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Introduction We described a case of initial unsuccessful outcome of failed macular hole treated with amniotic membrane, that resolved after amniotic membrane exchange and silicone oil injection. Case Description a woman affected by a high myopic macular hole that had failed to close after multiple surgeries, had been treated using an amniotic membrane graft and 20% sulfur hexafluoride but, after the gas reabsorption, the macular hole was still open, and the amniotic membrane. A second surgery with a second amniotic membrane patch and silicone oil was carried out. Two weeks after the procedure the macular hole closed, and the final visual acuity improved from 20/400 to 20/100. Conclusions In this case, a second surgery, using a new amniotic membrane graft and a longer-lasting endotamponade, closed the hole and improved the visual acuity.

Although the theory of evolution lies at the heart of contemporary biology, its influence on the study of child psychology and psychiatry has been limited. In earlier work we have argued that evolutionary thinking has much of value for clinicians. Here, we explore the possible significance of evolutionary theory for understanding child abuse by mothers, particularly neglect, emotional abuse and physical abuse. We draw on the research of anthropologists, primatologists and evolutionary theorists to make predictions about the environmental circumstances under which one would expect such abuse to be more prevalent. We discuss how in modern, Western cultures there is less understanding of the circumstances that may influence, even predispose, a mother to limit her emotional and material commitment to an infant or child. We use four short vignettes of clinical cases and one longer case description to illustrate the insights offered to clinicians by an evolutionary approach. We see our work both as contributing to greater understanding of these matters and as facilitating more compassionate models of care and intervention for women in such circumstances.

This is a descriptive article concerning a pedagogical intervention and philosophical activity carried out in a Law School in Brazil. The activity described has the pedagogical goal of stimulating the critical and comprehensive approach to law on students. The article presents the philosophical foundations and the ethnographic guidance necessary to develop the activity. The analysis of the results was done considering and interpreting student’s written and oral feedback. Results are shown in a positive light since the activity described is understood as a tool to facilitate and improve the awareness of the law students by making them reflect about the concrete practices, symbols and interactions in the professional field.

This article presents a case description of the design decisions, delivery methods, and assessment framework for an entrepreneurship micro-credential in a newly developed practice-based engineering degree, which was codesigned with industry partners who called for the integration of innovation, proactivity, and creativity (i.e., characteristics of entrepreneurship) into engineering education. Students undertake the micro-credential via online and face-to-face modules. Assessment is competency-based, requiring students to apply the theoretical knowledge provided in the micro-credential to an industry-based project. By participating in the micro-credential, it is expected that students will have a better understanding of how products and services can address customer needs, and how opportunities for product and service enhancement can create opportunities for growing the offerings of engineering. Several insights into the strengths, limitations, and design considerations for entrepreneurship micro-credentials in an engineering education context are outlined in addition to suggestions for improvement.

Sinonasal adenoid cystic carcinoma is a rare malignant epithelial tumor characterized by slow growth, multiple local recurrences, and perineural invasion; surgery followed by radiotherapy provides the best overall survival by means of an endoscopic, craniofacial, or combined approach. We present a previously undescribed case of frontal sinus adenoid cystic carcinoma involving the subcutaneous tissue and the dura mater treated with an open technique, free flap reconstruction, and hadron therapy together with a summary of the state of the art.

Introduction The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) is a diagnosis made by exclusion. In the literature, different etiological explanations are proposed for HaNDL, including an immune-mediated reaction after a viral infection. Case description We present a case of a 23-year-old woman with several episodes of transient headache, neurological deficits and cerebrospinal fluid lymphocytosis. All diagnostic criteria for the HaNDL syndrome were fulfilled; however, additional cerebrospinal fluid analysis showed a positive polymerase chain reaction (PCR) for human herpes virus type 7 (HHV-7). Discussion The possible role of a (prodromal) viral infection in the etiology of HaNDL is discussed. Also the role of electroencephalography (EEG) recordings is discussed. Serial EEG recordings showed generalized slowing, frontal intermittent rhythmic delta activity (FIRDA) and symmetric triphasic frontal waves with a dilation lag.

Dissociative fugue is rare entity to encounter with possible differentials of epilepsy and malingering. It is one of the dissociative disorders rarely seen in clinical practice more often because of the short lasting nature of this condition. This might also be because of organized travel of the individuals during the episodes and return to their families after the recovery from episodes. This is a case description of a patient who has experienced total three episodes of dissociative fugue. The patient has presented during the third episode and two prior episodes were diagnosed as fugue episodes retrospectively based on the history. Planned travel in this case by the patient to a distant location was prevented because of early diagnosis and constant vigilance till the recovery. As in this case, it may be more likely that persons with Dissociative fugue may develop similar episodes if they encounter exceptional perceived stress. However, such conclusions may require follow-up studies.

