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Clinics and Practice

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https://www.readbyqxmd.com/read/28176976/the-importance-of-surgery-as-part-of-multimodal-therapy-in-rapid-progressive-primary-extraosseous-ewing-sarcoma-of-the-cervical-intra-and-epidural-space
#1
Richard Bostelmann, Mario Leimert, Hans Jakob Steiger, Kristin Gierga, Athanasios K Petridis
Primary extraosseous Ewing sarcomas (EESs) are an extremely rare pathological entity. Less than 32 cases have been reported in the literature. Here we report an uncommon case with very rapid progression in the cervical region with extra- and intradural involvement. We present a thorough review of the literature and discuss possible treatment modalities. The Medline database was searched using the search terms: Ewing sarcoma, extraosseus tumour, treatment, management, cervical spine. A previously healthy 29-year-old man complained of right-sided radiculopathy (C7)...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28176971/compound-dorsal-dislocation-of-lunate-with-trapezoid-fracture
#2
Bong-Sung Kim, Gerrit Grieb, Patrick Rhodius, Arne H Böcker, Jan-Philipp Stromps, Nils Andreas Krämer, Norbert Pallua
We report about a dorsal dislocation of the lunate accompanied by a trapezoid fracture in a 41-year old male patient after a motorcycle accident. The lunate dislocation with no dorsal or volar intercalated segment instability (DISI, VISI) was diagnosed by x-ray whereas the trapezoid fracture was only diagnosable by computed tomography. A closed reduction and internal fixation of the lunate by two Kirschner wires was performed, the trapezoid fracture was conservatively treated. Surgery was followed by immobilization, intense physiotherapy and close follow-up...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28176962/renal-angiomyolipoma-in-pregnancy-surgical-management-with-fetal-preservation-approach-in-a-developing-setting
#3
Fred O Ugwumba, Emeka F Nnakenyi, Okechukwu C Okafor, Augustine C Onuh, Paschalina C Ezechukwu, Sunday Urube
Renal angiomyolipomas (RAML) are uncommon benign renal tumours that are associated with a tendency to rupture resulting in sometimes-torrential retroperitoneal hemorrhage as the Wunderlich syndrome or as severe potentially exsanguinating hematuria. When hemorrhage from RAML occurs in pregnancy it presents a unique challenge requiring timely and appropriately adapted intervention with the goal of preventing fatality, preserving renal function as well as preventing fetal loss if possible. We report the management of severe bleeding from RAML in pregnancy and highlight the need to adopt a management strategy that suits the practice environment and offers the patient standard and enduring care...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28174622/mesiodens-within-the-nasopalatine-canal-an-exceptional-entity
#4
Georges Aoun, Ibrahim Nasseh
A supernumerary tooth is one that is supplementary to the normal dentition. It can be found anywhere at the dental arch. A mesiodens is a supernumerary tooth located between the two maxillary central incisors usually palatally or within the alveolar process. Less frequently, the mesiodens is in relation with the nasal floor and the nasopalatine canal walls. This paper presents a very rare case of an impacted inverted mesiodens located inside the nasopalatine canal and found incidentally with a cone-beam computed tomography examination...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28174621/pediatric-endobronchial-inflammatory-myofibroblastic-tumor-a-case-report-and-review-of-the-literature
#5
Leilei Liu, Xianglei Kong, Xiaoqian Lu, Dianbo Cao
Inflammatory myofibroblastic tumor (IMT) belongs to the group of soft tissue tumor and could occur at any anatomical site from the central nervous system to gastrointestinal tract. The lung and abdomen are commonly affected sites, however, pulmonary IMT is predominantly located within the parenchyma rather than presenting as endobronchial lesion. IMTs may occur in any age group, but they are observed most commonly in children and adolescents. Here, we present a case of IMT arising from the left main stem bronchus in a 10-year-old girl...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28028432/rhabdomyolysis-and-autoimmune-variant-stiff-person-syndrome
#6
Shreyas Gangadhara, Suhas Gangadhara, Chetan Gandhy, Derrick Robertson
Stiff-person syndrome (SPS) is a rare neurologic disorder characterized by waxing and waning muscular rigidity, stiffness and spasms. Three subtypes have been described: paraneoplastic, autoimmune and idiopathic. Rhabdomyolysis has been described in the paraneoplastic variant, but to our knowledge no case has been reported involving the autoimmune variant. We report a case report of a 50-year-old man with history of SPS who presented with recurrent episodes of severe limb and back spasms. He was hospitalized on two separate occasions for uncontrollable spasms associated with renal failure and creatinine phosphokinase elevations of 55,000 and 22,000 U/L respectively...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28028431/oncocytic-pleomorphic-adenoma-of-palatal-salivary-gland-with-macrophages-and-giant-cells-associated-with-cholesterol-crystals
