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Reports, Volume 1, Issue 1 (June 2018)

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Open AccessCase Report Claudication-Like Vision Impairment from Spontaneous Dissection of Internal Carotid Artery
Received: 30 March 2018 / Revised: 10 May 2018 / Accepted: 14 May 2018 / Published: 16 May 2018
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Abstract
Among young adults, a carotid artery dissection is one of the etiologies of morbidity. In the general population, the incidence of stroke due to dissection is around 2.5%, whereas a carotid dissection accounts for 19.5% of ischemic stroke in young adults. This could
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Among young adults, a carotid artery dissection is one of the etiologies of morbidity. In the general population, the incidence of stroke due to dissection is around 2.5%, whereas a carotid dissection accounts for 19.5% of ischemic stroke in young adults. This could be due to injury or spontaneity, with the etiology controlled by several factors. A carotid artery dissection is a separation of arterial layers, which results in a tear in the arterial wall, causing invasion of blood into the wall of artery and leading to intra-luminal stenosis or aneurysmal dilatation. We describe a patient presented with claudication-like vision impairment. The image studies revealed spontaneous internal carotid artery dissection with severe occluded left internal carotid artery. With medical therapy with antiplatelets and anticoagulants, she was managed successfully with endovascular stenting with good neurological recovery to date. We also reviewed current reported studies of the dissection of the petrous portion of the internal carotid artery in Medline from 1960 to the present. Full article
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Open AccessCase Report Ischemic Bowel Disease Due to Superior Mesenteric Artery Occlusion: A Case Report
Received: 28 March 2018 / Revised: 3 May 2018 / Accepted: 4 May 2018 / Published: 7 May 2018
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Abstract
Acute mesenteric infarction is a rare but emergency disease with a high mortality rate. The rapidly restoration of intestinal blood flow is the early goal of vascular intervention. However, the unspecific presentation may confuse physicians and delay a timely diagnosis. The rate of
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Acute mesenteric infarction is a rare but emergency disease with a high mortality rate. The rapidly restoration of intestinal blood flow is the early goal of vascular intervention. However, the unspecific presentation may confuse physicians and delay a timely diagnosis. The rate of intestinal failure in survivors is still high. Here, we present the case of an 85-year-old male presenting with acute onset progressive periumbilical cramping pain with elevated D-dimer. The abdominal computed tomography (CT) revealed severe acute superior mesenteric artery occlusion. The surgical report showed a massively ischemic small intestine that was about 250 cm with 200 mL bloody ascites. We highlight that early diagnosis and timely intervention are important for improving outcomes. Full article
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Open AccessCase Report Bacillus cereus Induced Necrotizing Fasciitis Mimicking Gastroenteritis: A Case Report
Received: 26 March 2018 / Revised: 5 April 2018 / Accepted: 6 April 2018 / Published: 9 April 2018
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Abstract
Necrotizing fasciitis is a rapidly spreading inflammation of the soft tissue involving the fascia and the subcutaneous tissue. Early and aggressive surgical intervention accompanied with appropriate antibiotics are the key to improve clinical outcome in patients with necrotizing fasciitis. Here, we present the
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Necrotizing fasciitis is a rapidly spreading inflammation of the soft tissue involving the fascia and the subcutaneous tissue. Early and aggressive surgical intervention accompanied with appropriate antibiotics are the key to improve clinical outcome in patients with necrotizing fasciitis. Here, we present the case of a 46-year-old male who presented with acute onset progressive watery diarrhea and fever for one day. The abdominal ultrasound and computed tomography revealed diffuse gallbladder wall thickening with double layer sign, air density at right hepatic lobe and a small bowel edema. An intra-abdominal infection was initially suspected. However, a progressive erythematous change and bullae was found on the left thigh and lower abdomen. Progressed necrotizing fasciitis was suspected. After administration of broad antibiotics and emergency surgical intervention, the septic shock was reversed. Finally, the blood and wound culture reports revealed Bacillus cereus growth. This paper describes the clinical features of necrotizing fasciitis and highlights the Bacillus cereus-induced necrotizing fasciitis for physicians in order to promote timely intervention for septic shock. Full article
