Search

Hermeneutic procedures in a psychotherapeutic context using the example of an autobiography and a novel The article deals with hermeneutic procedures in the context of psychotherapeutic case analysis. On the one hand, it deals with hermeneutics and its philological roots as well as the possibilities of its adaptability to psychotherapeutic case analyses and interpretations. On the other hand, two concrete examples will be used to explore these possible applications. These examples do not refer to examples from psychotherapeutic practice, but to an autobiographical text and a novel. The autobiography in question is Manès Sperber's »Die Wasserträger Gottes« (1974) and the novel Angela Lehner's »Vater unser« (2019). In this way, an attempt is made to open up possible hermeneutic approaches to psychotherapeutic case interpretations in an exemplary manner. [ABSTRACT FROM AUTHOR]

Congenital interventricular septal aneurysms (IVSA) of the muscular septum are rare and can be associated with other familial abnormalities of the ventricular septum, arrhythmias, additional congenital heart disease, and chromosomal abnormalities. IVSA is also linked to ventricular dysfunction and non-compaction, although there are limited reports of this association presenting in utero. We describe a case of fetal ventricular septal aneurysm associated with ventricular dysfunction and pericardial effusion. [ABSTRACT FROM AUTHOR]

Introduction: Peer assessment in dental and medical education is a key tool for evaluating attitudes and communication skills, serving as an effective formative learning method. It not only boosts academic performance and encourages lifelong learning and reflective practice but also fosters collaboration, effective communication, and constructive feedback among peers. Objective: This study aimed to assess dental students' satisfaction and perceptions regarding implementing peer assessment in case presentations, including contribution to their learning. Methods: This cross‐sectional study involved third (n = 26), fourth (n = 54), and sixth (n = 71) dental students divided into five groups. Each student received peer assessments (n = 8) from the students of the other groups regarding their clinical presentation. At the end of the process, students were invited to complete an anonymous 9‐item questionnaire to assess student perceptions of the peer‐assessment process. Data were analyzed to evaluate students' perception and satisfaction with the peer assessment task. The bivariate analysis explored associations among questionnaire items. Results: A total of 151 students participated in the current study. Results showed a high level of agreement for most of the students regarding their preparedness for peer and self‐assessment. More than 75% of the students at all academic levels found it challenging to evaluate their peers. Student satisfaction scores increased with the level of education, (4.076, 4.214, and 4.246 out of five, respectively) with moderate correlations between peer evaluation characteristics. Conclusion: Peer assessment appears to enhance learning and professional development in dental students. Students' satisfaction with peer assessment grows with education level, reflecting its role in fostering critical evaluation skills and feedback. [ABSTRACT FROM AUTHOR]

Intense and uncontrolled internet use can lead to behavioral addiction, resulting in clinical-level symptoms. Mental health professionals use different theoretical perspectives while intervening in such situations. One of these approaches is reality therapy, which was examined for its suitability to Turkish culture. In this study, the counseling process based on reality therapy with a 25-year-old young adult showing symptoms of problematic internet use was analyzed. For this purpose, brief information was provided about problematic internet use, the basic concepts of reality therapy, and the wants, direction, evaluation, and planning WDEP system. Then, the counseling process was presented in the light of reality therapy. It has been observed that the client intensively uses the Internet as a way to escape from the current problems in his life, tries to meet his needs for entertainment and power through the Internet, and avoids taking responsibility. During the counseling process, the client discovered his own needs and managed to take responsibility for his life, made new plans, increased his control over internet use, and created alternatives to meet his needs in social life and playing games. In light of these results, it was inferred that the counseling process based on reality therapy would be functional for cases with problematic internet use and behavioral addiction symptoms. In this context, it is recommended that mental health professionals who work with clients who are problematic internet users or show signs of behavioral addiction should benefit from the basic concepts of reality therapy and the WDEP process in their intervention processes. [ABSTRACT FROM AUTHOR]

This article explores the use of between-session homework (BSH) in psychotherapy and its effectiveness in promoting positive outcomes for clients. The authors present six case studies that demonstrate how BSH can be applied in different treatment modalities and for various disorders. They emphasize the importance of tailoring BSH to each individual client's needs and strengths, and stress the need for collaboration between therapists and clients in selecting and reviewing BSH. The article advocates for the integration of BSH into clients' daily lives to promote symptom improvement and personal growth. [Extracted from the article]

Abstract Background Interstitial ectopic pregnancy is an ectopic gestation developing in the uterine part of the fallopian tube. The condition is rare and presents challenges for clinical as well as radiological diagnosis. This case report presents a rare case of interstitial ectopic pregnancy diagnosed intraoperatively. Case presentation A 36-year-old Black woman, referred from a peripheral health facility, presented at the emergency department with severe abdominal pains, vaginal spotting, nausea, and vomiting, with a 2-month history of irregular menstrual flow. Clinical and laboratory findings were suggestive of an acute abdomen likely due to a ruptured ectopic pregnancy (ultrasound was not available). An emergency exploratory laparotomy was done, which revealed a right adnexal ruptured interstitial pregnancy of a lifeless female fetus weighing 500 g (estimated mean gestational age of 22–23 weeks). The left fallopian tube looked normal. The site of rupture was repaired, followed by cleaning and closure of the abdomen. The post-operative period was uneventful, and the patient was discharged on postoperative day 7. Conclusion Interstitial pregnancies are uncommon and rarely attain advanced gestational ages, as in this case, compared with other tubal ectopic pregnancies. However, women presenting with signs of hypovolemic shock and acute abdomen, with a positive pregnancy test, warrant a high index of suspicion.

Abstract Background The European Association of Urology (EAU) defines primary urethral carcinoma (PUC) as a carcinoma that arises in the urethra without a previous diagnosis of carcinoma elsewhere in the urinary system. It is considered as a rare cancer, accounting for less than 1% of all malignant tumors and 5% of malignant tumors of the urinary system. The difficulty in diagnosis and its rarity can lead to delayed diagnosis and decreased survival. We think that a case report to be made in the literature for this rare disease with no consensus on treatment will contribute to disease management. Case presentation In this article, we describe the diagnosis and treatment process of a 75-year-old patient who was diagnosed with primary urethral cancer and had urethral discharge and difficulty in urination. The biopsy result from the suspected hyperemic area in the urethra in cystourethroscopy was primary urethral cancer. Urethrectomy followed by urethroplasty was performed on the patient's 2-cm primary urethral cancerous tissue. In the postoperative first month, an F-18 FDG whole-body PET scan for oncological evaluation showed increased pathological F-18 FDG uptake in the periphery of the mass in the penile urethra and indistinguishable boundaries from the prostatic urethra. After this, adjuvant gemcitabine and carboplatin therapy was planned by the oncology team. Conclusions Based on our outcome in this case, we believe that chemotherapy combined with surgery increases the chance of successful treatment in locally advanced urethral cancer.

