|
| ||
|
|
||
Case Presentation (case + presentation)
Selected AbstractsFibrosing TB Mediastinitis Presenting as a Superior Vena Cava Syndrome: A Case Presentation and Echocardiogram CorrelateECHOCARDIOGRAPHY, Issue 7 2006Lidiette Esquivel M.D. A 49-year-old woman developed a chronic obstruction of the superior vena cava (SVC) as a complication of mediastinal tuberculosis. Echocardiography findings are presented along with the cavography. Symptoms disappeared after stenting the fibrosed SVC. Transesophageal echocardiogram findings led to the condition's final resolution. [source] Angiosarcoma developing in a non-functioning arteriovenous fistula post-renal transplantJOURNAL OF SURGICAL ONCOLOGY, Issue 6 2010Yassar A. Qureshi MBBS Abstract Background Angiosarcomas comprise less than 1% of all sarcomas, arising from endothelial cells of blood or lymph vessels. Chronic immunosuppression increases the risk of many malignancies and an association between the development of angiosarcoma with an immunosuppressed state is established. A few cases have been reported of angiosarcomas arising in the post-renal transplant patient. Specifically, there have been six cases of an angiosarcoma arising in arteriovenous (AV) fistulae in this patient population. We describe a further case and review the relevant literature with specific emphasis on a possible mechanism for the development of angiosarcoma in the post-transplant patient. Case Presentation We report the case of a 48-year-old male who developed an angiosarcoma in a ligated native AV fistula. The lesion arose on the background of immunosuppression following a successful ABO-incompatible renal transplant for chronic renal failure. Conclusion Angiosarcomas are extremely rare tumours but should be considered as a differential diagnosis for an evolving mass near the site of an AV fistula. Diagnosis relies on an index of suspicion and obtaining a definitive histological diagnosis. Both clinicians and patients should be aware that an evolving mass within or around an AV fistula should prompt urgent biopsy. J. Surg. Oncol. 2010; 101:520,523. © 2010 Wiley-Liss, Inc. [source] ,Sick', irritable infant with fever, vomiting, bloody stool and abdominal distention (Case Presentation)ACTA PAEDIATRICA, Issue 9 2010Larisa Epov No abstract is available for this article. [source] Learning difficulties as late sequel of neonatal insult (Case Presentation)ACTA PAEDIATRICA, Issue 9 2010Anna López Sala No abstract is available for this article. [source] Cardiogenic shock after judo (Case Presentation)ACTA PAEDIATRICA, Issue 6 2010H De Wilde No abstract is available for this article. [source] A case of a prolonged quest for the diagnosis of recurrent abdominal pain (Case Presentation)ACTA PAEDIATRICA, Issue 6 2010Gösta Alfvén No abstract is available for this article. [source] A floppy neonate with respiratory failure and burst suppression EEG (Case Presentation)ACTA PAEDIATRICA, Issue 3 2010S Meyer No abstract is available for this article. [source] A girl with a purpuric rash (Case Presentation)ACTA PAEDIATRICA, Issue 3 2010PM Meyer No abstract is available for this article. [source] Vesicular eruption located on sunburned areas in an 8-year-old girl (Case Presentation)ACTA PAEDIATRICA, Issue 11 2009L Zoller No abstract is available for this article. [source] Social impairment due to extreme photophobia (Case Presentation)ACTA PAEDIATRICA, Issue 11 2009TL Sřrensen No abstract is available for this article. [source] Unusual aetiology for supraumbilical abdominal pain in school-age patient (Case Presentation)ACTA PAEDIATRICA, Issue 10 2009AK Saxena No abstract is available for this article. [source] Chest pain in a 15-year-old girl (Case Presentation)ACTA PAEDIATRICA, Issue 10 2009B Heinzl No abstract is available for this article. [source] Infant with tender oedema and purpuric lesions (Case Presentation)ACTA PAEDIATRICA, Issue 9 2009SH Chaudhry No abstract is available for this article. [source] Acute abdomen: always a puzzle (Case Presentation)ACTA PAEDIATRICA, Issue 9 2009G Vaos No abstract is available for this article. [source] Life-threatening hypokalemia in an infant (Case Presentation)ACTA PAEDIATRICA, Issue 8 2009Elpis Mantadakis First page of article [source] A child with syncope (Case Presentation)ACTA PAEDIATRICA, Issue 8 2009Martial M Massin No abstract is available for this article. [source] A case of fulminant septic shock with a rare gram-negative organism (Case Presentation)ACTA PAEDIATRICA, Issue 7 2009Rusheng Chew No abstract is available for this article. [source] A rare cause of jaundice in a newborn not predicted by maternal