Endoscopic management of migrated intrauterine device in the stomach

Ectopic intrauterine devices to the gastric wall are extremely rare and they can be managed by upper gastrointestinal endoscopy.

A Review of Classification, Diagnosis, and Management of Hydrocele

This article summarizes and updates a number of issues related to hydrocele including anatomy, embryology, classification, etiology, clinical manifestations, imaging findings, and management. Hydrocele is an abnormal collection of serous fluid between the parietal and visceral layers arising from the mesothelial lining of the tunica vaginalis that surrounds the testis and spermatic cord directly. Hydroceles result from an imbalance of secretion and reabsorption of fluid from the tunica vaginalis. Hydroceles can be divided into two types as primary and secondary. The diagnosis should be based on medical history, clinical manifestations, and imaging studies. Understanding the causes and types of hydroceles is useful for accurately diagnosing and treatment strategy. Hydroceles can be managed by conservative treatment, fluid aspiration, or hydrocelectomy.

Appendiceal Diverticulitis Mimics Cecal Diverticulitis Diagnosed Preoperatively

Appendiceal diverticulitis is an uncommon condition that clinically resembles acute appendicitis. However, it is an incidental finding in histopathological studies and is rarely diagnosed preoperatively by imaging studies. In this article, we present the clinical and imaging findings of a male patient presenting with right upper quadrant pain with a preoperative imaging diagnosis of appendiceal diverticulitis. He underwent laparoscopic appendectomy and confirmed the diagnosis of appendiceal diverticulitis. This is a rare preoperative diagnosis. The management is often like typical appendicitis which is appendectomy. It is important to differentiate it from diverticulitis of the small intestine or colon because these diseases usually require only conservative treatment.

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

BACKGROUND

Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours.

METHODS

In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186.

FINDINGS

Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78·6%] female patients and 4922 [21·4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1·4 [IQR 0·6-3·4]) compared with the prepandemic phase (2·0 [0·9-3·7]; p<0·0001) and pandemic decrease phase (2·3 [1·0-5·0]; p<0·0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69·0%] of 3704 vs 1515 [71·5%] of 2119; OR 1·1 [95% CI 1·0-1·3]; p=0·042), lymph node metastases (343 [9·3%] vs 264 [12·5%]; OR 1·4 [1·2-1·7]; p=0·0001), and tumours at high risk of structural disease recurrence (203 [5·7%] of 3584 vs 155 [7·7%] of 2006; OR 1·4 [1·1-1·7]; p=0·0039).

INTERPRETATION

Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation.

FUNDING

None.

Traumatic rupture of congenital cystic adenomatoid malformation mimicking traumatic pulmonary pseudocyst: a case report

Thoracic trauma is commonly encountered in daily clinical practice; however, blunt thoracic trauma in patients with congenital cystic adenomatoid malformation (CCAM) is rare. CCAM rupture denotes a broad spectrum of manifestations on imaging and may be misdiagnosed as many other conditions. Consequently, this leads to inaccurate treatment and poor patient outcomes. We report the case of a girl with the initial diagnosis of a cavitary lung lesion that was likely a traumatic pulmonary pseudocyst or CCAM. The patient received medical therapy for 20 days; however, her condition did not improve. Subsequently, she underwent right lower lobectomy. Ruptured CCAM was confirmed during surgery and with histopathology. No complications occurred postoperatively, and the patient made a good recovery.

How Job Crafting Transmits the Impact of Perceived Organizational Support and Autonomy on Work Engagement

In organizational practices, job crafting has emerged as a crucial professional activity that can create significantly improved workplace outcomes. This research aims to investigate how job crafting transmits the influence of organizational support and autonomy on work engagement. The empirical study was conducted by applying PLS-SEM to a sample of 255 service employees in Vietnamese retail companies. Especially in the context of emerging markets, there hasn't been much study on how service employees' job crafting improves their job engagement. The findings show that organizational support and autonomy are favorably associated with three dimensions of job crafting. Furthermore, job crafting promotes work engagement. Our findings imply that managers’ open interactions and empowerment may generate positive job crafting, hence increasing employee engagement with work and organizations.

