Vaping Associated Lung Illness: A Case Series
Joanna Sesti, MD, Safiyya Quintiliani, MD, Christine Minerowicz, MD, Delyse Garg, MD, Shabiah Martin, MD1, Karim Akl, MD, Claudio Guerrieri, MD, Sabiha Hussain, MD, Christina Migliore, MD, Pratik Patel, MD, Marc Linder, MD, Thiruvengadam Anandarangam, MD and Subroto Paul, MD, MPH
Article Type: Case Series | First Published: January 25, 2020
Electronic cigarette (e-cigarette) use, also known as vaping, has gained popularity among young adults. It has been promoted as a safer alternative to conventional cigarette smoking. Recent reports, however, have linked e-cigarette use to lung dysfunction. We report a series of four patients who were recently treated within our hospital system for vaping associated lung illness (VALI). All four were young, healthy individuals with no significant past medical histories. Lung biopsies were performed on three of these patients and the results are reviewed in the article. All patients were treated...
Giraffe Patterns in Idiopathic Pulmonary Fibrosis
Adem Dirican, MD, Pinar Yildiz Gulhan, MD, Duygu Zorlu, MD, Hulya Bayiz, MD, Yagmur Saritas, Medical Student, Tugce Uzar, Medical Student, Sevket Ozkaya, MD and Nurhan Koksal, MD
Article Type: Research Article | First Published: January 27, 2020
Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disease characterized by severe fibrosis and poor prognosis. We aimed to reveal to different radiological findings of IPF and to describe a different perspective on the complexity of diagnosis. We retrospectively evaluated patients with IPF between January 2015 and April 2019 in the Department of Pulmonary Medicine, VM Medical park Samsun Hospital, Samsun, Turkey. Totally 51 patients were included in this study; 35 (68.6%) were male and 16 (31.4%) were female. The mean age was 70.8 years (min, 50-max, 86). The mean FVC, FEV1...
Epstein-Barr Virus in Oral Cavity Squamous Cell Carcinoma of Chilean Patients
Gina Pennacchiotti, Camila Alvarez, Rodrigo Montes, Marcela Carcamo, Raul Saez and Maria Jose Martinez
Article Type: Research Article | First Published: February 01, 2020
Squamous cell carcinoma is the most frequent malignancy in the oral cavity. Although the role of tobacco and alcohol in the process of carcinogenesis is widely considered, viral participation in carcinogenesis is scarcely studied. Our aim was to detect the Epstein-Barr virus presence in fresh tissue samples from adult patients with oral cavity Squamous Cell Carcinoma and its relationship with clinical and socio-epidemiological variables. A cross-sectional study was carried out for two years in all untreated patients derived to the Chilean National Cancer Institute. A fresh sample of the tumour...
Efficacy, Effectiveness and Efficiency in the Health Care: The Need for an Agreement to Clarify its Meaning
Enrique Burches, MD, PhD and Marta Burches, MD
Article Type: Commentary | First Published: January 25, 2020
There is great interest in ensuring that health system resources are used effectively. Dictionary says efficacy, effectiveness and efficiency are synonymous. Curiously, it is in many scientific fields where there has been imposed an artificial interpretation of these terms. Efficacy, in the health care sector, is the capacity of a given intervention under ideal or controlled conditions. Effectiveness is the ability of an intervention to have a meaningful effect on patients in normal clinical conditions. Efficiency is doing things in the most economical way. Therefore, it would be more correct ...
Community Mental Health Services in Developing Countries, Time to Think Outside the Box
Sadat Muzammil, MBBS, MRCGP, FRCP (Glasg), CCFP and Georgina Lopes, MSc
Article Type: Review Article | First Published: January 20, 2020
Developing countries are struggling to provide adequate mental health care to its citizens. One of the main reasons is the serious shortage of psychiatrists and trained Mental Health Nurses (MHNs). In many countries the quality of mental health nursing is less than satisfactory. Some Western countries have devised nurse led care models under the supervision of psychiatrists, which have shown improvement in patient waiting times and care delivery as compared to low-income countries. Nurses with prescribing privileges have received mixed opinions but it has been shown to have benefits to a certa...
