Haystack Principle - Its Importance in Unearthing the Electrocardiogram in a Patient with Unexplained Syncope
Santosh Kumar Sinha, FACC, FAESC, FSCAI, Awadesh Kumar Sharma , Mahmodullah Razi and Umeshwar Pandey
Article Type: Case Report | First Published: December 12, 2020
The "haystack principle" is of great diagnostic and therapeutic importance to unearth the obscure P waves which gives clue to underlying diagnosis. Here, we report a case of 72-year-old women who came to outdoor department for evaluation of repeated episodes of loss of consciousness. Electrocardiogram revealed complete right bundle branch block pattern with bizarre T wave in lead II, III, and aVF. P wave were not discernible. However, lead aVR revealed well formed P wave with second-degree atrio...
Cardiovascular Diseases in Acromegaly: Not Diagnosed What is Not Suspected
Ivan Lozada Martinez, Daniela Torres Llinás and Andrés Llamas Nieves
Article Type: Commentary | First Published: December 12, 2020
Acromegaly has been described as a rare disease, the result of chronic excessive secretion of growth hormone (GH), with subsequent elevation of Insulin-like Growth Factor I (IGF-1) levels. This condition is associated with an increase in morbidity and mortality compared to the general population, without taking into account that this endocrine disorder per se, increases cardiovascular risk by causing metabolic disorders such as hyperglycemia, dyslipidemia and systemic hypertension...
Implantation of Durable VAD during COVID-19: An Epicenter Experience
Scott Stewart, DNP, David Silber, DO, Bernard Kim, MD, Kumar Satya, MD, George Batsides, MD, Kanika Mody, MD, and Mark Anderson, MD
Article Type: Patient Care | First Published: December 12, 2020
Ventricular Assist Devices (VAD) serves as an advanced treatment modality for end stage systolic heart failure patients. Implantation of VAD requires a multidisciplinary team approach with in depth family meetings and education sessions to ensure a successful outcome. During the COVID-19 pandemic, multiple new barriers were identified to allow for traditional VAD implantation and post-operative care. Modifications to current processes needed to be developed to accommodate a safe and comprehensiv...
Oxidative Stress and Cardiovascular Risk: Research Must Persist
Ivan Lozada Martinez, Daniela Torres Llinás, Jaine Anaya Rivera, Jennifer Jiménez Valverde and Milena Castro Berrio
Article Type: Commentary | First Published: December 16, 2020
Advances in medicine and experimental biology have supported the definition of concepts related to the process of cellular stress, depending on new discoveries at the molecular level. Oxidative stress is the product of the activity of various metabolic pathways including the mitochondrial electron chain, Nicotinamide Adenine Dinucleotide Phosphate Oxidase (NADPH), nitric oxide synthase, xanthine oxidase, among others. Physiologically, regular levels of reactive oxygen species (ROS) play a fundam...
The Introduction of Self Help Group Facilitator in an Alcohol Unit: Preliminary Results
Patrizia Balbinot and Gianni Testino
Article Type: Brief Report | First Published: December 11, 2020
The main outcome of Alcohol Use Disorders (AUDs) treatment is the achievement of abstention. Pharmacological and psychosocial activities are strictly imbricated, however the results at one year are still unsatisfactory. To date, the most effective tool for maintaining abstention is attendance at Self-Mutual-Help Groups (SHGs). Despite that, to date few patients attend Self-Help Groups (SHGs). For this reason we have decided to introduce the Self-Help Group Facilitator (SHGF) to our service. Aft...
Paenibacillus Isolated from Superficial Infection of the Left Knee Region in Middle-Aged Man
Mohamed Shaalan, Ali Omer, Mohamed Elrih and Satish Kutty
Article Type: Case Report | First Published: December 21, 2020
On admission, there is subcutaneous diffuse, fluctuant swelling anterior to the left patella measuring 3 × 4 cm, which is erythematous, warm and tender, the range of movements painful beyond 90 degrees. Temperature is 36.8 degrees, pulse rate 97 per minute. Haematological investigations revealed; CRP is 322, WBC 20.15, Neutrophils 18.88, an incision and drainage was done in theatre under general anaesthesia, it was yellowish fluid 15 ml which sent for culture and sensitivity and wound packed wi...
A Malrotated, Incarcerated Appendix within an Epigastric Hernia
Patrick E. McGovern, MD, Leandra Krowsoski, MD and Joseph F. Rappold, MD, FACS
Article Type: Case Report | First Published: December 16, 2020
A 40-year-old male who presented with non-reducible ventral abdominal mass that was tender to palpation on physical examination. He was found to have appendiceal incarceration within an epigastric ventral hernia defect secondary to congenital malrotation of the bowel, as initially identified on computed tomography. The patient was taken to the operating room emergently, where reduction of the hernia sac, appendectomy, and proper rotation of the colon was performed. Pathologic findings were consi...
Severe Spinal Cord Insult after Reverse Shoulder Arthroplasty
Eva García-Jarabo, Juan María Pardo-García, Leandro Manuel Ramos-Ramos and Manuel Ramón García-Rayo Rodriguez-Barbero
Article Type: Case Report | First Published: December 05, 2020
We present a case of a cervical spine cord ischemia with hemorrhage in a patient with a proximal humeral fracture treated with reverse shoulder arthroplasty (RSA), a rare complication, non-well described in the current literature. The aim of this study is to review immediate neurological post-operative complications of RSA that can be related to surgery or anesthetic technique. Thus, we describe a severe, rare central system neurological complication after RSA. Proximal humeral fractures (PHFs) ...
Leiomyoma of the Vulva
Nagat Bettamer, Ream Langhe, Zahia Elghazal, Farag Ben Ali and Lamia Alkikhia
Article Type: Case Report | First Published: December 06, 2020
The authors present a rare case of vulval swelling in a 2-year period in a 35-year-old woman. The swelling was associated with mild vulval discomfort but no other symptoms. The tumour was removed surgically with no complications. Histopathology of the swelling confirmed vulval leiomyoma. Postoperative recovery was unremarkable and the woman was discharged on postoperative day 2. A 35-year-old patient presented to our department with a history of painless left vulval swelling of over a duration o...
Ulipristal Acetate: Medical Management for Benign Metastasizing Leiomyoma?
Adina Schwartz, MD, Olivia Carpinello, MD and Alan DeCherney, MD
Article Type: Case Report | First Published: December 03, 2020
To describe the use of ulipristal acetate in an attempt to medically treat benign metastasizing leiomyoma (BML). Benign metastasizing leiomyoma (BML) is a rare disease characterized by smooth muscle tumors found outside of the uterus. Treatment options include surgery, embolization, and medical management. This case describes the use of ulipristal acetate in an attempt to medically manage an inoperable case of BML. A 40-year-old female presented with abdominal pain, urinary frequency, and decrea...