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Primary failure of eruption (PFE) is a rare, nonsyndromic condition in which non-ankylosed teeth fail to erupt either fully or partially due to malfunction of the eruption mechanism. Three young patients are presented in this article with features consistent with a diagnosis of PFE. The features of this condition are described together with different modalities of treatment planning for such patients. The following is a discussion about zygoma implants as a new approach to treatment for patients with PFE requiring full-mouth rehabilitation. [ABSTRACT FROM AUTHOR]

Secretory carcinoma is a malignant salivary gland tumor, which typically presents as an indolent painless mass within the parotid gland. Involvement of the minor gland is reported but less common. Secretory carcinoma was often misclassified as other salivary gland mimics, particularly acinic cell carcinoma, prior to 2010. It was first recognized as a molecularly distinct salivary gland tumor harboring the same fusion gene as well as histologic and cytogenetic features seen in juvenile breast cancer. Secretory carcinoma is generally managed in the same way as other low-grade salivary gland neoplasms and has a favorable prognosis; however, high-grade transformation requiring aggressive therapeutic interventions have been documented. Recent studies of biologic agents targeting products of this fusion gene offer the promise of a novel therapeutic option for treatment of this malignancy. Due to the limited number of reported cases, the spectrum of clinical behavior, best practices for management, and long-term treatment outcomes for secretory carcinoma remain unclear. A long-standing secretory carcinoma involving minor salivary glands of the mucobuccal fold, which was detected years after it was first noted by the patient, is reported. This case brings to light the importance of a thorough clinical exam during dental visits and reviews diagnostic differentiation of this malignancy from other mimics and discusses decision making for its management. [ABSTRACT FROM AUTHOR]

Orofacial pain is a worldwide pain problem, with many patients unable to find appropriate diagnosis and treatment. Orofacial pain includes pain arising from the odontogenic and nonodontogenic structures in the head and neck region. Dental clinicians need to have a thorough knowledge and skill to diagnose, manage, and treat patients with odontogenic pain or refer patients for treatment of nonodontogenic pain to specialists such as orofacial pain specialists, neurologists, otolaryngologists, and rheumatologists. More often, dental practitioners diagnose patients with a temporomandibular disorder (TMD), and when treatment is ineffective, term it "atypical facial pain." The first requirement for effective treatment is an accurate diagnosis. Dental clinicians must be aware of giant cell arteritis (GCA), a chronic large-vessel vasculitis, primarily affecting adults over the age of 50 years, as it frequently mimics and is misdiagnosed as TMD. GCA is associated with loss of vision, and stroke and can be a life-threatening disorder. Therefore, diagnostic testing for GCA and differential diagnosis should be common knowledge in the armamentarium of all dental clinicians. Historically, temporal artery biopsy was considered the definitive diagnostic test for GCA. Temporal artery ultrasound (TAUSG), a safe and noninvasive imaging modality, has replaced the previous diagnostic gold standard for GCA, the temporal artery biopsy, owing to its enhanced diagnostic capabilities and safety profile. The present case report describes a patient with GCA, and the role TAUSG played in the diagnosis. Case report: A 72-year-old woman presented with left-sided facial pain, jaw claudication, dysesthesia of the tongue, and episodic loss of vision of 2 years' duration. She was diagnosed with and treated for a myriad of dental conditions including endodontia and temporomandibular joint therapy with no benefit. A thorough history and physical examination, combined with serologic analysis, led to the diagnosis of GCA and TAUSG, which confirmed the diagnosis. Conclusion: This report underscores the responsibility of differential diagnosis and early recognition of GCA facilitated by TAUSG in optimizing treatment outcomes as a viable, noninvasive diagnostic tool. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether choroid plexus volume (CPV) could differentiate multiple sclerosis (MS) from its mimics. A secondary analysis of two previously enrolled studies, 50 participants with MS and 64 with alternative diagnoses were included. CPV was automatically segmented from 3T magnetic resonance imaging (MRI), followed by manual review to remove misclassified tissue. Mean normalized choroid plexus volume (nCPV) to intracranial volume demonstrated relatively high specificity for MS participants in each cohort (0.80 and 0.76) with an area under the receiver-operator characteristic curve of 0.71 (95% confidence interval (CI) = 0.55-0.87) and 0.65 (95% CI = 0.52-0.77). In this preliminary study, nCPV differentiated MS from its mimics.

