Excisional biopsy and radiotherapy for management of an olfactory neuroblastoma in an axolotl (Ambystoma mexicanum)

2022 ◽  
pp. 1-6
Author(s):  
Florent Modesto ◽  
Alexandra Nicolier ◽  
Clémence Hurtrel ◽  
Jérôme Benoît
Keyword(s):  
Physical Examination ◽  
Radiation Effects ◽  
Excisional Biopsy ◽  
Olfactory Neuroblastoma ◽  
Clinical Findings ◽  
Ambystoma Mexicanum ◽  
Nasal Fossa ◽  
Intact Male ◽  
Histologic Evaluation ◽  
Rostral Portion

Abstract CASE DESCRIPTION A 4-year-old sexually intact male leucistic axolotl (Ambystoma mexicanum) was presented with a 2-week history of dysrexia and difficulty swallowing. CLINICAL FINDINGS Physical examination revealed a 1-cm-diameter intraoral mass on the rostral aspect of the palate and swelling of the left nasal fossa. Local invasion into the left nasal fossa was suspected during oral examination. The lesion was marginally excised, and an incompletely excised olfactory neuroblastoma was diagnosed histologically. Five weeks later, physical examination revealed persistent erythema, delayed healing of the rostral portion of the palate, and a mild facial deformity associated with a white mass in the nasal cavity. TREATMENT AND OUTCOME 6 weeks after excision, adjuvant electron (6-MeV) beam radiotherapy was initiated for treatment of the incompletely excised olfactory neuroblastoma and likely presence of a recurrent mass. The protocol consisted of 4 weekly fractions of 8 Gy each (total, 32 Gy) with the axolotl under anesthesia. No acute adverse radiation effects were noted following radiotherapy. The oral erythema resolved after the third session. No recurrence was observed 2 months after treatment, and the owners reported no abnormal signs at home. The axolotl died 3.5 months after radiotherapy was completed (8 months after marginal excision of the tumor) secondary to an environmental management failure. Postmortem histologic evaluation showed no evidence of neoplasia. CLINICAL RELEVANCE In axolotls, olfactory neuroblastoma should be considered in the differential diagnosis of intraoral palatal masses. This report describes the first application of radiotherapy for treatment of an olfactory neuroblastoma in an axolotl.

scholarly journals Inter-examinerreliability study of physical examination procedures to assess the cervical spine

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Karthik V. Hariharan ◽  
Michael G. Timko ◽  
Christopher G. Bise ◽  
Meenakshi Sundaram ◽  
Michael J. Schneider
Keyword(s):  
Cervical Spine ◽  
Physical Examination ◽  
Facet Joint ◽  
Physical Therapists ◽  
Clinical Status ◽  
Clinical Findings ◽  
Qualitative Assessment ◽  
Segmental Mobility ◽  
Convenience Sample ◽  
Pain Provocation

Abstract Objective The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine. Materials: Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure. Results When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test. Conclusions Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.

Arthroscopic shoulder assessment in Turkish amateur boxers

Open Medicine ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 358-362
Author(s):  
Hüseyin Özkan ◽  
İbrahim Yanmış ◽  
Mustafa Kürklü ◽  
Ali Şehirlioğlu ◽  
Servet Tunay ◽  
...  
Keyword(s):  
Physical Examination ◽  
Clinical Findings ◽  
Subacromial Impingement ◽  
Shoulder Injuries ◽  
Pathological Findings ◽  
Glenoid Labrum ◽  
Arthroscopic Findings ◽  
Shoulder Region ◽  
Grade 3 ◽  
The Brain

