Pityriasis rubra pilaris (PRP) is an idiopathic papulosquamous disease that clinically presents with palmoplantar keratoderma and follicular hyperkeratotic papules that coalesce into scaly erythematous plaques. We report a unique case of atypical PRP beginning at 1 year of age with associated severe arthropathy and osteoporosis. We further discuss the clinical ...

Fifty-six hamsters with demodicosis were treated with daily oral administration of ivermectin (0.3 mg/kg). Thirty-three cases (58.9%) were cured and 6 cases (10.7%) had improved clinically but needed to continue treatment. Of 5 cases (8.9%) who relapsed within 3 months and were retreated with ivermectin, 4 were cured and 1 ...

Clinical mastitis in six Somerset dairy herds was monitored over a 12-month period. Escherichia coli was implicated in 34.7% of all clinical cases. Forty-one percent of all clinical E. coli mastitis cases occurred in just 2.2% of the population. A total of 23.9% of clinical E. coli cases occurred in ...

Juvenile-onset dystonia that improves after levodopa may occur in both dopa-responsive dystonia (DRD) and juvenile parkinsonism (JP), clinically similar conditions with different prognoses and management goals. The authors show normal striatal uptake of the dopamine transporter ligand FP-CIT with SPECT in a clinically atypical case of DRD, in contrast to ...

We present a case of mycetoma by Madurella mycetomatis on the foot of a Chinese young man, living in Italy for more than ten years. Clinically the lesion closely resembled and was initially misinterpreted as a vascular neoformation. We analyze the histological and morphological features of the Madurella mycetomatis infection ...

The clinical and haematological heterogeneity in cases of the rare combined factor V and VIII deficiency has not been reported so far from India. Nine such cases belonging to five unrelated families have been analysed in the present study for the various haematological and clinical parameters. A very mild clinical ...

Non-gonococcal urethritis (NGU) is a common problem presenting to sexual health clinics that is usually managed empirically. In many cases the aetiology is never clearly established or further investigated. Adenovirus has been identified in the past as an occasional cause of NGU but little has been written about its clinical ...

BACKGROUND: Case reports and clinical observations suggest that fluctuating cognition (FC) is common in the major dementias, particularly dementia with Lewy bodies (DLB), where it is one of three core clinical diagnostic features. OBJECTIVES: To examine the frequency, characteristics, and diagnostic utility of FC in dementia using clinical, attentional, and ...

Most individuals with the fragile X premutation are clinically unaffected; however, some show clinical manifestations, including learning difficulties, emotional problems, or even mental retardation. The basis of clinical involvement in these individuals is unknown. Premutation alleles are reportedly associated with normal levels of mRNA and protein (FMRP). To examine this ...

OBJECTIVE: To determine the frequency with which histopathologic examination of periapical biopsy specimens contributed information not anticipated clinically. STUDY DESIGN: Clinical and histopathologic information from 805 sequentially submitted periapical biopsy specimens over a 2-year period was compared. Clinical data included endodontic status, age and sex of patient, location of lesion, ...

Summary Clinical reasoning refers to the thinking and decision making processes which occur during clinical practice. It has its origins in the study and teaching of problem solving in medicine. A review of the literature of the allied health fields, suggests clinical reasoning is not only a cognitive and diagnostically ...

OBJECTIVE: To describe an unrecognized clinical entity, idiopathic bilateral vocal fold weakness, and propose recommendations regarding the diagnosis and management of these cases. STUDY DESIGN: Retrospective, nonrandomized case study. METHODS: All cases of bilateral vocal fold weakness evaluated at the University of Washington Voice Disorders Clinic between 1991 to 1998 ...

OBJECTIVES: To describe the methods and results of a standardized system for clinical endpoint determination for defining and reviewing endpoints in clinical trials for HIV-infected individuals. DESIGN: A system was developed utilizing standard definitions for the 24 diagnoses or clinical events that serve as trial endpoints and together define the ...

Sixteen cases of caliber-persistent labial artery of the lips have been reported to date in the English literature. Six of these were clinically misdiagnosed as squamous cell carcinoma and treated with wedge resection. To date, we have seen 187 cases clinically and an additional 23 cases through our surgical oral ...

Traditional review articles provide clinicians with syntheses of the medical literature but are criticised as being haphazard in their methodology and biased in their conclusions. Systematic reviews use rigorous methods to minimise bias and statistical methods to synthesise results (meta-analysis) that increase power and precision. They permit investigation of generalisability ...

The concept of malignant pyoderma (MP) has created controversy since its origin. The distinction of this disease from pyoderma gangrenosum was based on clinical criteria and response to treatment. Herein we discuss our current ideas on this entity and its possible relationship to Wegener's granulomatosis (WG). Follow-up data from the ...