Splenic lymphangioma in adult patient treated with laparoscopic splenectomy: A rare case report

Splenic lymphangioma is a benign cystic tumor that develops as a result of lymphatic vessels' congenital abnormalities. It is a rare condition that mostly occurs in children and young adults. Due to the lack of typical symptoms and signs, splenic lymphangioma is difficult to diagnose and often incidentally revealed during radiological examinations. We report a case of a 55-year-old Asian female, who presented with left upper quadrant abdominal pain in the past 3 days. She had mild upper abdominal tenderness, with no other specific findings. Abdominal contrast material-enhanced computed tomography revealed three hypodense lesions arising from a normal-sized spleen. The histologic findings after laparoscopic splenectomy demonstrated a 3-cm-diameter yellowish-white tumor made up of multiple cystic structures. Primary benign splenic tumors are exceedingly rare, especially in adults over 20. While small lesions are mostly asymptomatic, bigger lesions can cause organ compression or even rupture. Therefore, even in adults with pain in the left upper quadrant abdomen or enlarged spleen, splenic lymphangioma should be taken into account in the differential diagnosis. The case serves as an example of a rare congenital splenic tumor. Treatment of this benign splenic abnormality with laparoscopic splenectomy is a good, safe approach.

Left‐sided acute appendicitis with congenital gastrointestinal malrotation

We describe a 28‐year‐old man with acute appendicitis associated with gastrointestinal malrotation. The diagnosis was confirmed by a computed tomography scan, and he was treated by laparoscopic appendectomy without a Ladd procedure.

Pelvic schwannoma in an adult male

Schwannomas are benign nerve sheath tumors that are generally encapsulated and commonly detected in the head, neck, and mediastinal regions. Schwannomas localizing in the pelvis are extremely rare and tend to be asymptomatic initially due to slow growth rate. Schwannomas may be misdiagnosed as urologic or gynecologic tumors. Pelvic schwannomas are typically solitary, large, and well-circumscribed masses in the retroperitoneum or presacral areas. Other imaging characteristics are cystic degeneration, repeated hemorrhages, and calcifications. Calcification patterns can be punctate, speckled, curvilinear, or along the walls of the masses. We report a young man with a pelvic schwannoma with typical imaging features.

Safe endoscopic removal of ingested fish bone with esophageal perforation and impingement on the aortic wall

Esophageal foreign bodies are common conditions that may lead to serious complications, such as esophageal perforation, neck abscess, mediastinitis, arterial injury, and lung damage. We report a rare case of esophageal fish bone impingement on the aorta that was managed without complication by endoscopic removal.

Traumatic Kidney in a Patient With Unilateral Renal Cystic Disease

Renal trauma occurring in patients with unilateral renal cystic disease (URCD) is extremely rare. Unilateral renal cystic disease is benign, nonprogressive, nonfamilial, nonencapsulated, and unrelated to cysts in other organs. It should be differentiated from autosomal dominant polycystic kidney disease (ADPKD) parenthesis, multicystic dysplastic kidney disease, multiple renal simple cysts, and cystic renal neoplasms. We report a case of a 15-year-old male with URCD admitted to the hospital sustaining blunt trauma to his right flank after a motor vehicle crash. Final diagnosis in this case was renal injury in a URCD patient. The patient was treated conservatively and subsequently discharged. Unilateral renal cystic disease can be diagnosed and followed by a combination of imaging methods and functional studies. The management of URCD is conservative. Although the disease is stable, nephrectomy may occasionally be indicated when there is a strong suspicion for malignancy.

Traumatic epidural hematoma in a patient with severe schizencephaly

Schizencephaly is a rare congenital brain structural abnormality that is not clearly understood and has no specific treatment yet. Therefore, cases related to it should be added to the literature. This report aims to introduce a rare case of severe schizencephaly co-occurring with post-traumatic intracranial epidural hematoma.

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

Uterine arteriovenous malformation (UAVM) is a rare condition and is classified as either congenital or acquired UAVM. Patients with UAVMs usually experience miscarriages or recurrent menorrhagia. Ultrasound is used for the initial estimation of UAVMs. Computed tomography and magnetic resonance imaging are noninvasive and valuable methods that provide good compatibility with digital subtraction angiography to support the diagnosis and treatment of UAVM. Timely diagnosis is crucial to provide appropriate treatment for alleviating complications. This article presents a pictorial and literature review of the current evidence of the diagnosis and management of UAVM.

Balo's Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.

Rasmussen's encephalitis with persistent epilepsy in a young man

Rasmussen's encephalitis (RE) is an uncommon cause of the seizure. Important key findings of RE include intractable seizure activity in children, progressive atrophy of the involved hemisphere, and small hemisphere with the large ventricle.

