The Unsatisfied Patient after Cataract Surgery Ocular Surface Disease as a Major Contributor!
Adeeb M Rushdi Ubeid
Article Type: Review Article | First Published: November 08, 2018
In the era of advanced technology in managing patients with cataracts, yet a number of patients remain unhappy. We daily face unsatisfied patients despite having 20/20 vision. Many of the ocular symptoms are in the form of ocular irritation, stinging, and blurred vision. Unrecognized dry eye could be a major contributor to these symptoms. Although cataract surgery is an intraocular surgery, it causes microscopic ocular surface damage that could worsen the preexisting ocular surface disease or leads to dry eye. The aim of this article is to emphasis on the importance of assessing the state of o...
Acute Achilles Tendon Rupture Associated with Medial Malleolar Fracture: Is it Still a Rare Injury? Case Report and Review of the Literature
Nicolas Fontecilla Cornejo, Hube Laurent Maximiliano, Bastias Bedoya Gonzalo, Fuentes Carvajal Patricio and Arancibia Mettais Mauricio
Article Type: Case Report | First Published: November 05, 2018
A 57-year-old male with unremarkable previous medical history, presented to the emergency department after a motorcycle accident. He described having suffered a violent ankle dorsiflexion with external rotation as the mechanism of injury resulting with pain and functional impairment localized in the left calf and ankle. He was unable to bear weight after injury. Clinically, he had a palpable defect at the midpoint of the Achilles tendon and a positive Thompson test. In addition, the patient complained of acute swelling and tenderness located in the medial malleolus. An Achilles tendon rupture ...
A Rare Case of an Adult Congenital Diaphragmatic Hernia becoming Symptomatic after an Elective Procedure
Stylianos Voulgarelis and Sylvia Y Dolinski
Article Type: Case Report | First Published: November 03, 2018
Congenital diaphragmatic hernias may run undiagnosed for years before a change in symptomatology may lead to the diagnosis and treatment. We present a 63-year-old previously asymptomatic patient that developed progressive symptomatology after a laparoscopic procedure. The increased intraabdominal pressure related to the peritoneal insufflation and Trendelenburg intraoperative positioning in combination with the failure of the surgeon to perform the initial laparoscopic exploration of the whole abdomen resulted in an increased amount of viscera herniated through the diaphragm. The weeks followi...
Midgut Volvulus: The Whirlpool and Corkscrew Signs
Jessica Kris and Monica Epelman
Article Type: Image Article | First Published: Image Article
An 8-week-old male was referred to the emergency room from his primary care physician, with bile-tinged vomiting since birth increasing in frequency over the past 2 days. He was born at 39 weeks via spontaneous vaginal delivery, and has been otherwise a healthy child. His examination was rather unremarkable; his vitals were stable, he was mildly dehydrated, but alert, and had a soft, non-tender, non-distended abdomen with normal bowel sounds. The clinical concern was for pyloric stenosis, so an ultrasound was performed, showing, unexpectedly, a "whirlpool sign" on Doppler interrogation (Figure...
An Exploratory Study of the Knowledge, Perceptions, Confidence Levels, and Practices of Oral Implantology
Jana M Pierce
Article Type: Research Article | First Published: November 03, 2018
The All-On-4 (AO4) oral implant process positively impacts oral health related quality of life for edentulous individuals. The purpose of this study was to identify the knowledge level, perceptions, confidence levels, and self-reported practices of oral professionals regarding AO4. A convenience sample of 324 dentists and 237 dental hygienists licensed in the state of Oregon were invited to participate in a self-administered electronic questionnaire. Data were analyzed using frequencies, percentages, and chi-square test....
Thinking Outside the "Box": Severe Intra-Abdominal Bleeding Due to Liver Injury Post CPR
Catsim Fassassi and Ronald Simon
Article Type: Case report | First Published: November 02, 2018
35-year-old woman with a past psychiatric history and alcohol abuse was found unresponsive on the bathroom floor by her boyfriend. EMS was called, and chest compressions were commenced by the boyfriend while awaiting EMS arrival. EMS found the patient to be in PEA and continued CPR on scene and during transport. ROSC was achieved while en route to the hospital. On arrival to the ED she was initially normotensive but quickly decompensated requiring aggressive fluid resuscitation and vasopressors. FAST was performed by ED staff, revealing hemoperitoneum. A CT scan and surgical consult were obtai...
A Novel ATP1A2 Mutation in Pediatric Hemiplegic Migraine
Christopher J Butler and Andrew Mallick
Article Type: Case Report | First Published: November 02, 2018
Migraine is a common pediatric disorder presenting with unilateral frontal headache. Hemiplegic migraine is a rare and clinically challenging subtype of migraine with aura. There are two different subtypes of hemiplegic migraines; they can occur as either sporadic or familial forms. Recently our understanding of the genetics underlying hemiplegic migraine has rapidly evolved. Familial hemiplegic migraine has been associated with pathogenic mutations in three independent genes. Migraine is a common pediatric disorder typically presenting with severe unilateral frontal headache which can be asso...
Childhood Idiopathic Thrombocytopenic Purpura: Oral Manifestations and Dental Care
Rafaela Brito Vasconcelos, Gabriela Brito Vasconcelos, Michele Gomes do Nascimento and Viviane Colares
Article Type: Review Article | First Published: November 01, 2018
Oral manifestations may be the first clinical signs of idiopathic thrombocytopenic purpura (ITP) diagnosed by a pediatric dentist. The aim of the present study was to describe oral manifestations and dental care for patients with ITP. A narrative review of the literature was performed, involving a search in the MEDLINE (PubMED) electronic database for relevant articles published in English using the following keywords: "Purpura, Thrombocytopenic, Idiopathic", "Hematologic diseases" and "Dental care". No restrictions were imposed with regard to the year of publication. The inclusion criteria we...
Screening Colonoscopy Adverse Events in Aging Adults: Does Frailty Matter?
Toosizadeh N, Ehsani H, Taleban S, Golden T, Tirambulo C and Mohler J
Article Type: Research Article | First Published: November 01, 2018
Socio-demographic data, the Charlson Comorbidity Index (CCI), and UEF clinical frailty syndrome classification (non-frail versus pre-frail/frail) were assessed prior to colonoscopy, and acute colonoscopy outcomes were stratified into three severity categories. Logistic regression and ANOVA/ANCOVA were employed. 41% of non-frail had one or more complications, versus 70% of pre-frail/frail group. Those in the pre-frail/frail group had nearly three times the number of acute colonoscopy complications (OR 2.84, p = 0.01) when compared to the non-frail. Chronological age, and comorbidity score (CCI)...