Case Review Research Articles

Investigating what promotes and deters Scottish cybercrime reporting

Cybercrime is under-reported in Scotland, with the reasons for this being poorly understood. To investigate underreporting, we commenced with a search of the related research and then carried out a review of actual cases. Next, to uncover Scottish-specific factors, we qualitatively interviewed 10 Scottish cybercrime victims. It emerged that victims blamed themselves for falling prey to cybercrime and were reluctant to report the incident. This is arguably a direct consequence of the UK government’s cybersecurity responsibilization strategy. Informed by our findings, we articulated a national strategy for promoting cybercrime reporting using the MINDSPACE behavioral influence model. Subsequently, we verified this model with a survey of 380 Scottish respondents, a representative sample of the general population in terms of age and gender. We report on and discuss our findings. Finally, we recommend two interventions to inform a national strategy for improving cybercrime reporting in Scotland.

Optimizing Diagnosis of Pediatric Streptococcus pyogenes Infections: A Clinical Prediction Model

Group A Streptococcus (GAS) infections, caused by Streptococcus pyogenes, are a major health concern among children under 12 years, leading to conditions such as tonsillitis, rheumatic fever, and post-streptococcal glomerulonephritis. Accurate diagnosis is essential for effective treatment and prevention. This study aimed to develop and validate a Clinical Prediction Rule (CPR) for predicting the presence of S. pyogenes in throat swabs from children under 12. We analyzed clinical and laboratory data from 1,015 pediatric patients presenting with symptoms suggestive of GAS infection at Federal University Teaching Hospital, Owerri, Imo State, between January 2019 and December 2022. S. pyogenes was first isolated from throat swabs cultured on blood agar, and 233 positive isolates were further identified using Polymerase Chain Reaction (PCR) targeting the Spy 1258 gene, with DNA extracted via boiling and confirmed through phenotypic methods. Data from these 233 identified cases were used to develop and validate the CPR. Variables examined included gender, age, ward of admission, clinical diagnosis, and antibiotic susceptibility. Logistic regression modeling identified significant predictors of S. pyogenes presence, with potential biases minimized through systematic case review, standardized data extraction and cross-checking by multiple reviewers. Among the 233 cases analyzed, the mean age was 4 ± 0.25 years, with 62.7% under age 3. Tonsillitis was the predominant diagnosis, with GAS prevalence ranging from 56.7% to 69.3%. Antibiotic susceptibility test result varied, with significant predictors including Sepsis/Tonsillitis and ear discharge/tonsillitis (p < 0.001). The CPR model demonstrated a sensitivity of 95.4% and a specificity of 36.8%, highlighting its potential to enhance clinical diagnosis and management of GAS infections. This study offers valuable insights into predictors of S. pyogenes infection in pediatric patients and highlights the CPR’s potential for improving clinical diagnosis and management.

Unexpected right-sided sigmoid colon in laparoscopy: A case report and review of literature

BACKGROUND The presence of a right-sided sigmoid colon is a rare anatomical variation usually discovered incidentally during surgical interventions. This case report details an unexpected right-sided sigmoid colon identified during a laparoscopic appendectomy and examines the pertinent literature to explore its clinical importance. CASE SUMMARY A 71-year-old woman presented with acute appendicitis. A preoperative computed tomography (CT) scan showed peri-appendiceal inflammation but no significant anatomical abnormalities. During laparoscopic surgery, an unexpected finding was encountered: The sigmoid colon was situated on the right side and exhibited an abnormal relationship with the cecum and ascending colon. Postoperative pathological examination confirmed appendicitis with no additional pathological findings. The right-sided sigmoid colon anomaly was verified through intraoperative assessment and later re-evaluation with CT and colonographic imaging. The patient underwent a laparoscopic appendectomy and experienced a smooth postoperative recovery. CONCLUSION This case highlights the necessity of being attentive to anatomical variations during laparoscopic surgery, particularly when managing appendicitis. A review of the literature indicated that the occurrence of a right-sided sigmoid colon is infrequent and may be associated with anomalies in midgut rotation during embryonic development. Awareness of this variation can help prevent surgical complications and inform future clinical practice.