This case is unusual due to its extended clinical course. Clinical, histopathological, and immunohistochemical findings are presented.

Coryneform bacteria are aerobically growing, asporogenous, non-partially-acid-fast, gram-positive rods of irregular morphology. Within the last few years, there has been a massive increase in the number of publications related to all aspects of their clinical microbiology. Clinical microbiologists are often confronted with making identifications within this heterogeneous group as well ...

The prevalence of certain characteristics of genital discharge like (a) watery variety in sexually transmitted disease (STD) clinic 34% and in gynaecology clinic 26.6%, (b) fishy odour in STD clinic 29.2% and in gynaecology clinic 12.2% and (c) pH > 4.5 in STD clinic 53.6% and in gynaecology clinic 43% ...

We present three cases of dysphonia in which gastro-oesophageal reflux (GOR) appeared to be a precipitating factor. In all cases reflux was clinically occult. We discuss the theory and implications of GOR presenting atypically with laryngeal symptoms, and outline our current approach to laryngeal symptoms of clinically evident or occult ...

Raimer's solar elastotic bands of the forearm are a rarely described clinical variant of severe solar elastosis. We report a case of Raimer's bands on the forearm of a 43-year-old woman. Light microscopy demonstrated solar elastosis and electron microscopy revealed activated fibroblasts appearing to secrete the elastotic material. The clinical ...

The ball-and-socket ankle is a rare clinical condition that has a deformity of the talotibial articulation. Assorted anomalies frequently exist. Treatment is usually based on clinical presentation of a foot problem.

Our objective was to design a grading system to judge the methodological quality of toxicity symptoms assessment in rheumatologic randomized controlled trials, and to use this grading system to evaluate rheumatology case report forms. For comparison, we also evaluated instruments derived in other clinical specialties. To further determine whether variability ...

Clinical reasoning is increasingly recognized as a crucial component of the occupational therapy process. Different types of clinical reasoning used by occupational therapists have been identified, including scientific, procedural, interactive, narrative, conditional, and pragmatic reasoning. This article describes the use of the case method in the University of New Mexico ...

Why do we publish clinical data? Between the scientistic illusion that assumes that cases are objective data and the disillusioned observation that psychoanalytic literature is mainly used to boost identity feelings, what role is played by such publications? New psychoanalytical knowledge results from clinical practice and not from scientific experiments ...

OBJECTIVE: To find the reasons for legal claims against hospital doctors. DESIGN: Prospective analysis of requests for medical opinion submitted by solicitors during 1984-93 on legal claims against hospital doctors. SUBJECTS: 100 successive cases: 98 from the United Kingdom and two from the Republic of Ireland. MAIN OUTCOME MEASURES: Principal ...

The changes in frequency and distribution of the clinical types of cerebral palsy (CP) were evaluated in 1873 CP cases admitted to the Department of Pediatric Neurology between 1982 and 1989. The observed panorama of CP was unlike the situation in developed countries. The majority of the cases were term-born ...

Three cases of myophosphorylase deficiency with unusual clinical expression are presented. The 1st had clinical characteristics suggesting a mild congenital myopathy, and the patient never experienced cramps or myalgias. The 2nd had a slowly progressive myopathy without cramps or myoglobinuria which was detected by chance. The 3rd presented with myoglobinuria ...

Ocular toxocariasis is rare and therefore the spectrum of clinical disease is difficult to establish. We present a review of the clinical features and laboratory findings in a group of patients with positive Toxocara serology and ocular toxocariasis. The clinical spectrum was diverse and milder disease was commoner than might ...

This two-part series aims to familiarize the reader with essential occlusal principles and terminology and to give some guidelines as to which cases are suitable for crown and bridgework. The first article covers occlusal terminology and the conformative approach, whilst the second will describe the reorganized approach. Both papers contain ...

The authors review the empirical literature concerning the frequency of false allegations of sexual abuse as well as the case report literature that describes individual episodes of false allegations in detail. The authors then construct a clinical typology that is derived from the literature and their own clinical experience with ...

Eighteen cases of lacunar infarction are presented. Six of these cases had a purely motor clinical deficit. All the cases were studied by serial high resolution SPECT (single photon emission computerized tomography) using 99Tcm HMPAO. The degree and extent of the changes in cerebral perfusion consistent with diaschisis were noted ...

A case of anatomical sex conversion in a 21-year-old genotypic male Nigerian with ambiguous genitalia but who was reared as a girl is presented. The clinical features observed in this particular case and the result obtained after surgery, adjuvant hormone therapy and supportive psychotherapy are discussed. The relevant literature pertaining ...