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Open AccessCase Report Management and Prevention of Oral Self-Injuries in Lesch–Nyhan Syndrome
Received: 19 March 2018 / Revised: 28 March 2018 / Accepted: 6 April 2018 / Published: 9 April 2018
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Abstract
Lesch–Nyhan syndrome (LNS) is a rare X-linked recessive disorder with an incidence of 1/100,000–380,000 live births. It is characterized by neurological manifestations, including symptoms of compulsive self-mutilation, which result in the destruction of oral and perioral tissues. This report describes a case of
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Lesch–Nyhan syndrome (LNS) is a rare X-linked recessive disorder with an incidence of 1/100,000–380,000 live births. It is characterized by neurological manifestations, including symptoms of compulsive self-mutilation, which result in the destruction of oral and perioral tissues. This report describes a case of a four-year-old boy diagnosed with LNS, who was referred for evaluation and treatment of self-injury behaviour (SIB). The parents requested the prevention of self-mutilation of the lower lip and tongue by the child’s own teeth. After a thorough discussion with the parents, it was agreed that a conservative approach, avoiding extraction, should be followed initially. A removable dental appliance was fabricated. The parents were instructed and trained about insertion, removal, and cleaning of the appliance. The child was re-examined after one week: biting of the lips and tongue improved immediately after the insertion of the appliances. Initial healing of the lesion was observed. After two and four weeks, positive results were seen. The lesion had resolved completely. In conclusion, appropriate preventive methods have to be developed for each individual patient on the basis of the observation of each single case. Oral appliances represent a conservative solution for SIB and an alternative to more invasive approaches. They can be the initial solution for the management of oral self-injury in LNS patients. Full article
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Open AccessCase Report Klebsiella pneumoniae-Induced Multiple Infections in a Diabetes Mellitus Patient: Pneumonia, Liver Abscess, Endogenous Endophthalmitis, Urinary Tract Infection
Received: 13 March 2018 / Revised: 26 March 2018 / Accepted: 28 March 2018 / Published: 28 March 2018
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Abstract
Klebsiella pneumoniae-induced endogenous endophthalmitis is a rare but devastating disease, which usually occurs in immunosuppressed patients. Poorly controlled diabetes mellitus is a significant risk factor for this disease. The most common distant infection in patients with K. pneumoniae-induced endogenous endophthalmitis was
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Klebsiella pneumoniae-induced endogenous endophthalmitis is a rare but devastating disease, which usually occurs in immunosuppressed patients. Poorly controlled diabetes mellitus is a significant risk factor for this disease. The most common distant infection in patients with K. pneumoniae-induced endogenous endophthalmitis was reported to be liver abscess. Other less commons distant infections were found to be catheter-related bloodstream infection, urinary tract infection, soft tissue infection, renal and psoas abscesses, and endocarditis. Patients with coexisting multiple infection sites are rare according to previous studies. These patients may have a high risk of sepsis and death. Here, we present a case of a 64-year-old male who presented with a progressive visual disturbance with general malaise. A K. pneumoniae-induced endogenous endophthalmitis was suspected. After surveying distant infection sites, pneumonia, liver abscess, and urinary tract infection were reported. This paper also describes the clinical features of endogenous endophthalmitis and highlights K. pneumoniae-induced multiple infections in a diabetes mellitus patient, thus providing information that will be useful for physicians to perform timely interventions and avoid sepsis. Full article
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Open AccessCase Report Type A Aortic Dissection Presenting with Neurological Symptoms Mimicking Stroke and Intracranial Hemorrhage
Received: 19 March 2018 / Revised: 23 March 2018 / Accepted: 23 March 2018 / Published: 26 March 2018