Chest pain is a common presentation to the emergency department (ED) that can be caused by a multitude of etiologies. It can be challenging to differentiate life-threatening conditions from more benign causes. A 54-year-old woman presented to the ED complaining of chest pain with dyspnea in the setting of recent blunt trauma. This case offers a thorough yet practical approach to the diagnostic workup of chest pain with dyspnea in the ED setting. The surprising final diagnosis and case outcome are then revealed.

Background: This study aims to compare the differences in clinical features and inflammatory factors between unipolar depression and bipolar depression, and to investigate potential clinical characteristics and peripheral blood biomarkers that could be used to differentiate between these two conditions. Furthermore, the study seeks to establish a predictive model. Methods: Inpatients from the Shanghai Mental Health Center, admitted between June 2022 and June 2024, were selected as study participants. Based on diagnosis records, 274 patients were assigned to the unipolar depression group, and 128 patients to the bipolar depression group. A total of 128 patients were matched between the two groups using the propensity score matching method. Demographic data, clinical characteristics, and biological indicators were compared between the two groups. The biological markers assessed included neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), C-reactive protein (CRP), serum triiodothyronine (T3), thyroxine (T4), free thyroid hormones (fT3, fT4), thyroid-stimulating hormone (TSH), complement 3 (C3), complement 4 (C4), immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM). Binomial logistic regression analysis was employed to control for confounding factors and to explore the predictors of bipolar depression. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of clinical features and biological markers for bipolar depression. Results: Statistically significant differences were observed between the unipolar depression and bipolar depression groups with respect to life events (χ² = 15.397, P = 0.000), CRP (Z = 6.717, P = 0.000), TSH (Z = 1.988, P = 0.047), C3 (Z = 5.682, P = 0.000), C4 (Z = 4.216, P = 0.000), and IgM (Z = 2.304, P = 0.021). Logistic regression analysis indicated that life events (OR = 4.552, 95% CI = 2.238–9.257), CRP (OR = 13.886, 95% CI = 5.290-36.452), and IgM (OR = 0.561, 95% CI = 0.325–0.970) were associated with bipolar depression. ROC curve analysis revealed that the area under the curve (AUC) for the logistic regression model predicting bipolar depression was 0.806, with a sensitivity of 61.7% and a specificity of 85.9%. Conclusions: Compared to unipolar depression, bipolar depression was associated with the absence of life events, elevated CRP levels, and reduced IgM levels. The combined diagnostic model proved more effective in distinguishing bipolar depression from unipolar depression. [ABSTRACT FROM AUTHOR]

AbstractIntroductionResultsConclusionsSyncope is a clinical symptom that occurs commonly in all medical facilities, including the ophthalmology outpatient department. A broad differential diagnosis exists for syncope, of which vasovagal syncope is the most common.Efficient recognition and management of syncope in the ophthalmology department is essential to minimise its economic and time cost to patients, staff and the healthcare system.We propose a three-step approach to managing syncope for ophthalmology staff consisting of risk factor identification, preventative strategies and appropriate initial management to triage patients effectively and efficiently with minimal disruption to workflow in this inherently busy environment. [ABSTRACT FROM AUTHOR]

