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https://www.readbyqxmd.com/read/27915446/superior-dislocation-of-the-patella-a-pathognomonic-finding-and-review-of-literature
#1
P W van Egmond, M C Vermeulen, C F van Dijke, H C A Graat
A 59-year-old woman with a painful right knee that became locked in extension after a trivial trauma was seen at the emergency room. This was caused by unloaded hyperextension in bed. She was diagnosed with a superior dislocation of the patella. A closed reduction was performed, but a recurrent episode was seen within a week. An arthroscopy was performed, in which the causative osteophytes were removed. In the 12-month follow-up after treatment, no recurrence was seen. A superior dislocation of the patella is caused by patellofemoral osteophytes that interlock...
December 3, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27915441/ovarian-metastasis-from-uveal-melanoma-with-mlh1-pms2-protein-loss-in-a-patient-with-germline-mlh1-mutated-lynch-syndrome-consequence-or-coincidence
#2
João Lobo, Carla Pinto, Micaela Freitas, Manuela Pinheiro, Rámon Vizcaino, Esther Oliva, Manuel R Teixeira, Carmen Jerónimo, Carla Bartosch
Currently, uveal melanoma is not considered within the Lynch syndrome tumor spectrum. However, there are studies suggesting a contribution of microsatellite instability in sporadic uveal melanoma tumorigenesis. We report a 45-year-old woman who was referred for genetic counseling due to a family history of Lynch syndrome caused by a MLH1 mutation. She originally underwent enucleation of the right eye secondary to a uveal spindle cell melanoma diagnosed at age 25. The tumor recurred 22 years later presenting as an ovarian metastasis and concurrently a microscopic endometrial endometrioid carcinoma, grade 1/3 was diagnosed...
December 3, 2016: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/27915039/uterine-immune-profiling-for-increasing-live-birth-rate-a-one-to-one-matched-cohort-study
#3
Nathalie Lédée, Laura Prat-Ellenberg, Lucie Chevrier, Richard Balet, Cynthia Simon, Clarisse Lenoble, Elie El Irani, Dominique Bouret, Guy Cassuto, Dominique Vitoux, Katia Vezmar, Armand Bensussan, Gérard Chaouat, Marie Petitbarat
BACKGROUND: Embryo implantation remains the main limiting factor in IVF/ICSI program. Endometrial immune remodeling events begin before implantation and are a vital process for pregnancy, preparing future maternal immune tolerance and regulating the placentation process. METHODS: Between 2012 and 2014, 193 patients (analyzed group) enrolled in our IVF program benefitted of an endometrial immune profiling to determine if their uterus was immunologically ready to accept an embryo and, if not, the specific immune mechanisms involved...
November 24, 2016: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/27915010/a-large-tumour-of-the-left-atrium-a-10-year-follow-up
#4
Agnieszka M Łebek-Szatańska, L Łebek Zbigniew, Marek J Dąbrowski, Piotr S Kardaszewicz
Benign myxomas are the most common among primary tumours in the left atrium of the heart and they usually require an urgent operative management. However, in times of constant ageing of the population and dealing with patients with severe concomitant diseases, an interesting question appears about the conservative approach. We present a case of 75-year-old woman, once diagnosed and operated on left atrium myxoma, with recurrent tumour in the site of resection found in control echocardiography 1,5 years later...
November 30, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27914889/ventricular-tachycardia-and-prolonged-qt-interval-presenting-as-seizure-like-activity-a-case-report
#5
Max Wentlandt, Stephen C Morris, Steven H Mitchell
Seizures can be difficult to distinguish from other causes of transient cerebral hypoxia in the emergency room. We present a case of seizure activity in a woman in whom EKG led to a diagnosis of intermittent monomorphic and polymorphic ventricular tachycardia (torsades de pointes), highlighting the need for careful consideration of alternative causes of seizures, even in patients with known epilepsy.
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27914313/requests-for-cesarean-deliveries-the-politics-of-labor-pain-and-pain-relief-in-shanghai-china
#6
Eileen Wang
Cesarean section rates have risen dramatically in China within the past 25 years, particularly driven by non-medical factors and maternal requests. One major reason women request cesareans is the fear of labor pain, in a country where a minority of women are given any form of pain relief during labor. Drawing upon ethnographic fieldwork and in-depth interviews with 26 postpartum women and 8 providers at a Shanghai district hospital in June and July of 2015, this article elucidates how perceptions of labor pain and the environment of pain relief constructs the cesarean on maternal request...
November 24, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27914228/osteoblastic-extraosseous-osteosarcoma-of-the-neck
#7
Andro Košec, Majda Vučić, Vladimir Bedeković, Mirko Ivkić
Extraosseous osteosarcoma as a primary tumor of the neck is exceedingly rare, with only a few cases reported to date. The most appropriate therapy is still under investigation. We report a case of an aggressive, right-sided, advanced-stage extraosseous osteosarcoma in a female patient. A 48-year-old woman presented with a right-sided infra-parotid mass encompassing neck regions II and III, measuring over 6 cm in craniocaudal diameter. She was initially treated by wide surgical resection. The definitive histopathologic diagnosis was osteoblastic extraosseous osteosarcoma...
