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Introduction Organizing pneumonia is a rare clinico-pathological syndrome. This cryptogenic or secondary condition is of unknown origin, and may be infectious, or associated with autoimmune diseases, cancer, drugs, or radiation. Case description The case is presented of a 52-year-old patient who was diagnosed with organizing pneumonia secondary to anti-synthetase syndrome. Discussion It is intended to make known that not all pulmonary consolidative clinical pictures correspond to infectious processes. In this case, an organizing pneumonia secondary to anti-synthetase syndrome is documented. Despite being a disorder that is classified as an idiopathic inflammatory myopathy, it manifests as an interstitial lung disease with predominantly respiratory symptoms.

Summary Objective We aim to describe the supraclavicular nerve's vascular entrapment by the external jugular vein as an unreported anatomical finding. Case description In a routine cadaveric dissection, the superficial emergence of the first division of the left supraclavicular nerve emerged along a duct formed through the external jugular vein. No other vascular or neural anatomical abnormalities were found in the surrounding structures. Conclusion This unreported vascular entrapment of the supraclavicular nerve by the external jugular may harbour clinical implications for surgical and endovascular procedures on the external jugular vein and in refractory thoracic and scapular waist pain.

Purpose: Many individuals with cortical visual impairment (CVI) are unable to meet their daily communication needs through natural speech. Augmentative and alternative communication (AAC) provides supports for individuals with complex communication needs, including those with CVI. However, many forms of AAC involve access via a visual modality. This presents specific challenges for assessment and intervention of individuals with CVI using AAC. Method: This study used an automated eye tracking technology to analyze the gaze patterns of one individual with CVI to stimuli of varying complexity. The automated eye tracking technology captured the point of gaze of the participant every 16 ms (60 Hz), allowing for a detailed evaluation of what captured the participant's attention. Results: Variations in stimulus complexity resulted in changes in visual attention. Overall, the participant engaged significantly faster to and longer with simpler images both when presented one at a time and also during a preferential looking task when two stimuli were presented. Additionally, one stimulus displayed a teddy bear, with an animated face. The participant gazed at the face for the majority of her looking time to that stimulus, rather than the colorful foot pads. Conclusions: The participant demonstrated clear patterns of quicker response times and longer gaze times when the stimuli were simpler in design. This has implications for AAC interventions and choice of symbols. Additionally, the participant's ability to engage with the face of the teddy bear image suggests her visual processing was consistent with the score she received on the CVI Range, an assessment tool that describes functional vision in individuals with CVI.

Background and Overview The purpose of this article is to present the variations in maxillary molar palatal root canals and provide a reference for the possible variations in root canal treatment. Case Description Five rare cases with palatal canal variation presented in this case series received nonsurgical endodontic treatment successfully. These case reports highlight that understanding and managing the different types of canal configurations in palatal roots of maxillary molars is essential to successful root canal treatment. We tried 2 methods of examining the palatal canal variation to provide examples for clinicians in diagnosing and treating similar cases. Conclusions and Practical Implications The outline form of the access cavity and the shape of the pulp chamber floor are important factors for identifying variations in root canal number. Moreover, cone-beam computed tomography can help in detecting variations in root canals.

CASE DESCRIPTION A 30-year-old person with a unilateral transtibial amputation (TTAmp) was assessed performing an Olympic-style back squat with an energy storage and return prosthetic foot. OBJECTIVE Determine joint-level movement strategies of an individual with TTAmp while performing an Olympic-style back squat. STUDY DESIGN Case study design. TREATMENT Back squat mechanics are evaluated in an individual with TTAmp by comparing the contribution of the ankle, knee, and hip joint to total positive and negative amputated and sound limb work. OUTCOMES The hip joint was the greatest contributor to total positive limb work compared with the knee and ankle, respectively, in the amputated (55.0% hip vs. 30.8% knee, P < 0.001; vs. 14.2% ankle, P = 0.001) and sound limbs (52.2% hip vs. 38.9% knee, P < 0.001; vs. 8.9% ankle, P < 0.001). The hip joint was the greatest contributor to total negative limb work compared with the ankle in both the amputated (51.0% hip vs. 15.9% ankle, P < 0.001) and sound limbs (47.3% hip vs. 10.0% ankle, P < 0.001) and the knee in the amputated limb (51.0% hip vs. 32.5% knee, P < 0.001). Ankle joint power demonstrated an atypical bimodal negative/positive/negative/positive pattern. CONCLUSION The individual with TTAmp used a hip-dominant joint strategy in both the amputated and sound limbs while demonstrating more potential to optimize the prosthetic foot's energy storage and return capabilities when performing a back squat.