blood typing (Case Presentation)ACTA PAEDIATRICA, Issue 7 2009Emel Okulu No abstract is available for this article. [source] Malignant stroke in a female adolescent (Case Presentation)ACTA PAEDIATRICA, Issue 6 2009Klaus Pfurtscheller No abstract is available for this article. [source] A diagnosis hard to catch (Case Presentation)ACTA PAEDIATRICA, Issue 6 2009D Gustafsson No abstract is available for this article. [source] Sacral dimple: incidental findings from newborn evaluation (Case Presentation)ACTA PAEDIATRICA, Issue 5 2009Amiko Ohashi No abstract is available for this article. [source] Pancytopenia in a 4-year-old boy (Case Presentation)ACTA PAEDIATRICA, Issue 5 2009Kai Lehmberg No abstract is available for this article. [source] Severe generalized oedema with haemodynamic instability in a previously healthy patient Case Presentation)ACTA PAEDIATRICA, Issue 3 2009I Marín-Valencia No abstract is available for this article. [source] Case 1: An infant with heart failure (Case Presentation)ACTA PAEDIATRICA, Issue 1 2009Giovanni Battista Ferrero No abstract is available for this article. [source] Case 2: A 6-year-old boy with precocious puberty (Case Presentation)ACTA PAEDIATRICA, Issue 1 2009MAC Mattheij No abstract is available for this article. [source] Assessment of Teacher Interruptions on Learners during Oral Case PresentationsACADEMIC EMERGENCY MEDICINE, Issue 6 2007Glen Yang BA Background:Studies have only recently begun to investigate the effects of interruptions on physicians in the emergency department (ED). Objectives:To determine the frequency and nature of interruptions by the training physician that occur when medical trainees do oral case presentations (OCPs) in the ED. Methods:This was an observational study. Learner OCPs to attending emergency physicians were observed in the ED of an urban Level 1 trauma center at a major teaching hospital. A single investigator followed attending physicians blinded to the study objective in a nonrandomized convenience sampling of all ED shifts, recording information regarding teacher interruptions during new patient presentations. Learners completed a brief questionnaire after each OCP. Results:A total of 196 OCPs were observed. The mean (±SD) duration of OCPs was 3.30 (±1.85) minutes, and the mean (±SD) number of interruptions was 0.75 (±0.60) per minute and 2.49 (±1.95) per OCP. The number of interruptions (per OCP) and duration of OCP varied by learner level of training, with more experienced learners giving shorter presentations and being interrupted less often. Frequency (per minute) of interruptions did not vary by learner level. In 40.3% of OCPs, attending physicians interrupted to give an assessment and/or a plan before the learner had done so, but 8.3% of interrupted learners believed that teacher interruptions were "disruptive" to their OCP. Conclusions:Attending emergency physicians frequently interrupt learners during new patient OCPs, with the number of interruptions varying by learner level of training. Teacher interruptions appear to have minimal, if any, detrimental effect on the perceived effectiveness of OCPs as a learning experience. [source] Cancer risk from diagnostic radiology in a deliberate self-harm patientACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010L. J. Norelli Norelli LJ, Coates AD, Kovasznay BM. Cancer risk from diagnostic radiology in a deliberate self-harm patient. Objective:, Patients who engage in recurrent deliberate self-harm (DSH) behaviours have increased morbidity and mortality and use emergency services more than others. Unrecognized iatrogenic injury may play a role. Specifically, we call attention to the potential danger of cumulative radiation exposure. Method:, Case presentation and discussion. Results:, A 29-year-old woman with multiple episodes of deliberate foreign body ingestion received over 400 diagnostic radiology examinations during a 12 year period. The patient's calculated total radiation dose reached an average of 20.5 mSv per year, a dose comparable to atomic bomb survivors and nuclear industry workers, populations in which there is a significant excess cancer risk. Conclusion:, Patients with recurrent self-injurious behaviours, frequent users of healthcare services who often undergo repeated medical assessment and treatment, are likely at higher risk for iatrogenic adverse events. Multiple diagnostic radiology examinations have recently come under scrutiny for causing increased lifetime risk of cancer. Healthcare providers, in particular psychiatrists and emergency department physicians, should consider the cumulative risks of radiological procedures