Cardiac hypertrophy in polycythemia vera: A case report and review of literature

BACKGROUND The combination of polycythemia vera (PV) with pathological cardiac hypertrophy is uncommon. In this study, we describe a case of PV accompanied by pathological cardiac hypertrophy. It is hypothesized that the pronounced cardiac hypertrophy in this patient has a strong connection with PV. CASE SUMMARY In 2021, a 34-year-old Chinese man experienced chest constriction, shortness of breath, and palpitations during vigorous activity. Each episode lasted several minutes and resolved spontaneously following cessation of vigorous activity. He occasionally experienced syncope and vertigo without a headache. He underwent cardiac magnetic resonance imaging and was diagnosed with “hypertrophic cardiomyopathy (HCM)”. He was discharged after receiving symptomatic treatment, which resulted in an improvement. He presented to our department with chest constriction, shortness of breath, and respiratory distress for one month while climbing to the second floor in 2023. His blood pressure was 180/100 mmHg at the time of admittance, and he was receiving antihypertensive treatment. He had a history of PV for 2 years without treatment. Symptomatic treatment was implemented concurrently with the administration of hydroxyurea upon admission. Good blood pressure control was observed during the long-term follow-up, and echocardiography did not reveal any progression of myocardial hypertrophy. CONCLUSION Clinicians managing PV patients should remain highly vigilant regarding the risks of thrombosis and cardiovascular complications, particularly in those with refractory hypertension.

Treatment of fat-poor renal angiomyolipoma with ectopic blood supply by fluorescent laparoscopy: A case report and review of literature

BACKGROUND Renal angiomyolipoma and renal cell carcinoma are the most common benign and malignant tumors of the kidney respectively, and the preoperative differential diagnosis is crucial due to the wide difference in treatment methods. Fat-poor renal angiomyolipoma is a relatively rare type of in renal angiomyolipoma. Its fat imaging features are not obvious, and it is easily misdiagnosed as renal cell carcinoma. CASE SUMMARY We report the case of a 41-year-old man who complained of osphyalgia. Subsequent abdominal computed tomography scans revealed that a heterogeneous mass was seen in the lower pole of the right kidney, with the size of about 53 mm × 47 mm. And showed two right renal arteries, with the mass supplied by an ectopic vessel from the abdominal aorta. Fluorescent laparoscopic blockade of the right renal heterotopic artery and partial nephrectomy was performed. Based on histological and immunohistochemical findings, the tumor was diagnosed as fat-poor renal angiomyolipoma. CONCLUSION The use of fluorescent laparoscopy can effectively help intraoperative management, and the fluorescence pattern provided by intravenous indocyanine green can help suggest the final diagnosis, effectively guide the surgical decision-making, and avoid preoperative imaging diagnosis leading to nephrectomy for benign renal tumors, through fluorescent navigation of tumor supply vessel precise block, minimize the loss of renal function.

Primary pancreatic lymphoma: A case report and review of literature

BACKGROUND Primary pancreatic lymphoma (PPL) is a rare tumor that mimics pancreatic adenocarcinoma, leading to diagnostic and therapeutic challenges. PPL accounts for 0.2% of all pancreatic tumors and is typically treated with chemotherapy. However, the long-term survival rates for PPL with chemotherapy and radiotherapy alone are unsatisfactory. Due to the improvements in pancreatic surgery, there is a need to reevaluate the treatment strategies for PPL. CASE SUMMARY A 62-year-old male presented to our clinic. A biopsy was unsuccessful, and the imaging was suggestive of pancreatic adenocarcinoma. Therefore, subtotal splenopancreatectomy was performed and histopathology was performed. He was then diagnosed with primary pancreatic diffuse large B-cell lymphoma. He received adjuvant chemotherapy and radiotherapy. Currently, the patient is alive with no evidence of disease 36 months after surgery. CONCLUSION The potential role of surgery in the treatment of PPL should be emphasized and added in the management protocol of early stage lymphoma.

Concurrent spinal schwannoma and meningioma without neurofibromatosis: case presentation and review of literature

Abstract Background Concurrent multiple tumors developing in the spinal cord are rare, except for in genetic disorders, such as neurofibromatosis and von Hippel–Lindau disease. The presence of multiple histologically different spinal tumors in the absence of NF-2 is extremely rare. Schwannoma and meningioma can be explained partly by their common origin from the same mesenchymal cell, there is currently no explanation for the simultaneous existence of different spinal tumors other than simple coincidence. Case presentation After review of literature, there are thirteen such cases reported in the literature in addition to the present case. The current patient presents with lower limb weakness, and the patient radiology revealed intradural mass opposite the fourth lumbar vertebra with contrast enhancement and intradural extramedullary mass opposite the tenth dorsal vertebra with contrast enhancement in MRI spine. The coexistence of these tumors may be coincidental or might be due to a common histological origin of the Schwann cells and the meningocytes. Conclusion Schwannoma and meningioma have different radiological characteristics and require different managing procedures such as dural base coagulation in meningiomas and rootlet sacrifice in schwannomas.

