Clinical Medical Reviews and Case Reports (CMRCR) is an open access 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.
Articles Search by Keyword | Journal title | Author name | DOI
Open Access DOI:10.23937/2378-3656/1410329
A. Rkiouak, PH.D, I El Kassimi, MD, N Sahel, MD, M Zaizaa, MD and Y Sekkach, PhD
Article Type: Original Research | First Published: November 25, 2020
Hemolytic anemia is defined by the premature destruction of red blood cells (RBCs). Hemolytic anemia may be acute or chronic and life-threatening, and it should be considered in all patients with a normocytic or macrocytic anemia that is unexplained. Premature destruction of RBCs can be intravascular or extravascular in the monocyte-macrophage system of the spleen and liver; extravascular destruction is more common. The mechanism of antibody-mediated hemolysis is via phagocytosis or complement-m...
Open Access DOI:10.23937/2378-3656/1410328
Sheila CL Sanches, Fernando S Ramalho, Marlei J Augusto, Deyse M Silva and Leandra NZ Ramalho
Article Type: Review Article | First Published: Sanches SCL, Ramalho FS, Augusto MJ, Silva DM, Ram
Metabolic syndrome (MS) and non-alcoholic steatohepatitis (NASH) have been associated with bad eating habits. Supplementation with coconut oil (CO) has been proposed to control these conditions, as some authors suggest that CO provides weight loss and cardiovascular protective effects. However, the effectiveness and safety of emerging diets, such as CO, remain uncertain. This review focuses on the utilization of CO in the control of MS and NASH, besides in addition to describing this cardiovascu...
Open Access DOI:10.23937/2378-3656/1410327
Amr Edrees, MD, FACP, FACR
Article Type: Case Report | First Published: November 14, 2020
Diabetes mellitus is associated with a wide variety of musculoskeletal manifestations which can significantly affect a patient’s quality of life. One of these manifestations is Limited joint mobility syndrome (LJMS) also known as diabetic cheiroarthropathy (DCA) which affects the hands. Herein is a case of a 50-year-old female patient with type 2 diabetes mellitus who was diagnosed with DCA after complaining of limited movements of all joints in her hands and tightening of the skin. Her diabet...
Open Access DOI:10.23937/2378-3656/1410326
Pedro Llerena, MD, Francisco Besoain, MD, José Luis Winter, MD and Christian Dauvergne, MD
Article Type: Case Report | First Published: November 05, 2020
Takotsubo Syndrome usually presents with normal coronary arteries and the typical pattern of apical ballooning on the left ventricle. This entity can recur but very infrequently it presents with a different pattern of left ventricle wall motion abnormality. We describe the case of a 58-year-old woman presenting with recurrent TTS, associated with two different wall motion patterns in a period of nine years, triggered by a similar stressor factor. According to the modified Mayo Criteria, the diag...
Open Access DOI:10.23937/2378-3656/1410325
Casey A. Hughes, Thomas Boeding, Sanjay Desai, Katherine Westbrook, Constance Christian, Akash Patel, Ti Hoang and Raul Magadia
Article Type: Research Article | First Published: October 29, 2020
This study was conducted at the Regional Medical Center, a community hospital in Anniston, AL. We examined the outcomes of healthcare workers that were in contact with two patients that were asymptomatic during their stay, but were subsequently found to be positive upon discharge. The results of this study provide a better understanding of the risks of SARS-CoV-2 spread in asymptomatic patients with a focus on transmission to healthcare workers. The RMC Human Resources Department released a list...
Open Access DOI:10.23937/2378-3656/1410324
Sheetal Agarwal, MD, Dhirendra Singh, MD, Ankur Agarwal, MS, Ridhima Sharma, MD and Savitri Singh, MD
Article Type: Case Report | First Published: October 21, 2020
An adolescent male presenting with multiple congenital limb defects planned for corrective surgery was incidentally detected to have low oxygen saturation on room air at rest. The child was not on any medication. After a pediatric cardiologist opinion a 2D Echocardiography and ECG were done which turned out to be normal. Proper history, detailed examination and simple bedside test carried out by the pediatricians proposed the possibility of methemoglobinemia. Since the child was not on any medic...
Open Access DOI:10.23937/2378-3656/1410323
Maxim Geeroms, MD, Fabrice Rogge, MD, Rani Kronenberger, Bob De Frene, MD, Daan De Cock, MD, Luc Cornette, MD and Bob Casaer, MD
Article Type: Case Report | First Published: October 09, 2020
Extravasation of infusion fluids is a frequent complication in the neonatal patient population. The authors report the case of a newborn infant who had a necrotic soft tissue lesion due to extravasation in the lower arm, and discuss the therapeutic options from a surgical point of view. Extravasation is the accidental leakage of infusion fluids in the subcutaneous tissues. Intravenous therapy can be required for a long period of time in premature infants and the intravenous access is hard to ach...
Open Access DOI:10.23937/2378-3656/1410322
Mohammadali Boroumand, MD, Mina Ghorbanpour Landy, MD and Narges Shahbazi, MD
Article Type: Case Report | First Published: October 07, 2020
Malignant pleural mesothelioma is a rare neoplasm that mostly occurs in elderly men. Recurrent unilateral pleural effusion is the most typical presentation and it is very rare to find extra-thoracic lymphadenopathy before the primary tumor, even in advanced cases. Herein, we report a challenging case of a young man presenting with unresolved fever, sore throat, and dysphagia associated with massive pleural effusion, cardiac tamponade, and multiple cervical lymphadenopathy with mesothelial cells ...
Open Access DOI:10.23937/2378-3656/1410321
Article Type: Original Article | First Published: September 30, 2020
We report the case of a patient hospitalized for management of orbital hematoma on overdose with oral anticoagulants. With the increase of the hematoma and protrusion of the eyeball, the patient came to ICU, including CT scan of the eye had objectified hemorrhagic infiltration of the orbit, head of exophthalmos. Laboratory tests, found a INR greater than 9. The treatment consisted of a vitamin K antagonist by the associated PFC in default of prothrombin complex concentrate. Ophthalmological, evo...
Open Access DOI:10.23937/2378-3656/1410320
Abeer Awad Abdellatif, Mervat Essam Behiry and Asmaa Ezzat
Article Type: Case Report | First Published: September 30, 2020
Report on a known case of female patient, 58-years-old, deaf since birth with skeletal deformity presenting with acute kidney injury. These features are consistent with diagnosis of arthrogryposis multiplex congenita. A congenital disease presenting with multiple joint contractures and deformity with deafness and may be renal affection. The second point is that, up to our knowledge, we are the first authors to take into consideration that the arthrogryposis multiplex congenital may be presented ...
Open Access DOI:10.23937/2378-3656/1410319
Theresia A. Karuhanga MD, MMED and Joseph M. Lulengo, MD, MMED
Article Type: Case Report | First Published: September 19, 2020
A 25 years Gravida 4, para 3, with 2 living at gestation age of 20 weeks who presented at St Francis Hospital with three days of colicky abdominal pain, associated with abdominal distension and constipation. Abdominal X-ray revealed a dilated large bowel and coffee bean sign while abdominal ultrasound showed a single living intrauterine fetus. Emergency laparotomy was done in which the findings revealed a gangrenous and twisted sigmoid at its mesenteric axis by 360 degrees. End to end anastomosi...
Open Access DOI:10.23937/2378-3656/1410318
Ferdane Sapmaz, MD, Evrim Kahramanoğlu Aksoy, MD, Muhammed Yener Akpınar, MD, Ayşegül Erdem Metin Uzman, MD, and Yusuf Sedar Sakin
Article Type: Case Report | First Published: September 19, 2020
Intestinal MALT lymphoma is a very rare neoplasm and there is limited data about clinical and pathological characteristics. They can become visible in a very short time. A 47-year-old woman was referred to our department because of epigastric pain. Gastroduodenoscopy revealed an irregular mucosal nodular lesion with ulceration extending from the bulb to the second portion of the duodenum. Endoscopic findings were normal about one year ago. The pathology spesiemens show that; duodenal biopsy reve...
Open Access DOI:10.23937/2378-3656/1410317
Roaa Alosaimi, MD, Ahood A Albajri, MD and Roaa M Albalwi, MD
Article Type: Case Report | First Published: August 31, 2020
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is an enveloped RNA beta coronavirus. It is a novel coronavirus responsible for the current global pandemic and poses a critical threat to global health worldwide. While SARS-CoV-2 is known to cause significant pulmonary disease, including pneumonia and acute respiratory distress syndrome (ARDS), clinicians have observed many extrapulmonary manifestations of COVID-19 particularly thrombosis...
Open Access DOI:10.23937/2378-3656/1410316
Luis Gabriel Ladino, Melissa Vargas, Johana Rodriguez and Efrain López
Article Type: Review Article | First Published: August 31, 2020
The physiological predisposing factors of bruxism cannot be individualized, since this is the result of a combination of causes which produce a pathogenic, repetitive, and often unconscious action. Whenever bruxism is discussed in adults or children, the presence of dental contacts should be verified and established. Additionally, establishing a specific etiology for bruxism is impossible, since there are causes and factors associated with its presence, which may or may not be...
Open Access DOI:10.23937/2378-3656/1410315
Adeviye Elçi Atılgan and Şükriye Leyla Altuntaş
Article Type: Case Report | First Published: July 31, 2020
Management of pregnancy with uterine prolapse is challenging. Physician may encounter scenario which endanger both mother and baby during pregnancy, at labor and also after birth. Here, we present conservative management of a pregnancy with preexisting total uterine prolapse up to term. We performed cesarean section due to previous delivery by cesarean section. Interestingly, prolapse did not recur after delivery at two years follow up period. Further reports are needed to conclude as pre-existe...
Open Access DOI:10.23937/2378-3656/1410314
Desislava Kalinova, Alexander Kopchev, Zlatimir Kolarov and Rasho Rashkov
Article Type: Case Report | First Published: July 27, 2020
Immune-mediated necrotizing myopathy (IMNM) is a relatively new disease, described for the first time in 2004. IMNM is a form of myositis since it is an inflammatory myopathy with strict involvement of the skeletal muscles albeit lymphocytic infiltration is sparse or absent. The clinical picture, pathological features and autoantibodies (Abs) of IMNM differ markedly from those of antisynthetase syndrome and non-specific myositis. Anti-HMGCR and anti-SRP Abs are strongly specific for IMNM, but th...
Open Access DOI:10.23937/2378-3656/1410313
UDN Prasad, JMRP Bandara and HMS Senanayake
Article Type: Case Report | First Published: June 13, 2020
Ischemic stroke is a rare neurological complication following SriLankan Russell’s viper envenomation. We report a case of a 44-year-old person, who developed multiple cerebral and cerebellar infarctions following SriLankan Russell’s viper envenomation. The patient developed both local and systemic envenomation and was treated with Snake Venom Anti-Serum I.P. (VinsBioproducts Ltd). On day six, this patient developed left-sided hemiparesis. CT scan of the brain showed bilateral cerebellar, bil...
Open Access DOI:10.23937/2378-3656/1410312
Hassan Abdi, Ibrahim Caqli, MD, Mustafe Mumin, MD, Jama Osman, MD, Gregory Fricchione, MD, MPH and Zeina Chemali, MD, MPH
Article Type: Case Series | First Published: June 10, 2020
Tetanus is a global infectious disease caused by tetanospasmin toxin produced by the anaerobic clostridium tetani. It affects the brain stem and spinal cord and leads to high morbidity and mortality if untreated. East Africa reports the highest number of cases and the highest fatalities. The objective of this study is to report on five inpatient clinical cases at Hargeisa Group Hospital in Hargeisa City with lessons learned for our team, a way to educate others and advocate for a new governmenta...
Open Access DOI:10.23937/2378-3656/1410311
Aakash Trivedi, OMS-III, Tyler Bean, OMS-III, Kayla Brown, M.S., OMS-III and Carolyn Cain, M.D
Article Type: Case Report | First Published: May 25, 2020
Bosma arhinia microphthalmia (BAM) syndrome is a rare condition with less than 100 patients reported. The suggested criteria for BAM syndrome diagnosis include congenital arhinia, hypoplastic maxilla, hypogonadotropic hypogonadism, and normal cognition in males. Our patient presented with unique symptomatology of cardiac abnormalities not otherwise described in literature relating to BAM syndrome. Anatomically, our patient had a patent ductus arteriosus and questionable aortic coarctation, a pat...
Open Access DOI:10.23937/2378-3656/1410310
Hayatu Umar, Augie Ibrahim, Akintomide F. Akindotun, Muhammed E. Hadiza, Aminu M. Sakajiki, Maiyaki S. Abubakar, Balarabe A. Salisu, Mehmet S. Ulgen, Enver Erbilen, Mustafa Kirman
Article Type: Case Report | First Published: May 23, 2020
Venous thromboembolism (VTE) is a common medical condition encountered in emergency departments and is a major contributor to global disease burden. It’s often misdiagnosed in critically ill patients despite being common and diagnosis a times is at autopsy. This disease spectrum may present either as asymptomatic deep venous thrombosis (DVT) or acute pulmonary embolism (PE) leading to death. When established PE occurs without any evidence of DVT, this is known as de-novo pulmonary embolism...
Open Access DOI:10.23937/2378-3656/1410309
Meisam Moezzi, Golshan Afshari, Fakher Rahim, Meysam Alavian, Maryam Banitorfi, Saeed Hesam and Nasrin Fatemi
Article Type: Research Article | First Published: May 13, 2020
Cardiopulmonary resuscitation (CPR) has been a frequently performed medical intervention that increases the chance of survival of a person strickenby cardiac arrest, and there is a great value of diversity in the rate of successful rehabilitation in societies. There was no significant difference in the success rate of CPR between men and women. The comparison of age groups revealed a significant difference between the success rates of CPR in the age of 14-64 with the group above 64. The analysis...
Open Access DOI:10.23937/2378-3656/1410308
Adam Rindfleisch, MD, Hannah Do, MD, Tove M Goldson, MD, PhD and Samuel N Forjuoh, MD, MPH, DrPH
Article Type: Case Report | First Published: May 06, 2020
Pyelonephritis is a relatively common infection in pregnancy. We report a case of a 20-year-old pregnant woman with limited prenatal care and history of untreated asymptomatic bacteriuria who presented to labor and delivery triage with signs and symptoms suggestive of sepsis. The initial management, although primarily driven by the patient’s chief complaints, history, and vital signs, was confounded by a relatively unremarkable urinalysis and physical exam. The patient subsequently developed s...
Open Access DOI:10.23937/2378-3656/1410307
Mende Mensa Sorato, Majid Davari and Akbar AbdollahiAsl
Article Type: Review Article | First Published: May 04, 2020
We selected national guidelines of five countries (USA of America, Canada, Europe, Australia and Ethiopia) and one international guideline.We used clinical guideline appraisal tool to evaluate the quality of guidelines, and comprehensiveness of the guidelines was evaluated by using a tool developed reach team. National adult hypertension treatment guideline of Ethiopia addressed only 22 (64.7%) of quality appraisal tool components. The guideline is least comprehensive 15 (51.7%). Major problems ...
Open Access DOI:10.23937/2378-3656/1410306
Maham Khalid, BMSc, Han-Oh Chung, MD, MSc HS Ed, Dimitra Fleming, BSc Phm, George Farjou, MD and Jennifer LY Tsang, MD, PhD
Article Type: Case Report | First Published: April 23, 2020
We reported an early COVID-19 case in a young patient in a Canadian community intensive care unit (ICU) with severe acute respiratory syndrome (ARDS). We discussed the management according to the recently published Surviving Sepsis Guidelines on COVID-19. This will provide critical care physicians important and timely information on the management of severe COVID-19 using a real case when critical care physicians are facing a surge in COVID-19 cases. Many of the recommendations regarding ARDS ar...
Open Access DOI:10.23937/2378-3656/1410305
Giovanna Rosica, Daniela Bucari, Giovanni Pastore and Angela Musella
Article Type: Case Report | First Published: April 23, 2020
A tempestive diagnosis of conjoined twins pregnancy is highly important to lead to the best the rapeutic option. Thoracopagus conjoined twins account for more than 40% of conjoined twins pregnancies, and the prognosis is very poor because in most of cases a single heart and/ or liver is present. In our case, the premature diagnosis has given the family a chance to choose for pregnancy termination reducing as far as possible the already heavy emotional impact of that condition....
Open Access DOI:10.23937/2378-3656/1410304
Marco A Maurtua, MD, Amanda Pursell, MD, Kyle Damron, MD and Patel Sonal, MD
Article Type: Review Article | First Published: April 15, 2020
Remifentanil is a mu-receptor agonist chemically related to fentanyl, alfentanil, and sufentanil that was approved for use in general anesthesia in 1996 by the US Food and Drug Administration. It is a piperidine derivative, a 3-(4-methoxycarbonyl-4-[(L-oxopropyl)- phenylamino]-L-piperidine) propanoic acid, methyl ester. The introduction of the methyl ester group onto the N-acyl side chain of the piperidine ring is what makes remifentanil structurally unique among the currently available opioids....
Open Access DOI:10.23937/2378-3656/1410303
Supraja Thunuguntla, MD, Rizwan Mohammed, MBBS, Lauren Muenchow, MS and Jose Campo Maldonado, MD, FACP
Article Type: Case Report | First Published: April 11, 2020
A 72-year-old Hispanic male with an unconfirmed history of alcohol-related cirrhosis presented to the hospital for rectal bleeding and dark stool for two days. Vitals included a heart rate of 90-120 bpm, blood pressure 90-140 over 50-60 mmHg. A left thyroid nodule was appreciated on physical exam. His pertinent labs included TSH, free T3 and T4 levels that were 0.033 mU/L (low), 3.33 mU/L and 1.33 mU/L (both within normal limits) respectively. A TSH done 3 days later was low (0.024). Thyroid per...
Open Access DOI:10.23937/2378-3656/1410302
E Jane Gibson, MD, Tuyet T Pham, MD, Tove M Goldson, MD, PhD and Samuel N Forjuoh, MD, MPH, DrPH
Article Type: Case Report | First Published: March 30, 2020
Trench Fever is caused by Bartonella quintana, a small fastidious gram-negative rod organism carried by the body louse. We report a case of a 62-year-old woman who was admitted to a hospital in central Texas for a two-week history of fever and malaise. She was initially treated for Q fever which is usually caused by inhaling dust particles contaminated by infected animals, given that she was regularly around farm animals, but when her extensive infectious disease panel came back negative, the se...
Open Access DOI:10.23937/2378-3656/1410301
Rita M Kappel, MD, PhD and Ger JM Pruijn, PhD
Article Type: Original Article | First Published: March 24, 2020
During the last decade the international debate on adverse health effects of silicone breast implants has intensified and recently the related disorder has been termed Breast Implant Illness (BII). This study aimed to explore the effects of explantation of silicone implants. In a retrospective study, women with silicone breast implants, who consulted plastic surgeons for a variety of reasons, were requested to fill out a questionnaire, which was aimed at an evaluation of health complaints. In to...