#7
Gargi S Sarode, Sachin C Sarode, Shankargouda Patil, Sukumaran Anil
Pleomorphic adenoma (PA) is the most common salivary gland tumor characterized by histo-morphological diversity in the form of myxoid, hyalinized, chondroid, osseous, and squamous areas. In this paper, we report a rare case of predominantly oncocytic variant of PA in a 45-year-old male patient on the posterior palatal region. Microscopic examination showed homogenous eosinophilic cellular mass composed of epithelial components arranged in the form of tubular and solid patterns. The polygonal and oval cells showed abundant dark eosinophilic granular cytoplasm...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28028430/a-child-with-debilitating-pruritus
#8
Nikhil Sonthalia, Samit S Jain, Vinay B Pawar, Vinay G Zanwar, Ravindra G Surude, Pravin M Rathi, Kshitij K Munde, Sandeep Bavdekar
We describe a case of two-year-old boy presenting with debilitating pruritus, patchy alopecia and jaundice since the age of 6 months. On evaluation he had intrahepatic cholestasis with persistently raised serum alkaline phosphatase, normal Gamma glutamyl transferase and raised serum bile acid levels. His liver biopsy showed bland cholestasis and electron microscopy showed granular bile suggestive of progressive familial intrahepatic cholestasis type I. Medical therapy with ursodeoxycholic acid, cholestyramine, rifampicin with nutritional modification was successful in alleviating the symptoms and correcting the nutritional status...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/28028429/gastric-schwannoma-a-case-report
#9
Hayfa Romdhane, Myriam Cheikh, Zeineb Mzoughi, Sana Ben Slama, Rym Ennaifer, Najet Belhadj
Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis via endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27994842/diode-laser-versus-scalpel-in-the-treatment-of-hereditary-gingival-fibromatosis-in-a-6-year-old-boy
#10
Samia Aboujaoude, Antoine Cassia, Carla Moukarzel
Hereditary gingival fibromatosis (HGF) is a rare disease characterized by a benign enlargement of the gingiva involving both the mandible and the maxilla. This case is about a 6-year-old child with non syndromic HGF showing a severe gingival enlargement covering almost all surfaces of the teeth, in both arches, hence causing major aesthetic, phonetic and masticatory problems. The aim of the present article is to compare the outcomes of two therapeutical approaches: i) classical surgical removal with scalpel; and ii) diode laser resection...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27994841/do-all-critical-aortic-stenosis-with-chest-pain-need-aortic-valve-replacement-a-case-report
#11
Munish Sharma, Daniel A N Mascarenhas
Aortic valve replacement (AVR) remains the cornerstone of treatment for symptomatic critical aortic stenosis (AS). It is a Class I indication that symptomatic patients with critical AS undergo either surgical or transcatheter aortic valve replacement (TAVR). We present a patient with critical AS and new angina that was managed successfully with percutaneous coronary intervention (PCI) of the Right coronary artery. Physicians should consider that not all patients with critical AS and angina necessarily require AVR...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27994840/intraspinal-lumbar-juxtaarticular-cyst-treatment-through-ct-guided-percutaneus-induced-rupture-results-in-a-favorable-patient-outcome
#12
Adisa Kursumovic, Richard Bostelmann, Maria Gollwitzer, Stefan Rath, Hans Jakob Steiger, Athanasios K Petridis
Juxta-articular cysts are synovial cysts originating from the facet joints or the flava ligaments. If they grow intra-spinally they can compress nervous structures and cause a variety of symptoms. Micro-neurosurgery is usually the treatment of choice. Alternatively to surgical treatment the cyst can be approached and treated with a CT guided percutaneous injection inducing rupture. After fulfilling strict selection criteria twenty patients (25% of all treated lumbar synovial cyst patients), were treated minimally invasive by this method from 2010-2016...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777715/bifid-mandibular-canal-a-rare-or-underestimated-entity
#13
Ibrahim Nasseh, Georges Aoun
One of the rare anatomical variations that can be of significant importance for the dentist is the bifid mandibular canal. Many complications can occur from this condition such as failure of anesthesia when performing inferior alveolar nerve block, difficulties during the surgical extraction of the third mandibular molar, and during implants placement. Therefore, good knowledge of this condition is essential. In this report, we describe the radiographic finding of a unilateral bifid mandibular canal.
