, the fetuses died shortly after birth from respiratory distress due to severe pulmonary hypoplasia. Absence of urinary tract, imperforate anus, and spine deformity were confirmed in both cases. Although prenatal diagnosis of symelia dipus seems difficult, this condition must be considered in a fetus with severe oligohydramnios.

  4. Bertolotti's syndrome: a case report.

    Science.gov (United States)

    Mitra, Raj; Carlisle, Mark

    2009-01-01

    A case report and literature review is presented. To review relevant data for the management of Bertolotti's syndrome and to determine whether the transverse process-ilium articulation may be a pain generator. Bertolotti's syndrome is associated with axial low back pain secondary to arthritic changes; the pain generator in the disorder is unclear. We present a case report of symptomatic Bertolotti's syndrome managed with intra-articular steroid injections. A patient with Bertolotti's syndrome had significant relief of axial pain after steroid injection of the ilium-transverse process articulation. Steroid therapy may be a non-surgical alternative for the treatment of symptomatic Bertolotti's syndrome.

  5. A Case of New Familiar Genetic Variant of Autosomal Dominant Polycystic Kidney Disease-2: A Case Study.

    Science.gov (United States)

    Litvinchuk, Tetiana; Tao, Yunxia; Singh, Ruchi; Vasylyeva, Tetyana L

    2015-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is characterized by renal cyst formation due to mutations in genes coding for polycystin-1 [PKD1 (85-90% of cases), on ch 16p13.3] and polycystin-2 [PKD2 (10-15% of cases), on ch 4q13-23] and PKD3 gene (gene unmapped). It is also associated with TSC2/PKD1 contiguous gene syndrome. ADPKD is usually inherited, but new mutations without a family history occur in approximately 10% of the cases. A 17-year-old boy was followed up for bilateral cystic kidney disease, hypertension, and obesity since he was 13 years old. The diagnosis was an accidental finding during abdominal CT at age 13 to rule out appendicitis. A renal ultrasonogram also demonstrated a multiple bilateral cysts. Because of parental history of bilateral renal cysts, PKD1 and PKD2, genetic testing was ordered. Results showed, PKD2 variant 1:3 bp deletion of TGT; nucleotide position: 1602-1604; codon position: 512-513; mRNA reading frame maintained. The same mutation was later identified in his father. A smaller number of patients have a defect in the PKD2 locus on chromosome 4 (resulting in PKD2 disease). There are no known published cases on this familiar genetic variant of ADPKD-2 cystic kidney disease. In this case, the disease is present unusually early in life.

  6. Of what is this a case?

    DEFF Research Database (Denmark)

    Lund, Christian

    2014-01-01

    Case studies are often presented as self-evident. However, of what the material is a case is actually less evident. It is argued in this article that the analytical movements of generalization, specification, abstraction, and concretization can make us more conscious of what our work might...

  7. SPHENOCHOANAL POLYP: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Gaurav

    2015-09-01

    Full Text Available Sphenochoanal polyp is a rare clinical occurrence as compared to the much common antro - choanal polyp. It originates from the sphenoid sinus and extends into the choana via the sphenoid ostium. We present a case of spheno - choanal polyp and its clinical features and surgical management is discussed. Our aim in this case was to properly d elineate the origin of the polyp and differentiate it from other lesions such as the antro - choanal polyp and meningocele, followed by meticulous endoscopic excision of the polyp

  8. An unusual case of suprascapular nerve neuropathy: a case report

    Directory of Open Access Journals (Sweden)

    Kyriakides Theodoros

    2011-08-01

    Full Text Available Abstract Introduction Suprascapular nerve neuropathy constitutes an unusual cause of shoulder weakness, with the most common etiology being nerve compression from a ganglion cyst at the suprascapular or spinoglenoid notch. We present a puzzling case of a man with suprascapular nerve neuropathy that may have been associated with an appendectomy. The case was attributed to nerve injury as the most likely cause that may have occurred during improper post-operative patient mobilization. Case presentation A 23-year-old Caucasian man presented to an orthopedic surgeon with a history of left shoulder weakness of several weeks' duration. The patient complained of pain and inability to lift minimal weight, such as a glass of water, following an appendectomy. His orthopedic clinical examination revealed obvious atrophy of the supraspinatus and infraspinatus muscles and 2 of 5 muscle strength scores on flexion resistance and external rotation resistance. Magnetic resonance imaging showed diffuse high signal intensity within the supraspinatus and infraspinatus muscles and early signs of minimal fatty infiltration consistent with denervation changes. No compression of the suprascapular nerve in the suprascapular or spinoglenoid notch was noted. Electromyographic studies showed active denervation effects in the supraspinatus muscle and more prominent in the left infraspinatus muscle. The findings were compatible with damage to the suprascapular nerve, especially the part supplying the infraspinatus muscle. On the basis of the patient's history, clinical examination, and imaging studies, the diagnosis was suspected to be associated with a possible traction injury of the suprascapular nerve that could have occurred during the patient's transfer from the operating table following an appendectomy. Conclusion Our case report may provide important insight into patient transfer techniques used by hospital personnel, may elucidate the clinical significance of careful

  9. Case report: Ribavirin and vitamin A in a severe case of measles.

    Science.gov (United States)

    Bichon, Amandine; Aubry, Camille; Benarous, Lucas; Drouet, Hortense; Zandotti, Christine; Parola, Philippe; Lagier, Jean-Christophe

    2017-12-01

    Despite a vaccine being widely available, measles continues to occur frequently, with sometimes lethal consequences. The mortality rate reaches 35% and measles represents 44% of the 1.4 million deaths which are due to preventable diseases. Severe forms of measles are reported, mainly in young, unvaccinated adults, and in specific populations. The risk factors for severe measles include no or incomplete vaccination and vitamin A deficiency. Apart from secondary measles-related infections, severe measles is mainly represented by neurological, respiratory, and digestive symptoms. Strengthening the hypothesis that there is a link between vitamin A deficiency and severe measles in this paper we report the case of a 25-year-old unvaccinated man hospitalized for severe and complicated measles. The evolution was good after administration of intramuscular vitamin A as well as intravenous ribavirin. Measles remains a fatal and serious disease. The early use of ribavirin and vitamin A shows significant improvements regarding morbimortality and should be systematic in severe cases. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  10. A case of chemical pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Woo; Eun, Choung Ki; Choi, Byung Soo; Park, Soo Sung [Chungang University School of Medicine, Seoul (Korea, Republic of)

    1974-10-15

    A case of chemical pneumonia due to the fumes of nitric acid and chemical compounds was encountered, and it is reported with a review of the literatures. A 19 year old Korean male working in an electric materials manufacturing factory of poor facilities dealing with chemical compounds showed initial symptoms closely similar to those of pulmonary tuberculosis of hematogenous disseminating type, and a roentgenogram was hardly helpful for differentiating chemical pneumonia from pulmonary tuberculous of hematogenous disseminating type. The clinical course in this case was very favourable as compared with those of pulmonary tuberculosis and bacterial pneumonia.

  11. A case of chemical pneumonia

    International Nuclear Information System (INIS)

    Lee, Sung Woo; Eun, Choung Ki; Choi, Byung Soo; Park, Soo Sung

    1974-01-01

    A case of chemical pneumonia due to the fumes of nitric acid and chemical compounds was encountered, and it is reported with a review of the literatures. A 19 year old Korean male working in an electric materials manufacturing factory of poor facilities dealing with chemical compounds showed initial symptoms closely similar to those of pulmonary tuberculosis of hematogenous disseminating type, and a roentgenogram was hardly helpful for differentiating chemical pneumonia from pulmonary tuberculous of hematogenous disseminating type. The clinical course in this case was very favourable as compared with those of pulmonary tuberculosis and bacterial pneumonia

  12. Test case preparation using a prototype

    OpenAIRE

    Treharne, Helen; Draper, J.; Schneider, Steve A.

    1998-01-01

    This paper reports on the preparation of test cases using a prototype within the context of a formal development. It describes an approach to building a prototype using an example. It discusses how a prototype contributes to the testing activity as part of a lifecycle based on the use of formal methods. The results of applying the approach to an embedded avionics case study are also presented.

  13. SARS: a comparative study on the chest radiography of the mortal cases and the cured cases

    International Nuclear Information System (INIS)

    Jiang Songfeng; Liu Jingxin; Chen Bihua; Zhang Lieguang; Yin Chibiao; Zhang Fuchun

    2003-01-01

    Objective: This study is mainly on the radiological findings of the mortal cases of SARS. Methods: The chest X-ray (CXR) findings of 11 mortal cases of SARS were retrospectively studied, and compared with those of the 249 cured cases. Results: The major CXR findings of the mortal cases were: patchy shadows in 10 cases out of 11 (90.90%), frosted glass like change of the lung fields in 9 (81.82%), diffuse lesions in 11 (100%), and involvement of the bilateral lung. There was a statistical difference between the mortal cases and the cured cases on the following 4 manifestations: large shadows, extensive consolidation, frosted glass like change of the lung fields, and diffuse lesions (P<0.01). Conclusion: Large shadows, extensive consolidation, frosted glass like change of the lung fields, diffuse lesions and the bilateral involvement of the lung are the main CXR findings of the mortal cases of SARS. And extensive consolidation and diffuse involvement are strongly indicative. In most of the mortal cases, the latest CXR demonstrated widespread frosted glass like appearance in the lung fields with air bronchogram

  14. Making a Case for Case-Based Teaching in Data Literacy

    Science.gov (United States)

    Riddle, Derek R.; Beck, Jori S.; Morgan, Joseph John; Brown, Nancy; Whitesides, Heather

    2017-01-01

    Building on a study conducted by the authors, this article provides strategies for teaching data literacy and outlines the case-based teaching method as an effective way of developing data-literate teachers.

  15. Male Hypogonadism. A Case Report

    Directory of Open Access Journals (Sweden)

    Lisandro Hernández Madrazo

    2012-07-01

    Full Text Available The case of a 26 years old male patient who attended the Internal Medicine consultation at the La Fortaleza Integral Diagnostic Center in Maracaibo, Zulia State, Venezuela because of decreased external genitalia size, with poor development from childhood and swelling of the breasts is presented. Physical examination showed a trunk of feminoid configuration caused by adipose tissue accumulated in the lower abdomen, breast and pubic; wide pelvis; lower limb dominance over higher limbs; enucoid proportions; volume diffusely  increased in both breasts (gynecomastia; deposit of fatty tissue at the pelvic girdle, and absent or sparse facial, axillary and pubic hair. We observed decreased size, poor pigmentation, and soft consistency in penis and testicles. Exam was performed on plasma testosterone, luteinizing hormone and follicle stimulating hormone, thus concluding, by the Endocrinology Service at the Maracaibo University Hospital, to be the case of hypogonadotropic hypogonadism of improvable cause. The clinical diagnosis of hypogonadism in adults is unusual in medical practice, a fact that provides with relevance the case we present.

  16. Reflective practice: a framework for case manager development.

    Science.gov (United States)

    Brubakken, Karen; Grant, Sara; Johnson, Mary K; Kollauf, Cynthia

    2011-01-01

    The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article. The practice setting is a community based case management department in a large midwestern metropolitan health care system with Magnet recognition. Advanced practice nurses provide care for clients with chronic health conditions. Twenty-four narratives were used to identify behaviors of community based case managers and to distinguish stages of practice. The behaviors of advanced practice found within the narratives were labeled and analyzed for similarities. Related behaviors were grouped and descriptor statements were written. These statements grouped into 3 domains of practice: relationship/partnership, coordination/collaboration, and clinical knowledge/decision making. The statements in each domain showed practice variations from competent to expert, and 3 stages were determined. Reliability and validity of the framework involved analysis of additional narratives. The reflective practice process, used for monthly case review presentations, provides opportunity for professional development and group learning focused on improving case manager practice. The framework is also being used in orientation as new case managers acclimate to the role. Reflective writing has unveiled the richness and depth of nurse case manager practice. The depth of knowledge and skills involved in community-based case management is captured within this reflective practice framework. This framework provides a format for describing community based case manager practice development over the course of time and has been used as a tool for orientation and peer review.

  17. A rare mitochondrial disorder: Leigh sydrome - a case report

    Directory of Open Access Journals (Sweden)

    Shrikhande Dhananjay Y

    2010-09-01

    Full Text Available Abstract Leigh syndrome is a rare progressive neurodegenerative, mitochondrial disorder of childhood with only a few cases documented from India. The clinical presentation of Leigh syndrome is highly variable. However, in most cases it presents as a progressive neurological disease with motor and intellectual developmental delay and signs and symptoms of brain stem and/or basal ganglia involvement. Raised lactate levels in blood and/or cerebrospinal fluid is noted. It is the neuroimaging, mainly the Magnetic Resonance Imaging showing characteristic symmetrical necrotic lesions in the basal ganglia and/or brain stem that leads to the diagnosis. Here, we report a case of 7 months old female child presenting to us with status epilepticus, delayed developmental milestones and regression of the achieved milestones suspected to be a case of neurodegenerative disorder, which on MRI was diagnosed as Leigh syndrome.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. BCG induced granulomatous prostatitis ; a case report

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Min Hoan; Seong, Chang Kyu; Lee, Kyoung Ho; Kim, Seung Hyup [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of)

    2000-04-01

    Granulomatous prostatitis was relatively uncommon until the introduction of intravesical BCG for the treament of bladder cancer. Since that time, there has been an increase in the number of cases of granulomatous prostatitis, but the domestic literature contains no report. We recently encountered a classic case of BCG induced granulomatous prostatitis and describe this case, including its radiologic findings. (author)=20.

  20. A case of paliperidone-palmitate-induced tardive dyskinesia.

    LENUS (Irish Health Repository)

    Lally, John

    2012-06-13

    OBJECTIVES: This is one of the first cases reported in the literature of paliperidone-palmitate-induced prolonged dyskinesia. METHOD: Case report. RESULTS: We report the case of a 49-year-old woman with paranoid schizophrenia who developed orofacial dyskinesia some 4 months after the commencement of paliperidone long-acting injection. CONCLUSION: This case serves as a clinical reminder that dyskinesia can occur with all antipsychotic medications.

  1. Spontaneous Spinal Epidural Hematoma; a Case Report

    Directory of Open Access Journals (Sweden)

    Maryam Motamedi

    2014-09-01

    Full Text Available Spontaneous spinal epidural hematoma (SSHE is a rare entity can have several reasons. Its prevalence in population is 0.1 per 100,000 with the male to female ratio of 1/4:1. For the first time Jackson in 1869 reported a case of SSHE and after that it was declared as several hundred cases in literatures. Here, a case of SSHE was reported in a 52 year-old male referred to emergency department following severe low back pain.

  2. Toxoplasmosis in a patient who was immunocompetent: a case report

    Directory of Open Access Journals (Sweden)

    Hingwe Ameet S

    2011-01-01

    Full Text Available Abstract Introduction Toxoplasma gondii is an obligate intracellular protozoan that infects up to one-third of the world's population. Although this case is not the first of its kind, it is clinically important since it will help doctors keep a broad differential diagnosis in mind when attending to similar patients. Case presentation We present the case of a 20-year-old man of Middle Eastern heritage presenting with only generalized lymphadenopathy who was diagnosed with acute toxoplasmosis. Conclusion This case illustrates the important fact that toxoplasmosis can present with just simple lymphadenopathy, and thus can be confused with other infections such as Epstein-Barr virus and other mononucleosis-like illnesses such as cytomegalovirus, HIV with acute retroviral syndrome, cat scratch disease, leishmaniasis and syphilis. This case underlines why appropriate testing should be performed in confusing cases, and helps increase the knowledge about the diagnosis of this disease.

  3. Chediak-Higashi: a case report

    Directory of Open Access Journals (Sweden)

    A Paymard

    2016-06-01

    Full Text Available Background & aim: Chédiak–Higashi syndrome, a rare autosomal recessive disorder characterized by immune deficiency, bleeding diathesis, recurrent bacterial infections, albinism dynamic and progressive neurological disorder, as well as major organs such as the liver and spleen lymphocytic infiltration is determined. The aim of this study was to report a case of a rare manifestation of the disease. Case Report: The case-study in the present report was a 4-month-old female that two months after vaccination had intermittent fever associated with fever, weakness, which lasted more than a week. After blood tests, ultrasound and examination of blood cells, Chédiak–Higashi syndrome diagnosis was made. In terms of blood cells, pancytopenia, platelets and fresh frozen plasma were administered to the patient to prevent bleeding. After Buttock infections, the patient was suffering from septicemia and septic shock followed by a lack of response to resuscitation and cardiopulmonary arrest and then died. Conclusion: In this patient all Chediak Higashi syndrome, including long fever, loss of appetite, frequent infections, albinism variable and multiple neurological deficit was seen. Chdyak Higashi syndrome is treatable with early diagnosis and bone marrow transplantation.

  4. Born for a Noble Cause?--A Case Study on Fanconi Anemia

    Science.gov (United States)

    Elwess, Nancy L.; Butterfield, Savanna R.; Charles, Amanda; DeVeaugh, Maxine C.; Lu, Gloria J.; Shafqat, Hira; Watts, Andrew

    2005-01-01

    The fictional case study presented here is not based on one case, but is actually based on several cases. College students enrolled in a bioethics course for non-majors wrote it. The case entails the thought processes and decision-making involved in order to save one child suffering from a genetic disorder by producing another child, a "designer…

  5. [Pediatric lung lesions: a clinicopathological study of 215 cases].

    Science.gov (United States)

    Niu, Huilin; Wang, Fenghua; Liu, Wei; Wang, Yong; Chen, Zhengrong; Gao, Qiu; Yi, Peng; Li, Liping; Zeng, Rongxin

    2015-09-01

    To investigate clinical and pathological features of lung lesions in children. Clinical manifestations, radiologic imaging, histopathological features and immunohistochemical results were analyzed in 215 cases of lung lesions in children. A total of 215 cases of lung lesions in children aged 0 day to 13 years (average age of 27.2 months and the median age of 18.0 months) were selected, including 137 male and 78 female patients with a male to female ratio of 1.76:1.00. The incidence of congenital lung disease was higher in patients of less than 1 year old than those of over 1 year old age, and the difference of the two groups was statistically significant (P = 0.004). 142 cases had acquired lung diseases, and 73 cases had congenital bronchopulmonary dysplasia. Lung abscess was the most common lesion seen in 86 cases (40.0%), including 1 case of fungal abscess. Congenital pulmonary airway malformation (CPAM) was the second most common, seen in 44 patients (20.5%), including 20 cases of type 1, 18 cases of type 2 and 6 cases of type 4 CPAM. Pulmonary sequestration was found in 25 cases (11.6%) including 14 cases of intralobar type and 11 cases of extralobar type. Two cases of extralobar pulmonary sequestration showed simultaneous CPAM2 type 2 lesion. Other lesions included tuberculosis (13 cases, 6.0%), emphysema (12 cases, 5.6%), interstitial pneumonia (7 cases, 3.2%), pulmonary hemorrhage (6 cases, 2.8%), bronchogenic cyst (4 cases, 1.9%), bronchiolitis obliterans (2 cases, 0.9%), idiopathic pulmonary hemosiderin deposition disease (2 cases, 0.9%) and 1 cases of lung non-specific changes. 13 cases of neoplastic lesions (6.0%) were found, of which 11 cases were primary tumors (5.1%), including inflammatory myofibroblastic tumor in 5 patients (2.3%), pleuropulmonary blastoma in 5 cases (1 case of type I, 2 type II and 2 type III) and 1 case of mucoepidermoid carcinoma (0.5%) and 2 cases of metastatic tumors (hepatoblastoma and Wilm's tumor, 0.9%). Infectious diseases

  6. Two Legionnaires' disease cases associated with industrial waste water treatment plants: a case report

    Directory of Open Access Journals (Sweden)

    Putus Tuula

    2010-12-01

    Full Text Available Abstract Background Finnish and Swedish waste water systems used by the forest industry were found to be exceptionally heavily contaminated with legionellae in 2005. Case presentation We report two cases of severe pneumonia in employees working at two separate mills in Finland in 2006. Legionella serological and urinary antigen tests were used to diagnose Legionnaires' disease in the symptomatic employees, who had worked at, or close to, waste water treatment plants. Since the findings indicated a Legionella infection, the waste water and home water systems were studied in more detail. The antibody response and Legionella urinary antigen finding of Case A indicated that the infection had been caused by Legionella pneumophila serogroup 1. Case A had been exposed to legionellae while installing a pump into a post-clarification basin at the waste water treatment plant of mill A. Both the water and sludge in the basin contained high concentrations of Legionella pneumophila serogroup 1, in addition to serogroups 3 and 13. Case B was working 200 meters downwind from a waste water treatment plant, which had an active sludge basin and cooling towers. The antibody response indicated that his disease was due to Legionella pneumophila serogroup 2. The cooling tower was the only site at the waste water treatment plant yielding that serogroup, though water in the active sludge basin yielded abundant growth of Legionella pneumophila serogroup 5 and Legionella rubrilucens. Both workers recovered from the disease. Conclusion These are the first reported cases of Legionnaires' disease in Finland associated with industrial waste water systems.

  7. 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.

  8. Jane Doe: a cautionary tale for case reports.

    Science.gov (United States)

    Putnam, Frank W

    2014-12-01

    Historically, clinical case reports have played an essential role in the professional communication of medical and psychiatric knowledge. Case reports continue to play important roles in the initial identification of new syndromes or unusual variants of established conditions. Case reports and case series also serve to alert clinicians to preliminary evidence of the efficacy of novel treatments or adaptations to new populations. The Jane Doe Case provides a seminal example of the ethical/medico-legal dilemma arising from a patient's right to confidentiality versus the principle of independent review/replication as a necessary requirement for scientific credibility. As a result of being the subject of dueling case reports concerning the validity of her delayed recall of childhood sexual abuse, Jane Doe's identity was revealed. Consequently, she suffered significant emotional distress, bankruptcy, and the end of her career as a naval officer and aviator. Current medical journal guidelines call for protection of confidentiality of the patient's identity; yet, scientific credibility requires the possibility of an independent outside review if there are legitimate reasons to question facts or claims advanced in a case report. A potential solution is proposed as a starting point for resolving the dilemma posed for case study subjects and authors by the conflicting requirements of patient confidentiality and, if warranted, the possibility of an independent scientific review. © The Author(s) 2014.

  9. Unusual clinical presentation of rare case of vaginal leiomyoma: a case report

    OpenAIRE

    Ishrat Zuber; Purnima K. Nadkarni; Aditi A. Nadkarni; Akshay Nadkarni

    2016-01-01

    Primary vaginal leiomyoma are rare and usually arise from anterior vaginal wall, approximately 330 cases of vaginal fibroid reported in world literature. Vaginal myoma usually presented as discharge per vaginum, abnormal bleeding, pain lower abdomen, dyspareunia etc. We report a case of primary vaginal leiomyoma arising from lateral vaginal wall which is presented clinically as pain in hip joint and radiating to ipsilateral leg which is unusual clinical presentation creating diagnostic dilemm...

  10. The Case for Case Reports

    Directory of Open Access Journals (Sweden)

    George R. Saade

    2011-09-01

    Full Text Available If you are reading a hard copy of this editorial, then you are holding in hand the first issue of the American Journal of Perinatology Reports, or AJP Reports as we like to refer to it. Welcome to AJP Reports and thank you for taking the time to peruse it. I hope you find many of the reports interesting and helpful. The editorial team and publisher are very pleased to be able to bring this journal to our readers. Judging by the journal title, the editorial team, and the layout you may have already guessed that this is a companion to the American Journal of Perinatology. We will continue to publish original articles and topical reviews in the American Journal of Perinatology, but all case reports or case series will be referred to AJP Reports. Some may question the need for more case reports. Our decision to start AJP Reports obviously indicates that we think that case reports can be useful. I can refer to several diseases, treatment complications, and procedures that were first brought to the attention of healthcare providers through case reports. The best example of the usefulness of case reports is probably in infectious diseases. In the early phases of an emerging infectious disease, the case report or case series are usually the first clues of a problem. HIV was first brought to the attention of the medical community by case reports.[1] [2] [3] In our own field, the first attempts at treatment of twin-to-twin transfusion syndrome (TTTS using laser coagulation were reported in a case series.[4] After additional reports about the use of laser in TTTS, a randomized trial was performed that cemented laser photocoagulation as a therapeutic modality for TTTS.[5] While case reports or series are not considered the highest form of evidence, they are frequently the first form of evidence and the nudge that starts the cascade of investigation that ultimately leads to high-level evidence. Therefore, their impact on clinical practice may be easily

  11. Colonic leishmaniasis in a patient with HIV: a case report

    Directory of Open Access Journals (Sweden)

    Estela Soria-López

    Full Text Available Background: To describe an unusual clinical presentation of visceral leishmaniasis affecting the colon. Case report: We report the case of an HIV-positive patient with visceral leishmaniasis. We describe the clinical case, the procedures performed, the treatment provided and the patient's evolution. A comparative table of previously reported similar cases is shown. Discussion: Visceral leishmaniasis with intestinal involvement is an uncommon process. Nevertheless, this possibility should be taken into consideration in the differential diagnosis of immunosuppressed patients with symptoms of diarrhea, as a favorable prognosis depends on early diagnosis and appropriate treatment.

  12. Recurrent rhabdomyolysis in a child. Case presentation.

    Science.gov (United States)

    Ertuğrul, Sabahattin; Yolbaş, İlyas; Aktar, Fesih; Yılmaz, Kamil; Tekin, Recep

    2016-06-01

    Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case. Sociedad Argentina de Pediatría.

  13. 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.

  14. Waardenburg syndrome: A rare case

    Directory of Open Access Journals (Sweden)

    Shivlal M Rawlani

    2018-01-01

    Full Text Available Waardenburg Syndrome is a rare disorder of neural crest cell development. It is genetically inherited. Varying in prevalence from 1:42000 to 1:50,000, it compromises approximately 2-5% of congenital deaf children. The syndrome is not expressed in its complete form, in about 20% cases, which adds for its heterogenisity . Even among people affected in the same family,the features do vary. Unilateral heterochromia that manifests as lighter pigmentation of one iris is associated with Waardenburg syndrome and Parry-Romberg syndrome and less commonly with Hirschsprung disease. A case of ten yrs. old boy with a typical facial profile and hearing loss is reported.

  15. Microfibrillar cardiomyopathy: A rare case

    Directory of Open Access Journals (Sweden)

    Narender Kumar

    2011-01-01

    Full Text Available Microfibrillar cardiomyopathy is a very rare cause of restrictive cardiomyopathy (RCM. The index case was a male patient who presented with shortness of breath and pedal edema. Further clinical investigations favored a clinical diagnosis of RCM. An endomyocardial biopsy revealed subendocardial and interstitial hyaline eosinophillic material resembling amyloid that did not stain with Congo red. An electron microscopic examination showed that this material was composed of twisted linear and bundles of tangled microfibrils. The etiology of the microfibrillar deposition is currently unknown. The pathologists should entertain the diagnosis of microfibrillar cardiomyopathy in suspected cases of amyloidosis that are negative for Congo red.

  16. Xantogranulomatous pyelonephritis in a horseshoe kidney: a case report

    International Nuclear Information System (INIS)

    Macedo Lemos, D. de; Albuquerque, S.C. de; Lemos, R.S. de; Cruz, F.J.B.; Coelho, J.P.

    1991-01-01

    A case of xanthogranulomatous pyelonephritis in a horseshoe kidney. The patient was a child, female, 8-year-old. In a recent review of the literature, xanthogranulomatous pyelonephritis occurs more often in the fourth and fifth decades. It is rare in children and no case has been reported of the association of horseshoe kidney and xanthogranulomatous pyelonephritis. The use of several image diagnosis methods and the need of correlation with clinical history and laboratory examinations have been emphasized as very important to the definitive diagnosis, in despite of in some cases it was only established after surgery and histopathologic study. (author)

  17. Cytological diagnosis of erythema nodosum leprosum in clinically unsuspected cases: A report of two cases

    Directory of Open Access Journals (Sweden)

    Shruti Semwal

    2018-01-01

    Full Text Available Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The manifestations of this disease varies across the spectrum of tuberculoid (TT to lepromatous (LL leprosy.The course of this indolent disease is interrupted by acute exacerbations in the form of leprare actions. Erythema nodosum leprosum (ENL, a type 2 lepra reaction, occurs in lepromatous or borderline lepromatous cases, usually in response to multidrug therapy. Early detection and timely management of these patients is important to reduce the associated morbidity. We report two clinically unusual cases of ENL on fine-needle aspiration cytology. In one case, antileprosy treatment was completed 10 years back, whereas in the other case, ENL was the presenting feature of the disease. Cytological examination of swelling in both the cases showed neutrophils, lymphoid cells, clusters of foamy macrophages, histiocytes, and giant cells. Fite stain was positive, which confirmed the cytological diagnosis of ENL.

  18. CASE REPORT OF SUCCESSFUL RESUSCITATION OF A CASE O F SUICIDAL HANGING

    OpenAIRE

    Yanki D.

    2013-01-01

    ABSTRACT: In Sikkim, the rate of suicide has been on the rise since the last 10 years. Suicidal hanging as method of ending life is a major concern among school children. It is very rare that the victims are brought on time for successful resuscit ation in Sikkim. Suicide by hanging is probably the most easy way to go about taking one’s own life , as the means to do it are easily available and uncomplicated and, brutally efficient in most case s . This is a case ...

  19. Tetra-phocomelia: a rarest of rare case.

    Science.gov (United States)

    Shukla, Anil Kumar; Sanjay, S C; Krishna, L; Krishnappa, N

    2015-03-01

    We present a rarest of rare case of Tetra-Phocomelia evaluated by antenatal Ultrasonography. It is a condition seen in 0.62 per 100,000 live births. An ultrasonogram was done at 18 wk of pregnancy to assess the fetus and after termination gross specimen was evaluated and X-ray infantograms were done to confirm the findings. The case showed classic Tetra-Phocomelia with limbs like flippers of a seal. Our findings make it rarest of rare as only few cases have been so far reported.

  20. 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.

  1. Dissociative amnesia: a case with management challenges

    Directory of Open Access Journals (Sweden)

    Priti Singh

    2015-07-01

    Full Text Available A case of dissociative amnesia with regressed behaviour was diagnosed applying the existing criteria for dissociative disorder in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10. Though there are number of cases of such condition, but when coupled with regressed behaviour it adds to new dimension in the management. An applied strategy in lines with both pharmacological and non pharmacological was used, and we found that it helped our patient to gradually improve her behaviour. This is one of the few cases reported and we hope more such cases should be reported in understanding the psychopathology.

  2. Antipsychotic-associated psoriatic rash - a case report

    DEFF Research Database (Denmark)

    Bujor, Camelia-Eugenia; Vang, Torkel; Nielsen, Jimmi

    2017-01-01

    BACKGROUND: Antipsychotics are a heterogeneous group of drugs. Although, antipsychotics have been used for years, unexpected side effects may still occur. With this case report we focus on a possible association between psoriasis and antipsychotics. Data on the patient's course of psychiatric...... disease, onset of psoriasis and its evolution were extracted from the patient's medical files. CASE PRESENTATION: We present a case of a 21-year-old female diagnosed with schizophrenia. She was initially treated with quetiapine, and later switched to aripiprazole due to weight gain. After initiation...

  3. Endodontic microsurgery, presentation of a clinical case

    International Nuclear Information System (INIS)

    Zeledon Mayorga, Rodolfo

    2009-01-01

    A literature review is conducted on endodontic surgery. The report of a clinical case is facilitated. The technique chosen according to the clinical and radiographic examination was endodontic microsurgery, the case has presented a positive evolution of four years [es

  4. Adenofibroma of Skene's Duct: A Case Report

    Directory of Open Access Journals (Sweden)

    Yosep Chong

    2010-01-01

    Full Text Available Skene's glands, also known as paraurethral glands, are homologues of the male prostate, in which painless cystic masses and inflammation due to obstruction have been rarely found and reported. In addition, there have been rare reported cases of adenocarcinoma of Skene's glands. Recently, the authors experienced the first case of adenofibroma arising in Skene's glands of a 62-year-old woman with coital pain. Hereby, we present the case with pathologic and immunohistochemical findings and a short review of literature.

  5. A case-based assistant for clinical psychiatry expertise.

    Science.gov (United States)

    Bichindaritz, I

    1994-01-01

    Case-based reasoning is an artificial intelligence methodology for the processing of empirical knowledge. Recent case-based reasoning systems also use theoretic knowledge about the domain to constrain the case-based reasoning. The organization of the memory is the key issue in case-based reasoning. The case-based assistant presented here has two structures in memory: cases and concepts. These memory structures permit it to be as skilled in problem-solving tasks, such as diagnosis and treatment planning, as in interpretive tasks, such as clinical research. A prototype applied to clinical work about eating disorders in psychiatry, reasoning from the alimentary questionnaires of these patients, is presented as an example of the system abilities.

  6. Test case for a near-surface repository

    International Nuclear Information System (INIS)

    Elert, M.; Jones, C.; Nilsson, L.B.; Skagius, K.; Wiborgh, M.

    1998-01-01

    A test case is presented for assessment of a near-surface disposal facility for radioactive waste. The case includes waste characterization and repository design, requirements and constraints in an assessment context, scenario development, model description and test calculations

  7. The Case Method as a Form of Communication.

    Science.gov (United States)

    Kingsley, Lawrence

    1982-01-01

    Questions the wisdom of obscurantism as a basis for case writing. Contends that in its present state the case method, for most students, is an inefficient way of learning. Calls for a consensus that cases should be as well-written as other forms of scholarship. (PD)

  8. 12 CFR 585.110 - How do I apply for a case-by-case exemption?