Herein we present a case of a 65-year-old woman with enterocolic lymphocytic phlebitis (ELP) who presented with anemic syndrome and in whom severe stenosis of the right flexure of large bowel was detected. The microscopic examination revealed fibrosis of the submucosa and lymphoplasmacytic phlebitis of small veins and venules, whereas arteries were spared. There were 110 IgG4-positive and 160 IgG-positive plasma cells in 1 high-power field, respectively, with corresponding IgG4/IgG ratio of 0.69. The IgG4 serum level was 2.42 g/L. According to the currently proposed criteria, this ELP case is the first that may be diagnosed as definite IgG4-related disease (IgG4-RD). Although based on the sole case description, taken together with a recent review and a case report, we presume that a subset of ELPs is a manifestation of IgG4-RD.

The aim of this study was to discuss the clinical significance of perirenal puncture and drainage with urokinase treatment of perirenal hematoma complicated by infection following surgery for upper urinary tract calculi. Two cases of perirenal hematoma complicated by infection following surgery for upper urinary tract calculi in 2017, and later received perirenal puncture and drainage of perirenal hematoma with urokinase treatment were selected. Puncture and drainage of perirenal hematoma with urokinase treatment were performed without the occurrence of severe complications such as sepsis, septic shock, or secondary bleeding. Both the renal morphology and functions were well restored. Puncture and drainage with urokinase treatment had definite efficacy in the treatment of perirenal hematoma complicated by infection.

The program I will present tries to enrich learning encounters of gifted children with literary texts. These encounters are assumed to combine emotional factors with cognitive ones connected to the production of knowledge and its organization. The proposal emphasizes the interaction between these factors through sharpening children's awareness of their involvement in the reading process.The current research proceeds from a general hypothesis that states that intensive and personalized care is needed in order to promote an appropriate balance of cognitive and affective/emotional traits in the gifted child's personality, and to reduce stress, uneven development, and lack of personal contentment, all of which are problems common to the talented.The approach presents the meeting between reader and text as a personal encounter that allows the young reader to fashion his own instruments of textual analysis, basing himself on affective experience and intellectual abilities related to the production and organization of knowledge. The process of reading itself, aside from adult support and aid, develops the reader's awareness of the motivational, attitudinal, intellectual and other factors involved in skilled reading, permitting him to transform personal and subjective foci of interest into more abstract and defined tools of text-analysis.The approach is organized around three foci, which emphasize different aspects of the text-reader interface: Reading materials are developed through expanding “core ideas” which reflect a personal focus of interest The role of the reader is stressed through the improvement of his awareness to his use of meta-cognition, insight and vital self-instruction. Adult involvement is particularly significant in planning the steps that will permit transforming a casual experience into a personal and meaningful life-experience.The most salient characteristic of this program is its holistic nature, and its commitment to the creative aspects involved in reading. In the long term, in addition to the design of tools for text analysis, the program encourages the development of different kind of awareness: 1) of cognitive styles, that influence learning styles and its results; 2) of the meta-components of thinking, and 3) of “occurrences” and random feelings that give color and nuances to cognitive components and serve as a motivational background when “meeting” the text.

The focus here is a detailed case description of a broad-based model for treat ing developmental phonological disorders. Successful treatment comprising 27 consultations over 17 months, of a girl aged 4;4 at the outset, with a mod erate phonological disability, is examined in detail. The model’s strength is in its combination of family education, metalinguistic tasks, phonetic produc tion procedures, multiple exemplar techniques and homework. Treatment is administered in planned alternating therapy blocks and breaks from therapy attendance.

– Transitional cell carcinoma of the upper urinary tract is relatively uncommon and the fewer the symptoms the more difficult the diagnosis. Choice of therapeutic approach is also difficult because the exams do not always enable the disease to be accurately staged and being a fundamental organ the use of conservative or radical surgery is controversial. The authors report the case of an 80-year-old man with a urothelioma in hydrocalyx of the left kidney due to lithiasis of the collar of the upper calyceal groups. The case was unusual for the concomitance of lithiasis with consequent urostasis and chronic inflammation of the sequestered calyces and the onset of neoplasia in the same. The diagnostic routine was arduous and only the CT scan removed the doubts raised by previous exams. Although precise data regarding the stage could not be obtained, radical surgery was performed. The subsequent histological exam proved the authors’ choice of procedure correct since the neoplasm was infiltrating.

Using a detailed case description of unique names, their meaning, and the naming process among five African American families, the author discusses the application of a culturally competent practice framework. The historical significance of names in African American culture is highlighted, and issues surrounding practitioner-based research in the African American community are discussed.

This study examines an implementation model of performance-based management (PBM). It argues that technical competencies and stakeholder involvement are necessary for a successful PBM implementation. Using the case of PBM reforms in China Post, it finds that technical competencies are being developed in the reforms. It also finds that, although the channels of stakeholder participation exist, stakeholders may not be involved in making critical decisions in Chinese reforms.

To the best of our knowledge, H.E. Astles was the first Australian physician who, in a lecture in 1882, paid explicit attention to the illness of anorexia nervosa. We reproduce his paper because of its historical value, which we underline in our comments.

