A Current Approach to Hyperprolactinemia
Lau CS and Aw TC
Article Type: Review Article | First Published: December 04, 2019
Prolactin is a hormone secreted by the anterior pituitary lactotrophs and is controlled by the influence of hypothalamic dopamine. PRL stimulates the proliferation and differentiation of mammary cells for lactation. There are many causes for hyperprolactinemia, including analytical, physiological, pharmacological, pathological and idiopathic causes. Macroprolactin is a significant analytical cause of hyperprolactinemia, and the most common cause of pathological hyperprolactinemia is prolactin secreting adenomas. Symptoms of true hyperprolactinemia include galactorrhoea, secondary amenorrhea, o...
A Rare Case of Metastatic Heterogeneous Poorly Differentiated Neuroendocrine Carcinoma of Ileum: A Case Report and Literature Review
Andrei Nikiforchin, MD, Ruth Y. Peng, MD, Michelle Sittig, RN and Sandy Kotiah, MD
Article Type: Case Report | First Published: November 30, 2019
Neuroendocrine neoplasms (NENs) represent a diverse group of tumors arising from neuroendocrine cells. Current World Health Organization (WHO) classification is based on tumor differentiation and grade defined by mitotic rate and/or ki-67 index to determine prognosis and treatment options. However, some NENs do not meet WHO pathology criteria due to morphologic heterogeneity and this leads to management challenges. WHO defines poorly differentiated NENs of the GI tract as having morphologically large or small cell features with marked elevation of ki-67. We present a unique clinical case that ...
Phase Change Biological Switch: A New Hypothesis on the Mechanism of Cancer Formation
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....
Bone Marrow Necrosis and Fat Embolism in a Patient with Sickle Cell Crisis, a Fatal Complication
Gagandeep Kaur, Oluwaseyi Olayinka and Gunjan Gupta
Article Type: Case Report | First Published: November 22, 2019
Sickle cell disease is a group of inherited disorder due to substitution of valine for glutamic acid at position 6 of beta globin chain of hemoglobin leading to sickling of red blood cells. It is most common in African ancestry. The sickled RBC’s can cause vaso-occlusive crisis leading to dreadful complications. We report a case of a 56-year-old female with past medical history of sickle cell disease, atrial fibrillation and prior history of stroke. She presented to the emergency department with chief complaint of left leg pain. After few hours the pain moved to the lower and upper back. Acc...
Progressive First Degree AV Block Indicates the Need for Permanent Pacing
Han B Xiao, Waleed Arshad, Arvinder Kurbaan and Timothy J Bowker
Article Type: Research Article | First Published: November 27, 2019
First-degree AV block, though considered benign, has been reported to be associated with an increased risk for atrial fibrillation, permanent pacing, heart failure and allcause mortality. It is possible that the extent of PR prolongation indicates the severity of adverse outcome. This study investigated whether the length of PR and its change with heart rate can predict the need for permanent pacing. We retrospectively studied 21 patients with a PR over 270 ms. Nine patients underwent permanent pacing for symptomatic bradycardia or complete AV block and 12 did not. Two or more PR intervals and...
Spontaneous Hemopericardium as an Adverse Effect of Rivaroxaban Administration
Asif Surani, MD, Beatriz Martinez Quintero, MD, David Brual, MD, Hadi Elias, MD, Fahad Uddin Ahmed, MD and Matthew Peters, MD
Article Type: Case Report | First Published: November 25, 2019
Rivaroxaban is a direct oral anticoagulant with a favorable safety profile when compared to warfarin in respect to bleeding. During post-marketing surveillance, intracranial and retroperitoneal bleedings have been reported; however, hemopericardium has not been frequently described. In this case series, we present three cases of spontaneous hemopericardium where rivaroxaban was thought to be the causative agent. Predisposing factors for rivaroxaban induced hemopericardium might include impaired kidney function, concomitant use of antiplatelet agents, herbal supplements, and CYP3A4 metabolizers...
Peripheral Neuropathy as Initial Manifestation of Churg- Strauss Syndrome
Antonio Villa, MD
Article Type: Case Report | First Published: November 23, 2019
Peripheral neuropathies are well-known complications of primary systemic vasculitides. Antineutrophil cytoplasmic antibody (ANCA)-associated small vessel systemic vasculitides and medium-sized vessel vasculitis are known to frequently damage the peripheral nervous system. A 47-year-old man had a fifteen day history of pain in his lower and upper limbs associated to paresthesias and hypostenia. His medical history revealed no history of asthma, but in the last year some episodes of obstructive- congestive rhinitis were described....
Host-Related Predictors of Persistence of Hepatitis C Virus Infection
Engy Mohamed El-Ghitany and Azza Galal Farghaly
Article Type: Research Article | First Published: November 16, 2019
Spontaneous clearance occurs in varying proportions in individuals infected by hepatitis C virus (HCV). However, the factors associated with this clearance are debatable. Their recognition may lead to a better understanding of HCV natural history and eventually improve associated prediction and management models. Aim: This study was conducted to determine the host-related factors associated with persistence of HCV infection. Among 1059 HCV-antibody-positive individuals who denied receiving HCV antiviral treatment, 257 (24.3%) spontaneously cleared the virus. Patient groups with persistent infe...
Statistical Behavior of Hospital Admissions for Respiratory Diseases by Probability Distribution Functions
Amaury de Souza, Flavio Aristone, Widinei A Fernandes, Zaccheus Olaofe, Marcel Carvalho Abreu, Jose Francisco de Oliveira Junio, Guilherme Cavazzana and Cícero Manoel dos Santos
Article Type: Research Article | First Published: November 04, 2019
Climate change has a high impact on health and morbidity/ mortality in respiratory system diseases and remains poorly investigated in probability distribution modeling. The objective of this study was to analyze the adjustments of Burr (Bu), Inv Gausian 3P (IG3P), Lognormal (LN), Pert (Pe), Rayleigh 2P (Ra 2P) and Weibull 3P (W3P) distributions of the historical series of hospitalizations for respiratory diseases (total hospital admissions) for the period from 2004 to 2018, in Campo Grande, MS. For the data series, the shape and scale parameters of the distributions were determined to verify t...
Cytogenetics of Chrysichthys nigrodigitatus as Bioindicator of Environmental Pollution from Two Polluted Lagoons, South- Western Nigeria
Bassey OB, Chukwu LO and Alimba GC
Article Type: Research Article | First Published: November 14, 2019
Pollution of aquatic ecosystems from anthropogenic activities has heightened in recent times and this has elicited national and international concern on the impacts on aquatic biota. This study investigated the genotoxic effects in C. nigrodigitatus from two polluted lagoons. Micronuclei (MN) test, as an index of chromosomal damage, is widely applied in field studies. The peripheral erythrocytes from C. nigrodigitatus were subjected to MN analysis and physicochemical parameters were evaluated following APHA standardized protocol. There were significant (p < 0.05) seasonal variations in water t...