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Clinical Medical Reviews and Case Reports (CMRCR) is an open access bi-monthly journal publishing Cases, Reviews and Images to elaborate the importance of solving case challenges. The Journal allows clinical and medical reviews among elaborated fields such as Angiology/Vascular Medicine, Cardiology, Critical care medicine, Otolaryngology, Rhinology, Tumor Science, Ophthalmology, Dentistry, Endocrinology, Gastroenterology, Geriatrics, Hematology, Hepatology, Infectious diseases, Nephrology, Neurology, Oncology, Pathology, Pediatrics, Gynecology, Cytology, Andrology, Pulmonology, Rheumatology, etc. from scholarly open accessed attributes. This Journal focus upon building a thorough network among the doctors to understand the cases and provide improvised medical care and discuss further advancements in treating the challenging cases.

We are open to invite experts in the field to share their challenging skills in improving health care via CMRCR. It also includes original empirical, theoretical research and trends to enable policy makers to make informed decisions, as well as to identify health care trends. The Journal publishes novel research work conducted on various cases in the medical field on various types of diseases, covering their respective clinical and diagnosis issues. CMRCR assures enriched scientific documentation of a clinical and medical observations pooled together in our issues.


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Polysplenia syndrome is a rare congenital subtype of heterotaxy syndrome associated with various visceral and vasculer anomalies. Polysplenia syndrome is characterized by presence of two or more spleens and anomalies of other asymetric organs. It is reported incidence of 1 per 250.000 and more common in females. Here, we report the .. read more

December 16, 2016

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Pulmonary hypertension (PH) is an important complication of chronic pulmonary disease, especially of chronic obstructive lung disease (COPD). The exact prevalence of PH in COPD is unknown. PH is defined as an increase in mean pulmonary arterial pressure (PAPm) > 25 mmHg at rest as assessed by right heart catheterization. In .. read more

December 14, 2016

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This case is of a 67-year-old male who presented to the office with multiple symptoms and was treated for a variety of infections before the correct diagnosis of pyonephrosis in the setting of chronic ureteropelvic junction (UPJ) obstruction was made. .. read more

December 12, 2016

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Aedes albopictus, the Asian tiger mosquito, has lately become prominent, globally, while showing a marked "migratory" capacity. We have scrutinized the many consequences of the encounters between the Asian tiger mosquito and humans, and have chosen to review several of them. It seems inevitable that this mosquito be more and more .. read more

December 03, 2016

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Rasmussen's Encephalitis (RE) is defined by the presence of partial seizures associated to focal progressive cortical atrophy and in advanced stages hemiparesis, hemianopia and cognitive impairment, though it may appear focal neurological deficits at onset; and it's more prevalent in childhood. Approximately, 10% presents at adulthood. Because of its immunologic physiopathology, .. read more

December 01, 2016

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Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune demyelinating disease of the central nervous system. For our case presentation, a 52-year-old Hispanic male presented with altered mental status and focal neurological defects. MRI showed multiple lesions scattered throughout the brain. VDRL and FTA-ABS was positive in the CSF. Brain biopsy demonstrated .. read more

November 25, 2016

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Polycythemia in the newborn is defined as either venous hematocrit or hemoglobin levels above 65% and 22 g/dl, respectively. Its incidence is reported between 1 to 5%. In this article definition and epidemiology of polycythemia, physiological changes in postnatal hematocrit levels, relationship between polycythemia and hyperviscosity, pathophysiology and diagnosis of polycythemia, .. read more

November 23, 2016

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A 68-year-old man with sigmoid carcinoma was initially treated by surgical resection and adjuvant chemotherapy. Two years later, he was admitted to the hospital for recurrence of his disease with iliac parietal nodules and nodules in the recto-vesical pouch. Follow-up imaging with 18-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography (18-FDG PET) showed a focal .. read more

November 21, 2016

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Intestinal perforation is one of the leading fatal causes of death among individuals mostly in developing countries. Although many reports have associated perforations with typhoid infections, reports on the role of other bacterial pathogens especially resistant strains in causing ileal perforations are limited. We report a rare case of ileal perforation .. read more

November 16, 2016

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The experience of transcatheter closure combined with antibiotic therapies at our cardiovascular center was retrospectively analyzed in 5 cases of infective endocarditis with congenital heart disease. Transcatheter closure was performed at least 7 to 10 days after the patient's body temperature had recovered normal following effective antibiotic therapies, and after cardiac .. read more

November 12, 2016

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Single coronary artery (SCA), a congenital and rare anomaly, is defined as a coronary artery arising from the sinus of valsalva and supplying the entire heart. According to modified Lipton's classification criteria, L-1 subtype is the rarest type of SCA. Here we present two L-I subtype cases. In case one, one .. read more

November 09, 2016

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We present an immunocompromised patient with inadequate immune response to the rabies post exposure prophylaxis (PEP), and our management strategy after this inadequate response. Currently, evidence based strategy for action after failure of PEP is partial. Since the prevalence of immunocompromised patients is increasing, further studies and guidelines are necessary. .. read more

November 05, 2016

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A frequent side-effect of antiretroviral therapy is elevation of plasma lipids and cholesterol. Atazanavir has been shown in adults to have a smaller elevation in plasma lipids in relation to other protease inhibitors. The purpose of this study was to determine the efficacy of Atazanavir in pediatric patients switching to Atazanavir .. read more

October 31, 2016

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A 70-years-old man was admitted at the emergency room for onset of fever, malaise and discharge of melena. At the admission, his vital signs were: blood pressure 135/70 mmHg, heart rate 92 bpm, O2 saturation 95%. Blood sample showed mild normocyitc anaemia (Hb 12.1 g/dL), leucocytosis (White blood cells count 12.300/mmc, .. read more

October 12, 2016

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Anomalous systemic venous connection with the left atrium (LA) is an unusual congenital cause of a right-to-left shunt. The most common variant is persistent left superior vena cava (SVC), which is estimated to occur among 2.1% to 4.3% of the people with congenital hearts defects. Much less frequently, an anomalous right .. read more

