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https://www.readbyqxmd.com/read/29644869/pearls-and-pitfalls-in-imaging-of-blunt-traumatic-thoracic-aortic-injury-a-pictorial-review
#1
Neeral R Patel, Elizabeth Dick, Nicola Batrick, Michael Jenkins, Elika Kashef
Blunt thoracic aortic injury (TAI) occurs most frequently as a sequelae of high impact deceleration such as high velocity road traffic accidents and falls from height. The burden of mortality and morbidity is high, however advances in pre-hospital care, diagnostic imaging and endovascular therapies have improved outcomes in this group of patients. Emergent treatment depends on accurate, early diagnosis by the radiologist. It is therefore of paramount importance that radiologists are familiar with both the direct (intimal flap, pseudoaneurysm, aortic contour irregularity and contrast extravasation) and indirect (periaortic haematoma) imaging findings of TAI...
April 12, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29629646/fibroblastic-osteosarcoma-with-epithelioid-and-squamous-differentiation-in-a-dog
#2
Tiffany L Jenkins, Dalen Agnew, Daniel R Rissi
A fibroblastic osteosarcoma with epithelioid and squamous differentiation in the distal femur of a 9-y-old spayed female Greyhound dog is described. Grossly, the tumor consisted of a pale-white, firm-to-hard mass that replaced the medullary and cortical areas of the distal end of the right femur. Histologically, the mass was composed predominantly of spindle cells admixed with areas of mineralized and non-mineralized osteoid matrix that were surrounded by stellate osteoblasts and scattered multinucleate giant cells, consistent with the diagnosis of a fibroblastic osteosarcoma...
April 1, 2018: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/29622328/inborn-errors-of-metabolism-in-the-emergency-department-undiagnosed-and-management-of-the-known
#3
REVIEW
Emily C MacNeill, Chantel P Walker
An inborn error of metabolism should be considered in any neonate who presents to the emergency department in extremis and in any young child who presents with altered mental status and vomiting. In children with unknown diagnoses, it is crucial to draw the appropriate laboratory studies before the institution of therapy, although treatment needs rapid institution to mitigate neurologic damage and avoid worsening metabolic crisis. Although there are hundreds of individual genetic disorders, they are roughly placed into groups that present similarly...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29618113/surgical-resection-of-intramedullary-epidermoid-cyst-2-dimensional-operative-video
#4
Thomas Sorenson, Giuseppe Lanzino
Intramedullary epidermoid cysts are extremely rare lesions. Preoperative diagnosis can be challenging due to non-specific imaging futures. We illustrate the case of a 32-year-old man who presented with a symptomatic intramedullary mass, which at surgery proved to be an epidermoid cyst. The spinal cord was decompressed by removing the pearl-white keratin material, although the capsule, which was tenaciously adherent to the surrounding spinal cord parenchyma, was only partially removed. In this video, we illustrate the salient surgical points for the resection of this very unusual intramedullary lesion...
March 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29550866/fetal-anterior-abdominal-wall-defects-prenatal-imaging-by-magnetic-resonance-imaging
#5
REVIEW
Teresa Victoria, Savvas Andronikou, Diana Bowen, Pablo Laje, Dana A Weiss, Ann M Johnson, William H Peranteau, Douglas A Canning, N Scott Adzick
Abdominal wall defects range from the mild umbilical cord hernia to the highly complex limb-body wall syndrome. The most common defects are gastroschisis and omphalocele, and the rarer ones include the exstrophy complex, pentalogy of Cantrell and limb-body wall syndrome. Although all have a common feature of viscera herniation through a defect in the anterior body wall, their imaging features and, more important, postnatal management, differ widely. Correct diagnosis of each entity is imperative in order to achieve appropriate and accurate prenatal counseling and postnatal management...
April 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29537292/necrotizing-fasciitis-of-the-lower-extremity-imaging-pearls-and-pitfalls
#6
David K Tso, Ajay K Singh
OBJECTIVE: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease. CONCLUSION: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, US, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis...
March 14, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29525276/meigs-to-modern-times-the-evolution-of-debulking-surgery-in-advanced-ovarian-cancer
#7
John O Schorge, Amy J Bregar, John Durfee, Ross S Berkowitz
Joe V. Meigs was a visionary clinician and an early adopter of radical techniques in the surgical treatment of ovarian cancer. His 1934 textbook "Tumors of the Female Pelvic Organs", consolidated his approach to this "hopeless" disease, with pearls on diagnosis, outcomes, and even speculations about the benefits of minimally invasive surgery. Decades before adjuvant chemotherapy would prove of value, and in an era when sophisticated statistics were unheard of, he nonetheless tried to eke out what benefits he could using the methods available in his time...