Open Access DOI:10.23937/2378-3656/1410300
Supraja Thunuguntla, MD, Obinna Echeruo, MD and Jose Campo Maldonado, MD
Article Type: Case Report | First Published: March 05, 2020
A 50-year-old Hispanic female presented to her primary care physician with a progressively worsening headache over a week, associated with visual disturbances, prosopagnosia and episodes of disorientation. Outpatient workup with head CT showed abnormality in the ventral aspect of the left thalamus showing 1.2 × 1 cm low density cyst with approximately 2-3 mm right-left midline shift locally. Left basal ganglia showed multiple well-defined foci of low density measuring up to 3 mm reflecting edem...
Open Access DOI:10.23937/2378-3656/1410299
Jeremy Kay Hock Lee, Aaron Kwun Hang Ho and Lin Ho Wong
Article Type: Case Report | First Published: February 29, 2020
Hyperosmolar Hyperglycaemic State (HHS) is a diabetic emergency which requires prompt restoration of haemodynamic stability due to high early mortality. There is currently no study which recommends the use of oral hypoglycaemics to lower blood glucose levels, due to the high efficacy of parenteral Insulin. We report a case of our management of HHS using oral hypoglycaemics (Metformin and Gliclazide) due to the absence of parenteral Insulin in a rural setting, with remission of symptoms, stabiliz...
Open Access DOI:10.23937/2378-3656/1410298
Serap Akdeniz Gorgulu, MD and Can Sait Sevindik, MD
Article Type: Original Article | First Published: February 29, 2020
Patients who predominantly used marijuana (natural cannabis) and patients who predominantly used synthetic cannabinoids in their history were evaluated as two separate groups in our study which aimed to compare the sociodemographic characteristics and depressive symptoms of these two groups. The sample of our study consisted of those patients who referred to the Polyclinic of Psychiatry at Ardahan State Hospital and were diagnosed with substance addiction. 30 polyclinic patients who defined pred...
Open Access DOI:10.23937/2378-3656/1410297
Chahid Farah, Sabine Imad, Rachelle Abboud, Fady Nader, Rahil Zeaiter, Boutros Youssef, Karen Nicolas, Mireille Rizkallah, Alain Khalaf and Tony El Murr
Article Type: Case Report | First Published: February 14, 2020
Severe flank pain is a frequent complaint at the emergency department (ED). It is usually associated to other clinical symptoms like fever, dysuria, vomiting, diarrhea or radiation to the groin. Hereby, it may raise a lot of probable differential diagnosis that should be ruled out first depending on laboratory tests and imaging results. However, when flank pain is isolated and radiating to the groin without evidence of urolithiasis on abdominal CT scan, more rare diagnosis should be suggested su...
Open Access DOI:10.23937/2378-3656/1410296
Tarik Hanafi, Amine Essaoudi, Hicham Titou, Hasna Kerrouch, Rachid Frikh, Naoufal Hjira and Mohammed Boui
Article Type: Case Report | First Published: January 31, 2020
We report a particular case of fixed drug eruption (FDE), in its erythematous and pigmented form, as a fixed pigmented erythema (FPE), which manifests in a generalized form, evolving for three years, and discuss the imputability to piroxicam and the Ramipril/Hydrochlorothiazide combination. Indeed, chronological, semiological, bibliographic criteria, were imprecise and non-discriminatory. We ended up retaining the diagnosis of fixed pigmented erythema (FPE) of particular diffuse presentation ind...
Open Access DOI:10.23937/2378-3656/1410295
Tarik Hanafi, Hicham Titou, Hasna Kerrouch, Rachid Frikh, Naoufal Hjira and Mohammed Boui
Article Type: Case Report | First Published: January 27, 2020
Hidradenitis Suppurativa (HS), also called Acne inversa, is a Chronic inflammatory, suppurative, fistulizing disease, with a risk of malignant degeneration to squamous cell carcinoma (SCC). We report an intriguing case of a patient who developed an aggressive form of HS within a very short time of nine years, indeed, the patient was infected with the human immunodeficiency virus (HIV) and human papilloma virus (HPV). We believe that the oncogenic role of HPV was increased, given the very fast de...
Open Access DOI:10.23937/2378-3656/1410294
Tarik Hanafi, Hicham Titou, Hasna Kerrouch, Rachid Frikh, Naoufal Hjira and Mohammed Boui
Article Type: Case Report | First Published: January 25, 2020
We report a case of Non-Typhoidal Salmonella meningitis (NTS) in adult HIV patient with many relapses despite well-conducted treatment, we compare this situation to a hostage-taking situation, perpetrated by NTS, taking the body of HIV patient as a hostage who cannot get rid of this germ. This is a clinical alert to discuss the efficiency of prolonged oral administration of Trimethoprim/Sulfamethoxazole in preventing relapse and a whistleblower for the urgency of developing a vaccine....
Open Access DOI:10.23937/2378-3656/1410293
Dorovinis P, Roumpou A and Dimitroulis D
Article Type: Case Report | First Published: December 30, 2019
An 85-year-old man presented to our hospital because of an elevated value of CA 19-9 of 2000 U/ml, free of any symptoms. CT scan of the thorax and abdomen revealed a lesion in the upper lobe of the right lung and a cystic lesion located in the tail of the pancreas, comprised with dilation of the pancreatic duct, being indicative of peripheral pancreatic Intraductal Papillary Mucinous Neoplasm (IPMN). The pulmonary lesion was examined histologically through EBUS and had no specific signs of atypi...
Open Access DOI:10.23937/2378-3656/1410291
G Di Donna, MD, PhD and R. Di Muro, MD
Article Type: Research Article | First Published: November 25, 2019
The Authors hypothesize that, when in the presence of a chronic inflammatory process, the organism, while attempting to solve it, goes through a mechanism that the Authors define as Phase Change Biological Switch: the cell line regression, which differentiated in that organ with the purpose of reprogramming to overcome the chronic inflammatory process, but regression involves loss of connections with the surrounding tissues and provokes the cancerous degeneration....
Open Access DOI:10.23937/2378-3656/1410290
Article Type: Case Report | First Published: October 25, 2019
Although dextrocardia occurs rarely, the incidence of coronary artery disease is similar to the general population. Few cases of coronary angiography and percutaneous coronary intervention (PCI) in patients with dextrocardia have been reported. Because of unfamiliarity with performing catheterization, transradial coronary angiography has seldom been performed in a patient with dextrocardia. To the best of our knowledge, this is the first report of successful coronary angiography and ad hoc coron...
Open Access DOI:10.23937/2378-3656/1410289
Zachary Koehler, OMS IV, MPH, Jun Park, MD and Nicholas Jenkins, MD
Article Type: Case Report | First Published: October 07, 2019
Nocardiosis is a relatively rare disease with an incidence of 3 cases per 1,000,000 each year in the United States. The infection is caused by the Nocardia spp., which are aerobic, gram-positive, branching, weakly acid-fast bacilli found primarily in soil, water and decaying vegetation. Nocardiosis can be localized to a single organ, such as the skin or lung, or disseminated. Immunocompetent patients who are affected typically experience a chronic course involving one organ, most commonly the lu...
Open Access DOI:10.23937/2378-3656/1410288
Zulfiqar Ali Sandhu, Sharjeel Shaikh and Aidan Buckley
Article Type: Case Report | First Published: October 04, 2019
Pectus excavatum is a congenital deformation of the chest, presenting as a funnel-shaped impression in the median frontal chest between the fourth and the seventh rib. Asymmetric presentation occurs, and the extent of deformation may vary from slight to serious. Exact numbers about prevalence are difficult to obtain, as the deformation is often not noted or-when noted-is not mentioned in the medical reports. Pectus excavatum is found in Europe in at least one in every 1000 births, mainly in men ...
Open Access DOI:10.23937/2378-3656/1410287
Ulises Leal Quiroga, Erik Antonio Mier Escurra and Eduardo Mendoza Fuerte
Article Type: Case Report | First Published: October 03, 2019
Endoscopic ultrasound is important to assess gastric tumors in pediatric age. However, at present there is little information about its indications, applications and risks, as well as difficulty in obtaining adequate training. A 5-year-old male patient with a gastric tumor under study, in the endoscopy, an umbilicated tumor suggestive of ectopic pancreas is observed, the endoscopic ultrasound reveals that it is dependent on the muscular layer, pathology diagnosed Gastric adenomyoma....
Open Access DOI:10.23937/2378-3656/1410286
Article Type: Original Article | First Published: September 14, 2019
There were 280 male and 120 female patients. 378 patients had no postoperative septal perforation. 22 had perforation after surgery. Of the patients in the perforated group, 19 male and 3 female were female. 21 of these patients smoked, 1 patient did not drink. 11 of these patients were drinking alcohol and 10 of them did not drink alcohol. Transseptal suturation + nasal saturation splint was used in 14 patients to stabilize the septum while perforation rate was 22/400 (1.3%). Male sex ratio was...
Open Access DOI:10.23937/2378-3656/1410285
Alper KAPTAN, DDS, PhD., Vahti Kilic, DDS, PhD., Feridun HURMUZLU, DDS, PhD., Ahmet Serper, DDS, PhD. and Arife KAPTAN, DDS, PhD.
Article Type: Research Article | First Published: September 11, 2019
The purpose of this in vitro study was to evaluate the influence of different irrigation solutions on the microshear bond strength of a universal adhesive system applied in etch & rinse mode and self-etch mode to dentin- enamel junction (DEJ), coronal dentin, pulp chamber dentin, and floor of the pulp. As well as a highly adequate apical seal, an effective coronal seal, is one of the primary goals of a successful endodontic dental treatment. Recently, a large number of adhesive systems have been...
Open Access DOI:10.23937/2378-3656/1410284
Mandeep Kaur, Prema Bezwada and Ayala Rodriguez Cesar
Article Type: Case Report | First Published: September 09, 2019
Convulsive Syncope can be difficult to distinguish from seizures at times. We present a young adult with cardiogenic convulsive syncope that mimic seizures. Continuous cardiac monitoring revealed various arrythmias during seizure like activity. She had a viral prodrome. Cardiac MRI was diagnostic for myocarditis. More detailed studies for the role of a noninvasive cardiac testing such as Cardiac MRI (CMR) and newer treatment modalities such as anti-thymocyte immunoglobulin are required for the m...
Open Access DOI:10.23937/2378-3656/1410283
Mohammed Alghamdi, Tobias Strenger, Ruben Thoelken, Tina Schaller and Johannes Zenk
Article Type: Case Report | First Published: September 06, 2019
Facial Nerve Palsy is mostly idiopathic in nature. Every patient with a facial nerve Paralysis needs to go under through investigation, most importantly imaging to exclude other causes such as neoplasms. In very rare cases, the normal imaging results may be misleading and occult tumor or perineural spread along the nerve may not be detectable. Luckily these cases may present with alarming signs such as progressiveness nature associated with pain, complete Paralysis with no recovery and most impo...
Open Access DOI:10.23937/2378-3656/1410282
Kubra Ozgok-Kangal, Iclal Karatop-Cesur, Cesur Ustunel and Kemal Simsek
Article Type: Case Report | First Published: September 04, 2019
Chronic wounds fail to progress through the phases of wound healing; inflammation-proliferation-remodelling which are usually the result of persistent infection, malperfusion due to periwound hypoxia, cellular failure, and unrelieved pressure or repetitive trauma. In this report, we present a different rare cause of a chronic wound; a surgical incision on a post-burn scar during the surgery of transurethral resection of the prostate (TUR-P) because of urethral stricture. After six weeks, the sur...
Open Access DOI:10.23937/2378-3656/1410281
Article Type: Case Report | First Published: August 29, 2019
Ulcerative colitis and ankylosing spondylitis treatment options are limited to a few classes of medications at this time. Those options provide improvement for some patients, but leaves many with ongoing, unremitting symptoms. We report a case of ulcerative colitis (UC) with comorbid ankylosing spondylitis (AS), in which administration of a daily subcutaneous liraglutide, an exogenous Glucagon-like Peptide-1 receptor agonist (GLP-1RA), led to symptomatic remission of UC and significant improveme...
Open Access DOI:10.23937/2378-3656/1410279
Michiho Sodenaga, M.D., Ph.D., Koji Hori, M.D., Ph.D., Chiaki Hashimoto, M.D., Kyoko Katsumura, M.D., Ikuko Katsumura, M.D., Masananori Tadokoro, Ph.D. and Sachiko Tsukahara, PhD
Article Type: Case Report | First Published: August 26, 2019
Suicide rate in Japan is also high. The suicide cases were above 30,000 in 1998, which increased to 34,427 in 2003. Then it gradually decreased to 21,897 in 2016 but the suicide rate at the age of more than 60 years is the highest, accounting for about 40%. Morbidity of depression is said as a risk factor of suicide by elderly people. In this case, we have discussed about a 77 year old man, who was in depressed mood. His wife was also unaware with his depression; he often had quarrels and at las...
Open Access DOI:10.23937/2378-3656/1410278
Randa Tabbah, MD, Rachoin Rachoin, MD, Bassam Harb, MD and Kabalan Saroufim, MD
Article Type: Case Report | First Published: August 24, 2019
We report a rare case of an 18-years-old female surviving a single ventricle malformation associated with a single atrium and a situs inversus viscerum. She was misdiagnosed in utero and at birth and lost to follow up since her early age when diagnosed at 4-years-old and didn't undergo any palliative surgeries after then due to financial issues. Patient was admitted for heart failure decompensation with hepatic congestion, supraventricular arrhythmias and bilateral pleural effusion and was treat...
Open Access DOI:10.23937/2378-3656/1410277
Asma Jamil MD, Ayesha Jamil MD, Rajesh Gulati MD, Alina Popa MD and Hiba Ismail
Article Type: Case Report | First Published: August 14, 2019
True tracheal bronchus is an aberrant bronchus arising above 2-6 cm from carina, from the lateral wall of trachea and directed towards the upper lung lobe. Frequently located on the right side, it can be further described as supernumerary if there is an anatomic right bronchus with normal segmental apical, anterior and posterior bronchi. It is considered displaced if it's accompanied by an absence of anatomic segmental bronchi. Tracheal bronchus can supply the entirety or part of the upper lung ...
Open Access DOI:10.23937/2378-3656/1410276
Assessment of Knowledge, Attitude and Practice (KAP) on Prevention of Malaria at Gode Lalo Kebele (010), Anchar Woreda, West Haraarge Zone, Oromia, Ethiopia: A Community Based Descriptive Cross-Sectional Study Methods
Rahel Miliyon Mokonen, BSc, Maleda Tefera Iffa, BSc, MSc and Masresha Leta Serbesa, BSc, MSc
Article Type: Case Report | First Published: July 31, 2019
Malaria is a major public health problem in worldwide and causes high morbidity and mortality, despite global efforts to eradicate the disease. While the disease is easily preventable, curable and treatable, it remains a big health threat to many communities all over the world; most especially in Sub-Saharan Africa. Malaria affects about 5% the world’s population. It is the leading cause of death in children under 5 years in sub Saharan Africa still among the ten top leading causes of morbidit...
Open Access DOI:10.23937/2378-3656/1410275
Progressive Medullary Congestion Resulting in Life-Threatening Condition Caused by Lower Cervical Dural Arteriovenous Fistula Successfully Treated with Endovascular Treatment: A Case Report and Literature Review
Prasert Iampreechakul, Punjama Lertbutsayanukul, Yodkhwan Wattanasen and Somkiet Siriwimonmas
Article Type: Case Report | First Published: July 25, 2019
The authors describe a patient with lower cervical dural arteriovenous fistula (DAVF), subsequently developing brainstem dysfunction following progressive myelopathy caused by extension of venous congestion from the cervicothoracic cord to the medulla oblongata. A 34-year-old woman suffered from progressive paraparesis with bowel/bladder dysfunction for 2 months. Before transferring to our institute, she obtained magnetic resonance imaging (MRI) of the neck, showing abnormal hyperintensity on T2...
Open Access DOI:10.23937/2378-3656/1410274
Donia Ben Hassen and Sihem Ben Zakour
Article Type: Research Article | First Published: July 03, 2019
Even the advancement in the medical image, chest radiography still the most common used and cheapest method in detecting lung diseases. The generated image allows physicians to screen the normal, benign and malignant tissues in the lung. In order to better classify and reduce noise in the image's information, the employ of preprocessing methods is unavoidable. A novel scheme for lesions classification in chest radiographs is presented in this paper by combining discrete wavelet analysis (WA), FC...
Open Access DOI:10.23937/2378-3656/1410273
Article Type: Short Note | First Published: June 22, 2019
Very early preterm delivery is defined as delivery in week 23-28 GA. The incidence of preterm delivery in Denmark is about 5.6%. The incidence of breech presentation at date of delivery is 3-4% and there is an increase of breech presentation in lower gestational age. The few cases of extreme premature delivery have not been subjects to randomized controlled studies. In recent years retrospective multicentre studies comparing vaginal delivery versus cesarean section in breech presentation have no...
Open Access DOI:10.23937/2378-3656/1410272
Haddad S, Zemni I, Bettaieb I, Adouni O, Saadallah F, Slimane M, Chargui R and Rahal K
Article Type: Case Series | First Published: June 14, 2019
Molecular classification of breast cancer identified the basal like subtype, characterized by high heterogeneity and a very poor prognosis. These tumors are mainly triple negative, characterized by the expression of basal markers: CK5/6 and EGFR. In this study, we sought to investigate the features, outcome and therapeutic modalities of basal-like breast cancers (BLBC)....
Open Access DOI:10.23937/2378-3656/1410271
Rbab Taha, Mohamed Alama, Hessa Aljhdali, Ayaz khan and Reham Kaki
Article Type: Case Report | First Published: June 12, 2019
We are presenting 67-year-old female, known to have diabetes for 10 years, not compliance to medication. Presented with 3 weeks history of isolated right lower limb and left thigh pain. Then she started to develop redness and swelling in same areas. She had also History of dry cough for one week. Admitted as a case of necrotizing fasciitis based on clinical laboratory and radiological features. She was treated empirically with vancomycin and meropenem and went for debridement twice. Histopatholo...
Open Access DOI:10.23937/2378-3656/1410270
Euler Renato Westphal, Woryk Schoeder Nowak and Caciano Vinicius Krenchinski
Article Type: Research Article | First Published: June 10, 2019
To define euthanasia, as well as orthanasia, misthanasia and dysthanasia, to start from this, to discuss the different philosophical, ethical and moral visions that surround the subject. Exploratory qualitative study which defined from the existing literature the pertinent concepts and from them brought discussions about euthanasia....
Open Access DOI:10.23937/2378-3656/1410269
Ethem Bilgic and Eyup Murat Yilmaz
Article Type: Mini Review | First Published: May 31, 2019
Neurofibromatosis is one of the most common autosomal dominant tumor syndromes with 1: 3000 birth incidence and 1: 4000 prevalence. Neurofibromatosis has three main forms, clinical and genetic. Von Recklinghausen disease or Neurofibromatosis is the most common known as type 1 (NF-1). Neurofibromatosis type 2 (NF-2) and Schwannomatosis are two other forms....
