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JAMA Jul 2023
Topics: Humans; Contracture; Hand; Leprosy, Tuberculoid; Peroneal Neuropathies; Skin; Skin Diseases
PubMed: 37389854
DOI: 10.1001/jama.2023.9915 -
Cureus Jul 2023Schnitzler's metastasis occurs due to the deposition of the tumor cells in the submucosa of the rectum, leading to rectal stenosis. We present a 60-year-old female who...
Schnitzler's metastasis occurs due to the deposition of the tumor cells in the submucosa of the rectum, leading to rectal stenosis. We present a 60-year-old female who presented with abdominal pain, distension, and vomiting. Abdominal examination showed a distended abdomen and palpable bowel loops, and per rectal examination showed rectal stenosis. Imaging studies suggest rectal stenosis with carcinoma of the pancreas head. The patient was diagnosed with Schnitzler's metastasis with carcinoma of the pancreas head, which has not been reported in the literature. The patient underwent a diversion sigmoid colostomy and was planned for palliative chemotherapy after stenting the common bile duct.
PubMed: 37637582
DOI: 10.7759/cureus.42465 -
Journal of Nippon Medical School =... 2024Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy that is sometimes elicited by ganglia in the tarsal tunnel.
BACKGROUND
Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy that is sometimes elicited by ganglia in the tarsal tunnel.
METHODS
Between August 2020 and July 2022, we operated on 117 sides with TTS. This retrospective study examined data from 8 consecutive patients (8 sides: 5 men, 3 women; average age 67.8 years) with an extraneural ganglion in the tarsal tunnel. We investigated the clinical characteristics and surgical outcomes for these patients.
RESULTS
The mass was palpable through the skin in 1 patient, detected intraoperatively in 1 patient, and visualized on MRI scanning in the other 6 patients. Symptoms involved the medial plantar nerve area (n = 5), lateral plantar nerve area (n = 1), and medial and lateral plantar nerve areas (n = 2). The interval between symptom onset and surgery ranged from 4 to 168 months. Adhesion between large (≥20 mm) ganglia and surrounding tissue and nerves was observed intraoperatively in 4 patients. Of the 8 patients, 7 underwent total ganglion resection. There were no surgery-related complications. On their last postoperative visit, 3 patients with a duration of symptoms not exceeding 10 months reported favorable outcomes.
CONCLUSIONS
Because ganglia eliciting TTS are often undetectable by skin palpation, imaging studies may be necessary. Early surgical intervention appears to yield favorable outcomes.
Topics: Male; Humans; Female; Aged; Tarsal Tunnel Syndrome; Retrospective Studies; Magnetic Resonance Imaging; Skin
PubMed: 38462440
DOI: 10.1272/jnms.JNMS.2024_91-203 -
Radiology Case Reports May 2024Sclerosing epithelioid fibrosarcoma is a rare fibrosarcoma variant in which more than half of patients experience local recurrence or metastatic spread. In the current...
Sclerosing epithelioid fibrosarcoma is a rare fibrosarcoma variant in which more than half of patients experience local recurrence or metastatic spread. In the current literature, there is limited and nonspecific imaging data, contributing to frequent misdiagnosis and delays in treatment intervention. Given the poor prognosis associated with this malignancy and the high probability of metastases, accurate and prompt diagnoses are critical. In this article, we report the case of a 27-year-old female diagnosed with metastatic sclerosing epithelioid fibrosarcoma following the discovery of a growing palpable mass on her right gluteus maximus muscle. We focus on the use of radiological imaging modalities in optimizing diagnosis and correlate our imaging and pathological findings.
PubMed: 38415064
DOI: 10.1016/j.radcr.2024.01.080 -
Journal of Medical Case Reports Jan 2024Angiosarcoma of the gallbladder is a rare diagnostic entity rarely encountered by pathologists and has rarely been reported in literature. This review aimed to examine... (Review)
Review
BACKGROUND
Angiosarcoma of the gallbladder is a rare diagnostic entity rarely encountered by pathologists and has rarely been reported in literature. This review aimed to examine the clinicopathological features, immunohistochemistry, treatment, and outcomes of gallbladder angiosarcoma.
METHODS
A search of the PubMed, Science Direct and Google Scholar was done with the search terms ("angiosarcoma" OR "angiosarcomas") AND ("gallbladder" OR "gallbladders"). Based on inclusion and exclusion criteria, only case reports could be used for this review.
RESULT
8 case reports were chosen in the end for analysis. The mean age of the patients at presentation was 65 years. It was most frequently observed in males. Abdominal pain and palpable mass were the most commonly reported symptoms. Cholelithiasis and anemia were also reported. On histopathology morphologically epithelioid appearance of angiosarcoma was evident. Cytokeratin (CK) AE1/AE3, Von willebrand factor, Factor VIII antigen, Vimentin, CD31 were positive. Meanwhile, UEA, CD34, CD117, S-100, Keratin, EMA, and CEA showed negative outcome. Surgery was the preferred method of treatment and a mean 10-months follow-up was done.
CONCLUSION
Despite the unavailability of convincing data, histological and immunohistochemical analyses play a major role in the diagnosis of gallbladder angiosarcoma. Nevertheless, more comprehensive clinical studies are required to provide universal guidelines for the treatment and diagnosis of angiosarcoma of the gallbladder.
