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 Case Report 


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Published Date
December 19, 2016

Vol. 3, Issue 12

Isolated Limb Infusion in a Pregnant Patient with Sarcoma of the Upper Extremity: A Case Report with Literature Review

Milovanov V, Wodago FM, Sittig M and Gushchin V

Corresponding author: Vadim Gushchin, M.D., FACS, Mercy Medical Center, The Institute for Cancer Care at Mercy, Director of GI Oncology, 227 St Paul Place, 4th Floor Weinberg Bldg, Baltimore, MD 21202-200, USA

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 patients when radiation therapy is not an option.

Citation: Milovanov V, Wodago FM, Sittig M, Gushchin V (2016) Isolated Limb Infusion in a Pregnant Patient with Sarcoma of the Upper Extremity: A Case Report with Literature Review. Clin Med Rev Case Rep 3:149.



 Case Report 


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Published Date
December 16, 2016

Vol. 3, Issue 12

An İncidental Findings of Polysplenia Syndrome in an Adult Patient with Multiple Anomalies

Mehmet Sedat Durmaz, Ali Cengiz, Serdar Arslan, Hasan Erdogan, Ismet Tolu and Arzu Cengiz

Corresponding author: Mehmet Sedat Durmaz, MD, Specialist, Department of Radiology, University of Health Sciences, Konya Education and Research Hospital, Konya, 42090, Turkey

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.

Citation: Durmaz MS, Cengiz A, Arslan S, Erdogan H, Tolu I, et al. (2016) An İncidental Findings of Polysplenia Syndrome in an Adult Patient with Multiple Anomalies. Clin Med Rev Case Rep 3:148.



 Case Report 


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Published Date
December 14, 2016

Vol. 3, Issue 12

The Use of Macitentan in the Treatment of Out-of-Proportion Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease: Case Report

Luca Fallavollita, Paolo Spinaci and Pietro Scendoni

Corresponding author: Dr. Luca Fallavollita, Unit of Cardiology, Italian National Institute of Research on Aging INRCA, 6 Canale street, Fermo, Italy

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.

Citation: Fallavollita L, Spinaci P, Scendoni P (2016) The Use of Macitentan in the Treatment of Out-of-Proportion Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease: Case Report. Clin Med Rev Case Rep 3:147.



 Case Report 


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Published Date
December 12, 2016

Vol. 3, Issue 12

A Case of Pyonephrosis of an Obstructed Atrophic Kidney

Fareeha Khan, Rasha Nakhleh and Theodore Suh

Corresponding author: Fareeha Khan, MD, MPH, Department of Internal Medicine, Division of Geriatric & Palliative Medicine, University of Michigan, Ann Arbor, MI, USA

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.

Citation: Khan F, Nakhleh R, Suh T (2016) A Case of Pyonephrosis of an Obstructed Atrophic Kidney. Clin Med Rev Case Rep 3:146.



 Review Article 


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Published Date
December 03, 2016

Vol. 3, Issue 12

Outcome of Some of the Many Aedes Albopictus (Skuse, 1895) Mosquito Encounters with Man

Daniel Benharroch and Yane-Bianca Benharroch

Corresponding author: Prof. Daniel Benharroch, Department of Pathology, Soroka University Medical Center, 1, Itshak Rager Boulevard, PO Box 151, Beer-Sheva 84101, Israel

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, encompassing all ranges of severity. Few means of prevention, however, have proven successful.

Citation: Benharroch D, Yane-Bianca B (2016) Outcome of Some of the Many Aedes Albopictus (Skuse, 1895) Mosquito Encounters with Man. Clin Med Rev Case Rep 3:145.



 Case Report 


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Published Date
December 01, 2016

Vol. 3, Issue 12

Adult Rasmussen's Encephalitis

Campanille Veronica, De Aguirre Ines, Crespo Jose, Gonzalez Macarena, Lopez Juan Ignacio, Lucero Carolina, Perez Garcia Jorgelina and Knorre Eduardo

Corresponding author: Dr. Veronica Campanille, Servicio de Neurologia, Hospital Teodoro Alvarez Aranguren 2701, Ciudad Autonoma de Buenos Aires, Argentina

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 immunoglobulins (IVIg) and immunosuppressant drugs.

Citation: Veronica C, Ines DA, Jose C, Macarena G, Ignacio LJ, et al. (2016) Adult Rasmussen's Encephalitis. Clin Med Rev Case Rep 3:144.



 Review Article 


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Published Date
November 25, 2016

Vol. 3, Issue 11

Acute Disseminated Encephalomyelitis (ADEM) Secondary to Neurosyphilis

Ryan Kahn, Christopher Dermarkarian, Elizabeth Crocco, Gabrielle Yeaney and Marcia Williams

Corresponding author: Ryan Kahn, Miller School of Medicine, University of Miami, 55 SE 6th St. #2607 Miami, FL 33131, USA

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 neurosyphilis.