Diffuse Gallbladder Adenomyomatosis with an Inflammatory Complication in an Adult

Gallbladder adenomyomatosis (GA) is a benign alteration of the gallbladder wall. There are three types involved: segmental, fundal, and diffuse pattern; the last type is very rare. Ultrasound is the imaging method of choice for diagnosing that shows Rokitansky-Aschoff sinuses with cholesterol deposition creating comet-tail artifacts. Asymptomatic GA does not require surgery in case there are no malignant lesions defined by imaging diagnosis. We present the rare case of a 51-year-old man who was admitted to hospital due to abdominal pain concomitant with inflammatory syndrome. Imaging and histological findings were appropriate to diagnose diffuse GA and complication of cholecystitis.

A Rare Case of Diffuse Subependymal Periventricular Metastases from Small Cell Lung Carcinoma

Small cell lung cancer, whose essence is neuroendocrine tumors, makes up proximately 14-20% of all lung cancer circumstances. Compared to non-small cell lung cancer, its clinical manifestation seems more positive and has a tendency to disseminate earlier in the process of its natural past. About 10% of patients present with brain metastases at the time of provisional diagnosis and sometimes all along the course of their disease, there will be 40-50% of developed brain metastases in addition. Although metastases in the brain parenchyma are often found in patients with advanced lung cancer, periventricular metastases are rare. We report one case of diffuse subependymal periventricular metastases from small cell carcinoma of the lung.

A Case of Arteriovenous Fistula After Kidney Trauma Mimicking Tumor

Renal arteriovenous fistulas are rare complications of kidney injury that are usually caused by penetrating or blunt abdominal trauma, percutaneous or open biopsy, or surgery. We report a case of renal arteriovenous fistula after blunt abdominal trauma of a male patient who had traffic accidents. Computed tomography images show arteriovenous fistula lesion mimicking the tumor of the renal pelvis. Through this case, we present how to identify and avoid being confused in diagnosis as well as introduce its clinical manifestations, imaging, and treatment.

A Review of the Pathology, Diagnosis and Management of Colloid Goitre

Colloid goitres are a common, benign lesion of the thyroid gland, that involve a diffuse or nodular pattern. An important feature of colloid goitre is the contained colloid material inside and the comet-tail artefacts, which show up on ultrasound. However, some cases of colloid goitre do not show a comet-tail sign and sometimes these artefacts need to be distinguished from microcalcifications in malignant lesions. This review discusses the epidemiology, pathophysiology, clinical manifestations, ultrasound features and management of colloid goitres.

The dripping candle wax sign of melorheostosis

Melorheostosis is a rare benign bone disease including dysostosis and sclerosis. Dripping candle wax presence is a common and typical sign of melorheostosis. This sign appears as irregular hyperostosis of the cortical bone which is likened to melted wax flowing down one side of a candle. It can sometimes cause pain, stiffness joint, or limitation of motion in the affected areas implicitly but mostly has no symptoms. It is usually observed on plain radiography; its appearance is generally hyperplasia on one side of the bone. We report a 33-year-old male who has an incidental diagnosis of melorheostosis post-trauma.

HGM-4: A new multi-cameras dataset for hand gesture recognition

Gesture recognition technology is rapidly growing in the recent years due to the demands of many application such as computer game and sport, human robot interaction, assistant systems, sign language interpretation and e-commerce. One of the most important of gesture recognition is hand-gesture recognition. For example, it can be used to control all devices (television, radio, air-condition, and doors) by just hand gestures for smart home application. The HGM-4 dataset is built for hand gesture recognition (the full dataset is available from: https://data.mendeley.com/datasets/jzy8zngkbg/4) which contains total 4,160 color images (1280 × 700 pixels) of 26 hand gestures captured by four cameras at different position. The training and testing set are defined to create a benchmark framework for comparing the experimental results.

Carotid body tumor: a case report and literature review

The carotid body is the largest collection of paraganglia in the head and neck and is found on the medial aspect of the carotid bifurcation bilaterally. Carotid body tumors are rare neoplasms arising from the chemoreceptor cells of the carotid bulb. We report a case of carotid body tumor in a 42-year-old female, who presented with painless, pulsatile, gradually progressive lateral neck swelling. The diagnosis is suspected on the basis of history, clinical and radiological examination findings and a successful surgical excision of the tumor is performed. Histopathological examination confirms the diagnosis of carotid body tumor. We also present brief literature about carotid body tumors in terms of its clinical and imaging presentation, evaluation, and management.

Recurrence of retroperitoneal mature cystic teratoma in an adult: A case report

Mature cystic teratoma is one of the most common tumors of the ovaries, testis, mediastinum, and retroperitoneum; however, secondary retroperitoneum lesions are rare entities in adults. We report a case of a 22-year-old female who was previously diagnosed with a mature teratoma of left ovarian was hospitalized due to dull abdominal pain in right hypochondria. Radiological evaluation revealed a mass in the right upper abdominal and flank region with an extension from the posterior aspect of the duodenum, composed of greasy and cystic elements. A tumor was resected through the Kocher's laparotomy and the pathology report confirmed the diagnosis of a mature cystic teratoma with no evidence of malignancy or immature components.