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.

Background We present a first case report of an Actinomycosis lesion of the ventral tongue. Actinomycosis of the tongue is an uncommon finding. Case Description The 64-year-old female patient presented with a leukoplakic ventral tongue lesion. The diagnosis Actinomycosis was confirmed by histopathologic evaluation. The lesion was successfully treated with antibiotics and laser ablation therapy. Practical Implications Diagnostic and therapeutic concerns are discussed. Clinicians are alerted to considering Actinomycosis within the differential diagnosis of leukoplakic tongue lesions.

CASE DESCRIPTION A 2.5-month-old 17.5-kg female alpaca cria was presented for evaluation and treatment of severe bilateral carpal varus deformities. CLINICAL FINDINGS No lameness was evident at a walk, and neither carpal varus deformity could be corrected by means of manipulation. Radiography revealed severe varus of the left (27°) and right (21°) carpal regions. No additional conformational abnormalities were detected. TREATMENT AND OUTCOME A single 2.7-mm transphyseal cortical screw was placed in the distolateral aspect of the radius in each limb. On reexamination 8 weeks after screw placement, the left carpal varus deformity had corrected from 27° to 2.6°, and the left transphyseal screw was removed. The right carpal varus deformity had improved but was still present (18°), and hemicircumferential periosteal transection and elevation was performed on the mediodistal aspect of the right radius. Five weeks after the second surgery, the right carpal varus deformity had corrected to 2.4°, and the right transphyseal screw was removed. Six months after the second screw removal, both thoracic limbs remained straight, the cria had a normal gait, and the owner was happy with the cosmetic result. CLINICAL RELEVANCE Placement of a single transphyseal cortical screw with or without the addition of hemicircumferential periosteal transection and elevation can provide a favorable outcome in skeletally immature alpacas with severe carpal varus deformities.

CASE DESCRIPTION A 5-month-old domestic shorthair cat was presented for recurrent regurgitation and hypersalivation after eating, which had been evident since adoption 2 months earlier. CLINICAL FINDINGS Physical examination was unremarkable. Plain thoracic radiography, positive contrast esophagography, endoscopy, CT, electromyography, and blood analysis were performed. A caudal cervical esophageal diverticulum, likely congenital, was diagnosed. TREATMENT AND OUTCOME A diverticulectomy was performed with a surgical stapler while an endoscope was in the esophageal lumen. No intra- or postoperative complications were reported. Postoperative and short-term outcomes were excellent, with resolution of clinical signs and no endoscopic esophageal abnormality 3 months after surgery. The cat remained without clinical signs 8 months after surgery. CLINICAL RELEVANCE An esophageal diverticulum in a cat is rare. The cat of this report had a good outcome following surgical management of a cervical esophageal diverticulum. Surgery is worth considering for similarly affected cats, but additional cases are required to confirm the benefit of surgery versus conservative management. (J Am Vet Med Assoc 2021;259:396–400)

CASE DESCRIPTION 4 alpacas and 2 llamas (11 months to 11 years old) from 2 properties were examined for lethargy (6/6), salivation and regurgitation (4/6), and recumbency (3/6). Signs developed approximately 48 to 72 hours after accidental access to black oil sunflower seeds. CLINICAL FINDINGS 3 alpacas died suddenly prior to treatment and were necropsied. One llama survived, and 1 alpaca and 1 llama died after days of medical treatment. All 3 treated animals had systemic inflammatory signs including tachycardia, fever, and hematologic changes. Biochemical anomalies included azotemia, hyperglycemia, hyponatremia, hypochloremia, and hypoalbuminemia. Necropsy identified numerous sunflower seeds in the gastrointestinal tract of all 5 animals that died, with pulmonary congestion (5/5 animals), mild centrilobular vacuolar hepatic degeneration (4/5), and erosions of the esophagus (3/5) and first (3/5) and third (1/5) compartments of the forestomach. Renal tubular necrosis was found in the 2 animals that died on day 4 of treatment. TREATMENT AND OUTCOME One llama responded successfully to intensive medical management including supplemented IV fluid therapy, oral and partial parenteral nutrition, and administration of antimicrobials, furosemide, and insulin and was clinically normal with plasma biochemical analysis values within reference range 12 weeks later. Vitamin D, oxalates, heavy metals, and mycotoxins were excluded as the cause of clinical signs on the basis of screening of uneaten seeds and tissue samples and gastric content from the treated llama that died. CLINICAL RELEVANCE Inadvertent large volume black oil sunflower seed ingestion resulted in a high mortality rate in camelids. A specific toxic principle was not identified. Feeding this product to camelids is not recommended to avoid the risk of accidental overingestion and subsequent disease. (J Am Vet Med Assoc 2021;259:406–414)