Background: Necrotizing sialometaplasia (NSM) is a rare self-limiting inflammatory lesion, with most cases affecting the minor salivary glands, especially those located in the palate (70%). To date, about 261 cases of NSM have been reported. Of them, 7 cases affected the tongue; 37 cases occurred after surgery; and 17 cases showed association with neoplasms. Methods: A 50-year-old male patient was diagnosed with squamous cell carcinoma (SCC) of the tongue. After surgical excision, the tumor diagnosis was well-differentiated SCC with a close surgical margin. Re-excision of the margin was indicated. Results: Microscopically, the surgical margin showed neither residual SCC nor epithelial dysplasia. However, it was possible to observe 7 foci containing typical areas of NSM distributed throughout the surgical specimen, which, by immunohistochemistry, revealed a glandular nature with presence of myoepithelial cells. Conclusion: We present here an unusual multifocal NSM affecting the tongue at the site of a prior resection for SCC with close margins, which, to the best of our knowledge, has not been reported to date. [ABSTRACT FROM AUTHOR]

Purpose: Approximately 10% of all lymphomatoid papulosis (LyP) cases affect pediatric patients. Pediatric LyP is clinically similar to adult LyP, frequently with cutaneous involvement, whereas the affectation of mucosal surface is rare. The LyP clinicopathological spectrum includes type A, B, C, D, E, and LyP with DUSP22/IRF4 rearrangement, with LyP type D representing < 5% of all LyP cases. Methods: We have previously reported 2 cases of exclusively intraoral LyP type C and E. To date, about 50 cases of LyP type D have been reported; of them, 8 cases, all but one with exclusive skin involvement, corresponded to pediatric patients. Rare LyP type C cases can lack CD30 expression, creating diagnostic difficulties with lymphoma. Results: Here, we report an extremely rare case of intraoral LyP type D with scarce/absent CD30 expression affecting a 12-year-old white Brazilian boy. Conclusions: To our best knowledge, this is the first pediatric case of LyP type D with exclusive intraoral involvement. [ABSTRACT FROM AUTHOR]

Background: Adenomatoid tumor (AT) is a rare benign neoplasm of mesothelial origin, which mainly occurs in the male and female genital tracts. The most common site for AT occurrence in women is the uterus, which makes the presentation in the fallopian tube(s) a rarity with an incidence of approximately 0.5%. The reported extragenital sites include serosal surfaces, adrenal glands, and visceral organs, are even less common. Macroscopically, ATs present as white-grayish or yellowish irregular yet circumscribed firm nodules, often containing cystic components. Owing to a vast array of histomorphological growth patterns, ATs tend to mimic malignancy and trigger overresection. Such clinical situations have been described by several studies for the ovaries, uterus, and fallopian tubes, underlining the importance of differential diagnosis in order to avoid superfluous treatment. Methods: Herein, we report a presentation of an AT at the oviductal lumen, detected incidentally during prophylactic bilateral salpingo-oophorectomy in a 67-year-old patient with a BRCA1 mutation. Results: Immunohistochemical staining revealed a positive expression for calretinin, WT1, and cytokeratin 7, and negative expression for both PAX8 and CD34, thus confirming the diagnosis of AT and excluding tubal malignancy. Conclusions: This report, with a concise review of the global literature on tubal AT, brings attention to the solitary and asymptomatic nature of the tumor. With a clear diagnosis, no surgical radicality is necessary. [ABSTRACT FROM AUTHOR]