    Science.gov (United States)

    2010-01-01

    ... PROHIBITED SERVICE AT SAVINGS AND LOAN HOLDING COMPANIES Exemptions § 585.110 How do I apply for a case-by-case exemption? (a) Who may file. (1) A savings and loan holding company or a person who was convicted... exemption only for a designated position (or positions) with respect to a named savings and loan holding...

  9. A clear case. Selective investment in case management applications can yield significant returns.

    Science.gov (United States)

    Hagland, Mark

    2009-03-01

    Strategically conceived case management system implementation makes good patient care and business sense, CIOs agree. Significant financial savings can be achieved from case management IS implementations, if those implementations are executed in the context of partnership between clinical leaders and the CIO's team. CIOs agree that applying the concept of "investment" to the implementation of case management IT can make resource allocation decisions easier.

  10. UTERINE ARTERIOVENOUS MALFORMATION: A CASE REPORT

    OpenAIRE

    Chandrashekar Murthy; Kiran

    2014-01-01

    Uterine arteriovenous malformation (AVM) is a rare condition, with less than 100 cases reported in the literature. Despite it being rare, it is a potentially life threatening disease. This case report describes 31- year-old women who presented with abnormal uterine bleeding. Trans abdominal sonography, colour and spectral Doppler imaging was performed, diagnosis was confirmed by non- invasive MRI scan. Laparoscopic bilateral uterine artery ligation was done successfully.

  11. Xanthogranulomatous appendicitis with a fulminant course: report of a case.

    Science.gov (United States)

    Kochhar, Gaurav; Saha, Sudipta; Andley, Manoj; Kumar, Ashok; Kumar, Ajay

    2014-12-01

    Xanthogranulomatous inflammation is a well-described entity with involvement of various body organs. But the involvement of vermiform appendix in the disease process is quite rare with only few cases are reported in literature. This case report describes a 50-year-old man, who was diagnosed as a case of acute appendicitis with appendicular lump on the basis of clinical history, physical examination, and hematological and radiological investigations. Patient underwent surgical interventions twice. But, he succumbed to the disease. We are reporting this case in view of rarity of the disease and the fulminant course, which has not been described in any other reports.

  12. Delusional parasitosis with alcohol dependence: A case report

    Directory of Open Access Journals (Sweden)

    Nahid Dave, Austin Fernandes, Anup Bharati, Avinash De Sousa

    2014-04-01

    Full Text Available Delusional parasitosis is a syndrome with which most psychiatrists are familiar. However, most reports consist of case reports or small series. We present here a case report of delusional parasitosis of an extremely bizarre nature in a case of alcohol dependence that responded to pimozide, haloperidol and electroconvulsive therapy (ECT.

  13. Isolated hepatic actinomycosis: a case report

    Directory of Open Access Journals (Sweden)

    Shehab Thomas M

    2010-02-01

    Full Text Available Abstract Introduction Actinomyces are slow growing, non-spore forming, gram-positive, branching bacilli that thrive in anaerobic and microareophilic conditions. Actinomyces are more commonly associated with oral and cervicofacial infections. Hepatic involvement in infections of the abdomen (known as isolated hepatic actinomycosis is rare, accounting for only 5% of all cases of actinomycosis. Case presentation We present the case of a 75-year-old Caucasian woman with a 3-month history of night sweats, fever, chills, abdominal bloating, anorexia, weight-loss, and early satiety. The patient was found to have isolated hepatic actinomycosis infection after undergoing a laparotomy with a biopsy of the liver. The patient has now recovered. Conclusion Isolated hepatic actinomycosis is a rare and often overlooked etiology for a liver mass. Given its subacute presentation and nondescript symptomatology, physicians should be aware of this differential and the potential pitfalls in diagnosis and management.

  14. Sirenomelia in a Nigerian triplet: a case report.

    Science.gov (United States)

    Ugwu, Rosemary O; Eneh, Augusta U; Wonodi, Woroma

    2011-09-02

    Sirenomelia, also known as mermaid syndrome, is a very rare fatal congenital abnormality in which the legs are fused together, giving them the appearance of a mermaid's tail. It is commonly associated with abnormal kidney development, genital and rectal abnormalities. A handful of cases have been reported in other parts of the world, however, no cases have previously been reported in a Nigerian neonate. To the best of our knowledge, we believe that this is the first case reported from West Africa and in a triplet. A 16-hour-old baby boy, the second of a set of Nigerian triplets, presented to our facility with fusion of the entire lower limbs, imperforate anus, indiscernible genital structures, single umbilical artery and a neural tube defect. His parents were from the Hausa ethnic group and not related. Sirenomelia has not been previously described in a set of triplets, and it is hoped that this report from West Africa will give information about the non-racial predilection of this condition.

  15. Nonfamilial cleidocranial dysplasia (dysostosis): a case report

    International Nuclear Information System (INIS)

    Salem, G

    1990-01-01

    Cleidocranial dysplasia, previously known as cleidocranial dysostosis, is a rare hereditary disease of unknown etiology characterized by abnormalities in the skull, jaws, shoulder girdle, as well as abnormalities of the dentition. The disease usually follows an autosomal dominant mode of transmission. This is a report on a case in a 25-year-old Saudi female from Gizan, Saudi Arabia, which seemes to be the first case reported in the Kingdom. An outstanding feature of this case is that it did not follow a familial pattern of inheritance since the patient is the only member of the family suffering from such disorder. The abnor malities present in the dentition are described together with the associated skeletal malformations. The clin ical and radiographic findings, as well as the hereditary pattern of the disease as described in the literature, are discussed. The dental management of these cases is reviewed. (author)

  16. Juvenile Dermatomyositis in a Nigerian Girl: a Case Report ...

    African Journals Online (AJOL)

    Juvenile Dermatomyositis in a Nigerian Girl: a Case Report. MG Mustapha, MG Ashir, AA Mayun, Y Machoco, AB Ibrahim. Abstract. A case of Juvenile dermatomyositis (JDM) in a 10 year old Nigerian girl is herein reported to discuss some of the features of the disease and challenges in management of such a rare but ...

  17. The Woodworker's Website: A Project Management Case Study

    Science.gov (United States)

    Jance, Marsha

    2014-01-01

    A case study that focuses on building a website for a woodworking business is discussed. Project management and linear programming techniques can be used to determine the time required to complete the website project discussed in the case. This case can be assigned to students in an undergraduate or graduate decision modeling or management science…

  18. A systematic approach to safety case maintenance

    International Nuclear Information System (INIS)

    Kelly, T.P.; McDermid, J.A.

    2001-01-01

    A crucial aspect of safety case management is the ongoing maintenance of the safety argument through life. Throughout the operational life of any system, changing regulatory requirements, additional safety evidence and a changing design can challenge the corresponding safety case. In order to maintain an accurate account of the safety of the system, all such challenges must be assessed for their impact on the original safety argument. This is increasingly being recognised by many safety standards. However, many safety engineers are experiencing difficulties with safety case maintenance at present, the prime reason being that they do not have a systematic and methodical approach by which to examine the impact of change on safety argument. The size and complexity of safety arguments and evidence being presented within safety cases is increasing. Nowhere is this more apparent than for Electrical, Electronic and Programmable Electronic systems attempting to comply with the requirements and recommendations of software and hardware safety standards such as and UK Defence Standards 00-54 [MoD. 00-54 Requirements of Safety Related Electronic Hardware in Defence Equipment. Ministry of Defence, Interim Defence Standard, 1999], 00-55 []. However, this increase in safety case complexity exacerbates problems of comprehension and maintainability later on in the system lifecycle. This paper defines and describes a tool-supported process, based upon the principles of goal structuring, that attempts to address these difficulties through facilitating the systematic impact assessment of safety case challenges

  19. Contextualising case studies in entrepreneurship: A tandem approach to conducting a longitudinal cross-country case study

    DEFF Research Database (Denmark)

    Chetty, S. K.; Partanen, J.; Rasmussen, Erik Stavnsager

    2014-01-01

    Using predictive and effectuation logics as a framework, this research note explains how case study research was conducted to demonstrate rigour and relevance. The study involves a longitudinal cross-country case study on small and medium-sized firm growth and networks undertaken by research teams...... in three countries (Finland, Denmark and New Zealand) involving 33 firms. This research note outlines the implications of this research and provides valuable guidance and reflections upon opportunities for future research regarding the conduct of contextual studies in entrepreneurship without compromising...

  20. Clinical findings in two cases of atypical scrapie in sheep: a case report

    Directory of Open Access Journals (Sweden)

    Chaplin Melanie

    2007-02-01

    Full Text Available Abstract Background Atypical scrapie is a recently recognised form of transmissible spongiform encephalopathy of sheep that differs from classical scrapie in its neuropathological and biochemical features. Most cases are detected in apparently healthy sheep and information on the clinical presentation is limited. Case presentation This report describes the clinical findings in two sheep notified as scrapie suspects and confirmed as atypical scrapie cases by immunohistochemistry and Western immunoblotting. Although both sheep displayed signs suggestive of a cerebellar dysfunction there was considerable variation in the individual clinical signs, which were similar to classical scrapie. Conclusion Any sheep presenting with neurological gait deficits should be assessed more closely for other behavioural, neurological and physical signs associated with scrapie and their presence should lead to the suspicion of scrapie.

  1. Peripheral ossifying fibroma. A case report

    Directory of Open Access Journals (Sweden)

    Karen Nair Vallejos Duarte

    2016-12-01

    Full Text Available Introduction: Peripheral ossifying fibroma, a pseudotumoral injury, considered within simple reactive hyperplasia, which in general has a definite cause and is often reversible. Objective: To present a case of an injury to a patient, which manifested as a radiolucent and asymptomatic injury lesion. Its differential diagnosis, which is based on clinical manifestations and conventional radiographic study, is controversial. Case Description: A case is presented in a male patient with 51-year-old with a lesion in the maxillary incisor-canine area, aspects of which were suggestive of granuloma telangiectasico. Previous clinical and radiographic evaluation, the patient underwent surgical resection of the lesion and was sent for histopathological examination, showing compact osteoid material revealing the peripheral final diagnosis, ossifying fibroma. Conclusion: The professional dentist must have knowledge and ability to clinical management of oral pathologies, to make a correct diagnosis and treatment, for it is essential to perform a biopsy, to avoid possible disputes between the clinical and histological diagnosis.

  2. Casing Pipe Damage Detection with Optical Fiber Sensors: A Case Study in Oil Well Constructions

    Directory of Open Access Journals (Sweden)

    Zhi Zhou

    2010-01-01

    Full Text Available Casing pipes in oil well constructions may suddenly buckle inward as their inside and outside hydrostatic pressure difference increases. For the safety of construction workers and the steady development of oil industries, it is critically important to measure the stress state of a casing pipe. This study develops a rugged, real-time monitoring, and warning system that combines the distributed Brillouin Scattering Time Domain Reflectometry (BOTDR and the discrete fiber Bragg grating (FBG measurement. The BOTDR optical fiber sensors were embedded with no optical fiber splice joints in a fiber-reinforced polymer (FRP rebar and the FBG sensors were wrapped in epoxy resins and glass clothes, both installed during the segmental construction of casing pipes. In situ tests indicate that the proposed sensing system and installation technique can survive the downhole driving process of casing pipes, withstand a harsh service environment, and remain intact with the casing pipes for compatible strain measurements. The relative error of the measured strains between the distributed and discrete sensors is less than 12%. The FBG sensors successfully measured the maximum horizontal principal stress with a relative error of 6.7% in comparison with a cross multipole array acoustic instrument.

  3. 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.

  4. Disseminated Histoplasmosis in a 13-year-old girl: A case report ...

    African Journals Online (AJOL)

    Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of disseminated ...

  5. Disseminated Histoplasmosis in a 13-year-old girl: a case report

    African Journals Online (AJOL)

    EB

    Abstract. Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune- compromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of ...

  6. Evaluating a Tacit Knowledge Sharing Initiative: A Case Study

    Science.gov (United States)

    Gubbins, Claire; Corrigan, Siobhan; Garavan, Thomas N.; O'Connor, Christy; Leahy, Damien; Long, David; Murphy, Eamonn

    2012-01-01

    Purpose: This paper aims to present a case study illustrating the issues involved in the tacit knowledge conversion process and to determine whether such conversion delivers value to the organisation in terms of business value and return on investment (ROI). Design/methodology/approach: A single-case multiple baseline participants experimental…

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

    Directory of Open Access Journals (Sweden)

    Shankargouda Patil

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

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

    Science.gov (United States)

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

    2017-01-01

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

  9. Reverse case study: to think like a nurse.

    Science.gov (United States)

    Beyer, Deborah A

    2011-01-01

    Reverse case study is a collaborative, innovative, active learning strategy that nurse educators can use in the classroom. Groups of students develop a case study and a care plan from a list of medications and a short two- to three-sentence scenario. The students apply the nursing process to thoroughly develop a complete case study written as a concept map. The strategy builds on previous learned information and applies the information to new content, thus promoting critical thinking and problem solving. Reverse case study has been used in both associate and baccalaureate nursing degree theory courses to generate discussion and assist students in thinking like a nurse. 2011, SLACK Incorporated.

  10. Septooptic dysplasia : a case report

    International Nuclear Information System (INIS)

    Kim, Jung Hae; Choi, Dae Seob; Lee, Chang Wook; Kim, Soon; Kim, Seung Hyeon; Lee, Sung Woo; Ha, Jung Ho; Sakong, Jung Kyu; Lee, Hyeon Kyeong

    2001-01-01

    Septooptic dysplasia is a rare anterior midline anomaly considered to be a mild form of lobar holoprosencephaly. We describe a case with unilateral optic nerve hypoplasia and the absence of a septum pellucidum

  11. Left Sided Amyand's Hernia, A Rare Occurance: A Case Report.

    Science.gov (United States)

    Ravishankaran, Praveen; Mohan, G; Srinivasan, A; Ravindran, G; Ramalingam, A

    2013-06-01

    This is a case report about a 35 year old man admitted with complains of obstructed left sided inguinal hernia. On exploration of the left inguinal canal to our surprise a normal appendix was found in addition to a gangrenous omentum. Resection of the gangrenous omentum was done. Appendectomy was done. This case is reported for its rare occurance as only three such cases of left sided amyand's hernia has been reported so far in literature[4-6].

  12. Test case for a near-surface repository

    Energy Technology Data Exchange (ETDEWEB)

    Elert, M.; Jones, C. [Kemakta Konsult AB, Stockholm (Sweden); Nilsson, L.B. [Swedish Nuclear Fuel and Waste Co, Stockholm (Sweden); Skagius, K.; Wiborgh, M. [Kemakta Konsult AB, Stockholm (Sweden)

    1998-09-01

    A test case is presented for assessment of a near-surface disposal facility for radioactive waste. The case includes waste characterization and repository design, requirements and constraints in an assessment context, scenario development, model description and test calculations 6 refs, 12 tabs, 16 figs

  13. Apparatus and method for vibrating a casing string during cementing

    International Nuclear Information System (INIS)

    Rankin, R.E.; Rankin, K.T.

    1992-01-01

    This patent describes a method of cementing a string of casing in a well. It comprises: securing a vibrating device into the string of casing near the lower end of the string of casing; lowering the string of casing into the well to the desired depth; pumping a cement slurry down the string of casing; causing a portion of the cement slurry being pumped down the string of casing to vibrate the vibrating device; and wherein the vibrating device is secured in the string of casing by cementing the vibrating device within a sub, then securing the sub into the string of casing prior to lowering the string of casing into the well

  14. Ainhum - A Rare Case Report.

    Science.gov (United States)

    Prabhu, Ravi; Kannan, Narayanasamy Subbaraju; Vinoth, Sundaresan; Praveen, Chinnappan Balasubramanian

    2016-04-01

    The term 'AINHUM' is derived from the African word meaning 'to saw or cut'. True ainhum otherwise called dactylolysis spontanea is a condition involving soft tissue or digits with constricting rings commonly presenting in fifth toes, usually bilateral. It is to be differentiated from Pseudo-ainhum that occurs secondary to some hereditary and nonhereditary diseases that lead to annular constriction of digits. We report a rare case of true ainhum involving the left fourth toe only. It is a very rare case and a very few were reported worldwide. The highest incidence of ainhum has been reported in South Africa and South America. It is rarely reported in India. Ainhum when diagnosed and treated in early stages can be prevented from progressing to mutilating deformities.

  15. An ethical analysis of a home visit case study.

    Science.gov (United States)

    Pibernat, Artur Dalfó; Vidal, Jessica Rosell; Pibernat, Enric Dalfó; Rodríguez, Francisco Javier Pelegrina; Colomer, Gerard; Cid, Maria Feijoo

    2017-12-01

    This article will explore a clinical case study of a home visit carried out by the case manager nurse. In this case, we will discuss the dilemma of finding the balance between autonomy and beneficence from the perspective of principlist ethics, virtue ethics and the 'ethics of care'. The main conflict in this case study deals with all proposals are unsuitable and it is not necessary for a nurse to pay him a home visit, whereas for the healthcare system it is considered necessary. We could conclude that, during the home visit, the case manager aspires to achieve excellence, and throughout his clinical relationship with Francesc, searches for a series of virtues, respecting certain fundamental principles. In this way, the case managers ensure that Jaume's care is more humanised. The case has been anonymised and confidentiality maintained.

  16. A strange case of Evans syndrome

    Directory of Open Access Journals (Sweden)

    Manuel Monti

    2013-12-01

    Full Text Available Evans syndrome is a rare autoimmune disease presenting hemolytic anemia, thrombocytopenia and/or neutropenia. It may be associated with other autoimmune or lymphoproliferative diseases. It can have an extremely serious disease course and, in rare cases, this can even be life-threatening. First-line treatment consists of steroids and/or immunoglobulin. Further therapy with rituximab, vincristine, cyclophosphamide and other immunosuppressive drugs can be considered in unresponsive patients. We report a case of Evans syndrome in a 54-year old woman admitted to the Emergency Department (ED for asthenia. Etiopathogenic, clinical, therapeutic and evolutive aspects are discussed. In contrast to many cases described in the literature, our patient had a satisfactory response to corticoids. We also discuss how to make a specific diagnosis, even in a suburban ED with limited resources, in order to admit patients to the appropriate hospital department and allow the correct therapy to be started as early as possible.

  17. A skin-picking disorder case report: a psychopathological explanation

    Directory of Open Access Journals (Sweden)

    Ângela Ribeiro

    2015-06-01

    Full Text Available We describe the case of a 44-year-old woman, without known previous psychiatric history, hospitalized after a significant hemorrhage caused by self-inflicted deep facial dermal lesions (with muscle exposition. Psychopathological possible explanations of this case, as in similar reviewed ones, are related to frustration, aggression, and impulsivity.

  18. A case-mix in-service education program.

    Science.gov (United States)

    Arons, R R

    1985-01-01

    The new case-mix in-service education program at the Presbyterian Hospital in the City of New York is a fine example of physicians and administration working together to achieve success under the new prospective pricing system. The hospital's office of Case-Mix Studies has developed an accurate computer-based information system with historical, clinical, and demographic data for patients discharged from the hospital over the past five years. Reports regarding the cases, diagnoses, finances, and characteristics are shared in meetings with the hospital administration and directors of sixteen clinical departments, their staff, attending physicians, and house officers in training. The informative case-mix reports provide revealing sociodemographic summaries and have proven to be an invaluable tool for planning, marketing, and program evaluation.

  19. The importance of laboratory re-evaluation in cases of suspected child abuse - A case report.

    Science.gov (United States)

    Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B

    2017-09-01

    In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Orthodontic management of a dental concrescence: a case report.

    Science.gov (United States)

    Stanford, Nicky David; Hosni, Sara; Morris, Tim

    2017-09-01

    Dental concrescence is a rare dental abnormality resulting in the joining of two teeth at the level of the cementum. This is the first reported case of the orthodontic management of a dental concrescence and the options for patient treatment are discussed. In this case, a compromised occlusal result was accepted with restorative masking of the affected teeth.

  1. A CASE OF COR BILOCULARE ACCOMPANIED BY POLYSPLENIA

    Directory of Open Access Journals (Sweden)

    M. S. ROJHAN

    1972-07-01

    Full Text Available The clinical history and necroscopic fi ndings of a 3 -} year old girl - involved in cor biloculare was reported. In th is case dextrotransposition of the great a rteries and polysplenia was observed. The majority of cor biloculare cases appearing in the literature being accompanied by asplenia, the present case of polysplenia is relatively rare

  2. Neonatal appendicitis: a survival case study

    Directory of Open Access Journals (Sweden)

    Izabela Linha Secco

    Full Text Available ABSTRACT Objective: To report a case of neonatal appendicitis in a children’s hospital in southern Brazil, demonstrating the impact on neonatal survival. Method: Case study with data collection from medical records, approved by the Institution and Ethics Committee for Research with Human Beings. Results: The clinical picture is initially characterized by food intolerance, evolving to hypoactivity, alteration of vital signs and septicemia due to intestinal perforation. Management is exclusively surgical, since no case described in the literature was diagnosed preoperatively and the findings usually point to acute abdomen. Conclusion: A focused clinical surveillance should be established when the infant presents peritoneal irritation. Follow-up of the evolution and the worsening of the symptoms by nurses, as part of the care team in partnership with the medical team, enables an early surgical intervention, thereby avoiding complications such as septicemia and death.

  3. A Case of Unresectable Rectal Necrosis

    Directory of Open Access Journals (Sweden)

    Mohammed Nassif

    2011-01-01

    Full Text Available Introduction. Necrosis of the rectum is an uncommon finding due to abundant collateral vasculature. Its management remains challenging, without clear consensus in the literature. Case Report. We describe a case of a 53-year-old woman with multiple medical comorbidities that presented in septic shock and hematochezia. Colonoscopy revealed ischemic colitis. Conservative management was instituted. At two weeks, she presented evidence of peritonitis. Exploratory laparotomy revealed extensive necrosis of the left colon and rectum. Due to dense inflammation, resection was deemed unsafe. Therefore, a transverse ostomy with mucosal fistula was preformed. Multiple drains were left in place. The patient healed uneventfully. Conclusion. This case illustrates that, if extensive dissection of the distal colon and rectum is unsafe due to the patient's critical condition or technical feasibility, then a diverting ostomy of the proximal viable bowel along with a mucus fistula and good drainage of the abdomen represents an acceptable alternative.

  4. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    Science.gov (United States)

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

  5. A case of a massive mandibular schwannoma

    Directory of Open Access Journals (Sweden)

    Shishir Ram Shetty

    2011-01-01

    Full Text Available Schwannoma, a benign nerve sheath tumor is relatively rare in occurrence and even rarer in sites, such as jaw bones. There are only 45 reported cases of intraosseous schwannoma of the jaws reported in the literature. We report a rare case of mandibular schwannoma in a 50-year-old Indian male. The clinical features resembled that of a residual cyst, fibro-osseous lesion or an odontogenic tumor/cyst. Radiological differential diagnoses of ameloblastoma or odontogenic keratocyst was made based on the findings of the orthopantomogram. The lesion was examined histopathologically and a final diagnosis of schwannoma arising from the inferior alveolar nerve was made. The aim of this report is to add information to the existing sparse literature on intraosseous schwannomas of the jaw.

  6. Primary Oral Tuberculosis - A Case Report

    Directory of Open Access Journals (Sweden)

    B N Praveen

    2007-01-01

    Full Text Available Tuberculosis is most common disease in developing countries because of lack of public health awareness, poverty, nutritional deficiencies, absence of medical facilities. Primary oral lesions in tuberculosis are still exceedingly rare. Oral involvement may be primary or secondary to systemic involvement. Involvement of oral cavity is rare accounting for 0.2-1.5% of cases. A rare case report of primary oral tuberculosis is presented.

  7. Gigantic Suprapubic Lymphedema: A Case Study

    Directory of Open Access Journals (Sweden)

    Roozbeh Tanhaeivash

    2016-08-01

    Full Text Available We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg. Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases.

  8. Extramedullary hematopoiesis: A report of two cases.

    Science.gov (United States)

    Zhang, Huan-Zhu; Li, Ying; Liu, Xin; Chen, Bao-Rong; Yao, Guo-Hua; Peng, Yu-Na

    2016-12-01

    Extramedullary hematopoiesis (EMH) is defined as hematopoiesis occurring in organs outside of the bone marrow. The present report describes two cases of thalassemic patients with paraspinal medullary hematopoiesis and analyzes the clinical manifestations, imaging, pathology, diagnosis and treatment of EMH. In addition, a supplementary review of previously published cases is provided along with a review of the related literature. Computed tomography (CT) of the first case revealed multiple paraspinal masses, and the largest was 6.2×8.0 cm in diameter. Likewise, CT of the second patient revealed multiple paraspinal masses in the bottom of the left thoracic cavity, and the largest was measured 10.1×10.5 cm. The two cases underwent surgical biopsy and the findings were compatible with a diagnosis of EMH. In conclusion, EMH is a compatible and rare disease, and should be distinguished from other neoplasms. EMH must considered when masses with characteristic radiologic appearance are detected in patients with thalassemia intermedia.

  9. Melioidosis in Malaysia: A Review of Case Reports.

    Science.gov (United States)

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

    2016-12-01

    Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. We sought to review case reports of melioidosis from Malaysia. We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common-genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

  10. Melioidosis in Malaysia: A Review of Case Reports

    Science.gov (United States)

    Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

    2016-01-01

    Background Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. Objective We sought to review case reports of melioidosis from Malaysia. Methods We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Results Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24–48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common—genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of

  11. Melioidosis in Malaysia: A Review of Case Reports.

    Directory of Open Access Journals (Sweden)

    Paul Vijay Kingsley

    2016-12-01

    Full Text Available Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis.We sought to review case reports of melioidosis from Malaysia.We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome.Overall, 67 cases were reported with 29 (43% deaths; the median age was 44 years, and a male preponderance (84% was noted. Forty-one cases (61% were bacteremic, and fatal septic shock occurred in 13 (19% within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54% was the most common risk factor. Twenty-six cases (39% had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36% was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%. Other types of clinical presentations were less common-genitourinary (n = 5, neurological (n = 5, osteomyelitis/septic arthritis (n = 4 and skin (n = 2; five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21% was the most common followed by liver (18%; abscesses of the spleen and lung were the third most common (12% each. Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

  12. SINONASAL MYOPERICYTOMA: A CASE REPORT

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    K. M. Surendran

    2016-09-01

    Full Text Available AIM: Myopericytoma is a rare vascular neoplasm. It is extremely rare in sinonasal region. We report such a case which was treated by medial maxillectomy via lateral rhinotomy approach.

  13. A Case of Male Goltz Syndrome

    Directory of Open Access Journals (Sweden)

    Bhaswati Ghoshal

    2012-01-01

    Full Text Available We present the case of a boy with a clinical diagnosis of Goltz syndrome (focal dermal hypoplasia, a rare genodermatosis characterized by widespread dysplasia of mesodermal and ectodermal tissues. A 9-year-old male patient with Goltz syndrome presented with typical skin lesions along with progressive dimness of vision and mental retardation since birth. It is inherited in an X-linked dominant fashion and is normally lethal in male patients, and so very few male patients, like the index case, have been reported.

  14. Congenital generalized lipodystrophia: a case report

    International Nuclear Information System (INIS)

    Malheiros, N.R.; Marchiori, E.; Praxedes, M.C.; Machado, D.M.; Carvalho, A.A.V.

    1995-01-01

    Congenital generalized lipodystrophia is a rare genetic disorder, transmitted as an autosomal recessive trait and is prevalent on female. This paper presents a case of a man, 36-year-old, suffering from congenital generalized lipodystrophia with clinical features of diabetes mellitus and dyspnea. Radiographic findings have shown cystic areas in the skeleton, interstitial pulmonary fibrosis and paucity of abdominal fat. Radiological and anatomo-pathological aspects are presented as well as a review of the medical literature about the case. (author). 8 refs, 4 figs

  15. Medicamentosa keratoconjunctivitis: A case report

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    Chiemela C. Okoro

    2016-03-01

    Full Text Available We present a case of medicamentosa keratoconjunctivitis in a 42-year-old woman who complained of eye redness, blurred vision and pain after using inappropriate medications for treatment. Examination revealed severe conjunctival injection as well as punctate stains on the corneas. The patient was advised to stop her former medications and was prescribed an artificial tear supplement, an antibiotic-steroid combination and a topical nonsteroidal anti-inflammatory drug. Possible conditions that could elicit similar clinical features are highlighted. The purpose of the case report is to raise issues relating to drug-induced allergic/sensitivity reactions based on recent clinical and experimental reports and also the roles of active ingredients and preservatives. Keywords: Superficial punctate epitheliopathy; Medicamentosa; Factitious disease; Dry eye syndrome; Benzalkonium chloride

  16. Human born with a tail: A case report | Sarmast | South African ...

    African Journals Online (AJOL)

    Context. e dorsal cutaneous appendage, or so-called human tail, is often considered to be a cutaneous marker of underlying occult spinal dysraphism. Human tails have always elicited curiosity. A unique case of human dysraphism is described. Case report. An interesting case of a child with a tail-like caudal appendage ...

  17. SCHISTOSOMAL APPENDICITIS IN A SLIDING HERNIA (CASE ...

    African Journals Online (AJOL)

    We report a rare case of a forty-seven year old Nigeria male with schistosomal appendicitis in a sliding hernia. The clinical and pathological features of the case are discussed, followed by a review of the literature. It is concluded that a high index of suspicion is necessary to diagnose unusual presentations of ...

  18. A case-case study of mobile phone use and acoustic neuroma risk in Japan.

    Science.gov (United States)

    Sato, Yasuto; Akiba, Suminori; Kubo, Osami; Yamaguchi, Naohito

    2011-02-01

    Results of case-control studies of mobile phone use and acoustic neuroma have been inconsistent. We conducted a case-case study of mobile phone use and acoustic neuroma using a self-administered postal questionnaire. A total of 1589 cases identified in 22 hospitals throughout Japan were invited to participate, and 787 cases (51%) actually participated. Associations between laterality of mobile phone use prior to the reference dates (1 and 5 years before diagnosis) and tumor location were analyzed. The overall risk ratio was 1.08 (95% confidence interval (CI), 0.93-1.28) for regular mobile phone use until 1 year before diagnosis and 1.14 (95% CI, 0.96-1.40) for regular mobile phone use until 5 years before diagnosis. A significantly increased risk was identified for mobile phone use for >20 min/day on average, with risk ratios of 2.74 at 1 year before diagnosis, and 3.08 at 5 years before diagnosis. Cases with ipsilateral combination of tumor location and more frequently used ear were found to have tumors with smaller diameters, suggesting an effect of detection bias. Furthermore, analysis of the distribution of left and right tumors suggested an effect of tumor-side-related recall bias for recall of mobile phone use at 5 years before diagnosis. The increased risk identified for mobile phone users with average call duration >20 min/day should be interpreted with caution, taking into account the possibilities of detection and recall biases. However, we could not conclude that the increased risk was entirely explicable by these biases, leaving open the possibility that mobile phone use increased the risk of acoustic neuroma. Copyright © 2010 Wiley-Liss, Inc.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

    Science.gov (United States)

    Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

    2015-06-18

    Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

  1. A case of human babesiosis in Denmark

    DEFF Research Database (Denmark)

    Holler, Jon G; Röser, Dennis; Nielsen, Henrik Vedel

    2014-01-01

    We report the first human case of Babesia microti infection imported to Denmark from the United States by a 64 year old female traveller with fever of unknown origin. The case raises the possibility that Babesia-infections may be under-diagnosed, illustrates the importance of a thorough travel hi...

  2. Acute Lidocaine Toxicity: a Case Series

    Directory of Open Access Journals (Sweden)

    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%.

  3. CASE technology and the Systems Development Life Cycle: a proposed integration of CASE tools with DoD STD-2167A

    OpenAIRE

    Batt, Gary Thomas

    1989-01-01

    Approved for public release; distribution unlimited The use of Computer Aided Software Engineering (CASE) t ools has been marketed as a remedy for the software development crisis by automating analysis, design, and coding. The Systems Development Life Cycle (SDLC) has been employed in an attempt to ease the development backlog by applying structured methods to the development of software systems. This study reviews CASE tool components and the future of CASE integrated toolkits, compares a...

  4. [A case of parental alienation].

    Science.gov (United States)

    Menz, Wolfgang

    2014-01-01

    The clinical term "Parental Alienation Syndrome" (PAS) was introduced in 1984 by Richard Gardner, an American psychiatrist. Gardner described PAS and its symptoms, as a personality disorder, which appears chiefly in connection to child custody disputes wherein a child turns suddenly and massively against the non-custodial parent without reasonable grounds for doing so. This action by the child is a result of the custodial parent's emotionally abusive attempts to incite the child against the non-custodial parent.Where the child's rejection is based on some real past experience, there is not PAS. PAS only occurs as a result of the custodial parent's actions. Despite intensive effort, PAS was not included in the new DSM-V. In this case, a particularly impressive case history of parental alienation is described and discussed.

