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Hypoesthesia of the Lower Limb

Male patient had twist injury of his knee with tear of the ACL and was operated. After the surgery he suffered acute lumbalgia. Twelve days later he was re-admitted for knee effusion and elevated body temperature, and arthrolysis and joint washing were performed. Following the procedure he complained of hypoesthesia of the proximal lower left limb and knee. EMG reveled L4 and S1 root damage, and MRI showed reduced lumbar lordosis and different disc lesions. In case of compression neuropathy (tourniquet), the expert recommends symptomatic only treatment.

Spinal pathology – additional opinion

75-year-old male with multiple complaints related to both his lumbar and cervical spine. He complains of low back pain, cramping and numbness in his thigh muscles, radiating left leg pain to his toes, as well as unsteady gait. He experiences numbness in his shoulders, arms and hands that gets worse over the day. He had a C4-5 fusion and a lumbar procedure at L4-5. The cervical MTI showed degenerative disease worse at C6-7 where there is moderate central and foraminal stenosis.

Back Pain with Partial Sensory Leg Anesthesia – additional opinion

25-year-old male had an outbreak of sharp pain in the loin, and afterwards complained of partial sensory anesthesia in his leg. He has been given prescribed treatment that included blockades, magnetotherapy, and ultrasound massage with hydrocortison. He experienced back pain for the first time after lifting a heavy thing, and got a pain relief after taking a pain-killer and applying Finalgon ointment. After few months the pain reoccurred. The patient then got a MRT test and was prescribed Finalgon and Milgamma pills, but developed an allergy towards Milgamma.

Back Pain with Partial Sensory Leg Anesthesia

25-year-old male had an outbreak of sharp pain in the loin, and afterwards complained of partial sensory anesthesia in his leg. He has been given prescribed treatment that included blockades, magnetotherapy, and ultrasound massage with hydrocortison. He experienced back pain for the first time after lifting a heavy thing, and got a pain relief after taking a pain-killer and applying Finalgon ointment. After few months the pain reoccurred. The patient then got a MRT test and was prescribed Finalgon and Milgamma pills, but developed an allergy towards Milgamma.

Anterior chamber cleavage syndrome in right eye in a 2 months old infant

Infant female was diagnosed with anisocoria. "cornea of reduced size, anterior chamber nearly absent, anomalous iris marking, miotic pupil" were found in Ophthalmologic examination. Gonioscopy examination revealed posterior embryotoxon in both eyes, and bilateral "fibrous lobes" in the anterior chamber angle. There were also other anomalies found in the right eye.

Respiratory Insufficiency with Tracheotomy_2

72-year-old female recovered from protracted bronchopneumonia and sepsis that demanded mechanical ventilation via oral intubation and tracheostomy. She developed post tracheotomy tracheal stenosis and failed 2 attempts of Montgomery T-tube insertion.

 

Post traumatic shoulder luxation

31 years old healthy man, a month ago, during a soccer match, had a trauma of the right shoulder and was diagnosed with right glenohumeral luxation.
The Emergency Room orthopedist reduced luxation, and during the first days of the event, the patient treated pain, of modest importance and bearable. At present, the day pain has completely disappeared reappearing a bit at night and affecting mainly the forearm.

Recurrent metastases in malignant tumor of left forearm

4-year-old boy presented with a lesion on his left forearm was diagnosed with small cell malignant neoplasm. It was thought that he had a malignant myoepithelioma but other reports suggested a primitive poorly differentiated neoplasia of neuro-ectodermal origin. He underwent surgery and chemotherapy but subsequently developed pulmonary metastases. The treating doctors recommended a second line chemo approach.

Vesical Neoformations in Glandular Cystic Cystitis

58-year-old male diagnosed with sigmoid colon diverticulosis. In the past (2000&2008) he underwent trans urethral resections of bladder lesions which were diagnosed to be glandular cystitis cystica. Follow up cystoscopy performed lately revealed two new strawberry like lesions close to the bladder neck. Urine cytology was negative for malignant cells, pelvic ultrasound demonstrated a thickened bladder. The patient was offered another resection surgery.

Anaplastic Astrocytoma in the left temporal lobe

65-year-old male experienced loss of consciousness, and a CT scan showed a left temporal mass which was confirmed by MRI. The patient underwent Stereotacti biopsy of mass, and Histological examination gave a diagnosis of anaplastic astrocytoma. He started chemoradiation with fotemustine (nitrosourea alkylating agent). Repeated MRI showed progression with mass effect, mild uncal herniation and enlarging ventricles. He has stable expressive aphasia and hemisyndrome, lethargy and decreased motivation. His treatment was switched from phenobarbital to levetiracetam.

 

Recurrent miscarriage

42-year-old patient with hypothyroidism (Hashimoto's) with a history of primary recurrent abortions, probably due to a uterine septum. She underwent 2 IVF cycle, the 2nd – with poor response. The expert suggests some diagnostic and therapeutic strategies.

3-year old boy with Medulloblastoma

34 month old male has a classical medulloblastoma, probably originating in the vermis. A gross total resection was achieved. He is undergoing a chemotherapy based protocol with autologous stem cell re-infusion.

Asthenic-dispeptic syndrome post laparoscopic cholecystectomy

48-year-old male underwent laparoscopic cholecystectomy for symptomatic cholelithiasis. During post-surgery he developed intense abdominal colics and a situation of hepatitis, probably from medicines as the tests carried out. Performed tests revealed changes of haematic values related to the hepato-renal function. MR-cholangiography showed cystic formation in the right lobe of the liver, and tumor markers that gave evidence of an increase of alpha-fetoprotein which should be monitored.

Hyperthyroidism in autoimmune non-nodular thyroiditis

21 years old female who provided us medical report of her endocrinological examination with diagnosis of “Basedow’s Hyperthyroidism in autoimmune non-nodular thyroid (Hashimoto’s thyroiditis). Under therapy with Tapazole at the dosage of 2 tablets daily with FT3 and FT4 values within normal limits and TSH=0.00” . In the light of such values and of the clinical picture, the specialist confirmed the current therapy with Tapazole (2 tablets daily) suggesting therapeutic dosage of 131 Iodine after examination at nuclear medicine department.

Cricotracheal resection as treatment for laryngeal stenosis cotton grade IV

The patient is a former premature baby who underwent tracheostomy after 30 days of intubation and laryngotracheoplasty with anterior and posterior costal grafts and implantation of a T-tube. She is now 10 years-old and was diagnosed with Cotton’s grade 4 subglottic stenosis. The restricted airways (laryngeal stenosis) cause severe breathing and communication difficulties.

Recurrent episodes of dysuria in lower urinary tract

54-year-old male that Since the age of 35 years seeks medical help for Lower urinary tract symptoms mainly of irritative nature. Urological, Neurological, Orthopedic & Psychiatric aspects of his symptoms were evaluated. The patient was treated with a variety of drugs with marginal benefit.