scholarly journals Massive Orbital Myiasis Caused by Sarcophaga argyrostoma Complicating Eyelid Malignancy

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Anfisa Ayalon ◽  
Veronika Yehezkeli ◽  
Yossi Paitan ◽  
Krzysztof Szpila ◽  
Kosta Y. Mumcuoglu ◽  
...  
Keyword(s):  
Nursing Home ◽  
Surgical Excision ◽  
Medical Personnel ◽  
High Rate ◽  
Ocular Tissue ◽  
Nursing Home Staff ◽  
The Right ◽  
Fly Control ◽  
Sarcophaga Argyrostoma

Purpose. To report a case of massive orbital myiasis caused by the larvae of Sarcophaga argyrostoma, complicating eyelid malignancy. Observations. A 98-year-old man first presented to our clinic noted to have a fast-growing lesion on his right upper and lower eyelids. Squamous cell carcinoma of the eyelids was highly suspected, and surgical excision was advised, but the patient refused any surgical or nonsurgical intervention. For the next eight months, the patient’s family members continued to observe a high rate of tumor growth accompanied by deterioration of the general condition. During this whole period, the patient rejected admission to the hospital and was observed by nursing home staff. He was admitted to the emergency room in cachexic, unresponsive condition with fetid discharge and multiple live maggots crawling out from a large necrotic mass over the right orbit. On examination, no eyelids, eyeball, or other ocular tissue could be seen, while an extension of necrotic mass to forehead and midcheek was noted. Manual removal of larvae was performed. The patient passed away eight hours after his admission and larval removal. The maggots were identified as the third-instar larvae of Sarcophaga argyrostoma. Conclusions and Importance. This is the first reported case of home-acquired, massive orbital myiasis by S. argyrostoma. This case illustrates the crucial role of fly control as part of medical and home care in immobile patients. Moreover, it shows the importance of awareness by nursing home staff, paramedical, and medical personnel of possible myiasis, especially in bed-bound patients with skin malignancies and open wounds.

scholarly journals Big hitting collectors make massive and disproportionate contribution to the discovery of plant species

2012 ◽  
Vol 279 (1736) ◽  
pp. 2269-2274 ◽  
Author(s):  
Daniel P. Bebber ◽  
Mark A. Carine ◽  
Gerrit Davidse ◽  
David J. Harris ◽  
Elspeth M. Haston ◽  
...  
Keyword(s):  
Plant Species ◽  
Biological Diversity ◽  
High Rate ◽  
Type Specimens ◽  
Fundamental Goal ◽  
The World ◽  
Plant Families ◽  
The Right ◽  
Geographical Locations

Discovering biological diversity is a fundamental goal—made urgent by the alarmingly high rate of extinction. We have compiled information from more than 100 000 type specimens to quantify the role of collectors in the discovery of plant diversity. Our results show that more than half of all type specimens were collected by less than 2 per cent of collectors. This highly skewed pattern has persisted through time. We demonstrate that a number of attributes are associated with prolific plant collectors: a long career with increasing productivity and experience in several countries and plant families. These results imply that funding a small number of expert plant collectors in the right geographical locations should be an important element in any effective strategy to find undiscovered plant species and complete the inventory of the world flora.

scholarly journals Rare Leiomyoma of the Tunica Dartos: A Case Report with Clinical Relevance for Malignant Transformation and HLRCC

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Robert C. Bell ◽  
Evan T. Austin ◽  
Stacy J. Arnold ◽  
Frank C. Lin ◽  
Jonathan R. Walker ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Renal Cell ◽  
Cell Cancer ◽  
Surgical Excision ◽  
High Rate ◽  
Case Presentation ◽  
Increased Risk ◽  
The Right ◽  
Cutaneous Leiomyomas

Background. Genital leiomyomas fall under the broader category of cutaneous leiomyomas, which are rare smooth muscle neoplasms accounting for 5% of all leiomyomas. Genital leiomyomas arising from the dartos muscle are exceedingly rare with fewer than 30 cases reported in the literature. They are typically benign and adequately treated with simple surgical excision; however, previously reported cases of malignant transformation and a possible link to the hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome warrant closer follow-up.Case Presentation. We report a case of a 47-year-old male refugee from Rwanda found to have a mobile, pea-sized, mildly painful scrotal lesion near the left penoscrotal junction and 1.5 cm indeterminate vascular mass in the right kidney. Surgical excision of the scrotal nodule was performed and the diagnosis of a dartoic leiomyoma was rendered. The presence of moderate nuclear atypia, rare mitotic activity, and close surgical margins prompted a wide reexcision. We report the surgical approach, pathologic findings, and clinical follow-up related to this scrotal lesion.Conclusion. Scrotal leiomyomas demonstrate a high rate of recurrence and pose a risk for malignant transformation. They may also indicate an underlying autosomal dominant syndrome associated with increased risk for development of an aggressive form of renal cell carcinoma. When discovered, management should include surgical excision, screening for syndromic features, and routine follow-up.