Open Access DOI:10.23937/2378-3656/1410268
Chitsimran Mann, Gina Maki, DO, Marcus Zervos, MD and Nidhi Ravishankar
Article Type: Case Report | First Published: May 30, 2019
Genitourinary Tuberculosis (GUTB) is a common manifestation of tuberculosis and usually results from the reactivation of old, dormant tuberculous diseases by pathogens of the Mycobacterium tuberculosis complex. Most often, GUTB has a varied presentation ranging from irritative voiding symptoms to renal failure. Due to this varied presentation, diagnosis of GUTB is often very difficult. We present a case of a reproductive-age female with asymptomatic infertility. Many diagnostic measures failed t...
Open Access DOI:10.23937/2378-3656/1410267
Elaine dos Reis Coutinho, Jose de Arimatea Francisco, Daniele Orrico, Mauricio Lopes Marson, Cleydicion Eloy da Costa, Gustavo Calado de Aguiar Ribeiro, Jose Humberto Pucci de Mesquita Filho, Aloisio Marchi da Rocha and Jose Francisco Kerr Saraiva
Article Type: Case Report | First Published: May 29, 2019
A 24-year-old female patient was admitted to the emergency room with palpitations associated with precordial pain and dyspnea. She was pale, sweating, with the heart rate 220 bpm and blood pressure 80 × 40 mmHg. The ECG demonstrated a sustained ventricular tachycardia rhythm evolving to a ventricular fibrillation rhythm. Four defibrillation attempts were performed with 360 J until obtained to sinus rhythm. ...
Open Access DOI:10.23937/2378-3656/1410266
Youn Joo Jung, Dong-il Kim, Hyun-june Paik, Jeong Hee Lee and Hyun Yul Kim
Article Type: Case Report | First Published: May 29, 2019
Mucosa-associated lymphoid tissue lymphomas are a relatively recently recognized subset of B-cell non-Hodgkin's lymphomas. Generally, mucosa-associated lymphoid tissue lymphomas in the thyroid gland are known to have good prognosis, but recurrence and metastasis have also been reported....
Open Access DOI:10.23937/2378-3656/1410265
Shamsuddin Anwar MD, Allison Glaser MD and Mahreen Anwar
Article Type: Case Report | First Published: April 29, 2019
A 27-year-old HIV-1 positive male was admitted in September 2018 for sudden onset of vomiting and diarrhea and was conservatively managed for positive Norovirus on a Gastrointestinal PCR panel. It was anticipated to start him on ibalizumab intravenous infusions and enfuvirtide upon discharge and a PICC line was placed in the right internal jugular vein. On the third day of line placement, he developed a fever with mild respiratory symptoms. His respiratory PCR panel for Rhino/Enterovirus was pos...
Open Access DOI:10.23937/2378-3656/1410264
Irene Rutigliano, MD, Sara Gorgoglione, MD, Anna Pacilio, MD, Carmela De Meco, MD and Michele Carmine Sacco, MD
Article Type: Case Report | First Published: April 20, 2019
A 12-year-old nonsmoking asthmatic girl was admitted for general malaise and dry fatiguing cough. Diagnostic course reveled marked hypereosinophilia and chest radiography indicated multifocal and circumscribed bilateral pulmonary areas of consolidation. Bronchoscopy excluded the presence of neoplastic cells but marked hypereosinophilia was found in bronchoalveolar lavage. The increased number of eosinophils in blood and in bronchoalveolar lavage, the radiological findings were suggestive of Chro...
Open Access DOI:10.23937/2378-3656/1410263
Ronisie Duarte de Oliveira, Raquel Rodrigues Ferreira Rocha de Alencar, Bruno Vianei Real Antonio, Andre Luiz Tiuba Mendonca and Aryadine Allinne Machado de Miranda
Article Type: Case Report | First Published: April 13, 2019
A new problem, called cosmetic doping, has been inserted globally for some decades, and has grown in importance in Brazil in recent years, affecting athletes and non-athletes. The cosmetic doping consists in the use of oily substances by the intramuscular route to increase volumetrically the muscle, which can lead to the formation of oil deposits in the muscle, called oleomas, necrosis, physical deformities and even death. We present a 31-year-old male patient who sought the emergency room with ...
Open Access DOI:10.23937/2378-3656/1410262
Z Hadipour, F Hadipour, H van Bokhoven, R Hennekam and Y Shafeghati
Article Type: Case Report | First Published: April 10, 2019
Frank-ter Haar syndrome is a genetic disease that is transmitted by autosomal recessive pattern with characteristic features such as megalocornea or glaucoma, a developmental delay and multiple congenital anomalies. It was first recognized as a separate entity by Frank, et al. and subsequently confirmed by ter Haar, et al. The main characteristics are brachycephaly, wide fontanels, prominent forehead, hypertelorism, prominent eyes, megalocornea with or without glaucoma, full cheeks, small chin, ...
Open Access DOI:10.23937/2378-3656/1410261
Takao Miyoshi, MSc, Ikumi Sasaki, MT, Fumika Koike, MSc, Saki Oyama, MT, Wakaba Furuie, MT, Miho Akaza, MD, PhD, Tetsuo Sasano, MD, PhD, Meiyo Tamaoka, MD, PhD, Yasunari Miyazaki, MD, PhD, Naohiko Inase, MD, PhD and Yuki Sumi, MD, PhD
Article Type: Brief Report | First Published: March 30, 2019
The nastent classic, a nasal airway stent (NAS), is a tube-shaped medical device that is positioned from the nose to the soft palate near the uvula. It is expected to reduce snoring by preventing the narrowing and obstruction of the airway and reduce apnea/hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Out of 23 subjects recruited, 18 completed the study. Most of the subjects showed improvements of snoring measured as the percentage of snoring time in their total sleep time...
Open Access DOI:10.23937/2378-3656/1410260
Aysegul Altunkeser and Fatma Zeynep Arslan
Article Type: Case Report | First Published: March 27, 2019
Shear wave elastography(SWE) is a relatively new, promising modality which enables detailed information about tissues mechanical properties. Hamartomas are relatively rare, soft benign breast lesions comprised of glandulary and stromal components. The importance of radiological imaging methods increases especially in cases who do not have the typical appearance of hamartomas. Mammography and sonography are effective methods in evaluating morphological features of lesions. However, typical hamart...
Open Access DOI:10.23937/2378-3656/1410259
Aysegul Altunkeser and Fatma Zeynep Arslan
Article Type: Case Report | First Published: March 25, 2019
Shear wave elastography (SWE) is a relatively new and highly effective method to reveal mechanical features of tissue by demonstrating quantitative elasticity value. The morphological features including margin of the lesion, orientation, shape and border are considered in differentiation of breast lesions on USG. It is a known fact that malignant lesions are usually palpated as a hard mass in the physical examination. A qualitative broad information can obtain about the tissue elasticity by inte...
Open Access DOI:10.23937/2378-3656/1410258
Murat Akgul, MD, CenkYazıici, MD, NildaTurgut, MD, Arzu Malak and Mehmet Fatih Sahin, MD
Article Type: CASE REPORT | First Published: February 28, 2019
A 46-years-old male with the history of multiple sclerosis applied to urology outpatient clinic with frequency, urgency, incontinence, and nocturia. Urodynamic evaluation presented Valsalva-induced urge incontinence, which was an unusual finding for an MS patient. Here we present an MS patient with the urodynamic finding of Valsalva-induced urge incontinence. Multiple sclerosis (MS) is a chronic progressive demyelinating disease of the central nervous system, mostly affecting the people between ...
Open Access DOI:10.23937/2378-3656/1410257
Zoran Gluvic, Milena Lackovic, Vladimir Samardzic, Bojan Mitrovic, Violeta Mladenovic, Milan Obradovic, Danimir Jevremovic and Esma R Isenovic
Article Type: Case Report | First Published: February 22, 2019
Congenital adrenal hyperplasia (CAH) is a rare autosomal recessive disorder with mutations in genes involved in cortisol and aldosterone production. Based on overall 21-OHase activity, CAH is divided into classic (C-CAH) and non-classic (NC-CAH). Females who suffered from NC-CAH have had increased infertility rates and higher miscarriage susceptibility. The treatment of CAH in pregnancy is still debatable. We present 22 years old pregnant female (seventh week of gestation), who is currently unde...
Open Access DOI:10.23937/2378-3656/1410256
Hans-Christian Kolberg, MD, PhD and Cornelia Kolberg-Liedtke, MD, PhD
Article Type: Case Report | First Published: February 20, 2019
High focused ultrasound is a non-invasive treatment used for destroying benign and potentially also malignant tumors. Recent data have suggested that the generation of large volumes of tumor debris by high focused ultrasound may initiate an adaptive antitumor immune response by the release of tumor antigens and damage associated molecular patterns. The patient, a 48-year-old woman who was diagnosed with hormone receptor positive HER2 negative breast cancer 17 months before presentation had repea...
Open Access DOI:10.23937/2378-3656/1410255
Ramona Januska, MD, Alexander von Meyer, MD, Martin Fleck, MD and Andreas Luchner, MD
Article Type: Case Report | First Published: February 18, 2019
Soluble ST2 might be a sensitive marker of rheumatic (peri-)carditis before and during antirheumatic treatment. We describe a case of rheumatic heart disease with pericarditis and mild left ventricular dysfunction which was successfully treated by immunosuppression. An interesting pattern of activation of the cardiac marker ST2 was observed at detection and during treatment. It suggests ST2 as biomarker for diagnosis and monitoring of disease activity in rheumatic heart disease. Rheumatic disord...
Open Access DOI:10.23937/2378-3656/1410254
Jamile Nobrega Zeraik Abdalla, Livia Lugarinho Correa, Priscilla Gil, Silvia de Freitas, Ignacio Sajoux, German Guzman and Walmir Coutinho
Article Type: Case Report | First Published: January 12, 2019
Obesity is a chronic disease referred to as a world epidemic. Superobesus management is challenging and requires multidisciplinary follow-up. In this case report, the patient had an initial body mass index (BMI) of 110 kg/m² associated with comorbidities such as type 2 diabetes (T2DM). Initial clinical management was performed with changes in lifestyle, through hypocaloric and ketogenic diet, associated with several antiobesity drugs and the introduction of light physical activity. After a tota...
Open Access DOI:10.23937/2378-3656/1410253
Luciana de Andrade Agostinho, Luiz Felipe Vasconcellos, Victor Calil da Silveira, Thays Apolinario, Michele da Silva Gonçalves, Mariana Spitz and Carmen Lucia Antao Paiva
Article Type: Brief Report | First Published: January 04, 2019
We report a patient with paternally inherited JHD caused by a large (74 CAG) expansion. The patient was prescribed olanzapine 2.5 mg q.d., oxcarbazepine 300 mg bid and underwent botulinum toxin treatment, with partial improvement of aggressiveness and chorea and partial resolution of torticollis. The MRI revealed bilateral caudate and putamen atrophy. JHD is rarer than adulthood HD, with an average prevalence rate of 5%. UHDRS has limited efficacy in evaluating JHD patients independence and func...
Open Access DOI:10.23937/2378-3656/1410252
Rabindra Nath Das and Youngjo Lee
Article Type: Short Research Article | First Published: January 04, 2019
The hematocrit known as erythrocyte volume fraction (EVF) or packed cell volume (PCV), is the volume percentage of red blood cells in blood. The present report examines the association between hematocrit (HCT) and anyone of seven cardiac parameters such as shock type (SHOCKT), heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), systolic blood pressure (SBP), mean central venous pressure (MCVP), diastolic blood pressure (DBP) for shock patients. It is reported herein that that mean...
Open Access DOI:10.23937/2378-3656/1410251
Usman N Ikumapayi, Chilel Sanyang and Dora IA Pereira
Article Type: Case Report | First Published: January 04, 2019
Hymenolepis nana, also called dwarf tapeworm infection, is an intestinal helminth not previously reported in The Gambia and only very rarely reported in West Africa. We report a case of H. nana infection in a 29-month old child living in a rural community of the north bank of the Upper River Region (URR) in The Gambia. The child presented with mild iron deficiency anaemia and granulocytosis but was otherwise mostly asymptomatic despite the moderate-intensity of infection....
Open Access DOI:10.23937/2378-3656/1410250
Kyosuke Goda, Masanori Kawaguchi and Akiko Shiotani
Article Type: Case Report | First Published: January 03, 2019
A 64-year-old man underwent vascular graft surgery for an abdominal aortic aneurysm one year previously. Using esophagogastroduodenoscopy (EGD), he was definitively diagnosed as having an aortoenteric fistula (AEF) and underwent an urgent surgical procedure for treatment. Generally, the prognosis in cases of AEF after vascular graft operation remains poor, and the survival rate in cases of AEF that require surgery is low. We report this case of AEF because EGD played a significant role in its ea...
Open Access DOI:10.23937/2378-3656/1410249
Charelle Salem, Elie Makhoul and Tony El Murr
Article Type: Case Report | First Published: January 03, 2019
Autoimmune Hepatitis (AIH) is a chronic necroinflammatory liver disease of unknown etiology associated with circulating autoantibodies and high serum globulin level. Systemic lupus erythematous (SLE) is a disease of unknown etiology in which tissues and cells are damaged by pathogenic autoantibodies and immune complex, affecting multiple organs including the liver, kidney, and CNS. AIH has been considered to occur infrequently in SLE. We report a 42-year-old female patient with an overlap syndro...
Open Access DOI:10.23937/2378-3656/1410248
Progressive Cervical Myelopathy Caused by Bilateral Spontaneous High-Flow Vertebro-Vertebral Arteriovenous Fistulas Associated with Fibromuscular Dysplasia Successfully Treated by Endovascular V2 Segments Sacrifice Using Fibered Coils: A Case Report
Prasert Iampreechakul, Anusak Liengudom, Korrapakc Wangtanaphat, Punjama Lertbutsayanukul, Yodkhwan Wattanasen and Somkiet Siriwimonmas
Article Type: Case Report | First Published: December 19, 2018
The authors reported an extremely rare case of bilateral spontaneous vertebro-vertebral arteriovenous fistulas (VVAVFs) associated with fibromuscular dysplasia (FMD). A 53-year-old hypertensive woman has been placed on antiplatelet drug following diagnosis of supratentorial ischemic stroke for 2 years. Few months before hospitalization, she developed bilateral audible bruits and progressive spastic quadriparesis. Magnetic resonance imaging (MRI) of the cervical spine showed bilateral dilated epi...
Open Access DOI:10.23937/2378-3656/1410247
Agus Dwi Susanto and Steven Jonathan
Article Type: Case Report | First Published: December 14, 2018
Asbestos fibres, inhaled and displaced by various means to lung tissue, may cause a spectrum of diseases from benign diseases to malignancies. Pleural plaques (PPs) are usually asymptomatic and cause slight impairment of lung function only when they are extended in size. The cause of pleural plaques is exposure to asbestos fibres, most commonly in an occupational setting. Relationships between the dose-response and prevalence of asbestos-related diseases are complex. We present a case of asympto...
Open Access DOI:10.23937/2378-3656/1410246
Shauna Wentzell and Mary Ryan
Article Type: Case Report | First Published: December 10, 2018
We present the case of a 47-year-old male who was diagnosed with Visual Snow Syndrome following extensive specialist consults and medical testing. With an unknown pathogenesis, Visual Snow Syndrome is very difficult to treat and there is no one treatment suited for all patients. The patient in this case report was successfully treated with Amitriptyline based on the hypothesis that Visual Snow Syndrome is a form of peripheral neuropathy and pituitary fatigue. With nearly 200 documented cases of ...
Open Access DOI:10.23937/2378-3656/1410245
Bilal Farhan, Ahmed Aziz, Dina Saba and Gamal Ghoniem
Article Type: Case Report | First Published: December 03, 2018
As minimally invasive surgery becomes more prevalent, it is important to keep in mind the unique complications that can be associated with the use of carbon dioxide insufflation. Postoperative patients presenting with lower extremity pain and swelling should have the diagnosis of iatrogenic subcutaneous emphysema on the differential, alongside deep venous thrombosis and necrotizing fasciitis. A careful history and physical examination can help guide the appropriate management and avoid unnecessa...
Open Access DOI:10.23937/2378-3656/1410244
Article Type: Case Report | First Published: November 28, 2018
Clinical diagnosis is one of the most demanding tasks, even for experienced physicians. In daily clinical practice, common diseases may require, developed skills. Not only by the intrinsic difficulties of the disease itself, but also because some of them may threaten patients' life and demands a prompt and safe attention. As examples of that are sudden dyspnoea, chest pain or syncope....
Open Access DOI:10.23937/2378-3656/1410243
Marianna G Mavilia and George Y Wu
Article Type: Case Report | First Published: November 26, 2018
Xanthelasmas are lesions containing lipid-filled histiocytes, which can be found on the skin or in the gastrointestinal tract. Gastrointestinal xanthelasmas (GX) are rare lesions typically found incidentally on esophagogastroduodenoscopy. Several risk factors have been identified for development of GX including dyslipidemia, fatty liver, radiotherapy, Helicobacter pylori infection, and immunosuppression. We present a case of a gastroesophageal xanthelasma in a 78-year-old male without risk facto...
Open Access DOI:10.23937/2378-3656/1410242
Awdishu L and Morello CM
Article Type: Case Series | First Published: November 17, 2018
Tight glycemic control has been demonstrated to reduce the incidence of microvascular complications in type 1 and 2 diabetes. However, tight control comes at a risk of hypoglycemia, which is further increased in advanced diabetic kidney disease. GLP-1 agonists significantly lower HgA1c and have added benefits of early satiety and weight loss. However, the safety and efficacy of these agents has not been well documented in CKD stage 3-4....
Open Access DOI:10.23937/2378-3656/1410241
Guillermo Ropero Luis, Sonia Santamaria Fernandez, Jesica Martín Carmona and Ricardo Gomez Huelgas
Article Type: Case Report | First Published: November 16, 2018
A 61-year-old woman was admitted to our ward - after her third visit to the Emergency Department in two months - because of progressive lethargy, weakness, and persistent euvolaemic hyponatraemia. Based on the results of the first diagnostic workup (complete blood count, serum and urinary biochemistry), a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) was established. A comprehensive second diagnostic workup was performed, leading to the diagnosis of anterior hypop...
Open Access DOI:10.23937/2378-3656/1410240
Alexis C Gushiken, Adegbenga A Bankole, Jeff S Croteau and Douglas J Grider
Article Type: Case Report | First Published: October 31, 2018
When there are multiple vague positive findings and a plethora of possible answers, as well as multiple possible consultants with whom to work, it can sometimes be difficult to decide on the right course of action. A full and through history becomes especially more important in cases like this to help direct work up and therapy. Our case report illustrates that a consult that adds obtains more history and rules out a disease process adds helpful information in patient management. The input of co...