The research featured such an understudied issue as psychological safety in class, which currently lacks diagnostic tools. Standard tests cannot measure the relevant competencies of future teachers. The research objective was to determine the diagnostic potential of the case method in assessing the readiness of future teachers to provide psychological safety in the class environment. The study relied on the ideas about the psychological safety of the educational environment (I. A. Baeva) and the structure of teachers’ professional readiness (N. V. Kuzmina). The study involved 418 students of psychology and pedagogics who had to find solutions for case situations. The cases consisted of the case description and four tasks, the answers to which described certain aspects of the readiness to provide psychological safety in class. The results were subjected to a content analysis. The case method proved a reliable tool for assessing the professional readiness and competencies of future teachers.

BACKGROUND: Two patients received ocular injuries from rusted metallic projectiles at their industrial workplaces. Said injuries resulted in the loss of their eyes by evisceration surgeries to prevent fatal infections. CASE DESCRIPTION: The first case, a man in his twenties, received a stock conformer immediately after surgery and started prosthetic therapy within 2 months. The second case, a man in his forties, started prosthetic therapy after 10 years. Definitive custom ocular prostheses were fabricated and relined according to conventional protocol. RESULTS: On issue of the prosthesis, there was adequate retention, aesthetics and stability to extra-ocular movements and treatment was considered successful for both cases. However, follow-ups showed noticeable prosthetic eye movements for case 1 which, to some extent mimicked the physiologic movement of its fellow natural eye. Case 1 adjusted to his prosthesis better while case 2 was still adjusting with little to no physiologic movement. CONCLUSION: Prosthetic rehabilitation should be started as early as possible to obtain optimum rehabilitative results.

CASE DESCRIPTION A 3-year-old 17.5-kg (38.5-lb) mixed-breed dog was referred for evaluation because of nasal discharge, sneezing, and signs of nasal congestion of approximately 9 months’ duration. A diagnosis of nasopharyngeal stenosis (NPS) was made prior to referral. CLINICAL FINDINGS Sneezing, bilateral mucopurulent nasal discharge, reduced nasal airflow, stertor, and increased inspiratory effort were noted on physical examination. Results of serum biochemical analysis were within respective reference ranges. Review of CT images of the skull revealed findings consistent with severe bilateral partial osseous choanal atresia and NPS. Retrograde rhinoscopy confirmed membranous NPS. TREATMENT AND OUTCOME A ventral rhinotomy was performed; communication between the pharynx and nasal passageway was reestablished by surgical debridement of the caudal border of the palatine bone and vomerine crest and groove, followed by dissection of the membranous NPS and reconstruction of the caudal part of the nasopharynx. A covered nasopharyngeal stent was placed in the newly established nasopharynx. The dog recovered uneventfully but was presented 3 weeks later with recurrent signs; diagnostic findings were consistent with stenosis rostral to the stent. The stenosis was treated with balloon dilation, and a second covered stent was placed rostral to and overlapping the first stent, spanning the stenotic region. Eleven months after this procedure, the dog was doing well. CLINICAL RELEVANCE Results for this patient suggested that ventral rhinotomy and covered nasopharyngeal stent placement can be used successfully for the management of osseous choanal atresia in dogs; however, careful attention to preoperative planning and potential complications is necessary. (J Am Vet Med Assoc 2021;259:190–196)

Background and Overview Severely molar-incisor hypomineralization (MIH)–affected teeth are prone to develop early posteruptive enamel breakdown (PEB) and caries. A novel conservative interim approach for the prevention of this complication is presented. Case Description A 6-year-old boy with strong hypersensitivity and extensive brown opacities in the partially erupted mandibular permanent first molars (PFMs) was diagnosed with MIH. Constant hygiene and dietary counseling were followed by the application of luted orthodontic bands and glass ionomer sealants to protect PFMs from caries and PEB until the complete eruption of the teeth. After 36 months, the PFMs were completely erupted, with no caries and PEB, and the cooperation of the child increased. Conclusions and Practical Implications Temporary strategies are useful to preserve MIH-affected PFMs. With the methodology described, the hypersensitivity decreased and the patient reached a good degree of cooperation, making possible definitive rehabilitative considerations.