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Abstract
Acute aortic dissection is a rare but lethal cardiac disease involving the aorta, which presents with typical symptoms, including severe, sharp, or tearing acute onset of chest or back pain. Other unspecific symptoms, such as epigastric pain, nausea, and vomiting, may be also
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Acute aortic dissection is a rare but lethal cardiac disease involving the aorta, which presents with typical symptoms, including severe, sharp, or tearing acute onset of chest or back pain. Other unspecific symptoms, such as epigastric pain, nausea, and vomiting, may be also present. Neurologic symptoms induced by aortic dissection are also present in rare cases but often lead to delate diagnosis because they mimic stroke and intracranial hemorrhage. Therefore, it is important to understand acute aortic dissection-induced neurologic symptoms. Here, we present a case of a 60-year-old male who presented with an acute onset of progressive flaccid hemiplegia on the left side accompanied with slurred speech. Brain computed tomography showed widening of the cortical sulci and dilatation of the ventricles, without intracranial hemorrhage. When waiting for thrombolysis or thrombectomy intervention, acute chest pain was noted. After management, type A dissection from ascending aorta with extension to the right external iliac artery was noted in computed tomography angiography, which also involved the brachiocephalic trunk, left common carotid artery, celiac trunk, superior mesenteric artery, and right renal artery. This paper describes the clinical features of type A dissection, especially the neurological symptoms, and highlights the importance of early diagnosis and timely intervention for type A dissection patients. Full article
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Open AccessCase Report Endocervical Cavity Anomaly Mimicking the Uterine Cavity and Delaying Diagnosis of Endometrial Adenocarcinoma: A Case Report
Received: 13 March 2018 / Revised: 22 March 2018 / Accepted: 23 March 2018 / Published: 26 March 2018
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Abstract
We report a rare case of endometrial cancer in an endocervical anomaly with a dilated and isolated endocervical cavity mimicking the uterine cavity. A 75-year-old woman suffered from persistent brownish watery vaginal discharge. The cytology of the fluid showed some atypical cells, and
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We report a rare case of endometrial cancer in an endocervical anomaly with a dilated and isolated endocervical cavity mimicking the uterine cavity. A 75-year-old woman suffered from persistent brownish watery vaginal discharge. The cytology of the fluid showed some atypical cells, and trans-vaginal ultrasonography disclosed two distinct compartments in the pelvis. Under the impression of hematometra and adnexal cystic tumor with solid part, dilation and curettage (D&C) was done, but the pathology showed no evidence of malignancy. Although the hematometra and adnexal cyst disappeared afterward, the patient returned to the clinic with a complaint of persistent vaginal fluid two months later, and trans-rectal ultrasound revealed a cystic tumor with solid part again. Finally, endometrioid adenocarcinoma of endometrium was diagnosed by diagnostic laparoscopy and hysterectomy. This work highlights our experience in the diagnostic process and calls attention to the possibility of an occult endometrial cancer when evaluating postmenopausal women with continuous abnormal watery vaginal fluid and/or atypical cells shown in vaginal fluid cytology. Full article
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Open AccessCase Report Acute Retroperitoneal Hemorrhage Induced by Giant Adrenal Myelolipoma Mimicking Renal Colic Pain: A Case Report
Received: 1 March 2018 / Revised: 11 March 2018 / Accepted: 12 March 2018 / Published: 13 March 2018
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Abstract
Retroperitoneal hemorrhage is a life-threatening clinical entity which is difficult to diagnose due to numerous etiology and unspecific symptoms. Spontaneous severe retroperitoneal hemorrhage, known as Wunderlich’s syndrome presented with Lenk’s triad, includes acute flank pain, flank mass, and hypovolemic shock. Giant adrenal myelolipoma