Open Access DOI:10.23937/2378-3656/1410239
Abdelwahed Yahmadi, Hakim Zenaidi, Najeh Hsayaoui, Saber Rebii, Choaouki Mbarki, Hajer Bettaieb, Hedhili Oueslati and Ayoub Zoghlami
Article Type: Case Report | First Published: October 31, 2018
Migration of intrauterine contraceptive device (IUCD) to adjacent organs is rare but the most serious complication. Withdrawal of any migrated IUCD is advisable even if asymptomatic and Laparoscopic removal remain the gold standard, however sometimes finding the device intra-operatively is challenging for the surgeon. We report a case of laparoscopic removal of migrated IUCD to the sigmoid colon. Computed tomography (CT) precisely located the migrated device embedded in the sigmoid colon. After ...
Open Access DOI:10.23937/2378-3656/1410238
Ni Ni Tun, Thida Yamin Pyone, Yee Yee Aung and Frank Smithuis
Article Type: Case Report | First Published: October 21, 2018
In south-east Asia, cytomegalovirus (CMV) retinitis is a neglected disease , with no defined strategy for management. This is despite evidence that CMV retinitis is a common cause of HIV-associated blindness in this region and the second most common opportunistic infection to emerge during initiation of antiretroviral therapy (ART) and that CMV viremia is a strong predictor of mortality. The emerging body of data from resource-limited settings closely mirrors what was learned several decades ...
Open Access DOI:10.23937/2378-3656/1410237
Claudia Jong Chie TIEN and Priscilla Hui Yi PHOON
Article Type: CASE REPORT | First Published: September 29, 2018
Pulse oximetry is widely used perioperatively to detect respiratory events. Abnormal haemoglobins such as methemoglobin can result in inaccurate readings. Here we present the clinical challenges of managing a patient with congenital methemoglobinemia who went for surgery involving injection of patent blue dye and subsequently had a prolonged duration of poor saturation readings post-operatively. Differentials include desaturation due to respiratory causes, worsening of methemoglobinemia and dela...
Open Access DOI:10.23937/2378-3656/1410236
J Kelly Smith
Article Type: CASE REPORT | First Published: September 15, 2018
A 5-year-old boy was diagnosed as having chronic mucocutaneous candidiasis at the age of three months. He showed no improvement despite treatment with two courses of intravenous amphotericin B, 2½ years of oral 5-fluorocytosine, and daily treatment with topical Mycostatin. An immune assessment revealed that he was anergic and had low levels of circulating FCγR+ monocytes. Buccal smears revealed numerous candida and no inflammatory response. On treatment with transfer factor his FCγR+ monocyte...
Open Access DOI:10.23937/2378-3656/1410235
Maria Jose Burches Feliciano, Antonia Perez Lazaro and Juan Francisco Merino Torres
Article Type: CASE REPORT | First Published: September 14, 2018
New antineoplastic agents consisting of specific monoclonal antibodies which enhance the host's immune response against the tumoral cells are becoming more common in clinical practice. Ipilimumab, an antibody that blocks the cytotoxic T-lymphocyte antigen 4 (CTLA-4), and nivolumab, a programmed cell death 1 (PD-1) inhibitor are now approved for several advanced neoplasias such as melanoma, non-small cell lung cancer and renal cell carcinoma....
Open Access DOI:10.23937/2378-3656/1410234
Dongling Luo, Caojin Zhang and Yigao Huang
Article Type: CASE REPORT | First Published: September 12, 2018
Treprostinil is generally safe and efficacious prostacyclin analog that is recommended for patients with NYHA class III/IV pulmonary hypertension. The reported side effects of standard dosing of treprostinil include fatigue, facial flush, headache, chest pain, dyspnea, right ventricular heart failure and pallor. Other side effects include abdominal cramping, diarrhea, jaw pain, edema, vasodilation and nausea . Hypoglycemia as a side effect of treprostinil is extremely rare. We report the firs...
Open Access DOI:10.23937/2378-3656/1410233
Chia-Chi Yen, Chieh-Yi Kang, Hsing-Chun Tsai, Ming-Ting Chung, Meng-Chen Tsai and Yung-Chieh Tsai
Article Type: Case Report | First Published: September 06, 2018
Endometrial cancer is one of the most frequent gynecological cancers in women. According to a recent national survey, endometrial cancer has increased rapidly in the past 30 years in Taiwan and the incidence of endometrioid adenocarcinoma has increased more and more quickly in younger age. Although total hysterectomy is usually recommended to eradicate the malignant lesion, this procedure may not be suitable for a young nulliparous woman, especially when the endometrial cancer is early stage. We...
Open Access DOI:10.23937/2378-3656/1410232
Kaundinya Kiran Bharatam
Article Type: Research Article | First Published: August 17, 2018
As one of the most eﬀective and accepted minimally invasive techniques for inguinal hernia repair Laparoscopic Totally Extra Peritoneal (TEP) repair is met with a learning curve and caution towards injury of major vessels/nerves and mesh migration. Less experienced surgeon may tend to use excessive cautery and overzealous mesh fixation. Such practices in surgery can be avoided without any changes in immediate or late outcomes of the procedure....
Open Access DOI:10.23937/2378-3656/1410230
Article Type: Case Report | First Published: August 15, 2018
Acute intermittent porphyria (AIP) is a rare inherited disorder of heme metabolism caused by a heterozygous, loss-of-function mutation affecting the enzyme porphobilinogen deaminase (PBGD). The remaining enzymatic activity is sufficient to avoid accumulation of intermediate metabolites until hepatic heme production is further activated, i.e. by a precipitant....
Open Access DOI:10.23937/2378-3656/1410229
Kaundinya Kiran Bharatam
Article Type: Case Report | First Published: August 10, 2018
Laparoscopic cholecystectomy is guided by working knowledge of bilio-vascular anomalies to prevent common bile duct injuries and bleeding during surgery. Less importance is given to the dissection of the gall bladder from the gall bladder bed where the middle hepatic vein or its large branch can be encountered. The lack of awareness of this presence can result in uncontrolled bleeding and result in significant morbidity or mortality in a seemingly uneventful procedure....
Open Access DOI:10.23937/2378-3656/1410228
A Review on Separation Techniques of Graphene Oxide (GO)/Base on Hybrid Polymer Membranes for Eradication of Dyes and Oil Compounds: Recent Progress in Graphene Oxide (GO)/Base on Polymer Membranes-Related Nanotechnologies
Elahe Dadvar and Alireza Heidari
Article Type: Review Article | First Published: August 10, 2018
Nowadays, obtaining drink water for saving health of humans is very important. There have been various investigations about the cost effective and environmental friendly methods of water treatment. The purpose of the current study is reviewing the application of hybrid polymeric membranes Graphene Oxide (GO) as new techniques for separation of pollutants (Figures 1 and Figure 2)....
Open Access DOI:10.23937/2378-3656/1410227
Lopez-Villatoro JM, Palomares N, Diaz-Marsa M and Carrasco JL
Article Type: Research Article | First Published: August 04, 2018
Borderline Personality Disorder (BPD) is described as a severe mental condition characterized by high affective instability, impulsive behaviors, autolytic attempts, or unstable interpersonal relationships. Previous literature on BPD has focused mainly on symptoms of mood and anxiety and self-injurious behavior but relatively little is known about the association between borderline personality disorder and psychopathic traits....
Open Access DOI:10.23937/2378-3656/1410226
Shamit S Prabhu, Sameh Almousa, Kevin Fortier and Uday N Reebye
Article Type: Case Report | First Published: August 03, 2018
Tardive dyskinesia (TD) presents as uncontrolled, repetitive movements of the body, typically beginning with orofacial structures, due to antipsychotic medications. The two classes of antipsychotics, atypical and typical, are mainly distinguished by their likelihood of producing extrapyramidal side effects (EPS), with atypical producing lower rates. Our case discusses a patient who presented at our clinic for dental extractions. Pre-operative consultation presented the rapid, repetitive tongue, ...
Open Access DOI:10.23937/2378-3656/1410225
Abigail E Collett, Jean Payer and Xuezhi Jiang
Article Type: Case Report | First Published: July 26, 2018
Abnormal placental implantation (API) is an uncommon obstetrical complication that is associated with significant maternal morbidity. Typically, the diagnosis of API is made at the time of delivery in the third trimester. Less commonly there are reports of API presenting in the second trimester, and rarely in the first trimester. Cesarean Scar Pregnancy (CSP) is another entity that can present similarly to API and is associated with previous cesarean deliveries. Unlike early API, which can rarel...
Open Access DOI:10.23937/2378-3656/1410224
pradeep Kumar Mada, Gabriel Castano, Marithe G Gutierrez-Roberts and Andrew Stevenson Joel Chandranesan
Article Type: Case Report | First Published: July 25, 2018
Mycotic keratitis has been reported from many different parts of the world, with a worldwide incidence varying from 17% to 36% in various studies. It is particularly common in tropical areas, where the incidence ranges between 14%-40% of all ocular mycoses. Early diagnosis is highly important in every patient with the corneal lesion because infectious keratitis caused by various organisms such as bacteria, viruses, fungi, or Acanthamoeba the leading cause of monocular blindness....
Open Access DOI:10.23937/2378-3656/1410223
Umit Arslan, Eyupserhat Calik and Bilgehan Erkut
Article Type: Case Report | First Published: July 21, 2018
An 82-year-old male patient was admitted to our clinic because of shortness of breath and chest pain. A grade 4/6 diastolic murmur was heard on auscultation. Physical examination revealed signs of congestive heart failure and poor peripheral perfusion. There was a diagnosis of acute Stanford Type A ascending aortic dissection in the history of the patient. The patient had refused emergency surgical intervention three years ago. Computed tomography revealed chronic Stanford Type A dissection and ...
Open Access DOI:10.23937/2378-3656/1410222
Jayant Kumar Muduli and Meenakshi Mitra
Article Type: Case Report | First Published: July 04, 2018
Factor XII (FXII) deficiency, which is also known as Hageman factor deficiency, was first described in the medical literature by Dr. Oscar Ratnoff and Dr. Jane Colopy in 1955. It has an Autosomal Recessive inheritance. The precise incidence of the disorder in the common population is still unknown, but it is found approximately one in a million....
Open Access DOI:10.23937/2378-3656/1410221
Mormont M, Gero D, Moulin-Stephan C, Worreth M and Morel P
Article Type: Case Report | First Published: June 22, 2018
Liposarcoma is the most common soft tissues sarcoma in adults. Pleiomorphic liposarcoma (PLS) is a rare subtype of liposarcoma with the highest malignancy rate. In this paper we present a rare case of pleiomorphic liposarcoma of the colon and the management of the disease....
Open Access DOI:10.23937/2378-3656/1410220
Sacca A, Roscigno M, Nicolai M, Manica M, La Croce G, Bettini A, Chirco A, Bonomi L and Da Pozzo L
Article Type: Case Report | First Published: June 18, 2018
We describe the case of a 71-years-old male, who was submitted to a left laparoscopic radical nephrectomy for Clear Renal Cell Carcinoma (CRCC). After a 14-year follow-up, MRI scan showed a 5-cm solid lesion of the perineum, that originates from the right corpus cavernosum. A percutaneous trans-perineal biopsy revealed an atypical metastasis of CRCC. To reduce surgical risk during the exeresis of the mass, the patient received 4 cycles of pazopanib as presurgical treatment, with a shrinking of t...
Open Access DOI:10.23937/2378-3656/1410219
Maja Badovinac, Matevz Harlander, Branislava Rankovic and Marjeta Tercelj
Article Type: Case Report | First Published: June 15, 2018
Treatment of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) has not been established yet. The majority of patients is treated with glucocorticoids. This article presents a case when such treatment was inefficient. When switched to somatostatin analogues treatment, patient's clinical condition and radiologic findings improved. Nonetheless, we were not able to prove the expression of somatostatin receptors in the lung nodules....
Open Access DOI:10.23937/2378-3656/1410218
Romain Jouffroy, Antoine Pegat-Toquet, Alexandre Bourdiault, Pascal Philippe, Pierre Carli and Benoit Vivien
Article Type: Case Report | First Published: June 13, 2018
Angiotensin II (AII) is a strong physiological vasopressor hormone. Sartans act as antagonists of AT1 receptors of AII, inducing a vasodilatation via an upregulation of AT2 receptors. In July 2017, in the New England Journal of Medicine, efficiency of AII to increase blood pressure and reduce conventional vasopressors's dose in severe vasodilatory shock refractory to high-dose vasopressors were observed....
Open Access DOI:10.23937/2378-3656/1410217
Shafira Mohamad Sha
Article Type: Case Report | First Published: May 31, 2018
Cerebral vein and sinuses thrombosis (CVST) is a rare condition and accounts of 0.5-1% of all stroke. It is more common in women compared to men. Usage of oral contraceptive pill (OCP) has been recognised to increase the risk of developing CVST. We report a case of 46 Chinese lady with underlying systemic lupus erythematous (SLE) who presented with a second episode of sudden onset severe headache which secondary to CVST within 5 years....
Open Access DOI:10.23937/2378-3656/1410216
Ekrem Sahan and Suzan Sahan
Article Type: Case Report | First Published: May 28, 2018
Acute pulmonary embolism (APE) or acute aortic dissection is one of the most serious clinical presentations at emergency department. Chest pain and elevated serum D-dimer level can be found in both APE and AAD. Echocardiography can be used as first line imaging modality for differential diagnosis. Computed tomography angiography is the main diagnostic test for APE and AAD. We aimed to emphasize differential diagnosis of chest pain with this case report....
Open Access DOI:10.23937/2378-3656/1410215
James Jordan Johnston, Dev Tandon, Tary Yin and Paul Simcock
Article Type: Case Report | First Published: May 28, 2018
A 68-year-old female who underwent bilateral Functional Endoscopic Sinus Surgery (FESS) in 2000 for chronic rhinosinusitis, presented with a one year history of recurrent headaches. The headaches were located particularly around the eyes, occurred weekly and improved with paracetamol. She also complained of anosmia and purulent rhinorrhea bilaterally....
Open Access DOI:10.23937/2378-3656/1410214
Nidia Pereira, Marta Pereira, Liliana Carneiro, Luis Miguel Afonso, Ana veloso and M Catarina Tavares
Article Type: Case Report | First Published: May 28, 2018
Infected (mycotic) aneurysms (MA) are uncommon, and the aorta is the main vessel involved, with gram-positive bacteria being the most frequent causative agent. Their morbidity and mortality are important and an early diagnosis is challenging owing to their unspecified manifestations....
Open Access DOI:10.23937/2378-3656/1410213
Padmike Dayananda, Ramsh Dhamodaran Praba and Mohommed Rafaideen Balal
Article Type: Case Report | First Published: May 26, 2018
Gallbladder volvulus (GV) is an uncommon cause for abdominal pain and occurs due to rotation of gall bladder on its mesentery along the axis of the cystic duct and the cystic artery. Although it is often misdiagnosed as acute cholecystitis (AC) before surgery, critical constellation of presenting signs and symptoms which guide the emergency physician and surgeon to accurate and timely diagnosis of GV before surgical intervention....
Open Access DOI:10.23937/2378-3656/1410212
Padmike Dayananda, Jacinta Drew and Jacinta Cover
Article Type: Case Report | First Published: April 25, 2018
The cost of the procedure of laparoscopic appendectomy is significantly higher than that of open surgery. Costing includes instruments, duration of surgery, and the potential for requiring conversion to open. Reducing procedure costs in simple ways will better enable laparoscopic appendectomy to be cost-effective in Regional Hospitals....
Open Access DOI:10.23937/2378-3656/1410211
Apinya Bharmanee, Deemah Mahadin and Harinder R Singh
Article Type: Case Report | First Published: April 19, 2018
Arrhythmogenic right ventricular dysplasia (ARVD) is an inherited cardiomyopathy characterized by right ventricular structural abnormalities, dysfunction and ventricular tachycardia (VT) secondary to fibrofatty replacement of the myocardium. We report a male teenager with negative family history, presenting with sustained VT after sports practice....
Open Access DOI:10.23937/2378-3656/1410210
Padmike Dayananda, Sabrina Barrett and Sathiyaseelan Nair
Article Type: Case Report | First Published: April 11, 2018
Acute Haemorrhagic oedema of infancy (AHOI) is a cutaneous leukocytoclastic vasculitis, clinically characterized by the acute development of peripheral oedema and targetoid purpuric lesions on the face and extremities. It is commonly associated with Pneumococcal Bacteremia, CMV infection and Rotavirus infection....
Open Access DOI:10.23937/2378-3656/1410209
Fatih Uzer, I. Hicran Ozbudak, omer Ozbudak and Aykut Cilli
Article Type: Case Report | First Published: April 05, 2018
Pulmonary hyalinizing granuloma (PHG) which should be considered in the differential diagnosis of pulmonary nodules of unknown origin is a distinct fibrosing lesion of lung that occurs in middle-aged patients. It has been usually reported as case reports in the literature. Patients are usually symptomatic. We present the case which recognized during operation and determined rarely....
Open Access DOI:10.23937/2378-3656/1410208
Aykut Bahceci, M Metin Seker, Turgut Kacan, Nalan Akgul Babacan, Birsen Yucel and M Asım Gedikli
Article Type: Case Report | First Published: March 30, 2018
Most malignant kidney tumors are renal tubular epithelium derived adenocarcinomas and referred to as renal cell carcinoma (RCC). Kidney cancer accounts for 3-4% of adult cancers and one third of the overall cases of RCC are diagnosed at the advanced stages of the disease. RCC is a chemo-radioresistant cancer. Therefore, immunomodulatory agents and tyrosine kinase inhibitors (TKI) are commonly used in the treatment of mRCC....
Open Access DOI:10.23937/2378-3656/1410207
Rabab Taha, Talal Almteri, Nizar bahabri and Hani Almoallim
Article Type: Case Report | First Published: March 22, 2018
Mucormycosis is an invasive infection in immunocompromised host. It can lead to a devastating rhino-orbital-cerebral involvement with detrimental consequences. This disease is mainly caused by member of the family Mucoraceae that include Rhizopus, Rhizomucor, Mucor and Lichtheimia (formerly Absdia). This infection classically affects immunocompromised patients. The most common site of this infection in immunocompromised patients related to the pattern of the associated disease. In patients with ...
Open Access DOI:10.23937/2378-3656/1410206
Felicitas Stoll, Britta Vogel, Boris Radeleff, Hugo A Katus and Oliver J Müller
Article Type: Case Report | First Published: March 16, 2018
We present a case report on the Achenbach's syndrome, a condition characterized by a painful hematoma and swelling of the palmar side of the hand and/or fingers with a sudden onset. Symptoms are typically triggered by everyday activities like carrying a bag or pressing down a door handle. Achenbach's syndrome being rather unknown, its impressive clinical presentation might unsettle both patients and physicians and entail elaborate diagnostic measures despite its in fact benign and self-limiting ...