Background: Interstitial ectopic pregnancy is an ectopic gestation developing in the uterine part of the fallopian tube. The condition is rare and presents challenges for clinical as well as radiological diagnosis. This case report presents a rare case of interstitial ectopic pregnancy diagnosed intraoperatively. Case presentation: A 36-year-old Black woman, referred from a peripheral health facility, presented at the emergency department with severe abdominal pains, vaginal spotting, nausea, and vomiting, with a 2-month history of irregular menstrual flow. Clinical and laboratory findings were suggestive of an acute abdomen likely due to a ruptured ectopic pregnancy (ultrasound was not available). An emergency exploratory laparotomy was done, which revealed a right adnexal ruptured interstitial pregnancy of a lifeless female fetus weighing 500 g (estimated mean gestational age of 22–23 weeks). The left fallopian tube looked normal. The site of rupture was repaired, followed by cleaning and closure of the abdomen. The post-operative period was uneventful, and the patient was discharged on postoperative day 7. Conclusion: Interstitial pregnancies are uncommon and rarely attain advanced gestational ages, as in this case, compared with other tubal ectopic pregnancies. However, women presenting with signs of hypovolemic shock and acute abdomen, with a positive pregnancy test, warrant a high index of suspicion. [ABSTRACT FROM AUTHOR]

Aim of the study. The aim of the current study was to identify, analyze and systematize current information on the characteristics of dental erosion and to present a case report describing the clinical steps of a minimally invasive restorative technique in a patient with dental erosion. Methods. A systematic electronic search was carried out in four electronic databases (Pubmed, Embase, Web of Science, and Scopus), selecting articles published form 2018 to present date. After evaluation 55 studies were finally analysed. Results. The most common causes of dental erosion are gastroesophageal reflux disease (GERD), the consumption of acidic foods and drinks, bulimia, and certain medications. Environmental factors, such as exposure to sports drinks and acidic environmental vapors or industrial chemicals, can also contribute to dental erosion. Preventive measures include reducing risk factors, increasing protective factors and desensitization treatments. Restorative treatment involves minimally invasive additive strategies or more radical options, depending on case severity. Additionally, a case report is presented which describes the clinical steps of the Injection Moulding Technique, used for the management of dental erosion in a GERD patient. Conclusion: Recent years significant advances in understanding dental erosion have important implications for clinical practice and public health and highlight the need for continued targeted research in this area. Injection Moulding Technique is a novel, minimally invasive restorative option in clinical situations dealing with dental erosion, more consistent and predictable than freehand techniques.

The authors argue that there are good reasons for seriously considering the dynamics of the peer group when discussing psychoanalytical case material. The setting and procedure have to protect and facilitate for the presenter and the group members to work together. The aim of this paper is to discuss the problems connected with presenting and discussing clinical psychoanalytical material in a peer group and to describe one such specific method, which the authors call the Weaving Thoughts method. The design is primarily inspired by Bion's formulation thoughts in search of a thinker. The group participants reflect on the presented clinical material in a way that the authors metaphorically describe as creating a weave of thoughts that emerges from the material. The aim of the method is to facilitate a work-group climate that allows thoughts to wander about, and to avert group members from debating and compromising the integrity of its members by letting basic assumptions come into power. The method is described from theoretical and practical points of view, with two illustrations of seminars according to this design and finally a discussion of the advantages and drawbacks of the method. [ABSTRACT FROM AUTHOR]

Abstract Background Insulinoma is an uncommon insulin-secreting neuroendocrine tumor that presents with severe recurrent hypoglycemia. Although cases of extrapancreatic insulinomas have been reported, the majority of insulinomas occur in the pancreas. The number of reported cases of ectopic insulinomas with follow-up assessments is limited and they do not report disease recurrence. The current report presents the first documented case of recurrent extrapancreatic insulinoma with 8 years of follow-up, provides relevant literature review, and proposes surveillance and treatment strategies. Case presentation We describe an insulinoma localized in the duodenal wall of a 36-year-old female who presented in 2013 with weight gain and Whipple’s triad and was successfully managed with duodenotomy and enucleation. She presented again in 2017 with recurrent Whipple’s triad and was found to have metastatic disease localized exclusively to peripancreatic lymph nodes. Primary pancreatic insulinoma was not evident and her hypoglycemia resolved following lymph node dissection. Eight years after initial presentation continuous glucose monitoring (CGM) showed a trend for euglycemia, and PET-CT Gallium 68 DOTATATE scan evaluation indicated absence of recurrent disease. Conclusion Insulinomas are rare clinical entities and extrapancreatic insulinomas are particularly uncommon. Follow-up evaluation and treatment strategies for ectopic insulinoma recurrence presents a significant clinical challenge as the condition has hitherto remained undescribed in the literature. Available evidence in the literature indicates that lymph node metastases of intrapancreatic insulinomas likely do not change prognosis. Given the absence of long-term data informing the management and monitoring of patients with extrapancreatic insulinoma, we suggest patient education for hypoglycemic symptoms, monitoring for hypoglycemia with CGM, annual imaging, and a discussion with patients regarding treatment with octreotide or alternative somatostatin receptor analog therapies.

Abstract Background We needs to study Primary Large cell Non-Hodgkin’s Lymphoma of the cranial vault, which is rare, and its association with COVID19 has not been reported, which may have an immunosuppressive effect to aggravate its progression. Patient details Our patient, a 53-year-old male, noticed fast growth of posterior cranial vault lesion from 2 to 10 cm size in last 6 months after COVID 19 affliction. MRI brain with contrast revealed lesions suggesting meningioma. The whole-body PET scan was normal. Following Subtotal excision of the mass, histopathology revealed large B-cell Non-Hodgkin’s lymphoma (DLBCL). Immunohistochemistry showed positive results for CD10, CD20, CD45 (LCA), ALK, and BCL-VE with a Ki-67 index of 90–95%. Following radiotherapy and chemotherapy patient is disease-free on imaging and doing well at 5 months of follow-up. Conclusions Early intervention with excisional biopsy and timely chemo and radiotherapy in favorable immunostaining may add survival benefits even in malignant features induced by immunosuppressing diseases such as COVID19 in diffuse large B-cell lymphoma (DLBCL) of the scalp.