Epidemiology of respiratory pathogen carriage in the homeless population within two shelters in Marseille, France, 2015-2017: cross sectional 1-day surveys

Objectives

To assess risk factors for respiratory tract infection symptoms and signs in sheltered homeless people in Marseille during the winter season, including pathogen carriage.

Methods

Data on 479 male participants within two shelters who completed questionnaires and a total of 950 nasal and pharyngeal samples were collected during the winters of 2015–2017. Respiratory pathogen carriage including seven viruses and four bacteria was assessed by quantitative PCR.

Results

The homeless population was characterized by a majority of individuals of North African origin (300/479, 62.6%) with a relatively high prevalence of chronic homelessness (175/465, 37.6%). We found a high prevalence of respiratory symptoms and signs (168/476, 35.3%), a very high prevalence of bacterial carriage (313/477, 65.6%), especially Haemophilus influenzae (280/477, 58.7%), and a lower prevalence of virus carriage (51/473, 10.8%) with human rhinovirus being the most frequent (25/473, 5.3%). Differences were observed between the microbial communities of the nose and throat. Duration of homelessness (odds ratio (OR) 1.77, p 0.017), chronic respiratory diseases (OR 5.27, p <0.0001) and visiting countries of origin for migrants (OR 1.68, p 0.035) were identified as independent risk factors for respiratory symptoms and signs. A strong association between virus (OR 2.40, p 0.012) or Streptococcus pneumoniae (OR 2.32, p 0.014) carriage and respiratory symptoms and signs was also found.

Conclusions

These findings allowed identification of the individuals at higher risk for contracting respiratory tract infections to better target preventive measures aimed at limiting the transmission of these diseases in this setting.

Genetic diversity of Vietnamese domestic chicken populations as decision-making support for conservation strategies

The aims of this study were to assess the genetic diversity of 17 populations of Vietnamese local chickens (VNN) and one Red Jungle Fowl population, together with six chicken populations of Chinese origin (CNO), and to provide priorities supporting the conservation of genetic resources using 20 microsatellites. Consequently, the VNN populations exhibited a higher diversity than did CNO populations in terms of number of alleles but showed a slightly lower observed heterozygosity. The VNN populations showed in total seven private alleles, whereas no CNO private alleles were found. The expected heterozygosity of 0.576 in the VNN populations was higher than the observed heterozygosity of 0.490, leading to heterozygote deficiency within populations. This issue could be partly explained by the Wahlund effect due to fragmentation of several populations between chicken flocks. Molecular analysis of variance showed that most of genetic variation was found within VNN populations. The Bayesian clustering analysis showed that VNN and CNO chickens were separated into two distinct groups with little evidence for gene flow between them. Among the 24 populations, 13 were successfully assigned to their own cluster, whereas the structuring was not clear for the remaining 11 chicken populations. The contributions of 24 populations to the total genetic diversity were mostly consistent across two approaches, taking into account the within- and between-populations genetic diversity and allelic richness. The black H'mong, Lien Minh, Luong Phuong and Red Jungle Fowl were ranked with the highest priorities for conservation according to Caballero and Toro's and Petit's approaches. In conclusion, a national strategy needs to be set up for Vietnamese chicken populations, with three main components: conservation of high-priority breeds, within-breed management with animal exchanges between flocks to avoid Wahlund effect and monitoring of inbreeding rate.

Pathology of falciparum malaria in Vietnam

Autopsy samples from the brains of 20 patients who died of falciparum malaria were examined by light microscopy and by an immunohistologic method. Particular attention was paid to a comparison of the pathologic features of the white matter and the cortex. In the high-sequestration (greater than 50%) group (n = 8), the mean +/- SD percentage of cerebral microvessels that showed parasitized red blood cell (PRBC) sequestration was 71.2 +/- 8.1% in the cortex and 84.0 +/- 6.7% in the white matter. The difference in the PRBC sequestration rate between cortex and white matter was statistically significant (P less than 0.01). Perivascular and ring hemorrhages were seen more frequently in the white matter than in the cortex. Deposition of IgG and Plasmodium falciparum antigen in the cerebral microvessels was more highly significant in the white matter than in the cortex (P less than 0.01). Our study demonstrated that the localized concentration of PRBC sequestration in the brain correlated with the marked immunohistologic differences in the microvessels of cortex and white matter.