when assessing and treating patients with DSH. [source] Mohs Micrographic Surgery as an Alternative Treatment Method for Cutaneous MucormycosisDERMATOLOGIC SURGERY, Issue 8 2003F. Landon Clark BS Background. Mucormycosis is an invasive fungal disease that most commonly occurs in immunocompromised patients. Early angioinvasion and dissemination can lead to the rapid demise of the patient. The growing number of organ transplant patients on pharmacologic immunosuppression has increased the risk for this opportunistic mycosis. Traditional therapy has included aggressive debridement and resection as well as antifungal medications. Objective. To demonstrate that the margin control and tissue-sparing technique of Mohs micrographic surgery can effectively eradicate mucormycosis infection and decrease morbidity. Methods. Case presentation of a 64-year-old transplant patient presenting with biopsy-proven cutaneous mucormycosis treated with Mohs micrographic surgery. Margin control was confirmed by a rapid Gomori methenamine silver stain. Results. There has been no recurrence at 1-year follow-up with full preservation of extremity function. Conclusion. The use of the Mohs technique combined with rapid Gomori methenamine silver staining for mucormycosis can be an effective tissue-sparing method for local control of this fungal infection. Mohs micrographic surgery should be considered for the cutaneous manifestations of mucormycosis. [source] A patient with TSC1 germline mutation whose clinical phenotype was limited to lymphangioleiomyomatosisJOURNAL OF INTERNAL MEDICINE, Issue 2 2004T. Sato Abstract. Background:, Lymphangioleiomyomatosis (LAM) can occur as in isolated form (sporadic LAM) or as a pulmonary manifestation of tuberous sclerosis complex (TSC) (TSC-associated LAM). Recent studies, however, revealed that both forms of LAM are genetically related but that sporadic LAM is a distinct clinical entity caused by somatic mutations of TSC2 (not TSC1) rather than a forme fruste of TSC carrying either of the TSC1 or TSC2 germline mutations. Method:, Case presentation and in-depth molecular and histopathological examinations. A 34-year-old Japanese woman was diagnosed as having pulmonary lymphangioleiomyomatosis (LAM) when bilateral pneumothoraces were surgically treated in 1992. Although slowly progressive renal disfunction was observed due to bilateral multiple renal cysts during the past 4 years, she had no other clinical features of TSC and was diagnosed as having sporadic LAM with multiple renal cysts of undetermined aetiology. Her subsequent clinical course was complicated by an endobrochial carcinoid tumour, which eventually resulted in her death in June 1999 due to massive haemoptysis. Results:, Postmortem examination revealed the presence of LAM lesions in the lungs, mediastinal lymph nodes, kidneys and uterus. Diffuse renal LAM lesions are presumed to generate multiple renal cysts by constricting the nephron rather than epithelial hyperplasia obstructing lumina, which is analysis of the TSC genes demonstrated that she did not have TSC2/PKD1 contiguous gene syndrome but had a TSC1 germline mutation (Sato T et al. J Hum Genet 2002; 47: 20,8) that had occured de novo. Conclusion:, This patient therefore illustrates that clinical manifestations of TSC are sufficiently diverse as to allow a forme fruste of TSC that mimics sporadic LAM and that TSC1 mutation can cause multiple renal cysts resulting in renal failure. [source] Synchronous reconstruction of the floor of mouth and chin with a single skin island fibular free flapMICROSURGERY, Issue 4 2008F.A.C.S., Richard O. Wein M.D. Objectives: The goal this presentation is to: 1) Review the reconstructive options for anterior mandible through-and-through composite defects and 2) Instruct the audience in the application of the double-skin paddle fibular flap in selected patients. Methods: Case presentation with review of the literature. Results: A 70-year old male with an anterior floor of mouth squamous cell carcinoma underwent composite resection that included resection of a 5-cm ovoid component of overlying chin skin. The defect was reconstructed with a fibular osteocutaneous flap with a double skin paddle technique. Conclusions: Several reconstructive options have been described in the literature for extended oral cavity defects including the use of multiple free flaps, combinations of regional and distant flaps, and sequential reconstruction. This case report reviews the use of a single flap reconstruction of these defects for selected patients. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source] | |||||||||||||