October 06, 2016

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Reactive thrombocytosis (RT) is typically a result of bacterial infections in children. RT due to viruses is rarely seen and is most often secondary to a respiratory tract infection. Erythromelalgia (EM) is a rare condition caused by arteriovenous shunting and reduced capillary perfusion. Thrombocytosis can cause microvascular thrombi and can result .. read more

October 04, 2016

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Background: The venom of snake (Echis carinatus) induces hemorrhage and necrosis locally at the bite site as well as acute renal failure (ARF) as a consequence of morphological and functional alterations in glomerular and tubular cells. Objectives: It is not clear that ARF results from a direct cytotoxic effect on renal .. read more

September 26, 2016

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Treating wounds under normal wound healing processes often require little or no intervention, consisting primarily of debridement, as during the inflammatory stage the cells clear the wound to healing. However wound care professionals face many challenges in treating acute wounds with impairment on healing such as burn injuries or chronic wounds .. read more

September 16, 2016

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The problem of swollen joints in athletes represents a typical risk following a sports injury, but this is not the only cause, although it is the most frequent one. Indeed inflammatory arthritis may also be a source of joint effusion. We report the case of a 21-year-old professional football player who .. read more

September 14, 2016

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A 11-years-old boy was hospitalized for haematemesis. Clinical examination found a high blood pressure ranging at 170/90 mmHg. Renin activity was very high at 1825 mIU/l. The genetic study has identified 2 ABCC6 mutations in the composite state, what has allowed to confirm the diagnosis of PXE. .. read more

September 10, 2016

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A 70-year-old South African male with a history of type 2 diabetes mellitus presented with vague abdominal discomfort of 2 months' duration. This was associated with anorexia and 15-pound weight loss over the preceding 6 months. .. read more

September 08, 2016

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Diffuse malignant peritoneal mesothelioma (DMPM) represents one-fourth of all mesotheliomas. Association of asbestos exposure with DMPM has been observed, especially in males. Incidence is increasing worldwide and is not expected to peak for another 5 to 20 years. The majority of patients present with abdominal pain and distension, caused by accumulation .. read more

September 05, 2016

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Giardia lamblia is a protozoan parasite that can cause diarrhea in both HIV-positive and HIV-negative patients. The most frequent complaints associated with Giardia infection are loose, bulky, frothy and/or greasy stool with the absence of blood or mucus, flatulence, bloating, anorexia, cramps and foul belching. We report the case of a .. read more

August 22, 2016

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In order to explore the initiation of detoxification of addictive patients to opiates/opioids (along with some other anti-withdrawal agents), we developed a protocol to be utilized in treatment centers particularly with heavily dependent opiate/opioid subjects. Out of 17 subjects, only three received Buprenorphine/Naloxone (Bup/nx) along with KB220Z. In this pilot, we .. read more

August 16, 2016

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A case of a 45-year-old Caucasian female oropharyngeal cancer patient, who developed rare metastases to the skin and pleura, is presented. The tumour was characterised by four different histological types of cancer (mucoepidermoid carcinoma, squamous cell carcinoma, undifferentiated carcinoma and adenoid cystic carcinoma). The patient was first diagnosed with locoregionally advanced .. read more

August 10, 2016

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A 74-year-old male patient presented to our emergency room (ER) with recurring episodes of flash pulmonary edema (dyspnea worsened by lying down) and hypertension resistant to medical treatment. He had a history of left nephrectomy for renal cell carcinoma (RCC) and right renal artery angioplasty. We hereby report a case of .. read more

August 08, 2016

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Uterine inversion is usually encountered in the puerperal period and is considered a life-threatening event. The incidence of puerperal uterine inversion is 1 in 3500 deliveries; however, the incidence of non-puerperal uterine inversion is largely unknown. With few more than 100 cases reported in the literature, the management of this condition .. read more

August 06, 2016

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Melanoma usually occurs on the skin. Only 1% of all melanomas affect mucosal membrane of the head and neck with 1951 cases reported from 1945 to 2011 in the world. The article describes the case of the 65-year-old patient suffered from the palate melanoma that was irradiated on tumor area. The .. read more

August 03, 2016

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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy that manifests with ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). Hence immediate intervention is necessary for this type of presentation. A 67-year-old man was admitted to our emergency department with palpitation. Electrocardiogram (ECG) showed VT. Despite amiodarone and lidocaine .. read more

August 01, 2016

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A female newborn presented at day-1 with isolated right clavicle crepitus after vaginal delivery by certified nurse midwives. Shoulder dystocia was suspected at birth but delivery was successful with the sole aid of suprapubic pressure. The adequate weight-for-gestational-age female newborn (3605 gr. at 39 Wk.) was vigorous at birth and no .. read more

July 14, 2016

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Prasugrel is an anti-platelet agent in the thienopyridine class of adenosine diphosphate receptor inhibitors. It is commonly used in combination with low-dose aspirin as dual antiplatelet therapy (DAPT) in patients who have undergone percutaneous coronary intervention with stent placement. Prasugrel's use is associated with an overall low risk of bleeding (2.4% .. read more

July 11, 2016

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We report the case of a patient with severe adult-onset Still's disease not responding to treatment with high-dose corticosteroids and intravenous immunoglobulins. Partial remission was obtained under therapy associating anakinra and leflunomide but subsequently she developed acute hepatitis and disseminated intravascular coagulation consistent with a reactive hemophagocytic lymphohistiocytosis. The patient was .. read more

July 08, 2016

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Komiyama M, Shimada S, Takahashi Y, Hasegawa K (2016) Abrupt Increase in Glucose Intolerance after Smoking Cessation Therapy: A Case Report. Clin Med Rev Case Rep 3:116. .. read more

July 06, 2016

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We report a preterm infant with coxsackievirus B3 (CVB 3) infection accompanied by supraventricular arrhythmia and cerebral sinus venous thrombosis. CVB 3 belongs to the Picornaviridae family and usually causes mild respiratory and gastrointestinal symptoms. Newborns, especially preterm infants, are at higher risk of severe infection involving the cerebral and cardiovascular .. read more

July 04, 2016

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An 84 years-old female presented at emergency room with abdominal pain and diarrhea. Pathological background include arterial hypertension treated with losartan 100 mg/24h, cardiac arrhythmia treated with propafenona 75 mg/24h, osteoarthritis treated with non-steroidal anti-inflammatories (COX-2) and chronic diarrhea for the last three months treated with quinolones. .. read more