scholarly journals ‘Powerlessness’ or ‘doing the right thing’ – Moral distress among nursing home staff caring for residents at the end of life: An interpretive descriptive study

2017 ◽  
Vol 31 (9) ◽  
pp. 853-860 ◽  
Author(s):  
Amanda Young ◽  
Katherine Froggatt ◽  
Sarah G Brearley
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
Critical Incident ◽  
Nurse Managers ◽  
Moral Distress ◽  
Structured Interviews ◽  
Nursing Home Staff ◽  
The Right ◽  
Do The Right Thing

Background: Caring for dying people can contribute to moral distress experienced by healthcare professionals. Moral distress can occur when this caring is restricted by organisational processes, resources or the provision of futile care. These factors apply to end of life care in nursing homes but research is lacking. Aim: To describe how nursing home staff experience moral distress when caring for residents during and at the end of life. Methods: An interpretive descriptive design, using the critical incident technique in semi-structured interviews to collect data from nursing home staff. Data were analysed using a thematic analysis approach. Setting: Four nursing homes in one large metropolitan area. Participants: A total of 16 staff: 2 nurse managers, 4 nurses and 10 care assistants. Findings: Participants described holding ‘good dying’ values which influenced their practice. The four practice-orientated themes of advocating, caring, communicating and relating with residents were found to influence interactions with residents, relatives, general practitioners, and colleagues. These led staff to be able to ‘do the right thing’ or to experience ‘powerlessness’, which could in turn lead to staff perceiving a ‘bad death’ for residents. Conclusion: When there are incongruent values concerning care between staff and others involved in the care of residents, staff feel powerless to ‘do the right thing’ and unable to influence care decisions in order to avoid a ‘bad death’. This powerlessness is the nature of their moral distress.

scholarly journals Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 370
Author(s):  
Octavian Neagoe ◽  
Cosmin Ioan Faur ◽  
Mihaela Ionică ◽  
Flavia Baderca ◽  
Roxana Folescu ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Surgical Excision ◽  
High Rate ◽  
Biological Entity ◽  
Fatty Tissue ◽  
Oncologic Surgery ◽  
Elastofibroma Dorsi ◽  
The Right

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the asymptomatic presentation of the contralateral subscapular mass, the patient underwent clinical and imagistic monitoring for the contralateral tumor. Due to its rare nature, ED is a difficult preoperative diagnosis that can, however, be suggested by its specific location and may require an accurate histopathological examination for a final diagnosis.

TransmembraneI Ca contributes to rate-dependent changes of action potentials in human ventricular myocytes

1999 ◽  
Vol 276 (1) ◽  
pp. H98-H106 ◽  
Author(s):  
Gui-Rong Li ◽  
Baofeng Yang ◽  
Jianlin Feng ◽  
Ralph F. Bosch ◽  
Michel Carrier ◽  
...  
Keyword(s):  
Action Potential ◽  
Ventricular Myocytes ◽  
Slow Component ◽  
Cell Voltage ◽  
High Rate ◽  
Delayed Rectifier ◽  
Rate Dependent ◽  
Ventricular Cells ◽  
The Right

The mechanism of action potential abbreviation caused by increasing rate in human ventricular myocytes is unknown. The present study was designed to determine the potential role of Ca2+ current ( I Ca) in the rate-dependent changes in action potential duration (APD) in human ventricular cells. Myocytes isolated from the right ventricle of explanted human hearts were studied at 36°C with whole cell voltage and current-clamp techniques. APD at 90% repolarization decreased by 36 ± 4% when frequency increased from 0.5 to 2 Hz. Equimolar substitution of Mg2+ for Ca2+ significantly decreased rate-dependent changes in APD (to 6 ± 3%, P < 0.01). Peak I Ca was decreased by 34 ± 3% from 0.5 to 2 Hz ( P < 0.01), and I Ca had recovery time constants of 65 ± 12 and 683 ± 39 ms at −80 mV. Action potential clamp demonstrated a decreasing contribution of I Ca during the action potential as rate increased. The rate-dependent slow component of the delayed rectifier K+current ( I Ks) was not observed in four cells with an increase in frequency from 0.5 to 3.3 Hz, perhaps because the I Ks is so small that the increase at a high rate could not be seen. These results suggest that reduction of Ca2+influx during the action potential accounts for most of the rate-dependent abbreviation of human ventricular APD.

scholarly journals Neoadjuvant and adjuvant doxorubicin chemotherapy in a case of feline soft tissue sarcoma

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691985787
Author(s):  
Filippo Torrigiani ◽  
Giorgio Romanelli ◽  
Paola Roccabianca ◽  
Elisabetta Treggiari
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Surgical Excision ◽  
Mesenchymal Tumour ◽  
Tissue Mass ◽  
History Of ◽  
Local Tumour ◽  
The Right ◽  
Slow Growing

