Clinics and Practice 2019-05-24T12:34:56+02:00 Francesca Baccino Open Journal Systems <p><strong>Clinics and Practice</strong>&nbsp;[ISSN 2039-7283] is a peer-reviewed, Open Access, online-only journal that publishes both&nbsp;<em>brief reports</em>&nbsp;and&nbsp;<em>case reports</em>&nbsp;in all areas of clinical medicine. Our journal would welcome any interesting description of patients, procedures and treatment in any condition or disease disease that can contribute to develop scientifically rigorous and clinically meaningful practice methods. <br><strong>Clinics and Practice</strong> aims at creating an innovative, rapid and collaborative background intended to help healthcare professionals finding the latest advances to answer the most pressing questions coming from the medicine/patients relationship.</p> Leukoerythroblastosis in castration-resistant prostate cancer: A clue to diffuse bone marrow carcinomatosis 2019-05-23T21:40:52+02:00 Frank Sheng Fan Chung-Fan Yang <p>A 66-year-old man with a previous history of advanced prostate cancer failing complete androgen blockade, docetaxel chemotherapy, denosumab, and abiraterone acetate as judged by persistent high serum levels of prostate specific antigen presented with exertional dyspnea, normocytic anemia, and thrombocytopenia. Leukoery - throblastosis was noted in his peripheral blood. Bone marrow examination disclosed diffuse bone marrow carcinomatosis from prostate cancer. Prolonged activated partial thromboplastin time, prothrombin time, and an extremely elevated serum level of D-dimer led to a diagnosis of disseminated intravascular coagulation. Magnetic resonance imaging of spine revealed extensive bone marrow involvement but bone scan showed only scanty bony metastasis. We like to call attention to the importance of prompt bone marrow examination once recognizing leukoerythroblastosis in patients with advanced prostate cancer. Survey of a possible coexistent disseminated intravascular coagulation is as well strongly recommended in this condition.</p> 2019-05-06T14:53:51+02:00 ##submission.copyrightStatement## Subcutaneous calcification as a supportive radiologic finding for diagnosis of rhinofacial entomophthoromycosis 2019-05-23T21:40:54+02:00 Navarat Vatcharayothin Pornthep Kasemsiri Cattleya Thongrong Chanticha Laohakittikul Surapol Suetrong Piti Ungarreevittaya Nipon Chaisuriya <p>Rhinofacial entomophthoromycosis is an uncommon chronic fungal infection of the head and neck. The diagnosis is usually based on clinical manifestations; however, diagnosis of this infection based on early manifestations is difficult and occasionally rhinofacial entomophthoromycosis is mistaken for other diseases. Therefore, computed tomography is introduced to support the diagnosis. Radiologic findings were nonspecific with swelling of the sinonasal mucosa and perinasal region. However, subcutaneous calcification, that was observed in all our cases, may be a supportive radiologic evidence for diagnosis. The diagnosis should be confirmed definitively using histopathology or fungal culture. Early diagnosis allows prompt and appropriate treatment that will achieve excellent outcomes. We suggest that subcutaneous calcification radiologic finding may guide the aware physician to an early diagnosis of rhinofacial entomophthoromycosis.</p> 2019-03-22T00:00:00+01:00 ##submission.copyrightStatement## Non-traumatic splenic rupture in amyloidosis as a rare evolution of multiple myeloma 2019-05-23T21:40:50+02:00 Lorenzo Perrone Lorenzo Gervaso Eugenia Bosco Francesco Serra Erica Quaquarini <p>We report the case of a 64-year-old man with a diagnosis of IgG lambda multiple myeloma (MM) symptomatic for bone lesions for which he received autologous stem cell transplant after induction treatment and high-dose melphalan, thalidomide and lenalidomide therapy. Twelve years after the diagnosis, he had an unexpected and acute onset of abdominal pain with signs of hypovolemic shock. A computed tomography scan was immediately performed and demonstrated a splenic rupture. A splenectomy was performed but, a week after, the patient developed an acute respiratory distress syndrome and died. After histological exam of the spleen, non-traumatic spleen rupture due to amyloidosis was our final diagnosis. This event is potentially fatal and rare in patients with MM; clinicians should be aware of this potential course of the disease and monitor patients also for amyloid induced organ damages.</p> 2019-05-07T09:42:26+02:00 ##submission.copyrightStatement## An unexpected surprise: Delayed gastric outlet obstruction from coin ingestion 2019-05-24T12:34:56+02:00 Eric Omar Then Febin John Carmine Catalano Michell Lopez Vinaya Gaduputi <p>Gastric outlet obstruction (GOO) is characterized by postprandial vomiting due to mechanical obstruction. Rarely it can occur due to ingestion of a foreign body. Most cases of foreign body ingestion are benign, with passage of the ingested object into the stool with no clinical sequelae. We describe a case of an 80-year-old woman with GOO occurring secondary to ingestion of two coins (American quarters). Rarely will such a small object cause a true gastric outlet obstruction. To our knowledge this makes the second such case reported in the medical literature.</p> 2019-05-07T00:00:00+02:00 ##submission.copyrightStatement##