March 7, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29507134/pearls-oy-sters-ocular-motor-apraxia-as-essential-differential-diagnosis-to-supranuclear-gaze-palsy-eyes-up
#8
Kerstin Schweyer, Marc Aurel Busche, Jochen Hammes, Andreas Zwergal, Carsten Buhmann, Thilo van Eimeren, Günter U Höglinger
No abstract text is available yet for this article.
March 6, 2018: Neurology
https://www.readbyqxmd.com/read/29489307/emergency-department-management-of-smoke-inhalation-injury-in-adults-digest
#9
Karalynn Otterness, Christine Ahn, Jeffrey Nusbaum, Nachi Gupta
Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests...
March 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29472521/breast-metaplastic-squamous-cell-carcinoma-diagnosed-with-fine-needle-and-core-biopsy-a-case-study
#10
Na Cha, Shiyu Wang, Ming Lv, Dong-Wei Wang, Xiao-Jie Zhang, Min Zheng, Li-Xiang Tian
BACKGROUND Breast metaplastic squamous cell carcinoma (SCC) is a rare primary breast carcinoma, and overexpression of HER2 in this carcinoma is extremely uncommon. CASE REPORT We presented a case of a 48-year-old Asian female with breast metaplastic SCC. Fine needle aspiration biopsy (FNAB) and core needle biopsy (CNB) of the lesion were taken prior to surgical resection. FNAB smears demonstrated highly atypical squamous cells and a diagnosis positive for malignancy was rendered. CNB and a surgical resection specimen revealed invasive squamous carcinoma with keratin pearl formation and intercellular bridges...
February 23, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29469702/infantile-bullous-pemphigoid-with-string-of-pearls-sign
#11
Inês Raposo, Susana Machado, Rita Sampaio, Manuela Selores
Bullous pemphigoid (BP) is an immune mediated bullous disease that is manifested by urticarial plaques with superimposed subepidermal blisters and significant pruritus. It is generally found in the elderly, but is rare in the pediatric population. A 5-month-old girl previously diagnosed with hand-foot-mouth disease was examined in our dermatology department owing to vesicles and bullae, initially located to the hands and feet, which progressed with new lesions. Tense vesicles and bullae distributed in an annular string of pearls pattern on the abdomen and facial and cervical regions were noted...
July 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29461958/gout-in-duke-federico-of-montefeltro-1422-1482-a-new-pearl-of-the-italian-renaissance
#12
Antonio Fornaciari, Valentina Giuffra, Emanuele Armocida, Davide Caramella, Frank J Rühli, Francesco Maria Galassi
The article examines the truthfulness of historical accounts claiming that Renaissance Duke Federico of Montefeltro (1422-1482) suffered from gout. By direct paleopathological assessment of the skeletal remains and by the philological investigation of historical and documental sources, primarily a 1461 handwritten letter by the Duke himself to his personal physician, a description of the symptoms and Renaissance therapy is offered and a final diagnosis of gout is formulated. The Duke's handwritten letter offers a rare testimony of ancient clinical self-diagnostics and Renaissance living-experience of gout...
January 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29460929/practical-immune-barometer-sensor-for-trivalent-chromium-ion-detection-using-gold-core-platinum-shell-nanoparticle-probes
#13
Meng Xiao, Haicong Shen, Qiangqiang Fu, Wei Xiao, Hongfen Bian, Zhigang Zhang, Yong Tang
The technology progress of biosensors has markedly improved healthcare, disease diagnosis, environment monitoring, and food safety control over the past few decades. However, development of sensitive, robust, low-cost and portable assays for on-site bioanalysis is still a great challenge. In this study, we described a portable, feasible and miniaturized immune-barometer sensor (IBS), which can be used to sensitively measure the changes in a pressure signal, and we applied this IBS in the detection of Cr(iii)...
February 20, 2018: Analyst
https://www.readbyqxmd.com/read/29432243/epilepsy-syndromes-in-childhood
#14
Phillip L Pearl
PURPOSE OF REVIEW: Epilepsy syndromes are an important clinical construct in pediatric epilepsy, as they encompass recognizable patterns seen in patients with epilepsies, whether of the more benign variety or associated with encephalopathy. RECENT FINDINGS: Syndromes may be organized by age of onset: neonatal, infantile, childhood, or adolescent. The assignment of a syndrome has specific implications for diagnosis, management, and prognostication. The 2010 revised classification of the epilepsies by the International League Against Epilepsy preserved the syndrome approach, while progress in genetics continues to advance our understanding of the pathophysiology and overlap of the epilepsy syndromes...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29392464/primary-progressive-aphasia-a-clinical-approach
#15
Charles R Marshall, Chris J D Hardy, Anna Volkmer, Lucy L Russell, Rebecca L Bond, Phillip D Fletcher, Camilla N Clark, Catherine J Mummery, Jonathan M Schott, Martin N Rossor, Nick C Fox, Sebastian J Crutch, Jonathan D Rohrer, Jason D Warren
The primary progressive aphasias are a heterogeneous group of focal 'language-led' dementias that pose substantial challenges for diagnosis and management. Here we present a clinical approach to the progressive aphasias, based on our experience of these disorders and directed at non-specialists. We first outline a framework for assessing language, tailored to the common presentations of progressive aphasia. We then consider the defining features of the canonical progressive nonfluent, semantic and logopenic aphasic syndromes, including 'clinical pearls' that we have found diagnostically useful and neuroanatomical and other key associations of each syndrome...
