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Clinics and Practice

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https://www.readbyqxmd.com/read/27777715/bifid-mandibular-canal-a-rare-or-underestimated-entity
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27777707/multiple-esophageal-foreign-bodies-in-an-infant-a-rare-case-of-serious-parental-neglect
#9
Arunabha Chakravarti, Sunil Garg, Rahul Bhargava
A case of multiple esophageal foreign bodies, which were retrieved successfully by rigid esophagoscopy in a 1-year old child is being reported. There are few cases of multiple esophageal foreign bodies in children reported in the literature; this case was unique in presentation as there was no history of foreign body ingestion. This case also highlights the serious neglect present in our society towards children of lower socio-economic strata despite this child being the 1st child in the family.
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478586/ultrasound-guided-greater-auricular-nerve-block-as-sole-anesthetic-for-ear-surgery
#10
Michael K Ritchie, Colin A Wilson, Brian W Grose, Pavithra Ranganathan, Stephen M Howell, Matthew B Ellison
A greater auricular nerve (GAN) block was used as the sole anesthetic for facial surgery in an 80-year-old male patient with multiple comorbidities which would have made general anesthesia challenging. The GAN provides sensation to the ear, mastoid process, parotid gland, and angle of the mandible. In addition to anesthesia for operating room surgery, the GAN block can be used for outpatient or emergency department procedures without the need for a separate anesthesia team. Although this nerve block has been performed using landmark-based techniques, the ultrasound-guided version offers several potential advantages...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478585/further-effort-is-needed-to-improve-management-of-chronic-pain-in-primary-care-results-from-the-arkys-project
#11
Gaetano Piccinocchi, Roberto Piccinocchi
Treatment of chronic pain is challenging. The Arkys project was initiated in Italy to assist general practitioners (GPs) in the management of chronic pain. The main objective of this study was to determine the usefulness of Arkys for selecting new therapeutic strategies. An online interactive questionnaire for assessing pain and guiding therapeutic decisions was made available to GPs participating to Arkys. The GPs were invited to complete the questionnaire for each patient who presented moderate-severe chronic pain, and to decide on a new analgesic treatment based on the information provided by the questionnaire...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478584/metastatic-clear-cell-renal-cell-carcinoma-presenting-with-a-gingival-metastasis
#12
Rusha A E Ali, Kamal E H Mohamed
Metastatic deposits to the oral cavity are exceptionally rare. The commonest tumor types metastasizing to the oral cavity include lung and breast carcinoma. Renal cell carcinoma is believed to be the third most common infra clavicular tumor to metastasize to the head and neck. We report a case where an oral cavity deposit was the initial presentation for an occult clear cell renal carcinoma. Additional therapeutic options, including immunotherapy, tyrosine kinase inhibitors, and participation in a clinical trial, should be discussed with the patient despite the poor overall prognosis...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478583/huge-aneurysm-of-the-proper-hepatic-artery
#13
Mohamed Amine Attaoui, Rached Bayar, Zeineb Mzoughi, Sahir Omrani, Lassaad Gharbi, Mohamed Taher Khalfallah
Hepatic artery aneurysms are rarely diagnosed. It is mainly because of non specific symptoms. They are generally an incidental findings during imaging studies. They are usually detected in the sixth decade, predominantly in men. We report herein a case of an 80 year-old man with a huge hepatic artery aneurysm revealed by abdominal pain and chronic anemia. It was treated by embolisation. Hepatic artery aneurysms are second among visceral aneurysms. They may cause abdominal pain, jaundice and hemorrhagic events...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478582/a-rare-association-of-hepatitis-a-virus-infection-with-type-1-diabetes
#14
Mohammed Hasosah, Alaa Bokhari, Ashraf Alsahafi, Ghassan Sukkar, Abdullah Alzaben
Patients with type-1 diabetes are predisposed to develop a spectrum of liver diseases, which includes fatty liver, steatohepatitis and cirrhosis. The association of hepatitis A infection with type-1 diabetes is extremely rare. To the best of our knowledge, our case is the first case report in children. We described a nine year-old girl who had type-1 diabetes and developed hepatitis A virus infection without complications. A review of the literature is also provided.
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478581/exercise-triggered-chest-pain-as-an-isolated-symptom-of-myocarditis-in-children
#15
Prisca Tshimanga, Benoît Daron, Nesrine Farhat, Brigitte Desprechins, Marc Gewillig, Marie-Christine Seghaye
In childhood, chest pain occurring at exercise is a common complaint. A cardiac etiology for it is exceptionally found, explaining that most children do not undergo systematic cardiological investigation. However, chest pain at exercise may manifest as the unique symptom of a viral myocarditis. Recognizing this form of myocardial injury, however, might help to avoid clinical deterioration by providing adequate care. In this paper, we report on two children presenting with the unique clinical symptom of chest pain related to physical activity and in whom laboratory and cardiac investigations suggested transient myocardial damage related to myocarditis...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478580/acute-severe-cryptosporidiosis-in-an-immunocompetent-pediatric-patient
#16
Caitlin Tallant, Patrick Huddleston, Asim Alshanberi, Subhasis Misra
Severe diarrheal illness in children can be attributed to a number of different microbiological agents. Without appropriate microbiological testing of stool samples, patients who present with multiple days of severe diarrhea might have a delay in proper diagnosis and treatment. Here, we report a case of an immunocompetent pediatric patient presenting with acute cryptosporidiosis. Humans and bovine species are known hosts of cryptosporidium and several studies have evaluated the zoonotic transmission of cryptosporidium from cattle to humans...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478579/transient-superficial-peroneal-nerve-palsy-after-anterior-cruciate-ligament-reconstruction
#17
Majed Alrowaili
A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478578/sandwich-wound-closure-reduces-the-risk-of-cerebrospinal-fluid-leaks-in-posterior-fossa-surgery
#18
Verena Heymanns, Abidemi W Oseni, Ameer Alyeldien, Homajoun Maslehaty, Richard Parvin, Martin Scholz, Athanasios K Petridis
Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27478577/triorchidism-presenting-as-undescended-testis-in-a-case-of-indirect-inguinal-hernia
#19
Ajay H Bhandarwar, Saurabh S Gandhi, Chintan B Patel, Amol N Wagh, Virendra Gawli, Nimesh A Jain
Triorchidism is the commonest variety of polyorchidism, an entity with more than two testis is an extremely rare congenital anomaly of the testis. Although excision of the abnormal testis is a safer alternative proposed, recent literature suggests more conservative approach in normal testes with watchful regular follow up to screen for malignancy. This case presented as a left inguinal swelling diagnosed as indirect left inguinal hernia. The left side testis was of smaller size (about half) with normal sperm count, morphology and motility...
April 26, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27162608/simple-partial-status-epilepticus-manifested-as-homonymous-hemianopsia-a-rare-intracranial-recording
#20
Anna Siatouni, Stylianos Gatzonis, Andreas Alexopoulos, Nikos Georgakoulias, Mathildi Papathanassiou, Stefanos Korfias, Vaso Zisimopoulou, Damianos Sakas
A 30-year-old woman with intractable seizures evaluated as surgical candidate. During presurgical evaluation an invasive electroencephalogram was recommended to define the location and extent of epileptogenic zone and relationship to epileptogenic lesion. On third monitoring night the patient complained of persistent homonymous hemianopsia following a habitual seizure. Concurrently, persistent epileptic activity was evident in a small, restricted area around the right calcarine fissure. The ictal discharges persisted for the next 30 h despite high-dose administration of intravenous antiepileptic drugs, until patient was taken to operating room...
March 25, 2016: Clinics and Practice
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