June 30, 2016

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Spontaneous coronary artery dissection (SCAD) is one of the rare causes of acute coronary syndrome. Regarding the etiology, it is classified broadly into 2 groups: atherosclerotic and non-atherosclerotic. It is more common in females and left anterior descending coronary artery is the most commonly involved artery. Optimal therapy for SCAD is .. read more

June 27, 2016

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A recent survey reported on conspicuous prevalence and severity of sleep disorders in patients with cancer. Insomnia is defined as difficulty falling asleep, difficulty staying asleep - with wake episodes of more than half an hour, unintended early awakening and/or non restorative sleep. This symptom complex qualifies as insomnia when it .. read more

June 25, 2016

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A 49-year-old white female tailor that works for a subcontractor at Clemenceau medical center, had in 25/10/2010, a severe substernal chest pain with left shoulder and bilateral arm pain, followed by near collapse. Nursing staff at the hospital who is very well acquainted with her, since she is an extremely gentle .. read more

June 24, 2016

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Epiploic appendagitis is a rare diagnosis in pediatric population. It is a benign, self-limiting condition caused by infarction, torsion or thrombosis of the fatty appendages on the serosal surface of the colon. It can be a diagnostic dilemma as it can mimic acute appendicitis or diverticulitis, depending on its location. We .. read more

June 10, 2016

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A 53-year-old female patient who had undergone open cholecystectomy due to cholelithiasis 6 years earlier was admitted to hepatobiliary surgery unit with a painful mass in the right upper quadrant and fever. Ultrasonography showed that a 3-cm fluid-filled mass in the right upper quadrant subcutaneously, in computed tomography a fluid-filled tubular .. read more

June 03, 2016

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A 78-year-old Caucasian female with newly diagnosed atrial fibrillation was put on anticoagulation with phenprocoumon. Two months later she developed an intracranial hemorrhage localized in the brainstem. Neurological findings were paresis and paraesthesia of the left body side. The treatment was conservative and symptoms resolved within three months. .. read more

May 31, 2016

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Lung cancer accounts for the majority of cases of brain metastases, resulting in higher morbidity and mortality. Surgery and radiation are the current standard of care for the treatment of brain metastases. However, when brain metastases recur despite these treatments, the management options are limited, especially when recurrent metastatic events occur. .. read more

May 30, 2016

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Unexpected anomalies of the extrahepatic biliary ducts were found intraoperatively during open cholecystectomy in a 49-year-old male, with calcular obstructive jaundice. The patient had congenital absence of the common bile duct that appears to have been replaced by the cystic duct, which opened directly into the duodenum. The right and left .. read more

May 16, 2016

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Personal interest in cancer metastasis to the adrenal glands began in 1957 and matured in a Doctorate Thesis in 1961. Part of its eminence lay in cases in which it was the only soil selected for attack. What of the melanoma? The available historical account did not contain this answer. Therefore, .. read more

May 12, 2016

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With neurogenetic and epigenetic tools utilized in research and neuroimaging, we are unraveling the mysteries of brain function, especially as it relates to Reward Deficiency Syndrome (RDS). We encourage the development of pharmaceuticals or nutraceuticals that promote a reduction in dopamine resistance and balance brain neurochemistry, leading to dopamine homeostasis. We .. read more

May 11, 2016

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In the present case report we describe a 67 years old woman with clinically apparent ascites and no systemic causes for it and a giant mucinous cystadenoma of the right ovary diagnosed utilizing the CT scan and confirmed by the histological findings. Ascites consists in the accumulation of fluid within the .. read more

April 30, 2016

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We retrospectively analyzed the data base of the breast unit at King Fahd Hospital from January 2000 till May 2012. We calculated proportions with 95% confidence intervals (CI) and used Logistic regression analysis to explore the predictors. Odds ratios with 95% CI were reported and p value of 0.05 was considered .. read more

April 20, 2016

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Hemophilia A is a congenital X-linked recessive bleeding disorder due to factor VIII deficiency. It is exceedingly rare in females. The association of the most common bleeding disorder (Von Willebrand Disease) and hemoperitoneum secondary to a hemorrhagic corpus luteum is well known. Most women with Hemophilia A are asymptomatic but scattered .. read more

April 18, 2016

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This case report describes a 35-year-old woman who presented to the Emergency Department (ED) after a seizure. Her evaluation revealed a rare cause of her seizures, confounded by medication non-adherence. She was emergently treated and admitted for further management. With standard patient education, social services, and outpatient follow-up, she did well .. read more

April 13, 2016

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Pulmonary lymphangitic carcinomatosis (PLC) is part of the spectrum of metastatic disease. Most cases result from dissemination of adenocarcinomas. Micro hematogenous spread to the periphery of the lung, with subsequent retrograde, centripetal lymphatic extension toward the hilar region, is the responsible mechanism in approximately 75% of patients. The remaining cases are .. read more

March 31, 2016

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Solasodine rhamnosides, solamargine and solasonine, are antineoplastics with high affinity, high efficacy and low toxicity as shown in cell culture, animal and human studies. The mode of action is by apoptosis and is accompanied by a high order of specificity. This specificity towards cancer cells is ideal for treating skin cancers. .. read more

March 28, 2016

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To prevent language disorders in a vulnerable population we must understand that the language development is a multisensory and above-modal integration with specific neurodevelopmental period, some of which remain to study. The oral language development is done according to time of neuro developmental time for which information was recently confirmed in .. read more

March 23, 2016

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The involvement of the reticuloendothelial system in systemic lupus erythematosus (SLE) concomitant to the disease activity is highly variable, and well-recognised but spontaneous splenic rupture is an unusual occurrence. We report a 35-year-old woman with SLE who had spontaneous splenic rupture during the course of her illness. The spleen rupture was .. read more

March 14, 2016

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We report a challenging case of orbital socket reconstruction. A 49- year-old man presented two weeks after fireworks exploded in his face. He had multiple orbital bone fractures on the right and the globe was enucleated because of severe damage. No primary orbital implant was used due to infection risk. One .. read more