  5. Vitiligo: A study of 120 cases

    Directory of Open Access Journals (Sweden)

    Kar P

    2001-11-01

    Full Text Available Vitiligo is a common pignientary disorder and of major social and cosmetic concern in India. Purpose of the study was to find out age at onset and sex incidence in vitiligo, role of hereditary factors and associations with other diseases. 120 self reporting vitiligo patients attending out patient department of a service hospital were selected for the study and this data was analysed. In the present series out of 120 cases 62 (51.6% were males and 58(48.35%were females. There was practically no difference in sex incidence. The lowest age of onset was two years and the oldest was 65 years. In the majority of patients,52(43.2%, disease started before twenty years of age.8 (6.6% cases gave definite family history of vitiligo. Exposed areas of the body were commonly affected in majority (66.6% of cases. The legs were commonest site of involvement in 60(50% cases. Circunicript type of vitiligo (46.6% was heading the list. Majority of patients (56.6% had multiple lesions. Diabetes mellitus was found in 2 (2.6% patients. Cause of vitiligo is still idiopathic. Hereditary factors hardly play any role in manifestation of vitiligo

  6. Case Study: Camptocormia, a Rare Conversion Disorder.

    Science.gov (United States)

    Rajmohan, Velayudhan; Thomas, Biju; Sreekumar, Kumaran

    2004-01-01

    Camptocormia is a condition characterized by severe frontal flexion of the spinal cord and knees, with passive drooping of both arms. It occurs as a form of conversion disorder. Some cases are associated with behavioral problems. A case of camptocormia of 2-year duration in a south Indian adolescent girl with oppositional defiant disorder and…

  7. Writing a case report in English

    Directory of Open Access Journals (Sweden)

    Ivančević-Otanjac Maja

    2015-01-01

    Full Text Available A well-written case report is a clear, concise and informative paper, aimed at professionals from different fields of medicine, with the clear purpose to explain what lesson is to be learnt from the experience. The aim of this paper is to suggest useful guidelines for writing a good case report. It briefly reflects different “moves” in this piece of academic writing, thus outlining the required form, as well as the four principles of good writing: clarity, honesty, reality and relevance.

  8. Granulomatous lobular mastitis: A clinicopathological study of 112 cases.

    Science.gov (United States)

    Kfoury, H; Al Bhlal, L

    1997-01-01

    We report 12 cases of granulomatous lobular mastitis occurring in young women, between ages 30 and 47 years, diagnosed at King Faisal Specialist Hospital and Research Centre (KFSH&RC) from 1987 to 1995. The disease was unilateral in 10 cases, while there was a history of involvement of the contralateral breast in two patients. At the time of diagnosis, two patients were lactating, two were pregnant, and two were pregnant and lactating. Histopathological examination in all cases revealed centrilobular granulomas and microabscess formation. Immunohistochemical staining in seven cases for T and B cell markers showed a predominance of T cells in the infiltrate in all cases. The treatment comprised surgical removal of the mass, debridement and antibiotics in some of the cases. In one patient referred from another institution, mastectomy had been performed on the basis of an erroneous histopathologic diagnosis of carcinoma. Preoperative diagnosis was carcinoma in seven cases and benign disease in the remaining five cases. Follow-up of the patients was uneventful in all cases. Granulomatous lobular mastitis is a rare inflammatory disease of the breast, which may clinically and pathologically mimic carcinoma, sometimes leading to misdiagnosis resulting in unnecessary surgery.

  9. Imatinib-induced pleural effusion: A case report

    Directory of Open Access Journals (Sweden)

    R Banka

    2017-01-01

    Full Text Available Imatinib is a tyrosine kinase inhibitor and has rarely been reported to cause pleural effusion. We report the case of an 88-year-old male, known case of gastrointestinal stromal tumor on treatment with imatinib, who presented with a 2-week history of cough and dyspnea. He was diagnosed to have a right-sided pleural effusion and thoracentesis of the fluid revealed an exudate with low adenosine deaminase and negative cytology. Withdrawal of the drug lead to resolution of symptoms. We report this case to highlight the side effect profile of imatinib and warn physicians regarding this potential adverse effect which may be mistaken for metastasis or infection.

  10. 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.

  11. 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.

  12. Ambras syndrome: A rare case report

    Directory of Open Access Journals (Sweden)

    A Ishita

    2016-01-01

    Full Text Available Congenital generalized hypertrichosis associated with gingival hyperplasia are rare cases published in literature. The frequency incidence of generalized congenital hypertrichosis is about one to billions of people. Hypertrichosis and gingival hyperplasia are termed as Ambras syndrome (AS, which can be noticed at birth or soon after. Here, is a rare case report of 4-year-old male child who presented with generalized hypertrichosis with gingival fibromatosis and dysmorphic facial features.

  13. Giant calculus: review and report of a case.

    Science.gov (United States)

    Woodmansey, Karl; Severine, Anthony; Lembariti, Bakari S

    2013-01-01

    Dental calculus is a common oral finding. The term giant calculus is used to describe unusually large deposits of dental calculus. Several extreme cases have been reported in the dental literature. The specific etiology of these cases remains uncertain. This paper reviews previously reported cases, and presents another extreme example of giant calculus.

  14. Physiotherapy in a whiplash injury: a case report

    Directory of Open Access Journals (Sweden)

    C. Van Eck

    2008-01-01

    Full Text Available Study Design: Case ReportObjectives: To describe physiotherapy intervention in an individual with asuspected whiplash injury.Background: The patient was a 29-year old male with complaints of neckpain and tightness following a motor vehicle accident. Methods and Measures: The focus of the case study is physiotherapyassessment and intervention in a stage II whiplash injury. Results: Following intervention, positive changes occurred in outcome measures such as pain, work status and activities of daily living. Conclusion: Physiotherapy intervention is successful in addressing whiplash associated disorders.

  15. Solitary intraosseous neurofibroma: Report of a unique case

    Directory of Open Access Journals (Sweden)

    Sagar Satish Jangam

    2014-01-01

    Full Text Available Neural tumors located centrally in jaw bones are relatively rare compared with soft tissue neurofibromas. Less than 50 cases have been reported in the literature with a predilection for mandible. This article aims to elucidate a unique case of intraosseous neurofibroma of mandible in a 62-year-old edentulous female patient associated with facial asymmetry due to the swelling extending from the right body of mandible to left body of mandible. The uniqueness of this case is related to the age and extensiveness of this lesion. A review of clinical, radiographic, histological, and immunohistochemical features, and the surgical management pertaining to this case are discussed along with a review of the literature.

  16. A Case-Based Curriculum for Introductory Geology

    Science.gov (United States)

    Goldsmith, David W.

    2011-01-01

    For the past 5 years I have been teaching my introductory geology class using a case-based method that promotes student engagement and inquiry. This article presents an explanation of how a case-based curriculum differs from a more traditional approach to the material. It also presents a statistical analysis of several years' worth of student…

  17. Giant serpentine intracranial aneurysm: a case report

    International Nuclear Information System (INIS)

    Park, Jae Seong; Lee, Myeong Sub; Kim, Myung Soon; Kim, Dong Jin; Park, Joong Wha; Whang, Kum

    2001-01-01

    The authors present a case of giant serpentine aneurysm (a partially thrombosed aneurysm containing tortuous vascular channels with a separate entrance and outflow pathway). Giant serpentine aneurysms form a subgroup of giant intracranial aneurysms, distinct from saccular and fusiform varieties, and in this case, too, the clinical presentation and radiographic features of CT, MR imaging and angiography were distinct

  18. Multiple orthokeratinized odontogenic cysts: a case report.

    Science.gov (United States)

    Cheng, Yi-Shing Lisa; Liang, Hui; Wright, John; Teenier, Tom

    2015-03-01

    The purpose of this report is to document the clinical, radiographic, pathological and molecular findings of the first case of multiple orthokeratinized odontogenic cysts (OOCs). Multiple odontogenic keratocysts are one of the major features of nevoid basal cell carcinoma syndrome (NBCCS), and loss of heterozygosity in the PTCH gene, the culprit gene for NBCCS, has recently been found in sporadic OOC cases. Therefore, in this presenting case, we also investigated the possibility that this patient might also have NBCCS, by comparing the available clinical information and the molecular findings of this case to the diagnostic criteria for NBCCS (as proposed by the First International Colloquium on NBCCS in 2011). However, this patient with multiple OOCs showed no evidence of having NBCCS. This conclusion supports the findings from previous case series based on sporadic cases that OOC does not appear to be associated with NBCCS.

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

    Science.gov (United States)

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

    2013-12-01

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

  20. Calciphylaxis following kidney transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Hanvesakul Rajesh

    2009-11-01

    Full Text Available Abstract Introduction Calciphylaxis occurring after kidney transplantation is rare and rarely reported. It results in chronic non-healing wounds and is associated with a poor prognosis and is often fatal. We present a case of proximal lower limb calciphylaxis that occurred early after kidney transplantation. The patient had no classic associated risk factors. He had previously had a total parathyroidectomy but had normal serum calcium-phosphate product and parathyroid hormone levels. The clinical outcome of this case was favorable and highlights some fundamental issues relating to management. Case presentation A 70-year-old British Caucasian man with end-stage renal failure secondary to IgA nephropathy presented six months post kidney transplantation with cutaneous calciphylaxis lesions involving the medial aspect of the thigh bilaterally. Conclusion To the best of our knowledge, this is the first reported case of rapid onset cutaneous calciphylaxis occurring soon after kidney transplantation that was associated with a favorable outcome. Cutaneous calciphylaxis lesions should be promptly managed with meticulous wound care, antimicrobial therapy and the correction of calcium-phosphate product where indicated.

  1. A Case Report of Typhoidal Acute Acalculous Cholecystitis

    Directory of Open Access Journals (Sweden)

    Neeha Rajan

    2014-01-01

    Full Text Available Introduction. Acalculous cholecystitis in the setting of typhoid fever in adults is an infrequent clinical encounter, reported sparsely in the literature. In this case report we review the presentation and management of enteric fever involving the biliary system and consider the literature surrounding this topic. The aim of this case report is to alert clinicians to the potential diagnosis of extraintestinal complications in the setting of typhoid fever in the returned traveller, requiring surgical intervention. Presentation of Case. We report the case of a 23-year-old woman with acalculous cholecystitis secondary to Salmonella Typhi. Discussion. There is scarce evidence surrounding the optimal treatment and prognosis of typhoidal acalculous cholecystitis. In the current case, surgical invention was favoured due to failure of medical management. Conclusion. Clinical judgement dictated surgical intervention in this case of typhoidal acute acalculous cholecystitis, and cholecystectomy was safely performed.

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

    Directory of Open Access Journals (Sweden)

    Sandra Nordmann

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

  3. A case of a spontaneously ruptured epidermoid cyst

    International Nuclear Information System (INIS)

    Shiroyama, Yujiro; Saiki, Masahide; Ueda, Hiroyuki; Katayama, Sanao; Mitani, Tetsumi

    1987-01-01

    Intracranial fat-containing congenital tumors are characterized by negative absorption values on CT. We hereby report a case of an epidermoid cyst with subarachnoid free fats diagnosed preoperatively by CT. A 21-year-old female was admitted to our hospital because of continuous mild headache and nausea. At the time of admission, the results of her physical and neurological examinations were normal. CT, however, demonstrated multiple subarachnoid low-density spots and a suprasellar low-density area with high-density spots. In addition, there were negative absorption values (-12 ∼ -77), suggesting free fats. A spontaneously ruptured epidermoid or dermoid cyst was diagnosed on the basis of these findings. At surgery, a suprasellar tumor containing a yellowish, cheese-like material was confirmed. The patient made an uneventful recovery and was discharged 14 days after surgery. There have been several published reports of CT appearances of intracranial fat-containing tumors. However, spontaneously ruptured cases diagnosed by CT are rare. CT was found to be useful for the diagnosis of spontaneously ruptured cases of fat-containing tumors. (author)

  4. A case-based assistant for clinical psychiatry expertise.

    OpenAIRE

    Bichindaritz, I.

    1994-01-01

    Case-based reasoning is an artificial intelligence methodology for the processing of empirical knowledge. Recent case-based reasoning systems also use theoretic knowledge about the domain to constrain the case-based reasoning. The organization of the memory is the key issue in case-based reasoning. The case-based assistant presented here has two structures in memory: cases and concepts. These memory structures permit it to be as skilled in problem-solving tasks, such as diagnosis and treatmen...

  5. External rhinoplasty: a critical analysis of 500 cases.

    Science.gov (United States)

    Foda, Hossam M T

    2003-06-01

    The study presents a comprehensive statistical analysis of a series of 500 consecutive rhinoplasties of which 380 (76 per cent) were primary and 120 (24 per cent) were secondary cases. All cases were operated upon using the external rhinoplasty technique; simultaneous septal surgery was performed in 350 (70 per cent) of the cases. Deformities of the upper two-thirds of the nose that occurred significantly more in the secondary cases included; dorsal saddling, dorsal irregularities, valve collapse, open roof and pollybeak deformities. In the lower third of the nose; secondary cases showed significantly higher incidences of depressed tip, tip over-rotation, tip asymmetry, retracted columella, and alar notching. Suturing techniques were used significantly more in primary cases, while in secondary cases grafting techniques were used significantly more. The complications encountered intra-operatively included; septal flap tears (2.8 per cent) and alar cartilage injury (1.8 per cent), while post-operative complications included; nasal trauma (one per cent), epistaxis (two per cent), infection (2.4 per cent), prolonged oedema (17 per cent), and nasal obstruction (0.8 per cent). The overall patient satisfaction rate was 95.6 per cent and the transcolumellar scar was found to be unacceptable in only 0.8 per cent of the patients.

  6. 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.

  7. Alkaptonuria: A case report.

    Science.gov (United States)

    Damarla, Nirupama; Linga, Prathima; Goyal, Mallika; Tadisina, Sanjay Reddy; Reddy, G Satyanarayana; Bommisetti, Hymavathi

    2017-06-01

    Alkaptonuria is a rare inborn error of metabolism with autosomal recessive inheritance with a mutation in homogentisate 1,2-dioxygenase. It results in accumulation of homogentisic acid in connective tissues (ochronosis). Most common ocular manifestations are bluish-black discoloration of the conjunctiva, cornea, and sclera. In this case report, a 39-year-old Indian male patient with additional ocular features in the retina is described.

  8. Levofloxacin-induced rhabdomyolysis: a case report.

    Science.gov (United States)

    John, Febin; Oluronbi, Ruby; Pitchumoni, C S

    2016-08-24

    Rhabdomyolysis secondary to quinolones is not frequent. There are scarce reports in the literature associating rhabdomyolysis to levofloxacin. We describe a case of levofloxacin-induced rhabdomyolysis. A 52-year-old African-American man presented with muscle tightness after taking three doses of levofloxacin. He had elevated creatine kinase without acute kidney injury. His symptoms resolved after discontinuation of levofloxacin and supportive care. It is fascinating that our patient has a prior history of rhabdomyolysis, likely from levofloxacin. Our case highlights the need to be mindful of this potentially life-threatening complication of levofloxacin.

  9. [Localized scleroderma: a retrospective study about 92 cases].

    Science.gov (United States)

    El Fékih, Nadia; Réjaibi, Iménc; Kamoun, Hajer; Zéglaoui, Faten; Fazaa, Bécima; Kharfi, Monia; Kamoun, Mohamed Ridha

    2009-09-01

    Sclerodermas are rare affections which can be located or generalized. Localized form is the most frequent. The purpose of this study was to describe epidemiologic, clinics, biological, immunological, therapeutic, evolutionary characteristics of the localized scleroderma through a personal series and the data of the literature. We have performed a retrospective study on all patients followed in the department of dermatology of the Hospital Charles Nicole during 14 years period. Our study was about 92 cases of localized scleroderma (73 were females and 19 males). The mean age was 35 years (between 2 and 72 years). The majority of localised sclerodermas (66.2% of the cases) appeared before 40 years with a maximum of frequency between 10 and 30 years (41.6%). Only 11.9% of the cases were observed before 10 years. They were 51 cases (55%) of morphea, 35 cases (38%) of scleroderma in bands including 32 linear scleroderma and 3 scleroderma en coup de sabre, 5 cases (5.5%) of generalized morphea and 1 case (0.15%) of deep morphea. Average therapeutic was specified among 63 patients (87%), and the evolution could be appreciated among 45 patients. The epidemiologic data observed in our series are comparable with those reported in the literature. Therapeutic difficulties and risks of functional after-effects, particular in scleroderma in bands, remain the principal concern for all the authors.

  10. Mathematical modelling a case studies approach

    CERN Document Server

    Illner, Reinhard; McCollum, Samantha; Roode, Thea van

    2004-01-01

    Mathematical modelling is a subject without boundaries. It is the means by which mathematics becomes useful to virtually any subject. Moreover, modelling has been and continues to be a driving force for the development of mathematics itself. This book explains the process of modelling real situations to obtain mathematical problems that can be analyzed, thus solving the original problem. The presentation is in the form of case studies, which are developed much as they would be in true applications. In many cases, an initial model is created, then modified along the way. Some cases are familiar, such as the evaluation of an annuity. Others are unique, such as the fascinating situation in which an engineer, armed only with a slide rule, had 24 hours to compute whether a valve would hold when a temporary rock plug was removed from a water tunnel. Each chapter ends with a set of exercises and some suggestions for class projects. Some projects are extensive, as with the explorations of the predator-prey model; oth...

  11. Particular aspects of a pancreatic insulinoma case

    Directory of Open Access Journals (Sweden)

    Motoc R

    2016-06-01

    Full Text Available With a very low incidence (1-4 cases per 1 million per year, characterized by insulin hypersecretion, independent of the glycemia control system, insulinoma is a rare endocrine tumor, clinical with accentuated neuropsychological symptoms that hampers clinical diagnosis. We present a case of a 33 years old patient with no notable personal history, active lifestyle, non-smoker, a work environment that doesn’t involve professional toxicity; a remarkable family history of a brother with type 1 diabetes mellitus and grandmother with liver adenocarcinoma was noticed; in this particular case Whipple triad was strongly suggestive, gastrointestinal upper-ultrasonography endoscopy with tissue puncture as a tumor diagnostic tool was used and laparotomy was used successfully for removing the tumor, with favorable follow-up.

  12. a case study ondo state

    African Journals Online (AJOL)

    user

    the design of a Government Cloud (G-Cloud) network for Ondo State Government which will ... network for a developing economy; a case study of ... France is one of those countries that favour .... Arequipa city. .... Where region 0 = Akure, 1 =.

  13. A case of polyarteritis nodosa limited to the right calf muscles, fascia, and skin: a case report

    Directory of Open Access Journals (Sweden)

    Brett Francesca

    2011-09-01

    Full Text Available Abstract Introduction Limited polyarteritis nodosa is a rare benign disease that usually responds well to systemic corticosteroid treatment. We report a case limited to calf muscles, fascia, and skin treated with local corticosteroid therapy directed to the affected areas by ultrasound guidance. Case presentation A 36-year-old Caucasian woman presented with a 10-month history of progressive right calf pain and swelling, which were unresponsive to treatment with non-steroidal anti-inflammatory drugs and physiotherapy. An examination revealed a swollen tender right calf with indurated overlying skin. Laboratory investigations showed an erythrocyte sedimentation rate of 24 mm/hour and a C-reactive protein of 15 mg/dl. Full blood count, renal profile, and creatinine kinase level were normal. A full autoantibody screen and hepatitis B and C serology results were negative. A chest X-ray was unremarkable. Magnetic resonance imaging of the right leg revealed increased signal intensity in T2-weighted images and this was suggestive of extensive inflammatory changes of the gastrocnemius muscle and, to a lesser extent, the soleus muscle. There were marked inflammatory changes throughout the gastrocnemius muscle and the subcutaneous tissue circumferentially around the right lower leg. A biopsy of affected skin, muscle, and fascia showed histopathological features consistent with polyarteritis nodosa, including small-vessel vasculitis with fibrinoid changes in the vessel wall and intense perivascular and focal mural chronic inflammatory changes. Our patient declined treatment with oral steroids. She received a course of ultrasound-guided injections of steroid (Depo-Medrone, methylprednisolone in the involved muscle area and commenced maintenance azathioprine with a good response. Conclusions Limited polyarteritis nodosa is rare and affects middle-aged individuals. In most cases, treatment with moderate- to high-dose corticosteroids gives symptomatic relief

  14. Acquired secondary Grynfeltt's hernia: a case report

    International Nuclear Information System (INIS)

    Renck, Decio Valente; Lopes Junior, Joao Ivan

    2009-01-01

    Lumbar hernia is a rare condition whose diagnosis is hardly achieved. The prevalence is higher in elderly men. The present case report describes the case of a male, 78-year-old patient who underwent pleural effusion drainage 17 years before presenting with clinical manifestations and tomographic findings compatible with acquired secondary Grynfeltt's hernia. (author)

  15. A rare case of acute lymphoblastic leukaemia with hemophilia A

    Directory of Open Access Journals (Sweden)

    John Biju

    2009-12-01

    Full Text Available Abstract A rare case of Acute lymphoblastic leukemia with hemophillia in a 12 year old boy is presented in the article. Patient was known case of hemophillia (factor VIII deficiency. He was diagnosed as a case of ALL based on bone marrow examination and immunophenotypic study. Patient was treated as per Children Cancer group guidelines. The main aim of reporting this rare association lies in developing treatment strategies in preventing life threatening bleeding due to this rare association which though may be accidental but need further research.

  16. Concept Test of a Smoking Cessation Smart Case.

    Science.gov (United States)

    Comello, Maria Leonora G; Porter, Jeannette H

    2018-04-05

    Wearable/portable devices that unobtrusively detect smoking and contextual data offer the potential to provide Just-In-Time Adaptive Intervention (JITAI) support for mobile cessation programs. Little has been reported on the development of these technologies. To address this gap, we offer a case report of users' experiences with a prototype "smart" cigarette case that automatically tracks time and location of smoking. Small-scale user-experience studies are typical of iterative product design and are especially helpful when proposing novel ideas. The purpose of the study was to assess concept acceptability and potential for further development. We tested the prototype case with a small sample of potential users (n = 7). Participants used the hardware/software for 2 weeks and reconvened for a 90-min focus group to discuss experiences and provide feedback. Participants liked the smart case in principle but found the prototype too bulky for easy portability. The potential for the case to convey positive messages about self also emerged as a finding. Participants indicated willingness to pay for improved technology (USD $15-$60 on a one-time basis). The smart case is a viable concept, but design detail is critical to user acceptance. Future research should examine designs that maximize convenience and that explore the device's ability to cue intentions and other cognitions that would support cessation. This study is the first to our knowledge to report formative research on the smart case concept. This initial exploration provides insights that may be helpful to other developers of JITAI-support technology.

  17. Case Flow Management: A Format for Making Change

    Directory of Open Access Journals (Sweden)

    Kerry Connelly

    2009-08-01

    Full Text Available At the International Association for Court Administration (IACA Conference in 2008 in Dublin Barry Mahoney, President Emeritus, Justice Management Institute did an excellent job at presenting some of the major sources of delay in case processing. He identified both case-specific and systemic factors. He also identified the goals of case flow management. I was impressed by the thoroughness and succinctness of what he was presenting. On my way back home I thought about how I might present the same information to my judges and court staff and how the information might be used to make positive changes in one of my courts. The following is a description of what took place at our one-day workshop on felony case management, and the positive results we obtained in working with judges, court staff and our justice partners. The process described below identified specific barriers to case processing and resulted in the development of workable solutions to case delay.

  18. Case mix management education in a Canadian hospital.

    Science.gov (United States)

    Moffat, M; Prociw, M

    1992-01-01

    The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure--the Clinical Unit structure. The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget. To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.

  19. A case study on the successful management of Cotard's syndrome in pregnancy: Case Reports.

    Science.gov (United States)

    Howe, G; Srinivasan, M

    1999-01-01

    Cotard's Syndrome is rare and no cases have been reported in pregnancy. We describe a case of a woman in the third trimester who attempted suicide by jumping out of a window, sustaining multiple fractures. Delivery of her baby by Caesarean section and orthopaedic intervention was necessary before electroconvulsive therapy (ECT) could be administered, resulting in a successful outcome for both mother and child. (Int J Psych Clin Pract 1999; 3: 293-295).

  20. Successful treatment of persistent bronchorrhea by gefitinib in a case with Recurrent Bronchioloalveolar Carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Shimono Takatsugu

    2003-07-01

    Full Text Available Abstract Background Bronchorrhea is one of late complaints in patients with bronchioloalveolar carcinoma (BAC and hampers their quality of life. Although an effective treatment for bronchorrhea in these patients has not been established, recently we have treated effectively one case of persistent bronchorrhea associated with clinical recurrent BAC with gefitinib (ZD1839, 'Iressa™'; AstraZeneca Japan; Osaka, Japan. Case Presentation A 63-year-old Japanese female had undergone left pneumonectomy with radical lymph node dissection (ND2a for diffuse type bronchioloalveolar carcinoma originated in left lower lobe. Multiple pulmonary metastases in right lung were found one year after operation. Pulmonary metastatic lesion has grown and she complained of progressive symptoms of massive watery sputum and dyspnea, four years after operation. Although her symptom was getting worse in spite of routine treatment, it completely disappeared within 2 weeks of starting oral gefitinib. Thereafter, she has been symptom-free and shows good partial response on repeat scan after 9 months of oral gefitinib. Conclusions The dramatic remission of persistent bronchorrhea by gefitinib in the presented case suggests that gefitinib might be a promising option for bronchioloalveolar carcinoma, particularly in cases with severe bronchorrhea. Although it is not possible to comment on whether the improvement came from tumor cell death itself or suppressive effect of mucin synthesis by the epidermal growth factor receptor-tyrosine kinase inhibitory action.

  1. A Report of Three Cases

    African Journals Online (AJOL)

    Case 1. A 55-year-old gentleman presented to the surgical emergency with complaints of progressively increasing pain and ... Department of General Surgery, Maulana Azad Medical. College .... peritonitis, septicemia with shock was made.

  2. Marketing Plan for a New Product : A Study for a Case Company

    OpenAIRE

    Saari, Tomi

    2015-01-01

    This Bachelor’s thesis was conducted as a commission for a case company operating in the electrotechnical manufacturing and wholesale industry. The purpose of this thesis is to provide the case company some new marketing insights in order to penetrate a market with a new product faster. The theoretical framework aims at analyzing the case company’s macro environment through a PESTEL analysis, as well as the internal and external factors for success with the company SWOT analysis. The prod...

  3. A Case-Based Learning Model in Orthodontics.

    Science.gov (United States)

    Engel, Francoise E.; Hendricson, William D.

    1994-01-01

    A case-based, student-centered instructional model designed to mimic orthodontic problem solving and decision making in dental general practice is described. Small groups of students analyze case data, then record and discuss their diagnoses and treatments. Students and instructors rated the seminars positively, and students reported improved…

  4. Paraduodenal hernia. A case report

    International Nuclear Information System (INIS)

    Irion, K.L.

    1989-01-01

    The authors present a case of right paraduodenal hernia and a brief review of the embriology and anatomy of the paraduodenal fossae as well as of the clinical signs, symptoms and radiologic aspects of paraduodenal hernias. (author) [pt

  5. A False Case of Clozapine-Resistant Schizophrenia

    Directory of Open Access Journals (Sweden)

    J. P. Maia-de-Oliveira

    2010-01-01

    Full Text Available One of the subjects that most concerns physicians is treatment-resistance. About 30%–60% of schizophrenia patients do not respond adequately to antipsychotic treatment and are known as refractory schizophrenia patients. Clozapine has been the drug of choice in such cases. However, approximately 30% of them do not respond to clozapine either. Here, we describe a patient with an initial diagnosis of refractory schizophrenia who had a history of dramatic aggressiveness. However, in this case, “refractoriness” was a wrong diagnosis. A case of psychosis secondary to epilepsy had been treated as schizophrenia for almost 20 years. Reports like this one are important because they remind us of how a thorough investigation can lead to the correct diagnosis and improve the patient's prognosis.

  6. A postirradiation, myxoid type, malignant fibrous histiocytoma; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Masaki; Higuchi, Ryouhei; Ohsige, Kenji; Kouya, Michiko (Tokyo Metropolitan Fuchu Hospital, Tokyo (Japan)); Nozaki, Motohiro

    1993-09-01

    The authors discuss the case of a 59-year-old man who presented a mass in the dorsum of his right foot. He previously had had a hemangioma in this region from birth, and at the age of 10, radiation therapy had been administered to this region because of an ulcer that had developed. Additionally, so as to cover the ulcer, he had been given a free skin graft and a cross-leg flap. Some 50 years after this radiation, he noticed a mass in his foot, and a microscopic examination of a biopsied specimen of this mass revealed it to be a myxoid type, malignant fibrous histiocytoma (MFH). Thus, a below-the-knee amputation was performed. To the best of their knowledge, the authors report that 29 cases of an MFH developing after radiotherapy have been reported in the Japanese literature, and an analysis of these 29 cases is provided and the details of this case are given. (author).

  7. Spondylo-epiphyseal dysplacea tarda (a case report.

    Directory of Open Access Journals (Sweden)

    Pathare A

    1991-04-01

    Full Text Available A rare case of disproportionate short stature suggestive of spondylo-epiphyseal dysplasia tarda is reported and relevant literature reviewed. It is emphasized that its radiological features show a marked similarity to ochronotic spine, with which it is therefore commonly mistaken. An indeterminate pigment was observed in the liver biopsy in this case with connective tissue disorder.

  8. Larva migrans: a case report and review

    Directory of Open Access Journals (Sweden)

    Velho Paulo Eduardo Neves Ferreira

    2003-01-01

    Full Text Available A case of massive Ancylostoma sp. larval infestation is presented in a patient who had received systemic corticosteroid therapy. What attracts attention in this case is the exuberance and rarity of clinical manifestation. Based on the pertinent literature, we discuss the mechanisms of parasital infection, the natural history of the disease and its treatment.

  9. Severe falciparum malaria: A case report

    Science.gov (United States)

    Arcelia, F.; Asymida, F.; Lubis, N. F. M.; Pasaribu, A. P.

    2018-03-01

    Plasmodium parasites caused Malaria. Indonesia is one of the countries in Southeast Asia that endemic to malaria. The burden of malaria is more in the eastern part of Indonesia than the Western part as well as the endemicity. Some cases of malaria will develop to severe form. Usually, the manifestation of children and adult are different. We reported a severe case of malaria in a 14-year-old boy who develops several manifestations such as anemia, hypoglycemia, sepsis and black water fever. We successfully treated the patient with Artesunate intravenous and continued with Dihydroartemisinin-piperaquine.

  10. Chylous ascites following radical nephrectomy: a case report

    Directory of Open Access Journals (Sweden)

    Shah Shahzad S

    2008-01-01

    Full Text Available Abstract Introduction Chylous ascites may result from diverse pathologies. Ascites results either due to blockage of the lymphatics or leak secondary to inadvertent trauma during surgery. Case presentation We report the first case of chylous ascites following radical nephrectomy for a renal cell carcinoma involving the right half of a crossed fused renal ectopia. The patient was managed conservatively. Conclusion Post-operative chylous ascites is a rare complication of retroperitoneal and mediastinal surgery. Most cases resolve with conservative treatment which aims at decreasing lymph production and optimizing nutritional requirements along with palliative measures. Refractory cases need either open or laparoscopic ligation of the leaking lymphatic channels. A review of the current literature on the management of post-operative chylous ascites is presented.

  11. Prolonged social withdrawal disorder: a hikikomori case in Spain.

    Science.gov (United States)

    Ovejero, Santiago; Caro-Cañizares, Irene; de León-Martínez, Victoria; Baca-Garcia, Enrique

    2014-09-01

    The Japanese term hikikomori means literally 'to be confined'. Social withdrawal can be present in severe psychiatric disorders; however, in Japan, hikikomori is a defined nosologic entity. There have been only a few reported cases in occidental culture. We present a case report of a Spanish man with prolonged social withdrawal lasting for 4 years. This is a case of prolonged social withdrawal not bound to culture, as well as the second case of hikikomori reported in Spain. We propose prolonged social withdrawal disorder as a disorder not linked to culture, in contrast to hikikomori. Further documentation of this disorder is still needed to encompass all cases reported in Japan and around the world. © The Author(s) 2013.

  12. Case analysis online: a strategic management case model for the health industry.

    Science.gov (United States)

    Walsh, Anne; Bearden, Eithne

    2004-01-01

    Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

  13. 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.

  14. Toxicoderma by gemcitabine: About a case

    Directory of Open Access Journals (Sweden)

    Flora López-López

    2018-02-01

    Full Text Available Skin reactions are often related with drugs, particularly with chemotherapy. Several types of cutaneous involvement have been described from pruritus alone to generalized eruptions not always but generally related with hypersensitivity or inflammatory reactions that usually are independent of primary tumor location. Gemcitabine is a widely used chemotherapy drug that may typically produce a mild skin rash. Herein, we show a case of uncommon and severe direct skin toxicity because of gemcitabine in context of thrombocytopenia. We have also performed a review of the literature showing that this may be the first case of such toxicity.

  15. Rhodotorula fungemia: two cases and a brief review.

    Science.gov (United States)

    Duggal, Shalini; Jain, Hemant; Tyagi, Amit; Sharma, Anuradha; Chugh, T D

    2011-11-01

    Rhodotorula is emerging as an important cause of nosocomial and opportunistic infections. We present two cases of Rhodotorula mucilaginosa fungemia diagnosed over a period of 3 months at our hospital. The first case was of a pre-term neonate in the neonatal ICU who presented with respiratory failure and sepsis. The second involved an adult female who had been injured in a road traffic accident requiring an operation for a hematoma and was later shifted to the medical ICU. For a new hospital like ours, finding two cases of Rhodotorula fungemia within a span of 3 months prompted us to describe them in this report. These cases emphasize the emerging importance of Rhodotorula mucilaginosa as a pathogen and the importance of identification and MIC testing for all fungal isolates recovered from the blood stream.

  16. Alkaptonuria: A case report

    Directory of Open Access Journals (Sweden)

    Nirupama Damarla

    2017-01-01

    Full Text Available Alkaptonuria is a rare inborn error of metabolism with autosomal recessive inheritance with a mutation in homogentisate 1,2-dioxygenase. It results in accumulation of homogentisic acid in connective tissues (ochronosis. Most common ocular manifestations are bluish-black discoloration of the conjunctiva, cornea, and sclera. In this case report, a 39-year-old Indian male patient with additional ocular features in the retina is described.

