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https://www.readbyqxmd.com/read/27914160/infectious-postpartum-sacroiliitis-the-importance-and-difficulty-of-early-diagnosis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27911229/c-2-arteriovenous-fistula-presenting-as-a-pathologic-hangman-s-fracture-case-report
#14
Rajeev D Sen, Carolina Gesteira Benjamin, Howard A Riina, Donato Pacione
The authors report on an 81-year-old woman with a pathologic hangman's fracture secondary to a complex arteriovenous fistula (AVF). The patient presented with severe, unremitting neck pain and was found to have fractures bilaterally through the pars interarticularis of C-2 with significant anterior subluxation of C-2 over C-3 along with widening of the left transverse foramen. Due to an abnormally appearing left vertebral artery (VA) on CT angiography, the patient underwent conventional angiography, which revealed a complex AVF stemming from the left VA at the level of C-2 with dilated posterior cervical veins and a large venous varix...
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27911225/successful-treatment-of-mixed-yolk-sac-tumor-and-mature-teratoma-in-the-spinal-cord-case-report
#15
Akitake Mukasa, Shunsuke Yanagisawa, Kuniaki Saito, Shota Tanaka, Keisuke Takai, Junji Shibahara, Masachika Ikegami, Yusuke Nakao, Katsushi Takeshita, Masao Matsutani, Nobuhito Saito
Primary spinal germ cell tumors are rare, and spinal nongerminomatous germ cell tumors represent an even rarer subset for which no standard therapy has been established. The authors report the case of a 24-year-old woman with multifocal primary spinal germ cell tumors scattered from T-12 to L-5 that consisted of yolk sac tumor and mature teratoma. After diagnostic partial resection, the patient was treated with 30 Gy of craniospinal irradiation and 30 Gy of local spinal irradiation, followed by 8 courses of chemotherapy based on ifosfamide, cisplatin, and etoposide (ICE)...
December 2, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#16
Carolina M Perdomo, Jorge A Árabe, Miguel Á Idoate, Juan C Galofré
INTRODUCTION: Pituitary disorders during pregnancy are uncommon. The approach should include a close follow-up in order to reduce maternal and fetal risks associated with physiological changes during pregnancy or treatment side effects. MATERIALS AND METHODS: We report a 21-year-old woman with a thyroid-stimulating hormone-secreting pituitary macroadenoma and positive antithyroid antibodies. She was initially treated using transsphenoidal pituitary surgery. The patient relapsed 17-month post-surgery...
December 2, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27910226/successful-treatment-of-post-dural-puncture-headache-using-epidural-fibrin-glue-patch-after-persistent-failure-of-epidural-blood-patches
#17
Kevin Wong, Brian R Monroe
OBJECTIVES: Epidural blood patch is the gold standard for the treatment of post-dural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH. CASE REPORT: This case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27910213/dedifferentiated-chordoid-meningioma-with-rhabdomyosarcomatous-differentiation-on-the-middle-cranial-fossa
#18
Hirotaka Fudaba, Tatsuya Abe, Masaki Morishige, Yasutomo Momii, Kenji Kashima, Akira Yamada, Hirofumi Nagatomi, Atsushi Natsume, Junko Hirato, Yoichi Nakazato, Minoru Fujiki
A 46-year-old woman presented with headache and right hemiparesis. MRI demonstrated a mass in the left middle fossa. Total resection was performed. A histological examination of the tumor specimen showed several characteristic morphological features. A chordoid meningioma showing an epithelial-like palisade arrangement was observed. An anaplastic short spindle cell tumor exhibiting a fascicular pattern was considered to be a rhabdomyosarcoma. After conventional radiotherapy, the tumor was well controlled without any neurological deficit for 20 months...
December 2016: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/27909975/immunoglobulin-g4-related-hepatic-inflammatory-pseudotumor-invading-the-abdominal-wall
#19
Shinji Miyajima, Akihiro Okano, Masaya Ohana
A 50-year-old woman presented with epigastralgia. Computed tomography (CT) of the abdomen revealed a 6-cm well-enhanced mass extending from the left lobe of the liver to the abdominal wall, suggestive of cholangiocarcinoma. Liver and skin mass biopsies did not provide evidence of hepatic malignancy but were rich in plasma cells and sclerotic lesions. Subsequent detection of elevated serum immunoglobulin G4 (IgG4) led to a diagnosis IgG4-related inflammatory pseudotumor (IPT) of the liver. Treatment with systemic corticosteroids resulted in rapid clinical improvement...
December 1, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27909829/contrast-enhanced-ultrasound-in-diagnosis-of-primary-hepatic-angiosarcoma
#20
Wenwu Ling, Tingting Qiu, Lin Ma, Chuanfen Lei, Yan Luo
Primary hepatic angiosarcoma (PHA) is a rare malignant tumor that occurs mainly in the elderly, with almost no specific symptoms or tumor markers. Information on the imaging characteristics of this tumor is limited due to its rarity. Therefore, it is difficult to diagnose PHA. So far, its definite diagnosis depends on histopathologic examination combined with immunohistochemical results. Patients with PHA have a poor prognosis in spite of surgical resection of this tumor. In this case report, we present a 72-year-old woman with PHA, focusing on the imaging features of this tumor, especially its enhancement pattern on contrast-enhanced ultrasound images...
December 1, 2016: Journal of Medical Ultrasonics
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