scholarly journals Sternocostoclavicular Hyperostosis: An Insufficiently Recognized Clinical Entity

2017 ◽  
Vol 10 ◽  
pp. 117954411770287 ◽  
Author(s):  
Taro Sugase ◽  
Tetsu Akimoto ◽  
Hidenori Kanazawa ◽  
Atsushi Kotoda ◽  
Daisuke Nagata
Keyword(s):  
Contrast Material ◽  
Chronic Hemodialysis ◽  
Left Shoulder ◽  
Central Vein ◽  
Sternocostoclavicular Hyperostosis ◽  
Venous Catheterization ◽  
Structural Abnormalities ◽  
Structural Impact ◽  
Left Subclavian Vein ◽  
History Of

A 79-year-old male chronic hemodialysis patient with no history of central venous catheterization was referred to our hospital with progressive swelling of the left upper limb ipsilateral to a forearm arteriovenous fistula. Radiological assessments revealed marked hyperostosis in the ribs, sternum, and clavicles with well-developed ossification of the sternocostoclavicular ligaments. Such characteristic structural abnormalities and our failure to identify the left subclavian vein with contrast material despite the abundant dilated collaterals in the left shoulder area encouraged us to diagnose our patient with sternocostoclavicular hyperostosis (SCCH) complicated by central vein obstruction. The structural impact of the sternocostoclavicular region as a potential risk for inducing central vein obstruction and the diagnostic concerns of SCCH in this patient are also discussed.

Rapid Central Vein Assessment (RaCeVA): A systematic, standardized approach for ultrasound assessment before central venous catheterization

2018 ◽  
Vol 20 (3) ◽  
pp. 239-249 ◽  
Author(s):  
Timothy R Spencer ◽  
Mauro Pittiruti
Keyword(s):  
Vascular Access ◽  
Central Venous Catheterization ◽  
Central Vein ◽  
Arterial Cannulation ◽  
Central Venous ◽  
Anatomical Structures ◽  
Venous Catheterization ◽  
Ultrasound Technology ◽  
Ultrasound Assessment ◽  
Vascular Structures

Ultrasound technology has revolutionized the practice of safer vascular access, for both venous and arterial cannulation. The ability to visualize underlying structures of the chest, neck, and upper/lower extremities provides for greater success, speed, and safety with all vascular access procedures. Ultrasound not only yields superior procedural advantages but also provides a platform to perform a thorough assessment of the vascular structures to evaluate vessel health, viability, size, and patency, including the location of other important and best avoided anatomical structures—prior to performing any procedures. Such assessment is best performed using a systematic and standardized approach, as the Rapid Central Vein Assessment, described in this study.

Experiences of Spiritual Visitation and Impregnation: Potential Induction by Frequency-Modulated Transients from an Adjacent Clock

2001 ◽  
Vol 92 (1) ◽  
pp. 35-36 ◽  
Author(s):  
M. A. Persinger ◽  
S. A. Koren
Keyword(s):  
Holy Spirit ◽  
Complex Form ◽  
Roman Catholic ◽  
Magnetic Anomalies ◽  
Brain Trauma ◽  
Female Adolescent ◽  
Left Shoulder ◽  
Left Handed ◽  
The Holy Spirit ◽  
History Of

A left-handed Roman Catholic female adolescent with a history of early brain trauma reported nightly visitations by a sentient being. During one episode she experienced vibrations of the bed, an external presence along the left side that moved into her body, inner vaginal (not clitoral) and uterine sensations, and the sense of being impregnated by a force she attributed to the Holy Spirit. After the latter experience she felt an invisible baby superimposed upon her left shoulder. Analyses of the measurements for magnetic anomalies within her bedroom indicated an electric clock about 20 cm from her head while she slept. The complex form of the 4 microT magnetic pulses generated by the clock was similar to shapes that evoke electrical seizures in epileptic rats and sensitive humans.