November 16, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27914160/infectious-postpartum-sacroiliitis-the-importance-and-difficulty-of-early-diagnosis
#8
Emídio Vale-Fernandes, Fedra Rodrigues, Carla Monteiro, Luís Carvalho
The sacroiliitis accounts for about 1.5% - 10% of all cases of septic arthritis and it is strongly associated with gynaecological infections, pelvic trauma or drug abuse (3.4% - 12.8% of cases occur during the postpartum period). Early diagnosis is difficult because the symptoms are nonspecific in pregnancy and in the postpartum period, making the delay of treatment a serious risk of irreversible damage to the joint and development of post-infectious complications. The authors describe the case of a 37-year-old puerperal woman presented to hospital, weeks after urgent caesarean section, with endometritis, post-anesthetic epidural hematoma and secondary infectious postpartum sacroiliitis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914067/5q-syndrome-like-features-as-the-first-manifestation-of-myelodysplastic-syndrome-in-a-patient-with-an-unbalanced-whole-arm-translocation-der-5-19-p10-q10
#9
Hiroshi Ureshino, Haruna Kizuka, Kana Kusaba, Haruhiko Sano, Atsujiro Nishioka, Takero Shindo, Yasushi Kubota, Toshihiko Ando, Kensuke Kojima, Shinya Kimura
Derivative (5;19)(p10;q10) [der(5;19)(p10;q10)] is a rare chromosomal abnormality in myelodysplastic syndrome (MDS), and is genetically similar to deletion 5q [del(5q)]. However, MDS with der(5;19)(p10;q10) and 5q- syndrome are generally characterized as distinct subtypes. Here, we report a case of a patient with 5q- syndrome-like features as the first manifestation of MDS with der(5; 19)(p10;q10). A 59-year-old woman was admitted to our hospital for anemia without leukopenia and thrombocytopenia. She had received chemotherapy comprising carboplatin and docetaxel for endometrial cancer eight years before...
December 2, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27913914/tragedy-in-moral-case-deliberation
#10
Benita Spronk, Margreet Stolper, Guy Widdershoven
In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants...
December 2, 2016: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/27913780/multifocal-polymorphous-hemangioendothelioma-of-the-liver-case-report-and-review-of-literature
#11
Siba El Hussein, Yumna Omarzai
We report a case of polymorphous hemangioendothelioma, a rare vascular neoplasm, arising in the liver of a 51-year-old woman. Microscopically, this neoplasm is characterized by a polymorphous blend of solid, primitive vascular and angiomatous areas in variable proportions. Polymorphous hemangioendothelioma is considered to be an intermediate-grade vascular neoplasm. In most of the reported cases, its occurrence has been in lymph nodes, but a few cases have been found in extranodal sites such as the mediastinum, spinal cord, and liver...
December 2, 2016: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/27913056/the-best-of-intentions-a-structural-analysis-of-the-association-between-socioeconomic-disadvantage-and-unintended-pregnancy-in-a-sample-of-mothers-from-the-national-longitudinal-survey-of-youth-1979
#12
Akilah Wise, Arline T Geronimus, Pamela J Smock
OBJECTIVES: Births to less educated women are more likely to be classified as unintended than other births. We question a common interpretation that this association reflects a lack of contraceptive knowledge or self-efficacy among less educated women. We theorize that differences in early life educational advantages structure pregnancy desires and the salience and opportunity costs of precise fertility timing. We hypothesize that net of covariates indicative of early educational disadvantage, mothers with less education are not more likely to report births as unintended compared with mothers who have attained higher levels of education before becoming mothers...
November 29, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27913053/intestinal-metaplasia-of-appendiceal-endometriosis-is-not-uncommon-and-may-mimic-appendiceal-mucinous-neoplasm
#13
Monika Vyas, Serena Wong, Xuchen Zhang
Endometriosis of the appendix can be an incidental finding or a cause of appendicitis, intussusception, perforation or retention mucocele. Intestinal metaplasia of appendiceal endometriosis may occur, which can lead to a misdiagnosis of low-grade appendiceal mucinous neoplasm. On a retrospective search of the pathology database from 2001 to 2015, we identified 78 appendiceal endometriosis cases and intestinal metaplasia was present in 10/78 (13%) cases. In most of the cases (90%), the foci of intestinal metaplasia were mainly localized close to the mucosa...
October 25, 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27912922/agranulocytosis-occurrence-following-recent-acute-infectious-mononucleosis
#14
Anthony F Massoll, Stanlyn C Powers, David P Betten
Infectious mononucleosis secondary to Epstein-Barr virus typically follows a relatively benign and self-limited course. A small subset of individuals may develop further progression of disease including hematologic, neurologic, and cardiac abnormalities. A mild transient neutropenia occurring during the first weeks of acute infection is a common finding however in rare cases a more profound neutropenia and agranulocytosis may occur up to 6weeks following the onset of initial symptoms. We describe the case of an 18-year-old woman who presented 26days following an acute infectious mononucleosis diagnosis with agranulocytosis and fever...
