Posts Tagged ‘JMCR’

Case report of the week: Denying blindness – a case of Anton’s syndrome

September 11, 2009

Anton’s syndrome (sometimes referred to as Anton-Babinski syndrome) is a recognised but rare condition of visual anosognosia, where patients with objective blindness deny their loss of vision.Eye test chart

Dr Maddula and colleagues provide an excellent, comprehensive description of the case of an 83-year-old woman who was found collapsed at her house. Following admission, she was observed “walking into objects and was clearly blind”. “When asked to comment on the doctor’s tie, she was quick with an answer, but one that was incorrect”. Although she would attempt to carry out the activities of daily living herself, “assistance was required to help her finish her meals”. Despite these symptoms, the “patient maintained she was able to ‘see’ things around her”.

The details provided in this case will be valuable to add to the limited literature available regarding this rare condition and could help doctors to correctly diagnose patients presenting with similar symptoms.

For all the clinical details, read the full case report here.

Anton’s syndrome due to cerebrovascular disease: a case report“, September 2009 issue, Journal of Medical Case Reports.

Lindsay Dytham – Editorial assistant

Cases Network – Image of the month

August 18, 2009

Every month we select an image from Cases Journal or the Journal of Medical Case Reports (JMCR) that we feel is that little bit extra special.

Below is our choice for this month:

Photograph showing the sigmoid colonic perforation. Figure taken from Joglekar et al., "Sigmoid perforation caused by an ingested chicken bone presenting as right iliac fossa pain mimicking appendicitis: a case report"

Photograph showing the sigmoid colonic perforation. Figure taken from Joglekar et al., "Sigmoid perforation caused by an ingested chicken bone presenting as right iliac fossa pain mimicking appendicitis: a case report"

Sigmoid colonic perforation is an acute surgical emergency.

The patient in this case presented with a 3-day history of colicky generalised abdominal pain, gradually getting worse and eventually localising to the right iliac fossa (classical symptoms of acute appendicitis).

A provisional diagnosis of acute appendicitis was made, and consent was taken for appendicectomy. During the operation, a small (2 mm) perforation was found in the distal sigmoid colon through which a chicken bone was protruding outward.

Fewer than 1% of ingested foreign bodies will perforate the bowel. Although most sharp objects pass without complications, once beyond the oesophagus, they carry an increased risk of complications.

Diagnosis of an intestinal perforation can be difficult and the authors emphasise the need for a high degree of suspicion and awareness on the part of the clinician. They stress that situations such as these highlight the importance of obtaining full consent from the patients; this is particularly important when there is a diagnostic dilemma, as this may have future medico-legal implications. It is important to inform patients about an alternative diagnosis.

Our deputy editor said: “Excellent and intreresting case, also very well written“.

For all the clinical details, read the full case report here.

Title: “Sigmoid perforation caused by an ingested chicken bone presenting as right iliac fossa pain mimicking appendicitis: a case report”

Authors: Sandeep Joglekar, Iqbal Rajput, Sachin Kamat and Sarah Downey

To see a selection of our previous ‘Image of the month’ choices, visit our facebook site here.

EmailFor your chance to nominate a case report for the ‘Image of the month’, simply email us at: info@casesnetwork.com You can even nominate your own case!

Case report of the week: A rare case of primary lung cancer

August 14, 2009

Journal of Medical Case Reports (JMCR) publishes original and interesting case reports that expand medical knowledge and the newly published case by Syed Raza and colleagues, “Primary pulmonary mucinous cystadenocarcinoma presenting as a complex bronchocele: a case report”, is a great article to exemplify our journal’s scope.

There have only been 20 described cases of pulmonary mucinous cystadenocarcinoma (PMC) since it was first reported in 1978. PMC is a distinct but rare variety of lung cancer that, as with most lung cancers, predominantly occurs in older age and with a positive smoking history.

PMC is difficult to diagnose due to the scarcity of cancer cells present within the lesion. In this case the patient presented after collapsing and was diagnosed, based on CT findings, with a complex bronchocele (a dilation of the bronchus).  The patient went on to undergo open lung biopsy and histopathological testing that confirmed the diagnosis of PMC. This case is important in highlighting the need to consider primary PMC when investigating a suspicious bronchocele.

This case report is also excellent for its presentation of imaging and histological findings. Figure 3 from the article (below) is the view from the bronchoscopy that revealed the soft tissue lesion in the bronchus. It provides us with a very interesting insight into the investigation of such conditions.

Bronchoscopic view of Bronchoscopic view of the carina with the mass protruding from the right upper lobe bronchus

Bronchoscopic view. Figure taken from Raza et al., "Primary pulmonary mucinous cystadenocarcinoma presenting as a complex bronchocele: a case report" in the August issue of JMCR

The deputy editor described this report as “an extremely interesting and well written case, that is most suitable for JMCR” . Visit the journal to view the full article of this case and more in the August 2009 issue.

Lindsay Dytham – Editorial Assistant, Cases Network

Christian Koch on publishing case reports and TV’s Dr House

May 1, 2009

We caught up with Professor Christian Koch, one of our Deputy Editors for Journal of Medical Case Reports, for a few insights on his work with the journal.

What would you say is the ‘best’ paper you have reviewed and why?

CK: I have handled many “good” papers, each unique in its own way. However, one of the very best ones I can remember was one that dealt with the question whether several tumors in an individual could represent a syndrome, although only a subset of “potential” candidate genes had been tested and was negative (J Med Case Reports. 2007 Mar 28;1:9).

This should remind us of the initial observations and publications of the combination of medullary thyroid cancer and pheochromocytoma in some patients (for instance, Sipple syndrome or Multiple endocrine neoplasia type 2) many decades ago and the discovery of the RET proto-oncogene in 1985 and finally the implication of its role in MEN2 in 1993.

All this underscores that careful observation, a sharp mind, and sometimes an approach similar to the one of “Dr. House” (on TV) will not only help our individual patients but many others in the future.

Why do you feel it is important to publish case reports?

CK: We are in an era of “evidence-based medicine”. However, we finally begin to realize that much of the so-called evidence is derived from heterogeneous patient populations and not necessarily applicable to our individual patients we see on a daily basis. Numerous recent studies including ENHANCE, ACCORD, ADVANCE, and the VA Diabetes Outcome Trial, have shown us that heterogeneity of patients, equipment, investigators, etc. can limit our thrive for evidence on a large scale and make us think about personalized, individualized medicine…. that is, why publishing case reports is important in my mind.