Open Access DOI:10.23937/2378-3656/1410205
Lior Zusmanovich, Lior Charach and Gideon Charach
Article Type: Case Report | First Published: March 09, 2018
Impetigo is a highly contagious infection of the epidermis, seen especially among children, and transmitted through direct contact. Two bacteria are associated with impetigo: S. aureus and GAS. Over 140 million people are suffering from impetigo at each time point, over 100 million are children. Two forms of impetigo exist, namely impetigo contagiosa, known as the non-bullous form and the second one being bullous impetigo which presents with large and fragile bullae. Treatment options for impeti...
Open Access DOI:10.23937/2378-3656/1410204
Tomislav Krcmar, Kristijan Dula, Branimir Culo, Ivan Zeljkovic, Nikola Bulj and Vito Mustapic
Article Type: Case Report | First Published: February 28, 2018
Aberrant right subclavian artery (ARSA) or arteria lusoria is one of the most common congenital aortic arch anomaly with prevalence ranging from 1-2%. However, it is mostly asymptomatic and consequently often found sporadically during various diagnostic procedures with prevalence of 0.45% during coronary angiography....
Open Access DOI:10.23937/2378-3656/1410203
Tania Jain, Siddharth Gupta, Natasha Robinette, Dongping Shi and Ulka N Vaishampayan
Article Type: Case Report | First Published: February 21, 2018
Isolated central nervous system and dural metastasis from urothelial cancer are exceedingly rare. We describe 2 unique cases of intracranial lesions in patients with urothelial carcinoma-one with isolated brain and dural brain metastasis, and another with Nocardia brain abscess....
Open Access DOI:10.23937/2378-3656/1410202
Pradeep Kumar Mada, Gabriel Castano and Andrew Stevenson Joel Chandranesan
Article Type: Case Report | First Published: February 14, 2018
Mycobacterium tuberculosis is one of the most common diseases in the world, with a prevalence of approximately one-third of the global population and nine million new cases per year globally. In the USA, it is more common in immune suppressed conditions such as HIV or if there is a significant history of travel to tuberculosis-endemic regions. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Mycobacterial cervical lymphadenitis, also known as scrofula refers...
Open Access DOI:10.23937/2378-3656/1410201
Adsorption Isotherms and Kinetics of Multi-Walled Carbon Nanotubes (MWCNTs), Boron Nitride Nanotubes (BNNTs), Amorphous Boron Nitride Nanotubes (a-BNNTs) and Hexagonal Boron Nitride Nanotubes (h-BNNTs) for Eliminating Carcinoma, Sarcoma, Lymphoma, Leukemia, Germ Cell Tumor and Blastoma Cancer Cells and Tissues
Article Type: Research Article | First Published: January 31, 2018
Hydron, Transhumanism, H (S-train), Humanity+ (Humanity Plus), electron hole and Evolved High Speed Packet Access (or HSPA+ or HSPA (Plus) or HSPAP) from environment into human blood causes human blood cancer cells and tissues. Diagnosis and treatment of such human blood cancer before it is discharged into the human blood is essential. The present study investigated Hydron, Transhumanism, H (S-train), Humanity+ (Humanity Plus), electron hole and Evolved High Speed Packet Access (or HSPA+ or HSPA...
Open Access DOI:10.23937/2378-3656/1410200
Jason I Liounakos, Timur Urakov, Brian Snelling and Eric C Peterson
Article Type: Case Report | First Published: January 24, 2018
Scalp arteriovenous fistulae, as a result of hair transplantation, are exceedingly rare, with the current literature largely limited to few single case reports. Open surgical and endovascular treatments have been described with good results. We describe a case of scalp arteriovenous fistula following hair transplantation that was successfully treated by direct puncture embolization with n-butyl cyanoacrylate glue....
Open Access DOI:10.23937/2378-3656/1410199
Veronika A Levin, John Villeneuve and Xuezhi Jiang
Article Type: Case Report | First Published: January 17, 2018
Disseminated intravascular coagulation (DIC) is a disruption of hemostasis and imbalance between thrombosis and thrombolysis. DIC can result in life-threatening bleeding, clot formation, and multi-system end organ damage. Although the prevalence of DIC in pregnancy is low, ranging from 0.03-0.35%, the prevalence increases in pregnancies complicated by comorbidities such as placental abruption, postpartum hemorrhage, pre-eclampsia, hemolysis elevated liver enzymes and low platelets (HELLP syndrom...
Open Access DOI:10.23937/2378-3656/1410198
Lillian L Smith Mosley, Juan F Mosley II, Jessica R Fleischfresser and Tiffani Reed
Article Type: Review Article | First Published: December 30, 2017
Neuroleptic medications are prescribed for the management of mental, gastrointestinal, and neurological disorders. These disorders occur via over-excitation of dopamine in the brain. When neuroleptics are used, dopamine receptors are blocked reducing the excitation. Thus, the disorder becomes controlled. The long-term use of neuroleptics can result in a misfire of the neurons of the brain causing tardive dyskinesia (TD), an irreversible chronic condition of spontaneous movements....
Open Access DOI:10.23937/2378-3656/1410197
Maria Cui Ying Pang and Tan Kun Kiaang
Article Type: Case Report | First Published: December 23, 2017
Cervical and parapharyngeal teratomas are rare but possible causes for respiratory distress in neonates. They can also present as cystic masses in the neck and can be clinically indistinguishable from lymphatic malformations. Physicians must be cognizant of teratoma as an alternate diagnosis when faced with a cystic neck lesion that responds poorly to injection sclerotherapy. We present a case of a parapharyngeal teratoma which was initially diagnosed and treated as a lymphatic malformation....
Open Access DOI:10.23937/2378-3656/1410196
I Alharbi, A Algethami and T Almteri
Article Type: Case Report | First Published: December 22, 2017
Fibrinogen (Factor I) is an essential factor in the coagulation cascade. The activation of prothrombin to thrombin by Factor X is followed by the activation of fibrinogen. In turn, thrombin converts fibrinogen to fibrin, which is the end target of both extrinsic and intrinsic pathways. A deficiency in fibrinogen results in the tendency to bleed....
Open Access DOI:10.23937/2378-3656/1410195
Dilek Altun, Adnan Yüksek, Ahmet Arnaz, Yusuf Kenan Yalçınbaş and Tayyar Sarıoğlu
Article Type: Case Report | First Published: November 17, 2017
Prilocaine, widely used local anesthetic, can cause methemoglobinemia in pediatric patients even in therapeutic doses. Although complications related to local anesthesia are rare, it may occur especially in pediatric population when used in large doses exceeding the safe limits. Local anesthetic agent oxidizes hemoglobin and may cause methemoglobinemia....
Open Access DOI:10.23937/2378-3656/1410194
Irie bi GS, Asse KV, Pete Y, Kadiane NJ, Nda-koffi C, Ogondon B, Kouadio S, Kouame KE, Boua N and Yapo Brouh
Article Type: Case Report | First Published: November 16, 2017
The possibility of the occurrence of tetanus after application of a traditional topical for the treatment of a severe burn is a reality in tropical environment. This is true for this case....
Open Access DOI:10.23937/2378-3656/1410193
Daniel G Eichberg, Timur Urakov and Steven Vanni
Article Type: Case Report | First Published: November 16, 2017
To provide an overview of head, neck, and spine Desmoid Tumor (DT), to describe the case of a patient who underwent aggressive surgical resection of a large invasive cervical DT, and to analyze the DT literature. We discuss the importance of aggressive surgical margins in decreasing recurrence risk in head, neck, and spine DTs....
Open Access DOI:10.23937/2378-3656/1410192
Jo Y, Zalikha A, Watford D, Khramov I and Williams M
Article Type: Case Report | First Published: October 30, 2017
A 65-year-old homeless African American man with a past medical history significant for hypertension, Chronic Obstructive Pulmonary Disease (COPD), diabetes mellitus type II, multiple substance abuse disorder, major depression, and successful treatment of tuberculosis presented to the Miami VA emergency department with depressed mood, fatigue, and suicidal ideation....
Open Access DOI:10.23937/2378-3656/1410191
Carvalho LB, Rampim DB and Chung TM
Article Type: Case Report | First Published: October 28, 2017
Geniospasm is a rare movement disorder characterized by spontaneous, involuntary, irregular trembling of the chin and the lower lip with accompanying involuntary contractions of the mentalis muscle. It is thought to be an autosomal-dominant inherited condition with high penetrance, which typically manifests in early life and is triggered....
Open Access DOI:10.23937/2378-3656/1410190
Pauline dos Santos, Loic Cailleau, Yveline Coscoy, Antoine Strzelecki, Benjamin Le Gaillard, Christophe Pelletier, Mireille Houadec, Celine Guerrini and Edmundo Pereira de Souza Neto
Article Type: Case Report | First Published: October 27, 2017
Brugada syndrome is a distinct form of an arrhythmic disease affecting ionic channels of the heart. We report the anesthetic management of a patient with Brugada syndrome for inguinal hernia repair which was managed satisfactorily with combined light anesthesia, hypnosis with indirect suggestions and transversus abdominis plane block....
Open Access DOI:10.23937/2378-3656/1410189
Maria Eugenia Velasco-Contreras
Article Type: Commentary | First Published: October 25, 2017
It is a chronic disease associated with multiple health problems: Cardio-cerebrovascular, cancer, behavioral disorders, depression or anxiety, localized or generalized neuropathy problems due to irritation or destruction of the myelin layer, non-traumatic lower limb amputation, blindness, terminal renal damage, the leading cause of death in many countries....
Open Access DOI:10.23937/2378-3656/1410188
Nathan Catolino, Michel de Oliveira, Igor Age Kos, Maicon Piana Lopes and Valderilio Azevendo
Article Type: Case Report | First Published: October 05, 2017
T-Cell Large Granular Lymphocyte Leukemia (T-LGL Leukemia) is a lymphoproliferative disease that usually presents with an indolent behavior, even though in some cases it is complicated by cytopenias and recurrent infections. Felty Syndrome (FS) is a subtype of Rheumatoid Arthritis (RA) characterized by the association of RA, neutropenia and splenomegaly....
Open Access DOI:10.23937/2378-3656/1410187
Lauren Williams, Catherine McNeal and Don P Wilson
Article Type: Case Report | First Published: September 29, 2017
Fat Soluble Vitamins (FSV) is essential for the normal growth and development of children. Many genetic and acquired conditions have the potential of interfering with FSV absorption and transport. Understanding the physiology of these conditions is imperative in providing effective treatment, including prevention of FSV deficiency....
Open Access DOI:10.23937/2378-3656/1410186
Article Type: Case Report | First Published: September 23, 2017
Claudication is a common manifestation of Peripheral Arterial Disease (PAD) and atherosclerosis. Patients with claudication are at increased risk of cardiovascular events and limb-related complications. Optimal medical therapy is effective in relieving patient's symptoms and reducing their risk of cardiovascular events....
Open Access DOI:10.23937/2378-3656/1410185
Fatih Üzer, Levent Dertsiz and Aykut Çilli
Article Type: Case Report | First Published: September 11, 2017
Primary tumors of trachea are usually malignant (90%). Hamartomas are the most frequently seen benign lung tumors. Hamartomas are usually located peripherally but they can be present as endobronchial localization in 8-10% of cases....
Open Access DOI:10.23937/2378-3656/1410184
Vacchi C, Sebastiani M, Manfredi A and Ferri C
Article Type: CASE REPORT | First Published: September 04, 2017
Polymyositis (PM) is a systemic inflammatory disease affecting muscles and several other organs, including gastrointestinal system, in which the main symptom is dysphagia....
Open Access DOI:10.23937/2378-3656/1410183
Salvatore Marchese, Yassar Ahmed Qureshi and Ashish Rohatgi
Article Type: Case Report | First Published: August 31, 2017
A 73-year-old woman underwent total gastrectomy for cancer. Postoperative course was uneventful until day five when she felt unwell, showing distended and tender abdomen. Developed acute kidney injury and metabolic acidosis with a lactate level of 13.5 mmol/L....
Open Access DOI:10.23937/2378-3656/1410182
Peter Aldiss, Patricia Burton, Shalini Ojha, Helen Budge and Michael E Symonds
Article Type: Research Article | First Published: August 26, 2017
At birth Perirenal Adipose Tissue (PrAT) exhibits a brown-like phenotype and then becomes phenotypically white with ageing and obesity, potentially contributing to the onset of chronic disease. Little is known about the composition of PrAT in the later years of life and whether it is modulated by different types of disease....
Open Access DOI:10.23937/2378-3656/1410181
Salvatore Marchese, Rosario Vecchio and Eva Intagliata
Article Type: Clinical Image | First Published: August 26, 2017
A 44-year-old female presented at the accident and emergency service for having swallowed a dental bridge few hours before during dinner. At the time of the visit, she was completely asymptomatic and no abdominal discomfort was reported. She had no background of mental disorder or misuse of alcohol or other drugs....
Open Access DOI:10.23937/2378-3656/1410180
Emese Ivany, Mark Philip Marcus and Tamas Molnar
Article Type: Case Report | First Published: August 23, 2017
We present a case of a 68-year-old man who underwent control colonoscopy 10 years after sigmoid resection due to a previous adenocarcinoma. An ascending colon polypectomy was performed by endoscopic mucosa resection and a sessile polyp was resected from the sigmoid colon....
Open Access DOI:10.23937/2378-3656/1410179
RR Smeets, A Ryckx, AG Krasznai, CJJM Sikkink and LH Bouwman
Article Type: Case Report | First Published: August 21, 2017
Blunt traumatic injury to the subclavian, axillary or brachial artery is uncommon and could have devastating consequences. Historically open repair is performed however reports of successful endovascular treatments are increasing. A case is described of a seventy one-year-old patient with a blunt injury to his right arm after being crushed in a closing hydraulic door of a truck....
Open Access DOI:10.23937/2378-3656/1410178
Fatih Uzer, Levent Dertsiz and Aykut Cilli
Article Type: Case Report | First Published: July 29, 2017
Primary endobronchial tumor is seen rarely in young adults. Benign neoplasms such as hamartoma, hemangioma, papilloma, leiomyoma are seen more often whereas maling conditions are infrequent. Lymphoma is quite rare in children. ...
Open Access DOI:10.23937/2378-3656/1410177
Ana Ramirez Berlioz, Orlando Garner, Eliana Wiesner, Alfredo Iardino Scarano and Kalpana Bhairavarasu
Article Type: Case Report | First Published: July 27, 2017
A 41-year-old Hispanic female with known medical history significant for bronchial asthma presents to the Emergency Department (ED) in February 2010, complaining of a 3-week long history of an erythematous tender rash with irregular margins on the tip of her nose, upper and lower extremities (Figure 1) accompanied by bilateral elbow, knee and ankle pain. ...
Open Access DOI:10.23937/2378-3656/1410176
Hatim Mohammed A ALShareef, Hossam Mohammed Aref, Ahmed H AlHasan, Amer Mohammed A ALShreef and Mohammed Abdul Wahab Al Juhani1
Article Type: Review Article | First Published: July 24, 2017
Peritrochanteric fractures of the femur rank among the most severe fractures in elderly people. The Gamma Nail is one of the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures....
Open Access DOI:10.23937/2378-3656/1410175
J Kelly Smith
Article Type: Case Study | First Published: July 24, 2017
A 57-year-old hypertensive, obese woman presented with several weeks of a febrile flu-like illness, facial and extremity flushing, and laboratory findings of polycythemia. A workup revealed no evidence of polycythemia rubra vera or a secondary cause of her polycythemia (her erythropoietin level was normal, she had no splenomegaly, and a test for JAK2 v617F mutation was negative)....
Open Access DOI:10.23937/2378-3656/1410174
Andy Y Wen Jason Ziplow, Benjamin Wadowski and Tanya Chadha
Article Type: Case Study | First Published: June 30, 2017
Anti-N-Methyl-D-Aspartate Receptor Encephalitis (NMDARE) is a complex clinical entity that is both diagnostically and therapeutically challenging. A 17-year-old girl presented to the emergency room with worsening anxiety, confusion, and acute psychosis. While in an inpatient psychiatric unit, she developed progressive catatonia with decreased responsiveness. ...
Open Access DOI:10.23937/2378-3656/1410173
Fernanda Mafei Felix da Silva, Andrea Laudares Marques, Thais Rodrigues Campos Soares, Carla Martins and Gloria Fernanda Castro
Article Type: Case Study | First Published: June 30, 2017
Radicular cysts are considered rare in primary dentition. The aim of this article was to present two cases of radicular cysts associated to primary molars with different characteristics. Two children sought care at a dental clinic with complaints of a painless swelling and the absence of a premolar, respectively....
Open Access DOI:10.23937/2378-3656/1410172
Cassone G, Citriniti G, Sebastiani M, Manfredi A, Cesinaro AM and Ferri C
Article Type: Case Report | First Published: June 30, 2017
Tumor Necrosis Factor (TNF)-α blockers have been shown to be highly effective in the treatment of arthritis not responsive to traditional therapy. In parallel, there are an increasing number of reports about the development of cutaneous side effects after the administration of anti-TNF-α agents....
Open Access DOI:10.23937/2378-3656/1410171
Viviane de Carvalho, Jessica Ferreira Saldanha, Jozyel Castro Claudio and Guilherme Augusto Pivoto Joao
Article Type: Case Report | First Published: June 27, 2017
Reactive arthritis is the specific entity of aseptic inflammatory arthritis and follows the previous infection in other parts of the body. The association of soft tissue infections with this disease is rare. A 63-year-old male patient after blunt trauma to the left knee progressively evolved with inflammatory signals and loss of joint function, followed by additive polyarthritis of large joints....
Open Access DOI:10.23937/2378-3656/1410170
Delefortrie Quentin, Lambert Frederic, Bulliard Genevieve, Jurdan Maryvonne, Toffoli Sebastien, Sartenaer Daniel, Theate Ivan, de Prophetis Stephanie, Pranger Delphine, Konreich Anne and Mineur Philippe
Article Type: Case Report and Mini Review | First Published: May 31, 2017
The upper limit of normal range of eosinophils in the peripheral blood is an absolute eosinophil count of 350-500/mm3. Hypereosinophilia can further be classified as mild, moderate or severe according to absolute eosinophils counts (up to 1500/mm3, 1500-5000/mm3 and superior to 5000/mm3 respectively)....
Open Access DOI:10.23937/2378-3656/1410169
Raoul Stahrenberg, Wolfgang Schillinger and Claudius Jacobshagen
Article Type: Case Report | First Published: May 31, 2017
The first patient, a 65-year-old male, presented to our emergency department with unstable angina without troponin elevation for the first time in January 2015. A calcified culprit lesion in the Right Coronary Artery (RCA) was managed by stenting....
Open Access DOI:10.23937/2378-3656/1410168
Ahmed Elantably and Vinit V Oommen
Article Type: Case Report | First Published: May 29, 2017
Mumps is a viral infection of the salivary glands that commonly present as unilateral or bilateral parotitis usually during childhood. Serious complications of mumps include meningitis/encephalitis, as well as orchitis in adolescent boys and adult men. We report a case of a 29-year-old male patient with mumps associated bilateral epididymo-orchitis without signs of parotitis....