AbstractThe most common injuries reported in the literature regarding the sport of boxing are to the brain, eyes, kidneys and hands. Shoulder injuries have not been fully reported in the literature until recently, as a result we aimed to present our arthroscopic findings in amateur boxers. Ten amateur boxers with complaints of pain in the shoulder region and decreased performance during sportsplay were enrolled. They were evaluated by physical examination, radiology and arthroscopy. There were no clinical findings of instability. One patient was found to have subacromial impingement; six had crepitation at various degrees during shoulder movements. At arthroscopy, all patients had a variety of pathological findings. Five patients had Grade 1, three had Grade 2, and two had Grade 3 chondropathy. Various degrees of fraying of the anterosuperior and posterosuperior regions of the glenoid labrum were noted in all cases. Three patients had superior labrum anterior and posterior lesions, one patient had a posterior labroligamentous lesion, and one had chondral erosion in the anterosuperior portion of the humeral head. In conclusions, although the injury mechanism of the shoulder during boxing is unknown, this study shows that shoulder complaints in boxers should be considered as possible indicators of serious intra-articular lesions.

Extremity Injuries in Children: Predictive Value of Clinical Findings

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 803-807
Author(s):  
Frederick P. Rivara ◽  
Ruth Ann Parish ◽  
Beth A. Mueller
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Clinical Findings ◽  
Clinical Predictors ◽  
Lower Extremity Fracture ◽  
Extremity Fracture ◽  
Extremity Injuries ◽  
Physical Findings ◽  
Upper Extremity Fracture ◽  
Point Tenderness

This study sought to identify clinical predictors of extremity fracture in children with trauma. There were 189 children 1 to 15 years of age with 209 extremity injuries seen during a 9-month period. Gross deformity and point tenderness were the best predictors of upper extremity fracture; these two findings correctly identified 81% of children with fractures and 82% of these without fractures. Gross deformity and pain on motion best predicted lower extremity fracture, with 97% of children with fractures correctly identified. The study showed that physical examination is predictive of fractures in extremity injuries of children, regardless of age. In the absence of the specific physical findings identified by the study, the probability of diagnosing a fracture by roentgenographic findings is low.

scholarly journals Subcutaneous Lobular Capillary Hemangioma Presenting as a Facial Mass

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Charles Saadeh ◽  
Seckin O. Ulualp ◽  
Dinesh Rakheja
Keyword(s):  
Color Change ◽  
Benign Lesion ◽  
Excisional Biopsy ◽  
Capillary Hemangioma ◽  
Lateral Nasal Wall ◽  
Lobular Capillary Hemangioma ◽  
Mucous Membranes ◽  
Histologic Evaluation ◽  
Wall Mass ◽  
Surface Changes

Lobular capillary hemangioma is a benign lesion of the skin and mucous membranes. Subcutaneous lobular capillary hemangioma presents as a deeper nodule. Lack of the characteristic surface changes of this subtype of lobular capillary hemangioma makes the clinical diagnosis challenging. We describe clinical, radiologic, and histological features of a subcutaneous lobular capillary hemangioma tissue presenting as a facial mass in a 12-year-old male. The mass was a firm, nontender, immobile, subcutaneous nodule, with no color change of the overlying skin. CT imaging documented a hyperdense and nonlipomatous mass involving soft tissue of the left lateral nasal wall. An excisional biopsy was performed. Histologic evaluation showed subcutaneous lobular capillary hemangioma. Subcutaneous lobular capillary hemangioma, although uncommon, should be considered in the differential diagnosis of lateral nasal wall mass in children.

scholarly journals Cyclooxygenase Inhibitor Associated with Carboplatin in Treatment of Metastatic Nasal Carcinoma in Dog

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Carlos Eduardo Fonseca-Alves ◽  
Aline Gonçalves Corrêa ◽  
Fabiana Elias ◽  
Sabryna Gouveia Calazans
Keyword(s):  
Lymph Node ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Nasal Discharge ◽  
Upper Respiratory Tract ◽  
Intact Male ◽  
Nasal Sinus ◽  
Nasal Carcinoma