Case summary A 7-year old male neutered domestic shorthair cat was presented with a 2 month history of a slow-growing mass on the right zygomatic area. A CT scan revealed a soft tissue mass in the right zygomatic region with no alterations of the underlying bone and features of local invasiveness. Cytology was suggestive of a mesenchymal tumour and histopathology from an incisional biopsy was consistent with a soft tissue sarcoma (STS). The cat was treated with neoadjuvant intravenous doxorubicin chemotherapy at a dose of 25 mg/m2, every two weeks. The patient experienced a partial response and underwent surgical excision of the tumour. Doxorubicin was continued as an adjuvant treatment for three further chemotherapy sessions, at a dose of 25 mg/m2 every 21 days. Local tumour recurrence was detected on clinical examination and cytologically confirmed 259 days following surgery. Relevance and novel information Treatment with neoadjuvant doxorubicin can be considered in cases of inoperable STSs in order to cytoreduce the tumour and improve the chances of achieving complete surgical margins. The role of adjuvant chemotherapy in this setting remains unclear.

scholarly journals Optimizing Loco Regional Management of Oligometastatic Colorectal Cancer: Technical Aspects and Biomarkers, Two Sides of the Same Coin

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2617
Author(s):  
Giovanni Mauri ◽  
Lorenzo Monfardini ◽  
Andrea Garnero ◽  
Maria Giulia Zampino ◽  
Franco Orsi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Irreversible Electroporation ◽  
High Rate ◽  
Technical Aspects ◽  
Consensus Conferences ◽  
Common Cancer ◽  
The Right ◽  
Two Sides ◽  
Selection Of

Colorectal cancer (CRC) is the third most common cancer worldwide and has a high rate of metastatic disease which is the main cause of CRC-related death. Oligometastatic disease is a clinical condition recently included in ESMO guidelines that can benefit from a more aggressive locoregional approach. This review focuses the attention on colorectal liver metastases (CRLM) and highlights recommendations and therapeutic locoregional strategies drawn from the current literature and consensus conferences. The different percutaneous therapies (radiofrequency ablation, microwave ablation, irreversible electroporation) as well as trans-arterial approaches (chemoembolization and radioembolization) are discussed. Ablation margins, the choice of the imaging guidance as well as characteristics of the different ablation techniques and other technical aspects are analyzed. A specific attention is then paid to the increasing role of biomarkers (in particular molecular profiling) and their role in the selection of the proper treatment for the right patient. In conclusion, in this review an up-to-date state of the art of the application of locoregional treatments on CRLM is provided, highlighting both technical aspects and the role of biomarkers, two sides of the same coin.

scholarly journals Case Report: Incidentally diagnosed hemangioma of the right atrioventricular groove in an athlete

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1080
Author(s):  
Asma Achour ◽  
Mezri Maatouk ◽  
Ahmed Miladi ◽  
Marouane Mahjoub ◽  
Mabrouk Abdelali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Rare Case ◽  
Surgical Excision ◽  
Resonance Imaging ◽  
Atrioventricular Groove ◽  
Incidental Discovery ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

The purpose of this article is to illustrate a rare case of a pericardial hemangioma of the right atrioventricular groove of incidental discovery in a tennis player who presented with cough and dyspnea and was treated by surgical excision with a favorable outcome. We also report the role of cardiac magnetic resonance imaging (MRI) in the diagnosis and management of this pericardial tumor.

The Role of ICTs in Rural Schools of Patagonia

2013 ◽  
pp. 38-58 ◽  
Author(s):  
Flavio Caldas ◽  
Ana García-Valcárcel Muñoz-Repiso
Keyword(s):  
Indigenous People ◽  
Aboriginal People ◽  
Intercultural Education ◽  
First Century ◽  
High Rate ◽  
Early Twenty ◽  
Technological Tools ◽  
The Right

UNESCO indicates that one of the biggest problems we have to solve in the early twenty-first century is the abolition of differences between individuals and cultures. Intercultural education is a necessary and urgent alternative in order to change the current situation, and ICTs, with their potential to meet and interact with people from different countries and cultures, offer interesting tools in this matter. Argentina acknowledges the right of indigenous people to access bilingual and intercultural education and seeks to improve teachers’ skills to achieve a better quality of education that allows equal opportunities. However, recent research (Slavsky, 2006; Binstock, 2008) has demonstrated that in the province of Neuquen, with a high rate of aboriginal people (Mapuche), the reality is that schools are far from having achieved this target. There is no clear policy to solve this intercultural problem and a program of integration of ICTs in the classroom has not yet been implemented. This chapter presents data on the educational reality of Neuquen and the use of ICTs in schools, based on the opinion of students, teachers, and school managers. It also analyzes the performance of students and its relation to the use of technological tools.

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