Topics: Aged; Humans; Male; Gallbladder Neoplasms; Hemangiosarcoma; Immunohistochemistry; Female
PubMed: 38291481
DOI: 10.1186/s13256-023-04323-z -
Cureus Oct 2023Spheno-occipital synchondrosis (SOS) is the joint regarded as the most important foundation for understanding cranial osteopathy and craniosacral therapy. SOS is the... (Review)
Review
Spheno-occipital synchondrosis (SOS) is the joint regarded as the most important foundation for understanding cranial osteopathy and craniosacral therapy. SOS is the origin of the primary respiratory mechanism (PRM), a movement between the posterior surface of the body of the sphenoid bone and the anterior surface of the base of the occipital bone. From the PRM perspective, an alteration of the position between the two bone surfaces would create cranial and/or craniosacral dysfunction. These positional alterations of the SOS (in adults and children) would determine specific and schematical movements of the bones of the entire skull, whose movements are recognizable by palpation by trained operators. PRM expression is influenced by other elements, such as movement of the cranial bones, inherent movement of the central nervous system, cyclic movement of cerebrospinal fluid (CSF), mechanical tension of the cranial meninges, and passive movement of the sacral bone between the iliac bones. The article reviews the most up-to-date information on the evolution of cranial sutures/joints and meninges in adulthood, the fluctuations of the CSF, brain, and spinal mass movements. Research should reconsider the motivations that induce the operator to discriminate the palpable cranial rhythmic impulse, and probably, to rethink new cranial dysfunctional patterns.
PubMed: 37808591
DOI: 10.7759/cureus.46527 -
BMJ Case Reports Nov 2023An athletic man in his 40s was brought in to the emergency department by ambulance following a brief episode of central chest pain and dizziness five miles in to a ten...
An athletic man in his 40s was brought in to the emergency department by ambulance following a brief episode of central chest pain and dizziness five miles in to a ten mile stationary bike ride. Observations were normal at the scene and there were no ECG changes but he appeared unwell. Further assessment revealed no palpable right radial or brachial pulses and he complained of a severe right frontal headache. CT of the aorta showed an extensive type A dissection with a significantly dilated aortic root. Following emergency cardiothoracic surgery, he was found to have suffered cerebral hypoxia and died.
Topics: Male; Humans; Bicycling; Aortic Dissection; Aorta; Headache; Chest Pain
PubMed: 37977829
DOI: 10.1136/bcr-2023-257207 -
Cureus Apr 2024Background A comprehensive understanding of the anatomy of the obturator nerve after its emergence from the obturator foramen is essential when undertaking an obturator...
Background A comprehensive understanding of the anatomy of the obturator nerve after its emergence from the obturator foramen is essential when undertaking an obturator nerve block effectively. This study was conducted to provide precise anatomical guidance of the obturator nerve block with surface landmarks in the inguinal region. Materials and methods A cross-sectional observational study was carried out on 34 dissected embalmed cadaveric lower limbs to investigate anatomic variability of obturator nerve localization concerning bony/ligamentous landmarks viz. the pubic tubercle, anterior superior iliac spine, inguinal ligament, and femoral artery as well as the adductor longus. Results The pubic tubercle and inguinal ligament were found to be the "least variable indicator" and palpable landmark for localization of the main trunk of the obturator nerve exhibiting lesser standard deviation of the mean distance from the obturator nerve exit. Among the soft tissue (vessel/muscle) parameters, the shortest distance of the adductor longus muscle from the obturator nerve exit was found to have the lowest standard deviation, thus making it the most reliable parameter for obturator nerve localization. Conclusion High anatomic variability in the obturator nerve's localization does exist, and this explains the difficulty frequently encountered in the application of regional anesthetic techniques. The pubic tubercle and inguinal ligament points were found to be the least variable and most reliable landmarks for localization of the main trunk of the obturator nerve.
PubMed: 38803737
DOI: 10.7759/cureus.59125 -
Royal Society Open Science Jul 2023Twitter is in turmoil and the scholarly community on the platform is once again starting to migrate. As with the early internet, scholarly organizations are at the... (Review)
Review
Twitter is in turmoil and the scholarly community on the platform is once again starting to migrate. As with the early internet, scholarly organizations are at the forefront of developing and implementing a decentralized alternative to Twitter, Mastodon. Both historically and conceptually, this is not a new situation for the scholarly community. Historically, scholars were forced to leave social media platform FriendFeed after it was bought by Facebook in 2006. Conceptually, the problems associated with public scholarly discourse subjected to the whims of corporate owners are not unlike those of scholarly journals owned by monopolistic corporations: in both cases the perils associated with a public good in private hands are palpable. For both short form (Twitter/Mastodon) and longer form (journals) scholarly discourse, decentralized solutions exist, some of which are already enjoying some institutional support. Here we argue that scholarly organizations, in particular learned societies, are now facing a golden opportunity to rethink their hesitations towards such alternatives and support the migration of the scholarly community from Twitter to Mastodon by hosting Mastodon instances. Demonstrating that the scholarly community is capable of creating a truly public square for scholarly discourse, impervious to private takeover, might renew confidence and inspire the community to focus on analogous solutions for the remaining scholarly record-encompassing text, data and code-to safeguard all publicly owned scholarly knowledge.
PubMed: 38033719
DOI: 10.1098/rsos.230207