Objectives: This review examines the role of serum procalcitonin (PCT) as a diagnostic marker for sepsis and its potential implications in anaphylaxis. Elevated PCT levels, often associated with bacterial infections, can complicate diagnosis when seen in anaphylaxis, especially when clinical features overlap with sepsis. Methods: We conducted a literature review on PCT in anaphylaxis to highlight key patterns and present two cases of anaphylactic shock initially misdiagnosed as sepsis due to elevated PCT levels. Results: The review supports that elevated PCT can occur in anaphylaxis, stressing the need for thorough patient history and symptom evaluation. In both cases, elevated PCT led to initial sepsis diagnoses, but further investigation identified anaphylaxis triggered by sulfamethoxazole/trimethoprim (SMX/TMP). Conclusions: These findings emphasize the need for considering anaphylaxis in differential diagnoses when elevated PCT levels are observed. Increased awareness of PCT's potential association with allergic drug reactions is essential to ensure timely recognition, avoid diagnostic delays, and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background/Objectives: Multinodular and vacuolating neuronal tumors (MNVTs) are a type of recently identified benign neuroepithelial tumor with debated malformative or neoplastic origins. This review summarizes their neuroanatomical localization, imaging, histopathology, immunohistochemistry, and diagnostic challenges. Methods: A systematic review of PUBMED/MEDLINE was performed in December 2024. Results: Of 118 screened articles, 39 were eligible, covering 299 patients. MNVTs are often asymptomatic "leave me alone" lesions, discovered incidentally, though nonspecific symptoms (59.9%) and seizures (19.7%) are reported. Immunohistochemistry reveals variable profiles, reflecting complex cellular differentiation. The characteristic "bubble-like" MRI pattern along the subcortical ribbon and superficial white matter is a reliable diagnostic feature. Rare cortical involvement and atypical band-like lesions occur. MRI signal intensity varies. Over a mean follow-up of 36 months, lesions were stable or non-recurrent, with only one case of progression. Conclusion: MVNT imaging mimics other glioneuronal lesions, but reliable diagnostic MRI features include a "bubble-clustered" appearance, lack of cortical involvement, absence of enhancement, and temporal lobe predominance. Hemodynamic and metabolic properties support the diagnosis. Most lesions remain stable, requiring no treatment. Surgical resection is reserved for cases with uncontrolled seizures or atypical locations where the diagnosis is unclear. [ABSTRACT FROM AUTHOR]

This report describes a rare case of a pediatric tenosynovial giant cell tumor (TSGCT) with a delayed diagnosis. A 9-year-old boy presented with a 3-month history of knee pain and swelling, initially attributed to a femoral non-ossifying fibroma and arthritis based on computed tomography findings and slightly elevated C-reactive protein levels. The symptoms persisted despite medical treatment. Magnetic resonance imaging (MRI) revealed a tumor in the posterior compartment. He underwent surgery, and the pathology confirmed the diagnosis of localized TSGCT. Six months postoperatively, the patient remained asymptomatic. Pediatric knee pain is a complex symptom associated with inflammatory conditions and benign and malignant tumors. Benign tumors, as in this case, can be misdiagnosed as arthritis, delaying diagnosis and treatment. MRI is recommended in cases involving symptom persistence. However, histopathological, immunohistochemical, and morphological examinations are crucial for definitive diagnosis, particularly when the imaging findings are inconclusive. [ABSTRACT FROM AUTHOR]

Objective: Spinal tuberculosis (STB) and Brucella spondylitis (BS) represent two types of granulomatous infections affecting the spine, which exhibit significant similarities that often result in misdiagnosis and overlooked diagnoses during preoperative evaluations. This study aims to identify non-invasive evaluative indicators that facilitate the differentiation between STB and BS. Methods: This study conducted a retrospective collection of clinical features, laboratory tests, and imaging characteristics from 89 patients diagnosed with STB and 66 patients diagnosed with BS. Differences were assessed utilizing χ² tests, independent non-parametric tests, Mann-Whitney U tests, or Fisher's exact tests. Binary logistic regression analysis was employed to identify independent predictive factors for differential diagnosis, and receiver operating characteristic (ROC) curves were generated to assess the effectiveness by calculating the area under the curve (AUC). Results: Root symptoms (including limb pain and numbness) and necrosis formation exhibited statistically significant differences, with P values of 0.024 and 0.045, respectively. Furthermore, gender, decreased A/G ratio, involvement of thoracic vertebrae, number of damaged vertebrae, and straightening of spinal curvature were identified as independent predictive factors for differentiating between STB and BS, with P values of 0.009, 0.003, < 0.001, 0.005, and 0.014, respectively. ROC analysis revealed that the AUC and 95% confidence intervals (CIs) for these five evaluative indicators were 0.626 (0.537–0.714), 0.621 (0.533–0.709), 0.694 (0.612–0.777), 0.597 (0.508–0.686), and 0.631 (0.540–0.722), respectively. The predictive model exhibited an AUC and 95% CI of 0.854 (0.796–0.911), indicating strong predictive performance. Conclusion: Statistically significant differences were observed between STB and BS regarding root symptoms and necrosis formation. In cases where the patient is male, presents with a decreased A/G ratio, does not have thoracic vertebra involvement, number of vertebral body destructions < 2.5, and exhibits straightening of spinal curvature, the likelihood of diagnosing BS is significantly greater than that of STB. [ABSTRACT FROM AUTHOR]