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777714/giant-adrenal-cavernous-hemangioma-in-a-patient-with-familial-adenomatous-polyposis
#14
Dhouha Bacha, Abir Chaabane, Fatma Khanche, Saloua Néchi, Hassen Touinsi, Emna Chelbi
Adrenal hemangioma is an uncommon benign vascular tumor that is often discovered incidentally. It has never been reported in association with familial adenomatous polyposis. We report a case of a 60-year old man with a history of familial adenomatous polyposis, in whom a huge retroperitoneal cyst of 18x17 cm was discovered during routine radiologic evaluation. Because of the impossibility of ruling out the presence of malignancy, surgical cystectomy was performed, associated to a scheduled total colectomy. Pathological examination revealed that the cyst corresponded to an adrenal cavernous hemangioma...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777713/medication-error-when-switching-from-warfarin-to-rivaroxaban-leading-to-spontaneous-large-ecchymosis-of-the-abdominal-and-chest-wall
#15
Flavio Egger, Federica Targa, Ivan Unterholzner, Russell P Grant, Markus Herrmann, Christian J Wiedermann
Non-vitamin K oral anticoagulant (NOAC) therapy may be inappropriate if prescription was incorrect, the patient's physiological parameters change, or interacting concomitant medications are erroneously added. The aim of this report was to illustrate inappropriate NOAC prescription in a 78-year-old woman with non-valvular atrial fibrillation and borderline renal dysfunction who was switched from warfarin to rivaroxaban and subsequently developed bruising with hemorrhagic shock and acute on chronic renal failure...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777712/midterm-results-of-consecutive-periprosthetic-femoral-fractures-vancouver-type-a-and-b
#16
Klemens Trieb, Rainer Fiala, Christian Briglauer
Surgical treatment of periprosthetic femoral fractures has a high complication and mortality rate of more than 10%. The aim of this study is to report the outcome of a consecutive single center patient group. Thirty-four consecutive patients (mean age 81.2+/-8.5 years, 14 male, 20 female) with a periprosthetic femoral fracture Vancouver type A (n=5) or type B (n=29) were followed-up after 43.2 months, none of the patients were lost to follow-up. Nineteen of the patients were treated through change of the stem and cerclage fixation, five by plates and ten by cerclage cables...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777711/cocaine-use-and-splenic-rupture-a-rare-yet-serious-association
#17
Nishrutha Karthik, Karthik Gnanapandithan
Cocaine abuse is frequent in patients visiting the emergency department. The knowledge of the cardiovascular complications of cocaine is excellent among physicians. However the awareness regarding its abdominal complications, the most important of which include gastroduodenal perforation, bowel ischemia and splenic rupture is less adequate. We report a 58-year-old with cocaine use who presents with upper abdominal pain and a rapidly worsening clinical status. He was found to have atraumatic splenic rupture causing a hemoperitoneum that was managed by intervention radiology guided splenic artery embolization...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777710/oromandibular-dystonia-a-case-report-of-the-lateral-pterygoid-muscle-involvement-and-treatment-with-botulinum-toxin-a
#18
Athanasia Alexoudi, Zoi Dalivigka, Anna Siatouni, Anastasia Verentzioti, Stylianos Gatzonis
The objective of the present case report is to punctuate the importance of individualized therapy procedures and the accurate diagnosis of the muscles involved in oromandibular dystonia and underline the role of electromyography (EMG). We report a woman who presented sustained jaw movement towards the left, severe difficulty in jaw opening and jaw protrusion. The patient was treated with injections of botulinum A toxin in lateral pterygoid, masseter, platysma, sternoclidomastoid, temporalis muscles with EMG guidance...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777709/genetic-counseling-for-a-prenatal-diagnosis-of-structural-chromosomal-abnormality-with-high-resolution-analysis-using-a-single-nucleotide-polymorphism-microarray
#19
Akiko Takashima, Naoki Takeshita, Toshihiko Kinoshita
A 41-year old pregnant woman underwent amniocentesis to conduct a conventional karyotyping analysis; the analysis reported an abnormal karyotype: 46, XY, add(9)(p24). Chromosomal microarray analysis (CMA) is utilized in prenatal diagnoses. A single nucleotide polymorphism microarray revealed a male fetus with balanced chromosomal translocations on 9p and balanced chromosomal rearrangements, but another chromosomal abnormality was detected. The fetus had microduplication. The child was born as a phenotypically normal male...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27777708/persistent-hyperinsulinism-in-kabuki-syndrome-2-case-report-and-literature-review
#20
Hobia Gole, Raymond Chuk, David Coman
Kabuki syndrome is a clinically and genetically heterogeneous congenital malformation syndrome with protean clinical manifestations. This reflects the important epigenetic role in embryonic development of the two genes currently known to be associated with Kabuki syndrome i.e., KMT2D and KDM6A, which are responsible for Kabuki syndrome 1 and Kabuki syndrome 2, respectively. Hypoglycemia is thought to be a rare manifestation of Kabuki syndrome; however it may be under diagnosed. Herein we describe the case of a 5-year-old girl with Kabuki syndrome 2 in whom persistent hyperinsulinism was diagnosed at 4 years of age...
August 8, 2016: Clinics and Practice
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