March 14, 2016

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We present a unique case of a sixty two year old woman with symmetric lipomatosis of the lower back, similar to cup C female breast. Lipoma is the most common type of soft tissue mesenchymal tumor. Lipoma is commonly found in the upper back, neck, shoulder and abdomen, and rarely in .. read more

March 09, 2016

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In patients with congenital heart disease (CHD) imaging of coronary artery origin and course can be crucial for preoperative planning. A novel intravascular contrast agent Gadofosveset trisodium (GdT) has demonstrated to be superior for angiography due to improved intravascular contrast compared to the currently used extravascular contrast agent Gadopentetate dimeglumine (GdD). .. read more

February 29, 2016

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Our case involved a 72-year-old woman [height, 1.47 m; body mass index (BMI), 19.9 kg/m2] with T2DM and cardiovascular disturbance. She had been diagnosed with non-obese T2DM (BMI, 20 kg/m2; anti-GAD antibody, negative) during examination for coldness of the lower extremities attributed to cerebral ischemic attack or transient ischemic attack (TIA) .. read more

February 29, 2016

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Amyloidosis refers to the extracellular tissue deposition of fibrils resulting from abnormal folding of proteins. It may affect multiple organs, causing a broad range of symptoms, thus making the diagnosis particularly challenging. Polyneuropathy is one of the recognized manifestations of Amyloid Light-chain (AL) amyloidosis. .. read more

February 20, 2016

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Clostridium tetani is a spore-forming, toxin-producing, anaerobic, gram-positive bacillus which enters the CNS causing painful muscle contractions within the host. These painful spasms and stiffness typically manifest initially in the form of trismus, or lockjaw. According to the CDC, tetanus treatment includes the administration of Tetanus Immune Globulin (TIG), a tetanus .. read more

February 20, 2016

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A 69-year-old female was admitted to our hospital with complaints of abdominal pain and diarrhea for the last 2 weeks. She was obese, diabetic, and had peripheral arterial disease, but no history of bowel disease or previous gastrointestinal symptoms. Physical examination revealed severe dehydration, hypotension, and diffuse abdominal discomfort. Acute kidney .. read more

February 13, 2016

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Regorafenib monotherapy is useful for the treatment of colorectal cancer (CRC), which is refractory to multiple anti-cancer agents. However, it is associated with a high incidence of adverse events such as hand-foot skin reactions, elevated liver enzymes, etc. Although there are few reports of Stevens-Johnson syndrome (SJS) or intestinal perforation associated .. read more

February 09, 2016

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Some women, who have received silicone breast implants either for breast augmentation or breast reconstruction, develop health problems in different gradations over the years and a thorough explanation for this has yet to be given this is because this kind of research can only be performed on living humans. In addition, .. read more

January 29, 2016

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A 58-year-old woman was admitted to a psychiatric ward because of a psychotic episode. Psychiatric history revealed chronic daily stimulant use for more than thirty years, specifically cocaine, amphetamine and nicotine. She also suffered from a psychotic episode at the age of 23 after the death of a child. Medical history .. read more

January 26, 2016

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We report an early failure of a 19 mm mitroflow A12 aortic pericardial bioprosthetic valve. We excluded all described causes related with early bioprosthesis calcification and degeneration. Neither inflammatory cells nor bacterial colonization were identified in microscopic analysis, but fungal hyphae were observed in the tissue sections from both leaflets, suggesting .. read more

January 23, 2016

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Objective: To determine whether ultrasound-guided platelet-rich plasma (PRP) injections reduce pain and improve function in patients with chronic high hamstring tendinopathy. Design: Prospective case-control study in which patients who have failed treatment serve as their own controls. Setting: Patients were recruited through two sports medicine clinics, one academically based and the .. read more

January 23, 2016

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A fifty-year-old woman was the exceptional one who her clinical signs and symptoms was deteriorated after the administration of splinting. She showed deterioration of clinical and electrophysiological parameters after two weeks of using splint combined with steroid. After removing the splint, the patient showed relief of subsequent signs and symptoms. .. read more

January 12, 2016

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We herein describe two cases of non-surgical treatment for skin necrosis of the dorsum of the neonatal foot caused by extravasation. In both the cases, closure of the defects was achieved after 3 months of conservative treatment without any complications. Although the defects occupied almost all of the dorsal skin of .. read more

January 09, 2016

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Objectives:The screening for depressive symptoms at the beginning of outpatient cardiac rehabilitation (CR) can significantly increase the quality and quantity of clinical care. This study investigated the degree of depressive symptoms in CR patients according to what they perceived to be the underlying causes of their disease. Methods:The administrative data for .. read more

December 31, 2015

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The urinothorax or collection of urine in the pleural space is a rare complication following percutaneous nephrolithotomy (PCNL). We present a case of massive urinothorax who had undergone PCNL. Two weeks after PCNL, the patient was admitted to the emergency clinic with dyspnea, chest pain and fever. Thorax and abdomen computed .. read more

December 22, 2015

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A 62 year-old Caucasian female experienced cramping abdominal pain of two months' duration associated with 12 pound unintentional weight loss. Laboratory workup, computed tomography scan of abdomen and pelvis and colonoscopy revealed no etiology. Elimination of carrageenan-containing almond milk from her diet which she had substituted for cow's milk several months .. read more

December 22, 2015

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Patellar tendon disruptions are relatively uncommon knee injuries compared to fractures, ligaments sprains, or meniscal tears [1]. These tears may be traumatic or they may occur spontaneously in patients with other underlying diseases such as diabetes mellitus, rheumatoid arthritis, steroid medication or kidney failure. MRI can also be useful, by providing .. read more

December 22, 2015

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The management of long-segment tracheal stenosis (LSTS) can be quite challenging, particularly in the presence of other pulmonary anomalies. We present a complicated case of LSTS and left bronchial stenosis in a 4-month-old infant with a congenitally absent right lung. This case emphasize that a slide tracheo-bronchoplasty (STB) in the setting .. read more

December 18, 2015

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In this hypothesis, we are proposing that the combination of D-Phenylalanine and N-acetyl-L-cysteine (NAC) - two substances that have never been utilized together - is an important advancement to treat Reward Deficiency Syndrome (RDS) [1]. The key motivation for this notion is that the combination will have synergistic attributes to induce .. read more