Background: Meniere's disease (MD) affects 0.2% to 0.5% of the global population, with regional variations. Standard diagnostic methods, including the glycerol test and EcochG, show variable sensitivity and specificity, highlighting the need for more reliable diagnostic approaches. Objective: This study aims to investigate latency differences in wave V of the Auditory Brainstem Response (ABR) by comparing waveforms for rarefaction and condensation clicks to identify MD. Materials and methods: The study analyzed latency differences in wave V of the ABR using condensation and rarefaction clicks in 15 ears diagnosed with MD. The control groups included 10 ears with sensorineural hearing loss (SNHL) [non-MD ears] and 20 ears with normal hearing sensitivity. Results: MD patients exhibited a significant wave V latency shift between rarefaction and condensation stimuli, suggesting altered cochlear dynamics due to endolymphatic hydrops. No such shift was observed in normal hearing or SNHL ears. Patients with definite MD showed a greater latency difference than those with probable MD, possibly reflecting varying endolymphatic pressure. Discussion: These findings suggest that ABR testing with opposite polarity stimuli could serve as an adjunctive diagnostic tool for MD, particularly in differentiating the severity of the condition but further research is needed to validate these preliminary. [ABSTRACT FROM AUTHOR]

Background Previous work with reflectance confocal microscopy (RCM) has shown high sensitivity and specificity for basal cell carcinoma (BCC); however, to date, there have been few studies in UK cohorts. Objectives To assess the potential of RCM to accurately diagnose BCC in a private UK secondary care, single-clinician setting, and to investigate the potential of RCM as a routine diagnostic procedure. Methods In total, 522 lesions where BCC featured in the differential diagnosis after clinical examination were prospectively recruited; 78 lesions were subsequently excluded. We used an arm-mounted confocal microscope unless access to the lesion was awkward and required a handheld probe to be used. The likelihood of BCC was scored for each modality (clinical examination, dermoscopy and RCM), with each diagnosis building on the last. Histology was assessed by a single blinded histopathologist. The study was registered with ClinicalTrials.gov (NCT03509415). Results The analysis included 444 lesions (327 BCCs) from 326 patients. The median maximum lesion diameter was 6 mm. The sensitivity and specificity for BCC were 69.4% [95% confidence interval (CI) 64.1–74.4] and 53.0% (95% CI 43.6–62.3), respectively, for clinical examination alone; 91.8% (95% CI 88.3–94.5) and 41.0% (95% CI 32.0–50.5), respectively, for clinical examination plus dermoscopy; and 98.8% (95% CI 96.9–99.7) and 85.5% (95% CI 77.8–91.3), respectively, for clinical examination plus dermoscopy plus RCM. For RCM, the positive predictive value in diagnosing BCC was 95.0% (95% CI 92.1–97.1) and the negative predictive value was 96.2% (95% CI 90.4–98.9). The area under the curve increased from 0.61 to 0.66 to 0.92 as the respective modalities were added. Conclusions This study demonstrates that RCM can reliably and quickly diagnose BCC, and that the addition of RCM to dermoscopy permits higher diagnostic accuracy for BCC in the UK. The specificity and sensitivity of the RCM diagnosis did not alter significantly with experience, reflecting the ease and speed of acquiring the skills required to use this modality. [ABSTRACT FROM AUTHOR]