  17. A case of gastrointestinal bleeding due to right hepatic artery pseudoaneurysm following total remnant pancreatectomy: A case report

    Directory of Open Access Journals (Sweden)

    Atsushi Fujio

    Full Text Available Introduction: Pseudoaneurysm is a serious complication after pancreatic surgery, which mainly depends on the presence of a preceding pancreatic fistula. Postpancreatectomy hemorrhage following total pancreatectomy is a rare complication due to the absence of a pancreatic fistula. Here we report an unusual case of massive gastrointestinal bleeding due to right hepatic artery (RHA pseudoaneurysm following total remnant pancreatectomy. Presentation of case: A 75-year-old man was diagnosed with intraductal papillary mucinous carcinoma recurrence following distal pancreatectomy and underwent total remnant pancreatectomy. After discharge, he was readmitted to our hospital with melena because of the diagnosis of gastrointestinal bleeding. Gastrointestinal endoscopy was performed to detect the origin of bleeding, but an obvious bleeding point could not be detected. Abdominal computed tomography demonstrated an expansive growth, which indicated RHA pseudoaneurysm. Emergency angiography revealed gastrointestinal bleeding into the jejunum from the ruptured RHA pseudoaneurysm. Transcatheter arterial embolization was performed; subsequently, bleeding was successfully stopped for a short duration. Because of improvements in his general condition, the patient was discharged. Discussion: To date, very few cases have described postpancreatectomy hemorrhage following total remnant pancreatectomy. We suspect that the aneurysm ruptured into the jejunum, possibly because of the scarring and inflammation associated with his two complex surgeries. Conclusion: Pseudoaneurysm should be considered when the fragility of blood vessels is suspected, despite no history of anastomotic leak and intra-abdominal abscess. Our case also highlighted that detecting gastrointestinal bleeding is necessary to recognize sentinel bleeding if the origin of bleeding is undetectable. Abbreviations: PPH, RHA, CT, IPMC, RCCs, POD, LHA, GIE, TAE, Keywords: Case report, Pseudoaneurysm, Total

  18. Scapulothoracic Dissociation: A Rare Variant: A Case Report

    Directory of Open Access Journals (Sweden)

    Rajat Jangir

    2014-07-01

    Full Text Available Scapulothoracic dissociation is a rare injury involving separation of scapula from the thorax along with the upper extremity. Majority of the patients have concomitant neurovascular injury and the prognosis is uniformly poor in such cases. We present a case of scapulothoracic dissociation with comminuted fracture of scapula and acromioclavicular joint disruption without neurovascular deficit. There were associated avulsion fractures of the spinous processes of vertebrae (T3-T5. Such presentation is rare in an already rare scapulothoracic dissociation injury. A discussion regarding the probable mechanism of injury, management and prognosis is presented.

  19. Odontoid fractures: A retrospective analysis of 53 cases

    Directory of Open Access Journals (Sweden)

    Shetty Arjun

    2009-01-01

    Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

  20. A Case of Wolfram Syndrome

    Directory of Open Access Journals (Sweden)

    Gholamali Naderian

    2010-01-01

    Full Text Available Purpose: To report a case of Wolfram syndrome characterized by early onset diabetes mellitus and progressive optic atrophy. Case Report: A 20-year-old male patient with diabetes mellitus type I presented with best corrected visual acuity of 1/10 in both eyes with correction of -0.25+1.50@55 and -0.25+1.50@131 in his right and left eyes, respectively. Bilateral optic atrophy was evident on fundus examination. The patient also had diabetes insipidus, neurosensory deafness, neurogenic bladder, polyuria and extra-residual voiding indicating atony of the urinary tract, combined with delayed sexual maturity. Conclusion: One should consider Wolfram syndrome in patients with juvenile onset diabetes mellitus and hearing loss. Ophthalmological examination may disclose optic atrophy; urologic examinations are vital in such patients.

  1. Traumatic Floating Clavicle: A Case Report

    Directory of Open Access Journals (Sweden)

    Choo CY

    2012-07-01

    Full Text Available Shoulder girdle injuries after high energy traumatic impacts to the shoulder have been well documented. Based on the series of 1603 injuries of the shoulder girdle reported by Cave and colleagues, 85% of the dislocations were glenohumeral, 12% acromioclavicular and 3% sternoclavicular. Less frequently described are injuries involving both the sternoclavicular and acromioclavicular joints simultaneously in one extremity. The present case report discusses a case of traumatic floating clavicle associated with ipsilateral forearm and wrist injury which was treated surgically.

  2. Frontotemporal dementia and neurocysticercosis: a case report

    Directory of Open Access Journals (Sweden)

    Corina Satler

    Full Text Available ABSTRACT We report a case of a 67-year-old woman with frontotemporal dementia (FTD and a history of neurocysticercosis. After her retirement she showed progressive behavioral changes and neuropsychiatric symptoms with relative preservation of cognitive functioning. During the next three years, the patient manifested progressive deterioration of verbal communication gradually evolving to mutism, a hallmark of cases of progressive nonfluent aphasia.

  3. Intramural esophageal pseudodiverticulosis: report of a case

    International Nuclear Information System (INIS)

    Carnero, M.; Martinez, M.I.; Sanchez, D.; Sanjurjo, E.

    1997-01-01

    Intramural esophageal pseudodiverticulosis (IEP)is a very uncommon disorder, with only a hundred or so cases reported in the literature. It is characterized by the distension of the esophageal mucous glands. This results in the development of a great number of saccular structures, distributed segmentally or diffusely throughout the esophageal wall. We present a case of this lesion, describing the radiological findings. (Author) 4 refs

  4. a South African case study

    African Journals Online (AJOL)

    User

    learn different algorithms to solve problems, but in many cases cannot solve .... centre of Piaget‟s work is a fundamental cognitive process, which he termed ..... concept definition of continuity in calculus through collaborative instructional ...

  5. A Database-Based and Web-Based Meta-CASE System

    Science.gov (United States)

    Eessaar, Erki; Sgirka, Rünno

    Each Computer Aided Software Engineering (CASE) system provides support to a software process or specific tasks or activities that are part of a software process. Each meta-CASE system allows us to create new CASE systems. The creators of a new CASE system have to specify abstract syntax of the language that is used in the system and functionality as well as non-functional properties of the new system. Many meta-CASE systems record their data directly in files. In this paper, we introduce a meta-CASE system, the enabling technology of which is an object-relational database system (ORDBMS). The system allows users to manage specifications of languages and create models by using these languages. The system has web-based and form-based user interface. We have created a proof-of-concept prototype of the system by using PostgreSQL ORDBMS and PHP scripting language.

  6. Mesenchymal chondrosarcoma--a case report.

    Directory of Open Access Journals (Sweden)

    Tyagi S

    1992-01-01

    Full Text Available A Case of extraosseous mesenchymal chondrosarcoma occurring in the occipital region in a 26 year old male is being reported. The patient remained free from recurrence on any metastasis even after 2 years of the tumor resection.

  7. [Jerusalem syndrome - a case report].

    Science.gov (United States)

    Poleszczyk, Anna; Swiecicki, Łukasz

    2013-01-01

    The aim of the paper was to present the case of a patient who developed acute psychotic symptoms on her visit to Jerusalem. The analysis of the clinical case and medical history. The presented 62-year-old women with a history of previous psychiatric disorder arrived with her husband to Jerusalem as a part of organised touristic group. She developed acute psychotic reaction through some stages characteristic for the third type of Jerusalem syndrome. Symptoms resolved completely soon after returning to Poland and admission to the hospital where an antipsychotic treatment was performed. Despite the rare occurrence of this phenomenon, it is worth noting that we can divide Jerusalem syndrome into three types depending on its clinical course, patient's history of previous psychiatric disorders and this division has some clinical implications. This syndrome can be also considered in the context of some factors connected with travelling in general which may be responsible for psychiatric disturbances occurring among travelers. The course of psychiatric disturbances in the presented patient resembled the third type of Jerusalem syndrome despite her past psychiatric history and probably travelling caused her decompensations. In clinical practice we have to remember that in case of the patients with a known psychiatric history, clinical evaluation may be useful before travelling. In previously healthy patients developing the third type of the Jerusalem syndrome early intervention and separation from Jerusalem and its holy places and their contact with family are crucial for soon recovery.

  8. A Rare Case of Michelin Tire Baby Syndrome in a Newborn.

    Science.gov (United States)

    Ramphul, Kamleshun; Mejias, Stephanie G; Ramphul-Sicharam, Yogeshwaree

    2018-02-24

    Kunze-Riehm syndrome also known as Michelin tire baby syndrome (MTBS) is a rare genetic condition with a characteristic generalized folding of excess skin. The diagnosis is usually made based on clinical symptoms. There are approximately only 30 cases reported in the literature and some cases were associated with non-cutaneous anomalies as well. Herein, we report a case of MTBS in a five-day-old male of Iraqi origin.

  9. Case Study: A Separation of Powers Lesson.

    Science.gov (United States)

    Jenkins, Steve

    1986-01-01

    Presents a case study involving students in the issue of separation of powers as applied to the 1952 Immigration and Nationality Act. Students examine the case of Jagdish Rai Chadha, an immigrant threatened with deportation whose problems resulted in 1983 U.S. Supreme Court decision declaring legislative veto provision of Immigration and…

  10. Hyoid bone chondrosarcoma with cervical nodal metastasis: A case ...

    African Journals Online (AJOL)

    Background: Hyoid bone chondrosarcoma is a very rare condition. This study presents a case report of low-grade chondrosarcoma of hyoid bone with cervical nodal metastasis. The study also presents preoperative radiological investigations, pathological examination and the follow-up of the case. Case presentation: A 42 ...

  11. A case of primary hypersomnia

    Directory of Open Access Journals (Sweden)

    John Dinesh

    2007-01-01

    Full Text Available Primary hypersomnia (PH is a disorder of presumed central nervous system etiology that is associated with a normal or prolonged major sleep episode and excessive sleepiness consisting of prolonged (one or two hour episodes of non-rapid eye movement sleep. It has a similar presentation to narcolepsy, but is not generally associated with cataplexy or sleep-onset rapid eye movement. Although PH is a chronic disorder, fluctuations and spontaneous remissions are known to occur. Treatment with stimulants is beneficial in most patients. We present the case of a 32-year-old Caucasian woman with the classical features of PH. Her condition has progressed over the years and she sleeps for days on end or until aroused. She has been treated with multiple stimulants, with limited success. This case highlights the clinical presentation, diagnostic criteria and treatment modalities of this rare condition.

  12. Pancreaticopericardial Fistula: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Muhammad S. Khan

    2016-01-01

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

  13. Astrocinoma pilocytic maligno. A purpose of two cases

    International Nuclear Information System (INIS)

    Castillo, C.; Mañana, G.; Castillo, L.; Delgado, L.

    2010-01-01

    Malignant transformation of pilocytic astrocytoma (PA) is an event extremely uncommon (<3%), with only a few cases of malignant AP cerebellar published in the literature. Malignancy can occur de novo or after radiation treatment, the latter being the most frequent cases. the mitoses could be considered as a marker of anaplastic progression for some authors, but not have not been defined clearly where the morphological criteria for identification and distinction of the forms AP streams. In the present study, we describe two cases of patients with cerebellar AP a adult 27 years and a preschool 2 years, which were listed as AP de novo malignancies. Besides AP pilocíticas characteristics figures, the study atypical characters showed pathological increase in cell density and mitosis, cellular pleomorphic and foci of necrosis behavior aggressive clinical histology was consistent with both. The first case presented an early recurrence and rapid clinical progression despite treatment instituted, and died 8 months after diagnosis The second case presented two early tumor recurrence, performing surgery, radiant and systemic, and being now free from progression at 16 months of diagnosis

  14. A web-based endodontic case difficulty assessment tool.

    Science.gov (United States)

    Shah, P K; Chong, B S

    2018-01-25

    To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment. Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s. The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3-5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an 'educational tool' and for 'primary care triage' was deemed the most popular features and of greater importance than the secondary options of 'fee setting' and as a 'dento-legal justification tool'. Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress. EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing

  15. Adrenal Hemangioma: A Case of Retroperitoneal Tumor

    Directory of Open Access Journals (Sweden)

    Genta Iwamoto

    2018-01-01

    Full Text Available Introduction. Adrenal hemangioma is a rare disease, with only some 60 cases reported previously. Due to the difficulty of the preoperative diagnosis of adrenal hemangioma, almost all of the cases were diagnosed by a histopathological analysis of surgical specimens. Case Presentation. A 52-year-old man was referred to our department for further examination of his left retroperitoneal tumor. He had received hemodialysis due to chronic renal failure resulting from membranous nephropathy. Computed tomography revealed a mass around his left hilum. Magnetic resonance imaging (MRI and positron-emission tomography (PET-CT were unable to confirm or deny malignancy, and tumor markers, including CEA and CA19-9, showed slight elevation. His tumor grew from 38 mm to 54 mm in diameter in 7 months of follow-up. We therefore planned retroperitoneal tumor resection with left nephrectomy. Histopathologically, hyperplastic small vessels with hemorrhaging and denaturation were seen. The endothelial cells showed no variants or division of the nucleus. Based on this diagnosis, no further therapy was performed. He has had no recurrence in the eight months since the surgery. Conclusion. We herein report a rare case of adrenal hemangioma.

  16. System Dynamic Modelling for a Balanced Scorecard: A Case Study

    DEFF Research Database (Denmark)

    Nielsen, Steen; Nielsen, Erland Hejn

    Purpose - The purpose of this research is to make an analytical model of the BSC foundation by using a dynamic simulation approach for a 'hypothetical case' model, based on only part of an actual case study of BSC. Design/methodology/approach - The model includes five perspectives and a number...

  17. Agranulocytosis Associated with Topiramate: A Case Report and Review of Published Cases

    Directory of Open Access Journals (Sweden)

    Saroj Lohani

    2018-01-01

    Full Text Available A 41-year-old female presented to the hospital with sore throat and shortness of breath. She was hypoxic with an oxygen saturation of 87% in room air. Physical examination revealed swollen uvula with exudates. She had been started on topiramate for treatment of migraine few months ago. The dose of topiramate was increased to 100 mg twice daily 2 weeks ago. Complete blood count revealed an absolute neutrophil count (ANC of 8 c/mm3. She was intubated and started on broad-spectrum antibiotics. She was transferred to our hospital on the fifth day of hospitalization. On arrival, her absolute neutrophil count was 10 c/mm3. Her agranulocytosis was attributed to topiramate after ruling out other possible causes. ANC improved after topiramate was stopped. ANC increased to 1000 after 5 days of stopping topiramate. We also reviewed published cases of topiramate-associated agranulocytosis. Agranulocytosis is a rare side effect of topiramate, and only 3 case reports have been published so far. In all cases, agranulocytosis developed after months of topiramate therapy and when dose was increased to 200 mg daily suggesting a dose-dependent effect. Next steps would be further research on the pathogenesis of agranulocytosis associated with topiramate and creation of registry for data synthesis.

  18. Partial Ectopia Cordis: A Case Report

    Directory of Open Access Journals (Sweden)

    Reza Saeidi

    2017-09-01

    Full Text Available Background: One-third of all major congenital anomalies are Congenital heart disease (CHD and Reported CHD prevalence increased over time and in Asian countries is more than western countries. Ectopia cordis (EC is a rare congenital anomaly with an estimated incidence of 1:100 000 live births in developed countries. EC is characterized by abnormal heart placement outside the thorax, mostly on the thoracoabdominal side. This form is often associated with pentalogy of Cantrell.Case report: We report one cases of the ectopia cordis at the Emam Reza Hospital in Mashhad. In this report, a rare case with incomplete pentalogy of Cantrell are described. It was a boy with a large omphalocele with evisceration of the heart. He had normal capillary refill and responded to stimuli. This patient was a male fetus with ectopia cordis with intracardiac anomalies; a large omphalocele with evisceration of the heart; a hypoplastic sternum and rib cage.Conclusion: Prognosis seems to be poorer in patients with the complete form of pentalogy of Cantrell, EC, and patients with associated anomalies. Intracardial defects do not seem to be a prognostic factor

  19. What is in a business case? Business cases as a tool-in-use for promoting water management practices in the food sector

    DEFF Research Database (Denmark)

    Pedersen, Esben Rahbek Gjerdrum; Rosati, Francesco; Lauesen, Linne Marie

    2017-01-01

    This paper explores the role of business cases as a tool for supporting decision-making processes regarding water management. Based on an analysis of survey and interview data from 300þ organisations within the European food sector, it is concluded that the relative emphasis on business cases...... literature by moving beyond generic discussions of the business case for corporate sustainability to exploring the concrete use of business cases as a decision-making tool for managers....... and payback times influences the average level of water management engagement. However, the findings from the analysis also indicate that use of business cases are not set in stone but can be adapted and changed through ongoing dialogue and negotiations. The paper contributes to the existing academic...

  20. Evaluation of a Marketing Campaign: A Case Study of Company X

    OpenAIRE

    Moisio, Ada

    2015-01-01

    This thesis concentrates on evaluating a marketing campaign for the case Company X in Finland. The thesis will present the importance of thoroughly understanding different stages of the process of implementing a public communication campaign. Systematic evaluation of marketing campaigns can provide the case company with invaluable information. The reason for elaborating this research was the authors aspiration in cooperation with case companies management to evaluate campaign data from a ...

  1. A Rare Case of Neonatal Hypophosphatasia: A Case Report

    Directory of Open Access Journals (Sweden)

    Nasim Pouralizadeh

    2018-03-01

    Full Text Available Hypophosphatasia is a rare hereditary disorder of bone metabolism.In this article, we presented the case of a male infant with a soft skull and short, deformed limbs at birth, followed by seizures and respiratory distress during admission in the neonatal intensive care unit (NICU. Prenatal ultrasound showed limb hypoplasia, skull hypomineralization, and polyhydramnios. Seizures occurred on day nine of admission. The neonate was intubated after pneumonia on day 12of birth and died due to the same cause and respiratory failure on day 14. Clinical presentation and low alkaline phosphatase (ALP confirmed the diagnosis of hypophosphatasia. The disorder covers a spectrum of severe neonatal type with severe hypomineralization to various adult types with osteomalacia and dental problems. Prenatal hypophosphatasia is diagnosed based on the clinical signs, including soft skull, short limbs, breathing difficulty, seizures, respiratory distress, laboratory results (low ALP and high pyridoxal 5-phosphate, and radiographic findings (hypomineralization and metaphyseal dysplasia.

  2. Coinfection: A Case Report

    Directory of Open Access Journals (Sweden)

    Huldah I. Nwokeukwu

    2013-01-01

    Full Text Available Background. Tuberculosis is a major public health problem, and its control has been facing a lot of challenges with emergence of HIV. The occurrence of multidrug-resistant strain has also propounded the problem especially in children where diagnosis is difficult to make. Multidrug-resistant tuberculosis (MDR-TB is in vitro resistant to isoniazid (H and rifampicin (R. Paediatric multi-drug resistant tuberculosis with HIV coinfection is rare, and there is no documented report from Nigeria. Objective. To report a case of paediatric MDR-TB in Nigeria about it. Methods. The case note of the patient was retrieved, and relevant data were extracted and summarized. Results. A 9-year-old female HIV-positive pupil with a year history of recurrent cough, 3 months history of recurrent fever, and generalized weight loss was diagnosed and treated for tuberculosis but failed after retreatment. She was later diagnosed with MDR-TB and is presently on DOT-Plus regimen. Conclusion. Paediatric MDR-TB with HIV co-infection is rare. Early diagnosis and treatment is important to prevent spread of the disease. The use of Isoniazid preventive therapy is recommended for children who come in contact with patients with active tuberculosis and also for HIV patients without active tuberculosis.

  3. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    Science.gov (United States)

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  4. Atrophia maculosa varioliformis cutis: a pediatric case.

    Science.gov (United States)

    Paradisi, M; Angelo, C; Conti, G; Palermi, G; Provini, A

    2001-01-01

    Atrophia maculosa varioliformis cutis was described in 1918 by Heidingsfeld as a type of idiopathic noninflammatory macular atrophy typically occurring in young individuals. Only 13 cases have been reported since the first description. Considering that atrophia maculosa varioliformis cutis can be mistaken for a scarring and artifact dermatitis, it is important for physicians to distinguish this condition. We report a new case in a 5-year-old boy.

  5. Improving adolescent pregnancy outcomes and maternal health:a case study of comprehensive case managed services.

    Science.gov (United States)

    Bowman, Elizabeth K; Palley, Howard A

    2003-01-01

    Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

  6. Pure erythrocytosis: reappraisal of a study of 51 cases

    International Nuclear Information System (INIS)

    Najean, Y.; Triebel, F.; Dresch, C.

    1981-01-01

    Fifty-one cases of pure, primary erythrocytosis were identified and followed at Hopital Saint-Louis, Paris, and compared with 350 cases of polycythemia vera (PV) observed during the same period. At the initial evaluation, these cases did not differ from PV cases with respect to age, sex ratio, degree of red cell volume increase, and clinical symptoms. They did differ by the absence of splenomegaly, granulocytosis and thrombocytosis. At a late stage of evolution only a few cases developed classical criteria of PV. From this group of apparently homogeneous cases, two subgroups evolved. Sixty percent of the cases were highly responsive to myelosuppression with 32 P. The median duration of the first remission was greater than five years, the mean yearly dose of 32 P was very low, and there was a low incidence of complications. The other group (40% of cases) was relatively resistant to myelosuppressive agents. The development of better methods of investigate this disorder might help in discriminating these two groups from both an etiological and pathophysiological viewpoint. The thromboembolic risk of these diseases suggests that myelosuppressive therapy should be utilized in older patients with higher risk of vascular accidents, reserving phlebotomy for younger patients and those who are shown to be resistant to 32 P therapy

  7. A case study on successful ayurvedic management of a rare case of reiter's syndrome

    Directory of Open Access Journals (Sweden)

    Vaishali Kuchewar

    2017-01-01

    Full Text Available Reiter's syndrome is a clinical syndrome of arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. Skin and mucosal involvement is observed in about 10% of the cases. A 34-year-old male was brought in severe condition. He had red colored foul smelling maculopapular skin lesions all over body, swollen and painful knee and shoulder joints. History revealed that he was suffering from Reiter's syndrome since 2003. He used to get admitted between the months of February and May every year due to aggravation of symptoms. Every time he was treated with systemic antibiotics, corticosteroids, immunosuppressants and non-steroidal anti-inflammatory drugs. He was successfully treated with external application and internal medication with tikta (bitter and kaṣāya (astringent drugs. He got significant relief in skin lesions as well as joint pain and his quality of life was markedly improved. This case study demonstrates that Reiter's syndrome can be well managed with Ayurvedic medicines.

  8. Neurolymphomatosis mimicking neurosarcoidosis: a case report

    Directory of Open Access Journals (Sweden)

    Scolding Neil J

    2010-01-01

    Full Text Available Abstract Introduction Both neurosarcoidosis and central nervous system lymphoma can be very difficult to diagnose. We describe the case of a patient in whom neurosarcoidosis was strongly suspected, but who was eventually found to have lymphoma. We believe the case to be of interest and practical value to neurologists, oncologists and internists with an interest in inflammatory diseases. Case presentation A diagnosis of neurosarcoidosis was considered in a 49-year-old Caucasian man on the basis of the following symptoms and indications: a cough, bilateral hilar lymphadenopathy confirmed by thoracic computed tomography, the development of an S1 radiculopathy, cerebrospinal fluid abnormalities (raised protein level, bilateral lung hilar and lachrymal gland uptake on a gallium scan, and erythema nodosum confirmed with skin biopsy. These were followed by the development of multiple cranial neuropathies, including seventh nerve palsy. Exhaustive further investigations yielded no evidence for an alternative diagnosis. Treatments with steroids, cyclophosphamide, intravenous immunoglobulin and finally infliximab were of no benefit. He eventually developed cutaneous nodules, a biopsy of which revealed lymphoma that proved resistant to therapy. Conclusion Constant diagnostic vigilance is required in disorders such as neurosarcoidosis.

  9. A Case of Pasqualini Syndrome

    Directory of Open Access Journals (Sweden)

    P.M. Liashuk

    2016-05-01

    Full Text Available The article presents a case of isolated congenital deficiency of luteinizing hormone (Pasqualini syndrome that manifested by secondary hypogonadism with abnormalities of copulative and fertile functions, which were normalized after the treatment using chorionic gonadotropin.

  10. A Case of Unifocal Eosinophilic Granuloma of the Mandible in an Adult Female: A Case Report

    Directory of Open Access Journals (Sweden)

    Anshita Agarwal

    2012-01-01

    Full Text Available Eosinophilic granuloma of bone is a disease with an incidence of one new case per 350,000 to 2 million per year, which is an uncommon disease of maxillofacial region, and presents in more than 90% in children under the age of ten with predominance for males. As a result, eosinophilic granuloma of the jaw is always unconsidered in the differential diagnosis of similar lesions by many clinicians. It is difficult to make a correct diagnosis on it without proof of a pathological diagnosis, which correlates with the diverse clinical and radiographic presentations of eosinophilic granuloma in the jaws. In the present paper we report a rare case of unifocal eosinophilic granuloma of mandible occurring in an adult female.

  11. An unusual case of hip disability--(a case report.

    Directory of Open Access Journals (Sweden)

    Bhosale P

    1989-10-01

    Full Text Available An unusual case of postero-superior periarticular irritation of the hip joint of six months′ duration due to an extension of a pre-sacral foreign body granuloma in an 18 year old unmarried girl is presented. Two wooden sticks which probably were inserted pervaginally by a village midwife to induce an abortion for an unwanted pregnancy had found its way to presacral region. The scanning of the vaginal fornix indicated a possible route through which the sticks might have been migrated.

  12. A Database Design and Development Case: NanoTEK Networks

    Science.gov (United States)

    Ballenger, Robert M.

    2010-01-01

    This case provides a real-world project-oriented case study for students enrolled in a management information systems, database management, or systems analysis and design course in which database design and development are taught. The case consists of a business scenario to provide background information and details of the unique operating…

  13. Identifying Human Trafficking Victims on a Psychiatry Inpatient Service: a Case Series.

    Science.gov (United States)

    Nguyen, Phuong T; Lamkin, Joanna; Coverdale, John H; Scott, Samuel; Li, Karen; Gordon, Mollie R

    2018-06-01

    Human trafficking is a serious and prevalent human rights violation that closely intersects with mental health. Limited empirical attention has been paid to the presentations and identification of trafficking victims in psychiatric settings. The primary goal of this paper is to describe the varied presentations of trafficking victims on an urban inpatient psychiatric unit. A literature review was conducted to identify relevant empirical articles to inform our examination of cases. Adult inpatient cases meeting criteria for known or possible human trafficking were systematically identified and illustrative cases were described. Six cases were identified including one male and five females. Two had been labor trafficked and four were suspected or confirmed to have been sex trafficked. The cases demonstrated a tremendous diversity of demographic and psychiatric identifying factors. These cases indicate the importance of routinely screening for trafficking victims in inpatient psychiatry settings. Identification of cases is a requisite step in providing informed and evidence-based treatments and enabling the secondary prevention of re-exploitation. Additional research is warranted given the limited current empirical research on this topic area.

  14. Intramedullary tuberculoma: A case report

    International Nuclear Information System (INIS)

    Maamar, M.; El Quessar, A.; El Fatemi, N.; El Hassani, My R.; Chakir, N.; Jiddane, M.

    2007-01-01

    Study design: We report a case of intra-medullary tuberculoma in a 22 year-old man with progressive paraparesis and sphincter dysfunction. Objectives: To present a case of intra-medullary tuberculosis and to describe the MRI's contribution to the diagnosis. Summary of background data: Intra-medullary spinal tuberculoma is a rare form of central nervous system tuberculosis. The subject and diagnosis methods: The patient, a 22 year-old man, presented with an intra-medullary tuberculoma of the dorsal spinal cord diagnosed after 6 month history of progressive paraparesis and sphincter dysfunction. MRI visualized ring enhancement of the intra-medullary dorsal lesion. Results: Total resection of the intra-medullary mass was performed through a posterior myelotomy. Histological examination revealed a granulomatous necrosis with caseum. The patient was treated with four anti-tuberculosis drugs in association with corticotherapy. The paraparesis and sphincter dysfunction improved. Conclusions: Intra-medullary spinal tuberculoma is rare, but must be considered in the differential diagnosis of spinal cord compression

  15. Development of a safety case editor with assessment features

    NARCIS (Netherlands)

    Luo, Y.; Li, Z.; van den Brand, M.G.J.

    2016-01-01

    A safety case is an argumentation for showing confidence in the claimed safety assurance of a system, which should be comprehensible and well-structured. Typically, safety cases are represented in plain text, but the structure of safety cases might become ambiguous and unclear. To address this, the

  16. A case of intermittent explosive disorder

    Directory of Open Access Journals (Sweden)

    Amitabh Saha

    2010-01-01

    Full Text Available A case of impulse control disorder was observed and managed. In this case, the serving soldier of the Indian army presented with explosive outbursts of extreme violence and anger, which was not clearly directed. Following this act of aggression, he would experience a sense of gratification and relief. The episodes were recurrent and resulted in assaults or destruction of property. The aggression displayed was out of proportion to any perceived provocation and the individual felt increasing tension or arousal before committing the act. He did not have any feelings of regret, remorse or guilt about the behavior.

  17. Plasmacytoma of larynx--a case report.

    Science.gov (United States)

    Pratibha, C B; Sreenivas, V; Babu, M K; Rout, Pritilata; Nayar, Ravi C

    2009-11-01

    Plasma cell myeloma, the most common plasma cell neoplasm, is characterized by the presence of multiple lesions in the bone marrow. A single isolated lesion may occur either in bone (solitary plasmacytoma of bone) or in soft tissue (extramedullary plasmacytoma). Most cases of extramedullary plasmacytoma occur in the head and neck region. The diagnosis is established by histopathology and immunohistochemistry. A detailed evaluation for lesions at other sites is recommended as extramedullary plasmacytoma treated by radiation therapy has better survival rates than plasma cell myeloma, which is treated by chemotherapy. A case of plasmacytoma of the larynx is presented highlighting clinical and histological features with a review of literature.

  18. Anterior mediastinal paraganglioma: A case for preoperative embolization

    Directory of Open Access Journals (Sweden)

    Shakir Murtaza

    2012-07-01

    Full Text Available Abstract Background Paraganglioma is a rare but highly vascular tumor of the anterior mediastinum. Surgical resection is a challenge owing to the close proximity to vital structures including the heart, trachea and great vessels. Preoperative embolization has been reported once to facilitate surgical treatment. Case presentation We report a case of anterior mediastinal paraganglioma that was embolized preoperatively, and was resected without the need for cardiopulmonary bypass and without major bleeding complications. Conclusion We make a case to further the role of preoperative embolization in the treatment of mediastinal paragangliomas.

  19. Crossed Apraxia of Speech: A Case Report

    Science.gov (United States)

    Balasubramanian, Venu; Max, Ludo

    2004-01-01

    The present study reports on the first case of crossed apraxia of speech (CAS) in a 69-year-old right-handed female (SE). The possibility of occurrence of apraxia of speech (AOS) following right hemisphere lesion is discussed in the context of known occurrences of ideomotor apraxias and acquired neurogenic stuttering in several cases with right…

  20. Severe malaria - a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report

    Directory of Open Access Journals (Sweden)

    Adem Patricia

    2010-01-01

    Full Text Available Abstract Background Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. Case presentation A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a post-mortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. Conclusions The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further

  1. Cogan's Syndrome in a Jordanian patient: A case report | Al ...

    African Journals Online (AJOL)

    We reported a Jordanian case of Cogan's Syndrome (CS). A 22-year old male patient presented with interstitial keratitis. The patient was treated successfully with topical steroids but over the following months, he developed vertigo, sensorineural hearing loss (SNHL) and generalized vasculitis. This is the first reported case ...

  2. Lung abcess in a child: a case report

    Directory of Open Access Journals (Sweden)

    Mervan Bekdas

    2013-08-01

    Full Text Available Lung abcess is a rarely identified suppurative infection that has air-liquid level bigger 2 cm diameter on pulmonary graphy. It should especially be considered in the case of treatment-refractory pneumonic infections of persons with chronic diseases. In order to point out to the importance of this issue, this study presents a case of pulmonary abcess identified in a patient who was followed up due to mental - motor retardation and rehospitalized atshort intervals. Our patient did not respond to parenteral antibiotic treatment, the thorax CT revealed lung abscess, chest tube insertion when the fever continue. Abscess had disappeared after 3 weeks of treatment with antibiotics.

  3. Rachipagus: A Report of Two Cases - Thoracic and Lumbar

    OpenAIRE

    Sanoussi, Samuila; Rachid, Sani; Sani, Chaibou Maman; Mahamane, Bawa; Addo, Guemou

    2010-01-01

    We present two cases of rachipagus in two male infants and review the literature on this anomaly. These infants were from consanguineous marriages and cases of twins were reported in their families. In the first case it was a limb attached to the lower lumbar region with a rudimentary posterior arch. At the junction there was a lipomeningocele. Anatomical dissection of the limb identified the bones of the lower limb. In the second case, the parasites were joints of the upper limb that were at...

