Spontaneous Hemorrhage of a Liver Metastasis from Squamous Cell Cervical Carcinoma: Case Report and Review of the Literature

Liver metastases are an uncommon cause of spontaneous bleeding compared with primary benign/malignant liver lesions. Since metastatic lesions tend to maintain the vascular characteristics of the primary tumor, some metastases have a greater proclivity for hemorrhage into the host organ than others. We describe the clinical and computed tomography (CT) features of a patient previously treated for nonkeratinizing small cell squamous carcinoma of the cervix uteri. As the metastatic rupture was diagnosed while still intraparenchymal and subcapsular, with minimal peritoneal reaction, the patient's outcome was favorable.

Assessing the effects of biomechanical overload on dairy parlor workers' wrist: Definition of a study approach and preliminary results

BACKGROUND

Dairy milking is a demanding work task that has been associated with hand and wrist musculoskeletal disorders. Clinical approaches to identify the early effects of musculoskeletal disorders among dairy parlor workers' wrist have not been well defined.

OBJECTIVES

The purpose of this pilot study was to develop a study protocol that would assist in the identification and quantification of hand and wrist disorders among dairy workers that perform tasks in the dairy parlor. Additionally, such a study protocol was needed to perform relatively rapid assessments of the wrist/hand on large samples of dairy workers.

METHODS

Fourteen dairy parlor workers were assessed for i) upper limb symptoms and work history through questionnaire, ii) a physical examination of the upper limb and in particular wrists and iii) wrist ultrasonography. An additional 21 unexposed paired participants (the control group) also participated in the data collection.

RESULTS

The study results identified two ultrasound acoustic windows characterized by the highest predictive value for alteration of the wrist's structure. Study results indicated an impairment of the distal median nerve in structure and mobility and impairment of the distal tendon of the muscle extensor carpi ulnaris that included dislocation and frank damage.

CONCLUSIONS

This study identified at least two acoustic windows that should be assessed with ultrasound studies on larger groups and in prospective periodical health surveillance of dairy workers. The study confirmed the wrist was at risk for biomechanical stress among workers conducting milking tasks in the dairy parlors.