To evaluate ChatGPT's effectiveness in medical imaging interpretation within urology, addressing the critical need for safe AI application in healthcare by identifying its strengths and limitations as a diagnostic and educational resource. Using publicly available cases from Radiopaedia.com, we entered 1-3 CT or MRI images into ChatGPT. A standard prompt instructed the model to provide a differential diagnosis ranked by probability. This task was repeated a second time with organ guidance (OG), which provided the organ of diagnostic interest to the model (eg, kidney). Primary outcomes included whether the model's top or differential diagnosis correctly identified the underlying pathology. ChatGPT correctly identified the pathologic condition as its top diagnosis in 14% of CT (7/50) and 28% (14/50) of MRI cases (P =.08). OG increased the model's ability to recognize the top diagnosis by 18% (P =.03) when interpreting CT images, a benefit not shared when interpreting MRI images (P =.4). At baseline the differential diagnosis contained the final diagnosis for 30% and 56% of CT and MRI cases (P =.03). With the inclusion of OG, the model's differential diagnosis was able to correctly identify the underlying condition in 62% of both CT and MRI cases (CT: P =.001, MRI: P =.31). ChatGPT's effectiveness in medical imaging diagnostics is initially limited, yet it substantially benefits from the addition of user guidance. The study underscores AI's current shortcomings but also its considerable capacity to improve clinical operations when enriched with more data and expert direction. [ABSTRACT FROM AUTHOR]

Purpose: In mucinous ovarian tumors, preoperative prediction of histological subgroup is important for treatment approach. Therefore, we aimed to determine salient magnetic resonance imaging (MRI) findings and estimate optimal cut off values for quantitative features in differential diagnosis of benign, borderline and malignant mucinous ovarian tumors. Methods: Between January 2011 and December 2021, preoperative MRI scans of 50 patients with mucinous ovarian tumors (n = 54) were evaluated retrospectively. MRI findings [size, signal intensity, contrast pattern, features of loculation, wall, septa and mural nodule (MN), diffusion restriction] were investigated. There were benign, borderline, and malignant groups based on histopathological results. The relationship between radiological and histopathological results was analyzed by performing Kruskal Wallis test, Pearson's chi-squared test, receiver operating characteristic analysis. Results: In our study, there were 54 mucinous ovarian tumors in 50 patients. Of 54, 33 were benign, 13 borderline and eight malignant tumors. In comparison of three groups, tumor size, number of loculation, number and frequency of MN were higher and apparent diffusion coefficient (ADC) value were lower in malignant group (p < 0.05). Septa thickness was lower with optimal cut off value of 2.45 mm in benign group compared to borderline and malignant groups [sensitivity: 79%, specificity: 75%, AUC (Area under the curve): 0.861] (p < 0.05). T2-weighted (T2-w) signal intensity ratio (SIR) of MN was higher in borderline compared to malignant group, with a cut-off value of 3.9 (sensitivity: 85%, specificity: 83%, AUC: 0.943) (p < 0.05). Ascites was also significant in malignant group (p < 0.05). Conclusion: T2-w SIR of MN with a cut off value of 3.9 is beneficial for differential diagnosis. By awareness of some salient MRI findings (size, septa thickness, number of loculation, number and T2-w SIR of MN, ADC value and ascites), preoperative prediction of histological subgroup of mucinous tumors for appropriate treatment planning is possible. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of signs and symptoms potentially indicative of dementia • To update your knowledge of the differential diagnoses of dementia • To learn about a nurse-led community memory impairment service in Great Yarmouth and Waveney. In response to a decline in dementia diagnoses during the coronavirus disease 2019 (COVID-19) pandemic, a new community nursing service was launched in 2022 in Norfolk to enhance the care of patients with memory or cognitive issues. The Memory Impairment Nursing Service assesses adults who experience symptoms potentially indicative of dementia, such as memory issues, cognitive issues, confusion and behavioural changes. Each patient undergoes a comprehensive assessment to determine the likely cause of their symptoms and what their treatment and support needs are. Apart from dementia, memory loss and cognitive issues can be caused by several physical health conditions and by issues such as stress, sleep issues and side effects of certain medicines. One of the benefits of the new service is that it offers timely assessment and support for patients who probably do not have dementia, enabling the specialist memory clinic at the local mental health trust to focus on those who are likely to have dementia. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is a condition characterized by clonal proliferation of the phagocytic cells derived from the bone marrow. In this article, we present an exceedingly rare case of congenital/neonatal LCH in a 3-week-old girl who initially presented with an isolated swelling of the eyelid, initially misdiagnosed as a chalazion. Subsequently, a biopsy was performed, and histopathological evaluation confirmed the diagnosis of LCH. A staging work-up revealed no evidence of multisystem involvement, and thus, local steroid injection was performed as the initial treatment for the residual lesion. Cases of localized LCH that manifest as eyelid masses are rare, and most reported cases involve children over the age of one year. To the best of our knowledge, this case represents the first reported instance of neonatal LCH presenting as an eyelid mass. Although neonatal LCH is rare, ophthalmologists must be aware of this presentation and include it in the differential diagnosis for eyelid lesions in infants during the first month of life. [ABSTRACT FROM AUTHOR]