Open Access DOI:10.23937/2378-3656/1410167
Eduardo Esteban-Zubero, Isabel Torres-Courchoud, Alvaro Flamarique-Pascual, Moises Alejandro Alatorre-Jimenez, Sara Anabel Alonso-Barragan and Fernando Jose Ruiz-Laglesia
Article Type: Case Report | First Published: May 29, 2017
Hypothalamus-Pituitary-Adrenal (HPA) may be disturbed by drugs, including opioids. In fact, opioids are a well-recognized cause of hypogonadotropic hypogonadism due to its effects in the hypothalamic-pituitary-gonads axis. Nevertheless, these results are not observed in all the studies and there are numerous contradictions in the literature....
Open Access DOI:10.23937/2378-3656/1410166
Sara M Drayer and Jessica J Shank
Article Type: Case Series | First Published: April 28, 2017
Two Filopina women presented with abdominal distension and had evaluations suggestive of advanced gynecologic malignancy. The first patient underwent surgery and was found to have peritoneal tuberculosis. Intra-operative pathology from the second case revealed ovarian carcinoma with schistosomal granulomas of the intestines....
Open Access DOI:10.23937/2378-3656/1410165
Saul Pampa-Saico, Maite Rivera-Gorrin, Estefania Yerovi-Leon, Victor Burguera, Milagros Fernandez-Lucas and Jose L Teruel-Briones
Article Type: Case Series | First Published: April 26, 2017
A 40-year-old Caucasian man with end-stage renal disease (ERSD) due unknown cause had been on continuous ambulatory peritoneal dialysis (CAPD) since 2009 with 3.5 meq/l calcium dialysate....
Open Access DOI:10.23937/2378-3656/1410164
Oceane Landon-Cardinal , Yves Allenbach and Olivier Benveniste
Article Type: Case Series | First Published: April 22, 2017
In 2004, a 57-years-old female received rosuvastatin for secondary prevention of stroke. In 2010, an asymptomatic CK elevation around 900 IU/L is noticed on a routine workup and persisted despite statin discontinuation. A rise in CK level is progressively observed (up to 2,400 IU/L) and the patient referred in Neurology for consultation in March 2011....
Open Access DOI:10.23937/2378-3656/1410163
Sudipta Sen, Michael E Franklin, Veerandra Babu Koyyalamudi, Elyse M Cornett and Charles J Fox
Article Type: Case Series | First Published: April 20, 2017
In this study we discuss five case scenarios where we felt bilateral brachial plexus blocks were appropriate and, if performed with caution, the benefits would outweigh the risks. Each of these patients suffered severe bilateral upper-extremity traumatic injuries, requiring multiple surgical procedures and debridement's while inpatient on the trauma service....
Open Access DOI:10.23937/2378-3656/1410162
Rollino Cristiana, Giulietta Beltrame, Roberta Fenoglio, Michela Ferro, Paola Mesiano, Giacomo Quattrocchio and Dario Roccatello
Article Type: Case Report | First Published: March 30, 2017
We present the case of a 52-year-old lady affected with cortico dependent minimal change disease who developed a blue pigmentation of her fingernails during a 3-months treatment with cyclophosphamide for cortico dependent minimal change disease. The typical manifestation of onset of Minimal Change Disease (MCD) is a pure nephrotic syndrome....
Open Access DOI:10.23937/2378-3656/1410161
Bradley J Scherer, Brian D Benneyworth, Mara E Nitu and Brian D Lelan
Article Type: Case Report | First Published: March 30, 2017
An 11-year-old female who was admitted to the pediatric intensive care unit (PICU) intubated and mechanically ventilated with severe traumatic brain injury and occipito-cervical dislocation following a high speed motor vehicle collision, underwent both posterior arthrodesis from occiput to C3 and open reduction of cranio-cervical dislocation on hospital day 7....
Open Access DOI:10.23937/2378-3656/1410160
Seher Cetinkaya Altuntas, Mehtap Evran, Murat Sert and Tamer Tetiker
Article Type: Case Report | First Published: March 29, 2017
Hypothyroidism is a frequently seen endocrine disorder which may be managed by levothyroxine (LT4) replacement in most of the patients. Some patients with hypothyroidism do not respond and are refractory to oral LT4 therapy. The most encountered causes of unresponsiveness to oral LT4 replacement comprise non-compliance with therapy and malabsorption....
Open Access DOI:10.23937/2378-3656/1410159
Hashim Qureshi, Hussain Mithaiwala, Jacob Ezell and Marco Maurtua
Article Type: Original Review | First Published: March 27, 2017
Worldwide, Traumatic Brain Injury (TBI) is a leading cause of morbidity and mortality. It is the third most common cause of injury related death with direct and indirect costs totaling an estimated 60 billion dollars annually in the United States. Management of a TBI patient is guided by recommendations made by the Brain Trauma Foundation (BTF)....
Open Access DOI:10.23937/2378-3656/1410158
Emilie S Baekgaard, Lars Christensen, Roar B Medici and Hans-Henrik Bulow
Article Type: Short Review | First Published: February 28, 2017
Mobility scooters are three- or four-wheeled vehicles, powered by an electric engine. Often acquired by the elderly population, they neither require a drivers' license, nor an assessment of operator skills prior to use. Other vehicles used primarily by older people are powered wheelchairs and electric bicycles. ...
Open Access DOI:10.23937/2378-3656/1410157
Brian J Horner, Ryan Craig, Estelle S Harris, Tibor Kovacsovics and Juan F Gallegos-Orozco
Article Type: Case Report | First Published: February 28, 2017
AL amyloidosis, the most common form of amyloidosis, involves the extracellular deposition of immunoglobulin light chain protein fibrils, usually in the setting of a plasma cell dyscrasia. Amyloid deposition can occur in any organ system, including the gastrointestinal tract and liver....
Open Access DOI:10.23937/2378-3656/1410156
Giorgio Berlot and Cristina Calderan
Article Type: Case Report | First Published: February 25, 2017
The authors describe a case of myiasis occurred in a self-intoxicated patient lying outdoor in a reduced state of consciousness for more than two days. The causes and the favoring circumstances of the infestation are described and discussed. The word Myiasis indicates the infestation of alive vertebrates, including humans, by larvae of different species of Diptera....
Open Access DOI:10.23937/2378-3656/1410155
Article Type: Case Report | First Published: February 14, 2017
Her past medical history included squamous cell carcinoma of lung origin T2BN0M0 treated in 2012 with a right lower lobectomy via video assisted thoracoscopy with a wound infection preventing adjuvant chemotherapy. She then developed local chest wall recurrence in 2014 which was resected. In June 2016, there was further recurrence on the chest wall, which was confirmed on PET scan. She had received one cycle of chemotherapy and presented as above....
Open Access DOI:10.23937/2378-3656/1410154
Juan F Martin-Lazaro, Justin Hayde-West, Stelios Chatzimichael and Simon Kirwin
Article Type: Case Report | First Published: January 31, 2017
Serotonin syndrome is a potentially life-threatening complication of using serotonergic agents. Mirtazapine is a relatively safe antidepressant and has a comparatively low incidence of side effects but can induce serotonin syndrome in combination with other serotonergic agents such as methadone and sertraline. We describe a 41-year-old man with a history of heroin misuse and depression....
Open Access DOI:10.23937/2378-3656/1410153
Carl C Bell and Rochelle Gaudet
Article Type: Case Report | First Published: January 31, 2017
his case report addresses the misdiagnosis of Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) in adults. The American Psychiatric Association's (APA's) Diagnostic and Statistical Manual - Fifth Edition (DSM-5) has proposed Fetal Alcohol Spectrum Disorders (FASD) be designated as ND-PAE. ND-PAE is prevalent in some contexts and populations, and is the cause of significant morbidity and mortality....
Open Access DOI:10.23937/2378-3656/1410152
Kim Lewis, Christopher Sheasgreen and Waleed Alhazzani
Article Type: Case Report | First Published: January 30, 2017
Alkaline material ingestions can cause a wide variety of injuries, ranging from mild to fatal. Cement is an alkaline agent and can lead to abrasions, allergic dermatitis, and chemical burns. There are very few case reports of cement ingestion in the literature. The gold standard for assessing the extent of injury after cement ingestionis via an esophagogastroduodenoscopy (EGD) within 12-24h....
Open Access DOI:10.23937/2378-3656/1410151
Rama Atluri and Mian Muhammad Rizwan
Article Type: Case Report | First Published: January 13, 2017
Cryoglobulinemia is a rare immune-complex-mediated small vessel vasculitis that has a smoldering clinical course and can potentially involve multiple organ systems. The discovery of its relationship with hepatitis C infection shows the striking association between a viral infection, an autoimmune disease and lymphoproliferative disorders....
Open Access DOI:10.23937/2378-3656/1410150
Ossama Maadarani, Zouheir Bitar and Rashed Alhamdan
Article Type: Case Report | First Published: December 26, 2016
The availability of novel classes of medication for the treatment of type 2 Diabetes mellitus (type 2 DM) provides doctors with options to choose individualized treatments based on patient and agent characteristics beyond metformin therapy, as per current guidelines. Independent of impaired beta-cell function and insulin resistance, sodium glucose cotransporter type 2 (SGLT2) inhibitors represent a different treatment strategy for reducing plasma glucose levels and glycosylated hemoglobin concen...
Open Access DOI:10.23937/2378-3656/1410149
Milovanov V, Wodago FM, Sittig M and Gushchin V
Article Type: Case Report | First Published: December 19, 2016
Several scientific publications have shown Isolated Limb Infusion (ILI) as a promising treatment option for patients with soft tissue sarcomas. This minimally invasive technique has a high complete response rate (42-90%) and could serve as a neo-adjuvant treatment for limb sparing sarcoma surgical treatment to increase the likelihood of R0 resection. ILI technique has low levels of systemic leak (< 1%) and systemic toxicity rate, which makes this treatment potentially relevant in pregnant patien...
Open Access DOI:10.23937/2378-3656/1410148
Mehmet Sedat Durmaz, Ali Cengiz, Serdar Arslan, Hasan Erdogan, Ismet Tolu and Arzu Cengiz
Article Type: Case Report | First Published: December 16, 2016
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 case of a 53-year-old woman who presented with polysplenia syndrome....
Open Access DOI:10.23937/2378-3656/1410147
Luca Fallavollita, Paolo Spinaci and Pietro Scendoni
Article Type: Case Report | First Published: December 14, 2016
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 most cases, PH in COPD patients is usually mild to moderate. Only a small proportion of this cohort may present with severe pulmonary hypertension....
Open Access DOI:10.23937/2378-3656/1410146
Fareeha Khan, Rasha Nakhleh and Theodore Suh
Article Type: Case Report | First Published: December 12, 2016
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....
Open Access DOI:10.23937/2378-3656/1410145
Daniel Benharroch and Yane-Bianca Benharroch
Article Type: Review Article | First Published: December 03, 2016
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 present in our lives. It is a tremendous nuisance to man through its bite. However, several arboviral infections are the main consequences of these confrontations, enco...
Open Access DOI:10.23937/2378-3656/1410144
Campanille Veronica, De Aguirre Ines, Crespo Jose, Gonzalez Macarena, Lopez Juan Ignacio, Lucero Carolina, Perez Garcia Jorgelina and Knorre Eduardo
Article Type: Case Report | First Published: December 01, 2016
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, RE is considered autoimmune epilepsy. Treatment is focused on antiepileptic drugs (AEDs), steroids, intravenous immuno...
Open Access DOI:10.23937/2378-3656/1410143
Ryan Kahn, Christopher Dermarkarian, Elizabeth Crocco, Gabrielle Yeaney and Marcia Williams
Article Type: Review Article | First Published: November 25, 2016
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 foamy macrophages, loss of myelin, and perivascular T cells. The diagnosis was acute disseminated encephalomyelitis secondary to n...
Open Access DOI:10.23937/2378-3656/1410142
S Umit Sarici, Murat Ozcan and Demet Altun
Article Type: Review Article | First Published: November 23, 2016
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, etiology, clinical signs and complications of polycythemia with a special emphasis on treatment algorithms and long-...
Open Access DOI:10.23937/2378-3656/1410141
Mennet A, De Blasi V, Simone G, Mormont M and Morel P
Article Type: Case Report | First Published: November 21, 2016
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 increased uptake in the left side of the neck at the level of the thyroid gland and the absence of lung or liver metastases....
Open Access DOI:10.23937/2378-3656/1410140
Michael Owusu, Augustina Annan, Nimako Sarpong, Ellis Owusu-Dabo, Yaw Adu-Sarkodie, Kwadwo Sarfo Marfo, Isaac Osei and Kofi Tawiah Mensah
Article Type: Case Report | First Published: November 16, 2016
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 associated with extended-spectrum beta-lactamase (ESBL) - producing Escherichia coli (E. coli) in Ghana....
Open Access DOI:10.23937/2378-3656/1410139
Boli Ran, Minfeng Li, Yeqing Li, Yang Lin, Weimin Liu, Qiulin Luo, Yongxin Fu, Qianmei Tang, Ya Yang and Yunfei Pu
Article Type: Case Report | First Published: November 12, 2016
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 vegetations were not detected by echocardiography....
Open Access DOI:10.23937/2378-3656/1410138
Yang Zhuo, Yu-qi Fan, Zhao-fang Yin, Li Fan, Zhi-hua Han, Chang-qian Wang and Zuo-jun Xu
Article Type: Case Series | First Published: November 09, 2016
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 of the side branches from the first septal artery proceeded as the right coronary artery (RCA). In case two, the distal septal artery and distal circumflex artery together served as the RCA...
Open Access DOI:10.23937/2378-3656/1410137
Rana Shibli and Shmuel Rishpon
Article Type: Case Report | First Published: November 05, 2016
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....
Open Access DOI:10.23937/2378-3656/1410136
Janice Piatt, Jeff Foti, Kimberley Bickes, Deborah Frusciano and Laura Clarke-Steffen
Article Type: Research Article | First Published: October 31, 2016
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 from other HAART regimens and to compare the lipid levels after the switch....
Open Access DOI:10.23937/2378-3656/1410135
Giuseppe Grande, Helga Bertani, Angelo Caruso and Rita Conigliaro
Article Type: Case Report | First Published: October 12, 2016
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, Neutrophil 77%), rise of C-reactive protein (7.3 mg/dL, normal value < 0.5 mg/L), normal kidney function (creatinine 1.0 mg/dL). Clinical examination was remarkable for mild epi...
Open Access DOI:10.23937/2378-3656/1410134
Songul Usalp, Ali Rıza Karaci, Kevser Gulcihan Balci, Volkan Yazicioglu, Murat Baskurt and Nurcan Arat Koc
Article Type: Case Report | First Published: October 06, 2016
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 superior vena cava (SVC) connects to the LA....
Open Access DOI:10.23937/2378-3656/1410133
Gulsum Alkan, Melike Keser Emiroglu and Huseyin Tokgoz
Article Type: Case Report | First Published: October 04, 2016
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 in EM....
Open Access DOI:10.23937/2378-3656/1410132
Mahboobeh Balali Bahadorani and Abbas Zare Mirakabadi
Article Type: Original Article | First Published: September 26, 2016
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 epithelia or from a renal ischemia due to systemic hemodynamic disturbances. This work investigated the in vitro effect of Echis Carinatus crude venom, using cultured Human embry...
Open Access DOI:10.23937/2378-3656/1410131
Fletes-Vargas Gabriela, Leon-Mancilla Benjamin and Esquivel-Solis Hugo
Article Type: Review Article | First Published: September 16, 2016
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 like diabetic, vascular and pressure ulcers. Wound healing is a complex process of several stages that requires being free of complications....
Open Access DOI:10.23937/2378-3656/1410130
Cinzia Casu, Francesco Benazzo, Eleonora Bruschi, Franco Combi and Oscar Massimiliano Epis
Article Type: Case Report | First Published: September 14, 2016
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 suffered from pain and swelling in his joints after a mild sprain. He first underwent arthroscopy, followed by intra-articular steroid injections at a later stage....
Open Access DOI:10.23937/2378-3656/1410129
A Dibi, M ElFahime, N Mouane, R Dafiri and A Bentahila
Article Type: Case Series | First Published: September 10, 2016
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....
Open Access DOI:10.23937/2378-3656/1410128
Ghufran A, Agni R, Winslow E, Dalvie P and Agarwal PD
Article Type: Case Report | First Published: September 08, 2016
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....
Open Access DOI:10.23937/2378-3656/1410127
Victoria Achaval Rodriguez, Patricia Moreira, Maria Camara, Pilar Rondon, Maria Garrido, Ricardo Hitt and Maria Jose Echarri
Article Type: Case Report | First Published: September 05, 2016
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 of tumors and ascitic fluid....
Open Access DOI:10.23937/2378-3656/1410126
Nina Yancheva, Nina Tsvetkova, Maria Nikolova, Ivo Alexiev and Tatyana Tchervenyakova
Article Type: Case Report | First Published: August 22, 2016
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 34-year-old HIV-infected male patient with refractory giardiasis. He had two relapses of giardiasis with nausea, loss of appetite, diarrhea, bloating, foul belchi...
Open Access DOI:10.23937/2378-3656/1410125
Kenneth Blum, Debra Whitney, Lye Fried, Marcelo Febo, Roger L Waite, Eric R Braverman, Kristina Dushaj, Mona Li, John Giordano, Zsolt Demetrovics and Rajendra D Badgaiyan
Article Type: Case Series | First Published: August 16, 2016
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 first used a dose of KB220Z of 2 oz twice daily before meals along with clonidine and benzodiazepines and other anti-nausea and s...
Open Access DOI:10.23937/2378-3656/1410124
Aleksandra Danieluk, Aleksandra Filimoniuk, Joanna Mandziuk, Anna Marczuk, Marek Z Wojtukiewicz and Ewa Sierko
Article Type: Case Report | First Published: August 10, 2016
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 mucoepidermoid carcinoma (T3N0M0). She was primarily treated with radical surgery. Histopathological report identi...
Open Access DOI:10.23937/2378-3656/1410123
Husain Alturkistani, Youri Kaitoukov, Patrick Gilbert and Vincent Oliva
Article Type: Case Report | First Published: August 08, 2016
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 a complication of renal artery stenosis in a patient with a single kidney secondary to an under-deployed renal artery stent that was retrieved....
Open Access DOI:10.23937/2378-3656/1410122
Leeya F Pinder, Kennedy O Ouma and Brett D Nelson
Article Type: Case Report | First Published: August 06, 2016
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 poses many challenges....
Open Access DOI:10.23937/2378-3656/1410121
Elzbieta Sierko, Aleksander Nobis, Dominika Hempel, Marek Z Wojtukiewicz and Ewa Sierko
Article Type: Case Report | First Published: August 03, 2016
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 other therapeutic options for melanoma patients were discussed....
