Baby survives a rare tumor!
This is a unique case of a 2 months old baby that was brought by his parents for a quickly progressive exophtalmos. The clinical status and the CT scan images didnt fit any of the common diagnosis of ocular tumors.
The team had to get the results of a stereotaxic biopsy to conclude it was an atypical teratoid rhabdoid tumor (these tumors are common pediatric malignant central nervous system tumours in children ≤1 year of age).
They are grade IV tumors, meaning they are highly malignant (cancerous) and fast-growing.
They develop in the nervous system and in this case, the extension was important and the tumor envaded the right orbit through the optic canal causing the exophtalmos of the right eye.
The prognosis of these tumors is not well known since they are very rare.
But this case seems to evolve well after the baby went through surgery and started chemo sessions.
Case by @dr.bengi
494 32,8695 hours ago
Trust me, you need to follow @SyattFitness right now for the best science-based health and fitness workouts/diets on Instagram! @SyattFitness @SyattFitness @SyattFitness
🏓Important to note, I am NOT saying nuts, quinoa, and chia seeds are bad for you. They aren't. What am saying is, per calorie, they are not nearly as high protein as we've been led to believe. And if you want to get leaner so you're watching your calorie intake, it would be smart to emphasize other foods (like Greek yogurt, chicken breast, and salmon) which have way more protein for far fewer calories.
🐥Also worth noting, I did this comparison by equal weight - a 3oz serving of each food. With that in mind, pay special attention to how many calories the right column has per 3oz versus the left. This is a *major* reason why Greek yogurt, chicken breast, and salmon are generally so much better for fat loss - not because they're magical. But because you can eat wayyyy more for far fewer calories and fill up for longer.
🐿Again, not saying any of these foods are "bad" or "unhealthy." Just saying, in some situations, the foods on the right might be a strategically better choice.
And go follow @SyattFitness right now!
209 8,8838 hours ago
Case of a 17 year old boy with an 18 cm long tail!!
Credit to @medicalpedia.
A 17-year-old adult male was referred to the hospital with a tail-like appendage in the middle of lumbosacral region that was present since birth. He presented with a complaint of difficulty and slight pain while sitting. He also started having discomfort while doing daily activities such as wearing clothes due to this long tail.
This condition usually presents in newborns and is brought to medical attention very early. In this case, the patient seeked medical advice very late at the age of 17 years when his tail had grown considerably to the size of 18 cm. The patient and his family did not consult doctors because of superstition, illiteracy, social stigma, and shame. The parents were made to believe that this tail is a gift from Hindu monkey god “Hanuman,” and hence named their child after him.
The patient was operated under general anesthesia. At operation, an elliptical skin incision was made around base of appendage. The stalk of appendage was identified and followed through a defect in lumbosacral fascia. The tail was connected with small fibrous band to the dura. There was no intradural connection with neural tissue or filum. The bony spur at the base of tail was nibbled and flattened. Primary layered closure was achieved. There was no postoperative complication.
The human tail is an example of vestigial organ and is supposed to represent useless remnant of what were once functional and useful organ in our primitive ancestors.
4,357 71,98110 hours ago
Umbilical cord blood stem cell sample!!
Stem cells are the next frontier in medicine.
The doctor here is taking cord blood from this umbilical cord after a delivery!
Umbilical cord blood was once discarded as waste material but is now known to be a useful source of blood stem cells.
Right after birth, the umbilical cord is clamped and cut. Once it is clamped, it is wiped with antiseptic and a needle is inserted into the vein in the umbilical cord to withdraw a few ounces of blood.
This blood is rich in stem cells, which have the remarkable potential to develop into many different cell types in the body during early life & growth.
In addition, in many tissues they serve as a sort of internal repair system, dividing essentially without limit to replenish other cells as long as the person or animal is still alive.
They literally renew the tissues that they populate.
When a stem cell divides, each new cell has the potential either to remain a stem cell or become another type of cell with a more specialized function, such as a muscle cell, a red blood cell, or a brain cell.
Hematopoietic stem cells can make every type of cell in the blood – red cells, white cells and platelets. They are responsible for maintaining blood production throughout our lives.
Stem cells may offer a renewable source of replacement cells to treat hematopoietic and genetic disorders!
This blood is routinely used in bone marrow transplants in the treatment of leukemia, lymphoma, and several other life threatening malignant and non‐malignant diseases of the blood and immune systems.
Take a second to remind yourself that you are a community of 50 trillion living cells! Each cell is a living individual, a sentient being that has its own life & functions, but interacts with other cells in the nature of a community. How cool is that?
Credit to @medspired & @drdilekozdur
908 73,66719 May, 2019
A giant step for mankind - 3D printed human heart!!!