We present an overview of the epidemiology and differential diagnosis of Marcus Gunn jaw-winking syndrome. We scrutinize various hypotheses regarding its etiology and pathogenesis, encompassing abnormal nerve connections, heredity factors, genetic variation, and the release hypothesis, as proposed in prior studies. Furthermore, we discuss the clinical manifestations of Marcus Gunn jaw-winking syndrome and highlight cases with exceptional clinical presentations or concurrent diseases. Moreover, we not only describe the existing surgical and nonsurgical treatments for Marcus Gunn jaw-winking syndrome but also delineate therapies for related conditions such as Meige syndrome, sequelae of facial paralysis, and other oculopalpebral and facial synkinesis. This comprehensive approach serves as a valuable reference for the holistic management of Marcus Gunn jaw-winking syndrome. [ABSTRACT FROM AUTHOR]

Background: Spinal bulbar muscular atrophy (SBMA) and amyotrophic lateral sclerosis (ALS) are motor neuron disorders that demonstrate overlapping clinical features, especially in the early stage. Therefore, the aim of this study was to investigate the utility of chest tomography (CT) imaging in distinguishing between SBMA and ALS. Methods: This was a retrospective study reviewing CT images from patients with SBMA and sporadic ALS and those in the control group. The CT images were assessed to measure the diameter and morphology of glandular tissue associated with gynecomastia. We compared CT-measured gynecomastia between the SBMA, ALS, and control groups. Additionally, correlation analyses were performed between the quantitative measurements of gynecomastia obtained from CT scans and various clinical/laboratory parameter in the SBMA group. Results: 15 chest CT images were collected from SBMA, 41 from ALS, and 29 from control group. No statistical differences were observed in BMI, functional scales, or age at the time of CT scans between the SBMA and ALS groups. Despite similar functional scales and age in both groups, the mean glandular tissue diameter of breast tissue observed in chest CT imaging differed significantly between SBMA, ALS, and controls: 32.22 ± 12.57 mm, 15.91 ± 4.81 mm, and 15.76 ± 7.26 mm, respectively. This disparity allowed for the differentiation of SBMA from ALS and controls with statistical significance. Clinical gynecomastia was 80%, while radiological gynecomastia was 93.3% in SBMA. A significantly higher prevalence of diffuse glandular morphology pattern in SBMA (50%) was observed, contrasting with the predominance of nodular morphology in ALS and controls (9.1% and 20%). Correlative analysis between glandular tissue diameter and other clinical/laboratory parameters within the SBMA group showed no specific finding. Conclusion: CT-based radiological gynecomastia effectively differentiated SBMA from ALS. These findings support the usefulness of radiological gynecomastia as a potential differential diagnostic marker for SBMA, especially in the early stages. [ABSTRACT FROM AUTHOR]