Among young, otherwise healthy adults with unprovoked deep vein thrombosis (DVT), uncommon causes like variation in the normal sequential development of the inferior vena cava (IVC), must be explored. Anomalous IVC conditions are estimated to occur in up to 9% of the general population, with the rarest anomaly being IVC agenesis at 0.0005% - 1% general population prevalence. DVTs are more likely to develop in this population due to venous stasis from decreased venous return, even with the formation of extensive collateral veins. Herein, the authorial team presents a 22-year-old patient with leg pain and swelling who was found to have acute DVT, and, incidentally, the absence of the suprarenal IVC with a robust collateral system on further imaging studies. The morbidity of DVTs in this population is very high, and attention should be given to young patients who present with new-onset DVT in the setting of normal coagulation studies and lack of personal or family history of clotting disorders, as the need for specialized imaging such as venograms is necessary to secure the proper diagnosis.

Background: Case presentation assessment is common in both medicine and dentistry and is known under various names depending on the country and institution. It relates mainly to aspects of diagnosis and treatment planning and is considered highly authentic and useful. The COVID-19 pandemic necessitated the movement of this assessment from face-to-face to online. The aim of this investigation was to explore the students' impressions of the two different examination modalities. With this information, a decision on future diets of this examination can be made to accommodate the students' perspectives. Methods: Quantitative and qualitative data were gathered using an online, self-administered survey. Results: The students were split 50/50 regarding which assessment modality they preferred. Overall, they considered the online examination to be fair, and the majority agreed that the online format allowed them to display their knowledge as well as face-to-face. Conclusions: The delivery of case presentation examination is possible online. An online case presentation is a fair, useful, and authentic assessment that is appropriate to the needs of the faculty and students. Satisfaction with the two possible methods of conducting this assessment suggests it would be reasonable to conduct this examination online in the future. [ABSTRACT FROM AUTHOR]

E-cigarette or vaping product use-associated lung injury (EVALI) is a potentially severe acute interstitial lung disease primarily observed in the United States, with sporadic cases reported in Europe. EVALI, though rare, could be susceptible to under-diagnosis due to limited awareness and diagnostic suspicion. We present a case of a 19-year-old male in Denmark diagnosed with severe EVALI. The patient presented with profound respiratory symptoms necessitating intensive care unit (ICU) admission, subsequent intubation, and eventually initiation of extracorporeal membrane oxygenation (ECMO) support. EVALI should be suspected in users of vaping products, who present with sudden-onset severe respiratory insufficiency, and where other main causes can be excluded., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Abstract Background Atrial septal defect is the most common acyanotic congenital cardiac anomaly in the adults after bicuspid aortic valve with high prevalence in females. Major challenges in the management of large ASD with severe pulmonary hypertension includes hypoxemia, hypercarbia, hypothermia leading to reversal of shunt (Eisenmenger syndrome), fatal arrhythmias and congestive heart failure. Case presentation We report the successful management of the case of 44-year-old female patient with large ASD and severe pulmonary arterial hypertension posted for total abdominal hysterectomy with salpingectomy. She had history of palpitations with exertional dyspnoea and history of abnormal uterine bleeding with failed medical treatment. Echocardiography showed large OS-ASD (24 mm) with left to right shunt, moderate TR, severe PAH with estimated RVSP 60 mmHg, LVEF 50% and grossly dilated RA/RV. She underwent total abdominal hysterectomy with salpingectomy under regional anaesthesia with prophylactic use of adrenaline infusion. Conclusions Cardiac patients for non-cardiac surgery can be managed under regional anaesthesia.

Abstract Background Most individuals with eating disorders will either recover, settle into an unrecovered but self-defined acceptable quality of life, or continue to cycle from crisis to relative stability over time. However, a minority of those with severe and enduring eating disorders recognize after years of trying that recovery remains elusive, and further treatment seems both futile and harmful. No level of harm reduction proves achievable or adequately ameliorates their suffering. In this subgroup, many of those with anorexia nervosa will experience the medical consequences of malnutrition as their future cause of death. Whereas anyone who wishes to keep striving for recovery despite exhaustion and depletion should wholeheartedly be supported in doing so, some patients simply cannot continue to fight. They recognize that death from anorexia nervosa, while perhaps not welcome, will be inevitable. Unfortunately, these patients and their carers often receive minimal support from eating disorders health professionals who are conflicted about terminal care, and who are hampered and limited by the paucity of literature on end-of-life care for those with anorexia nervosa. Case presentation Three case studies elucidate this condition. One patient was so passionate about this topic that she asked to be a posthumous co-author of this paper. Conclusions Consistent with literature on managing terminal illness, this article proposes clinical characteristics of patients who may be considered to have a terminal eating disorder: diagnosis of anorexia nervosa, older age (e.g. age over 30), previous participation in high quality care, and clear and consistent determination by a patient who possesses decision-making capacity that additional treatment would be futile, knowing their actions will result in death. By proposing the clinical characteristics of terminal anorexia nervosa, we hope to educate, inspire compassion, and help providers properly assess these patients and provide appropriate care. We hope that this proposal stimulates further expert consensus definitions and clinical guidelines for management of this population. In our view, these patients deserve the same attendant care and rights as all other patients with terminal illness, up to and including medical aid in dying in jurisdictions where such care is legal.

Abstract Background Inflammatory aneurysms and mycotic aneurysms make up a minority of abdominal aortic aneurysms. Mainly autoimmune mechanisms are proposed in the pathogenesis of inflammatory aneurysms, and it is not routine to check for infectious agents as disease culprits. Case presentation A 58-year-old European male with complaints of abdominal and back pain for 8 weeks was admitted after a semi-urgent computed tomography scan revealed an 85 mm inflammatory abdominal aortic aneurysm. The patient had normal vital signs, slightly elevated inflammatory markers, and mild anemia on admission. Clinical examination revealed a tender pulsating mass in his abdomen. His clinical condition was interpreted as impending rupture and urgent repair of the aneurysm was deemed necessary. Due to the patient’s relatively young age and aneurysm neck morphology, open aortic repair was preferred. Preoperatively, the aneurysm appeared inflamed, with fibrous wall thickening and perianeurysmal adhesions. Aneurysm wall biopsies were sent to histopathological and microbiological diagnostics. Routine cultures were negative, but 16S rRNA gene real-time polymerase chain reaction was positive and Borrelia afzelii was identified by DNA sequencing of the polymerase chain reaction product. B. afzelii was also identified by sequencing the polymerase chain reaction product of a Borrelia-specific groEL target. Immunoglobulin G and M anti-Borrelia antibodies were present on serological analysis. Histopathological analysis displayed loss of normal aortic wall structure and diffuse infiltration of lymphocytes and plasma cells. The patient had an uneventful recovery and was discharged after 1 week to a regional rehabilitation facility. Though the patient fares clinically well and inflammatory markers had normalized, antimicrobial treatment with doxycycline continues at 3 months follow-up due to remaining radiologic signs of inflammation. Conclusions Borrelia infection in the setting of acute aortic pathology is a rare entity. To our knowledge, this is the first case report to demonstrate a mycotic abdominal aortic aneurysm as a rare manifestation of Lyme disease. Aortic wall biopsies and real-time polymerase chain reaction analysis of the specimen were essential for accurate diagnosis. This finding may contribute to the understanding of the etiology of inflammatory aneurysmal disease and abdominal aneurysms in general.

