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Editors choice

The case of chest pain

7 Feb, 14 | by Kristy Ebanks

A Trojan Horse Saddle stuck in the Lung

We have a very interesting image for you but, can you answer the questions below?

saddle

1. What is your differential diagnosis for chest pain and dyspnoea?
2. What abnormality is seen on the CT scan and ECG?
3.What is the gold standard for investigation of this condition?

If you don’t know the answers or want to know more read A Trojan Horse Saddle stuck in the Lung !!

Alveolar Ethmoidal Rhabdomyosarcoma in a Young Adult Male

20 Dec, 13 | by Kristy Ebanks

A very well written case, which would be of interest to many specialties, with a clear discussion and relevant references. It may be useful for readers to highlight that rhabdomyosarcoma is most common in the paediatric population and thereby making the  presentation of this type of tumour in this case more unusual. Also mention of the reasoning behind mode of imaging includes the learning point “MR imaging is preferred to CT for diagnostic and follow-up investigation”. Most centres will have easier access to CT scanning and usually perform CT sinus imaging with such a presentation, as was done in this case, so it would be helpful to discuss features on CT than would make one consider further imaging. I believe this case to be fit for publication and enjoyed reading it.

Reviewer
Dr Emma Parish
Ninewells Hospital and Medical School, Dundee

Alveolar Ethmoidal Rhabdomyosarcoma in a Young Adult Male

An Unusual Posterior Fossa Tumour in a Young Child

10 Dec, 13 | by Kristy Ebanks

The authors describe the case of a 23-month old child with a posterior fossa tumour, which was removed and turned out to be a choroid plexus papilloma. As they state, choroid plexus papilloma is encountered commonly in the first two years of life, but very rarely in the posterior fossa. It is more common in the lateral ventricles. In such a young child, the most likely diagnoses at this age would be medulloblastoma or Atypical Teratoid Rabdoid Tumour (ATRT). This is an interesting case, worth illustrating, serving as a reminder of rare pathological entities.

Reviewer
Professor Spyros Sqouros
Mitera Childrens Hospital

An Unusual Posterior Fossa Tumour in a Young Child

Chiari malformation and central sleep apnoea: successful therapy with adaptive pressure support servo-ventilation following surgical treatment

3 Dec, 13 | by Kristy Ebanks

This is a well written manuscript. The case is of interest to general physicians and highlights an important associations. The therapy described is of innovative nature and allows the reader to be familiarized with this novel mode of therapy. The case also discusses important, to general physicians, Chiari malformation. In my opinion this is a very interesting case that provides valuable learning points.

Reviewer
Dr Kastelik
Castle Hill Hospital

Chiari malformation and central sleep apnoea: successful therapy with adaptive pressure support servo-ventilation following surgical treatment

Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab

26 Nov, 13 | by Kristy Ebanks

These cases illustrate a number of important points of relevance to acute and general medical physicians as well as in specialties such as Rheumatology. Firstly, patients who are on anti-IL-6 medications may present in a different and less florid way when infected systemically with Staphylococcus aureus than immunocompetent patients. Secondly, they provide a reminder to doctors to ask about any injected therapies that the patient may have received in the last 6 months when taking a drug history. Thirdly, they give a warning to prescribers of drugs such as tocilizumab that such bacterial dissemination can occur, and to be particularly wary in the presence of likely risk factors, such as indwelling prosthetic material or previous invasive disease caused by Staphylococcus aureus.

Reviewer
Dr Thomas C Morris
NHS - Infectious Diseases

Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab

Hypertrophic Pulmonary Osteoarthropathy and Congenital Heart Disease

22 Nov, 13 | by Kristy Ebanks

Secondary Hypertrophic osteoarthropathy in cyanotic congenital heart disease is a well known complication but its awareness is coming down. Though its prevalence may have come down thanks to total correction and better palliation during childhood it has not totally disappeared. Awareness about its presentation and x-ray findings is must for a timely diagnosis and management as illustrated in this aptly titled case report.

Reviewer
Dr.Ravindran Rajendran
Sri Jayadeva Institute of Cardiovascular Sciences and Research

Hypertrophic Pulmonary Osteoarthropathy and Congenital Heart Disease

Failure of anti-TNF therapy to reactivate previously septic prosthetic joints

22 Nov, 13 | by Kristy Ebanks

There are many problems and alarms arising from anti-TNF therapy employed by biological drugs and infections. On the other hand, the medical behavior on this issue is usually personal and medical decisions are made on a case-by-case.  In this case, the elapsed time from the previous infections is really considerable and it is also reasonable that enough time has been passed to considered safe the use of immunosuppressive therapy. However, I must admit that in such a case many doctors may not prescribe this type of biological drugs, and this is the reason for which the publication of this case could be important.

Reviewer
Dr Luchetti
Università Politecnica delle Marche

Failure of anti-TNF therapy to reactivate previously septic prosthetic joints

Laugh-induced syncope

18 Nov, 13 | by Kristy Ebanks

Syncope is a common symptom in outpatient clinics or emergency departments. Laugh induced syncope is rare and laughter may not be recognized by physicians as a cause of syncope. I believe this case report is useful for generalists.

Reviewer
Dr Kurokawa
Kawasaki Medical School

Laugh-induced syncope

 

Bilateral cataracts and insulin oedema in a child with type 1 diabetes mellitus

8 Oct, 13 | by Emma

Well written case report of insulin edema and cataract following intense insulin. The only similar case is by Juliusson[1] but in this latter case cataract was present initially and insulin edema followed insulin therapy.

The current case report offers good discussion allowing students to learn about the pathophysiology of cataract and insulin edema. This unique case is one more example to illustrate the need for a gradual insulin therapy and not intense upfront. This case report is a good addition to the literature.

Reference
1 Júlíusson PB, Bjerknes R, Søvik O, et al. [Generalized edema following insulin treatment of newly diagnosed diabetes mellitus]. Tidsskr Nor Laegeforen 2001;121:919-20.

Reviewer
Professor Ahmad M Mansour
American University of Beirut

Bilateral cataracts and insulin oedema in a child with type 1 diabetes mellitus

Vulvar adenocarcinoma: the visual resemblance with a vulvar abscess

1 Jul, 13 | by jhudson

Though vulvar cancer is not very common, the misdiagnosis of malignancy as an abscess by practising gynaecologists is a mistake, which can prove costly to the patient. This article focuses attention on this aspect.

Reviewer
Ranganath Ratnagiri
Yashoda Cancer Institute

Vulvar adenocarcinoma: the visual resemblance with a vulvar abscess

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