Psychological intolerance to implantable cardioverter defibrillator

Background: Implantable cardioverter defibrillators (ICD) are mobile implantable cardiac devices for immediate treatment of live threatening ventricular arrhythmias. However, these devices can affect patients, physiologically, psychologically and have effects on electrical devices. Case report: The case of a 61-year-old patient is reported. The patient came for regular 3-months visits with his ICD and complained about electromagnetic interference with all household electrical appliances, especially refrigerator and digital television set-top box. He described several phantom shocks when he came close to the electrical appliances. He noted the exact times and symptoms of the episodes but the device memory did not record anything. Conclusion: This case demonstrates the rare occurrence of psychological intolerance to implanted ICD shortly after implant. The device was programmed for higher sensitivity. The patient was calmed and reassured about the reprogramming.     

"Genetic emergencies" in a pediatric intensive care service

Case histories from the pediatric reanimation department (intubated children of 0 to 15) and neonatology of Renne's hospital are reviewed for the years 1987 and 1988. Among 1.555 admissions (486 in reanimation, 1069 in neonatology), 63, that is 4%, concerned the clinical geneticist. The distribution may be done in 32 malformations and genetic syndromes, 8 chromosomal defects, 6 neuro-muscular diseases, 6 metabolic diseases, 3 cystic fibrosis, 3 spina bifida, 5 varied diseases. The advice of the genetic counsellor was requested 8 times for an urgent case, and to arrive at a decision about a reanimation, 7 times before the death of a patient for the management of diagnostic techniques: biopsy, blood or urines sent to a specialized center.     

Traumatic Lesions of the Optic Chiasma: A Report of Four Cases

Case histories of four patients who suffered severe head trauma resulting in complete bitemporal hemianopia are presented. The optic chiasm was visualized in only one patient. It was markedly swollen and disintegrated. This appearance was consistent with multiple minute tears of the crossed fibres in the median sagittal plane. Other theories to explain the bitemporal field defect are discussed.     

SEARCH: a system for evaluation and archiving of radiation accidents based on case histories

Overexposure of humans to ionizing radiation has occurred worldwide in the past and will surely occur again in the future. In order to allow an effective radiation accident management, it is consequently necessary to be prepared for such emergency situations and to improve means and ways to help people suffering from radiation-induced health impairments. Such approaches should rely on knowledge and experience gained from previous radiation incidents. A prerequisite for any scientific evaluation and comparison of information related to radiation accidents is to collect data in a standardized way. Therefore, the SEARCH database (System for Evaluation and Archiving of Radiation accidents based on Case Histories) has been developed in our department and implemented as an Oracle 8.0 database containing to date more than 800 case histories. The use of this registry is so far limited to active contributors and requires each contributor to sign a cooperation agreement. More information is available under http://www.faw.uni-ulm.de/radmed/. Received: 7 February 2000 / Accepted: 8 May 2000     

Incomplete intestinal obstruction as the possible main complaint in Behcet’s disease after surgery for recurrent abdominal aortic pseudoaneurysms: a case report and literature review

Background

Behcet’s disease (BD) is a systemic vasculitis characterized by oral and genital aphthosis, and ocular and skin lesions. The disease is involved in vascular, gastrointestinal, and central nervous systems. Vasculitis may exacerbate fatal problems, such as anastomotic pseudoaneurysms. If the mesenteric vessels are involved, severe abdominal symptoms such as intestinal obstruction may occur.

Case presentation

This case report describes a young female patient who suffered from BD with recurrent abdominal aortic pseudoaneurysms, as well as deep venous thrombosis and subsequent complications of incomplete intestinal obstruction. This patient first underwent stent grafting, which was followed by rupture of two newly formed anastomotic pseudoaneurysms within six months. Emergency open surgical repair (OSR) was then performed on the ruptured pseudoaneurysms. Thrombosis and incomplete ileus occurred five months after surgery. This case was unique due to the presence of incomplete intestinal obstruction being the possible main complaint for a patient with Behcet’s disease, and it is the first ever case to be reported.

Conclusion

Intestinal obstruction may present as the possible main complaint in BD. Careful and attentive strategy should be carried out to prevent fatal outcomes.

     

Fibroma with minor sex cord elements – an incidental finding in a normal sized ovary A case report with literature review

Background

Glomerulocystic kidney disease is an uncommon type of cystic renal disease. It is characterized by cortical microsysts, which are represented by cystic dilatation of Bowman's spaces.

Case presentation

We describe a case of glomerulocystic disease in a neonate and another in an abortus associated with tracheo-oesophageal fistula and megacystic-megaureter syndrome. The kidney on autopsy was sponge-like and revealed presence of cysts corresponding to dilatations of Bowman's space microscopically. In these two cases, the Glomerulocystic Kidney Disease in one case corresponded to a sporadic form and, in the other, to a syndromic, non-heritable form of glomerulocystic kidney disease.

Conclusion

The associated anomalies in Glomerulocystic Kidney disease are well described in the literature. Two more new unrelated associations are described in this article.     