Background: We needs to study Primary Large cell Non-Hodgkin's Lymphoma of the cranial vault, which is rare, and its association with COVID19 has not been reported, which may have an immunosuppressive effect to aggravate its progression. Patient details: Our patient, a 53-year-old male, noticed fast growth of posterior cranial vault lesion from 2 to 10 cm size in last 6 months after COVID 19 affliction. MRI brain with contrast revealed lesions suggesting meningioma. The whole-body PET scan was normal. Following Subtotal excision of the mass, histopathology revealed large B-cell Non- Hodgkin's lymphoma (DLBCL). Immunohistochemistry showed positive results for CD10, CD20, CD45 (LCA), ALK, and BCL-VE with a Ki-67 index of 90-95%. Following radiotherapy and chemotherapy patient is disease-free on imaging and doing well at 5 months of follow-up. Conclusions: Early intervention with excisional biopsy and timely chemo and radiotherapy in favorable immunostaining may add survival benefits even in malignant features induced by immunosuppressing diseases such as COVID19 in diffuse large B-cell lymphoma (DLBCL) of the scalp. [ABSTRACT FROM AUTHOR]

Background: Insulinoma is an uncommon insulin-secreting neuroendocrine tumor that presents with severe recurrent hypoglycemia. Although cases of extrapancreatic insulinomas have been reported, the majority of insulinomas occur in the pancreas. The number of reported cases of ectopic insulinomas with follow-up assessments is limited and they do not report disease recurrence. The current report presents the first documented case of recurrent extrapancreatic insulinoma with 8 years of follow-up, provides relevant literature review, and proposes surveillance and treatment strategies. Case presentation: We describe an insulinoma localized in the duodenal wall of a 36-year-old female who presented in 2013 with weight gain and Whipple's triad and was successfully managed with duodenotomy and enucleation. She presented again in 2017 with recurrent Whipple's triad and was found to have metastatic disease localized exclusively to peripancreatic lymph nodes. Primary pancreatic insulinoma was not evident and her hypoglycemia resolved following lymph node dissection. Eight years after initial presentation continuous glucose monitoring (CGM) showed a trend for euglycemia, and PET-CT Gallium 68 DOTATATE scan evaluation indicated absence of recurrent disease. Conclusion: Insulinomas are rare clinical entities and extrapancreatic insulinomas are particularly uncommon. Follow-up evaluation and treatment strategies for ectopic insulinoma recurrence presents a significant clinical challenge as the condition has hitherto remained undescribed in the literature. Available evidence in the literature indicates that lymph node metastases of intrapancreatic insulinomas likely do not change prognosis. Given the absence of long-term data informing the management and monitoring of patients with extrapancreatic insulinoma, we suggest patient education for hypoglycemic symptoms, monitoring for hypoglycemia with CGM, annual imaging, and a discussion with patients regarding treatment with octreotide or alternative somatostatin receptor analog therapies. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Bullous systemic lupus erythematosus (BSLE) is a rare form of subcutaneous blistering lupus erythematosus (SLE). There is currently no effective treatment for BSLE. However, here, we present the first report of the successful treatment of refractory BSLE with belimumab in a 16-year-old girl. CASE PRESENTATION: A 16-year-old girl with BSLE had undergone different treatment options, with no significant improvement. Since B-lymphocyte stimulator plays an important role in the pathophysiology of SLE, belimumab was administered and showed remarkable effects for the first time in this patient with both SLE and BSLE. The patient's skin lesions improved steadily over the course of three weeks and completely disappeared in 30 days. In addition, no sign of recurrence of BSLE was observed over the 9-month follow-up period. CONCLUSIONS: To our knowledge, this is the first report of the successful short-term therapy of refractory BSLE/SLE overlap syndrome with belimumab in a pediatric patient. Although the use of belimumab resulted in excellent. [ABSTRACT FROM AUTHOR]

Abstract Background Impaction of foreign body is a common condition presented to ear, nose, and throat department among Asian population. The commonest foreign body seen among this population has been documented as fish bone. Fish bone can migrate to lateral neck space or related organs around the neck and chest. By presenting this case report, we aim to emphasize the importance of taking proper history and make clinicians aware of the possibility of a fish bone migrating into different spaces. This will help to prevent diagnosis delay leading to complications due to migrated fish bone. Case presentation A 50-year-old female Sinhalese patient presented to ear, nose, and throat department with right-sided neck pain for 2 days, who had a history of suspected fish bone impaction a few days ago that subsided without any investigations or treatments. She did not have any symptoms related to throat, and neck examination showed mild swelling and tenderness. Computer tomography revealed a migrated fish bone into the lateral neck close to carotid artery, and the fish bone was removed by neck exploration under general anesthesia without any complications. Conclusion In conclusion, migrated fish bone should be suspected if patient is having persistent symptoms mainly in the neck without having difficulty swallowing and who gives a history of fish bone impaction and having negative laryngoscopic examination. Proper history taking is very important in the assessment of these patients to prevent misdiagnosis of the condition. Clinicians should aware that migrated fish bones are not uncommon and that early suspicion can prevent later diagnosis and complications.

Cardiac tamponade is a rare life-threatening condition in breast cancer. About 25% of patients who have pericardial metastasis develop pericardial effusion, and only a small proportion of cases develop cardiac tamponade. The prognosis of patients presenting with cardiac tamponade is shadowy, with a survival rate ranging from a few days to 14 months, with a median survival of 5.5 months. We present the case of a 55-year-old woman diagnosed in 2020 with right luminal B stage IIIB breast cancer. After eight cycles of neoadjuvant chemotherapy (four cycles of liposomal doxorubicin and four cycles of paclitaxel/carboplatin), a Madden mastectomy with right axillary lymph node dissection was performed, followed by intensity-modulated radiation therapy (IMRT) and adjuvant hormonal therapy. After three years of no signs of oncological progression, the patient presented to the emergency room with clinical Beck’s triad. Echocardiography revealed a massive pericardial effusion with “swinging” heart and collapsed right atrium and right ventricle. To release the pericardial fluid, a pericardiocentesis followed by thoracocentesis were performed, significantly decreasing the symptomatology. The cytology examination confirmed the pericardial effusion containing metastatic breast cancer cells. The tumor board considered palliative chemotherapy treatment with liposomal doxorubicin/cyclophosphamide. After two cycles, no further accumulation of pericardial effusion was visible on the CT scan. In conclusion, given the fact that malignant pericardial effusion is considered to be an end-stage disease because it may lead to sudden cardiac death when left uncontrolled, the correct clinical diagnosis followed by the right therapeutic approach is crucial for the patient’s survival. [ABSTRACT FROM AUTHOR]