For the first time in recorded history, Israeli scientists at Tel Aviv University have created a working, vascularized engineered heart using human cells by printing it in 3D — a stunning achievement that could change the world of medicine by ending the reliance on donated organs.
The world’s first “printed heart” was made with actual human biological material, although only about the size of a rabbit’s heart, making it too small for a human. But the achievement demonstrates the potential for being able to 3D print full-sized organs one day.
This is the first time anyone anywhere has successfully engineered and printed an entire heart replete with cells, blood vessels, ventricles and chambers.
To create the 3D printed heart, a biopsy of fatty tissue was taken from patients. The cellular and a-cellular materials of the tissue were then separated. While the cells were reprogrammed to become pluripotent stem cells, the extracellular matrix (ECM), a three-dimensional network of extracellular macromolecules such as collagen and glycoproteins, were processed into a personalized hydrogel that served as the printing “ink.”
After being mixed with the hydrogel, the cells were efficiently differentiated to cardiac or endothelial cells to create patient-specific, immune-compatible cardiac patches with blood vessels and, subsequently, an entire heart.
The researchers are now planning on culturing the printed hearts in the lab and “teaching them to behave” like hearts. They then plan to transplant the 3D-printed heart in animal models.
Heart transplants are the only form of treatment for people with end-stage heart failure and many sick people die while waiting for a transplant, which can take six months or more.
1,082 97,09819 May, 2019
Worms in the heart (they were still moving)!!
This is one of the most interesting cases you can come across!
You are looking at the famous parasite known as the "Heartworm", or in more medical terms Dirofilaria Immitis.
Dirofilaria are long, thin parasitic roundworms that infect a variety of mammals. Infection is transmitted by mosquito bites.
There are many species of Dirofilaria, but human infection is caused most commonly by three species:
D. immitis, D. repens, and D. tenuis.
The most common natural hosts for these three species are dogs and wild canids, such as foxes and wolves.
During a blood meal, an infected mosquito introduces third-stage filarial larvae of Dirofilaria immitis into the skin of the definitive host, which is usually a domestic dog or coyote
The adult parasite that can measure up to 14 inches in length, is housed in the right heart and in the pulmonary arteries, which are the large blood vessels that connect the heart with the lungs. The blockage and damage caused by the heartworm can lead to heart failure and damage to other organs such as the liver and kidneys.
The blockage in the pulmonary artery blockage leads to an illness that includes exhaustion upon exercise, fainting, coughing up blood, and severe weight loss.
In humans , D. immitis larvae tend to follow the same migratory pathway as in the canine host, ending up in the lungs, where they often lodge in small-caliber vessels, causing infarcts and typical “coin lesions” visible on radiographs.
1,247 94,61518 May, 2019
Photograph of patient's knee showing multiple xanthoma tuberosum!!
What you see are sharply demarcated yellowish collection of cholesterol underneath the skin, which develop in the setting of altered systemic lipid metabolism or as a result of local cell dysfunction.
They consist of foam cells; these specific cells are formed from macrophages as a result of an excessive uptake of low density lipoprotein (LDL) particles and their oxidative modification.
Xanthomas are usually located around the eyelids.
Xanthoma tuberosum on the other hand is characterized by xanthomas located over the joints.
All nodular dermal lesions are associated with increased cardiovascular risk and reduced average lifespan, especially in patients with familial hypercholesterolemia or dysbetalipoproteinemia.
Treatment consists of simple excision of the mass in case of compromised function with a trichloroacetic acid peel, surgery, lasers or cryotherapy, as well as treatment of the underlying hyperlipidemia.
212 34,59117 May, 2019
Eye knifeman! 👁🔪
Today we bring a case that surpasses any concept of "luck".
This patient carried a stab in the face, and the blade penetrated the medial face of the orbit, but without causing major damage to the patient's eyes. The knife was removed, the patient was sutured and continues to see well!
Transorbital penetrating injuries are dangerous as the walls of orbit are very thin, hence easily broken by the otherwise innocent objects. Because of the very critical anatomical area involved, these injuries pose a serious challenge to the treating team and are often associated with serious complications and delayed sequel. Prompt evaluation by utilizing best diagnostic modality available and timely interference to remove them are the key aspects to avoid damage to vital organs surrounding the injury and to minimize the late complications.
Credit to @amiralizadetab86 & @medicalpedia
5,660 139,05916 May, 2019
Infants born prematurely might be the smallest, but they are the toughest!!
Born 16 weeks before he was due, the tiny baby weighed just 800 grams. He was kept alive in a plastic bag!
Babies born prematurely often have medical challenges right out the gate. Doctors worry not only about their birth weights, but their organs, blood, breathing patterns, body temperature, and a host of other complications.
From the head down (except the face), this preemies’ body was placed in a plastic bag/wrap to keep her warm. She was rushed to the neonatal intensive care unit to prevent hypothermia.