  4. Silent Sinus Syndrome: A Retrospective Review of 11 Cases

    Directory of Open Access Journals (Sweden)

    Karima DARGHAL

    2014-06-01

    Full Text Available Objective: The purpose of this study is to describe the clinical and radiological features of SSS, and to review therapeutic possibilities and their outcomes.Patients and Methods: Retrospective observational case series in the department of Arthur Vernes Institute between Mars 2007 and  Novembre 2012. Clinical records, including ophthalmology and otolaryngology evaluations as well as computed tomography scans and operative reports, were carefully examined. A literature review for relevant studies was performed to examine similar cases.Results: Eleven cases of  SSS were identified. Nine men and two women (sex ratio 4.5, aged between 23 and 54 years (mean, 30 years. there was 3 to 4 mm enophthalmos in 10 cases (90.9%, and hypoglobus in all cases, with no effect on visual function. In all 11 cases, the maxillary roof (orbital floor was drawn downwards, and the one or more walls of the maxilla were concave. In 4 cases septal deviation was present. 8 patients (72.7% underwent endoscopic sinus surgery, while 3 refused it. Septoplasty was performed in 4 cases (36.3%.Conclusion: The silent sinus syndrome is a rare entity. It mainly presents as unilateral enophthalmos in younger people and has very characteristic clinical and radiologic signs.This case series reports our diagnostic and therapeutic experience with this syndrome.

  5. A rare case of a retroperitoneal enterogenous cyst with in-situ adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Woodland James G

    2007-10-01

    Full Text Available Abstract Background Retroperitoneal enterogenous cysts are uncommon and adenocarcinoma within such cysts is a rare complication. Case presentation We present the third described case of a retroperitoneal enterogenous cyst with adenocarcinomatous changes and only the second reported case whereby the cyst was not arising from any anatomical structure. Conclusion This case demonstrates the difficulties in making a diagnosis as well as the importance of a multi-disciplinary approach, and raises further questions regarding post-operative treatment with chemotherapy.

  6. Casing study

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2000-12-01

    An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

  7. A Case of Conjunctival Melanoma Presenting with Breast Metastasis

    Directory of Open Access Journals (Sweden)

    Mustafa Canhoroz

    2014-03-01

    Full Text Available Most breast masses arise from the breast. Metastasis to the breast is fairly uncommon, but can occur in breast skin and parenchyma. In particular, leukemia and lung cancers, and MM may metastasize to the breast. Breast metastasis might be the first symptom or may occur during the course of other malignancies. Our case presented with a fixed mass in the upper-medial quadrant of her left breast during regular follow-up visits. The mean time to breast metastasis in patients with MM is 62 months (13-178. In our case this time was 48 months. In a case series with 7 patients hematological malignancies (Hodgkin lymphoma, non-Hodgkin lymphoma, and leukemia were the leading cause of breast metastasis, whereas in only 1 case the cause was MM. In another case series of 15 MM patients with metastasis to the breast, the primary tumor was frequently localized to the upper extremities and trunk. In a report of 250 conjunctival MM cases the mortality rate was significantly higher in patients with tumors >4 mm in vertical thickness. In another 45-case MM series tumors with a diameter >10 mm were associated with higher mortality rates. In our case the thickness of the tumor was 5 mm. In conclusion, histopathological evaluation should be mandatory in patients with known primary malignancies in order to differentiate new primary tumors, metastases, and benign tumors.

  8. Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa.

    Science.gov (United States)

    Chowdhury, Sharfuddin; Nicol, Andrew John; Moydien, Mahammed Riyaad; Navsaria, Pradeep Harkison; Montoya-Pelaez, Luis Felipe

    2018-01-01

    The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death. Prospective audit of patients presenting to GSH trauma center following penetrating or blunt chest, abdominal, neck and peripheral vascular trauma who underwent surgery over a 4-month period was performed. Post-operative complications were graded according to Clavien-Dindo classification of surgical complications. One-hundred six patients underwent surgery during the study period. One-hundred two (96.2%) cases were related to penetrating trauma. Stab wounds comprised 71 (67%) and gunshot wounds (GSW) 31 (29.2%) cases. Of the 106 cases, 6, 47, 40, and 13 patients were booked as red, orange, yellow, and green, respectively. The median delay for green, yellow, and orange cases was within the expected time. The red patients took unexpectedly longer (median delay 48 min, IQR 35-60 min). Thirty-one (29.3%) patients developed postoperative complications. Among the booked red, orange, yellow, and green cases, postoperative complications developed in 3, 18, 9, and 1 cases, respectively. Only two (1.9%) postoperative deaths were documented during the study period. There was no statistically significant association between operative triage and post-operative complications ( p  = 0.074). Surgical case categorization has been shown to be useful in prioritizing emergency trauma surgical cases in a resource constraint high-volume trauma center.

  9. Dilemmas of a Newly Recruited Academic Qualified Professor: A Case

    Science.gov (United States)

    Agrawal, Anand

    2015-01-01

    This case describes the situation of a newly recruited academic professor who volunteered to teach a course on Research Methods to first-term MBA students in a practitioner-oriented case method Business School. Research Methods is a unique course due to its relevance not only in business but also across all graduate programs. Instructional and…

  10. A CASE OF CORPORATE DECEIT: THE ENRON WAY

    Directory of Open Access Journals (Sweden)

    Amol Gore

    2011-04-01

    Full Text Available This case documents the evolution of ‘fraud culture’ at Enron Corporation and vividly explicates the downfall of this giant organization that has become a synonym for corporate deceit. The objectives of this case are to illustrate the impact of culture on established, rational management control procedures and emphasize the importance of resolute moral leadership as a crucial qualification for board membership in corporations that shape the society and affect the lives of millions of people. The data collection for this case has  included various sources such as key electronic databases as well as secondary data available in the public domain. The case is prepared as an academic or teaching purpose case study that can be utilized to demonstrate the manner in which corruption creeps into an ambitious organization and paralyses the proven management control systems. Since the topic of corporate practices and fraud management is inherently interdisciplinary, the case would benefit candidates of many courses including Operations Management, Strategic Management, Accounting, Business Ethics and Corporate Law. In order to enhance the academic value, the in-class discussions could be initiated by elucidating the effects of mass unethical behaviour and conceptualisation of the management morality principles, delving into the implications for  managers.

  11. Case-Based Instruction: Improving Students' Conceptual Understanding through Cases in a Mechanical Engineering Course

    Science.gov (United States)

    Yadav, Aman; Vinh, Megan; Shaver, Gregory M.; Meckl, Peter; Firebaugh, Stephanie

    2014-01-01

    Recently, there has been a push within engineering curricula to adopt more learner-centered pedagogies, such as case-based instruction. Case-based instruction has been hypothesized to make the curriculum more relevant and motivating for students by pushing them to integrate the concepts they have learned with other experiences. The current study…

  12. Case - Case-Law - Law

    DEFF Research Database (Denmark)

    Sadl, Urska

    2013-01-01

    Reasoning of the Court of Justice of the European Union – Constr uction of arguments in the case-law of the Court – Citation technique – The use of formulas to transform case-law into ‘law’ – ‘Formulaic style’ – European citizenship as a fundamental status – Ruiz Zambrano – Reasoning from...

  13. Osteoid osteoma of the cervical spine. A case report

    International Nuclear Information System (INIS)

    Holl, K.; Wurm, G.

    2001-01-01

    The clinical picture of an OO in the 5th cervical vertebra is illustrated with the case history of a 13 year-old boy. Although in fact a rare case, it becomes evident through reference to and comparison with the literature that this case is a typical one in all aspects. (orig./CB) [de

  14. Morning glory disc anomaly: A case report | Saraswat | Nigerian ...

    African Journals Online (AJOL)

    Morning glory disc anomaly: A case report. Neeraj K. Saraswat, Ravi Ranjan, Dipendra Shukla, Sushil Ojha. Abstract. A rare case of congenital anomaly of the optic disc is presented to draw attention to the occurrence of this anomaly in rural India. The typical case presented with excavated, enlarged colobomatous optic ...

  15. Stories as case knowledge: case knowledge as stories.

    Science.gov (United States)

    Cox, K

    2001-09-01

    Every case contains a human story of illness and a medical story of disease, which together cover person management, case management, health system management and self-management. Much of that management can be learned via a thorough set of stories of typical and atypical core cases compiled by clinical teachers. Stories provide a highly flexible framework for illustrating the lessons of experience, the tips and traps for young players, and the dilemmas requiring careful judgement in the trade-offs between benefits and risks. Listening to real stories unfold is much more fun than being lectured (and better remembered). Stories illustrate 'what can happen' in a case as a guide to 'what to do'. A story begins with a real world situation with some predicament and a (causal) sequence of events or plot in which things are resolved one way or another. Patients tell their illness story; their clinician translates that into a disease story. Stories sort out what is important in such a predicament, consider the strategy and tactics of what to do, and speak about the outcomes. Each local situation provides relevance, context and circumstantial detail. Stories about case management can encapsulate practical knowledge, logical deduction, judgement and decision making, sharing with the student all the ingredients that develop expertise. Sometimes it is the plot that is important, sometimes the detail, sometimes it is the underlying message, the parable that resonates with the listener's experiences and feelings.1 Stories can also accommodate the complexity of multiple variables and the influence of other stakeholders, the uncertainties and dilemmas within the trade-offs, and the niceties of 'informed judgement'. This paper makes four points. First, clinical stories recount pointed examples of 'what happened' that expand our expertise in handling 'a case like that'. Second, cases are the unit of clinical work. Case stories expand the dimensions and details of case knowledge

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

    Science.gov (United States)

    Lederer, Henry T; Sullivan, Eva; Crum-Cianflone, Nancy F

    2016-03-01

    Sporotrichosis is an infection of worldwide distribution caused by the dimorphic fungus, Sporothrix schenckii. Acquisition typically occurs via cutaneous inoculation with development of a localized cutaneous and/or lymphocutaneous infection. We present a rare case of osteoarticular sporotrichosis in a 39-year-old man and review the literature noting only 20 published cases since 1980. Recommendations on the diagnosis and management of this unusual infection are provided.

  17. Mucocele - A study of 36 cases

    Directory of Open Access Journals (Sweden)

    Jani Dhaval

    2010-01-01

    Full Text Available Background: Mucocele is one of the most common benign soft tissue tumor present in the oral cavity. They are of two types - one is extravasation and second one is retention type but the majority are extravasation type. Aims: The objective is to determine various factors related to mucocele such as role of trauma due to nearby teeth, recurrence, duration, and to find out whether there is any role of psychological stress which initiates trauma like lip or cheek biting. Materials and Methods: 36 cases of mucocele diagnosed at the Department of the Oral Pathology, Govt. Dental College and Hospital, Ahmedabad, between 2004 and 2008 were reviewed. The clinical data were recorded and histopathologic diagnosis was made. Statistical Analysis Used: Data analysis tool, Microsoft Office Excel 2007. Results: A diagnosis of mucocele was established in 36 cases with male-to-female ratio of 1.77:1. Most common type was extravasation in 30 (83.33% cases. The peak age of occurrence was between 1st and 3rd decade. Lateral side of the lower labial mucosa was the most affected site in 34 (94.44% cases. The history of trauma appeared the major etiological factor seen in 28 (77.77% cases. Conclusion: We conclude that there was male predominance and they were more affected in 2nd and 3rd decade. The lateral side of lower labial mucosa was the commonest site and the trauma due to teeth or lip biting was the major etiological factor for the occurrence of the mucocele. The article highlights role of psychological stress in occurrence of mucocele. The reader should understand the importance of histopathology examination and should try to control the psychological stress in such mucocele patients.

  18. An unusual case of an isolated capitellar fracture of the right elbow in a child: a case report

    Directory of Open Access Journals (Sweden)

    Gonçalves Pestana José

    2012-02-01

    Full Text Available Abstract Introduction Although elbow fractures have a high incidence in the pediatric population, fractures of the capitellum are almost exclusively observed in individuals older than 12 years of age. Due to their rarity in children, reports with large numbers of cases are lacking in the literature and the surgical treatment options are poorly defined. Case presentation We present the case of an 11-year-old Portuguese girl with a displaced fracture of the capitellum of the right elbow, a typical Hahn-Steinthal or Type 1 fracture, which was followed for one year. The treatment and outcome of this fracture are described. Our patient underwent an open reduction and internal fixation with two cannulated screws. There were no complications and normal elbow function was recovered. Conclusion The authors believe that cannulated screw fixation is a reliable method of treatment for Type 1 capitellar fracture in children because it enables good interfragmentary compression, early mobilization, faster functional elbow recovery and implant removal is rarely necessary.

  19. Sudden Death Following Exercise; a Case Series Study

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    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.

  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. [Coccidioidomycosis: a new brazilian case].

    Science.gov (United States)

    Moraes, M A; Martins, R L; Leal, I I; Rocha, I S; Medeiros Júnior, P

    1998-01-01

    A case of pulmonary coccidioidomycosis from the rural zone of Bertolinia, PI, is reported. The patient, a farm worker, attributed his illness to the dust inhaled while digging a water well during the dry season of the year, some weeks before the onset of the clinical manifestations. The main symptoms of the disease were severe chest pain and moderate fever. The diagnosis was made histopathologically: tissue phase fungal organisms--immature spherules and spherules with endospores--were observed in histological sections of a lung fragment obtained by open chest biopsy. This is the twelfth autochthonous case of coccidioidomycosis found so far in Brazil. All of them involved native inhabitants of the semi-arid part of Northeastern Brazil. The hot and dry environment of the region seems to favor the development of C. immitis in the soil. Humans and animals probably acquire the infection by digging the soil, when they become exposed to the conidium-bearing dust raised by this activity.

  2. Diogenes Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Projna Biswas

    2013-01-01

    Full Text Available Cessation of normal skin cleansing seen in geriatric or self-neglected patients can cause accumulation of keratinous crusts on the skin. In the extreme end of this spectrum is a condition known as Diogenes syndrome (DS. These patients may have psychiatric disorders like paranoid disorders, mood affection, or temporofrontal dementia. Subjects are mainly the elderly but few cases in younger age group of patients have also been reported. Lesions of DS are usually found over upper central chest, back, and groin. In the young, lesions are mainly found over scalp, face, or arms. Absence of normal skin cleaning causes keratin and dirty debris to accumulate and with time form a thick shell. These debris can be secondarily infected by bacteria, fungus, and so forth. These skin lesions are not usually seen in individual with proper hygiene. We report a case of Diogenes syndrome in a 34-year-old young male patient who had associated schizophrenia.

  3. Collaural Fistula: A Case Report

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    Kalyan Pal

    2016-12-01

    Full Text Available Introduction Collaural fistula or cervico-aural fistula is rare and accounts for less than 8% of branchial cleft anomalies. Their rarity and diverse presentations have frequently led to misdiagnosis and inappropriate treatment. Case Report We report one such case of a 7 year old girl who presented to us with two discharging cutaneous openings on the left side; one in the floor of the left external auditory canal and another in the upper neck and lower face (infra-auricular region. Discussion Surgical exploration and excision is the definitive treatment of a collaural fistula. A sinus/ fistula opening into the external auditory canal, should be removed with skin and cartilage. If more than 30% of the circumference of the external auditory canal is denuded, split thickness skin grafting and stenting are recommended. The potential post-operative complications are facial nerve paralysis and recurrence of the lesion. Fistulogram is a useful diagnostic tool.

  4. Rectum perforation during transanal irrigation: a case story

    DEFF Research Database (Denmark)

    Biering-Sørensen, F; Bing, J; Berggreen, P

    2008-01-01

    STUDY DESIGN: Case report. OBJECTIVES: Report a case of rectum perforation during transanal irrigation (TAI). SETTING: Clinic for Spinal Cord Injuries, and Departments of Gastroenterological Surgery and Radiology. CASE REPORT: A 54-year-old woman with spinal cord lesion for 35 years emptied...... for years her bowel using oral laxative. This became more difficult and took more than 2 h three times a week with reflex stimulation after a chlysma. She wanted to try TAI, and went through the procedure with a nurse one time. The next time she performed the TAI by herself without difficulty. Two hours...

  5. A Case Study for Business Integration as a Service

    OpenAIRE

    Chang, Victor

    2013-01-01

    This paper presents Business Integration as a Service (BIaaS) to allow two services to work together in the Cloud to achieve a streamline process. We illustrate this integration using two services; Return on Investment (ROI) Measurement as a Service (RMaaS) and Risk Analysis as a Service (RAaaS) in the case study at the University of Southampton. The case study demonstrates the cost-savings and the risk analysis achieved, so two services can work as a single service. Advanced techniques are u...

  6. Mandibular metastasis of cholangiocarcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    You, Tae Min [Dept. of Advanced General Dentistry, Dankook University, Cheonan (Korea, Republic of); Kim, Kee Dong; Jeong, Ho Gui; Park, Won Se [Advanced General Dentistry, Dankook University, Cheonan (Korea, Republic of)

    2015-12-15

    Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case.

  7. A neglected case of Renal Tubular Acidosis

    International Nuclear Information System (INIS)

    Derakhshan, A.; Basiratnia, M.; Fallahzadeh, M.H.; Al-Hashemi, G.H.

    2007-01-01

    In this report, we present a case of a child with distal renal tubular acidosis, severe failure to thrive and profound rickets, who was only 7.8 Kg when presented at 6 years of age. His response to treatment and his follow up for four years is discussed. Although failure to thrive is a common finding in renal tubular acidosis but the physical and x-ray findings in our case were unique. (author)

  8. A curious case of the necklace hair

    Directory of Open Access Journals (Sweden)

    Mukherjee Samipa Samir

    2016-01-01

    Full Text Available Monilethrix is a rare autosomal dominant inheritable hair shaft defect with variable penetrance. The diagnosis is confirmed by the characteristic beaded appearance of the hair under light microscopy which occurs due to defective keratinization. We hereby describe a case of monilethrix syndrome with keratotic follicular papules, moniliform hair, and koilonychias in an 8-year-old Indian female child. A rare association of trichorrhexis nodosa was also noted in our case.

  9. Role of nutrition in pre-eclampsia and eclampsia cases, a case control study

    Directory of Open Access Journals (Sweden)

    Punyatoya Bej

    2014-12-01

    Full Text Available Background: Preeclampsia and eclampsia during pregnancy contribute to maternal and fetal morbidity as well as mortality. The identification of the role of maternal nutrition during pregnancy will help in reducing morbidity and mortality. Aims & Objective: The objective of this study is to find out the role of nutrition, in the form of total calorie, protein, fruits, iron, folic acid and calcium intake in the development of preeclampsia and eclampsia among pregnant women in a tertiary level hospital. Material Methods: After ethical approval and informed consent, 122 women who delivered beyond 22 weeks of gestation and diagnosed as preeclampsia or eclampsia were selected. Simultaneously, 122 controls with no diagnosis of preeclampsia or eclampsia were selected from the post natal ward. Cases and controls were administered the same pre-tested questionnaire containing questions related to food and micronutrient intake by cases and control. Results: Logistic regression was applied in the statistical analysis. The factors that were found to be significant predictors of risk for development of preeclampsia and eclampsia were higher calorie intake (adjusted Odds Ratio (OR 14.12 [6.41-43.23] P < 0.001, less protein intake (adjusted OR 3.87 [1.97-8.01] P < 0.001 during pregnancy. Fruits intake in both cases and controls were similar. 77.9% of cases and 84.4% of controls had taken iron tablets during their antenatal period. 75.4% of cases and 82.8% of controls had taken calcium tablets during their antenatal period. Iron and calcium intake is not significantly associated with development of preeclampsia and eclampsia. Conclusion: Higher calorie intake and less protein intake during pregnancy were associated with development of preeclampsia and eclampsia. Fruits intake, iron and calcium intake were not associated with development of preeclampsia and eclampsia

  10. A Case Report of Peritoneal Tuberculosis: A Challenging Diagnosis

    Directory of Open Access Journals (Sweden)

    Dilara Bulut Gökten

    2018-01-01

    Full Text Available Peritoneal tuberculosis is a disease which can mimick malignancy especially in women who present with ascites and elevated CA125 levels. It should always be considered in differential diagnosis, but the diagnosis is rarely easy for clinicians. A young female patient who presented with abdomen tenderness and diagnosed with peritoneal tuberculosis as a result of performed tests is discussed hereby in the case report. We expect that this case report adds to the existing literature on this subject.

  11. 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.

  12. Streptococcus Constellatus Spondylodiscitis in a Teenager: A Case Report.

    Science.gov (United States)

    Lim, S W; Lim, H Y; Kannaiah, T; Zuki, Z

    2017-11-01

    Streptococcus constellatus is an extremely rare cause of pyogenic spondylodiscitis. Literature search yielded only one case report in an elderly 72 years old man with spontaneous T10-T11 S. constellatus spondylodiscitis. It is virtually unheard of in young teenage. We report the case of a 14 years old male teenager who presented with worsening low back pain for one year with no neurological deficit. Imaging studies were consistent with features of L4-L5 spondylodiscitis. CT guided biopsy grew a pure culture of streptococcus constellatus sensitive to penicillin and erythromycin. He showed full recovery with six weeks of intravenous antibiotics. Due to the insidious onset, this case highlight the importance of high clinical suspicion and early diagnosis, with image guided biopsy followed by treatment with appropriate intravenous antibiotics to enable full recovery without further neurological deterioration.

  13. Tuberculosis and HIV/AIDS dual infection: A Case study for ...

    African Journals Online (AJOL)

    A total of 479 (99%) cases had their HIV test results recorded. The HIV positive cases were 244 (51%). Dual infection: The proportion of TB cases also having HIV/AIDS infection was 51%. The cure rate of smear positive, HIV positive cases was 71%; the cure rate of smear positive, HIV negative case was 85%.The mortality ...

  14. CASE REPORT Acute pituitary apoplexy complicating a pituitary ...

    African Journals Online (AJOL)

    SA JOURNAL OF RADIOLOGY • December 2010. CASE REPORT. Acute pituitary apoplexy complicating a pituitary macroadenoma. Abstract. Pituitary apoplexy is a rare but potentially life-threatening condition caused by either haemorrhage or infarction of the pituitary gland. In most cases, a pre-existing pituitary ...

  15. A computer case definition for sudden cardiac death.

    Science.gov (United States)

    Chung, Cecilia P; Murray, Katherine T; Stein, C Michael; Hall, Kathi; Ray, Wayne A

    2010-06-01

    To facilitate studies of medications and sudden cardiac death, we developed and validated a computer case definition for these deaths. The study of community dwelling Tennessee Medicaid enrollees 30-74 years of age utilized a linked database with Medicaid inpatient/outpatient files, state death certificate files, and a state 'all-payers' hospital discharge file. The computerized case definition was developed from a retrospective cohort study of sudden cardiac deaths occurring between 1990 and 1993. Medical records for 926 potential cases had been adjudicated for this study to determine if they met the clinical definition for sudden cardiac death occurring in the community and were likely to be due to ventricular tachyarrhythmias. The computerized case definition included deaths with (1) no evidence of a terminal hospital admission/nursing home stay in any of the data sources; (2) an underlying cause of death code consistent with sudden cardiac death; and (3) no terminal procedures inconsistent with unresuscitated cardiac arrest. This definition was validated in an independent sample of 174 adjudicated deaths occurring between 1994 and 2005. The positive predictive value of the computer case definition was 86.0% in the development sample and 86.8% in the validation sample. The positive predictive value did not vary materially for deaths coded according to the ICO-9 (1994-1998, positive predictive value = 85.1%) or ICD-10 (1999-2005, 87.4%) systems. A computerized Medicaid database, linked with death certificate files and a state hospital discharge database, can be used for a computer case definition of sudden cardiac death. Copyright (c) 2009 John Wiley & Sons, Ltd.

  16. Hermansky-Pudlak Syndrome: A Case Report

    Science.gov (United States)

    Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Koroglu, Mustafa; Gul, Mehmet; Bentli, Recep

    2014-01-01

    Objective. The aim of this paper is to report the case of a patient diagnosed with Hermansky-Pudlak syndrome, as a result of bleeding diathesis. Clinical Presentation and Intervention. A 23-year-old male presented with recurrent epistaxis and, upon physical examination, was found to be remarkable for albinism and suborbital ecchymosis. The absence of dense bodies in the platelets was demonstrated using electron microscopy. This patient was (slowly) administered one unit of a platelet suspension, and his bleeding decreased considerably. Conclusion. This case shows that Hermansky-Pudlak syndrome should be considered in the differential diagnosis of a patient presenting with bleeding diathesis, when the clinical presentation also includes oculocutaneous albinism and visual problems. PMID:24707413

  17. Hermansky-Pudlak Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Ilhami Berber

    2014-01-01

    Full Text Available Objective. The aim of this paper is to report the case of a patient diagnosed with Hermansky-Pudlak syndrome, as a result of bleeding diathesis. Clinical Presentation and Intervention. A 23-year-old male presented with recurrent epistaxis and, upon physical examination, was found to be remarkable for albinism and suborbital ecchymosis. The absence of dense bodies in the platelets was demonstrated using electron microscopy. This patient was (slowly administered one unit of a platelet suspension, and his bleeding decreased considerably. Conclusion. This case shows that Hermansky-Pudlak syndrome should be considered in the differential diagnosis of a patient presenting with bleeding diathesis, when the clinical presentation also includes oculocutaneous albinism and visual problems.

  18. Hemobilia caused by a ruptured hepatic cyst: a case report

    Directory of Open Access Journals (Sweden)

    Dutta Sudhir

    2011-01-01

    Full Text Available Abstract Introduction Hemobilia is a rare cause of upper gastrointestinal bleeding. More than 50% of hemobilia cases are related to iatrogenic trauma from hepatobiliary procedures, and needle biopsy of the liver represents the most common cause. A minority of hemobilia cases are due to hepatobiliary disorders such as cholangitis, hepatobiliary cancers, choledocholithiasis, and vascular abnormalities in the liver. The classic presentation of hemobilia is the triad of right upper quadrant (biliary pain, obstructive jaundice, and upper gastrointestinal bleeding. We report a rare case of hemobilia caused by a spontaneous hepatic cyst rupture, where our patient presented without the classical symptoms, in the absence of therapeutic or pathological coagulopathy, and in the absence of spontaneous or iatrogenic trauma. Case presentation A 91-year-old African-American woman was referred to our out-patient gastroenterology clinic for evaluation of mild epigastric pain and intermittent melena. An abdominal computed tomography scan was remarkable for multiple hepatic cysts. Esophagogastroduodenoscopy revealed multiple blood clots at the ampulla of Vater. Endoscopic retrograde cholangiopancreatography showed a single 18 mm-sized filling defect in the common hepatic duct wall at the junction of the right and left hepatic duct, adjacent to one of the hepatic cysts. The ruptured hepatic cyst communicated to the bile ducts and was the cause of hemobilia with an atypical clinical presentation. Conclusion Hemobilia is an infrequent cause of upper gastrointestinal bleeding and rarely occurs due to hepatic cyst rupture. To the best of our knowledge, this is only the second case report in the literature that describes hemobilia due to hepatic cyst rupture. However, it is the first case in the literature of hemobilia due to hepatic cyst rupture in the absence of iatrogenic or spontaneous trauma, and in the absence of a spontaneous or pathological coagulopathy.

  19. Using Case Studies to Teach About Global Issues, Bali: A Case Study

    Science.gov (United States)

    Oswald, James M.

    1974-01-01

    The South Pacific island of Bali is used as a case study of overpopulation and food shortage. A brief description of the resources, the typical lifestyle of the Balinese farmer, and possible teaching techniques are given. (DE)

  20. Our experience in eight cases with urinary hydatid disease: A series of 372 cases held in nine different clinics

    International Nuclear Information System (INIS)

    Yilmaz, Y.; Koesem, M; Ceylan, K.; Koeseoglu, B.; Yalcinkaya, I.; Arslan, H.; Guenes, M.; Soeylemez, Oe

    2006-01-01

    Hydatid disease, a parasitic infestation caused by the larval stage of the cestode Echinococcus granulosus, is diagnosed commonly in the east and south-east regions of Turkey. The aim of this study is to emphasize the relatively frequent occurrences of echinococcosis in our region, and to discuss therapeutic options and treatment results according to current literature. A retrospective 10-year review of nine different clinics' records of the Research Hospital of the Medical School of Yuezuencue Y 1 l University revealed 372 hydatid disease cases that were localized in various organs and treated surgically (271 cases) or drained percutaneously (99 cases). Hydatid disease was diagnosed by ultrasonography (US) and computed tomography scans (CT) and confirmed histopathologically. The involved organ was lung in 203 cases (131 adults, 72 children), liver in 150, spleen in 9, brain in 2, kidneys in 7 cases and the retrovesical area in 1 case. The urogenital system is involved at a rate of 2.15%. Two hundred and seventy-one cases were treated surgically and 99 percutaneously. Two cases with renal hydatid cyst refused the surgical procedure (one had a solitary kidney with hydatid cyst). Albendazole was administered to 192 patients; 93 patients had open surgical procedure and 99 patients underwent percutaneous procedure. Cysts were excised totally in the open surgical procedure; however, involved kidneys were removed totally (four cases) except one. Cystectomy and omentoplasty was performed in one case. Complications were as follows: in six cases, cystic material was spilled into the bronchial cavity during the dissection and a renal hydatid cyst ruptured and spilled retroperitoneally. Hydatid disease is a serious health problem in Turkey. The mainly affected organs are liver and lung. It can be treated surgical or by percutaneous aspiration. (author)

  1. Intracranial germinoma: a clinical analysis of 33 cases

    International Nuclear Information System (INIS)

    Zhao Xiangfei; Kang Jingbo; Nie Qing; Zhang Jun; Jia Haiwei

    2012-01-01

    Objective: To analyze the characteristics of clinical symptoms, examinations, and treatments in patients with intracranial germinoma. Methods: Medical records of 33 cases with intracranial germinoma between January 2000 and January 2011 were retrospectively reviewed. Results: The study population consisted of 26 males and 7 females. Eighteen patients had a single tumor and 15 patients had multiple tumor. Twelve (36.4% ) were in the sellar region, 13 (39.4% ) in the pineal region, 5 cases (15.2% ) in basal ganglia and 9 cases in the periventricular region. Clinical manifestations: 21 patients (63.7% ) had headache, nausea and vomiting; 10 (30.3% ) had blurred vision and visual field damage; 11 (33.3% ) patients had diabetes insipidus and 7 patients (21.2% ) had limb weakness. Image study: MRI examination showed long T1, T2 or abnormal T1, T2 in MRI, which were enhanced equally by contrast medium. Diagnostic methods: 17 cases were confirmed by pathological diagnosis and 16 cases by diagnostic radiotherapy. Treatment: 3 cases underwent resection; 4 cases with obstructive hydrocephalus underwent ventriculoperitoneal shunt, and 10 patients underwent stereotactic surgery. All the patients underwent radiotherapy combined with chemotherapy. Symptoms were relieved obviously, but 2 patients had spinal cord metastasis. Conclusion: The increased intracranial pressure, polyuria, diplopia are the most common clinical symptoms of intracranial germ cell tumors. Common locations of lesions are the saddle area and pineal region. The whole brain + local radiotherapy combined with chemotherapy treatment is a common and effective modality for intracranial germinoma. Most patients have clinical symptoms remission and long survival. (authors)

  2. 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...

  3. A Case of Classic Raymond Syndrome

    Directory of Open Access Journals (Sweden)

    Nicholas George Zaorsky

    2012-01-01

    Full Text Available Classic Raymond syndrome consists of ipsilateral abducens impairment, contralateral central facial paresis, and contralateral hemiparesis. However, subsequent clinical observations argued on the presentation of facial involvement. To validate this entity, we present a case of classic Raymond syndrome with contralateral facial paresis. A 50 year-old man experienced acute onset of horizontal diplopia, left mouth drooling and left-sided weakness. Neurological examination showed he had right abducens nerve palsy, left-sided paresis of the lower part of the face and limbs, and left hyperreflexia. A brain MRI showed a subacute infarct in the right mid-pons. The findings were consistent with those of classic Raymond syndrome. To date, only a few cases of Raymond syndrome, commonly without facial involvement, have been reported. Our case is a validation of classic Raymond syndrome with contralateral facial paresis. We propose the concept of two types of Raymond syndrome: (1 the classic type, which may be produced by a lesion in the mid-pons involving the ipsilateral abducens fascicle and undecussated corticofacial and corticospinal fibers; and (2 the common type, which may be produced by a lesion involving the ipsilateral abducens fascicle and undecussated corticospinal fibers but sparing the corticofacial fibers.

  4. Investigation of Pertussis Cases in a Texas County, 2008-2012.

    Science.gov (United States)

    Staudt, Amanda; Mangla, Anil T; Alamgir, Hasanat

    2015-07-01

    Within the past 25 years, there has been a dramatic increase in the incidence of pertussis cases in the United States. As such, this investigation reports on the high-risk groups and describes risk factors of pertussis cases in a large Texas county. This study was a cross-sectional analysis of data collected by health department employees using the Texas Department of State Health Service's Pertussis Case Track Record, which is the standard investigation form for collecting vital information on pertussis cases. We extracted and analyzed county-level data for a 5-year period (2008-2012). The study population at risk included all current residents in this county, and cases included all who were clinically diagnosed as having confirmed or probable pertussis cases that were reported to the health department according to the Centers for Disease Control and Prevention case definition. The vaccination status of a case was defined as fully vaccinated, partially vaccinated, or not vaccinated. A total of 198 probable and confirmed pertussis cases were included in this analysis. Most of the cases were infants younger than 1 year old (n = 107). The largest category of cases was not vaccinated and of the rest, 32.8% were partially vaccinated, 17.2% had unknown vaccination status, and 13.1% were fully vaccinated. Only 48 (24.2%) sources of exposure were identified and they included fathers (14.6%), sisters (14.6%), brothers (14.6%), other children (14.6%), and mothers (12.5%). Many sources of exposure (n = 26, 54.1%) were unaware of their vaccination history. Hispanics accounted for 84.5% of cases in the younger than 1 year old group and 88.9% of cases were in the 1 to 2 years old group. With respect to race/ethnicity and vaccination status of the cases, 39.46% of Hispanics, 32% of whites, and 50% of blacks were reported to be unvaccinated. Increasing pertussis vaccination coverage among children, as well as providing booster shots to adults with special attention on the

  5. A ten-step process to develop case management plans.

    Science.gov (United States)

    Tahan, Hussein A

    2002-01-01

    The use of case management plans has contained cost and improved quality of care successfully. However, the process of developing these plans remains a great challenge for healthcare executives, in this article, the author presents the answer to this challenge by discussing a 10-step formal process that administrators of patient care services and case managers can adapt to their institutions. It also can be used by interdisciplinary team members as a practical guide to develop a specific case management plan. This process is applicable to any care setting (acute, ambulatory, long term, and home care), diagnosis, or procedure. It is particularly important for those organizations that currently do not have a deliberate and systematic process to develop case management plans and are struggling with how to improve the efficiency and productivity of interdisciplinary teams charged with developing case management plans.