The history of using ultrasound in dentistry goes back to 1952. The first report on the use of ultrasound as an adjunct to mechanical debridement was given by Richman in 1957. It's popularity started with the work of Martin then many clinical evaluations were reported mainly discussing the efficiency of ...

The clinical and MRI features were correlated in five cases of infarction in the territory of the anterior inferior cerebellar artery. The lateral portion of the pons area was affected in four cases, the middle cerebellar peduncle in two, and the cerebellar hemisphere in three. The lesion was restricted to ...

Platypnea-orthodeoxia is an infrequently reported clinical form of position dependent dyspnea and oxygen desaturation. There are several diverse etiologies for this syndrome. This case report of a patient with platypnea-orthodeoxia is the first known presentation of a case secondary to a patent foramen ovale and idiopathic hemidiaphragm paralysis. A major ...

The members of the Committee on Scientific Activities of the American Psychoanalytic Association are concerned about the paucity of clinical data in psychoanalytic reports and by the quality of what does exist. We have proposed a few standards for clinical reports that we believe will be reliable and clear and ...

Clinical cases can be simulated by using computers with programs designed to provide all of the information required to make a diagnosis and initiate a treatment plan. The cases are uncued, simulate time, and require sound clinical judgment for management. All transactions between the physician and case are recorded so ...

Transient global amnesia (TGA) is a well-recognized clinical entity, but its pathophysiology and prognosis have remained arguable. We reported that a 63-year-old woman with scleroderma developed two TGA episodes. The patient sometimes suffered from headaches when Raynaud's phenomenon appeared in her fingers, but she did not experience further cerebrovascular events. ...

The clinical picture of speech-prompt catatonia, one of the six catatonic subtypes in Leonhard's classification, is demonstrated by a case report. The Leonhardian catatonic subtypes offer a radically different way of approaching the problem of catatonia. The need for a reevaluation of Leonhard's intricate, clinically oriented system, rich in psychopathological ...

Since the first observations have been published by Macbeth in England 1965 adenocarcinomas of the nose arising after exposure to wood dust have been considered as occupational diseases in a number of countries. As many questions concerning epidemiology, clinical course and pathology are still open, the Industrial Insurance Institute for ...

We describe the patterns of omissions (and substitutions) of freestanding grammatical morphemes and the patterns of substitutions of bound grammatical morphemes in 20 so-called agrammatic patients. Extreme variation was observed in the patterns of omissions and substitutions of grammatical morphemes, both in terms of the distribution of errors for different ...

The clinical evaluation of alopecia is becoming less precise as more histopathologic correlations become available. According to the classic approach, the clinician should initially differentiate between scarring and nonscarring alopecia. Because several case reports in the past ten years have demonstrated that the definition of "scarring alopecia" is ambiguous, the ...

The amobarbital interview has been in use for over 50 years. Its clinical indications have been primarily as an aid in determining a diagnosis and in conducting psychotherapy. This article presents an overview of the procedure along with a brief historic perspective. A case is presented which highlights its potential ...

A recent necropsy study has shown that 80% of patients with the Wernicke-Korsakoff syndrome were not diagnosed as such during life. Review of the clinical signs of these cases revealed that only 16% had the classical clinical triad and 19% had no documented clinical signs. The incidence of clinical signs ...

Circular prolapse of the urethral mucosa in the elderly female is rarely reported in the literature, but is a common clinical entity. During the years 1972-1983 thirteen women with urethral prolapse were operated upon in our department, in all of whom differentiation of the benign lesion from malignancy could not ...

A 10% sample of English language papers, published in 1980, listed in Index Medicus, and classified under the heading, Clinical Trials, was used to assess the state of trials and reports from them. Tabulations are presented concerning the design of the trials represented by the papers in the sample. The ...

The laboratory diagnosis and therapeutic management of disseminated sporotrichosis can present many problems to the clinical laboratory and the clinician. Culturing of clinical specimens is necessary because the direct microscopic examination of specimens for Sporothrix schenckii often is not useful. Although this organism has been recovered from many specimen sites, ...

Clinical case report forms--from both a content and format point of view--play a key role in the successful completion of a clinical trial. However, as many of us are too well aware, the design of these forms are often given less attention than they should be in the rush to ...

For the urologist, especially, a knowledge of the anatomy of the retroperitoneum is important. Anatomical and surgical texts frequently do not describe the retroperitoneal anatomy, particularly the retroperitoneal connective tissue, clearly enough to facilitate clinical applications. The anatomy of the retroperitoneal connective tissue is reviewed and clinical applications are provided.