Materials and method. We used the information from the database of the Medical Oncology Ward of the “Elias” Emergency University Hospital, Bucharest, Romania. Objective. This article describes the management of a case of gastric adenocarcinoma with its challenges regarding the diagnosis of certitude, treatment protocols and toxicities. Results. We present the case of a 53-year-old Caucasian male, with locally advanced gastric adenocarcinoma, HER2+, pMMR, who underwent surgery and six out of eight cycles of peri-surgical chemotherapy, with complete response to treatment, then he neglected the oncological follow-up. After two years, he presented to the emergency room with jaundice, due to an invading tumoral mass. He underwent palliative surgical management and biopsies, which confirmed the relapse – negative for HER2, pMMR. The imaging revealed metastases in the liver and lymphatic nodes. He started the systemic treatment for recurrent disease, with multiple challenges regarding the treatment options and adverse events. Throughout the treatment, he preserved his quality of life. Conclusions. In this case report, we underline the relevance of a tumor board, the difficulty of treatment choices, the close follow-up, the palliative care and the management of adverse events in patients with gastric adenocarcinoma. [ABSTRACT FROM AUTHOR]

Case presentations have been researched as both an important form of intra/inter-professional communication, where a patient's clinical information is shared among health professionals involved in their care, and an equally key discursive tool in education, where learners independently assess a patient and present the case to their preceptor and/or care team. But what happens to the case presentation, a genre that governs physician (and learner) talk about patients, when it is used in patients' presence? While they were commonly used at the bedside in the past, case presentations today are more commonly performed in hallways or conference rooms, out of patient earshot. This paper draws on interview data from a study involving patient-present case presentations in a medical education setting. Our analysis asks what participants' metageneric comments about the encounter can teach us about the genre, about patient involvement in medical education, and about linguistic adaptations to the genre that the profession might make to support patient involvement. [ABSTRACT FROM AUTHOR]

This study explored the application of a model for teaching tooth wear diagnosis, risk assessment, and treatment decisions to undergraduates at the UCLouvain, Belgium, based on an inverted classroom combined with case presentations. The aim was to explain its implementation and assess improvement in learning, engagement, and satisfaction. The hypothesis tested was that this model would enhance students' performance. This controlled clinical trial included 29 dental students in the test group and 30 in the control group. All students received instructions and pre-class material for reading via e-mail 2 weeks prior to class time (T0). The test group included students attending the class time (attendance was not obligatory). The control group consisted of students only attending the preclinical training (attendance was obligatory). Both groups assessed three case presentations with no, moderate, and severe erosive tooth wear. The test group assessed the cases at the beginning of the class time (T1). One week later, at the beginning of the preclinical training, the students of the control group assessed the case presentations (T2). In parallel, to measure the contribution of the class time to students' performance, the test group reassessed the cases (T2). This was followed by discussion of each case in which the lecturer presented the benchmark assessments. Students' perception of their learning experience was recorded. The generalized linear mixed regression model showed that for the overall assessments of cases, students in the control group were significantly less likely to agree with the benchmark than students in the test group (OR = 0.62; p = 0.006). Students' satisfaction was higher in the test group than in the control group but only significantly regarding the quality of the cases presentations (Fisher test p < 0.01). The class time contributed significantly to students' improvement in learning in the test group (liner mixed model; p < 0.01). In conclusion, the model applied improved significantly in performance, learning, and to some extent satisfaction. However, the motivation strategy applied resulted in only half of the students adhering/engaging to the complete interactive model of teaching. Further motivation strategies should be implemented to make the complete model more widely accepted by students. [ABSTRACT FROM AUTHOR]

Abstract Background Left ventricular noncompaction is a rare cardiomyopathy characterized by a thin, compacted epicardial layer and a noncompacted endocardial layer, with trabeculations and recesses that communicate with the left ventricular cavity. In the advanced stage of the disease, the classical triad of heart failure, ventricular arrhythmia, and systemic embolization is common. Segments involved are the apex and mid inferior and lateral walls. The right ventricular apex may be affected as well. Case presentation A 29-year-old Caucasian male was hospitalized with dyspnea and fatigue at minimal exertion during the last months before admission. He also described a history of edema of the legs and abdominal pain in the last weeks. Physical examination revealed dyspnea, pulmonary rales, cardiomegaly, hepatomegaly, and splenomegaly. Electrocardiography showed sinus rhythm with nonspecific repolarization changes. Twenty-four-hour Holter monitoring identified ventricular tachycardia episodes with right bundle branch block morphology. Transthoracic echocardiography at admission revealed dilated left ventricle with trabeculations located predominantly at the apex but also in the apical and mid portion of lateral and inferior wall; end-systolic ratio of noncompacted to compacted layers > 2; moderate mitral regurgitation; and reduced left ventricular ejection fraction. Between apical trabeculations, multiple thrombi were found. The right ventricle had normal morphology and function. Speckle-tracking echocardiography also revealed systolic left ventricle dysfunction and solid body rotation. Abdominal echocardiography showed hepatomegaly and splenomegaly. Abdominal computed tomography was suggestive for hepatic and renal infarctions. Laboratory tests revealed high levels of N-terminal pro-brain natriuretic peptide and liver enzymes. Cardiac magnetic resonance evaluation at 1 month after discharge confirmed the diagnosis. The patient received anticoagulants, antiarrhythmics, and heart failure treatment. After 2 months, before device implantation, he presented clinical improvement, and echocardiographic evaluation did not detect thrombi in the left ventricle. Coronary angiography was within normal range. A cardioverter defibrillator was implanted for prevention of sudden cardiac death. Conclusions Left ventricular noncompaction is rare cardiomyopathy, but it should always be considered as a possible diagnosis in a patient hospitalized with heart failure, ventricular arrhythmias, and systemic embolic events. Echocardiography and cardiac magnetic resonance are essential imaging tools for diagnosis and follow-up.