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Retroperitoneal hemorrhage is a life-threatening clinical entity which is difficult to diagnose due to numerous etiology and unspecific symptoms. Spontaneous severe retroperitoneal hemorrhage, known as Wunderlich’s syndrome presented with Lenk’s triad, includes acute flank pain, flank mass, and hypovolemic shock. Giant adrenal myelolipoma causing Wunderlich’s syndrome is rare. Here, we presented a 59-year-old woman with spontaneous acute onset persistent left flank pain. The kidney, ureter, and bladder (KUB) study revealed left renal stones. The abnormal D-dimer level and progressive symptoms alerted emergency physicians to intervene timely. The computed tomography (CT) scan revealed a giant adrenal mass with retroperitoneal hemorrhage. After hemodynamically controlled and surgical intervention, she recovered and was followed up at the outpatient department (OPD). In this article, we highlight that myelolipoma-induced spontaneous retroperitoneal hemorrhage may cause Wunderlich’s syndrome and lead to hypovolemic shock. It is important for emergency physicians to intervene timely. Early diagnosis and management lead to a better outcome. Full article
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Open AccessCase Report Imaging Study of Pseudotumoral Chronic Sialadenitis with Cystic-Like Pattern in a Sjögren Syndrome Patient
Received: 12 February 2018 / Revised: 4 March 2018 / Accepted: 6 March 2018 / Published: 7 March 2018
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Abstract
Ultrasonography has become a valuable tool for the assessment of salivary gland involvement in Sjögren syndrome. Diagnostic pitfalls can be encountered in late stages of the disease, in which morphologic changes may overlap with other pathologies of the salivary glands. We present the
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Ultrasonography has become a valuable tool for the assessment of salivary gland involvement in Sjögren syndrome. Diagnostic pitfalls can be encountered in late stages of the disease, in which morphologic changes may overlap with other pathologies of the salivary glands. We present the case of a female Sjögren syndrome patient with lack of significant sicca symptoms and unilateral occurrence of parotidomegaly, which prompted the suspicion of a parotid gland tumor. Due to the atypical clinical profile, diagnosis of Sjögren syndrome was delayed, at which point, severe sialadenitis produced a cystic transformation of the parotid gland parenchyma. Full article
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Open AccessCase Report Cognitive Evolution of a Patient Who Suffered a Subarachnoid Haemorrhage Eight Years Ago, after Being Treated with Growth Hormone, Melatonin and Neurorehabilitation
Received: 25 January 2018 / Revised: 8 February 2018 / Accepted: 10 February 2018 / Published: 12 February 2018
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Abstract
To describe the cognitive evolution of a patient who suffered a subarachnoid haemorrhage resulting in a total loss of his cognitive functions. The patient was initially treated with GH (0.8 mg/day), melatonin (50 mg/day) and neurorehabilitation 1 year after his brain damage, during
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To describe the cognitive evolution of a patient who suffered a subarachnoid haemorrhage resulting in a total loss of his cognitive functions. The patient was initially treated with GH (0.8 mg/day), melatonin (50 mg/day) and neurorehabilitation 1 year after his brain damage, during 3 months. Then continued with GH (0.5 mg/day, 6 months/year, during 2 years) and melatonin treatments and neurorehabilitation (3 days/week). 5 years later the patient came back to our Centre due to the absence of recent memory and personal and spatio-temporal orientation and he received an intensive specific neurorehabilitation, including EINA (Auditory Stimulation and Neurosensory Integration), together with GH (0.8 mg/day) and melatonin, for 6 months. At discharge of his first treatment period cognitive functions showed very poor changes but these had been improved when he came back 5 years later. A review carried out 8 years after SHA demonstrated that the patient significantly recovered in all the cognitive functions and he was able to live an independent life. GH plays a key role on cognition, including its actions on recent memory. Melatonin, in turn, helps as a neuroprotective agent. A specific neurostimulation must be performed so that the effects of GH can be expressed. Within neurostimulation, EINA seems to play a very important role for enhancing the effects of medical and rehabilitative treatments on brain plasticity. Full article
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Open AccessEditorial Welcome to the New Open Access Reports
Received: 27 November 2017 / Revised: 27 November 2017 / Accepted: 27 November 2017 / Published: 28 November 2017
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Abstract
With sincere satisfaction and pride, I present to you the new Journal, Reports, for which I am pleased to serve as Editor-in-Chief [...]
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