  6. An Unusual Os Trigonum Syndrome Case Secondary to Car Accident: A Case Report

    Directory of Open Access Journals (Sweden)

    Safer

    2016-03-01

    Full Text Available Introduction The os trigonum syndrome is a common cause of posterior ankle pain, often affecting ballet dancers, soccer players, runners and gymnasts who frequently force the ankle into plantar flexion. In rare cases, onset of the os trigonum syndrome followed an acute injury. Case Presentation A 62-year-old female patient was admitted with load depended ankle pain and swelling, lasting for five years which promptly started after a car accident. We incidentally discovered os trigonum on plain radiography on a lateral view of the right ankle. Conclusions The os trigonum syndrome should take in consideration in elderly subject who had posterior ankle pain starting after a car accident.

  7. A Case of True Hermaphroditism Presenting as a Testicular Tumour

    Directory of Open Access Journals (Sweden)

    Michelle Ceci

    2015-01-01

    Full Text Available True hermaphroditism represents only 5% cases of all of disorders of sexual differentiation (DSD and usually present in early childhood with ambiguous genitalia. Occasionally, cases might present later on in adolescence with problems of sexual maturation. Our case report presents a true hermaphrodite with normal male phenotype that presented as a left testicular mass, two years after being diagnosed with Sertoli cell only syndrome in the contralateral testis. Histological examination of the left testis showed ovarian, fallopian tube, myometrial, endometrial, and epididymal tissue. This combination of findings is found in approximately one-third of true hermaphrodites, but it is very rare to present clinically as an inguinoscrotal mass.

  8. Dilated cardiomyopathy in cats - A case report

    Directory of Open Access Journals (Sweden)

    K. Jeyaraja

    2013-08-01

    Full Text Available Two cats were brought to Madras Veterinary College Teaching Hospital with the history and clinical signs suggestive of congestive heart failure ie, coughing, exercise intolerance, dyspnea, abdominal distension etc. There was history of feeding the cat with home made diet in one case and in other with commercial dog food. Based on electrocardiographic, radiographic and echocardiographic findings, the diagnosis of dilated cardiomyopathy was done in both the cases. The cases were managed with enalapril maleate, furosemide, dietary taurine supplementation and other supportive therapy. Among these two cases, one cat died on 2nd day of treatment and the other showed recovery after 8 days of treatment. [Vet World 2013; 6(4.000: 226-227

  9. [A case of flomoxef-induced pneumonitis].

    Science.gov (United States)

    Wako, Y; Hamauzu, T; Tamura, M; Yokote, M; Yokote, M; Shoji, S; Takikawa, H; Miyake, K; Yamanaka, M; Goto, H

    1992-04-01

    We report a case of flomoxef-induced pneumonitis. A 22-year-old man was treated with flomoxef following liver biopsy. A few days later he developed a high fever and severe dyspnea, and his chest X-ray film revealed diffuse reticulo-nodular shadows in both lung fields. We suspected interstitial pneumonitis due to flomoxef, and pulse therapy with methylprednisolone was started. He showed rapid recovery of symptoms and marked regression of pulmonary infiltration in his chest X-ray. Lymphocyte stimulation test was positive to flomoxef, which was compatible with the diagnosis of drug-induced pneumonitis. To our knowledge, there has been no previous case of pulmonary hypersensitivity to flomoxef reported in Japan.

  10. Glandular odontogenic cyst: A case report

    International Nuclear Information System (INIS)

    Tambawaia, Shahnaz S.; Karjodkar, Freny R.; Yadav, Archana; Sansare, Kaustubh; Sontakke, Subodh

    2014-01-01

    Glandular odontogenic cysts (GOCs) are rare intrabony solitary or multiloculated cysts of odontogenic origin. The importance of GOCs lies in the fact that they exhibit a propensity for recurrence similar to keratocystic odontogenic tumors and that they may be confused microscopically with central mucoepidermoid carcinoma. Thus, the oral and maxillofacial radiologists play an important role in definitive diagnosis of GOC based on distinctive cases; though they are rare. In large part, this is due to the GOC's complex and frequently non-specific histopathology. This report describes a case of GOC occurrence in the posterior mandibular ramus region in a 17-year-old female, which is a rare combination of site, age, and gender for occurrence.

  11. Calcifying Bursitis ischioglutealis: A Case report

    Science.gov (United States)

    Schuh, Alexander; Narayan, Chirag Thonse; Schuh, Ralph; Hönle, Wolfgang

    2011-01-01

    Introduction: The ischiogluteal bursa is an inconstant anatomical finding located between the ischial tuberosity and the gluteus maximus. Ischiogluteal bursitis is a rare disorder. Case Report: We report the case of a 43-year-old female patient with bilateral calcifying ischiogluteal bursitis. The patient had no relevant medical history of systemic illness or major trauma to the buttock. After aspiration of both ischiogluteal bursitis which delievered calcareous deposits and instillation of a mixture of 1cc betamethasone (6 mg) and 4 cc of 1% lidocaine the patient was out of any complaints. Conclusion: Calcifying ischiogluteal bursitis is a rare entity but easily diagnosed on radiographs. Aspiration and local steroid instillation give good relief from symptoms. PMID:27298836

  12. Glandular odontogenic cyst: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Tambawaia, Shahnaz S.; Karjodkar, Freny R.; Yadav, Archana; Sansare, Kaustubh; Sontakke, Subodh [Nair Hospital Dental College, Mumbai (India)

    2014-03-15

    Glandular odontogenic cysts (GOCs) are rare intrabony solitary or multiloculated cysts of odontogenic origin. The importance of GOCs lies in the fact that they exhibit a propensity for recurrence similar to keratocystic odontogenic tumors and that they may be confused microscopically with central mucoepidermoid carcinoma. Thus, the oral and maxillofacial radiologists play an important role in definitive diagnosis of GOC based on distinctive cases; though they are rare. In large part, this is due to the GOC's complex and frequently non-specific histopathology. This report describes a case of GOC occurrence in the posterior mandibular ramus region in a 17-year-old female, which is a rare combination of site, age, and gender for occurrence.

  13. Isolated Hydatid Cyst of Ankle: A Case Report

    Directory of Open Access Journals (Sweden)

    Tuna Demirdal

    2015-11-01

    Full Text Available Hydatid cyst is a zoonotic infection usually caused by Echinococcus granulosus. Hydatid cysts are most often localized in the liver and lungs. Isolated cases of hydatid cyst in soft tissue is very rare. The incidance of isolated soft tissue hydatid cyst is 2.3% in endemic areas. Medical treatment is successful in 30-40% of cases. The first choice of treatment is surgery, especially in atypical localization of hydatid cyst. We aimed to present our patient with ankle hydatid cyst, a rare case in the literature.

  14. Does a Claims Diagnosis of Autism Mean a True Case?

    Science.gov (United States)

    Burke, James P.; Jain, Anjali; Yang, Wenya; Kelly, Jonathan P.; Kaiser, Marygrace; Becker, Laura; Lawer, Lindsay; Newschaffer, Craig J.

    2014-01-01

    The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis…

  15. Recognizing thyrotoxicosis in a patient with bipolar mania: a case report

    Directory of Open Access Journals (Sweden)

    Lee Catherine

    2008-02-01

    Full Text Available Abstract Background A thyroid stimulating hormone level is commonly measured in patients presenting with symptoms of mania in order to rule out an underlying general medical condition such as hyperthyroidism or thyrotoxicosis. Indeed, many cases have been reported in which a patient is initially treated for bipolar mania, but is later found to have a thyroid condition. Several case reports have noted the development of a thyroid condition in bipolar patients either on lithium maintenance treatment or recently on lithium treatment. Case presentation We review a case in which a patient with a long history of bipolar disorder presents with comorbid hyperthyroidism and bipolar mania after recent discontinuation of lithium treatment. Conclusion Physicians should consider a comorbid hyperthyroidism in bipolar manic patients only partially responsive to standard care treatment with a mood stabilizer and antipsychotic.

  16. A Case of Peeling Skin Syndrome.

    Science.gov (United States)

    Singhal, Anil K; Yadav, Devendra K; Soni, Bajrang; Arya, Savita

    2017-01-01

    Peeling skin syndrome is a very rare autosomal recessive disease characterized by widespread painless peeling of the skin in superficial sheets. Etiology is still unknown with an autosomal recessive inheritance. Less than 100 cases have been reported in the medical literature. We present a 32-year-old man having asymptomatic peeling of skin since birth. Sheets of skin were peeling from his neck, trunk, and extremities, following friction or rubbing especially if pre-soaked in water but sparing palm and soles. Histologically, there was epidermal separation at the level of stratum corneum, just above the stratum granulosum. This case is being presented due to its rarity.

  17. A case of peeling skin syndrome

    Directory of Open Access Journals (Sweden)

    Anil K Singhal

    2017-01-01

    Full Text Available Peeling skin syndrome is a very rare autosomal recessive disease characterized by widespread painless peeling of the skin in superficial sheets. Etiology is still unknown with an autosomal recessive inheritance. Less than 100 cases have been reported in the medical literature. We present a 32-year-old man having asymptomatic peeling of skin since birth. Sheets of skin were peeling from his neck, trunk, and extremities, following friction or rubbing especially if pre-soaked in water but sparing palm and soles. Histologically, there was epidermal separation at the level of stratum corneum, just above the stratum granulosum. This case is being presented due to its rarity.

  18. Osteomalacia mimicking spondyloarthropathy: a case report.

    Science.gov (United States)

    Garip, Y; Dedeoglu, M; Bodur, H

    2014-07-01

    Osteomalacia is a metabolic bone disorder characterized by impaired mineralization of bone matrix. Symptoms of osteomalacia can be confused with other conditions such as spondyloarthropathy, polymyalgia rheumatica, polymyositis, and fibromyalgia. In this case, we report a patient with axial osteomalacia who developed low back pain, morning stiffness, and "grade 3 sacroiliitis" in pelvis X-ray, leading to the misdiagnosis as seronegative spondyloarthropathy. Serum biochemical studies revealed low serum phosphorus, low 25-hydroxy vitamin D3, normal calcium, elevated parathyroid hormone, and alkaline phosphatase levels. Her symptoms were relieved with vitamin D and calcium therapy. The diagnosis of osteomalacia should be considered in case of sacroiliitis and spondylitis.

  19. Phagophobia: a case report

    OpenAIRE

    Suraweera, Chathurie; Hanwella, Raveen; de Silva, Varuni

    2014-01-01

    Background Phagophobia is a rare disorder and the literature is sparse. There is no specific treatment described for this life threatening condition. Case presentation The patient is a 25-year-old Sri Lankan female with recurrent difficulty in swallowing. Following her initial episode which lasted one year, she presented to us with inability to swallow for one week. She was dependent on liquids and semisolids. The medical team confidently excluded an organic cause. She had difficulty swallowi...

  20. Cystic poorly differentiated nephroblastoma: A case report and ...

    African Journals Online (AJOL)

    M.O. Odubanjo

    Abstract. Background: Cystic poorly differentiated nephroblastoma (CPDN) is a rare variant of nephroblastoma which follows a benign clinical course. Case diagnosis/treatment: In this report, we document a case of CPDN in a 2 year old boy who pre- sented with recurrent gross painless hematuria and progressive ...

  1. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P

    1993-05-01

    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

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

    Directory of Open Access Journals (Sweden)

    Henry T. Lederer

    2016-03-01

    Full Text Available Sporotrichosis is an infection of worldwide distribution caused by the dimorphic fungus, Sporothrix schenckii. Acquisition typically occurs via cutaneous inoculation with development of a localized cutaneous and/or lymphocutaneous infection. We present a rare case of osteoarticular sporotrichosis in a 39-year-old man and review the literature noting only 20 published cases since 1980. Recommendations on the diagnosis and management of this unusual infection are provided.

  3. [Atypical cerebellar neurocytoma resembling a hemangioblastoma. A case report].

    Science.gov (United States)

    Lista Martínez, Olalla; Rivas López, Luis Alfredo; Pombo Otero, Jorge Francisco; Amaro Cendón, Santiago; Bravo García, Christian; Villa Fernández, Juan Manuel

    2014-01-01

    Through August 2013, 105 cases of intracranial extraventricular neurocytoma (EVN) had been described; 6% were located in cerebellum and 22% were atypical EVN. A rare morphologic form of neurocytoma, atypical EVN has had only 24 cases reported to date. Its prognosis is poorer than the typical central neurocytoma. This case report describes an atypical cerebellar EVN, a form that has not been reported yet, hence the interest of this article. We emphasise its cystic nature and mural nodule, in an infrequent presentation. EVN are low-incidence tumours that we need to take into consideration when making the differential diagnosis of cystic cerebellar lesions with mural nodule. Given that the prognosis of atypical EVNs depends on the atypical nature and on the grade of resection, medical follow up has to be more constant, due to the greater degree of recurrence. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  4. A Case of Trapezium Avascular Necrosis Treated Conservatively

    Directory of Open Access Journals (Sweden)

    Evangelos Petsatodis

    2017-01-01

    Full Text Available Introduction. Avascular necrosis (AVN of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. Case Presentation. A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium. Conclusion. AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.

  5. A rare case of thymoma in a 15-month-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Boylan, Emma; Wyers, Mary; Jaffar, Reema [Children' s Memorial Hospital, Department of Medical Imaging, Chicago, IL (United States)

    2011-11-15

    We report a case of thymoma in a 15-month-old girl successfully treated with thymectomy. This case is unique due to the very young age of the child and a family history of thymoma in the father, who was treated with resection at age 10. Radiographic and CT findings mimicked thymic hyperplasia, and highlight the difficulty of distinguishing between these two conditions, since the latter is more common in children. The case is followed by a discussion of thymic hyperplasia and thymoma. (orig.)

  6. The Association Between Urban Tree Cover and Gun Assault: A Case-Control and Case-Crossover Study.

    Science.gov (United States)

    Kondo, Michelle C; South, Eugenia C; Branas, Charles C; Richmond, Therese S; Wiebe, Douglas J

    2017-08-01

    Green space and vegetation may play a protective role against urban violence. We investigated whether being near urban tree cover during outdoor activities was related to being assaulted with a gun. We conducted geographic information systems-assisted interviews with boys and men aged 10-24 years in Philadelphia, Pennsylvania, including 135 patients who had been shot with a firearm and 274 community controls, during 2008-2011. Each subject reported a step-by-step mapped account of where and with whom they traveled over a full day from waking until being assaulted or going to bed. Geocoded path points were overlaid on mapped layers representing tree locations and place-specific characteristics. Conditional logistic regressions were used to compare case subjects versus controls (case-control) and case subjects at the time of injury versus times earlier that day (case-crossover). When comparing cases at the time of assault to controls matched at the same time of day, being under tree cover was inversely associated with gunshot assault (odds ratio (OR) = 0.70, 95% confidence interval (CI): 0.55, 0.88), especially in low-income areas (OR = 0.69, 95% CI: 0.54, 0.87). Case-crossover models confirmed this inverse association overall (OR = 0.55, 95% CI: 0.34, 0.89) and in low-income areas (OR = 0.54, 95% CI: 0.33, 0.88). Urban greening and tree cover may hold promise as proactive strategies to decrease urban violence. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  7. Case prediction in BPM systems : a research challenge

    NARCIS (Netherlands)

    Reijers, H.A.

    2007-01-01

    The capabilities of Business Process Management Systems (BPMS's) are continuously extended to increase the effectiveness of the management and enactment of business processes. This paper identifies the challenge of case prediction, which for a specific case under the control of a BPMS deals with the

  8. Laryngeal sarcoidosis: a case report presenting transglottic involvement

    NARCIS (Netherlands)

    Broek, E.M.J.M. van den; Heijnen, B.J.; Verbist, B.M.; Sjögren, E.V.

    2013-01-01

    Isolated laryngeal sarcoidosis is a very rare disease. In most cases, it will present as a supraglottic pale edematous swelling. In our case, the patient presented with hoarseness and dyspnea during exertion. Laryngeal examination did show not only supraglottic edema but also prominent subglottic

  9. Implant-Retained Auricular Prosthesis: A Case Report

    OpenAIRE

    Ozturk, A. Nilgun; Usumez, Aslihan; Tosun, Zekeriya

    2010-01-01

    Extraoral implant retained prosthesis have been proven to be a predictable treatment option for maxillofacial rehabilitation. This case report describes the clinical and laboratory procedures for fabricating an auricular prosthesis. In this case report, an auricular prosthesis was fabricated for a patient who lost the left and right external ear in an electrical burn. Extraoral implants and bar-and-clip retention for the proper connection of the auricular prosthesis to implant were used. This...

  10. Leiomyoma of the trachea : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon; Han, Young Min; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univeristy Hospital, Chonju (Korea, Republic of)

    1997-12-01

    Tracheal leiomyoma is a rare benign tumor arising from the smooth muscle in the tracheal wall. As in other cases of benign tracheal tumors, the obstructive symptoms due to leiomyoma are similar to those of asthma and bronchitis, and diagnostic delay is therefore common. We describe the case of a patient with leiomyoma arising from the trachea and review the literature, with particular emphasis on the two dimensional CT images. (author). 5 refs., 3 figs.

  11. Leiomyoma of the trachea : a case report

    International Nuclear Information System (INIS)

    Lee, Heon; Han, Young Min; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul

    1997-01-01

    Tracheal leiomyoma is a rare benign tumor arising from the smooth muscle in the tracheal wall. As in other cases of benign tracheal tumors, the obstructive symptoms due to leiomyoma are similar to those of asthma and bronchitis, and diagnostic delay is therefore common. We describe the case of a patient with leiomyoma arising from the trachea and review the literature, with particular emphasis on the two dimensional CT images. (author). 5 refs., 3 figs

  12. Lepromatous Leprosy of Prepuce- A Case Report

    Directory of Open Access Journals (Sweden)

    Kalpana R. Sulhyan

    2013-01-01

    Full Text Available Leprosy is commonly seen over cooler parts of the body and very rarely found over external genitalia because of their warm temperature.We report a case of lepromatous leprosy of prepuce in a 79 years old male who presented with phimosis. Local examination revealed anodule over prepuce and the clinical diagnosis was carcinoma of penis. This case highlights that leprosy should be kept in mind in the differential diagnosis of penile lesions.

  13. Left-sided appendicitis: review of 95 published cases and a case report.

    Science.gov (United States)

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

    2010-11-28

    To give an overview of the literature on left-sided acute appendicitis (LSAA) associated with situs inversus totalis (SIT) and midgut malrotation (MM). We present a new case of LSAA with SIT and a literature review of studies published in the English language on LSAA, accessed via PubMed and Google Scholar databases. Ninety-five published cases of LSAA were evaluated and a 25-year-old female, who presented to our clinic with left lower abdominal pain caused by LSAA, is reported. In the reviewed literature, fifty-seven patients were male and 38 were female with an age range of 8 to 82 years and a median age of 29.1 ± 15.9 years. Sixty-six patients had SIT, 23 had MM, three had cecal malrotation, and two had a previously unnoted congenital abnormality. Fifty-nine patients had presented to the hospital with left lower, 14 with right lower and seven with bilateral lower quadrant pain, and seven subjects complained of left upper quadrant pain. The diagnosis was established preoperatively in 49 patients, intraoperatively in 19, and during the postoperative period in five; 14 patients were aware of having this anomaly. The data of eight patients were not unavailable. Eleven patients underwent laparoscopic appendectomy, which was combined with cholecystectomy in two cases. Histopathological examination of the appendix specimens revealed adenocarcinoma in only two of 95 patients. The diagnosis of left lower quadrant pain is based on well-established clinical symptoms, physical examination and physician's experience.

  14. Acanthamoeba keratitis challenges a case report.

    Science.gov (United States)

    Cristina, Stan; Cristina, Vlăduţiu; Mihaela, Popovici

    2016-01-01

    Acanthamoeba keratitis is a rare, chronic, mainly contact lens-related infection caused by a free-living amoeba found ubiquitously in water and soil. A case of a 9-year-old child, who presented to our clinic with painful, red left eye, associated with photophobia, and decreased visual acuity, wais reported. The clinical examination revealed a discoid opacity inferiorly bounded by a dense, gray infiltrate. The progressive nature of the corneal infiltrate, the epithelial defect, and the lack of response to treatment was highly suggestive for Acanthamoeba keratitis. The distinctiveness of this case was the presence of Acanthamoeba keratitis in a child without a history of trauma or contact lens usage, the lack of an appropriate diagnosis and management of this vision-threatening infection.

  15. Symptomatic endometriosis of the colon - a case report

    International Nuclear Information System (INIS)

    Leutloff, U.C.; Roeren, T.; Feldmann, K.; Sillem, M.; Rabe, T.; Kauffmann, G.

    1996-01-01

    The intestinal endometriosis in need of treatment is a rare case in the surgical department. Preoperative diagnosis is very difficult and in any case must be based on histologic findings; endoscopy-guided biopsy very frequently yields negative results. Dual-contrast scanning of the colon still is a major examination method, but the findings make it difficult to rule out malignomas. Cyclic, recurrent abdominal complaints reported in the case history strongly indicate the possibility of endometriosis. Typing can be done in general only after surgery. The article reports the clinical and diagnostic parameters of a symptomatic endometriosis of the colon. (orig.) [de

  16. An unusual case of hypothermia associated with therapeutic doses of olanzapine: a case report

    Directory of Open Access Journals (Sweden)

    Ratnayake Shiroma L

    2011-05-01

    Full Text Available Abstract Introduction We report a case of a 42-year-old man who had symptomatic hypothermia as a result of taking olanzapine for paranoid schizophrenia. According to published data, only a few cases of hypothermia associated with olanzapine have been reported since its introduction into clinical use. Case presentation A 42-year-old Sri Lankan man with schizophrenia who was being treated with a therapeutic dose of olanzapine presented with reduced level of consciousness. He had a core temperature of 32°C and was bradycardic. At the time of admission, the electrocardiogram showed sinus bradycardia with J waves. He did not have any risk factors for developing hypothermia except the use of olanzapine. There was improvement in his clinical condition with reversal of electrocardiogram changes following gradual rewarming and the omission of olanzapine. Conclusion Hypothermia induced by antipsychotic medications is not uncommon, but olanzapine-induced hypothermia is rare and occurrence has been reported during initiation or increasing the dose. But here the patient developed hypothermia without dose adjustment.

  17. Parapharyngeal Angiofibroma: A Case Report

    OpenAIRE

    Lee

    2015-01-01

    Nasopharyngeal angiofibroma is a relatively uncommon vascular tumor affecting adolescent males and it characteristically originates in the posterior lateral wall of the nasopharynx. Primary extra-nasopharyngeal angiofibroma is very rare. Here, I present a case of angiofibroma of the parapharyngeal space in a 53-year-old woman with CT and sonographic findings.

  18. Parapharyngeal Angiofibroma: A Case Report

    International Nuclear Information System (INIS)

    Lee, Byung Hoon

    2015-01-01

    Nasopharyngeal angiofibroma is a relatively uncommon vascular tumor affecting adolescent males and it characteristically originates in the posterior lateral wall of the nasopharynx. Primary extra-nasopharyngeal angiofibroma is very rare. Here, I present a case of angiofibroma of the parapharyngeal space in a 53-year-old woman with CT and sonographic findings

  19. Birth outcomes of cases with isolated atrial septal defect type II--a population-based case-control study.

    Science.gov (United States)

    Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Urbán, Róbert; Czeizel, Andrew E

    2013-07-01

    In general, epidemiological studies have evaluated cases with congenital cardiovascular abnormalities together. The aim of this study is to describe the birth outcomes of cases with isolated/single atrial septal defect type II (ASD-II, i.e. only a fossa ovalis defect) after surgical correction or lethal outcome in the light of maternal sociodemographic data. Comparison of birth outcomes and maternal characteristics of cases with ASD-II and controls without defect. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities. Hungarian newborn infants with or without ASD-II. Medically recorded birth outcomes, maternal age and birth order were evaluated. Marital and employment status was based on maternal information. The lifestyle factors were analyzed in a subsample of mothers visited at home based on a personal interview with mothers and their close relatives, and the family consensus was accepted. Mean gestational age at delivery and birthweight, rate of preterm birth and low birthweight, maternal age, birth order, marital and employment status. The evaluation of 471 cases with ASD-II and 38,151 controls without any defects showed a female excess in cases with ASD-II, having shorter gestational age and lower mean birthweight, and thus a higher rate of preterm births and low birthweight. Intrauterine growth restriction and shorter gestational age were found in cases with ASD-II, particularly in female children. These factors may have a general developmental process in which there was not closure of the foramen ovale, thus echocardiographic screening of these babies might be of value. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. Pembrolizumab-induced myasthenia gravis: A fatal case report.

    Science.gov (United States)

    March, Katherine L; Samarin, Michael J; Sodhi, Amik; Owens, Ryan E

    2018-03-01

    Purpose Pembrolizumab, a monoclonal antibody which inhibits the programmed cell death 1 receptor, has been shown to efficaciously enhance pre-existing immune responses to malignancies. However, safety concerns must also be considered as pembrolizumab use has been associated with several life-threatening immune-related adverse events (irAEs). We report a fatal case of pembrolizumab-induced myasthenia gravis in a patient with no prior myasthenia gravis history. Case report A 63-year-old male presented with right eyelid drooping, puffiness, blurred vision, and shortness of breath two weeks after an initial infusion of pembrolizumab. He was subsequently diagnosed with new onset acetylcholine-receptor positive myasthenia gravis. Despite aggressive treatment with corticosteroids, pyridostigmine, intravenous immunoglobulin, and plasmapheresis, the patient clinically deteriorated and ultimately expired from acute respiratory failure after a 12-day hospitalization. Discussion Current package labeling for pembrolizumab warns against various irAEs associated with its use including pneumonitis, colitis, and endocrinopathies. To date, only one case of new onset myasthenia gravis and two case reports of myasthenia gravis exacerbation have been identified. This case further highlights the mortality risk associated with development of irAEs. Conclusion While rare, evidence for the development of MG associated with pembrolizumab is growing. Prompt recognition of symptoms and discontinuation of pembrolizumab is necessary to help improve prognosis.

  1. Seasonal ataxia: a case report of a disappearing disease | Moyo ...

    African Journals Online (AJOL)

    Case report: We present the case of a 35 year old woman from western Nigeria who was admitted in October 2012 with acute onset of gait instability and bilateral hand tremors, preceded by several episodes of vomiting. She had ingested a meal containing roasted larvae of the African silkworm, 2 hours before the onset of ...

  2. Takayasu Arteritis Associated with Sarcoidosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Im, Mi Hye; Woo, Jeong Joo; An, Jin Kyung; Choi, Yun Sun [Dept. of Radiology, Eulji Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of); Lee, Byung Hoon [Dept. of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

    2011-11-15

    Takayasu arteritis associated with sarcoidosis is very rare with only a few cases reported. We report on a case of a 55-year-old woman who was incidentally diagnosed with sarcoidosis and demonstrated numbness and weakness of the left upper limb and lower extremities associated with Takayasu arteritis.

  3. Collagenous sprue: a clinicopathologic study of 12 cases.

    LENUS (Irish Health Repository)

    Maguire, Aoife A

    2012-02-01

    Collagenous sprue is a rare form of small bowel enteropathy characterized by chronic diarrhea and progressive malabsorption with little data available on its natural history. The pathologic lesion consists of subepithelial collagen deposition associated with variable alterations in villous architecture. The small bowel biopsies of 12 cases were reviewed. Clinical details, celiac serology, and T-cell receptor gene rearrangement study results, when available, were collated. There were 8 females and 4 males (age ranged from 41 to 84 y) who presented with chronic diarrhea and weight loss. Small intestinal biopsies showed subepithelial collagen deposition with varying degrees of villous atrophy and varying numbers of intraepithelial lymphocytes. Four patients had previous biopsies showing enteropathic changes without collagen deposition. Seven cases were associated with collagenous colitis and 1 also had features of lymphocytic colitis. Three patients also had collagen deposition in gastric biopsies. One case was associated with lymphocytic gastritis. Celiac disease (CD, gluten-sensitive enteropathy) was documented in 4 patients. Five patients made a clinical improvement with combinations of a gluten-free diet and immunosuppressive therapy. Two patients died of complications of malnutrition and 1 of another illness. Clonal T-cell populations were identified in 5 of 6 cases tested. Four of these patients improved clinically after treatment but 1 has died. Collagenous sprue evolved on a background of CD in 4 cases. There was no history of CD in others and these cases may be the result of a biologic insult other than gluten sensitivity. None has developed clinical evidence of lymphoma to date.

  4. Orbital Metastasis of Hepatocellular Carcinoma: A Case Report ...

    African Journals Online (AJOL)

    Background: Hepatocellular carcinoma is one of the commonest malignancies in Nigeria, however metastasis to the orbit is a rare presentation. Objective: To present a rare case of orbital metastasis of hepatocellular carcinoma. Case Report: A 25-year-old man presented with a 3-month history of pain, progressive swelling ...

  5. Tracheal stoma necrosis: a case repor

    Directory of Open Access Journals (Sweden)

    Pak S

    2017-04-01

    Full Text Available Acute tracheal dilatation, due to an overinflated cuff, has been reported early in the course of mechanical ventilation through an endotracheal tube. Tracheal stoma necrosis is a rare complication, but such can accompany acute tracheal dilation. Herein, we report a case of tracheal necrosis 9 days following tracheostomy placement in a 71-year old woman associated with overinflation of the tracheal tube cuff. This case report aims to 1 add to the scant body of knowledge about the diagnosis and management for the patients with tracheal stoma necrosis and 2 raise awareness for error-traps in interpreting diagnostic images, specifically satisfaction of search error, inattentional blindness error, and alliterative error.

  6. Wilms' tumor in adults: apropos of a case

    International Nuclear Information System (INIS)

    Izquierdo-Gonzalez, Marlen

    2009-01-01

    Wilms tumor accounts for 8% of solid tumors in children, making up over 80% of tumors genitourinary children under 15 years. In the United States of America reported 350 new cases each year and Cuba 14 a year, usually unilateral, but in 5-10% involvement is bilateral and also identifies cases extrarenal, but more isolated. The presentation of this tumor outside the pediatric age exceptional. But as recent cases reported in the literature. According to statistics reported in Europe and United States, its frequency is 0.2 cases per million adults. The aim of this study is to analyze the elements allowed the diagnosis of Wilms tumor in a patient adult of 43 years and the treatment he was subjected in Medical Surgical Research Center in Havana Cuba and clinical elements of its evolution and correlation with necropsy findings. (Author)

  7. Humeral metastasis from a sacrococcygeal chordoma: a case report

    Directory of Open Access Journals (Sweden)

    Sepidbakht Sepideh

    2011-08-01

    Full Text Available Abstract Introduction Chordomas are rare tumors of the skeletal system that arise from an intra-osseous benign precursor of notochordal cells. They are mainly locally aggressive. However, metastases to other sites, including the humeri, resulting in pathological fractures have been reported. We report the case of a patient with a metastatic chordoma that produced a pathologic fracture of the humerus. Case presentation We report the case of a 60-year-old Iranian woman who presented with a fracture of her right humerus following a minor trauma. She had a history of a sacrococcygeal chordoma. Histological and immunohistochemical studies of the fracture site suggested the diagnosis of a chordoma. Conclusions Chordoma is a rare tumor and rarely metastasizes, but it should be considered in the differential diagnosis of epithelioid bone tumors. The only current effective treatment for this type of tumor is carbon ion therapy. There is currently no effective medical therapy available for advanced chordoma, and this type of tumor is not very responsive to radiotherapy.

  8. Role of rehabilitation a case of diastematomyelia

    Directory of Open Access Journals (Sweden)

    Stanescu Ioana

    2017-12-01

    Full Text Available Diastematomyelia (split cord malformation is a rare dysraphic lesion in which a part of the spinal cord is split in the sagittal plane into two hemicords, a bony, cartilagenous or fibrous spur projecting through the dura mater is visible in 33% of cases. Vertebral anomalies (spina bifida are common. It occurs usually between D9 and S1. Classificatin includes two types: type 1 with a duplicated dural sac, with common midline spur, usually symptomatic, and type 2 with a single dural sac and usually less symptomatic. The majority of patients are presenting with tethered cord syndrome (neurologic deficits in the lower limbs and perineum. MRI is the modality of choice for diagnosis. In symptomatic cases, surgical release of the cord and resection of spur with repair of dura are performed, with good results. We present a case of a pauci-symptomatic type 1 dyastematomyelia, manifested by intermittent and resistant lumbar pain, in which physiotherapy during rehabilitation program have shown to improve pain intensity.