This method is common for premature infants who weigh under 3.3 pounds, where babies were wrapped in sterile plastic to keep their body temperatures from dropping. An added benefit was that the babies did not suffer from overheating or rashes when using this technique.
In an environment where they could suffer from heat loss, it was discovered that this was an inexpensive yet effective way to save their lives.
841 81,57815 May, 2019
Chronic oral mucositis as a consequence of radiation therapy and chemotherapy!!
To start off, mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, which goes from the oral cavity to the anus.
Chemotherapy and radiotherapy are widely used in treatment for cancer, with various side effects.
One of the most debilitating and unfortunate consequences of these therapies is the development of painful mouth sores, known as oral mucositis.
High dose chemotherapy, and localized high dose radiation therapy to the head and neck region (e.g. for treatment of head and neck cancer and lymphoma), are the main risk factors for developing oral mucositis. These treatments effectively target the rapidly dividing cancer cells, but also inadvertently affect normal healthy cells that rapidly turnover, such as the oral mucosa lining of the inside of the mouth. A complicated series of biological events are triggered that ultimately compromise the integrity of the oral mucosa.
Minor trauma to the mouth from speaking, chewing, and swallowing, is sufficient to breakdown the mucosa, resulting in the formation of painful ulcerations.
Individuals undergoing chemotherapy or radiation therapy are often advised to eat a soft or liquid diet. Mucositis is not an infectious process and therefore cannot be prevented with antibiotics or antiviral medications and cannot be passed to another person.
606 38,63314 May, 2019
Viewer discretion advised! ⚠️ What happened here? Necrosis of the index finger! But what caused it?
This can be a SFX makeup, but nevertheless makes a real life scenario and a great educational case.
When a patient comes to the outpatient clinic with a fingertip necrosis and gangrene, the physicians have to identify the cause first. It is very important to distinguish the causes of hand ischemia because the treatment must be different depending on the cause. If the finger became necrotic fast, we have to consider acute causes such as trauma and thrombosis. And if the finger necrosis progressed slowly, chronic causes such as vasculitis have to be considered. If multiple fingers are involved, and if the patient is a smoker, thromboangiitis obliterans can be considered. However in this case, it looks like just the index finger is necrotic!
There are several types of gangrenes.
Dry gangrene happens due to insufficient blood flow to the tissue, typically from atherosclerosis. Wet gangrene involves bacterial infection, usually with skin flora.
The third type, gas gangrene, is due to Clostridium perfingens infection.
The limited oxygen in the ischemic limb limits putrefaction and bacteria fail to survive. The affected part is dry, shrunken and dark reddish-black. The line of separation usually brings about complete separation, with eventual falling off of the gangrenous tissue if it is not removed surgically, a process called autoamputation.
Dry gangrene is the end result of chronic ischemia without infection.
Diabetes for example damages blood vessels, restricting or compromising the blood supply to the hands and feet, tissues are deprived of oxygen, thus causing the cells to die.
What do you think caused it? Leave a comment.
1,361 38,01213 May, 2019
Ouch, radius and ulnar shaft fracture, aka broken forearm!!!
This young patient got injured after his back foot slipped and he landed on his arm.
The injury may be sustained from a direct blow or an indirect injury involving a bending or rotational force placed on the forearm.
The patient with a midshaft forearm fracture typically complains of pain, and possibly deformity, at the site immediately following trauma. The mechanism involves either low energy (eg, ground-level fall, especially in older adults) or relatively high energy (eg, motor vehicle accident, collision during sporting event).
Physical examination begins with visual inspection, which may reveal swelling and an obvious deformity, suggesting a displaced fracture, or a wound overlying the fracture site (ie, open fracture) requiring immediate surgical evaluation.
Range of motion may be limited due to pain, and testing should be performed gently, judiciously, and only if there are no obvious signs of displaced fracture or dislocation.
In cases of suspected midshaft forearm fracture, anteroposterior and lateral radiographs showing the entire length of the radius and ulna are usually diagnostic.
Due to significant displacement, the initial treatment is closed reduction that is attempted when fracture angulation exceeds 10 degrees or displacement exceeds 50%.
Reduction involves placing the patient’s affected arm in finger traps while the brachium is secured with a strap or weights. This setup allows for ready manipulation of the forearm and rapid splinting once reduction is achieved.
After satisfactory alignment is achieved, the fractured arm is placed in a long-arm posterior splint with the elbow at 90 degrees and the wrist in neutral (ie, without supination or pronation) and slight extension for 7 to 10 days.
After the period of immobilizaion, the cast or splint is removed, and the patient is placed in a functional forearm brace for four to six more weeks. The functional brace, which is generally custom-made to fit the patient, allows full flexion and extension at the elbow and wrist and full pronation and supination of the forearm.