Clinics and Practice https://www.clinicsandpractice.org/index.php/cp <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 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> PAGEPress Scientific Publications, Pavia, Italy en-US Clinics and Practice 2039-7275 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="http://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> Congenital methemoglobinemia: Rare presentation of cyanosis in newborns https://www.clinicsandpractice.org/index.php/cp/article/view/1188 <p>Methemoglobin (MetHb) is an oxidized form on hemoglobin, which is unable to bind oxygen and consequently carry it to the tissues. Normally present in small quantities (&lt;1%) without detrimental effects, its elevation produces hypoxemia which can be profound and even lethal. Methemoglobinemia is an abnormal increase of MetHb (&gt;3%) of total hemoglobin. It can be classified in two types: hereditary and acquired. Acquired form is caused by exogenous oxidizing agents, such as nitrites or certain medications, while hereditary types of disease are the result of genetic deficiency in cytochrome B5 reductase, an enzyme responsible for MetHb reduction to hemoglobin. Little data is available on the epidemiology of methemoglobinemia. In general population only sporadic cases are described, while some isolated ethnic populations have increased incidence, possibly inherited from a common ancestor. We present a case of congenital methemoglobinemia in which detection of MetHb was hampered by faulty initial blood gas spectrometry results. A short literature review is also included.</p> Ernestas Viršilas Lina Timukienė Arūnas Liubšys ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-11-05 2019-11-05 9 4 10.4081/cp.2019.1188 Primary Sjogren’s syndrome presenting as autoimmune cytopenia https://www.clinicsandpractice.org/index.php/cp/article/view/1190 <p>Sjogren’s syndrome (SS) is a chronic systemic autoimmune disease, characterized by lymphocytic infiltration of lacrimal and salivary glands. Although extra glandular manifestations are uncommon, they can occur with the musculoskeletal, renal, pulmonary and hematological disease. We report the case of a 35-year-old woman presented to us with persistent unexplained bicytopenia (anemia and thrombocytopenia). Antinuclear antibody and direct Coombs test were positive. Anti-Ro/SSA and anti-La/SSB antibodies were also positive in high titer. The final diagnosis of primary SS with autoimmune cytopenia was made. Cytopenias in SS are rarely reported. Our case illustrates that clinically significant cytopenias may present as an extraglandular manifestation of SS.</p> Durga Shankar Meena Gopal Krishana Bohra ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-11-06 2019-11-06 9 4 10.4081/cp.2019.1190 Mandibular neurofibroma: Case report of a rare tumor https://www.clinicsandpractice.org/index.php/cp/article/view/1143 <p>Neural tumors localized in jaw bone are relatively rare. This article presents a case of intraosseous neurofibroma of the mandible in a 37-year-old female patient. A review of clinical, radiographic, histological features and surgical management of the patient are discussed along with a review of the literature.</p> Ziad Sleiman Loubna Abboud Elie Mehanna Ramzi Mahmoud Elie Yaacoub Georges Ghanime ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-11-07 2019-11-07 9 4 10.4081/cp.2019.1143 Rapidly fatal encephalitis associated with atypical lymphoid proliferations of the basal ganglia subsequent to aneurysmal subarachnoid hemorrhage https://www.clinicsandpractice.org/index.php/cp/article/view/1187 <p>Rapidly fatal encephalitis associated with atypical lymphoid proliferations after intracranial aneurysm rupture has not been reported. Here, we describe a 52-year-old female who presented to the emergency department with a severe headache. Imaging demonstrated aneurysmal subarachnoid hemorrhage due to a ruptured left posterior inferior cerebellar artery aneurysm, which was treated with endovascular embolization and subsequent external ventricular drain. She recovered without neurologic sequelae by day seven; however, five weeks later she represented with a severe headache associated with nausea and fever. Initial repeat imaging was unremarkable. She deteriorated quickly and was empirically treated for meningitis despite negative cerebrospinal fluid studies. Magnetic resonance imaging revealed diffuse cerebral edema within the basal ganglia and thalamus. Biopsy of the caudate nuclei revealed atypical lymphoid proliferations. She was treated accordingly with no significant improvement. This case highlights the necessity for a better understanding of the etiology, chronology, and natural history of atypical lymphoid proliferations.</p> Ayesha Kar Evin L. Guilliams Joshua A. Cuoco Eric A. Marvin ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-11-11 2019-11-11 9 4 10.4081/cp.2019.1187