Preparation for Rural Practice with a Multimodal Rural Emergency Medicine Curriculum

Rural regions face emergency medicine (EM) physician shortages. Most training programs are located in cities and lack rural clinical experiences, didactics, and mentorship to excite and prepare residents for rural EM practice. There is limited data on optimal training methods for preparing residents for rural practice. To address this need for rural EM training and workforce, we developed a rural EM curriculum. We began with a two-year case review from critical access emergency departments. Rural EM skills were defined and taught using lectures, simulation cases, and clinical rotations. We obtained quantitative and qualitative feedback from the first ten residents participating in the curriculum. Qualitatively, 10/10 residents gained new skills and found these experiences valuable to their training and career choice, with 100% expressing interest in rural practice and 75% choosing a rural practice. Quantitatively, residents managed a greater variability in patient acuity and volume and performed a greater variety of procedures compared to their academic center rotations, all while gaining unique skills from the challenges of a rural environment. Focused rural emergency medicine clinical experience and didactic training during residency are a promising approach to bridge the gap between urban tertiary care training programs and rural emergency care needs.

De Novo RB1 Germline Variant in Retinoblastoma with Two Subsequent Independent Neoplasms: Case Report and Literature Review

Variants in the RB1 gene are associated with retinoblastoma (RB) development, and their presence in germline cells considerably increases the risk of subsequent malignant neoplasms (SMNs) in RB survivors. We report a female patient with bilateral RB who developed two SMNs in less than ten years, with a de novo pathogenic nonsense variant in RB1 [NM_000321.3:c.306T&gt;A, p.(Cys102*)] in heterozygosity. The updated literature review of similar cases of SMN in patients with a previous diagnosis of RB reveals a wide range in both the type of subsequent malignancy and the age at which these SMNs develop. In addition, we identified only three cases with two SMNs following RB diagnosis, with at least one of these being an EWS. This case broadens the clinical and genetic landscape of RB, demonstrates the importance of a multidisciplinary approach in these patients, and highlights genetic diagnosis as a mandatory feature for management.

Electrocution Cervical Myelopathy Presenting with Partial Brown Sequard Syndrome: A Case Report and Review of Literature

Electrocution Cervical Myelopathy Presenting with Partial Brown Sequard Syndrome: A Case Report and Review of Literature

Glomus tumors in the urinary tract: a rare case and literature review

Background: The Glomus tumor is a rare mesenchymal tumor that predominantly affects the subcutaneous skin of the distal extremities. Solid organs are rarely affected, and the urinary tract has been the reason for isolated reports. This paper reviews the occurrence of glomus tumors in the entire urinary tract. Case Report: We report a case of a 56-year-old female, asymptomatic, with a 5.5 cm renal glomus tumor, and review the literature about the urinary tract involvement by this rare neoplasia. Conclusion: Glomus tumor mostly behaves as a benign lesion that rarely affects solid organs, being the kidney, the most affected organ in the urinary tract. It should be considered in the differential diagnosis of another renal cell tumor, especially those that are eosinophilic.

Collision of a Pancreatic Neuroendocrine Tumor and Intra-ampullary Carcinoma: A Case Report and Review of the Literature

Collision of a Pancreatic Neuroendocrine Tumor and Intra-ampullary Carcinoma: A Case Report and Review of the Literature

RETRACTED: Albano et al. Systematic Review of Fatal Sodium Nitrite Ingestion Cases: Toxicological and Forensic Implications. Toxics 2024, 12, 124

The journal retracts the article titled “Systematic Review of Fatal Sodium Nitrite Ingestion Cases: Toxicological and Forensic Implications” [...]