A Rare Form of Dermoid Cyst: A Fetiform Teratoma
Erciyestepe SG, Turan H and Kahramanoglu I
Article Type: Case Report | First Published: January 24, 2020
Thirty three-years-old patient presented with abdominal distention and intermittent abdominal pain. She gave vaginal birth 2 times; last one three years ago. She didn’t have history of any abdominal operation, family history, or comorbidities. Her menstrual periods were regular. Review of the systems were unremarkable. In the pelvic examination, a 10 cm abdominal mass palpated which deviated to the left side. The pelvic mass had a soft consistency and free mobility. In the ultrasonography, 80*80*70 mm measured complex lesion that resembles dermoid cyst was visualised at the right ovary. The ...
Patient Reported Outcomes of Balloon Dilation for Eustachian Tube Dysfunction Using the SNOT-22 Survey
Zahrah M Taufique, MD, MBA, Steven A Gordon, MD, MPH, Janine M Rotsides, MD, Jamie R Oliver, BA and Lisa A Liberatore, MD
Article Type: Original Resear ch | First Published: January 15, 2020
Eustachian tube dysfunction is a common medical condition affecting approximately 1% of the adult population. Previous studies have evaluated eustachian balloon tuboplasty using tympanometry, ability to perform Valsalva maneuver and subjective improvement in symptoms to measure effectiveness. In this study, we propose using the Sino-Nasal Outcome Test (SNOT-22) to measure outcomes following eustachian tube balloon dilation, with a focus on ear-specific symptoms within the survey....
Case of Preslip Capital Femoral Epiphysis: A Visual Vignette
Mai Adnan Banjar, MBBS, EDiR, Premilla Pillay, MD, FRCR and Salil Babla Singbal, MBBS, FRCR
Article Type: Short Commentary | First Published: January 23, 2020
9-year-old presented with left thigh pain for several weeks. Physical assessment of gait noted external rotation of the left hip. Anteroposterior and lateral radiographs of the hip demonstrated normal alignment. No fractures or dislocation. In particular, no femoral epiphysis slip was noted. The lateral view first interpreted as normal, although in hindsight there might have been subtle alignment irregularity. MRI was performed which showed high T2/STIR signal intensity with slight widening of the physeal line of the left hip with no slippage or subluxation of...
Reconstruction of Subacute Pectoralis Major Tendon Rupture from CrossFit Injury: Case Report and Literature Review
William H Miears, BS, Christian Douthit, MD and Mimi Zumwalt, MD
Article Type: Case Report | First Published: January 18, 2020
Pectoralis major tendon ruptures are uncommon injuries that are most commonly seen in active males between 20-40 years of age. While the most frequently cited mechanism of injury is during bench press, other causes from activities such as contact sports have also been reported. With the rise in popularity of CrossFit, or high intensity variable functional training, practitioners may begin to notice an increase in other mechanisms of injury. In this clinical case we present a patient who ruptured his pectoralis major tendon while performing a CrossFit workout as a coach....
Chronic Fatigue Syndrome (CFS): An Imprecisely Defined Infectious Disease Caused by Stealth Adapted Viruses
W John Martin
Article Type: Commentary | First Published: January 20, 2020
Much of the research on the chronic fatigue syndrome (CFS) is misguided for two major reasons. First, it is falsely assumed that CFS is a distinct, definable illness, which can be reliably differentiated from other neurological and psychiatric illnesses. Second, in spite of compelling evidence to the contrary, CFS is not generally regarded as an infectious illness. This review addresses these two issues and is followed by a brief discussion on stealth adapted viruses and the alternative cellular energy (ACE) pathway....