Bilateral brachiocephalic vein stenosis in a chronic hemodialysis patient with well-functioning arteriovenous fistula – A rare entity

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
MAJ GEN SINGH ◽  
VINOD KUMAR
Keyword(s):  
Arteriovenous Fistula ◽  
Young Female ◽  
Chronic Hemodialysis ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Chronic Hemodialysis Patient ◽  
Stage Renal Disease ◽  
End Stage ◽  
Vein Stenosis ◽  
Central Vein Stenosis

<b>Introduction:</b> Central vein stenosis has been reported in patients of end stage renal disease with subclavian vein being more commonly affected than brachiocephalic vein. <br><b>Case report:</b> We present a case of young female with bilateral brachiocephalic vein obstruction following arteriovenous fistula creation for hemodialysis.

scholarly journals Neurologic involvement in patients with atypical Chediak-Higashi disease

Neurology ◽  
2017 ◽  
Vol 88 (7) ◽  
pp. e57-e65 ◽  
Author(s):  
Wendy J. Introne ◽  
Wendy Westbroek ◽  
Catherine A. Groden ◽  
Vikas Bhambhani ◽  
Gretchen A. Golas ◽  
...  
Keyword(s):  
Natural History ◽  
Neuropsychological Testing ◽  
Early Adulthood ◽  
Systemic Complications ◽  
Natural History Study ◽  
Atypical Form ◽  
Blood Smears ◽  
Structural Abnormalities ◽  
History Of

Objective:To delineate the developmental and progressive neurodegenerative features in 9 young adults with the atypical form of Chediak-Higashi disease (CHD) enrolled in a natural history study.Methods:Patients with atypical clinical features, but diagnostically confirmed CHD by standard evaluation of blood smears and molecular genotyping, underwent complete neurologic evaluation, MRI of the brain, electrophysiologic examination, and neuropsychological testing. Fibroblasts were collected to investigate the cellular phenotype and correlation with the clinical presentation.Results:In 9 mildly affected patients with CHD, we documented learning and behavioral difficulties along with developmental structural abnormalities of the cerebellum and posterior fossa, which are apparent early in childhood. A range of progressive neurologic problems emerge in early adulthood, including cerebellar deficits, polyneuropathies, spasticity, cognitive decline, and parkinsonism.Conclusions:Patients with undiagnosed atypical CHD manifesting some of these wide-ranging yet nonspecific neurologic complaints may reside in general and specialty neurology clinics. The absence of the typical bleeding or infectious diathesis in mildly affected patients with CHD renders them difficult to diagnose. Identification of these individuals is important not only for close surveillance of potential CHD-related systemic complications but also for a full understanding of the natural history of CHD and the potential role of the disease-causing protein, LYST, to the pathophysiology of other neurodevelopmental and neurodegenerative disorders.

scholarly journals HEPATITIS C VIRUS INFECTION IN HEMODIALYSIS PATIENTS: COMPARISON OF THE SURABAYA DIALYSIS CENTER AND JUNTENDO UNIVERSITY HOSPITAL DIALYSIS CENTRE

2010 ◽  
Vol 1 (3) ◽  
pp. 105 ◽  
Author(s):  
Djoko Santoso ◽  
Pranawa Pranawa ◽  
Moh. Yogiantoro ◽  
Widodo Widodo ◽  
Aditia Wardana ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Chronic Hemodialysis ◽  
University Hospital ◽  
Hepatitis C Virus Infection ◽  
Serum Samples ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Hepatitis C virus infection is highly prevalence in chronic hemodialysis (HD) patients. The present study will compare prevalence of HCV positive population in difference countries where there are great contrasts in and diversity of care available to patients who have end stage renal disease. All serum samples of the 100 patients were tested for HCV antibodies, using third-generation enzyme immunoassay. The prevalence of anti-HCV was correlated with a history of blood transfusion and with duration of hemodialysis. HCV prevalences were 88% of Surabaya group and 6% of Juntendo Group, respectively. In Surabaya Group, prevalence of HCV positive was high and the risk factors are not only those of the Juntendo Group, but also a combination of poor living conditions, frequent blood transfusions, and lack of adherence. Much needs to be studied about the role of universal screening and effective techniques for primary prevention in Surabaya Group

scholarly journals Case Report: Humeral avulsion of the glenohumeral ligament of the shoulder