December 17, 2015

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BCG therapy is the standard treatment for superficial bladder tumors. However, this treatment is not devoid of local and systemic side effects such as flu-like symptoms, liver granulomatosis, damage of both the gastrointestinal and the urinary tracts and bone lesions. Rheumatological complications such as arthralgia, reactive arthritis and osteoarticular infections, .. read more

December 08, 2015

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Computed Tomography Colonography (CTC) is a feasible and minimally invasive technique widely accepted both for screening and diagnosis of colon cancer. The major limit of CTC compared to optical endoscopy resides in its minor specificity due to false positive findings. Several non-pathologic aspects mimicking true polyps are described in medical literature .. read more

December 08, 2015

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A 26 year old male with no significant past medical history presented in March of 2015 with hematuria found to have bilateral renal masses - large mixed cystic/solid lesions on computerized tomography. He was diagnosed with clear-cell renal cell carcinoma with metastasis to the lymph nodes and pulmonary nodules suspicious of .. read more

December 02, 2015

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Olecranon fractures are the most common type of injury seen in the upper extremities and restricted joint mobility may be developed due to the long plaster cast time. Most of these patients will be required to participate in intense physical therapy in order to maintain and increase range of motion postoperatively. .. read more

December 02, 2015

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A premenopausal Chinese female in her forties had recently undergone thyroidectomy for multinodular goiter which she suffered for decades and failed conservative treatments. On pathology specimens, multifocal subcentimenter papillary thyroid carcinoma was detected with the largest lesion measures 3.7 cm. On the histopathology report, there was no metastatic lymph nodes, neurovascular .. read more

November 25, 2015

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Gemella, a facultative anaerobic Gram-positive cocci normally found in the oral cavity, is a well-described but rare cause of subacute infective endocarditis. Its exact incidence may be underestimated because of difficulties isolating this organism. We describe a case of bioprosthetic aortic valve, late-onset endocarditis with Gemella that was treated with vancomycin .. read more

November 18, 2015

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The patient is a 71 years old lady who initially presents with significant gastroesophageal reflux, chronic blood loss anemia, and mild dysphagia. Her reflux symptoms have been refractory to optimal medical treatments. She was initially afebrile with unremarkable vital signs, and physical exam was otherwise normal: abdomen was non-tender, non-distended, .. read more

November 12, 2015

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Aneurysms of the portal vein (PV), superior mesenteric vein (SMV), and splenic vein (SV) are rare. There are less than 200 cases reported in the English literature since the condition was first described in 1956 by Barzilai and Klecker. Studies to date have commented on the radiographic characteristics, natural history, and .. read more

November 09, 2015

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A variety of medications such as non-steroidal anti-inflammatory drugs, anti-malarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals, and psychotropic drugs, may cause cutaneous hyperpigmentation. Recently, hyperpigmentation of the tongue and oral mucosa have also been reported in patients with hepatitis C virus (HCV) infection who were being treated with either short acting .. read more

October 30, 2015

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Acute Pancreatitis is most often diagnosed based on a threefold elevation of amylase and lipase in the appropriate clinical setting. Very rarely the enzyme levels may be completely normal casting a doubt on the diagnosis. We present a case of acute pancreatitis without elevation of enzymes, review the literature, enlist the .. read more

October 30, 2015

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Steal syndrome is an infrequent complication of arteriovenous fistulas (AV) graft for patients on hemodialysis. We report a case of a patient with history of orthotopic heart transplant with end-stage renal disease that subsequently underwent real transplant from a living donor that developed delayed graft function due to steal syndrome of .. read more

October 28, 2015

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Primary transitional cell carcinoma of the ovary is a rare form of ovarian cancer, which has many features in common with transitional cell carcinoma of the bladder. Here we describe a case of metastatic transitional cell carcinoma to the ovary in a patient with a remote history of primary superficial urothelial .. read more

October 12, 2015

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We report a case of widespread unilateral drusen in a healthy 31 year old Caucasian woman using multi-modal imaging including ultra-high resolution optical coherence tomography (UHR-OCT). Dilated fundus exam multiple drusen-like lesions in the posterior pole without heme or fluid. Fundus auto fluorescence demonstrated hyper auto fluorescence at the deposits. Fluoresce .. read more

October 10, 2015

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Spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is rare hereditary disorder with autosomal recessive, X-linked recessive or autosomal dominant inheritance. Because of joint involvement SEDT-PA may be confused with juvenile idiopathic arthritis and SEDT-PA also called progressive pseudorheumatoidarthropathy of childhood. The present case had been misdiagnosed as juvenile arthritis and received .. read more

October 09, 2015

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Cystitis Cystica Et Glandularis (CCEG) is a metaplastic lesion of the bladder mucosa with a characteristic histopathologic appearance. CCEG are commonly found in specimens taken from the bladder wall of patients with cancer and other diseases or at autopsy. In most cases the course of CCEG is asymptomatic. Some patients complain .. read more

October 05, 2015

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We describe a case of untreated Chiari I malformation in adulthood. It is characterized by displacement of the cerebellar tonsils caudally through the foramen magnum, associated with massive hydrosyringomyelia and tetraventricular hydrocephalum. Magnetic Resonance (MR) imaging provides excellent visualization of intracranial and intraspinal malformations, and thus contributes greatly to their correct .. read more

October 1, 2015

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A 24-year-old woman, gravida 5, para 2, with single gestation at 41 weeks and 1 day was admitted to the labor unit with regular uterine contractions. Her obstetrical history was significant for two previous uncomplicated spontaneous vaginal deliveries, one ectopic pregnancy and one missed abortion. Her medical history was unremarkable. Her .. read more

September 28, 2015

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Signs and symptoms of infection in Nursing Home Residents (NHR) are often atypical with a lack of specific ones, causing a delay in diagnosis and treatment. The complexity of detecting infections in NHR can be explained by difficulties in understanding and interpreting non-specific signs and symptoms and co-existing chronic diseases that .. read more

September 26, 2015

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Nodular fasciitis is a benign proliferative lesion that is generally found in the soft tissue of the upper extremity and trunk. It has rarely been reported in the breast and that of the breast is indistinguishable from breast cancer.A 77-year-old woman visited our department to biopsy the swelled axillary lymph node. .. read more