Open Access DOI:10.23937/2378-3656/1410120
Kevser G Balci, Mustafa M Balci, Samet Yilmaz and Ramazan Akdemir
Article Type: Case Report | First Published: August 01, 2016
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 administration VT persisted....
Open Access DOI:10.23937/2378-3656/1410119
Joana Oliveira, Andreia Abrantes, Raque Gouveia and Graca Oliveira
Article Type: Case Report | First Published: July 14, 2016
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 resuscitation was needed. Bilateral clavicle fracture was later confirmed by radiographic studies and associated birth injuries like brachial plexus paralysis...
Open Access DOI:10.23937/2378-3656/1410118
Article Type: Case Report | First Published: July 11, 2016
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% risk of major hemorrhage), but is avoided in the elderly and those with a low body mass index....
Open Access DOI:10.23937/2378-3656/1410117
Sarah Rosset-Zufferey, Karim Gariani and Carlo Chizzolini
Article Type: Case Report | First Published: July 08, 2016
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 successfully treated with a combination of tocilizumab, cyclosporine and corticostero...
Open Access DOI:10.23937/2378-3656/1410116
Maki Komiyama, Sayaka Shimada, Yuko Takahashi and Koji Hasegawa
Article Type: Case Report | First Published: July 06, 2016
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....
Open Access DOI:10.23937/2378-3656/1410115
Friederike Sophie Weber, Antje Heilmann, Gabriele Hahn, Mario Rudiger and Jurgen Dinger
Article Type: Case Report | First Published: July 04, 2016
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 system....
Open Access DOI:10.23937/2378-3656/1410114
Freddy A. Rodriguez-Hernandez, Giselle Blanco-Lamont, Cinthia Patricia Vargas-Chavez, Maria Valeria Jimenez-Baez, Cristian Alejandro Aguirre-Alva, Luis Sandoval-Jurado and Luis A. Medina-Andrade
Article Type: Case Report | First Published: June 30, 2016
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....
Open Access DOI:10.23937/2378-3656/1410113
Huseyin Bozbas, Tugba Kayhan Altuner, Ezgi Polat Ocakli, Mehmet Sanser Ates, Murat Kurtoglu and Mehmet Emin Korkmaz
Article Type: Case Report | First Published: June 27, 2016
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 not well-defined. Treatment options include a conservative approach, percutaneous intervention, and bypass grafting surgery. We present an old woman with t...
Open Access DOI:10.23937/2378-3656/1410112
Andrea Reim, David Strobl, Gerda Saletu-Zyhlarz, Matthias Preusser, Maria Theresia Schmook, Karin Dieckmann, Christoph C Zielinski and Christine Marosi
Article Type: Case Report | First Published: June 25, 2016
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 occurs at least three times a week, results in distress and impairs day time functioning. In cancer patients, especially in patients complaining about fatigue, ...
Open Access DOI:10.23937/2378-3656/1410111
Maroun Matar, Elie Chammas and Samer Nasr
Article Type: Case Report | First Published: June 24, 2016
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 person, rushed and connected her to a monitor that showed a polymorphic ventricular tachycardia followed by ventricular fibrillation....
Open Access DOI:10.23937/2378-3656/1410110
Neha Gupta, Tony A Abdel Maseeh, Leyden Standish-Parkin and Yekaterina Sitnitskaya
Article Type: Case Report | First Published: June 10, 2016
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 report a case of a teenage girl who presented with right lower quadrant abdominal pain without any associated vomiting, fever, and diarrhea. Laboratory work up was non-contr...
Open Access DOI:10.23937/2378-3656/1410109
Ihsan Yildiz, Yavuz Savas Koca and Ibrahim Barut
Article Type: Case Report | First Published: June 03, 2016
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 lesion extending from the right lobe of liver to right upper quadrant, and percutaneous cholangiography showed that a radio-opaque density communicat...
Open Access DOI:10.23937/2378-3656/1410108
Sebastian Greiner and Hugo A Katus
Article Type: Case Report | First Published: May 31, 2016
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....
Open Access DOI:10.23937/2378-3656/1410107
Alejandra C Fuentes, Reordan O De Jesus and David N Reisman
Article Type: Case Report | First Published: May 30, 2016
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. The role of systemic chemotherapy for brain metastases remains undefined, with advances in drug delivery and ongoing studies using targeted age...
Open Access DOI:10.23937/2378-3656/1410106
Maher N Ghabriel
Article Type: Case Report | First Published: May 16, 2016
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 hepatic ducts drained into the posterior wall of the gallbladder by a short common hepatic duct. Intraoperatively the gallbladder wall (with uncompromised n...
Open Access DOI:10.23937/2378-3656/1410105
Wilson I B Onuigbo
Article Type: Review Article | First Published: May 12, 2016
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, this paper aims to determine the situation in the classical Transactions of the Pathological Society of London, which began to publish during the 1846 - 1848 period....
Open Access DOI:10.23937/2378-3656/1410104
Neurobiology of KB220Z-Glutaminergic-Dopaminergic Optimization Complex [GDOC] as a Liquid Nano: Clinical Activation of Brain in a Highly Functional Clinician Improving Focus, Motivation and Overall Sensory Input Following Chronic Intake
Lucien L Duquette, Frank Mattiace, Kenneth Blum, Roger L Waite, Teresa Boland,Thomas McLaughlin1, Kristina Dushaj, Marcelo Febo and Rajendra D Badgaiyan
Article Type: Case Report | First Published: May 11, 2016
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 disclose self-assessment of a highly functional professional under work-related stress following KB220Z use, a liquid (aqua) ...
Open Access DOI:10.23937/2378-3656/1410103
Marco Rossato, Marta Burei and Roberto Vettor
Article Type: Case Report | First Published: April 30, 2016
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 peritoneal cavity and is a common finding with a wide range of causes. Although at least 80% of patients with ascites are found to have liver cirrhosis other pathologies as well as heart failu...
Open Access DOI:10.23937/2378-3656/1410102
Muna M Baslaim, Forough Farrokhyar, Shefaa A Al-Amoudi, Arwa A Ashoor and Oussamah M Saidam
Article Type: Original Article | First Published: April 20, 2016
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 for significance. Breast feeding data were available for 1970 parous women of which 1856 (94.3%; 95% CI: 93.1%-95.2%) breast fed their babies....
Open Access DOI:10.23937/2378-3656/1410101
Mitchell Hoffman, Odette Daly and John Bomalaski
Article Type: Case Report | First Published: April 18, 2016
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 moderate and severe cases have been described....
Open Access DOI:10.23937/2378-3656/1410100
Lindsay S. Leech, Nicole G. Tasker and Julie L. Welch
Article Type: Case Report | First Published: April 13, 2016
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 for three years, however had two subsequent admissions for recurrent seizures from non-adherence. This case demonstrates a rare but treated ca...
Open Access DOI:10.23937/2378-3656/1410099
Somaya AM Albhaisi and Neama Luqman
Article Type: Case Report | First Published: March 31, 2016
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 due to retrograde extension from a hilar tumor or from an ipsilateral lung or breast carcinoma. In the latter settings, the ...
Open Access DOI:10.23937/2378-3656/1410098
Batsev AF, Dobrokhotova VZ and Cham BE
Article Type: Case Report | First Published: March 28, 2016
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. Previous studies show that solasodine rhamnosides in a topical cream formulation CuradermBEC5 is a highly regarded therapy for nonmelanoma skin cancers....
Open Access DOI:10.23937/2378-3656/1410097
Article Type: Short Note | First Published: March 23, 2016
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 children born preterm....
Open Access DOI:10.23937/2378-3656/1410096
Maria do Socorro Teixeira Moreira Almeida, Amanda Gualberto Carvalho, Lina Gomes dos Santos, Eliton Carlos Batista de Sousa and Gabriela Lustosa Said
Article Type: Case Report | First Published: March 14, 2016
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 evident on histophatological analysis. A brief review of spontaneous splenic rupture in systemic lupus erythematosus (SLE) is also presented....
Open Access DOI:10.23937/2378-3656/1410095
Reili Rebane, Mari Tamsalu and Artur Klett
Article Type: Case Report | First Published: March 14, 2016
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 month after the trauma he suffered from infection of the conjunctival sac and periorbital skin despite initial intravenous and oral antibiotics. Because of inability to wear a cover shell ey...
Open Access DOI:10.23937/2378-3656/1410094
Maisel Lotan Adi, Retchkiman Meir and Gronovich Yoav
Article Type: Case Report | First Published: March 09, 2016
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 the face, hands or feet. When lipomatosis is symmetrical it is often termed Multiple Symmetrical Lipomatosis (MSL), also known as Madelung disease, a rare syndrome of unknown etiology....
Open Access DOI:10.23937/2378-3656/1410092
Nathalie Dedieu, Dirk Lossnitzer, Marcus R Makowski, Miguel Silva Nodgueira Vieira, Tarique Hussain, James Wong, Reza Razavi, Rene M Botnar and Gerald F Greil
Article Type: Original Research | First Published: February 29, 2016
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)....
Open Access DOI:10.23937/2378-3656/1410093
Kyuzi Kamoi and Hideo Sasaki
Article Type: Case Report | First Published: February 29, 2016
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) in June 2008 (at 65 years old)....
Open Access DOI:10.23937/2378-3656/1410091
Marta Pereira, Luis Afonso, Goncalo Fernandes and Rui Araujo
Article Type: Case Report | First Published: February 20, 2016
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....
Open Access DOI:10.23937/2378-3656/1410090
John D. Hill, Eric Wombwell, Jelyn Miller and Gina M. Rochetti
Article Type: Case Report | First Published: February 20, 2016
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 toxoid booster, agents to control muscle spasms (benzodiazepines), and antibiotics (metronidazole)....
Open Access DOI:10.23937/2378-3656/1410089
Marta Pereira, Luis Miguel Afonso, Sofia Patrao and Rui Araujo
Article Type: Case Report | First Published: February 13, 2016
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 injury with anuria and significant leukocytosis were documented. Furthermore, the patient had severe lactic acidosis....
Open Access DOI:10.23937/2378-3656/1410088
Tetsuhito Muranaka, Yoshito Komatsu, Kentaro Sawada, Hiroshi Nakatsumi, Yasuyuki Kawamoto, Satoshi Yuki, Riichiro Abe, Kanako C Hatanaka and Naoya Sakamoto
Article Type: Case Report | First Published: February 09, 2016
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 with regorafenib, such events should be taken into consideration, as with various other anti-cancer therapies, including bevacizumab....
Open Access DOI:10.23937/2378-3656/1410087
R.M. Kappel, L.L. Boer and H. Dijkman
Article Type: Research Article | First Published: January 29, 2016
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, as the existence of associated complaints is still largely denied and neglected by the various medical disciplines, they are not recorded in medical histories of the involved wom...
Open Access DOI:10.23937/2378-3656/1410086
Anne Jacobs, Sonja C. Stalpers-Konijnenburg, Cornelis A. de Jong and Radboud M. Marijnissen
Article Type: Case Report | First Published: January 26, 2016
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 did not report any somatic comorbidities....
Open Access DOI:10.23937/2378-3656/1410085
Yolanda Carrascal, Gregorio Laguna and Nuria Arce
Article Type: Case Report | First Published: January 23, 2016
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 sub-clinical fungal endocarditis, which might have contributed to early failure....
Open Access DOI:10.23937/2378-3656/1410084
Jeffrey Krauss, Ryan Nugent, Marko Bodor and Michael Fredericson
Article Type: Original Research Article | First Published: January 23, 2016
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 other in a community medical center. Injections were performed by a single practitioner. Patients: 14 adult pati...
Open Access DOI:10.23937/2378-3656/1410083
Mahdi Hadidi, Mohammad-Reza Hadian, Ali Arab Kheradmand, Mahmood Farzan, Hamidreza Monsef, Maryam-Raheleh Dadras, Saeed Talebian and Gholam Reza Olyaei
Article Type: Case Report | First Published: January 12, 2016
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....
Open Access DOI:10.23937/2378-3656/1410082
Hiromu Masuoka, Susumu Saito, Yoko Nakamura and Shigehiko Suzuki
Article Type: Short Communication | First Published: January 09, 2016
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 the foot, no significant contracture disabling the toe or ankle occurred during the maximum follow-up period of 9 years. Non-surgical treatments could be an alternative treatment fo...
Open Access DOI:10.23937/2378-3656/1410081
Saeid Komasi and Mozhgan Saeidi
Article Type: Research Article | First Published: December 31, 2015
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 this cross-sectional study was obtained from the database of the CR department at Imam Ali hospital in the city of Kermanshah in Iran....
Open Access DOI:10.23937/2378-3656/1410080
Ibrahim Halil Bozkurt, Salih Polat, Ismail Gulden, Serkan Yarimoglu, Ozgu Aydogdu, Tarik Yonguc and Volkan Sen
Article Type: Case Report | First Published: December 22, 2015
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 tomography (CT) revealed massive pleural effusion on the left hemithorax and a stone located at the proximal segment of left ureter. A chest tube and a ureteral DJ stent ...
Open Access DOI:10.23937/2378-3656/1410079
Margaret R. Coleman and Mary Thoesen Coleman
Article Type: Case Report | First Published: December 22, 2015
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 prior resulted in stabilization of weight and resolution of symptoms. Conclusion:Certain food substitutions for dairy products may ex...
Open Access DOI:10.23937/2378-3656/1410078
Article Type: Case Report | First Published: December 22, 2015
Patellar tendon disruptions are relatively uncommon knee injuries compared to fractures, ligaments sprains, or meniscal tears . 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 additional information such as the location of the rupture. We reported one case of neglected patellar disruption and the other case was trau...
Open Access DOI:10.23937/2378-3656/1410077
Daniel J. Weber, Mark D.Rodefeld, Bruce H. Matt and John W. Brown
Article Type: Case Report | First Published: December 18, 2015
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 of congenital absence of the contralateral lung is complicated but can be performed with reasonable results....
Open Access DOI:10.23937/2378-3656/1410076
Hypothesizing Balancing Endorphinergic and Glutaminergic Systems to Treat and Prevent Relapse to Reward Deficiency Behaviors: Coupling D-Phenylalanine and N-Acetyl-L-Cysteine (NAC) as a Novel Therapeutic Modality
Kenneth Blum, Marcelo Febo, Claudia Fahlke, Trevor Archer, U Berggren, Zsolt Demetrovics, Kristina Dushaj and Rajendra D. Badgaiyan
Article Type: Hypothesis | First Published: December 17, 2015
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) . The key motivation for this notion is that the combination will have synergistic attributes to induce dopamine release as well as dopamine stabilization at the brain reward circuitry via different mechanisms. We hypothesize that preferential release of Dopamin...
Open Access DOI:10.23937/2378-3656/1410075
R Bouchentouf, K Idrissi Koulali, O Ghoundale, A Elktaibi and A Benjelloun
Article Type: Case Report | First Published: December 08, 2015
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, although rare, were reported after BCG therapy....
Open Access DOI:10.23937/2378-3656/1410074
Francesco Lassandro, Luigi Urciuoli, Marilina D'Amora, Tullio Valente, Giulia Lassandro and Enrica Barra
Article Type: Case Report | First Published: December 08, 2015
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 and are well known to radiologists. In this study we report seven pathologically documented cases of reactive edema appearing after a previou...
Open Access DOI:10.23937/2378-3656/1410073
Ashima Lal, Paul L Desandre and Tammie E Quest
Article Type: Case Report | First Published: December 02, 2015
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 metastasis. Shortly after diagnosis, he completed 3 cycles of chemotherapy (sunitinib) prior to developing a pleural effusion, requiring thoracentesis for symptom relief as ...
Open Access DOI:10.23937/2378-3656/1410072
Ilke Kupeli, Ufuk Kuyrukluyildiz, Hakan Gokalp Tas and Aysin Alagol
Article Type: Case Report | First Published: December 02, 2015
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. This physiotherapy process is a serious stressor for these patients because of pain. In addition to several modalities such as systemic administration of opioids, permanent/temporary ...
Open Access DOI:10.23937/2378-3656/1410071
Teo Tee Yin T, McNeely Parren, Stolpen Alan, Menda Yusuf, and Graham Michael M
Article Type: Case Report | First Published: November 25, 2015
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 or lymphovascular invasion identified. As part of the clinical staging process, patient was given a small dose of...
Open Access DOI:10.23937/2378-3656/1410070
Rupa Patel, Drew Schwartz, Lemuel Non and Alan Braverman
Article Type: Case Report | First Published: November 18, 2015
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 and gentamicin initially, in a 59 year-old man who reported severe allergy to penicillin....
Open Access DOI:10.23937/2378-3656/1410069
Amir Aryaie, Yuxiang Wen and Leena Khaitan
Article Type: Case Series | First Published: November 12, 2015
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, and no hepatosplenomegaly. Despite the fact that she denied recent weight gain or weight loss, her hemoglobin and hematocrit levels were 8.6 an...
Open Access DOI:10.23937/2378-3656/1410068
Anthony Visioni, John Ammori and Jeffrey Hardacre
Article Type: Case Series | First Published: November 09, 2015
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 possible management options of this clinical entity. While most of the literature falls under the category of portal venous aneurysms, there are also case reports of isolated...
Open Access DOI:10.23937/2378-3656/1410067
Yu-Jong Weng and Min-Fu Tsan
Article Type: Case Report | First Published: November 01, 2015
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 IFN or long acting polyethylene glycol-conjugated IFN (PEG-IFN) combined with ribavirin (RBV). The IFN or PEG-...
Open Access DOI:10.23937/2378-3656/1410066
Edupuganti Mohan Mallikarjuna Rao, Vjayanthi Ganga, Michael Moore and Srikanth Medarametla
Article Type: Case Report | First Published: October 30, 2015
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 situations where serum enzyme levels are not elevated, discuss the diagnostic criteria, enzyme kinetics and briefly delve into the newer biomarkers of acute pancreatitis....
Open Access DOI:10.23937/2378-3656/1410065
Lugo-Baruqui Jose A, Burke George W, Guerra Giselle, Salsamendi Jason and Ciancio Gaetano
Article Type: Case Report | First Published: October 28, 2015
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 a thigh AV fistula. We discuss the presentation, diagnosis and treatment....
Open Access DOI:10.23937/2378-3656/1410064
Kathleen Mahoney, Mamta Gupta and Akash Patnaik
Article Type: Case Report | First Published: October 12, 2015
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 carcinoma. Metastasis from a superficial urothelial carcinoma is exceedingly rare. CK7/CK20 positivity is not typical of transitional cell carcinoma (TCC) of the ovary, thus co-expressio...
Open Access DOI:10.23937/2378-3656/1410063
Talisa E de Carlo, Mehreen Adhi, Chen D Lu, Jay S Duker, James G Fujimoto and Nadia K Waheed
Article Type: Case Report | First Published: October 10, 2015
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 in angiography revealed mild hyper fluorescence and staining of the lesions....