A 10-year-old, intact male, pinscher was presented with unilateral bloodstained nasal discharge, sneezing, dyspnea, zygomatic arch deformity, submandibular lymph node increase, blindness in right eye, and exophthalmia. After clinical examination, it was found that the animal presented with upper respiratory tract dyspnea origin, possibly caused by an obstructive process. Complete blood count (CBC), ocular ultrasonography, thoracic radiographs, mandibular lymph node, and nasal sinus fine needle aspiration were performed. The right mandibular lymph node excisional biopsy was conducted and a tumor sample was obtained through the nasal fistula at hard palate. The material was processed, paraffin embedded, sectioned, and stained with hematoxylin and eosin. Immunohistochemical staining for cytokeratin (AE1/AE3), vimentin, and COX-2 was performed. After histopathological evaluation nasal carcinoma diagnosis was obtained. Chemotherapy was established with carboplatin 300 mg/m2intravenously—four cycles with intervals of 21 days—and firocoxib 5 mg/kg orally every 24 hours for 7 months. After 7 months the treatment started, the animal presented with ataxia, vocalization, hyperesthesia, and anorexia. Due the clinical condition presented, the animal owner opted for performing euthanasia. The chemotherapy protocol was effective causing the disease stagnation, minimizing the clinical signs, and extending patient survival and quality of life.

scholarly journals Clavicle Pseudarthrosis: A Rare Cause of Thoracic Outlet Syndrome

2010 ◽  
Vol 37 (6) ◽  
pp. 863-865 ◽  
Author(s):  
Kathleen Joy Khu ◽  
Rajiv Midha
Keyword(s):  
Physical Examination ◽  
Shoulder Pain ◽  
Thoracic Outlet Syndrome ◽  
Clinical Findings ◽  
Radial Pulse ◽  
History Of ◽  
Arm Elevation ◽  
One Year ◽  
The Right ◽  
Intrinsic Muscles

A 22-year-old man presented with a one year history of rightsided shoulder pain, hand weakness and tingling, and purplish discoloration of the upper extremity upon abduction. He had congenital pseudarthrosis of the right clavicle since childhood. Aside from an obvious deformity characterized by asymmetry of the shoulders and a palpable bony depression over the right clavicle, the patient had been previously asymptomatic. Physical examination revealed the musculoskeletal deformities as described, as well as prominent veins over his right shoulder, arm, and chest. With arm elevation, his right arm became dusky and his radial pulse diminished. Neurologically, the patient had no deficits except for mild weakness (Grade 4+/5) of the ulnarinnervated intrinsic muscles of the right hand. The clinical findings were consistent with a combined neurogenic and vascular form of thoracic outlet syndrome.

scholarly journals Objective Structured Clinical Examination’s adaptation for final evaluation of the curricular component “Semiological Bases”

2019 ◽  
Vol 3 (1) ◽  
pp. 61
Author(s):  
Fernando Muti Carvalho ◽  
Marta Silva Menezes ◽  
Iêda Maria Barbosa Aleluia ◽  
Humberto Castro Lima Filho ◽  
Ana Veronica Mascarenhas Batista ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Physical Examination ◽  
Clinical Case ◽  
Medical Knowledge ◽  
Clinical Findings ◽  
Whole Process ◽  
Medical Student Learning ◽  
Practical Exam ◽  
De Medicina

BACKGROUND: The combination of both physiological knowledge of a variety of sistems and the clinical findings it is of extreme relevance to the medical student learning process. The proposal of a simulated enviroment, with clinical data collection and regular physical examination, is crucial to this process. The Semiological bases of Escola Bahiana de Medicina e Saúde Pública module, used by the OSCE’s 4th semester medical students, capacitate them for such means. SUMMARY OF WORK: The evaluation logistic was divided into two segments: the first one was made through a theorical exam with close questioning, exhibiting images and videos, but also containing an open-ended question requesting a construction of a fictional clinical case; in the second one it was applied a practical exam segmented by different fields of medical knowledge (neurological, cardiovascular and respiratory/abdomen), with the evaluation of 120 students and followed by the teacher’s feedbacks at the conclusion of each field exam. SUMMARY OF RESULTS: The experience was important, however, it is notable the need for a complex management and understanding of the evaluational process. Discussion between students and teachers happened in behalf of the development of such proposal. CONCLUSIONS: The application of theorical exams throughout the semester combined with a practical exam (the OSCE) at the conclusion of the curricular component Bases Semiológicas had significant weight to the whole process.