Introduction: Patients presenting to direct access physiotherapists may present with a serious pathology that mimics a musculoskeletal condition. Recognition of atypical clinical patterns allows for referral to an appropriate provider when a serious pathology is present. This case report details a patient with a pulmonary pathology who presented to a physiotherapist with a complaint of neck and chest pain following medical consultations. Case Presentation: A 29-year-old amateur volleyball player arrived at the physiotherapist's clinic five days after experiencing the onset of neck pain. She complained of pain on the right side, which extended to the trapezius, as well as occasional discomfort in the lower lateral and anterior chest. The patient noted that the pain worsened when lying supine or on her left side, and during coughing. After developing symptoms resembling a cold, she sought care at two different emergency clinics where physicians diagnosed seasonal flu and an unrelated muscle strain. Despite treatment, the pain persisted, accompanied by fever and general weakness, disrupting her sleep. Following a review of a medical history and a physical examination, musculoskeletal causes of pain appeared unlikely, prompting consideration of a pulmonary pathology. Referral to a specialist was deemed necessary. Conclusion: This case report highlights the importance of screening for serious pathology in direct access physiotherapy, irrespective of a prior physician consultation. [ABSTRACT FROM AUTHOR]

Background: In daily work, there are still many pathologists who have difficulty handling the diagnosis of atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic adenocarcinoma, and the boundaries are not clear enough. Sometimes, the diagnosis is difficult, and there is sometimes poor reproducibility between different pathologists. Accurate diagnosis and differential diagnosis require a certain amount of experience. Methods: During the COVID-19 pandemic, we collected a large number (n = 381) of specimens of early lung adenocarcinoma, most of which (n = 356) were solitary lesions and 25 were multifocal lesions. There were 78 nodules in multifocal lesions, total 434 nodules. We summarized very careful microscopic observation and comparative analysis on all frozen and paraffin sections collected from many early lung adenocarcinoma specimens, continuously summarizing our experience. Results: Based on the World Health Organization's 2021 classification and diagnostic criteria for lung adenocarcinoma, new perspectives have been proposed on how to distinguish between atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic adenocarcinoma. In particular, new perspectives have been proposed on how to identify invasive aspects, and there are also some new perspectives on early lung mucinous lesions. Conclusion: Atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic adenocarcinoma all have corresponding morphological diagnostic criteria, but the morphological boundaries are sometimes not easy to determine and require some experience accumulation. The intraoperative frozen pathological diagnosis of early adenocarcinoma of the lung needs to be closely combined with imaging examination, and has very rich morphological experience. [ABSTRACT FROM AUTHOR]

Acute pelvic pain in reproductive-aged persons who are assigned female at birth is associated with an extensive differential diagnosis, with possible causes ranging from the genitourinary or gastrointestinal to the musculoskeletal or neurovascular, in some cases even extending to psychological and dermatologic presentations. This article presents a case study that serves as an exemplar of the differential diagnosis of acute pelvic pain, culminating in diagnosis of the patient with a hemorrhagic ovarian cyst as well as a review of outpatient surveillance guidelines for adnexal masses. Management of this difficult-to-diagnose condition is reviewed, and special populations are considered. Acute pelvic pain in reproductive-aged persons who are assigned female at birth is associated with an extensive differential diagnosis, with possible causes ranging from the genitourinary or gastrointestinal to the musculoskeletal or neurovascular, in some cases even extending to psychological and dermatologic presentations. This article presents a case study that serves as an exemplar of the differential diagnosis of acute pelvic pain, culminating in diagnosis of the patient with a hemorrhagic ovarian cyst. Management of this difficult-to-diagnose condition is reviewed, and special populations are considered. [ABSTRACT FROM AUTHOR]