November 19, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27912798/bilateral-anomalous-drainage-of-the-posterior-divisions-of-renal-veins-into-the-azygos-venous-system-in-a-20-year-old-woman-a-case-report
#15
Pedro Pallangyo, Frederick Lyimo, Paulina Nicholaus, Stephano Masatu, Mohamed Janabi
BACKGROUND: Renal vein anomalies are relatively infrequent and generally asymptomatic. Preoperative knowledge of such variants is, however, of paramount importance in several angiographic and surgical procedures including renal venography, renal vein sampling, spermatic embolization, and renal transplantation. Inadequate knowledge and failure to recognize such anatomic variations may lead to several operative hazards including hemorrhage, nephrectomy, and even death. CASE PRESENTATION: We report a case of bilateral anomalous drainage of the posterior divisions of renal veins into the azygos venous system in a 20-year-old woman of African descent from Tanzania who presented to us with a 12-year history of recurrent anemia...
December 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27912791/possible-failure-of-novel-direct-acting-oral-anticoagulants-in-management-of-pulmonary-embolism-a-case-report
#16
James Rankin, Menachem Nagar, Jonathan Crosby, Nojan Toomari, Richard Pietras, Uri M Ben-Zur
BACKGROUND: The relative effectiveness of vitamin K antagonists compared with novel oral anticoagulants in treating pulmonary embolism remains unclear. Recent trials comparing the efficacy of vitamin K antagonists with factor Xa inhibitors for the treatment of pulmonary emboli have been non-inferiority studies based primarily on risk reduction (such as bleeding events), rather than resolution of specific diseases such as pulmonary embolism. Consequently, there is a lack of evidence indicating which of these agents are more effective...
December 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27912790/fetal-malformation-in-maternal-toxoplasma-and-rubella-co-infection-in-cameroon-a-case-report
#17
Andreas Ateke Njoh, Sarah Namondo Njoh, Messang Blandine Abizou
BACKGROUND: There has been a recent increase in the number of newborns with brain malformations due to congenital infections, but the impact of these diseases remains largely under ascertained in middle-income and low-income countries. This case report presents a fetal anencephaly following maternal toxoplasma and rubella co-infection in a resource-limited setting and the challenges faced by the patient and the health care provider in the management of the condition. CASE PRESENTATION: A 25-year-old black Cameroonian woman of Bakossi origin, gravida3 para1010, presented with a positive rubella and toxoplasma immunoglobulin G serologic test at 21 weeks of pregnancy; she could not benefit from a fetal morphologic ultrasound partly because there was none at the site of her antenatal clinic and because there were accessibility constraints getting to the nearest referral hospital approximately 100 km away...
December 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27912770/endometriosis-associated-clear-cell-carcinoma-arising-in-caesarean-section-scar-a-case-report-and-review-of-the-literature
#18
Gabriella Ferrandina, Eleonora Palluzzi, Francesco Fanfani, Stefano Gentileschi, Anna Lia Valentini, Maria Vittoria Mattoli, Ilaria Pennacchia, Giovanni Scambia, Gianfranco Zannoni
BACKGROUND: Malignant transformation has been reported in approximately 1% of the endometriosis cases; herein, we report a case of clear cell endometrial carcinoma arising from endometriosis foci located within a caesarean section scar. CASE PRESENTATION: In November 2014, a Caucasian, 44-year-old woman was transferred to our institution because of severe respiratory failure due to massive lung embolism and rapid enlargement of a subcutaneous suprapubic mass. Abdomino-pelvic magnetic resonance showed a 10...
December 3, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27911591/type-b-insulin-resistance-masquerading-as-ovarian-hyperthecosis
#19
Rebecca J Brown, Jalaja Joseph, Elaine Cochran, Cornelia Gewert, Robert Semple, Phillip Gorden
CONTEXT: Hyperinsulinemia can lead to pathologic ovarian growth and androgen production. CASE DESCRIPTION: A 29 year old woman developed an autoantibody to the insulin receptor (Type B insulin resistance), causing extreme insulin resistance and hyperinsulinemia. Testosterone levels were elevated to the adult male range. Treatment with gonadotropin releasing hormone (GnRH) analog led to normalization of testosterone, despite persistent extreme insulin resistance...
December 2, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27911477/vascularized-appendicular-lymph-node-transfer-for-treatment-of-extremity-lymphedema-a-case-report
#20
Pedro Ciudad, Oscar J Manrique, Shivprasad Date, Wei-Ling Chang, Fabio Nicoli, Stamatis Sapountzis, Hsu-Tang Cheng, Agko Mouchammed, Hung-Chi Chen
Vascularized lymph node transfer has demonstrated promising results for the treatment of extremity lymphedema. In an attempt to find the ideal donor site, several vascularized lymph nodes have been described. Each has a common goal of decreasing morbidity and avoiding iatrogenic lymphedema while obtaining good clinical results. Herein, we present the preliminary clinical outcomes of an intra-abdominal lymph node flap option based on the appendicular artery and vein used for the treatment of extremity lymphedema...
December 2, 2016: Microsurgery
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