In clinical practice it is common to find patients in whom urinary retention is not secondary to cervicourethral obstruction. Therapeutic measures, surgical or otherwise, do not live up to expectations in these patients. The Authors describe the case of a 54-year-old patient who presented with urinary retention. Neuro-urological exams excluded the presence of a cervicourethral obstruction and instead revealed probable parasympathetic denervation, subsequently confirmed by the Cutaneous Sympathetic Response recording and Cardiovascular Tests. In such cases correct diagnosis relies on close co-operation between the urodynamics and the neurophysiology doctors. These are undoubtedly particular cases, but an incorrect diagnostic framework could lead to inappropriate surgical treatment.

Liposarcoma of the renal capsule is a very rare mesenchymal tumour. Since the tumour presents with signs of a solid renal mass, correct preoperative diagnosis is usually difficult. Urography, ultrasound and CT do not always make it possible to distinguish a parenchymal from a capsular mass. The most useful investigation seems to be renal arteriography. In this report a case of capsular liposarcoma is presented. The difficulties of preoperative diagnosis are discussed.

The collective lived experience of translational research teams requires further appreciation, particularly at the stages of group formation. To achieve this, we conducted a case study of a translational research team (n = 16). Through the case description and then discussing case-based themes with community of practice theory, themes such as "Being Open" and "Working as a Group" found that this team’s mutual respect, cooperation, and their sharing of knowledge uncovered an alternative way that professionals organize themselves for translational research projects. In conjunction to this finding, our analysis showed that the team has qualities of a community of practice. Refereed/Peer-reviewed

Cysts of the suprarenal gland, classified as parasitical cysts, epithelial cysts, endothelial cysts and pseudocysts are uncommon. We report a case of pseudocysts of the suprarenal gland. Clinical signs consisted of flank pain and palpable mass. Urography, ultrasonography and computed tomography were essential for diagnosis. Treatment consisted of surgical extirpation, as percutaneous needle aspiration entails high rate of recurrences.

After reading a case description of a 20-year-old woman, subjects attributed her personal shortcomings to her weight rather than to herself per se. In particular, people who scored higher on a measure of self-handicapping were even more likely to attribute shortcomings to a person's weight and excuse or overlook them. A person who attributes shortcomings to being overweight will very likely find a sympathetic audience. These results support the suggestion by Baumeister, Kahn, and Tice (1990) that obesity can be a self-handicapping strategy.

A dramatic case description of events in a Dutch company which is put under pressure to change its policy illustrates how managerial behaviour is subject to the prevailing climate of opinion in society. The clash of interests both inside and outside the organiza tion and the mobilization of consumer opinion by external pressure groups compelled management to revise its policy position. The case is analysed from the point of view of the value systems of various actors inside and outside the company, and of the cultural specificity of the Dutch environment in which it took place. It is also considered as an example of 'garbage can' decision-making. Its consequences are explored for the management of both business corporations and civic action groups.

Freud long ago noted the difficulty some psychotherapists have in terminating their patients, much in the same way parents have difficulty in letting their children go. The same problem can arise in supervision too, as the following case description illustrates. The psychologist supervised graduate student interns at a psychiatric hospital, typically for just one of their patients. Subsequently, when these interns eventually set up private practices, many of them joined this psychologist's group in which concern focused on problems that arose with patients and general problems arising from setting up a clinical practice. Almost al l of those who joined these groups also joined an institute that was set up by the psychologist and another colleague for the purpose of advancing professional skills by organizing meetings and workshops. The membea of the supervision groups and the institute occasionally referred patients to one another, and occasionally potential patients contacted the institute and were referred to members of the institute. Several of the members worked together occasionally as cotherapists with clients, families or groups. In addition, many of the members of the supervisory groups and the institute eventually started psychotherapy with the psychologist or the colleague. Some were in individual psychotherapy, some in group psychotherapy and some in psychotherapy for couples. A few were in nvo or all three of these treatment modalities. (The psychotherapy provided was long-term and in depth.) In this way, this psychologist (and the colleague), who had supervised the former interns for one patient each, later ran a supervisory group for them, a professional institute with them as members and had them in individual, group, and/or couples therapy. The multiplicity of roles this psychologist had with former students raises the issue of boundary violations. Did the many roles conflict, and could a psychologist function in all of these roles with his students/ clients/colleagues? A legal action based in part on whether these multiple roles constituted a clear breach of ethical rules was settled out of court before a decision could be handed down. In some respects, the multiplicity of roles included many that Sigmund Freud had with his first disciples. But Freud functioned many years ago before ethics for those conducting psychotherapy had been discussed. Furthermore, the present psychologist involved was barely known outside of this group. Such a tightly-knit group of psychotherapists is rare. Even if a psychotherapist feels the need for these experiences, typically each experience is sought from a different source. In the present case, all experiences were bound up in the same small group with the same leader. Such a practice probably contravenes the ethical rules of the profession, and it appears to be an unhealthy arrangement.