2005 ◽  
Vol 17 (1) ◽  
pp. 27
Author(s):  
RVP De Villiers ◽  
JF De Beer ◽  
K Van Rooyen ◽  
PE Huijsmans ◽  
CP Roberts ◽  
...  
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
South African ◽  
Rotator Cuff Tear ◽  
Sports Medicine ◽  
Left Shoulder ◽  
Anterior Instability ◽  
Glenohumeral Ligament ◽  
Cuff Tear ◽  
History Of

A 24-year-old rugby player presented to an orthopaedic surgeon with a history of dislocation of the left shoulder. It reduced spontaneously and dislocated again later during the same match. On examination there was no residual instability, but the apprehension test for anterior instability was positive. Speed s test as well as O Brien s test for SLAP (Superior Labrum Anterior to Posterior tear) lesions were negative. There were no signs of rotator cuff tear or impingement. South African Sports Medicine Vol.17(1) 2005: 27-28

Atypical Spindle Cell Lipomatous Lesion Resected From Patient With History of CLL

2020 ◽  
Vol 86 (9) ◽  
pp. 1208-1211
Author(s):  
Chase J. Wehrle ◽  
J. Will Daigle ◽  
Asad Ullah ◽  
Suash Sharma ◽  
Edmond F. Ritter ◽  
...  
Keyword(s):  
Spindle Cell ◽  
Lymphocytic Leukemia ◽  
Left Shoulder ◽  
Spindle Cell Lipoma ◽  
Atypical Lipomatous Tumor ◽  
Lipomatous Tumor ◽  
Adipocytic Tumors ◽  
History Of ◽  
Pathologic Analysis ◽  
Mdm2 Amplification

Atypical spindle cell lipomatous neoplasm, also known as well-differentiated spindle cell liposarcoma, represents a newly discovered entity of adipocytic tumors. Recent research has shown this tumor variant to be more related to spindle cell lipoma, rather than the originally hypothesized atypical lipomatous tumor spectrum. Here we present a case of a 58-year-old man with a history of chronic lymphocytic leukemia with an enlarging mass on the posterior left shoulder, initially hypothesized to be a benign lipoma. However, magnetic resonance imaging showed a large, multiseptated, heterogeneous mass concerning for soft tissue sarcoma. After resection, pathologic analysis showed cells closely resembling spindle cell lipoma, with additional cellular and fascicular zones containing lipoblasts and mitotic figures. Molecular analysis showed no MDM2 amplification. This lack of amplification indicates this tumor is distinctly different from an atypical lipomatous tumor, which characteristically displays MDM2 amplification. However, tumor expression of RB1 was normal. The majority of atypical spindle cell lipomatous neoplasms are associated with RB1 deletions. We conclude that we have a unique example of an atypical spindle cell lipomatous tumor.

scholarly journals 24 CerefolinNAC Therapy-Induced Dysgeusia

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 186-186
Author(s):  
Jasir T. Nayati ◽  
Fizah S. Chaudhry ◽  
Tajinder Parhar ◽  
Ather M. Ali ◽  
Alan R. Hirsch
Keyword(s):  
Treatment Options ◽  
Brain Mri ◽  
Hot Flashes ◽  
Unknown Origin ◽  
Oral Pain ◽  
Smell Test ◽  
Structural Abnormalities ◽  
Abductor Digiti Minimi ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

