Low back pain as the presenting sign in a patient with primary extradural melanoma of the thoracic spine - A metastatic disease 17 Years after complete surgical resection

Primary spinal melanomas are extremely rare lesions. In 1906, Hirschberg reported the first primary spinal melanoma, and since then only 40 new cases have been reported. A 47-year-old man was admitted suffering from low back pain, fatigue and loss of body weight persisting for three months. He had a 17-year-old history of an operated primary spinal melanoma from T7-T9, which had remained stable for these 17 years. Routine laboratory findings and clinical symptoms aroused suspicion of a metastatic disease. Multislice computed tomography and magnetic resonance imaging revealed stage-IV melanoma with thoracic, abdominal and skeletal metastases without the recurrence of the primary process. Transiliac crest core bone biopsy confirmed the diagnosis of metastatic melanoma. It is important to know that in all cases of back ore skeletal pain and unexplained weight loss, malignancy must always be considered in the differential diagnosis, especially in the subjects with a positive medical history. Patients who have back, skeletal, or joint pain that is unresponsive to a few weeks of conservative treatment or have known risk factors with or without serious etiology, are candidates for imaging studies. The present case demonstrates that complete surgical resection alone may result in a favourable outcome, but regular medical follow-up for an extended period, with the purpose of an early detection of a metastatic disease, is highly recommended

Inspiring and transforming the pre-service teacher through authentic classroom preparation

In this chapter, a course design was examined that sought to bridge the university experience of PSTs with the rich and complex reality of classroom life through a focus on authenticity. By augmenting concepts with richly authentic materials and introducing classroom encounters through microteaching with simulated misbehaviour, PSTs were brought close to the reality of the classroom. Carefully selected streamable, unscripted video footage of actual classrooms enabled the analysis of key sequenced strategies. Each analysed strategywas supported by conceptual accounts from lecture materials and readings. These strategies were then practised through microteaching with role-play scenarios where PSTs re-enacted authentic school student behaviours, including challenging misbehaviours. Concept, strategy and modelling came together in this course to bring the reality of the classroom as near as possible. The effectiveness of the design was examined through in-depth semi-structured interviews of course participants’ post-teaching placements. Results showed a substantial positive self-assessed transfer in course learning into the school classroom—the primary goal of the course design. In addition to competence, a reduction in anxiety and stress due to a sense of preparedness was commented upon.Robert Matthew