ABSTRACT
Stress fractures may be easily misdiagnosed as another entity, especially tumors, which may prompt very severe surgical treatment and sometimes amputation. The appropriate use of modern radiography may make the difference in proper diagnosis of stress fractures.
Subject(s)
Ankle Joint/pathology , Fibula/injuries , Fractures, Stress/diagnosis , Sarcoma, Ewing/diagnosis , Adult , Diagnosis, Differential , Diagnostic Errors , Fibula/diagnostic imaging , Fracture Healing , Fractures, Stress/complications , Fractures, Stress/diagnostic imaging , Humans , Imaging, Three-Dimensional , Male , Pain/diagnosis , Pain/etiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Our aim was to investigate the long term effectiveness of intravenous immunoglobulin (IVIG) against intractable childhood epilepsy in the era of new antiepileptics and to determine the predictors of a favorable response in a prospective open-label add-on study. Of thirty-seven 9.9+/-0.9-year-old patients (11 with partial seizures, 26 with generalized seizures of whom 9 had West syndrome and 17 Lennox-Gastaut syndrome) followed for 15+/-3 months, 43% had a >50% decrease in seizures (including 15% seizure free, 229+/-58 compared with 104+/-3 seizures/month, P=0.035: generalized 246+/-318 to 117+/-200, P=0.025, partial 191+/-437 to 72+/-179, P>0.05; power=0.2). Males were more likely to respond than females (P=0.011, odds ratio=9.3). Review of the literature revealed nine other articles reporting efficacy of IVIG against epileptic seizures. Only one other used statistical methods and, unlike ours, showed only a trend toward seizure frequency reduction without achieving statistical significance, presumably because it was underpowered. These results indicate large-scale controlled studies of IVIG in epilepsy are still needed.
Subject(s)
Epilepsy/drug therapy , Immunoglobulins, Intravenous/administration & dosage , Immunologic Factors/administration & dosage , Adolescent , Child , Child, Preschool , Epilepsy/classification , Epilepsy/physiopathology , Female , Humans , Longitudinal Studies , Male , Multivariate Analysis , Young AdultABSTRACT
Malignant eccrine porocarcinoma is a rare tumor of sweat glands with a high local recurrence rate and a tendency to metastatic spread. We present a case of a 77-year-old male patient that presented with a recurrent, periungual porocarcinoma mimicking onychomycosis and ingrown toe nail that was successfully treated by surgical excision. To our knowledge no such case has been described in this location in the English literature.
