Gastroesophageal intussusception with complete herniation of the spleen in a 12 months old dog with idiopathic megaoesophagus

A 12 months old, castrated male, mix-breed dog was presented due to acute onset of vomiting, retching, anorexia, and tachypnoea. Idiopathic megaoesophagus was diagnosed three months prior to presentation. Radiographic and CT examination revealed gastroesophageal intussusception with herniation of the complete spleen into the intussusception. After initial stabilization surgical treatment was performed. The stomach and spleen were manually reduced into the abdomen. Due to questionable viability of the gastric wall an inverting suture pattern was used to invaginate the compromised part. Left sided gastropexy was performed to reduce risk of recurrence. Additionally oesophagopexy was performed to reduce the risk of hiatal hernia due to intraoperative damage to the hiatus. The patient recovered uneventful and was discharged from hospital five days following surgery. Conservative treatment of concurrent megaoesophagus was continued. At last follow up, 10 months later, the dog was clinically fine, had gained weight, and showed no signs of regurgitation

Merkel cell carcinoma in a 17-year-old boy, report of a highly aggressive fatal case and review of the literature

Merkel cell carcinoma is a rare tumor frequently involving the skin with an aggressive behavior and fatal outcome. It occurs mostly in the caucasian race between 60–80 years of age and it is rare in children. Herein we report our experience with a highly aggressive fatal Merkel cell carcinoma in an immunocompetent 17-year-old boy. Its characteristics and treatment modalities will be also discussed

Malignant melanoma of the rectum: a case report

<p>Abstract</p> <p>Introduction</p> <p>Anorectal melanoma represents an unusual but important presentation of rectal malignancy. There have only been a few cases reported and the optimum management for this condition is still undecided, however, prompt diagnosis is essential. We have outlined current treatment options.</p> <p>Case presentation</p> <p>We report a case of malignant melanoma of the rectum in a 55-year-old Caucasian man presenting as an emergency with rectal bleeding. Biopsies were taken of the fleshy mass found on digital examination, which confirmed malignant melanoma. No distant metastases were found. He underwent an abdominoperineal resection. We report the surgical management of this rare and aggressive malignancy.</p> <p>Conclusion</p> <p>Treatment options for this condition are divergent. Surgical management varies from wide local excision to abdominoperineal resection. Clinical awareness in both medical and surgical clinics is required for prompt diagnosis and treatment.</p

The Clicker Study

Purpose: A recent study in orthopedics showed that clicker-based learning was more effective than traditional feedback when teaching procedures. We sought to determine whether this principle is applicable to ultrasound skills. Methods: Our prospective randomized control trial used a population of new ultrasound learners. Exclusion criteria included previous ultrasound experience of more than one hour. Students were shown an instructional video on the Focused Assessment with Sonography in Trauma (FAST) exam and randomized to receive clicker or scripted feedback. Each student performed the FAST exam once without feedback, then with either scripted or clicker-based feedback. They were timed and scored on 18 microskills. Results and Conclusions: 45 students were enrolled in the study, with 6 excluded from analysis. This included 24 premedical and 15 medical students. No significant differences were observed between groups for time or accuracy on the FAST exam. Among medical students, there was a trend toward faster results in the clicker group (mean=83 seconds) than the script group (mean=103 seconds) (p=0.22). Among undergraduates, there was a trend toward higher accuracy in the script group (mean=100%) than the clicker group (mean=95%) (p=0.068) and towards faster performance (mean=103 seconds) than the clicker group (mean=121 seconds) (p=0.38). Although no significant differences were observed, there seemed to be a trend toward faster performance with clicker feedback among medical students and faster and more accurate performance with scripted feedback among premedical students. This may be an area for future study

Radiation-associated sarcoma of the skull base after irradiation for pituitary adenoma

Secondary, radiation-induced neoplasms represent a significant long-term risk after radiation treatment, and radiation-induced sarcomas (RAS) have an especially poor prognosis. These have rarely been reported after irradiation for pituitary adenomas

Concurrence of Danish Dementia and Cataract: Insights from the Interactions of Dementia Associated Peptides with Eye Lens α-Crystallin

Familial Danish Dementia (FDD) is an autosomal disease, which is distinguished by gradual loss of vision, deafness, progressive ataxia and dementia. Cataract is the first manifestation of the disease. In this article, we demonstrate a specific correlation between the poisoning of the chaperone activity of the rat eye lens α-crystallins, loss of lens transparency in organ culture by the pathogenic form of the Danish dementia peptide, i.e. the reduced Danish dementia peptide (redADan peptide), by a combination of ex vivo, in vitro, biophysical and biochemical techniques. The interaction of redADan peptide and lens crystallins are very specific when compared with another chaperone, HSP-70, underscoring the specificity of the pathogenic form of Danish dementia peptide, redADan, for the early onset of cataract in this disease

Towards an understanding of the information and support needs of surgical adolescent idiopathic scoliosis patients: a qualitative analysis

<p>Abstract</p> <p>Background</p> <p>Informed decision making for adolescents and families considering surgery for scoliosis requires essential information, including expected outcomes with or without treatment and the associated risks and benefits of treatment. Ideally families should also receive support in response to their individual concerns. The aim of this study was to identify health-specific needs for online information and support for patients with adolescent idiopathic scoliosis who have had or anticipate having spinal surgery.</p> <p>Methods</p> <p>Focus group methodology was chosen as the primary method of data collection to encourage shared understandings, as well as permit expression of specific, individual views. Participants were considered eligible to participate if they had either experienced or were anticipating surgery for adolescent idiopathic scoliosis within 12 months, were between the ages of 10 and 18 years of age, and were English-speaking.</p> <p>Results</p> <p>Two focus groups consisting of 8 adolescents (1 male, 7 female) and subsequent individual interviews with 3 adolescents (1 male, 2 female) yielded a range of participant concerns, in order of prominence: (1) recovery at home; (2) recovery in hospital; (3) post-surgical appearance; (4) emotional impact of surgery and coping; (5) intrusion of surgery and recovery of daily activities; (6) impact of surgery on school, peer relationships and other social interactions; (7) decision-making about surgery; (8) being in the operating room and; (9) future worries.</p> <p>Conclusion</p> <p>In conclusion, adolescents welcomed the possibility of an accessible, youth-focused website with comprehensive and accurate information that would include the opportunity for health professional-moderated, online peer support.</p