September 12, 2015

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The aim of the present work was to use and evaluate the SENS method, for the first time in Macedonia, in comparison with SHS, and to test the agreement between the readers for the two scoring methods, in a group of patients with established RA. .. read more

September 09, 2015

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The carpal instability is a biomechanical alteration with multiple pathogenesis. It ensues due to disturbance of the normal ligament and bone connections that control the wrist. There are four major types of carpal instability: 1 Dorsal Intercalated Segment Instability (DISI) 2.Volar Intercalated Segment Instability (VISI) 3.Ulnar translocation, and 4. Medial carpal .. read more

September 08, 2015

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Colorectal cancer is one of the most important oncological issues worldwide. It is estimated that in 2012 1.4 millions of colorectal cancer patients were newly discovered, which accounts for 9,7% of newly diagnosed cancers. Almost 700 000 people died because of colorectal cancer in 2012, that is 8,5% of cancer-related deaths. .. read more

September 06, 2015

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We present the case of a 38-year-old male patientwho presented with new onset nephropathy on a background of psoriatic skin and joint disease. The pathogenesis and link between nephropathy with psoriatic disease is discussed, along with potential diagnostic and management challenges. This case highlights that nephropathy in psoriatic skin and joint .. read more

September 05, 2015

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Patients with Human Immunodeficiency Virus (HIV) infection have an increased risk for several variants of psoriasis as well as being refractory to standard treatment regimens. While psoriasis does not affect HIV survival, quality of life may be significantly impaired and these considerations warrant special attention with management. We report a case .. read more

August 29, 2015

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Introduction: Renal native artery is an uncommon localisation of mycotic aneurysm that involves most frequently the artery of renal transplant in immuno-suppressed patients. Septic embolization often occurs during endocarditis and direct infection could complicate endovascular procedures with device placing.

Case report: We herein describe the case of a leaking mycotic aneurysm of .. read more

August 28, 2015

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Background:The present paper describes the general and oral manifestations in a 32-year-old man previously diagnosed with Apert syndrome. Clinical examination revealed features of acrocephalosyndactyly. The patient was found to have a flattened occiput with frontal prominence, abnormal contour of head (brachycephaly), shallow and downward slanting orbits with bilateral proptosis, hypertelorism, retruded .. read more

August 26, 2015

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The amplitude of Sensory Nerve Action Potentials (SNAPs), as an indicator for the amount of peripheral sensory nerve axon, is important in the diagnosis of peripheral neuropathy. Since the sural and radial nerves are at low risk for compressive injury, the sural and radial SNAPs are especially useful in the electrodiagnosis .. read more

August 21, 2015

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Hepatic arterio portal fistulae are inappropriate connections between the hepatic artery and portal vein and are obscure causes of acquired portal hypertension. There have been a small number of cases reported since it was first described in 1892 by Sachs. These fistulae can cause significant morbidity and mortality as a result .. read more

August 20, 2015

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The concept of lifelong learning has received widespread attention in the healthcare field and in numerous other industries due to the sheer volume of new and expanding knowledge and information continuously created by one hand and rendered obsolete by the other. As a result, physicians need to be engaged in lifelong .. read more

August 14, 2015

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Introduction: To evaluate the diagnostic test for Assymetric Dimethyl Arginine (ADMA), Rheumatoid factor (RF), C-reactive protein (CRP), Disease Activity Score with 28 joint ( DAS 28 index ), and to define the effect of untreated rheumatoid arthritis on endothelial function. In order to determine whether ADMA changes depending on the disease .. read more

July 31, 2015

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A 12-year-old female was referred in our center for management of a chorioretinopathy. Ophthalmologic examination revealed unilateral chorioretinal scar with subretinal detachment. Laboratory evaluation revealed IgG antibodies for Bartonella hensalae. Treatment with oral azithromycin led to regression of lesions, resolution of subretinal detachment, and improvement in visual acuity. .. read more

July 30, 2015

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Though rare, zolpidem has been implicated in perceptual disturbances. Zolpidem elimination can be reduced with liver or kidney pathology. Concomitant Selective Serotonin Reuptake Inhibitor (SSRI) and alcohol use have increased susceptibility to delirium. This case describes a 63 year old Caucasian male, seen by the consulting service, having depression and alcohol .. read more

July 29, 2015

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The objective of study is to compare in a randomized fashion biatrial and left atrial Maze by continuous event recorder at one year follow-up. Methods: From January 2011 to December 2012, 19 patients were prospectively enrolled. Patients were allocated in 3 groups regarding their rythm, 7 continuous atrial fibrillation, 8 paroxysmal .. read more

July 27, 2015

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Migration of sternal wires is a rare, but potentially serious, complication of median sternotomy and there are a limited number of reports in the literature regarding such migration. Most of these reports document cardiac and/or vascular injuries related to thoracic migration of stainless steel wires. Imran et al. reported bilateral pneumothoraces .. read more

July 26, 2015

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Fertility sparing surgery is advocated for reproductive-age women with benign and borderline ovarian tumors. The hormonal milieu of pregnancy may, however, complicate the decision making process. The patient presented in the third trimester with a rapidly growing tumor that was diagnosed as benign steroid cell tumor by intraoperative frozen section. Fertility-sparing .. read more

June 08, 2015

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Uterine artery embolization for intractable postpartum hemorrhage saves lives while preserving fertility. The procedure-related risks of uterine infarction and ovarian insufficiency are rare. A primparous patient underwent bilateral internal hypogastric artery embolization to control severe postpartum hemorrhage following primary cesarean section. The bleeding continued, and a repeat aortogram demonstrated significant filing .. read more

June 07, 2015

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The patient is a 32 year old man whose only past medical or surgical history includes an appendectomy presented to our emergency room with diffuse abdominal pain. Th pain had been present for approximately 3 days, and was characterized by episodes of diffuse, intense cramping followed by long intervals of relative .. read more

June 27, 2015

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Lung herniation, defined as the protrusion of the lung beyond the thorax, is rarely encountered in the clinical setting. Most pulmonary hernias are caused by congenital defects and thoracic trauma. Spontaneous hernias are uncommon. We present a 70 year old patient with spontaneous intercostal lung herniation following a bout of bronchitis .. read more