February 1, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29388753/acute-gastroenteritis-evidence-based-management-of-pediatric-patients-digest
#16
KeriAnne Brady, Kathryn H Pade
Although most cases of acute gastroenteritis require minimal medical intervention, severe dehydration and hypoglycemia may develop in cases of prolonged vomiting and diarrhea. The mainstay of treatment for mild-to-moderately dehydrated patients with acute gastroenteritis should be oral rehydration solution. Antiemetics allow for improved tolerance of oral rehydration solution, and, when used appropriately, can decrease the need for intravenous fluids and hospitalization. This issue reviews the common etiologies of acute gastroenteritis, discusses more-severe conditions that should be considered in the differential diagnosis, and provides evidence-based recommendations for management of acute gastroenteritis in patients with mild-to-moderate dehydration, severe dehydration, and hypoglycemia...
February 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29323067/modified-cajal-s-trichrome-stain-as-a-diagnostic-aid-in-the-study-of-epithelial-pathology
#17
Karpagaselvi Sanjai, Anjum Baker, Lokesh Papiah Reddy, Bhavna Pandey
BACKGROUND: Diagnosis of initial epithelial pathology maybe difficult in Squamous Cell Carcinoma (SCC), Carcinoma In Situ and other atypical epithelial malignancies, under routine Haematoxylin and Eosin (H and E) stain. The detection of minor basement membrane alterations in doubtful cases is both time consuming and confusing. AIMS: To evaluate efficacy of Modified Cajal's Trichrome Stain (CTS) in relation to Haematoxylin and Eosin for study of epithelial dysplasia, carcinoma in situ, micro invasive SCC, frank SCC, and SCC in lymph nodes...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29241101/marjolin-s-ulcer-in-a-20-years-old-split-thickness-skin-graft-on-the-knee-a-case-report
#18
Iselin Saltvig, Steen H Matzen
OBJECTIVE: Marjolin's Ulcer (MU) is a rare cutaneous neoplasm arising in cikatrical tissue. Due to its typical clinical presentation as a non-healing lesion in scar tissue, the diagnosis can be delayed and even overlooked. METHODS AND RESULTS: We present the case of an elderly woman who developed an ulcerated, exophytic lesion in a split thickness skin graft (STSG) on the lateral aspect of the left knee. Histology showed a radically excised highly differentiated squamous cell carcinoma (SCC) with keratine pearls and a component of basocellular carcinoma (BCC)...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29227042/ex-vivo-confocal-microscopy-features-of-cutaneous-squamous-cell-carcinoma
#19
Daniela Hartmann, Sebastian Krammer, Mario R Bachmann, Leonie Mathemeier, Thomas Ruzicka, Isin S Bagci, Tanja von Braunmühl
BACKGROUND: Rapid microscopic evaluation of cutaneous squamous cell carcinoma (SCC), its grade of differentiation and level of invasiveness would enable better management of patients' therapy. OBJECTIVES: Analyzing specific ex vivo confocal microscopy criteria whether they can predict diagnosis of invasive SCC vs carcinoma in situ and poorly differentiated or undifferentiated vs well and moderately differentiated SCC. METHODS: Ex vivo confocal images of 102 SCCs in 57 patients were evaluated immediately after excision for the presence of predefined criteria based on confocal and histological knowledge...
December 11, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/29219007/anthropometric-research-of-congenital-auricular-deformities-for-newborns
#20
Hui Zhao, Guanfeng Lin, Yong Hae Seong, Jin Shi, Jing Xu, Wenhua Huang
OBJECTIVE: This study aimed to get the data of Neonatal auricle for helping pediatricians and obstetricians to make definite diagnosis and individualized treatment for newborn congenital auricular deformities in China. METHODS: A total of 1500 newborns' ears were evaluated in this study. Six surface measurements were performed directly on the auricles of the subjects as follows: physiognomic ear length and breadth, morphological ear length and breadth, cephalo-auricular distance, and cephalo otic angle...
December 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
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