  9. Lymphangioma circumscriptum of the penis: a case report.

    Science.gov (United States)

    Kokcam, Ibrahim

    2007-06-01

    We report a case of lymphangioma circumscriptum of the penis in a 19-year-old male. The lesions developed during puberty and resembled molluscum contagiosum and genital herpes. The case is presented because of its rarity and to increase diagnostic awareness and treatment with non-surgical intervention.

  10. Building Maintenance Management in a Malaysian University Campus: A Case Study

    Directory of Open Access Journals (Sweden)

    Olanrewaju Abdul Lateef

    2010-07-01

    Full Text Available University buildings require maintenance in order to create a conducive environment that supports and stimulates learning, teaching, innovation, and research. The prime objective of maintenance is to ensure, as far as practicable, the continued peak performance of the building throughout its design life. This paper seeks to report the maintenance management system of a university institution in Malaysia. Primary data was gathered through the analysis of a case study. The objectives of the case study are to identify, describe and assess the maintenance management system used by the university. The major conclusion drawn from the case study was that although university building maintenance practices are corrective and cyclical there is a lack of a comprehensive maintenance management framework that guides the decision-making processes. The case study also revealed irregularities in the university’s maintenance management system.

  11. Primary familial hypercholesterolaemia in a South African black. A case report

    NARCIS (Netherlands)

    van Wingerden, J. J.

    1981-01-01

    A case of familial hypercholesterolaemia is presented. This is to the best of our knowledge the first report of such a case in a South African black. The modes of presentation and inheritance are discussed and the relevant literature is reviewed

  12. A review of cases of tracheobronchial foreign bodies in children

    International Nuclear Information System (INIS)

    Asai, Masatsugu; Adachi, Yuichi; Nakagawa, Hajime

    2007-01-01

    Twenty-three children with tracheobronchial foreign bodies were statistically studied. The number of cases under 3 years of age was 16 (70%). The male-female ratio was 1.9:1. In 19 cases, the foreign bodies were radiolucent. Within these 19 cases, 12 cases involved peanuts. In 4 cases, the foreign bodies were radiopaque. Eight patients underwent extirpation more than 1 week after inhalation because of diagnostic delay. Some of these cases showed granulation in the bronchus and other complications. For early diagnosis, education is necessary not only for parents but also for general physicians. Foreign bodies were lodged in the right bronchus in 11 cases, left bronchus in 11 cases, and trachea in 1 case. Chest X-ray was performed in all patients. Auxiliary examinations performed were lung perfusion scintigraphy (n=9), CT scan (n=8) and MR imaging (n=4). Lung perfusion scintigraphy and CT scan are easy to perform and seemed to be effective for diagnosis. Observation of the trachea and bronchus using a flexible fiberoptic bronchoscope before insertion of rigid ventilation bronchoscopy (VBS) is useful for avoiding subglottic swelling. Furthermore, it is helpful for suctioning sputum and for collecting useful information on the airway before using VBS. For extirpation, we used VBS in 20 cases and a flexible fiberoptic bronchoscope in 3 cases. Sometimes, after extirpation patients suffer respiratory disturbance from complications such as pneumonia. Cooperation of otolaryngologists and pediatricians as a team is necessary for treatment of tracheobronchial foreign bodies. (author)

  13. Subsidence over AML and its causes - A case study

    International Nuclear Information System (INIS)

    Peng, S.S.; Lin, P.M.; Hsiung, S.M.

    1988-01-01

    Subsidence over abandoned mined lands can be attributed to several causes. For purposes of compensation and liability and developing remedial measures, it is essential to identify the real causes. The detailed procedures for a subsidence investigation and the keys to identify and determine the causes and severity of the damages are illustrated and discussed through a case study in this paper. A subsidence check list has been developed for investigation purposes. The case discussed in this paper is a mining-related subsidence. The associated subsidence index was 60%. The damage to the dwelling was due to tension. The major damage was developed within two days. A crackmeter was installed on the exterior wall to monitor the house movement. An inclinometer casing and a Sondex casing were installed in a borehole to monitor the ground movement. The results of the geotechnical instrumentation are presented to illustrate the procedures developed for investigating the subsidence cases over the abandoned mine lands

  14. FOREIGN BODY ASPIRATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Nafia Ozlem Kazanci

    2013-03-01

    Full Text Available Foreign body aspiration (FBA is common under 3 years of age. FBA can cause sudden respiratory failure. Furthermore, it leads to many respiratory system complications. Therefore, FBA is an important cause of mortality and morbidity for this age group. FBA cases are usually followed by diagnoses like pneumonia, bronchitis or bronchial asthma in the late period that history, clinical and laboratory findings suggesting foreign body aspiration can not be detected. We reported a 2-year-old male patient with pneumonia, who were administered various treatments. In thorax CT of this case, an image compatible with foreign body was seen in the right middle lobe-upper lobe separation area. Granulation tissue was detected in the entrance of the right main bronchus by rigid bronchoscopy and marked improvement occured in lung aeration after bronchoscopy. This case was reported to emphasize the importance of early diagnosis of foreign body aspiration because of high mortality and morbidity and the necessity of considering the foreign body aspiration in children with recurrent pulmonary infections. [J Contemp Med 2013; 3(1.000: 58-61

  15. Butterfly vertebra. A case report and a short review of the literature.

    Science.gov (United States)

    Kapetanakis, S; Giovannopoulou, E; Nastoulis, E; Demetriou, T

    2016-01-01

    A butterfly vertebra is a rare congenital anomaly, encountered as isolated finding or as part of syndromic diseases. We report a case of a 40-year- old female presenting with low back pain and sciatica due to 'butterfly' dysplasia of the first sacral vertebra. This novel case includes posterolateral displacement of the completely separated hemivertebrae, causing left lateral recess stenosis and compression of S1 nerve root. Additionally, we conducted a short review of the literature. Few cases are reported in literature. Only one refers to a sacral vertebra. There is no previous case of a butterfly vertebra that accounts for narrowing of the lateral recess and associated radiculopathy.

  16. A case of instantaneous rigor?

    Science.gov (United States)

    Pirch, J; Schulz, Y; Klintschar, M

    2013-09-01

    The question of whether instantaneous rigor mortis (IR), the hypothetic sudden occurrence of stiffening of the muscles upon death, actually exists has been controversially debated over the last 150 years. While modern German forensic literature rejects this concept, the contemporary British literature is more willing to embrace it. We present the case of a young woman who suffered from diabetes and who was found dead in an upright standing position with back and shoulders leaned against a punchbag and a cupboard. Rigor mortis was fully established, livor mortis was strong and according to the position the body was found in. After autopsy and toxicological analysis, it was stated that death most probably occurred due to a ketoacidotic coma with markedly increased values of glucose and lactate in the cerebrospinal fluid as well as acetone in blood and urine. Whereas the position of the body is most unusual, a detailed analysis revealed that it is a stable position even without rigor mortis. Therefore, this case does not further support the controversial concept of IR.

  17. "Tarantula keratitis": a case report.

    LENUS (Irish Health Repository)

    McAnena, L

    2013-09-01

    A case of an 11-year-old boy presenting with a two-week history of a red, irritated right eye after handling a Chilean Rose Tarantula at an exotic pet exhibition. Examination revealed innumerable microscopic hairs embedded at all levels of the cornea. He was commenced on steroid drops with subjective and objective improvement at follow up.

  18. A CASE OF METABOLIC SYNDROME

    OpenAIRE

    Khoo Ee Ming; Rabia Khatoon

    2006-01-01

    This case report illustrates a 40-year-old woman who presented with chest discomfort that was subsequently diagnosed to have metabolic syndrome. Metabolic syndrome is a common condition associated with increased cardiovascular morbidity and mortality. As primary care providers, we should be detect this condition early, intervene and prevent appropriately before complications occur.

  19. Supratentorial ependymoma in child: a case report

    International Nuclear Information System (INIS)

    Santa Anna, Tatiana Kelly Brasileiro de; Zuppani, Aguinaldo Cunha

    2008-01-01

    Ependymoma is a neuro epithelial tumor of the glioneural group which originates in the ependyma, with slow growth and infratentorial location in 2/3 of the cases. The infratentorials are more common in children and the supratentorials in adults. This report describes a case in childhood, supratentorial, in close contact with the lateral ventricle, predominantly cystic, with solid areas, little regional expansive effect and evidenced by the pathology as an infrequent subtype in this age group, the subependymoma. (author)

  20. A business case method for business models

    OpenAIRE

    Meertens, Lucas Onno; Starreveld, E.; Iacob, Maria Eugenia; Nieuwenhuis, Lambertus Johannes Maria; Shishkov, Boris

    2013-01-01

    Intuitively, business cases and business models are closely connected. However, a thorough literature review revealed no research on the combination of them. Besides that, little is written on the evaluation of business models at all. This makes it difficult to compare different business model alternatives and choose the best one. In this article, we develop a business case method to objectively compare business models. It is an eight-step method, starting with business drivers and ending wit...

  1. A New Look at Worst Case Complexity: A Statistical Approach

    Directory of Open Access Journals (Sweden)

    Niraj Kumar Singh

    2014-01-01

    Full Text Available We present a new and improved worst case complexity model for quick sort as yworst(n,td=b0+b1n2+g(n,td+ɛ, where the LHS gives the worst case time complexity, n is the input size, td is the frequency of sample elements, and g(n,td is a function of both the input size n and the parameter td. The rest of the terms arising due to linear regression have usual meanings. We claim this to be an improvement over the conventional model; namely, yworst(n=b0+b1n+b2n2+ɛ, which stems from the worst case O(n2 complexity for this algorithm.

  2. Hanging an Airplane: A Case Study in Static Equilibrium

    Science.gov (United States)

    Katz, Debora M.

    2009-11-01

    Our classrooms are filled with engineering majors who take a semester-long course in static equilibrium. Many students find this class too challenging and drop their engineering major. In our introductory physics class, we often breeze through static equilibrium; to physicists equilibrium is just a special case of Newton's second law. While it is difficult to find more time in the syllabus for any one topic, a hands-on case study may help students to develop their physical intuition about static equilibrium and may help them to succeed in their subsequent classes. This article describes a hands-on case study that you may wish to use in your classroom. (You may also wish to check a case study involving a boat published in this journal in the 1990s. ) The hands-on case study presented here can be easily modified to work at the high school or introductory college level. There are three major components: I) planning, II) doing, and III) calculating.

  3. A Service Member's Self in Transition : A Longitudinal Case Study Analysis

    NARCIS (Netherlands)

    Grimell, Jan

    2017-01-01

    Adopting a narrative approach with a dialogical framework, a longitudinal case study is presented that describes a service member's self in transition from active service into the civilian population. An analysis and interpretation of the case study leads to the hypothesis that if a dominant

  4. Chylothorax--a conservative approach (a case report.

    Directory of Open Access Journals (Sweden)

    Oak S

    1991-10-01

    Full Text Available Lymphatic blockage due to a non-specific inflammation probably of a filarial origin caused dilatation and ectasia of lymph channels at thoracic inlet of a child. Transudation of lymph through these channels led to chylothorax. The present case report highlights the significance of conservative approach towards this complex problem.

  5. Mining Product Data Models: A Case Study

    Directory of Open Access Journals (Sweden)

    Cristina-Claudia DOLEAN

    2014-01-01

    Full Text Available This paper presents two case studies used to prove the validity of some data-flow mining algorithms. We proposed the data-flow mining algorithms because most part of mining algorithms focuses on the control-flow perspective. First case study uses event logs generated by an ERP system (Navision after we set several trackers on the data elements needed in the process analyzed; while the second case study uses the event logs generated by YAWL system. We offered a general solution of data-flow model extraction from different data sources. In order to apply the data-flow mining algorithms the event logs must comply a certain format (using InputOutput extension. But to respect this format, a set of conversion tools is needed. We depicted the conversion tools used and how we got the data-flow models. Moreover, the data-flow model is compared to the control-flow model.

  6. Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China.

    Science.gov (United States)

    Jian, Wei-Yan; Lu, Ming; Cui, Tao; Hu, Mu

    2011-01-01

    Case-mix is an important tool for health planning and management in many countries. As a major developing country, China is considering the introduction of the case-mix system in the health reform. Beijing, the capital of China, developed a local case-mix version whose performance needs to be evaluated before utilization. The objective of this study was to evaluate the performance of the case-mix system developed in Beijing by comparing it with those used in Australia and the U.S.A. A total of 1.3 million inpatient records from 154 hospitals in Beijing in 2008 were grouped respectively using three case-mix systems: (i) Beijing Diagnosis Related Groups (BJ-DRGs); (ii) US-based All Patient DRGs; and (iii) Australian Refined DRGs. Coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of DRGs system. The BJ-DRGs produced the best CV and RIV results for expenditure. However, at the level of Major Diagnostic Category (MDC), three MDCs of BJ-DRGs gave the poorest RIVs for both expenditure and length of stay. Although the performance of BJ-DRGs was acceptable, further revision and improvement is needed. Comparisons with other mature DRGs versions can assist in identifying the improvement priorities of the local version. Copyright © 2011 John Wiley & Sons, Ltd.

  7. A Mixed Methods Sampling Methodology for a Multisite Case Study

    Science.gov (United States)

    Sharp, Julia L.; Mobley, Catherine; Hammond, Cathy; Withington, Cairen; Drew, Sam; Stringfield, Sam; Stipanovic, Natalie

    2012-01-01

    The flexibility of mixed methods research strategies makes such approaches especially suitable for multisite case studies. Yet the utilization of mixed methods to select sites for these studies is rarely reported. The authors describe their pragmatic mixed methods approach to select a sample for their multisite mixed methods case study of a…

  8. How to develop and write a case for technical writing

    Science.gov (United States)

    Couture, B.; Goldstein, J.

    1981-01-01

    Case of different sizes and shapes for teaching technical writing to engineers at Wayne State University have been developed. The case approach was adopted for some assignments because sophomores and juniors lacked technical expertise and professional knowledge of the engineering world. Cases were found to be good exercises, providing realistic practice in specific writing tasks or isolating particular skills in the composing process. A special kind of case which narrates the experiences of one technical person engaged in the problem-solving process in a professional rhetorical situation was developed. This type of long, realistic fiction is called a an "holistic" case. Rather than asking students to role-play a character, an holistic case realistically encompasses the whole of the technical writing process. It allows students to experience the total communication act in which the technical task and data are fully integrated into the rhetorical situation and gives an opportunity to perform in a realistic context, using skills and knowledge required in communication on the job. It is believed that the holistic case most fully exploits the advantages of the case method for students of professional communication.

  9. Octreotide-induced thrombocytopenia: a case report

    Directory of Open Access Journals (Sweden)

    Rizvi Nahid

    2011-07-01

    Full Text Available Abstract Introduction Thrombocytopenia is an extremely rare complication of octreotide therapy and can be life threatening in the setting of esophageal variceal bleeding. We report a case of octreotide-induced reversible thrombocytopenia in a 54-year-old Caucasian man with alcohol-induced cirrhosis and upper gastrointestinal bleeding. Case presentation Our patient's platelet count dropped from 155,000/mm3 upon admission to 77,000/mm3 a few hours after initiation of octreotide therapy and stayed low until the drug's administration was discontinued. Significant recovery was achieved quickly after discontinuation of octreotide. Conclusions Thrombocytopenia is a rare but potentially serious side effect of octreotide therapy and may complicate esophageal variceal bleeding. Physicians should be vigilant in identifying this potentially serious condition.

  10. CASE REPORT: Primary Cutaneous Nocardiosis of Axillary Region: A Case Report

    Directory of Open Access Journals (Sweden)

    Basavaraj V. Peerapur

    2012-07-01

    Full Text Available Background: Nocardiosis is an uncommon but world-wide infection caused by several species of soil-borne aerobic bacteria belonging to the genus Nocardia. Primary cutaneous nocardiosis (PCN is an uncommon entity. It usually occurs among immunocompetent but occupationally predisposed individuals. Clinically, it can present as acute infection (abscess or cellulitis, mycetoma, or sporotrichoid infection [1]. Here we are reporting a case of PCN presented as mycetoma in axilla which is a rare site. Case History: The patient had extensive lesions in and around the axilla, which could be attributed to the fact that the patient, being an agriculturist, had been exposed to recurrent trauma while carrying firewood and soiled sacks. Single lesion initiated four years ago, progressed to multiple lesions with few healed scars. Despite the treatment in several hospitals, lesions recurred. The present patient was diagnosed as PCN caused by Nocardia brasiliensis and appropriately treated. Conclusion: Nocardia infection should be considered in the differential diagnosis of a supportive and granulomatous dermatitis that presents clinically as multiple discharging sinuses with papules and nodules in and around axilla apart from tuberculosis.

  11. Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

    Science.gov (United States)

    Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

    2017-01-01

    Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

  12. Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report

    Directory of Open Access Journals (Sweden)

    Gülçin Bayramoğlu

    2012-03-01

    Full Text Available Vulvovaginitis caused by Shigella species (Shigella spp. has rarely been reported. This paper describes two cases of prepubertal vulvovaginitis, presenting with a bloody and purulent vaginal discharge, separately caused by ampicillin-resistant Shigella flexneri and trimethoprim-sulfomethoxazole-resistant Shigella sonnei. Our conclusions are that Shigella spp. is the potential cause of vulvovaginitis in prepubertal girls in developing countries where these pathogens are endemic, and identification of the bacteria and making antibiotic susceptibility testing in these cases should not be overlooked.

  13. Analysis of Clinical Cohort Data Using Nested Case-control and Case-cohort Sampling Designs. A Powerful and Economical Tool.

    Science.gov (United States)

    Ohneberg, K; Wolkewitz, M; Beyersmann, J; Palomar-Martinez, M; Olaechea-Astigarraga, P; Alvarez-Lerma, F; Schumacher, M

    2015-01-01

    Sampling from a large cohort in order to derive a subsample that would be sufficient for statistical analysis is a frequently used method for handling large data sets in epidemiological studies with limited resources for exposure measurement. For clinical studies however, when interest is in the influence of a potential risk factor, cohort studies are often the first choice with all individuals entering the analysis. Our aim is to close the gap between epidemiological and clinical studies with respect to design and power considerations. Schoenfeld's formula for the number of events required for a Cox' proportional hazards model is fundamental. Our objective is to compare the power of analyzing the full cohort and the power of a nested case-control and a case-cohort design. We compare formulas for power for sampling designs and cohort studies. In our data example we simultaneously apply a nested case-control design with a varying number of controls matched to each case, a case cohort design with varying subcohort size, a random subsample and a full cohort analysis. For each design we calculate the standard error for estimated regression coefficients and the mean number of distinct persons, for whom covariate information is required. The formula for the power of a nested case-control design and the power of a case-cohort design is directly connected to the power of a cohort study using the well known Schoenfeld formula. The loss in precision of parameter estimates is relatively small compared to the saving in resources. Nested case-control and case-cohort studies, but not random subsamples yield an attractive alternative for analyzing clinical studies in the situation of a low event rate. Power calculations can be conducted straightforwardly to quantify the loss of power compared to the savings in the num-ber of patients using a sampling design instead of analyzing the full cohort.

  14. Chanarin Dorfman Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Yasemin Ozkale

    2015-09-01

    Full Text Available Chanarin Dorfman Syndrome is a multisystem inherited metabolic disorder associated with congenital ichthyosis and accumulation of lipid droplets in varios types of cells. Observation of lipid vacuoles in neutrophils (Jordan's anomaly in peirpheral blood smears in patients with ichthyosis is diagnostic for Chanarin Dorfman Syndrome. Since the initial case was reported by Dorfman in 1974, nearly 50 cases have been reported in the literature, and the majority were from Middle East countries. In this report we presented a 5 year old patient who admitted to our hospital for creatine kinase elevation and diagnosed as Chanarin Dorfman Syndrome with clinical and laboratory findings. [Cukurova Med J 2015; 40(3.000: 614-618

  15. The Skateboard Factory: a teaching case on discrete-event simulation

    Directory of Open Access Journals (Sweden)

    Marco Aurélio de Mesquita

    Full Text Available Abstract Real-life applications during the teaching process are a desirable practice in simulation education. However, access to real cases imposes some difficulty in implement such practice, especially when the classes are large. This paper presents a teaching case for a computer simulation course in a production engineering undergraduate program. The motivation for the teaching case was to provide students with a realistic manufacturing case to stimulate the learning of simulation concepts and methods in the context of industrial engineering. The case considers a virtual factory of skateboards, which operations include parts manufacturing, final assembly and storage of raw materials, work-in-process and finished products. Students should model and simulate the factory, under push and pull production strategies, using any simulation software available in the laboratory. The teaching case, applied in the last two years, contributed to motivate and consolidate the students’ learning of discrete-event simulation. It proved to be a feasible alternative to the previous practice of letting students freely choose a case for their final project, while keeping the essence of project-based learning approach.

  16. Giant tubercular brainstem abscess: A case report

    Directory of Open Access Journals (Sweden)

    Pragati Chigurupati

    2014-01-01

    Full Text Available Tubercular brain abscesses are uncommon and tubercular brainstem abscesses are rarely reported. Most of these cases occur in immunocompromised patients. We report a case of giant brainstem abscess in a 5-year-old human immunodeficiency virus-seronegative female child who presented with complaints of headache, diplopia and unsteadiness of gait since 6 months. Diagnosis was made by a magnetic resonance imaging scan of brain. The patient demonstrated a remarkable clinical recovery after microsurgery combined with a course of antituberculous therapy. Microbiological and histological findings confirmed the diagnosis of a tuberculous abscess.

  17. TESTICULAR CAPILLARY HEMANGIOMA: DESCRIPTION OF A CASE

    Directory of Open Access Journals (Sweden)

    A. S. Markova

    2012-01-01

    Full Text Available The paper describes a clinical case of testicular capillary hemangioma in a 24-year-old man undergone a partial resection of the testis with the intraoperative morphological examination. Testicular capillary hemangioma is a rare benign tumor of a vascular origin, which can be similar to malignant testicular tumors on the clinical presentation, as well as on the imaging methods, in particular to seminoma. The intraoperative histological study can assist in avoiding organ-removing surgical interventions in diagnostically ambiguous cases if a benign testicular tumor is diagnosed.

  18. A case report of anodontia

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won; Kwon, Hyuk Choon [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1971-11-15

    Authors observed a rare case of total anodontia. The patient was 4 years old boy whose roentgenologic aspects of bone pattern was decreased in trabeculation and there was not tooth and toothlike substances. It was supposed that the cause of this disease was endocrine dysfunctions in his childhood.

  19. An uncommon case of random fire-setting behavior associated with Todd paralysis: A case report

    OpenAIRE

    Kanehisa, Masayuki; Morinaga, Katsuhiko; Kohno, Hisae; Maruyama, Yoshihiro; Ninomiya, Taiga; Ishitobi, Yoshinobu; Tanaka, Yoshihiro; Tsuru, Jusen; Hanada, Hiroaki; Yoshikawa, Tomoya; Akiyoshi, Jotaro

    2012-01-01

    Abstract Background The association between fire-setting behavior and psychiatric or medical disorders remains poorly understood. Although a link between fire-setting behavior and various organic brain disorders has been established, associations between fire setting and focal brain lesions have not yet been reported. Here, we describe the case of a 24-year-old first time arsonist who suffered Todd’s paralysis prior to the onset of a bizarre and random fire-setting behavior. Case presentation...

  20. A very rare case of a small bowel leiomyosarcoma leading to ileocaecal intussusception treated with a laparoscopic resection: a case report and a literature review.

    Science.gov (United States)

    Guzel, Tomasz; Mech, Katarzyna; Mazurkiewicz, Michał; Dąbrowski, Bohdan; Lech, Gustaw; Chaber, Andrzej; Słodkowski, Maciej

    2016-02-24

    Small bowel tumours are rare and comprise less than 2% of all primary gastrointestinal neoplasms. Among these tumours, a leiomyosarcoma belonging to soft tissue sarcomas is extremely rare and accounts for about 1 % of malignant mesenchymal lesions in the gastrointestinal tract. Due to its aggressive nature and slow growth, it is often diagnosed at the late stage when curative treatment is impossible. Authors report a first case of leiomyosarcoma with chronic recurrent ileocaecal intussusception and literature review to analyse diagnosis and treatment features of the ileum mesenchymal tumours. We present a case of an 87-year-old Caucasian man suffering from cramp-like abdominal pain for months. Due to lack of clinical signs and unspecific complaints, a diagnosis was delayed. Despite a detailed in-hospital examination, a proper diagnosis was established as late as during an operation. The patient was treated by surgery with good results. An uncommon laparoscopic resection of the small bowel with a tumour was performed. A histopathological investigation confirmed a very rare mesenchymal lesion of the distal ileum. The patient is under control with no recurrence for 1 year of the follow-up period. Reported case indicates that a usually asymptomatic tumour can cause uncommon chronic recurrent ileus signs. CT and MRI scans are investigation of choice in such cases, but they are sometimes inconclusive. It might be worth highlighting the good results of laparoscopic leiomyosarcoma lesion resection with a very good outcome.

  1. Gold Enamel Choumps – A Case report

    Directory of Open Access Journals (Sweden)

    Sargam D. Kotecha

    2016-09-01

    Full Text Available Tooth jewellery has been practiced since time immemorial and has become an increasingly popular trend. This case report provides a brief insight into a kind of tooth adornment/a tooth tattoo on the enamel prevalent in parts of western Uttar Pradesh, India locally known as a ‘Choump’. A tooth tattooed with ‘Choumps’ has extremely low incidence and could be used as an identification trait. Tooth adornment with ‘Choumps’ has been reported in adults however, this is the first reported case of ‘Choumps’ in children.

  2. A case report of the hemophilic arthritis

    International Nuclear Information System (INIS)

    Choi, Seung Wook; Choi, Byung Sook

    1971-01-01

    A case report of the hemophilic arthritis of which incidence is not common. Hemophilia is a constitutional disease characterized by a delayed clotting time of the blood and a lifelong history of repeated prolonged hemorrhages. The disease is hereditary and its transmission depends upon a sex-linked recessive mendelian characteristic. Since hemophilia is dominant in the male and recessive in the female, women never suffer from the disease but transmit it to some of their male offspring. The family history was not contributory in this case. Roentgenological feature of this condition are also reviewed

  3. A case report of the hemophilic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Wook; Choi, Byung Sook [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1971-10-15

    A case report of the hemophilic arthritis of which incidence is not common. Hemophilia is a constitutional disease characterized by a delayed clotting time of the blood and a lifelong history of repeated prolonged hemorrhages. The disease is hereditary and its transmission depends upon a sex-linked recessive mendelian characteristic. Since hemophilia is dominant in the male and recessive in the female, women never suffer from the disease but transmit it to some of their male offspring. The family history was not contributory in this case. Roentgenological feature of this condition are also reviewed.

  4. JET Tokamak, preparation of a safety case for tritium operations

    Energy Technology Data Exchange (ETDEWEB)

    Boyer, Helen, E-mail: helen.boyer@ccfe.ac.uk [CCFE, Culham Science Centre (United Kingdom); Plummer, David; Johnston, Jane [CCFE, Culham Science Centre (United Kingdom)

    2016-11-01

    Highlights: • A safety case incorporating technical and ITER related upgrades. • Hazard analysis reworked to include new modelling assessments. • Fitness for purpose assessment of safety controls. - Abstract: A new Safety Case is required to permit tritium operations on JET during the forthcoming DTE2 campaign. The outputs, benefits and lessons learned associated with the production of this Safety Case are presented. The changes that have occurred to the Safety Case methodology since the last JET tritium Safety Case are reviewed. Consideration is given to the effects of modifications, particularly ITER related changes, made to the JET and the impact these have on the hazard assessments as well as normal operations. Several specialized assessments, including recent MELCOR modelling, have been undertaken to support the production of this Safety Case and the impact of these assessments is outlined. Discussion of the preliminary actions being taken to progress implementation of this Safety Case is provided, highlighting new methods to improve the dissemination of the key Safety Case results to the plant operators. Finally, the work required to complete this Safety Case, before the next tritium campaign, is summarized.

  5. Infant sporotrichosis in northeast China: a report of 15 cases.

    Science.gov (United States)

    Song, Yang; Yao, Lei; Zhong, Shu-Xia; Tian, Ya-Ping; Liu, Yuan-Yuan; Li, Shan-Shan

    2011-05-01

    Sporotrichosis is a deep mycosis caused by Sporothrix schenckii. It is not uncommon in adults and children but is very rare in infants. We collated a series of case reports. Clinical data and laboratory and therapeutic results in 15 infants with cutaneous sporotrichosis were analyzed. A total of 15 cases of sporotrichosis in infants aged sporotrichosis were seen in 11 (73.3%) and four (26.7%) patients, respectively. All patients lived in rural areas and had not experienced prior trauma or had contact with soil, plants, animals, or other sporotrichosis patients. Sporothrix schenckii was isolated in all cases, and pathological findings showed suppurative granuloma, tuberculoid granuloma, or mixed inflammatory reaction. One of the 15 patients achieved a spontaneous resolution after biopsy. Fourteen were treated with oral agents, including potassium iodide (KI) alone in two cases, itraconazole alone in three cases, terbinafine alone in four cases, and a combination of KI and terbinafine in five cases. Twelve cases were followed for 4-24 months and were cured with a mean of 2.96 months of treatment (range: 2-4 months) without adverse effects. Infant sporotrichosis usually presents as a solitary lesion on the face. This is the largest series of infant sporotrichosis to be reported in the literature. © 2011 The International Society of Dermatology.

  6. Mitochondrial myopathy presenting as fibromyalgia: a case report

    Directory of Open Access Journals (Sweden)

    Abdullah Mishal

    2012-02-01

    Full Text Available Abstract Introduction To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy. Treatment of the mitochondrial myopathy resulted in resolution of symptoms. This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia. Case presentation Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points. Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms. A six-minute walk study demonstrated an elevated lactic acid level (5 mmol/L; normal Conclusions This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy. This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms.

  7. Topical lignocaine for vaginismus: a case report.

    Science.gov (United States)

    Praharaj, S K; Verma, P; Arora, M

    2006-01-01

    Vaginismus is a sexual dysfunction in which spasm of vaginal musculature precludes penetrative intercourse. In many cases associated pain or fear of pain may contribute to the maintenance of vaginismus. We report a case of primary vaginismus with associated pain that benefited from topical application of lignocaine gel along with systematic desensitization resulting in successful consummation, and suggest that it may be a useful adjunct during finger dilatation in the treatment of vaginismus, specifically in patients who have associated pain or areas of hyperesthesia in the introitus.

  8. Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study.

    Science.gov (United States)

    Pan, Chun-Hung; Li, Min-Shan; Yang, Tien-Wey; Huang, Ming-Chyi; Su, Sheng-Shiang; Hung, Yen-Ni; Chen, Chiao-Chicy; Kuo, Chian-Jue

    2018-05-05

    Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Diffuse pulmonary ossification. A case report

    International Nuclear Information System (INIS)

    Torres D, Carlos A; Ojeda L, Paulina

    1997-01-01

    The diffuse pulmonary ossification (DPO) is a rare disease characterized by metaplastic formation of bony tissue in the lung parenchyma. Generally it is associated with other disorders as mitral stenosis and interstitial fibrosis. Sometimes the DPO is idiopathic. We report the case of a 49-year-old man who presented with cough and hemoptysis. The radiological findings suggested an interstitial lung disease. The fiber optic bronchoscopy was normal. The pulmonary function tests showed a mild airway obstruction. The bacteriological and serological studies for tuberculosis, mycosis, and collagen-vascular disease were negatives. An open lung biopsy was performed and the pathologic findings were interpreted as diffuse pulmonary ossification (DPO). Any other disease was found; so, in this case the DPO was classified as idiopathic

  10. Kartagener′s syndrome: A case series

    Directory of Open Access Journals (Sweden)

    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.

  11. Xanthogranulomatous Appendicitis: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Nikhil Mehrotra

    2017-07-01

    Full Text Available Xanthogranulomatous inflammation is a form of chronic inflammation where the exact eitiology is not known. It is commonly reported in organs like kidney and gall bladder Very few cases of xanthogranulomatous inflammation of appendix have been reported in the literature. We report a case of 30 year female presenting with pain abdomen and fever for which provisional diagnosis of appendicitis was made. Open appendicectomy was performed which on intraoperative examination showed that appendix was adherent to surrounding structures forming a mass. Resection of the mass was done and sent for histopathological examination. Gross examination of the received specimen revealed multiple irregular tissue bits and one tubular tissue bit. Multiple sections studied from resected tissue showed features of xanthogranulomatous inflammation in appendix and periappendicular tissue.

  12. Lipoleiomyoma of the uterus: A case report

    International Nuclear Information System (INIS)

    Yang, IK; Ko, Young Tae; Lim, Jae Hoon; Lee, Dong Ho; Lim, Joo Won; Lee, Eil Seong

    1993-01-01

    Lipoleiomyomas of the uterus are extremely rare benign neoplasm that can be difficult to differentiate from benign cystic ovarian teratomas. Only a few pure lipomas of the uterus have been documented. We presented a case of lipoleiomyoma of the uterus, in which sonography and computed tomography were performed, but because of its rarity, and confusion with more common uterine leiomyoma and ovarian dermoid tumor, preoperative diagnosis was not suggested. To our best knowledge, this is the first case of uterine lipoleiomyoma in Korea

  13. Fetal diprosopus (Double face): A case report

    OpenAIRE

    Onankpa BO, Ukwu E, Singh S, Adoke AU, Tahir A

    2014-01-01

    Diprosopus is an extremely rare form of congenital anomaly that results in partial or total duplication of the face. Most cases of diprosopus are delivered as stillborn or die few moments after delivery. The aim of this report is to alert clinicians that the antenatal finding of polyhydramnious may be strongly associated with fetal diprosopus, this routine high resolution anomaly scans should be recommended to help detect such anomaly early in pregnancy. We report a case of a female neonate w...