June 26, 2015

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Descending Necrotizing Mediastinitis (DNM) is uncommon infection of mediastinum arising from neck or oral cavity. Despite improvements in diagnostic imaging and treatment, its mortality rate remains relatively high. We describe a unique case of descending necrotizing mediastinitis secondary to the third branchial sinus. The patient was successfully treated with antibiotics and .. read more

June 25, 2015

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Myasthenia Gravis (MG) is a neuromuscular junction disease, for which the most specific test is an increase in anti-acetylcholine receptor antibodies (anti-ACHR-Abs) titer. Myasthenic symptoms are rarely detected in patients with Amyotrophic Lateral Sclerosis (ALS). We report the case of a patient with sporadic ALS who presented at onset clinical and .. read more

June 23, 2015

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Drug-induced pseudolymphoma syndrome refers to a benign, drug induced lymphocytic infiltrate in the skin that mimics malignant lymphoma histologically, clinically, or both. At times, exposure to medication may result in cutaneous inflammatory patterns that resemble lymphoma. These pseudolymphomatous drug eruptions may resemble either T-cell or B-cell lymphomas. .. read more

June 23, 2015

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A 55-year-old man with a two-year history of peripheral arterial disease (PAD) was urgently referred to rheumatology via the vascular clinic. He was scheduled for a balloon-angioplasty due to bilateral aortoiliac and femoro-popliteal disease and occlusion of the iliac arteries. His past medical history included stent revascularisation of the left external .. read more

June 09, 2015

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We report a case of a 31-year-old man with a basilar artery aneurysm and associated different imaging findings caused by a septic embolus originating from infective mitral valve endocarditis. Cerebrovascular complications (CVC) are well-known causes of morbidity and mortality in patients with infective endocarditis (IE). Patients with IE may present with .. read more

June 05, 2015

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Occult cerebral vascular malformations (CVM) include cerebral cavernous malformations (CCM), developmental venous anomalies, and cerebral capillary telangiectasias (CCT). Conventional magnetic resonance imaging (MRI) has low sensitivity in visualizing these angiographically invisible low-flow vascular lesions. Susceptibility weighted imaging (SWI), a novel high spatial resolution gradient echo MRI sequence with both phase and .. read more

June 04, 2015

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Persistent Left sided superior vena cava is a rare congenital anomaly that can complicate a variety of cardiac procedures. We present a patient where a persistent superior vena cava was encountered unexpectedly during routine pacemaker insertion. The condition was diagnosed on the table and greatly lengthened the operating time. Given the .. read more

June 03, 2015

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Introduction: Perineural cysts, also known as Tarlov cysts, are benign cerebrospinal fluid-filled cysts of the spinal cord. They were first described by IM Tarlov in 1938. Case presentation: We describe a Tarlov cyst located in the cervical spine, a location quite rare in literature. The patient is a 44-year-old woman who .. read more

June 02, 2015

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Teratomas are germinal cell tumors originating from all three germ cell layers. When intracranial in location, they typically occur in the pineal or suprasellar regions. Ruptured intracranial teratomas are exceedingly rare. The authors report a case of a 34-year-old woman with a ruptured fourth ventricular mature teratoma that was treated with .. read more

June 01, 2015

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Discrete Subvalvar Aortic Stenosis (DSS) is an uncommon acquired cause of left ventricular outflow tract obstruction (LVOT) and often found during Transthoracic Echocardiography (TTE). The membranes are located adjacent to the Aortic Valve (AV) or extended to the anterior leaflet of the mitral valve. The high-velocity systolic jet collides and damages .. read more

April 30, 2015

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Psychiatrists started using urine pyrroles (hydroxyhemopyrrolin-2-one, HPL) to diagnose mental disorders many years ago. The biological origins of HPL are not known, nor are the causes of elevated urinary pyrrole excretion well understood. .. read more

April 03, 2015

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Hodgkin Lymphoma (HL) is one of the most common cancers in young adult. Early stage Hodgkin disease has a good prognosis and high survival rates with modern therapeutic approaches. Clinical management of early stage HL involves two therapeutic options: one is combined modality therapy with abbreviated chemotherapy plus involved field radiation .. read more

March 30, 2015

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According to American Cancer Society, there estimated to have one million new colorectal cancer cases worldwide each year, and half of them die from clinical complications and metastasis. The dominant metastasis site for patient with colon cancer is liver. In this report, a 77-year-old male presented with occult blood in stool, .. read more

March 29, 2015

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We report a 69-year-old female with personal history of gallbladder cancer who was referred to our institution with a circumferential obstructing intra-luminal colonic mass that possessed pathological features common to both primary colorectal as well as gallbladder cancer, which posed a significant diagnostic and treatment challenge. This case reviews the method .. read more

March 28, 2015

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A 28-year-old deaf female patient underwent 10 sessions of repetitive Transcranial Magnetic Stimulation (rTMS) as a participant in a placebo-controlled clinical trial for treatment of tinnitus. Trial participants received 2000 pulses of rTMS per session at a stimulation rate of 1 Hz. The neural target for rTMS was auditory cortex within .. read more

March 24, 2015

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Cardiac Resynchronization Therapy (CRT) improves systolic performance in Heart Failure (HF). However, the effects of CRT on Left Ventricular (LV) diastolic function were variable and not fully understood. The aim of this study was to determine the effects of cardiac resynchronization therapy on LV diastolic filing pattern and the relation between .. read more

March 23, 2015

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A 27-year old man presented with ocular symptoms and signs of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) who was also confirmed to have acute Lyme Disease (LD) by serology. The patient was treated timely for systemic LD and the APMPPE-like ocular findings regressed. Possible mechanism linking APMPPE and LD was .. read more

March 12, 2015

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Traditional trabeculectomy has been the main surgery for many kinds of glaucoma. However, it is of limitation and high risk in some cases. Vitrectomy is a significant microsurgery developed in the early 1970s. Anterior segment laceration and traumatic cataract is one of indications of vitrectomy. Besides, malignant glaucoma, soft cataract, crystal .. read more