The process of forming the motivation to learn as the basis for the effectiveness of the educational process continues to be a relevant object of research. The effectiveness of the learning process is largely determined by the students’ attitude to this process. The purpose of our research was to analyze the effectiveness of project methods using authentic materials to increase the motivation of middle school students to learn a foreign language. The study took place in the gymnasium during the on-the-job training. The experimental group consisted of students who were trained by «English» teaching materials by O. Afanasyeva and I. Mikheeva. In the experimental class the curriculum was supplemented with the application of the project method, game technologies and the use of authentic materials. The preparation of methodological materials for the study consisted of creating a technological map of the lesson and preparing additional materials and handouts for students. The article analyzes the results of the application of the project method with the use of game technologies and authentic materials for the formation of motivation to learn a foreign language at the middle stage of training. The article presents the results of a pedagogical study with an example of creating a technological map of a lesson, recommendations for increasing motivation to learn a foreign language at the middle stage of training. Based on the results of the study, the recommendations to increase motivation to learn a foreign language at the middle stage of education have been developed.

Abstract Background Vogt-Koyanagi-Harada syndrome is a rare disease characterized by skin and eyelash bleaching, chronic granulomatous iridocyclitis and exudative retinal detachment, and aseptic meningitis and encephalopathy. IgA nephropathy complicated by Vogt-Koyanagi-Harada syndrome is very rare, even though they might have similar pathogeneses. Ocular lesions often are not examined when patients are diagnosed with IgA nephropathy, which affects the prognosis. Case presentation We describe a 55-year-old male IgA nephropathy patient who was admitted with high fever and hematuria. Physical examination revealed impaired binocular vision with blurred vision, impaired hearing, and a congestive rash on the chest and back. Renal ultrasound examination showed no abnormalities. Laboratory examination showed that glomerulonephritis was complicated by infection, and anti-infection therapy was ineffective. Bilateral fluorescein angiography showed Vogt-Koyanagi-Harada syndrome. Further renal biopsy confirmed IgA nephropathy. Hormone shock therapy and cyclophosphamide adjuvant therapy were administered, and the patient’s symptoms improved. Conclusion For the first time, we reported the case of simultaneous onset of IgA nephropathy and Vogt-Koyanagi-Harada syndrome, which is very rare. The onset of Vogt-Koyanagi-Harada syndrome is rapid and serious, while that of IgA nephropathy is relatively milder, making it easy for specialized doctors to neglect this condition. Doctors should be highly alert to the clinical concomitant occurrence of the two diseases with similar mechanisms, especially in the case of neurological defects and ocular symptoms in IgA nephropathy patients, since timely immunosuppressive treatment may improve the outcome of ocular diseases.

Abstract Background Management of warfarin-associated major haemorrhage in prosthetic valve diseases is difficult as there is a fine line between haemorrhage and thrombosis. An individual’s propensity towards thrombosis, such as pregnancy, makes this situation even more complicated. Cases like these are very rare in the literature. Case presentation A 26 weeks pregnant, gravida two, para one, 35-year-old patient with prosthetic aortic and mitral valves presented to an external emergency clinic with clouding of consciousness. Her international normalised ratio(INR) was 8.9 at presentation. Brain MRI revealed a left subdural haematoma with no significant mass effect. Warfarin treatment was discontinued. On the second day of follow-up, she was referred to our centre for further evaluation of her clinical deterioration. She was haemodynamically stable on admission to the intensive care unit and followed up with a stable condition until the fourth day when she developed right eye drop and subsequent loss of consciousness. Her haematoma was surgically evacuated, and her condition improved. Eventually, she and a healthy newborn were discharged. Conclusion Intracranial haemorrhage during pregnancy is a relatively rare complication that requires a multidisciplinary management plan. Although the thrombogenic risk is high, it is vital to complete a reversal of warfarin anticoagulation in pregnant women with major bleeding.

Lyell syndrome, also known as toxic epidermal necrolysis (TEN), is a rare but life-threatening skin condition, often triggered by certain medications. Antiepileptics, allopurinol, and some nonsteroidal anti-inflammatory drugs are the most common causes. Some antibiotics are also common culprits, although tetracyclines are rarely linked to this condition. We hereby report a case of TEN induced by doxycycline in an 18-year-old girl who was taking the drug for the treatment of acne., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sandakly et al.)

Background: Atrial septal defect is the most common acyanotic congenital cardiac anomaly in the adults after bicuspid aortic valve with high prevalence in females. Major challenges in the management of large ASD with severe pulmonary hypertension includes hypoxemia, hypercarbia, hypothermia leading to reversal of shunt (Eisenmenger syndrome), fatal arrhythmias and congestive heart failure. Case presentation: We report the successful management of the case of 44-year-old female patient with large ASD and severe pulmonary arterial hypertension posted for total abdominal hysterectomy with salpingectomy. She had history of palpitations with exertional dyspnoea and history of abnormal uterine bleeding with failed medical treatment. Echocardiography showed large OS-ASD (24 mm) with left to right shunt, moderate TR, severe PAH with estimated RVSP 60 mmHg, LVEF 50% and grossly dilated RA/RV. She underwent total abdominal hysterectomy with salpingectomy under regional anaesthesia with prophylactic use of adrenaline infusion. Conclusions: Cardiac patients for non-cardiac surgery can be managed under regional anaesthesia. [ABSTRACT FROM AUTHOR]

Background: Most individuals with eating disorders will either recover, settle into an unrecovered but self-defined acceptable quality of life, or continue to cycle from crisis to relative stability over time. However, a minority of those with severe and enduring eating disorders recognize after years of trying that recovery remains elusive, and further treatment seems both futile and harmful. No level of harm reduction proves achievable or adequately ameliorates their suffering. In this subgroup, many of those with anorexia nervosa will experience the medical consequences of malnutrition as their future cause of death. Whereas anyone who wishes to keep striving for recovery despite exhaustion and depletion should wholeheartedly be supported in doing so, some patients simply cannot continue to fight. They recognize that death from anorexia nervosa, while perhaps not welcome, will be inevitable. Unfortunately, these patients and their carers often receive minimal support from eating disorders health professionals who are conflicted about terminal care, and who are hampered and limited by the paucity of literature on end-of-life care for those with anorexia nervosa. Case presentation: Three case studies elucidate this condition. One patient was so passionate about this topic that she asked to be a posthumous co-author of this paper. Conclusions: Consistent with literature on managing terminal illness, this article proposes clinical characteristics of patients who may be considered to have a terminal eating disorder: diagnosis of anorexia nervosa, older age (e.g. age over 30), previous participation in high quality care, and clear and consistent determination by a patient who possesses decision-making capacity that additional treatment would be futile, knowing their actions will result in death. By proposing the clinical characteristics of terminal anorexia nervosa, we hope to educate, inspire compassion, and help providers properly assess these patients and provide appropriate care. We hope that this proposal stimulates further expert consensus definitions and clinical guidelines for management of this population. In our view, these patients deserve the same attendant care and rights as all other patients with terminal illness, up to and including medical aid in dying in jurisdictions where such care is legal. [ABSTRACT FROM AUTHOR]