  14. Linear Basal Cell Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Yuko Ichinokawa

    2011-07-01

    Full Text Available Basal cell carcinoma (BCC presents with diverse clinical features, and several morphologic and histologic variants of BCC have been reported [Sexton et al.: J Am Acad Dermatol 1990;23:1118–1126]. Linear BCC was first described as a new clinical subtype in 1985 by Lewis [Int J Dematol 1985;24:124–125]. Here, we present a case of linear BCC that we recently encountered in an elderly Japanese patient, and review other cases reported in Japan.

  15. Education research: a case-based bioethics curriculum for neurology residents.

    Science.gov (United States)

    Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth

    2015-03-31

    In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

  16. Cerebrotendinous xanthomatosis (a rare lipid storage disorder): a case report

    OpenAIRE

    Razi, Syed Mohd; Gupta, Abhinav Kumar; Gupta, Deepak Chand; Gutch, Manish; Gupta, Keshav Kumar; Usman, Syeda Iqra

    2016-01-01

    Background Cerebrotendinous xanthomatosis is a very rare autosomal recessive lipid storage disorder affecting bile acid biosynthesis. It is manifested by subtle neurological and non-neurological symptoms due to abnormal tissue lipid deposition. Diagnosis is usually delayed but early diagnosis and replacement therapy can prevent devastating neurological sequelae. Case presentation We present a case of a 25-year-old Asian Indian woman who presented with gait difficulty, fusiform swellings of bi...

  17. Unusual case of spindle cell sarcoma metastases to right ventricle: a case report and a literature review.

    Science.gov (United States)

    Frakulli, Rezarta; Cammelli, Silvia; Salvi, Fabrizio; Balestrini, Damiano; Baldissera, Antonella; Degli Esposti, Claudio; Martelli, Ombretta; Abate, Massimo; Piaoli, Anna; Ferrari, Stefano; Morganti, Alessio G; Frezza, Giovanni Piero

    2017-09-01

    Cardiac metastases from sarcoma are uncommon. Due to their rarity there is not a standard of care. However, complete cardiac metastases resection is the best option but most of patients has widespread disease. In these patients palliative radiotherapy (RT) might improve symptoms and prevent further cardiac function decline. Here we present the case of a symptomatic 30-year-old woman with spindle cell sarcoma metastasis of right ventriculum and widespread disease. The patient received radiotherapy to the heart with palliative intent. Cardiac metastases represent a challenging clinic problem. Treatment should be individualized in a multidisciplinary setting, when possible surgery seems to be the best options. However, radiotherapy even in case of widespread disease can improve clinical control symptoms by reducing the mass effect.

  18. 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

  19. The Role of Information Systems and Technology in Case Management: a case study in health and welfare insurance

    Directory of Open Access Journals (Sweden)

    Helen Richardson

    2003-05-01

    Full Text Available This study reports the role of information system and technology (IST in supporting case management at the Accident Compensation Corporation (ACC of New Zealand. Case management is a managerial approach that seeks to gain improved business performance by enhancing both employee and customer satisfaction. Despite millions of dollars spent annually by health, social, and insurance agencies in automating case management, little research has been conducted into the role of IST in this practice. The findings of this study show that for ACC, IST’s most valuable role is enhancing the relationship between client and case manager rather than replacing it for, even after the addition of IST, the most valuable knowledge continues to accrue from the face to face interaction of client and case manager. The findings also show two distinct phases to the development of case managers as knowledge workers. The first phase focuses on control of the processes and the second on the delivery and sharing of information resources.

  20. Adult posterior urethral valve: a case report

    Science.gov (United States)

    Kilciler, Mete; Basal, Seref; Irkilata, Hasan Cem; Zor, Murat; Istanbulluoglu, Mustafa Okan; Dayanc, Murat

    2010-01-01

    Introduction: Posterior urethral valve (PUV) is a congenital obstructive defect of the male urethra with an incidence of 1/8,000 to 1/25,000 live births. PUV is the most common cause of lower urinary tract obstruction in neonates. The diagnosis of PUV is usually made early, and PUV cases have rarely been detected in adults. Case presentation: Here we report the case of a 35 years old man presented with obstructive urinary symptoms. In spite of bladder neck rejection uroflowmetry pointed out infravesical obstruction with max. flow rate 9 ml/s and average flow rate 6 ml/s in uroflowmetry. During cystoscopy mild bladder trabeculation and resected bladder neck were seen. While the cystoscope was taken off, PUV were obtained. Conclusion: Since PUV is a rare condition in adults and the diagnosis of PUVs is also difficult in these groups we must consider this situation during evaluation of adult patients with obstructive symptoms especially during cystourethroscopy. PMID:20379394

  1. Adult posterior urethral valve: a case report

    Directory of Open Access Journals (Sweden)

    Dayanc, Murat

    2010-03-01

    Full Text Available Introduction: Posterior urethral valve (PUV is a congenital obstructive defect of the male urethra with an incidence of 1/8,000 to 1/25,000 live births. PUV is the most common cause of lower urinary tract obstruction in neonates. The diagnosis of PUV is usually made early, and PUV cases have rarely been detected in adults. Case presentation: Here we report the case of a 35 years old man presented with obstructive urinary symptoms. In spite of bladder neck rejection uroflowmetry pointed out infravesical obstruction with max. flow rate 9 ml/s and average flow rate 6 ml/s in uroflowmetry. During cystoscopy mild bladder trabeculation and resected bladder neck were seen. While the cystoscope was taken off, PUV were obtained. Conclusion: Since PUV is a rare condition in adults and the diagnosis of PUVs is also difficult in these groups we must consider this situation during evaluation of adult patients with obstructive symptoms especially during cystourethroscopy.

  2. BOOMERANG SIGN - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Justin

    2016-01-01

    Full Text Available INTRODUCTION Boomerang sign is a transient abnormality at the level of splenium of corpus callosum in MRI seen in various conditions.[1-2] We do here report a case of malaria, which presented with the above findings. The transient appearance of such findings need not need any aggressive management, other than managing the underlying cause.

  3. Occipital Encephalocele: A Case Report

    OpenAIRE

    Aslanova, Rakhshanda; Dolgun, Zehra Nihal; Turhan, Emrah; Ökten, Sabri Berkem

    2015-01-01

    Encephalocele is a neural tube defect characterized by sac-like protrusions of the brain and the covering membranes through an opening in the skull. In this case we presented a 21-year old 20 weeks pregnant woman with fetal occipital encephalocele accompanying lemon sign, normal posterior fossa imaging and normal level of maternal serum alpha-fetoprotein (MSAFP).

  4. Hashimoto Encephalopathy in Case of Progressive Cognitive Impairment; a Case Report

    Directory of Open Access Journals (Sweden)

    Abbas Tafakhori

    2014-08-01

    Full Text Available Hashimoto's encephalopathy (HE is a rare condition characterized by atypical psychiatric and heterogeneous neurological manifestations such as acute cerebral ischemia, seizure, tremors, myoclonus, psychosis, depression, cognitive disorders, and fluctuating loss of consciousness. Here, a case of 28 year-old man was reported who referred to the emergency department (ED with different acute neurologic disorders and final diagnose of HE.

  5. [A Case of Amusia Following Right Temporal Subcortical Hemorrhage].

    Science.gov (United States)

    Nagayoshi, Narumi; Arai, Takao; Tanno, Maiko; Watanabe, Motoi; Suzuki, Tadashi; Akasaki, Yasuharu; Murayama, Yuichi

    2017-07-01

    A woman in her 60s presented with amusia due to a localized subcortical hemorrhage of the right temporal lobe. No other symptoms of higher brain dysfunction or body paralysis were observed. One characteristic symptom in this case was rhythm impairment. Few cases of this impairment have been previously reported, and the responsible lesion and underlying mechanisms are still a matter of speculation. However, in this case, a relationship with the right temporal lobe was indicated.

  6. Management of Pulmonary Tuberculosis- A Family Case Study ...

    African Journals Online (AJOL)

    Family medicine tools including the Family circle, Family life cycle, Home visits and Family counseling were used in the management of this case. This case emphasizes the need for a thorough contact tracing, family involvement in care, home visits and individualization in the management of pulmonary tuberculosis.

  7. [Description of dysphonia cases assisted in a mutua in 2013].

    Science.gov (United States)

    Rodríguez Bayarri, M Jesús; Oliveres Verges, Joan; Linares Salas, Carlos; Martínez Llorente, Enrique; Puget Bosch, Dulce

    2015-01-01

    To describe a case series of patients with dysphonia evaluated in a national Spanish mutua. Computerized medical records of 2013 were reviewed and 129 patients with diagnoses compatible with dysphonia were identified. Eighty-six (67%) of the 129 cases were recognized as occupational diseases, three cases were considered as occupational injuries (two with a diagnosis of Reinke's edema) and the remaining 40 cases were considered to not be work-related. Most of the cases (90%) occurred in women between the ages of 30 and 49 years. Ninety-three percent of the cases diagnosed as occupational diseases underwent speech therapy and, of these, 72% were cured. The majority of the cases (61%) occurred in teachers. Average duration of sickness absence, among those patients who took it, was 113.5 days. All cases reported as occupational disease met the criteria set by the Spanish legislation (RD 1299/2006). Non-occupational diseases were referred to the national health service. Customized speech therapy was effective for most of the patients. The average duration of sick leave in our series was high. Copyright belongs to the Societat Catalana de Salut Laboral.

  8. Laryngeal sarcoidosis: a case report presenting transglottic involvement.

    Science.gov (United States)

    van den Broek, Emke M J M; Heijnen, Bas J; Verbist, Berit M; Sjögren, Elisabeth V

    2013-09-01

    Isolated laryngeal sarcoidosis is a very rare disease. In most cases, it will present as a supraglottic pale edematous swelling. In our case, the patient presented with hoarseness and dyspnea during exertion. Laryngeal examination did show not only supraglottic edema but also prominent subglottic swelling and edematous true vocal folds. Histology showed noncaseating granulomas. After excluding other causes and localizations, the patient was diagnosed with laryngeal sarcoidosis and treated with systemic corticosteroid with good result. We describe our case of isolated transglottic sarcoidosis and discuss the disease, its presentation, diagnosis, and therapeutic options. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  9. Infections after PRK could have a happy ending: a series of three cases.

    Science.gov (United States)

    Bertschinger, D R; Hashemi, K; Hafezi, F; Majo, F

    2010-04-01

    Infectious keratitis after PRK remains a rare but potentially devastating complication. Medical records of 3 male patients with infectious keratitis after uneventful PRK for myopia and astigmatism were reviewed retrospectively. PRK was performed using the Wavelight Allegretto excimer laser. Postoperative care included a bandage contact lens (BCL) for 5 days, topical antibiotics, ketorolac, and artificial tears. Keratitis presented 2 - 4 days postoperatively. In one case, each culture was negative (case 1), and was positive for Streptococcus pneumoniae (case 2) and Staphylococcus aureus (case 3). Final BSCVA (best spectacle corrected visual acuity) after intensive antibiotic treatment and removal of BCL were 1.0 (case 1), 0.9 (case 2) and 0.3 correctable to 0.8 with pinhole (case 3). Postoperative broad-spectrum antibiotics are mandatory after PRK to prevent infectious keratitis. However, resistant organisms are more and more common. The presence of a bandage soft contact lens after surgery is an unfavourable element that may increase risk of infection. Based on our case series, we suggest limiting soft contact lens wear during the two postoperative days even if the corneal ulceration is not healed. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  10. Hamartomatous Polyp of the Tonsil: A Case Report

    African Journals Online (AJOL)

    dysphagia. These are nonspecific symptoms due to mass effect. We present a case of hamartomatous polyp to stress on the benign nature of this rare lesion, clinically diagnosed as neoplasm. We want to emphasize the hamartomatous nature of this lesion with review of literature. CASE REPORT. A 17‑year‑old male patient ...

  11. [Case-non case studies: Principles, methods, bias and interpretation].

    Science.gov (United States)

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  12. A Human Case of Hymenolepis diminuta in a Child from Eastern Sicily

    Science.gov (United States)

    Patamia, Ildebrando; Cappello, Elisa; Castellano-Chiodo, Donato; Greco, Filippo; Cacopardo, Bruno

    2010-01-01

    We report a case of Hymenolepis diminuta infection in a 2-year-old child living in a suburban area of Catania, Italy. This case was initially referred to us as Dipylidium caninum infection, which was not cured after being treated twice with mebendazole. However, by analyzing the clinical presentation and stool samples we arrived to the diagnosis of H. diminuta infection. The case presented with atypical allergic manifestations which had never been reported as clinical features of symptomatic H. diminuta infection; remittent fever with abdominal pain, diffuse cutaneous itching, transient thoracic rash, and arthromyalgias. The patient was treated with a 7-day cycle of oral niclosamide, which proved to be safe and effective. This case report emphasizes that a correct parasitological diagnosis requires adequate district laboratories and trained personnel. In addition, we recommend the importance of reporting all H. diminuta infection cases, in order to improve knowledge on epidemiology, clinical presentation, and treatment protocols. PMID:20585535

  13. Renal hemangiopericytoma secondary to refractory hypertension in a child: A case report.

    Science.gov (United States)

    Hu, Qingfeng; Fang, Zujun; Zhou, Zhongwen; Zheng, Jie

    2014-12-01

    Hemangiopericytoma is a rare perivascular tumor that often involves the extremities, pelvis, head and neck, and meninges, but rarely occurs in the kidney. The differentiation from renal cancer prior to surgery is extremely challenging; therefore, almost all cases of renal hemangiopericytoma are diagnosed by pathological examination. The majority of cases are identified in patients between the ages of 20 and 50 years of age, and a considerable proportion of patients exhibit hypertension, hypoglycaemia or additional paraneoplastic syndromes. The current study reports a rare case of renal hemangiopericytoma with drug refractory hypertension in a 14-year-old female. Following the complete resection of the tumor, the patient's blood pressure returned to normal. No evidence of recurrence or metastasis was observed during a follow-up of 12 months following surgery. The present case indicated that surgery provides satisfactory outcomes and appears to be the most effective modality of treatment for renal hemangiopericytoma. Furthermore, this case also demonstrated that secondary hypertension may also recover following tumor excision.

  14. A cloud-based multimodality case file for mobile devices.

    Science.gov (United States)

    Balkman, Jason D; Loehfelm, Thomas W

    2014-01-01

    Recent improvements in Web and mobile technology, along with the widespread use of handheld devices in radiology education, provide unique opportunities for creating scalable, universally accessible, portable image-rich radiology case files. A cloud database and a Web-based application for radiologic images were developed to create a mobile case file with reasonable usability, download performance, and image quality for teaching purposes. A total of 75 radiology cases related to breast, thoracic, gastrointestinal, musculoskeletal, and neuroimaging subspecialties were included in the database. Breast imaging cases are the focus of this article, as they best demonstrate handheld display capabilities across a wide variety of modalities. This case subset also illustrates methods for adapting radiologic content to cloud platforms and mobile devices. Readers will gain practical knowledge about storage and retrieval of cloud-based imaging data, an awareness of techniques used to adapt scrollable and high-resolution imaging content for the Web, and an appreciation for optimizing images for handheld devices. The evaluation of this software demonstrates the feasibility of adapting images from most imaging modalities to mobile devices, even in cases of full-field digital mammograms, where high resolution is required to represent subtle pathologic features. The cloud platform allows cases to be added and modified in real time by using only a standard Web browser with no application-specific software. Challenges remain in developing efficient ways to generate, modify, and upload radiologic and supplementary teaching content to this cloud-based platform. Online supplemental material is available for this article. ©RSNA, 2014.

  15. Rectal duplication: a case report.

    Science.gov (United States)

    Didden, K; Masereel, B; Geyskens, P

    2013-01-01

    Gastrointestinal tract duplications are uncommon congenital abnormalities, that may occur anywhere along the alimentary tract. Most frequently they occur at the level of the small bowel tract and are symptomatic before the age of two. In our case we report the history of a 68-years old women with a colon duplication, especially a rectal duplication. This is very exceptional.

  16. Vesical Leiomyoma: Presentation of a clinical case

    International Nuclear Information System (INIS)

    Rodriguez Carballo, Michel; Gonzalez Gonzalez, Gonzalo Antonio; Sanchez Falcon Ania

    2009-01-01

    The vesical leiomyoma is a tumor of mesenchymal origin, and extremely rare. Most of them are diagnosed casually after the pathologic study of samples collected after surgery. Few cases were found in the reviewed literature, leading us to think of the scarce incidence of this kind of tumors. We present a case treated in our service, of an 18-years-old female patient, assisting to our consultation presenting a polaquiuria, ardor and mictional effort. The complementary exams led to the surgical treatment and follow up of the patient

  17. A case of familial isolated hemihyperplasia

    Directory of Open Access Journals (Sweden)

    Bacino Carlos A

    2004-02-01

    Full Text Available Abstract Background Hemihyperplasia (hemihypertrophy is defined as asymmetric body overgrowth of one or more body parts. Hemihyperplasia can be isolated or be part of well-defined syndromes such as in the case of Beckwith-Wiedemann syndrome (BWS. Isolated hemihyperplasia is usually sporadic, but a number of familial occurrences have been described. Case presentation We describe a Tunisian family in which three maternal cousins and their maternal grandfather present with isolated hemihyperplasia. Conclusions The etiology of isolated hemihyperplasia is unknown although in BWS, genomic imprinting has been shown to play a role in the asymmetric overgrowth. Given the similarity between these two conditions, it is possible that both may share a common pathogenesis. We also discuss the possible genetic mechanisms leading to the production of hemihyperplasia in this family.

  18. A study of acute expired cases with intraventricular hemorrhage

    International Nuclear Information System (INIS)

    Ikeda, Yukio; Higuchi, Hiroshi; Ueda, Kenji; Kobayashi, Shiro; Yajima, Kouzo

    1981-01-01

    Prior to the introduction of the CT scan, the diagnosis of intraventricular hemorrhage (IVH) was very difficult. The CT scan has, though, been recognized to be extremely informative in the evaluation of IVH. During the first three years we have had experience with 91 cases of IVH diagnosed by the CT scan. Acute death within seven days occurred in 42 of these cases. Hypertension was the most common Acute death within seven days occurred in 42 of these cases. Hypertension was the most common etiological factor, accounting for 18 cases. Cerebral aneurysm was the second most common cause, accounting for 10 cases. Head injury was seen in 8 cases, while the causes of 4 deaths were unknown. 31 cases were distributed over all ventricles. 30 cases revealed over two cast formations. The presence of IVH in the third and/or the fourth ventricle, which can easily affect the function of the hypothalamus and the brain stem anatomically, was closely correlated with the high mortality rate. The analysis of the CT findings regarding the mechanisms of IVH reveals three types: the direct type, which bleeds directly into ventricles without forming definite intracerebral hematomas; the extension type, which is characterized by extension and rupture from massive intracerebral hematoma, and the reflux type, which is characterized by a reflux of the subarachnoid blood. The prognosis depends on the differences in these mechanisms. (author)

  19. Rapid Revival of a Patient after very Severe Metabolic Acidosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Sajad Ahmadi

    2013-01-01

    Full Text Available Background: Metabolic acidosis is a fatal finding in trauma patients thatcomplicates the process of resuscitation.Case: The case was a 37-year-old man with open fracture in both legs and fracturein second lumbar vertebral (L2. The serial arterial blood gas (ABG test resultsshowed a pH value of 6.7 indicating a very severe and special case of metabolicacidosis. The rate of mortality for such a case was very high. The patient wastreated with sodium bicarbonate and successfully revived after four hours posttreatment and metabolic acidosis was resolved.Conclusion: This indicated that bicarbonate administration is useful for verysevere cases. The good condition of the patient after survival from the severeacademia allowed for extubation.

  20. MYOPERICYTOMA OF THE TONGUE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sevtap Akbulut

    2013-01-01

    Full Text Available Myopericytoma is a rare benign tumour composed of pericytic cells that show myoid differentiation and have a tendency for concentric perivascular growth. It belongs to a spectrum of perivascular myoid cell neoplasms. To date, only a small number of cases of myopericytoma involving the oral cavity have been reported. We describe a case of myopericytoma presenting as a slowly growing tongue nodule in a 61-year-old woman. A diagnosis of myopericytoma was established with the histopathological findings combined with immunohistochemical staining. Myopericytoma should be included in the differential diagnosis of well-circumscribed, slow-growing lesions of the oral cavity.

  1. What is a Leading Case in EU law? An empirical analysis

    DEFF Research Database (Denmark)

    Sadl, Urska; Panagis, Yannis

    2015-01-01

    Lawyers generally explain legal development by looking at explicit amendments to statutory law and modifications in judicial practice. As far as the latter are concerned, leading cases occupy a special place. This article empirically studies the process in which certain cases become leading cases....... Our analysis focuses on Les Verts, a case of considerable fame in EU law, closely scrutinising whether it contains inherent leading case material. We show how the legal relevance of a case can become “embedded” in a long process of reinterpretation by legal actors, and we demonstrate that the actual...

  2. Case management.

    Science.gov (United States)

    Woodward, Judy; Rice, Eve

    2015-03-01

    Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. A parathyroid scintigraphy case study

    International Nuclear Information System (INIS)

    O'Leary, Desiree

    2005-01-01

    Background: There has been much debate concerning the most suitable protocol for parathyroid scintigraphy; the merits of various radiopharmaceuticals versus the correct imaging protocol to visualise both ectopic and anatomically placed adenomas against the various equipment choices have been debated. Aim: To demonstrate, through the use of a case study, the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion. Method: Use is made of Tc99mMIBI, full field chest scintigraphy, a clearly defined imaging protocol and SPECT imaging to locate ectopic parathyroid tissue in a female patient with significant symptoms of parathyroid hyperfunction. Results: A single hyperfunctioning adenoma is located in the pre-carinal area of the mediastinum. Using a radioguided surgical technique the hyperfunctioning tissue is excised and confirmed by histopathology. Conclusion: Whilst a dramatic reduction in patient symptoms was not seen immediately in this patient, the symptoms of the illness have been subsiding since January 2003. This case study demonstrates the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion

  4. Lance-Adams syndrome: A special case of a mother.

    Science.gov (United States)

    Nigam, Gaurav Bhaskar; Babu, Sachin Suresh; Peter, C Sudhir; Peter, C Shobhna

    2016-09-01

    Predicting the neurological outcome in survivors of cardiorespiratory arrest is difficult. A distinction has been made between acute and chronic posthypoxic myoclonus, called myoclonic status epilepticus and Lance-Adams syndrome (LAS), respectively, with the acute condition carrying a bad prognosis. Here, we report a case of a 37-year-old female who developed seizures after a successful cardiopulmonary resuscitation. The available literature on such cases is very rare and has generally mentioned a poor outcome. However, our patient was successfully managed and showed clinical features of LAS. Thus, making an early diagnosis and proper management of hypoxic brain insults is positively related to improving the patient's functional outcome.

  5. Case of a spontaneously ruptured epidermoid cyst

    Energy Technology Data Exchange (ETDEWEB)

    Shiroyama, Y; Saiki, M; Ueda, H; Katayama, S; Mitani, T

    1987-02-01

    Intracranial fat-containing congenital tumors are characterized by negative absorption values on CT. We hereby report a case of an epidermoid cyst with subarachnoid free fats diagnosed preoperatively by CT. A 21-year-old female was admitted to our hospital because of continuous mild headache and nausea. At the time of admission, the results of her physical and neurological examinations were normal. CT, however, demonstrated multiple subarachnoid low-density spots and a suprasellar low-density area with high-density spots. In addition, there were negative absorption values (-12 -- -77), suggesting free fats. A spontaneously ruptured epidermoid or dermoid cyst was diagnosed on the basis of these findings. At surgery, a suprasellar tumor containing a yellowish, cheese-like material was confirmed. The patient made an uneventful recovery and was discharged 14 days after surgery. There have been several published reports of CT appearances of intracranial fat-containing tumors. However, spontaneously ruptured cases diagnosed by CT are rare. CT was found to be useful for the diagnosis of spontaneously ruptured cases of fat-containing tumors.

  6. A clinical study of 68 cases of small intestinal perforation

    International Nuclear Information System (INIS)

    Ogura, Masaharu; Tanaka, Nobutaka; Furuya, Takatoshi; Nomura, Yukihiro; Nagai, Motoki; Takahashi, Michiro; Takayama, Toshio; Hirao, Hirofumi

    2010-01-01

    From January 2000 to September 2008 we analyzed the clinical features of 68 patients attending our hospital who had undergone surgery for small intestinal perforations. The nature of the rupture in 51 patients was endogenous, and endogenous in the other 17. Endogenous ruptures included ileus in 16 cases, tumors in 7 cases, of unknown origin in 5 cases, and blunt trauma in 23 cases. Exogenous rupture included iatrogenic in 5, foreign body digestion in 5, and penetrating trauma in 7. Postoperative complications occurred significantly more in the endogenous rupture cases than in the exogenous ones. There were 4 hospital deaths, which were in all endogenous cases. The high complication rate and a certain proportion of poor prognosis in cases of endogenous rupture necessitate imminent treatment as soon as an endogenous perforation is suspected. (author)

  7. Ureteroarterial fistula: a case report

    International Nuclear Information System (INIS)

    Kim, Young Sun; Kim, Ji Chang

    2007-01-01

    Ureteroarterial fistula is an extremely rare complication, but is associated with a high mortality rate. Previous pelvic surgery, long standing ureteral catheter insertion, radiation therapy, vascular surgery and vascular pathology contribute the development of this uncommon entity. Herein, a case of ureteroarterial fistula in a 69-year-old female patient, who presented with a massive hematuria, proven in a second attempt at angiography, is reported

  8. Souvenirs: A Case Study for the 90s.

    Science.gov (United States)

    Shagam, Janet Yagoda; Decker, Janet; Stanley, Ethel

    The case-based study, which presents students with a dilemma that encourages exploration, is becoming a popular method for teaching biology. This Web-based report offers one such case study that asks readers to solve problems and make decisions based on information gathered as they engage with characters or situations in the story. The basis for…

  9. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-06-15

    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  10. Craniopharyngioma in the temporal lobe: a case report

    International Nuclear Information System (INIS)

    Sohn, Chul-Ho; Baik, Seung-Kug; Kim, Sang-Pyo; Kim, Il-Man; Sevick, Robert J.

    2004-01-01

    Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe

  11. Craniopharyngioma in the temporal lobe: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Chul-Ho; Baik, Seung-Kug; Kim, Sang-Pyo; Kim, Il-Man; Sevick, Robert J. [University of Calgary, Calgary (Canada)

    2004-03-15

    Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe.

  12. [The whole world in a cup of coffee. Case reports].

    Science.gov (United States)

    De Fiore, Luca

    2009-01-01

    There is a rising interest for clinical cases in medicine. Actually, they don't necessarily conflict with the evidence-based medicine approach; rather, as several authors made clear, EBM-oriented case reports and clinical trials could be complementary. Cases and case series could even represent the first line of evidence and they are extremely valuable in discovering new pathologies and monitoring unexpected drug effects. They also play a relevant role in continuing medical education. The new section of Recenti Progressi in Medicina is edited by a prominent Italian research Institute (Istituto di Fisiologia Clinica, CNR). It focuses on a single case, guiding the physicians' decision-making from differential diagnosis to the treatment options.

  13. A combined prosthodontic and orthodontic treatment approach in a case of growth inhibition induced by dental implants: a case report.

    Science.gov (United States)

    Krieger, Elena; Wegener, Joachim; Wagner, Wilfried; Hornikel, Sandra; Wehrbein, Heinrich

    2012-01-01

    Functional and esthetic results can improve significantly when a combined prosthodontic-orthodontic treatment approach is employed in cases requiring extensive oral rehabilitation. The patient presented in this case report was treated in his late teens with dental implants as a replacement for his maxillary incisors. Ten years later, the entire maxillary anterior segment was in infraocclusion compared to the rest of the dentition and lip line. Since prosthodontic follow-up treatment alone could not achieve an optimal functional and esthetic outcome, the patient was treated orthodontically prior to renewing the restoration. A fixed appliance was used to intrude the mandibular anterior teeth as well as vertically align the infrapositioned maxillary lateral incisors.

  14. A Case of a Contraband Body Packer Requiring High-Dose Naloxone

    Directory of Open Access Journals (Sweden)

    Khusro Shamim

    2017-09-01

    Full Text Available Background:Body packers occasionally refer to the Emergency Department (ED, after leakage of package contents within intestinal lumen, resulting in life-threatening toxicities, depending upon the nature of the chemical product. Case Presentation: We present a case report of a patient presented with sudden onset of drowsiness while he was on board a flight. He was brought in by the airport security staff. On arrival to the ED, his Glasgow Coma Scale (GCS was 3/15 and pupils were pinpoint bilaterally. He was empirically treated with Naloxone on clinical suspicion of narcotic overdose. He required a cumulative dose of 12 mg of Naloxone for reversal of respiratory depression and coma. On subsequent investigation in the ED, he was identified to be a body packer. Discussion: This case represents a rare clinical example of narcotic overdose which resulted in a life-threatening opioid toxicity due to leakage of the package contents into his bowels. In this case, a dosage greater than 10 mg of the maximum recommended dose of Naloxone is required for reversal of toxicity. Conclusion:It is imperative to have a high level of suspicion for managing possible opioid intoxication as immediate treatment can be diagnostic and lifesaving. Our case required more than the recommended dosage of Naloxone, highlighting the possible suggestion of further studies to look into the maximum threshold of this reversal agent.

  15. Craniopharyngioma in the Temporal Lobe: A Case Report

    Science.gov (United States)

    Baik, Seung Kug; Kim, Sang-Pyo; Kim, Il-Man; Sevick, Robert J.

    2004-01-01

    Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed a cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe. PMID:15064562

  16. A case of peeling

    DEFF Research Database (Denmark)

    Nielsen, Anders

    2016-01-01

    Peeling of paint and plaster from building facades is a well-known phenomenon. This contribution analyses a case of peeling on a villa and its gardens walls, Figure 1. The walls were levelled with cement plaster, before painted with a formally very dense acrylic paint. - The analysis shows...... that the present layer of acryl paint is not very dense because it is applied on a rough plaster surface. - However, the main reason of the peeling seems to be the difference in thermal expansion between the masonry and the cement plaster. It is shown that the peeling takes place both winter and summer....

  17. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam Zuid-Oost (Netherlands); Bilo, Rob A.C. [Netherlands Forensic Institute, Department of Forensic Pathology, Amsterdam (Netherlands); Robben, Simon G.F. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands)

    2009-01-15

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  18. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    International Nuclear Information System (INIS)

    Rijn, Rick R. van; Bilo, Rob A.C.; Robben, Simon G.F.

    2009-01-01

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  19. Intraocular gnathostomiasis: report of a case and review of literature.

    Science.gov (United States)

    Pillai, Gopal S; Kumar, Anil; Radhakrishnan, Natasha; Maniyelil, Jayasree; Shafi, Tufela; Dinesh, Kavitha R; Karim, Shamsul

    2012-04-01

    Intraocular gnathostomiasis is a rare parasitic infection caused by the third-stage larvae of spiruroid nematode Gnanthostoma spp. seen mostly in tropical and subtropical regions. It is a food-borne zoonosis caused by ingestion of raw or undercooked freshwater fish, amphibians, reptiles, birds, and mammals, all of which are known to harbor advanced third-stage larvae of Gnanthostoma spp. To date, 74 cases of intraocular gnathostomiasis have been reported from 12 different countries. Only four countries have reported more than 10 cases each, and India shares the rare distinction of being one of them, with 14 cases. Surprisingly, not a single case of cutaneous gnanthostomiasis has ever been reported from India. We present one such case of intraocular gnathostomiasis in a 41-year-old male who presented with an actively motile worm attached to the iris, and we review the pertinent literature of all such cases reported from India.

  20. The 2002 Drigg post-closure safety case: implementation of a multiple factor safety case

    International Nuclear Information System (INIS)

    Lean, C.B.; Grimwood, P.D.; Watts, L.; Fowler, L.; Thomson, G.; Kelly, E.; Hodgkinson, D.

    2004-01-01

    British Nuclear Fuels plc (BNFL) owns and operates the Drigg disposal site, which is the UK's principal facility for the disposal of low level radioactive waste (LLW). Disposals are carried out under the terms of an authorization granted by the UK Environment Agency (the Agency). The Agency periodically reviews the authorization to take account of new information and any revisions to regulatory requirements. In September 2002 new Operational Environmental and Post-Closure Safety Cases (OESC and PCSC respectively) were submitted to the Agency to support the next authorization review. The OESC assesses radiological safety aspects up until closure of the site, including a post-operational management phase, whilst the PCSC considers the longer-term radiological safety. The Drigg disposal facility has been operational since 1959. For the first 3 decades of operations, disposals were solely by tumble tipping wastes into excavated trenches. This was phased out in favour of vault disposal and disposals to the trenches were completed in 1995. The first vault (Vault 8) commenced operations in 1988 and construction of future vaults is planned up to the estimated end of disposal operations in about 50 years time. This paper describes the main components of the 2002 Drigg PCSC and how they relate to each other. Central to the safety case is a systematic comprehensive post-closure radiological safety assessment (PCRSA). However, the importance of the more qualitative aspects of the safety case, including a demonstration of optimisation, is also highlighted. In addition, other confidence-building activities which are key to developing and presenting the safety case are discussed. (author)