AbstractIntroductionCerefolinNAC (CFLN-NAC) is a prescription medical food reported to help with mild to moderate cognitive impairment [Pamlab 2017]. It contains L-methylfolate calcium (6mg), methylcobalamin (2mg), Schizochytrium (90.3mg), and N-acetylcysteine (NAC) (600mg) [Pamlab 2017]. However, dysgeusia secondary to CFLN-NAC therapy has not heretofore been described.MethodsA 64 year-old female presented with an eight year history of progressively decreased ability to smell and taste of unknown origin. CFLN-NAC was prescribed off-label to treat her hypogeusia and hyposmia. Three days after treatment initiation, her taste sensations gradually returned and she was able to describe food as bitter, salty, sour and sweet. Also, she was able to decipher the taste of different nuts, such as almonds, macadamia, pecans, and peanuts at baseline. However, her taste sensations became distorted and she was unable to distinguish specific foods. She reported that most food tasted bland, but she was still able to sense textures of various foods describing them as, “crunchy, but without taste.” She denied any oral pain, xerostomia, hot flashes, and psychological distress. CFLN-NAC was continued for three months and her hypogeusia improved from 20% to 80%. Her dysgeusia persisted, but remitted once CFLN-NAC was discontinued.ResultsAbnormalities in physical examination: General: scalloped tongue, decreased blink frequency, and hypokinesia. Cranial Nerve (CN) Examination: Olfaction (CN I) Testing: Alcohol Sniff Test: 8 (hyposmia). Pocket Smell Test: 2 (hyposmia). Olfactometer Identification Test: Left: 5 (anosmia); Right: 12 (hyposmia). CN III, IV, VI: saccadization on horizontal eye movement. Motor Examination: hypokinetic movements and 1+ cogwheel rigidity in bilateral upper extremities. Drift Test: bilateral abductor digiti minimi signs with cerebellar spooning. Reflexes: absent patellar and Achilles bilaterally. Hoffman’s Reflex: present bilaterally. Other: Magnetic resonance imaging (MRI) of the brain with contrast was unremarkable.ConclusionWhen treating taste impairments, vitamins and minerals have been found to enhance the effect of non-injured nerves, but they do not repair damaged nerves. The presence of a scalloped tongue may suggest nerve injury of unknown proportion, and can either diminish or alter taste. CFLN-NAC may have enhanced the gustatory stimulus of the non-injured nerves. This transient increase could have either caused her dysgeusia or possibly unmasked the dysgeusia secondary to a scalloped tongue. Notable impairments found in her exam evince Parkinson’s disease as a possible etiology, but structural abnormalities were not seen on brain MRI, making this unlikely. Conversely, the relatively rapid resolution after terminating CFLN-NAC strongly suggests that this is not merely a coincidence, but rather an origin. Those initiated on CFLN-NAC should be queried for new onset of dysgeusia and warrant other treatment options.Funding Acknowledgements: Smell & Taste Treatment and Research Foundation

INDEX OF SUSPICION

1996 ◽  
Vol 17 (8) ◽  
pp. 291-294
Author(s):  
J. Peter Harris ◽  
Carol J. Buzzard ◽  
Liliana D. Gutierrez ◽  
Franz E. Babl ◽  
Susan K Ratzan
Keyword(s):  
Early Diagnosis ◽  
Good Health ◽  
Left Shoulder ◽  
High School Senior ◽  
Left Chest ◽  
School Senior ◽  
History Of ◽  
Female High School ◽  
Case Presentations ◽  
The Right

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation While driving to work, a 17-year-old female high school senior who has been in good health has an abrupt syncopal episode resulting in a headon collision at 40 miles per hour. She is alert and oriented right after the accident, but complains of sternal pain as well as pain in her left chest, left shoulder, and the right side of her jaw. Evaluation in the emergency department reveals slight tachypnea of 26 breaths/min, blood pressure of 90/60 mm Hg, a midsternal abrasion, a left pneumothorax, and nondisplaced fractures of the left clavicle and right mandible. Results of her neurologic examination, including mental status, are normal. She denies the use of any medication, street drugs, or alcohol, but she does report a 9-month history of brief spells of lightheadedness, diaphoresis, nausea, and visual blackouts, with one previous episode proceeding to complete syncope.

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