March 10, 2015

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Idiopathic Granulomatous Mastitis (IGM) is an uncommon breast disease often mistaken for breast infection, abscess or Carcinoma. Here are two cases of IGM diagnosed after prolonged ineffective treatment of presumed infectious mastitis with abscess and carcinoma. The diagnosis was confirmed by biopsy and the patients were further evaluated to exclude other .. read more

March 12, 2015

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We are entering the era of genomic medicine and neuroimaging as it relates to addiction a subset of Reward Deficiency Syndrome. In 2005 our laboratory received the first USA patent on Nutrigenomics and RDS treatment. This was awarded on the basis of our earlier work showing anti-addiction activity of a nutraceutical .. read more

February 28, 2015

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This case report details a case of chorioamnionitis via hematogenous spread of bacteria following a perforation of the small bowel. Chorioamnionitis is typically thought of as an ascending infection so this case serves as a reminder that intraamniotic infection can arise from multiple sources including bacteremia. The signs and symptoms may .. read more

February 25, 2015

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When establishing new diagnostic method for detection of the endothelial dysfunction in Rheumathoid Arthritis (RA), it is necessary to compare the diagnostic values with other laboratory variables. Aim: To Assess Asymmetric Dimethylarginine (ADMA) in RA and study its relation to ACPA and different clinical and laboratory parameters of disease activity in .. read more

February 26, 2015

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Spindle Cell Carcinoma (SpCC) also known as sarcomatoid carcinoma is a rare biphasic malignant neoplasm that occurs mainly in the upper aerodigestive tract. It has spindled or pleomorphic tumor cells which simulate a true sarcoma but of epithelial origin. WHO classification has placed this tumour under a highly malignant variant of .. read more

February 26, 2015

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Atrial fibrillation (AF) is the most common sustained arrhythmia and the prevalence of AF increases with age. Ageing, hypertension, coronary artery disease, heart failure, diabetes mellitus, valvular heart diseases, congenital heart defects, thyroid dysfunctions, chronic obstructive pulmonary disease, drugs and alcohol are associated with atrial fibrilliation. New-onset AF can be converted .. read more

January 04, 2015

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A 56-year-old Caucasian woman presented to the Emergency Department of our hospital with acute headache and a speech disorder characterized by mild aphasia and dysarthria. She had a history of arterial hypertension and nicotism for several years. Neurological evaluation at admission revealed mild motor aphasia and dysarthria (NIHSS: 2). Brain computed .. read more

January 03, 2015

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Objective: Left Recurrent Laryngeal Nerve (RLN) palsy is a well known complication of cervical mediastinoscopy and is not infrequent if specifically looked for. Electro-physiological monitoring of the RLN is common practice in thyroid surgery and has greatly improved outcomes. We applied the same technique during cervical video-mediastinoscopy. Patients and methods: Between .. read more

December 29, 2014

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The authors propose a new research hypothesis about cancer pathology, starting from the hypothesis of considering cancer as a process of adaptation to changed conditions, which can be internal or external to the organism, with the aim of reaching the survival of the species. The authors, in the present work, put .. read more

November 30, 2014

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Injection of mineral oils for breast augmentation has disappeared in most developed countries for over 40 years because of major complications secondary to its infiltration in breast tissue. We present the case of a woman of 32 years old, who had received intramammary massive injections of vaseline oils 2 years ago .. read more

November 23, 2014

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There are over 100,000 bariatric surgeries in the United States each year, with the majority of these Roux-en-Y procedures. Most complications of this surgery present early with nonspecific symptoms such as abdominal pain, nausea, vomiting, and dysphagia. Some complications, however, can occur years after surgery. We report the case of a .. read more

November 22, 2014

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Carotid Body Tumours (CBTs) are paragangliomas located at the carotid bifurcation, treated surgically or by follow-up. First Bite syndrome (FBS) is a rare complication of CBT surgery, with only a few reports in literature. We present a case of a 34-year-old female patient who developed FBS after CBT surgery to raise .. read more

November 22, 2014

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Background: Sponsoring of medical meetings by life science companies has led to reduced participation fees for physicians but questions potential drawbacks. Ongoing discussions are proposing to ban such sponsoring which may increase participation fees. Objectives: To evaluate factors associated with general practitioners' willingness to pay for medical meetings, their support of .. read more

November 18, 2014

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Orphan children suffer greatly from much physical, physiological and mental disorders leading to the bad effect on their, over-all adjustment, emotional stability autonomy, security-insecurity, intelligence and self concept. Yogic practices are providing the best method to achieve good mental health. Thus keeping in view the benefits of yogic practices, an attempt .. read more

October 27, 2014

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Introduction: Cerebro-vascular accidents do happen for both adults & children. Pediatric data in contrary to adult data are clearly defiient & lacking behind. Childhood cerebellar strokes are much more rare & diffiult to pick up.
Case Report: We are reporting a toddler girl, who happened to be an ex premature & .. read more

October 27, 2014

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Aim: The aim of this study was to compare the diagnostic values of laboratory variables, to present quantitative evaluations of the anti citrullinated protein / peptide antibody (ACPA), or anti CCP ( anti-cyclic citrullinated peptide, anti-CCP 2) antibodies in second generation antibody assay diagnostic test with reference to sensitivity and specifiity, .. read more

October 27, 2014

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Advantages of bilateral Cochlear Implantation (CI) over unilateral implantation in individuals with severe to profound sensorineural hearing loss are well established. In most developed countries, cochlear implant recipients receive full funding for bilateral implantation. In Malaysia, we have been advocating bilateral implantation since 2003.Our objective is to review all cases of .. read more

September 22, 2014

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Latina/o students in rural communities face unique challenges in their efforts to pursue a 4-year college degree. I describe a 2+2 pilot program in which a large land grant university partnered with a rural community college to offer a distance Bachelor of Science degree in family studies and human development. In .. read more

September 12, 2014

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Injury to the paraspinal muscle during posterior spinal surgery has been related to the intensity of postoperative pain. The aim of the study was to confirm the validity of serum postoperative creatine kinase (CK) values as an indicator of muscle lesion as well as to assess the relationship of CK with .. read more

September 10, 2014

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International Journal of Anesthetics and Anesthesiology (ISSN: 2377-4630)
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