This is a clinical case presentation of a Catholic hospital chaplain, who, like thousands of deeply wounded children from around the world, was sexually abused by his parish priest. Believing he had received 'a special blessing' contributed to his denial, rationalization and ultimate identification with his abuser. For 58 years, having repressed his earlier experience, this man lived as a Catholic cleric, abusing others. Entering analysis provided him with an opportunity to work with his dreams and memories. Analysis enabled him to consciously come to terms with and benefit from a future that fostered his individuation and allowed him to become a spokesman for the rehabilitation of others suffering a similar fate. [ABSTRACT FROM AUTHOR]

Background: Inflammatory aneurysms and mycotic aneurysms make up a minority of abdominal aortic aneurysms. Mainly autoimmune mechanisms are proposed in the pathogenesis of inflammatory aneurysms, and it is not routine to check for infectious agents as disease culprits.Case Presentation: A 58-year-old European male with complaints of abdominal and back pain for 8 weeks was admitted after a semi-urgent computed tomography scan revealed an 85 mm inflammatory abdominal aortic aneurysm. The patient had normal vital signs, slightly elevated inflammatory markers, and mild anemia on admission. Clinical examination revealed a tender pulsating mass in his abdomen. His clinical condition was interpreted as impending rupture and urgent repair of the aneurysm was deemed necessary. Due to the patient's relatively young age and aneurysm neck morphology, open aortic repair was preferred. Preoperatively, the aneurysm appeared inflamed, with fibrous wall thickening and perianeurysmal adhesions. Aneurysm wall biopsies were sent to histopathological and microbiological diagnostics. Routine cultures were negative, but 16S rRNA gene real-time polymerase chain reaction was positive and Borrelia afzelii was identified by DNA sequencing of the polymerase chain reaction product. B. afzelii was also identified by sequencing the polymerase chain reaction product of a Borrelia-specific groEL target. Immunoglobulin G and M anti-Borrelia antibodies were present on serological analysis. Histopathological analysis displayed loss of normal aortic wall structure and diffuse infiltration of lymphocytes and plasma cells. The patient had an uneventful recovery and was discharged after 1 week to a regional rehabilitation facility. Though the patient fares clinically well and inflammatory markers had normalized, antimicrobial treatment with doxycycline continues at 3 months follow-up due to remaining radiologic signs of inflammation.Conclusions: Borrelia infection in the setting of acute aortic pathology is a rare entity. To our knowledge, this is the first case report to demonstrate a mycotic abdominal aortic aneurysm as a rare manifestation of Lyme disease. Aortic wall biopsies and real-time polymerase chain reaction analysis of the specimen were essential for accurate diagnosis. This finding may contribute to the understanding of the etiology of inflammatory aneurysmal disease and abdominal aneurysms in general. [ABSTRACT FROM AUTHOR]

Background: The management of non-small cell lung cancer (NSCLC) has become increasingly complex due to the evolution of personalized medicine approaches. Such approaches are characterized by the necessity of adequate tumor samples; hence, improved biopsy techniques are needed. Transbronchial lung cryobiopsy is a novel endoscopic procedure designed to collect peripheral pulmonary tissue, and it is currently employed in interstitial lung diseases. The use of this technique in oncology might result in improved mediastinum staging and molecular characterizations; however, available data involving the use of a cryoprobe on mediastinal lymph nodes are still limited.Case Presentation: Here we present a series of five consecutive patients who underwent endoscopic assessment of mediastinal lymph nodes for oncologic reasons. All patients were subjected both to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS TBNA) and cryobiopsy of mediastinal lymph nodes during the same procedure, and no complications were observed. In three of the reported cases, both cryobiopsy and cell block from EBUS TBNA were positive, while in one case cryobiopsy was not diagnostic and EBUS TBNA was negative; moreover, one case showed discordance between the procedures, as cryobiopsy was negative and cell block obtained from multiple stations was diagnostic for small cell lung cancer. In one case involving a patient treated for lymphoma, cryobiopsy provided more complete histologic characterization, and in another case involving a patient affected by NSCLC cryobiopsy provided more material for molecular analyses.Conclusion: This case presentation series suggests that cryobiopsy, which has been generally used on peripheral lung lesions so far, is a feasible and safe approach for diagnosis and staging of mediastinal lymph nodal involvement, especially when station 7 is involved. Compared to EBUS TBNA, cryobiopsy might provide more adequate histological samples, with a possible impact on molecular characterizations and, therefore, therapeutic decisions. However, the learning curve of the procedure has not to be understated and optimal protocols for implementing this technique are needed. In our opinion, further studies designed to integrate the routine use of cryobiopsy in current practice for solid and eventually hematologic tumors with mediastinal lymph node involvement are warranted. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Case presentation assessment is common in both medicine and dentistry and is known under various names depending on the country and institution. It relates mainly to aspects of diagnosis and treatment planning and is considered highly authentic and useful. The COVID-19 pandemic necessitated the movement of this assessment from face-to-face to online. The aim of this investigation was to explore the students’ impressions of the two different examination modalities. With this information, a decision on future diets of this examination can be made to accommodate the students’ perspectives. Methods: Quantitative and qualitative data were gathered using an online, self-administered survey. Results: The students were split 50/50 regarding which assessment modality they preferred. Overall, they considered the online examination to be fair, and the majority agreed that the online format allowed them to display their knowledge as well as face-to-face. Conclusions: The delivery of case presentation examination is possible online. An online case presentation is a fair, useful, and authentic assessment that is appropriate to the needs of the faculty and students. Satisfaction with the two possible methods of conducting this assessment suggests it would be reasonable to conduct this examination online in the future.

ABSTRACT. Children with Autistic Spectrum Disorders (TSA) often engage in stereotypical behaviors that greatly impede interaction with the environment and the learning process. Because these behaviors are self‐reinforcing, they are often difficult to reduce. Moreover, for a method to be effective, we believe it is necessary to analyze the context in which they occur and the level of development of the child in each area that may influence the appearance or maintenance of these behaviors, besides analyzing their antecedents, consequences and functions. There are few studies that approach stereotypical behaviors in an integrative perspective. The goal of the current study is to analyze the stereotypical behaviors of a child with ASD from an integrative perspective, including Applied Behavior Analysis (ABA), The Neurosequential Model of Therapeutics (NMT) and Sensory Integration Therapy. This study has a great practical relevance because, based on theoretical foundation, it presents a complex perspective of analyzing the stereotypic behaviors and provides practical recommendations for intervention. Further research could test the hypotheses derived from this case presentation.

