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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.

Clin. Pract., Volume 4, Issue 2 (June 2014) – 9 articles

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1054 KiB  
Case Report
Management of a Failed Metatarso-Phalangeal Joint Fusion Utilizing a Hemicup Prosthesis
by Nicola Stadler, Stefan Hofstätter and Klemens Trieb
Clin. Pract. 2014, 4(2), 646; https://doi.org/10.4081/cp.2014.646 - 8 Oct 2014
Cited by 2 | Viewed by 565
Abstract
We report a case of a 65-year-old man with a painful nonunion of the first metatarsophalangeal joint (MTPJ). It is one of the main severe complications of this surgery. Its prevalence is described between 5% and 10% across different operative techniques. The implantation [...] Read more.
We report a case of a 65-year-old man with a painful nonunion of the first metatarsophalangeal joint (MTPJ). It is one of the main severe complications of this surgery. Its prevalence is described between 5% and 10% across different operative techniques. The implantation of hemicup-prosthesis has been successfully used for the hallux rigidus treatment with very promising results. In our case report, we introduce a treatment method of converting a pseudoarthrosis of the first MTPJ, made of two crossing screws into a hemicup-prosthesis as a salvage procedure. This is to our best knowledge the first report using this device for treatment of pseudoarthrosis of the first MTPJ. Full article
532 KiB  
Case Report
A Rapidly Enlarging Cutaneous Hemangioma in Pregnancy
by Marwan Ma’ayeh, Nikhil Purandare, Michelle Harrison and Michael P. Geary
Clin. Pract. 2014, 4(2), 644; https://doi.org/10.4081/cp.2014.644 - 8 Oct 2014
Cited by 1 | Viewed by 636
Abstract
This is a case of a rapidly enlarging cutaneous pedunculated tumor on a patient’s thumb during her pregnancy. This was excised and identified as a hemangioma. A literature search identified a possible hormonal factor in causing an accelerated growth of this tumor. Full article
650 KiB  
Case Report
Ewing’s Sarcoma: An Uncommon Breast Tumor
by Sawsen Meddeb, Mohamed Salah Rhim, Mouna Kouira, Sarra Mestiri, Mohamed Bibi and Mohamed Tahar Yacoubi
Clin. Pract. 2014, 4(2), 659; https://doi.org/10.4081/cp.2014.659 - 3 Oct 2014
Cited by 3 | Viewed by 660
Abstract
Ewing’s sarcoma/primitive neuroectodermal tumors (EWS/PNET) are rare malignant and aggressive tumors, usually seen in the trunk and lower limbs of children and young adults. They are uncommon in the breast. We report a case of a 43-year-old woman who developed a painless breast [...] Read more.
Ewing’s sarcoma/primitive neuroectodermal tumors (EWS/PNET) are rare malignant and aggressive tumors, usually seen in the trunk and lower limbs of children and young adults. They are uncommon in the breast. We report a case of a 43-year-old woman who developed a painless breast mass. An initial core needle biopsy concluded to a fibrocystic dystrophy contrasting with a rapidly growing mass; thus a large lumpectomy was done. Diagnosis of primary PNET of the breast was established, based on both histopathological examination and immunohistochemical findings. Surgical margins were positive, therefore, left modified radical mastectomy with axillary lymph nodes dissection was performed. The patient was given 6 cycles of adjuvant chemotherapy containing cyclophosphamide, adriamycin and vincristine. Twenty months later, she is in life without recurrence or metastasis. EWS/PNET may impose a diagnostic challenge. Indeed, mammography and ultrasonography features are non specific. The histopathological pattern is variable depending on the degree of neuroectodermal differentiation. Immuno-phenotyping is necessary and genetic study is the only confirmatory tool of diagnosis showing a characteristic cytogenetic anomaly; t (11; 22) translocation. Full article
860 KiB  
Brief Report
Clinical Evaluation of the Ability of a Proprietary Scoliosis Traction Chair to De-Rotate the Spine: 6-month Results of Cobb Angle and Rotational Measurements
by Clayton J. Stitzel, Brian Dovorany, Mark W. Morningstar and Aatif Siddiqui
Clin. Pract. 2014, 4(2), 642; https://doi.org/10.4081/cp.2014.642 - 3 Oct 2014
Cited by 3 | Viewed by 789
Abstract
The aim of this study was to investigate the immediate and 6-month effects of a scoliosis traction chair on scoliosis rotation and Cobb angle. The scoliosis traction chair has been used clinically for 10 years and has been part of previous studies, but [...] Read more.