Management of cold sepsis in a patient receiving peptide radionuclide receptor treatment (PRRT): a case review

Management of cold sepsis in a patient receiving peptide radionuclide receptor treatment (PRRT): a case review

Acute poisoning with Jatropha curcas in North Eastern Himalayan region – A case series and review of literature

Plant poisoning is one of the common accidental sources of poisoning amongst the villagers and the troops going on long-range patrolling. Seeds of Jatropha curcas a/k/a biodiesel pant mimicking nuts are an uncommon source of poisoning, manifesting as mainly gastrointestinal symptoms and less frequently the other systemic manifestations. Here, we report a case series of two cases of serving soldiers who presented with gastrointestinal symptoms after consumption of seeds of unknown plants mimicking nuts, which was later identified as J. curcas. Both patients had favorable outcomes with syndromic management of the unknown poisoning.

Superior Ophthalmic Vein Thrombosis Associated With Acute Suppurative Parotitis and Masticator Space Cellulitis: A Case Report and Review of the Literature

Superior Ophthalmic Vein Thrombosis Associated With Acute Suppurative Parotitis and Masticator Space Cellulitis: A Case Report and Review of the Literature

UNVEILING THE VEIN

Cerebrospinal fluid (CSF)-venous fistula represents a formidable yet often overlooked neurosurgical dilemma. Despite its disabling consequences, it remains significantly underdiagnosed. This abstract sheds light on the clinical intricacies, diagnostic challenges, and therapeutic interventions associated with CSF-venous fistula. Early diagnosis is paramount, yet hindered by its rarity and diverse and often unspecific clinical presentations. The importance of heightened awareness among clinicians and radiologists for timely detection and management cannot be overstated. This presentation will draw upon a review of clinical cases operated in the Royal Hallamshire Hospital, supplemented by a concise surgical video which is focused on surgical technique and benefit of microscope mediated augmented reality.

Esophageal melanosis: Two case reports and review of literature

BACKGROUND Esophageal melanosis (EM) is a rare condition characterized by melanin pigmentation in the esophageal mucosa. It is not well understood and has been documented in less than 100 cases worldwide. CASE SUMMARY We report two cases of African American patients who complained of significant weight loss (over 20 pounds in approximately six months) and abdominal pain during their first visit. The first case involves a 54-year female with a history of hepatic steatosis and polysubstance abuse, who also experiences nausea and vomiting. The second case is a 59-year-old male with hypertension and gastroesophageal reflux disease (GERD), who was diagnosed with esophageal squamous cell carcinoma. Both cases show benign melanocytes in the basal layer on the esophagus biopsy and are diagnosed as EM. CONCLUSION It is important to note that EM has been associated with malignancies such as carcinoma and melanoma. Therefore, accurate diagnosis and appropriate management are crucial. Patients with EM, especially those with concurrent risk factors (e.g. , GERD, smoking), should be carefully monitored for any signs of malignancy.

Chest pain and coronary artery disease in cardiac amyloidosis: Prevalence, mechanisms, and clinical implications.

Amyloidosis is a systemic disease affecting multiple organs, and often presents with cardiac involvement, with two primary underlying pathologies: amyloid light chain- and transthyretin cardiac amyloidosis. Chest pain can occur in both types with variable clinical presentations. This narrative review describes the relationship between CA and chest pain. A PubMed search (June 03. 2024) identified 393 articles related to chest pain in CA. Twenty-eight studies, in English and with full text, were selected. Articles included were case reports, reviews, perfusion- and autopsy studies. In CA patients 10-20% report chest pain as the initial symptom preceding the diagnosis, and the overall prevalence of chest pain is 38% of patients with CA and it is related to an increased risk of heart failure hospitalization. The mechanisms leading to chest pain in CA patients include increased left ventricular diastolic pressure, infiltration of amyloid fibrils inside and around coronary arteries, and amyloid compression of the microvasculature. The mechanisms commonly lead to elevations of plasma troponin levels, which are higher in amyloid patients with chest pain compared to amyloid patients without chest pain. Symptomatic treatment of chest pain can be challenging due to the low tolerability of medical therapy and poor outcomes of coronary interventions in alleviating the pain and with a higher rate of complications. Our review underscores the importance of recognizing chest pain as a CA symptom, particularly in the elderly. Persistent troponin elevation without coronary artery disease could indicate CA. Screening-based and longitudinal studies are crucial for understanding the relationship between chest pain and CA. Acknowledging the significance of chest pain in CA may facilitate early intervention and improve patient outcomes.

The judet quadricepsplasty for elderly traumatic knee extension contracture: a case report and review of the literature

The judet quadricepsplasty for elderly traumatic knee extension contracture: a case report and review of the literature