Background: Impaction of foreign body is a common condition presented to ear, nose, and throat department among Asian population. The commonest foreign body seen among this population has been documented as fish bone. Fish bone can migrate to lateral neck space or related organs around the neck and chest. By presenting this case report, we aim to emphasize the importance of taking proper history and make clinicians aware of the possibility of a fish bone migrating into different spaces. This will help to prevent diagnosis delay leading to complications due to migrated fish bone.Case Presentation: A 50-year-old female Sinhalese patient presented to ear, nose, and throat department with right-sided neck pain for 2 days, who had a history of suspected fish bone impaction a few days ago that subsided without any investigations or treatments. She did not have any symptoms related to throat, and neck examination showed mild swelling and tenderness. Computer tomography revealed a migrated fish bone into the lateral neck close to carotid artery, and the fish bone was removed by neck exploration under general anesthesia without any complications.Conclusion: In conclusion, migrated fish bone should be suspected if patient is having persistent symptoms mainly in the neck without having difficulty swallowing and who gives a history of fish bone impaction and having negative laryngoscopic examination. Proper history taking is very important in the assessment of these patients to prevent misdiagnosis of the condition. Clinicians should aware that migrated fish bones are not uncommon and that early suspicion can prevent later diagnosis and complications. [ABSTRACT FROM AUTHOR]

Background: Left ventricular noncompaction is a rare cardiomyopathy characterized by a thin, compacted epicardial layer and a noncompacted endocardial layer, with trabeculations and recesses that communicate with the left ventricular cavity. In the advanced stage of the disease, the classical triad of heart failure, ventricular arrhythmia, and systemic embolization is common. Segments involved are the apex and mid inferior and lateral walls. The right ventricular apex may be affected as well.Case Presentation: A 29-year-old Caucasian male was hospitalized with dyspnea and fatigue at minimal exertion during the last months before admission. He also described a history of edema of the legs and abdominal pain in the last weeks. Physical examination revealed dyspnea, pulmonary rales, cardiomegaly, hepatomegaly, and splenomegaly. Electrocardiography showed sinus rhythm with nonspecific repolarization changes. Twenty-four-hour Holter monitoring identified ventricular tachycardia episodes with right bundle branch block morphology. Transthoracic echocardiography at admission revealed dilated left ventricle with trabeculations located predominantly at the apex but also in the apical and mid portion of lateral and inferior wall; end-systolic ratio of noncompacted to compacted layers > 2; moderate mitral regurgitation; and reduced left ventricular ejection fraction. Between apical trabeculations, multiple thrombi were found. The right ventricle had normal morphology and function. Speckle-tracking echocardiography also revealed systolic left ventricle dysfunction and solid body rotation. Abdominal echocardiography showed hepatomegaly and splenomegaly. Abdominal computed tomography was suggestive for hepatic and renal infarctions. Laboratory tests revealed high levels of N-terminal pro-brain natriuretic peptide and liver enzymes. Cardiac magnetic resonance evaluation at 1 month after discharge confirmed the diagnosis. The patient received anticoagulants, antiarrhythmics, and heart failure treatment. After 2 months, before device implantation, he presented clinical improvement, and echocardiographic evaluation did not detect thrombi in the left ventricle. Coronary angiography was within normal range. A cardioverter defibrillator was implanted for prevention of sudden cardiac death.Conclusions: Left ventricular noncompaction is rare cardiomyopathy, but it should always be considered as a possible diagnosis in a patient hospitalized with heart failure, ventricular arrhythmias, and systemic embolic events. Echocardiography and cardiac magnetic resonance are essential imaging tools for diagnosis and follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Due to the circumstances of the Covid-19 pandemic, the teaching during the block internship at the Department for Otorhinolaryngology was switched to digital learning. Various online courses were created and the utilisation by the students was analyzed. Material & methods: Examination videos, surgical images and videos were created and live lectures were held. In addition, patient cases of common otorhinolaryngological diseases were reconstructed on an interactive platform. A total of 16 cases were offered in weekly rotation. These cases are provided with gap texts, open and selection questions, links and videos and thematically appropriate digression offers. The time-consuming creation was carried out as a HTML 5 learning package with the authoring program Exelearning 2.5. Each case was to be evaluated separately after being worked on by the students. Results: The direct feedback and the evaluation results of the students on the internship and case presentations were consistently positive. However, on average only 50.72% of the registered students took part in the weekly video meetings. In the course of the semester, the willingness to participate decreased. In addition, the willingness to evaluate the patient cases was low.Discussion: With the case presentation tool, concrete patient examples can be well presented, especially when patient contact is not possible (especially in an ENT clinic due to violation of distance and hygienic rules). Even though the evaluations were positive in terms of content, the frequency of utilisation and also the motivation for feedback seems disappointing. This seems to be associated above all with an increasing return to everyday life after the end of the lockdown.

Kişinin kendi hayatına son verme teşebbüsü olarak tanımlanabilecek intihar, sadece şahısları ve aileleri değil toplumları derinden sarsan, bütün insanlığı ilgilendiren uluslara- rası bir insanlık sorunudur. İslam başta olmak üzere bütün semavi dinlerin olumsuz de- ğerlendirdiği ve önlemeye çalıştığı bu eylemin, sebep ve sonuçlarının özellikle de İslam fıkhı açısından incelenmesi önem arz etmektedir. Modern yaşam alışkanlıkları ile zaman- la sayısı artan bu eylem, İslam toplumlarında da görülebilmektedir. Bu davranışın İslami ilkeler ve modern bulgular çerçevesinde yeniden değerlendirilmesi, İslam toplumlarının geleceğine katkıda bulunacaktır.

Background: Abiraterone is a medication frequently used for metastatic castrate-resistant prostate cancer. We report a case of non-sustained episodes of TdP associated with severe hypokalemia due to androgen-deprivation therapy. Few case presentations describe this association; the novelty lies in the potentially lethal cardiovascular events among cancer patients receiving hormonal therapy.Case Presentation: A 70-year-old male presented with recurrent syncope without prodrome. ECG revealed frequent ventricular ectopy, non-sustained episodes of TdP, and severe hypomagnesemia and hypokalemia. During potassium and magnesium infusion for repletion, the patient underwent temporary transvenous atrial pacing. As part of the work-up, coronary angiography revealed a mild coronary artery disease, and transthoracic echocardiogram showed a moderately depressed ejection fraction. After electrolyte disturbances were corrected, the QT interval normalized, and transvenous pacing was no longer necessary. Abiraterone was discontinued during the admission, and the patient returned to baseline.Conclusions: Cancer treatment is complex and requires a multidisciplinary approach. We presented a case of non-sustained TdP associated with androgen-deprivation therapy in an elderly patient with mild coronary artery disease and moderately reduced ejection fraction. Close follow-up and increased awareness are required in patients with hormonal treatment, especially in the setting of other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]