The aim of this study was to investigate the immediate and 6-month effects of a scoliosis traction chair on scoliosis rotation and Cobb angle. The scoliosis traction chair has been used clinically for 10 years and has been part of previous studies, but has not been the focus of any previous study. Our goal was to test the scoliosis traction chair’s ability to de-rotate the spine to create scoliosis correction. Fifteen patient files were retrospectively selected for study. Patients were radiographically studied in a proprietary traction chair to evaluate impact on Cobb angle and apical vertebral rotation. Six-month follow-up results were recorded. Six-month results showed an average overall Cobb angle increase of about 7°. Patients with in-chair apical de-rotation showed 9° of Cobb angle improvement, while those with increased in-chair apical rotation showed an average 16° progression. Scoliotic curves whose apical rotation worsened on stress radiography showed deterioration of the curve at 6 months. Those with improved apical rotation showed Cobb angle corrections at 6 months. Since progression of scoliotic curvatures was observed in our cohort of patients after 6 months of home and clinical use, it is imperative that further studies attempt to qualify which patients and scoliosis curve patterns are best suited for the scoliosis traction chair. Full article
786 KiB  
Article
Sublingual Epidermoid Cyst Presenting with Distinctive Magnetic Resonance Imaging Findings
by Naohiro Yoshida, Kozue Kodama and Yukiko Iino
Clin. Pract. 2014, 4(2), 664; https://doi.org/10.4081/cp.2014.664 - 21 Aug 2014
Cited by 3 | Viewed by 711
Abstract
A case of sublingual epidermoid cyst presenting distinctive magnetic resonance imaging (MRI) findings is described. A 39-year-old man presented to our hospital with a three months progressive left submandibular swelling, difficulty moving his tongue, and snoring. Preoperative evaluation with MRI and fine needle [...] Read more.
A case of sublingual epidermoid cyst presenting distinctive magnetic resonance imaging (MRI) findings is described. A 39-year-old man presented to our hospital with a three months progressive left submandibular swelling, difficulty moving his tongue, and snoring. Preoperative evaluation with MRI and fine needle aspiration cytology (FNAC) revealed that the heterogeneous cystic lesion contained the squamous cells, which is compatible with ectodermal tissue. The mass was located above the mylohyoid muscle and spread to the pharyngeal space. By considering the size, infection history, patient age, and location, the cyst was completely resected under general anesthesia via cervical approach without any complication. Histopathologically, the cyst wall was lined by stratified squamous epithelium with no skin appendage, suggesting an epidermoid cyst. Ultrasound (US), MRI and FNAC were very useful of the preoperative diagnosis for oral and sublingual lesion. The postoperative course was uneventful and without recurrence after 24 months. This case showed that epidermoid cysts formed the rarely heterogeneous cystic tumor and it underlined usefulness of preoperative diagnosis, such as US, MRI and FNAC for oral and sublingual tumor. Full article
832 KiB  
Case Report
Tuberculous Osteomyelitis of Sternum Secondary to Primary Tuberculous Mastitis
by Girish D. Bakhshi, Sachin S. Shenoy, Kavita V. Jadhav, Mukund B. Tayade, Suhaib S. Rawoot and Kavitha Jain
Clin. Pract. 2014, 4(2), 656; https://doi.org/10.4081/cp.2014.656 - 21 Aug 2014
Cited by 2 | Viewed by 516
Abstract
Sternal tuberculosis secondary to tuberculous mastitis is uncommon. The invasion of the sternum following a primary focus in the breast has not been reported. This may be due to the resistance offered by pectoral fascia and periosteum to the spread of infection into [...] Read more.