scholarly journals A case report and literature review: post-traumatic mammary myofibroblastoma

2019 ◽  
Vol 6 (4) ◽  
pp. 1385 ◽  
Author(s):  
Hadi Abdullah Alaskar ◽  
Ahmed Mohammed AlMuhsin ◽  
Mirza Faraz Saeed ◽  
Amro Salem
Keyword(s):  
Case Report ◽  
Malignant Tumors ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Clinical Findings ◽  
Histopathological Analysis ◽  
Minor Trauma ◽  
Elderly Age ◽  
Rare Benign Tumor ◽  
A Minor

Mammary myofibroblastoma is a rare benign tumor of the breast, with a higher incidence in elderly age group. It is diagnosed via radiologic and histologic findings, as clinical findings share the same presentation with other, more common, benign breast pathologies. Surgical excision is the only treatment modality used to treat this tumor. We report the case of a 56-years-old-male, who presented with the complaint of left-sided chest swelling for 1 year following a minor trauma to the chest. Ultrasonographic imaging of the mass was the initial investigation and it revealed a well-defined hypoechoic lesion, excisional biopsy was done, followed by histopathological analysis of the mass, which gave the diagnosis of mammary myofibroblastoma. The aim of this case-report is to further study and characterize this rare lesion and its relationship to previous minor or major trauma and other risk factors, in addition, a proper diagnosis should be taken when encountering a similar mass as it mimics many benign and malignant tumors, furthermore a follow up plan should be established to assess the rate of possible recurrence.

CLINICAL EVALUATION FOR SINUSITIS: MAKING THE DIAGNOSIS BY HISTORY AND PHYSICAL EXAMINATION

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 253-253
Author(s):  
Allen Adinoff
Keyword(s):  
Physical Examination ◽  
Clinical Evaluation ◽  
Clinical Findings ◽  
Clinical Impression ◽  
General Internists ◽  
Low Probability

The authors conclude that general internists, focusing on five clinical findings and their overall clinical impression, can effectively stratify patients with sinus symptoms as having a high, intermediate, or low probability of sinusitis.

Metabolic alkalosis following mitral valvuloplasty in a dog with preoperative acute kidney injury

2021 ◽  
pp. 1-5
Author(s):  
Katsuhiro Matsuura ◽  
Tomohiko Yoshida ◽  
Takuya Uehara ◽  
Shusaku Yamada ◽  
Hideki Yotsuida ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Mitral Valve ◽  
Metabolic Alkalosis ◽  
Kidney Injury ◽  
Clinical Findings ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Intact Male ◽  
Plasma Urea ◽  
Acid Base Status

Abstract CASE DESCRIPTION An 11-year-old sexually intact male Shih Tzu diagnosed with acute kidney injury and left-sided congestive heart failure that had nonelective mitral valve surgery. CLINICAL FINDINGS Metabolic alkalosis developed postoperatively, and plasma bicarbonate concentration peaked 2 days after surgery (40.2 mmol/L; pH, 7.550). TREATMENT AND OUTCOME Acetazolamide administration increased the urinary excretion of bicarbonate and contributed to the improvement of the dog’s acid-base status and oxygenation capacity. Metabolic alkalosis persisted for 4 days after surgery, and no treatment was required after resolution. Plasma urea nitrogen and creatinine concentrations normalized 2 days after surgery. CLINICAL RELEVANCE Severe metabolic alkalosis can occur as a complication following mitral valve surgery. Acetazolamide may be suitable for the treatment of severe metabolic alkalosis.

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