Open Access DOI:10.23937/2378-3656/1410062
Fatma Gul Yurdakul, Rezan Kocak, Filiz Sivas, Aysegul Altun Guvenir and Hatice Bodur
Article Type: Case Report | First Published: October 09, 2015
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 unnecessary treatments for years....
Open Access DOI:10.23937/2378-3656/1410061
Zafer Demirer, Ali Guragac, Burak Kopru, Bilal Firat Alp and Ibrahim Yildirim
Article Type: Case Report | First Published: October 05, 2015
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 of hematuria, symptoms associated with the obstruction of the upper urinary tract, or lower urinary tract symptoms. The main symptoms of CCEG accompanied with upper urin...
Open Access DOI:10.23937/2378-3656/1410060
Carlo Nicola De Cecco, Davide Bellini, Elisa Porretta, Francesca Cortese, Andrea Laghi and Gianluca Coppola
Article Type: Case Report | First Published: October 1, 2015
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 diagnosis and treatment....
Open Access DOI:10.23937/2378-3656/1410059
Anna Grassi, Benjamin Scott, Dominic Cammarano, Xuezhi Jiang and Peter F Schnatz
Article Type: Case Report | First Published: September 28, 2015
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 surgical history was significant for a congenital diaphragmatic hernia repair as an infant and dilation and curettage for missed abortion. During an uneventfu...
Open Access DOI:10.23937/2378-3656/1410058
Sund-Levander M and Grodzinsky E
Article Type: Case Report | First Published: September 26, 2015
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 blur the clinical picture. The case of Mr. Nilsson illustrates the process from the first signs and symptoms of infection to diagnosis in an elderly person with...
Open Access DOI:10.23937/2378-3656/1410057
Ryuji Takahashi, Ayaka Ishii, Roka Namoto Matsubayashi, Shino Nakagawa, Momoko Akashi, Kana Tsutsui, Shino Harada, Seiya Momosaki and Yoshito Akagi
Article Type: Review Article | First Published: September 12, 2015
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. Contemporary, a breast tumor was found in her left breast. Mammography showed a high density mass with microlobulated margin. On ultrasonography, there was an irregular hypoechoic m...
Open Access DOI:10.23937/2378-3656/1410056
Article Type: Research Article | First Published: September 09, 2015
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....
Open Access DOI:10.23937/2378-3656/1410055
Article Type: Research Article | First Published: September 08, 2015
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 instability. Instability in the wrist in Rheumatoid Arthritis (RA) appears as a result of incongruity between joint and bone surfac...
Open Access DOI:10.23937/2378-3656/1410054
Potisek M, Velenik V and Omejc M
Article Type: Research Article | First Published: September 06, 2015
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. Rectal cancer represents approximately one third of colorectal cancer....
Open Access DOI:10.23937/2378-3656/1410053
Savvas Psarelis, Sophia Corsava, Kyriakos Polycarpou, Kyriakos Ioannou, Ioanna Zouvani and Elena Nikiphorou
Article Type: Case Report | First Published: September 05, 2015
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 disease can and does occur and high vigilance is necessary especially in patients taking potentially nephrotoxic drugs. The complexity of these cases...
Open Access DOI:10.23937/2378-3656/1410052
Omar F Merchant and Wayne X Shandera
Article Type: Case Report | First Published: August 29, 2015
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 of psoriasis in a 43-year-old Hispanic male with HIV infection, adequately managed with antiretroviral therapy. He presented with chronic and persi...
Open Access DOI:10.23937/2378-3656/1410051
Arru Luca, De Magistris Luigi, Arendt Charlie, Pillet Jeanchristophe, Azagra Juan Santiago, Goergen Martine and Pouthier Dominique
Article Type: Case Report | First Published: August 28, 2015
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 the native renal artery (MANRA) in a renal transplanted patient, successfully treated by open aneurysmectomy and ...
Open Access DOI:10.23937/2378-3656/1410050
Villarreal-Becerra Einer, Luis Sanchez-Soler, Angel Espias-Gomez, Leonard RH Jr, Julio Herrero-Payo and Eduardo Chimenos-Kustner
Article Type: Case Report | First Published: August 26, 2015
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 midface, and prognathic mandible.Dental anormalies were present in a patient....
Open Access DOI:10.23937/2378-3656/1410049
Ying Guo, J Lynn Palmer, Xun S Brown and Jack Fu
Article Type: Review Article | First Published: August 21, 2015
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 of polyneuropathy....
Open Access DOI:10.23937/2378-3656/1410048
Thanh Tran, Marc Burrell and William M. Lee
Article Type: Case Report | First Published: August 20, 2015
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 of the portal hypertension, but unlike cirrhosis, are potentially curable. Therefore, early diagnosis and treatment is important. The two cases presented here illustrate ...
Open Access DOI:10.23937/2378-3656/1410047
Jack Contessa, Tassos C. Kyriakides and Geoffrey Nadzam
Article Type: Research Article | First Published: August 14, 2015
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 learning to improve, expand, and maintain mastery of their knowledge, skills, and competencies....
Open Access DOI:10.23937/2378-3656/1410046
Article Type: Research Article | First Published: July 31, 2015
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 evolution, ADMA was used as an indicator for endothelial dysfunction in subclinical atherosclerosis Methods: Using a ELISA technology of DLD-Diagnostika-GMB...
Open Access DOI:10.23937/2378-3656/1410045
Zimmermann, Nicolas Lefebvre, Jaulhac B and Sauer A
Article Type: Case Report | First Published: July 30, 2015
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....
Open Access DOI:10.23937/2378-3656/1410044
Nitin Chopra, Abner Rayapati and Aarti Patel
Article Type: Case Report | First Published: July 29, 2015
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 dependence, presenting with auditory and visual hallucinations with paranoid delusions. He was prescribed zolpidem 10mg for several y...
Open Access DOI:10.23937/2378-3656/1410043
Walid Ben Ali, Pierre Page, Jean Lambert, Michel Carrier and Denis Bouchard
Article Type: Research Article | First Published: July 27, 2015
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 atrial fibrillation and 4 sinus rhythm with atrial size above 45 mm. Patients were randomized to receive left atrial or biatrial or not receive a Maze. Patients were...
Open Access DOI:10.23937/2378-3656/1410042
O'Connell BP, DeNino WF and O'Rourke AK
Article Type: Case Report | First Published: July 26, 2015
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 due to lateral displacement of sternal wires. Rungatscher et al. described sternal wire segments adjacent to, and inside of, the sternal insertion of ...
Open Access DOI:10.23937/2378-3656/1410041
Michael H. Bloch, Ramey Z. Elsarrag, Mazin Z. Elsarrag and Sana M. Salih
Article Type: Case Report | First Published: June 29, 2015
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 surgery with right oophorectomy and partial left oophorectomy was performed....
Open Access DOI:10.23937/2378-3656/1410040
Sarah Z. Elsarrag, Abigail R. Forss, Susan Richman and Sana M. Salih
Article Type: Case Report | First Published: June 29, 2015
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 of the uterus from an anomalous proximal take off of the right uterine ...
Open Access DOI:10.23937/2378-3656/1410039
Steven Lee-Kong and Herbert Irving Pavilion
Article Type: Case Report | First Published: June 27, 2015
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 relief. It was accompanied by intermittent nausea and vomiting, as well as diarrhea that at least twice included bright red blood....
Open Access DOI:10.23937/2378-3656/1410038
Edupuganti Mohan Mallikarjuna Rao, Sarah Patterson Mitchell, Janina Fordyce and Vyjayanthi Ganga
Article Type: Case Report | First Published: June 26, 2015
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 and several days of vigorous coughing....
Open Access DOI:10.23937/2378-3656/1410037
Jiang Xiuwen, Shao Jinyan, Hou Tiening, He Lina and Tang Jianguo
Article Type: Case Report | First Published: June 25, 2015
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 transcervical surgical drainage....
Open Access DOI:10.23937/2378-3656/1410036
Giovanni Piccirillo, Francesca Trojsi, Maria Rosaria Monsurro, Bernardo Maria De Martino, Francesco Habetswallner and Gioacchino Tedeschi
Article Type: Case Report | First Published: June 23, 2015
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 instrumental features suggestive of a disorder of the neuromuscular junction....
Open Access DOI:10.23937/2378-3656/1410035
Yasar Albushra Ahmed and Mohamed Fatani
Article Type: Case report | First Published: June 23, 2015
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....
Open Access DOI:10.23937/2378-3656/1410034
Sophia Corsava, Savvas Psarelis and Elena Nikiphorou
Article Type: Letter to Editor | First Published: June 09, 2015
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 iliac artery, endarterectomy of both right common superficial and deep femoral arteries and a polytetrafluroethylene patch (PTFE) graft....
Open Access DOI:10.23937/2378-3656/1410033
Neslin Sahin, Aynur Solak, Berhan Genc and Ugur Kulu
Article Type: Case Report | First Published: May 27, 2015
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 different types of neuroradiological findings alone or in combination and thus have a worse prognosis than patients without CVCs....
Open Access DOI:10.23937/2378-3656/1410032
Neslin Sahin, Aynur Solak and Liya Alkılıc
Article Type: Case Report | First Published: May 26, 2015
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 magnitude information, is exquisitely sensitive to blood products and ...
Open Access DOI:10.23937/2378-3656/1410031
Edupuganti Mohan Mallikarjuna Rao, Hakan Paydak and Jawahar Mehta
Article Type: Case Report | First Published: May 25, 2015
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 situation and an absence of a pre procedure diagnosis the surgeon had to be innovative and invent approaches to navigate the complex anatomy on the spot....
Open Access DOI:10.23937/2378-3656/1410030
Zibis H. Aristeidis, Fyllos C. Apostolos and Arvanitis L Dimitris
Article Type: Case Report | First Published: May 23, 2015
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 presented with a 3-week history of radicular symptoms of the right C6 root. A perineural cyst was identified at the C5-6 level after Magnetic Resonance Imaging of the cervical ...
Open Access DOI:10.23937/2378-3656/1410029
Luis R. Romero, Betty Y. Chen, Miguel A. Guzman, Yihua Zhou, Jin-Ping Lai and Fang Xiang Chen
Article Type: Case Report | First Published: May 20, 2015
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 open surgery. The patient initially presented complaints of headache, nausea, and dizziness....
Open Access DOI:10.23937/2378-3656/1410028
Xiaomei Lin, Howard Axelrod, Bruno Dantas, Patrick O'Beirne, Kenneth Khaw, Edward Wrobleski, John Saia, Gerald Ukrainski, Lannae Ewing, Chad Bousanti, Lawrence J Wehner and Jingsheng Zheng
Article Type: Case Report | First Published: April 30, 2015
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 the AV leaflets making the valve more likely to fail and more susceptible to clot and vegetation formation....
Open Access DOI:10.23937/2378-3656/1410027
Article Type: Clinical Study | First Published: April 03, 2015
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....
Open Access DOI:10.23937/2378-3656/1410026
Annalisa Nardone, Leonarda Rella, Anna Milella, Antonio Pascali, Pasquale Tamborra, Michele Telegrafo and Marco Lioce
Article Type: Case Report | First Published: April 02, 2015
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 therapy (IFRT) and the other is chemotherapy alone....
Open Access DOI:10.23937/2378-3656/1410025
Ruijun Bao and Lijiang Ma
Article Type: Case Report | First Published: April 01, 2015
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, weight loss and abnormal liver function tests....
Open Access DOI:10.23937/2378-3656/1410024
Zhifei Sun, Jonathan Galeotti, Shannon McCall and Christopher R. Mantyh
Article Type: Case Report | First Published: March 28, 2015
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 and rationale for arriving at the final diagnosis of gallbladder cancer metastasis and highlights the importance of modern molecular d...
Open Access DOI:10.23937/2378-3656/1410023
Sarah M. Theodoroff and Robert L. Folmer
Article Type: Research Article | First Published: March 24, 2015
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 Heschl's gyrus. The primary outcome measure was the Tinnitus Functional Index (TFI); secondary outcome measures included a Visual Numeric Scale (VNS) for selfrat...
Open Access DOI:10.23937/2378-3656/1410022
Kammoun Ikram, Marrakchi Sonia, Jebri Faten and Kachboura Salem
Article Type: Research Article | First Published: March 23, 2015
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 the diastolic filing pattern and the response to CRT....
Open Access DOI:10.23937/2378-3656/1410021
Mingwu Wang, Rahul N. Khurana, Jill J. Hopkins and Narsing A. Rao
Article Type: Case Report | First Published: March 12, 2015
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 discussed in conjunction with acute syphilitic posterior placoid choroiditis, another spirochete infection....
Open Access DOI:10.23937/2378-3656/1410020
Wei Xu, Zheng Wang and Ao Rong
Article Type: Case Report | First Published: March 10, 2015
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 located of the anterior chamber and vitreous cornea contact syndrome are also the adaptation disease....
Open Access DOI:10.23937/2378-3656/1410019
Akash Virupakshaiah, Praneeth Pasam, Prachi Kala, Shilpa Lakkundi and Mayilvaganan Sabaretnam
Article Type: Case Report | First Published: February 28, 2015
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 causes that would present with granulomatous formation....
Open Access DOI:10.23937/2378-3656/1410018
Kenneth Blum, Rajendra D Badgaiyan, Zsolt Demotrovics, James Fratantonio, Gozde Agan and Marcelo Febo
Article Type: Opinion | First Published: February 28, 2015
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 consisting of amino-acid precursors and enkephalinase inhibition properties and our discovery of the first polymorphic gene (Dopamine D2 Receptor Gene [DRD2] to associate with sever ...
Open Access DOI:10.23937/2378-3656/1410017
Anne Kennard, Michael R. Foley and Jordan Perlow
Article Type: Case Report | First Published: February 25, 2015
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 be the same as a typical intraamniotic infection, however, may require different treatment due to the different route and pathogens associated with hematogen...
Open Access DOI:10.23937/2378-3656/1410016
Outcomes of Influence of Dimethylarginine Derivats, PAD Isoenzymes, or both as Hallmark on Citrullinisation Process on Autoantigens ACPA/ Anti CCP Antibodies overall for Diagnosis in Rheumatoid Arthritis
Dejan Spasovski and Tatjana Sotirova
Article Type: Review Article | First Published: February 26, 2015
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 early non treated RA patients....
Open Access DOI:10.23937/2378-3656/1410015
Ezulia T, Saim L, Primuharsa Putra Sha and MS Kenali
Article Type: Case Report | First Published: January 30, 2015
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 squamous cell carcinoma and labelled it spindle cell carcinoma. It is known for propensity for recurrence and metastases....
Open Access DOI:10.23937/2378-3656/1410014
Ekrem Sahan and Suzan Sahan
Article Type: Case Report | First Published: January 04, 2015
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 to sinus rhythm. 'Pill in the Pocket' administration can be effective in new-onset AF. Herein, we present a...
Open Access DOI:10.23937/2378-3656/1410013
Article Type: Case Report | First Published: January 03, 2015
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 tomography (CT) showed two hypodense lesions, in the lef temporal and the right frontal lobes respectively. Results of laboratory tests revealed e...
Open Access DOI:10.23937/2378-3656/1410012
Wolfram Karenovics, Sebastien Guigard, Besa Zenelaj, Marc Licker and Frederic Triponez
Article Type: Research Article | First Published: December 29, 2014
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 October 2012 and October 2013 patients undergoing mediastinoscopy were enrolled prospectively for intra-operative monitorin...
Open Access DOI:10.23937/2378-3656/1410011
G. Di Donna and R. Di Muro
Article Type: Research Article | First Published: November 30, 2014
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 forward an hypothesis which is based on the observation of natural phenomenon, referred to the previously described mutations, some as natural evolutionary phenomena which are geneticall...
Open Access DOI:10.23937/2378-3656/1410010
Remi Foissac, Olivier Camuzard, Jonathan Fernandez, Thierry Balager and Berengere Chignon-Sicard
Article Type: Case Report | First Published: November 23, 2014
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 with important breast pains. The management was surgical with excision of maximum of vaseline nodules and immediate reconstruction with a subpectoral implant covered up at its lower p...
Open Access DOI:10.23937/2378-3656/1410009
Adeleke Adesina, Farook Taha, Adeshola Fakulujo, Alex Gandsas and Rebecca Jeanmonod
Article Type: Case Report | First Published: November 22, 2014
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 patient presenting 5 years after laparoscopic Roux-en-Y gastric bypass (LRYGBP) with intermittent abdominal pain, vomiting, and local bowel ischemia secondary t...
Open Access DOI:10.23937/2378-3656/1410008
Dilek Yilmaz and Jaap F. Hamming
Article Type: Case Report | First Published: November 22, 2014
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 awareness for this rare and underestimated complication affecting quality of life....
Open Access DOI:10.23937/2378-3656/1410007
Shahzia Lambat Emery, Reto Auer, Nicolas Senn, Isabella Locatelli and Jacques Cornuz
Article Type: Research Article | First Published: November 18, 2014
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 a binding legislation prohibiting sponsoring and their opinion on alternative financing options. Methods: An anonymous...
Open Access DOI:10.23937/2378-3656/1410006
Morteza Alibakhshi Kenari
Article Type: Research Article | First Published: October 27, 2014
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 has made to investigate scientifically the effect yogic practices on mental health of orphan children. In this study the investigator...
Open Access DOI:10.23937/2378-3656/1410005
Abdulhafeez M Khair, Mahmoud Elseid, Khalid Mohamed, Rana Al-shami, Khalid Ibrahim and Ahmed Elsotouhy
Article Type: Case Report | First Published: October 27, 2014
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 & part of quadruplet. She presented with severe headache & head tilting in the absence of other focalizing CNS symptoms. Her brain MRI showed changes suggestive of cerebellar stroke. Pati...
Open Access DOI:10.23937/2378-3656/1410004
Dejan Spasovski, Tatjana Sotirova, Svetlana Krstevska-Balkanov, Maja-Slaninka-Micevska, Trajan Balkanov, Sonja Alabakovska, Sonja Genadieva-Stavric
Article Type: Research Article | First Published: October 27, 2014
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, the predictive value of the positive and negative test and precision of the test for ACPA antibodies, rheumatoid factor, C-reactive protein and ...
Open Access DOI:10.23937/2378-3656/1410003
Tan SN and Saim L
Article Type: Research Article | First Published: September 22, 2014
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 unilateral & bilateral implantation that used the Cochlear Nucleus implants (Cochlear Ltd. Australia) and determine...
Open Access DOI:10.23937/2378-3656/1410002
Morteza Alibakhshi Kenari
Article Type: Original Article | First Published: September 12, 2014
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 this program, students located near the community college attend courses both on that campus and virtually at the partnering university. I address specific experiences and lessons lear...
Open Access DOI:10.23937/2378-3656/1410001
Domingo Lombao Iglesias, Joan Bago Granell, Teresa Vilor Ribero
Article Type: Research Article | First Published: September 10, 2014
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 variables indicating surgical invasiveness and investigate the association between CK values and excessive postoperative pain. Material and Method: The study included 96 patients (mean age 62.8 y...
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