Sternal tuberculosis secondary to tuberculous mastitis is uncommon. The invasion of the sternum following a primary focus in the breast has not been reported. This may be due to the resistance offered by pectoral fascia and periosteum to the spread of infection into the bone. We present a case of tubercular sternal osteomtyelitis following tubercular mastitis in a 40-year old female. A brief case report and a review of literature are presented. Full article
919 KiB  
Article
Feminizing Adrenocortical Carcinoma with Distant Metastases: Can Surgery Be Considered?
by Alessandro Fancellu, Antonio Pinna and Alberto Porcu
Clin. Pract. 2014, 4(2), 651; https://doi.org/10.4081/cp.2014.651 - 9 Jul 2014
Cited by 3 | Viewed by 602
Abstract
Functioning adrenocortical carcinomas are rare diseases with dismal prognosis. A 41-year-old man presenting with gynecomastia had a giant feminizing adrenocortical carcinoma at stage IV. Although surgical resection was controversial, we removed the primary tumor to reduce the mass effects. He lived for 12 [...] Read more.
Functioning adrenocortical carcinomas are rare diseases with dismal prognosis. A 41-year-old man presenting with gynecomastia had a giant feminizing adrenocortical carcinoma at stage IV. Although surgical resection was controversial, we removed the primary tumor to reduce the mass effects. He lived for 12 months with an acceptable quality of life. Gynecomastia may be the first sign of feminizing adrenal malignancies. Surgery may ameliorate the quality of life in selected patients with metastatic disease. Full article
681 KiB  
Case Report
Acute Respiratory Failure as Primary Manifestation of Antineutrophil Cytoplasmic Antibodies-Associated Vasculitis
by Evdokia Sourla, Vasilis Bagalas, Helias Tsioulis, Asimina Paspala, Sofia Akritidou, Athanasia Pataka, Katalin Fekete, Ioannis P. Kioumis, Ioannis Stanopoulos and Georgia Pitsiou
Clin. Pract. 2014, 4(2), 653; https://doi.org/10.4081/cp.2014.653 - 4 Jul 2014
Viewed by 640
Abstract
The systemic vasculitides are multifocal diseases characterized by the presence of blood vessel inflammation in multiple organ systems. Their clinical presentation is variable extending from self-limited illness to critical complications including diffuse alveolar hemorrhage and glomerulonephritis. Alveolar hemorrhage is a lifethreatening manifestation of [...] Read more.
The systemic vasculitides are multifocal diseases characterized by the presence of blood vessel inflammation in multiple organ systems. Their clinical presentation is variable extending from self-limited illness to critical complications including diffuse alveolar hemorrhage and glomerulonephritis. Alveolar hemorrhage is a lifethreatening manifestation of pulmonary vasculitis that can rapidly progress into acute respiratory failure requiring ventilatory support. We present the case of a 74-year-old patient admitted to the Intensive Care Unit with severe hypoxic respiratory failure and diffuse alveolar infiltrates in chest imaging that was later diagnosed as antineutrophil cytoplasmic antibodies-associated vasculitis. The report highlights the importance of differentiate between alveolar hemorrhage and acute respiratory distress syndrome of other etiology because alveolar hemorrhage is reversible with prompt initiation of treatment. Full article
637 KiB  
Brief Report
An Experience with Blunt Abdominal Trauma: Evaluation, Management and Outcome
by Nikhil Mehta, Sudarshan Babu and Kumar Venugopal
Clin. Pract. 2014, 4(2), 599; https://doi.org/10.4081/cp.2014.599 - 18 Jun 2014
Cited by 42 | Viewed by 2826
Abstract
Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates [...] Read more.
Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates that, by 2020, trauma will be the first or second leading cause of years of productive life lost for the entire world population. This study endeavors to evaluate 71 cases of BAT with stress on early diagnosis and management, increase use of non operative management, and time of presentation of patients. A retrospective analysis of 71 patients of BAT who were admitted in Kempegowda Institute of Medical Sciences hospital (KIMS, Bangalore, India) within a span of 18 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Most of the patients in our study were in the age group of 21-30 years with an M:F ratio of 3.7:1. Motor vehicle accident (53%) was the most common mechanism of injury. Spleen (53%) was the commonest organ injured and the most common surgery performed was splenectomy (30%). Most common extra abdominal injury was rib fracture in 20%. Mortality rate was 4%. Wound sepsis (13%) was the commonest complication. Initial resuscitation measures, thorough clinical examination and correct diagnosis forms the most vital part of management. 70% of splenic, liver and renal injuries can be managed conservatively where as hollow organs need laparotomy in most of the cases. The time of presentation of patients has a lot to do with outcome. Early diagnosis and prompt treatment can save many lives. Full article
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