某二级医院住院病历中不良事件风险评估的应用与研究

目的:通过病历中发生的不良事件及其风险度来评价病历质量,目的为加强病历环节和细节的质控,减少或杜绝病历中不良事件的发生,提高病历书写质量,保证医疗安全,减少医疗纠纷。方法:随机抽查2007-2010年某二级医院住院病历4837份,对其进行不良事件风险评估,对病历的终末质量和环节质量进行综合评价分析,找出影响医疗质量的相关联因素。结果:通过对某二级医院2007-2010年随机抽查的终末病历和病房中运行病历的不良事件风险评估,数据经过统计学处理后P值<0.01,说明总的病历中不良事件发生率年度间逐年减少,有极为显著的差别,证明此种病历评价方法切实可行。结论:病历中不良事件风险评估,是减少病历中不良事件发生的有效办法,可以消除病历书写中存在的医患矛盾和医疗纠纷隐患。     

Semantics of case

This paper presents a framework which connects case assignment with the semantics of argument realization. Broad notions of agency and affectedness are decomposed into more fine-grained semantic properties, loosely based on Dowty??s Proto-Role theory, but conceived in terms of privative opposition and organized into a lattice. This lattice provides a semantic space of participant properties and supports defining hierarchical relations among participant types, interpreted as semantic prominence, as well as topological relations such as ??closeness??, interpreted as semantic similarity between participant types. Cases are defined as connected regions of this space, relating a given case to a structured set of semantic properties. A case system is represented as a semantic system, which embodies oppositions and contrasts, and operates against the backdrop of the general semantics of argument realization, where one can define notions such as maximal agents and maximal patients and represent generalizations from the research on transitivity. Core case markers (e.g. ergative, accusative) are represented as subspaces of the lattice spreading outwards from the maximal agent and maximal patient nodes of the lattice. Case alternations arise when the subspace of the lattice delimited by a predicate??s entailments for an argument is partitioned by different cases, exemplified with the genitive/accusative alternation in Russian occurring with direct objects of certain intensional predicates. This method also provides a treatment of case polysemy, viz. a single case subsuming multiple uses, by relating the diverse uses at the more abstract semantic level of the case??s region on the lattice, demonstrated with non-canonical uses of the dative.     

Langerhans's cell histiocytosis in old subjects: two rare case reports and review of the literature

doi: 10.1111/j.1741‐2358.2012.00629.x Langerhans’s cell histiocytosis in old subjects: two rare case reports and review of the literature Background: Langerhans cell histiocytosis (LCH) is a proliferative disease of histiocyte‐like cells that generally affects children; LCH onset is rare in adults; immunohistochemistry is essential to obtain the correct diagnosis, and treatment protocols are controversial. Objective: To describe two new cases of adult onset oral LCH. Case reports: Case 1: a 71‐year‐old woman, complaining of diffuse oral pain, presented with erythematous mucosal lesions; the panoramic radiograph and CT scan showed multiple mandible radiolucent areas. Immunohistochemical assay for S‐100, CD1a and langerin test was essential in reaching the correct diagnosis. Case 2: a 77‐year‐old female patient presented with a non‐painful, non‐bleeding, slightly elevated erythematous palatal lesion of 6 months duration, together with a genital vulvar lesion of uncertain nature. The pathology confirmed the diagnosis of LCH. Many therapies (etoposid, radiotherapy) could induce only a clinical partial remission; Cladribine induced a complete recovery. Conclusion: The first case was difficult to diagnose: the clinical presentation and course of the disease (LCH) in the elderly are multiple and unpredictable. An immunohistochemistry study is often essential to obtain the correct diagnosis. The second case required several therapeutic interventions: even though some cases regress spontaneously, others require systemic chemotherapy.     

Liaison psychiatry on a coronary care unit.

This paper presents several of the author's experiences as a liaison psychiatrist on coronary care units. Technological and pharmacological advancements over the past decade have made major contributions toward reducing the psychological stress of patients admitted to these units. The psychiatrist's main liaison role is in assisting with patient education and rehabilitation efforts. Examples are given of a patient education program and reasons for systematic evaluations for such programs. The psychiatrist also can aid in patient rehabilitation efforts carried out in the outpatient clinic. Results are given from an experimental program of group therapy as an adjunct to the treatment of post-myocardial infarction patients. Finally, two case histories are briefly presented which exemplify subjects' serum uric acid and serum cholesterol variability associated with psychological stresses encountered during their hospitalization following a myocardial infarction.     

The Admissibility of Outer Continental Shelf Delimitation Claims Before the ICJ Absent a Recommendation by the CLCS

In the 2017 Maritime Delimitation in the Indian Ocean Case, the International Court of Justice stated that “in appropriate circumstances” maritime delimitation claims beyond 200 nm may be admitted before the Commission on the Limits of the Continental Shelf issues a recommendation. This is a deviation from the Court's previous approach in the 2016 Nicaragua v. Colombia (Preliminary Objections) Case. This article follows the evolution of the international case law with respect to the admissibility of outer continental shelf delimitation claims absent a final and binding outer limit, and highlights the positive implications of the International Court's most recent formula.