Citation: Kahn R, Dermarkarian C, Crocco E, Yeaney G, Williams M (2016) Acute Disseminated Encephalomyelitis (ADEM) Secondary to Neurosyphilis. Clin Med Rev Case Rep 3:143.



 Review Article 


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Published Date
November 23, 2016

Vol. 3, Issue 11

Neonatal Polycythemia: A Review

S Umit Sarici, Murat Ozcan and Demet Altun

Corresponding author: Demet Altun, Department of Pediatrics, Ufuk University Faculty of Medicine, Ankara, Turkey

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-term neurodevelopmental outcome considering all current review articles and meta-analyses are reviewed.

Citation: Sarici SU, Ozcan M, Altun D (2016) Neonatal Polycythemia: A Review. Clin Med Rev Case Rep 3:142.



 Case Report 


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Published Date
November 21, 2016

Vol. 3, Issue 11

Thyroid Metastasis from Colorectal Cancer: A Case Report and Review of Literature

Mennet A, De Blasi V, Simone G, Mormont M and Morel P

Corresponding author: Andre Mennet, Department of Visceral Surgery, University Hospital of Geneva, Switzerland

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.

Citation: Mennet A, De Blasi V, Simone G, Mormont M, Morel P (2016) Thyroid Metastasis from Colorectal Cancer: A Case Report and Review of Literature. Clin Med Rev Case Rep 3:141.



 Case Report 


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Published Date
November 16, 2016

Vol. 3, Issue 11

An Ileal Perforation Associated with Extended Spectrum β-Lactamases-Producing Escherichia Coli: Medical Case Report

Michael Owusu, Augustina Annan, Nimako Sarpong, Ellis Owusu-Dabo, Yaw Adu-Sarkodie, Kwadwo Sarfo Marfo, Isaac Osei and Kofi Tawiah Mensah

Corresponding author: Ellis Owusu-Dabo, Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Ghana

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.

Citation: Owusu M, Annan A, Sarpong N, Owusu-Dabo E, Adu-Sarkodie Y, et al. (2016) An Ileal Perforation Associated with Extended Spectrum β-Lactamases-Producing EscherichiaColi: Medical Case Report. Clin Med Rev Case Rep 3:140.



 Case Report 


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Published Date
November 12, 2016

Vol. 3, Issue 11

Transcatheter Closure Combined with Antibiotic Therapies for Patients with Infective Endocarditis and Congenital Heart Disease

Boli Ran, Minfeng Li, Yeqing Li, Yang Lin, Weimin Liu, Qiulin Luo, Yongxin Fu, Qianmei Tang, Ya Yang and Yunfei Pu

Corresponding author: Yunfei Pu, Department of Cardiology, Third People's Hospital of Chongqing, Chongqing 400014, P. R. China

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.

Citation: Ran B, Li M, Li Y, Lin Y, Liu W, et al. (2016) Transcatheter Closure Combined with Antibiotic Therapies for Patients with Infective Endocarditis and Congenital Heart Disease. Clin Med Rev Case Rep 3:139.



 Case Series 


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Published Date
November 09, 2016

Vol. 3, Issue 11

Percutaneous Coronary Intervention for Single Coronary Artery: Two Case Studies

Yang Zhuo, Yu-qi Fan, Zhao-fang Yin, Li Fan, Zhi-hua Han, Chang-qian Wang and Zuo-jun Xu

Corresponding author: Chang-qian Wang, Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China

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. Both two patients underwent percutaneous coronary intervention because of unstable coronary artery disease.

Citation: Zhuo Y, Yu-qi F, Zhao-fang Y, Fan L, Zhi-hua H, et al. (2016) Percutaneous Coronary Intervention for Single Coronary Artery: Two Case Studies. Clin Med Rev Case Rep 3:138.



 Case Report 


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Published Date
November 05, 2016

Vol. 3, Issue 1

Unresolved Issues concerning Inadequate Immune Response after Rabies Post-Exposure Prophylaxis in an Immunocompromised Patient

Rana Shibli and Shmuel Rishpon

Corresponding author: Dr. Rana Shibli, Ministry of Health, Haifa District Health Office, Government Complex, Palyam Ave. 15a, Haifa 31999, Israel

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.

Citation: Shibli R, Rishpon S (2016) Unresolved Issues concerning Inadequate Immune Response after Rabies Post-Exposure Prophylaxis in an Immunocompromised Patient. Clin Med Rev Case Rep 3:137.



 Research Article 


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Published Date
October 31, 2016

Vol. 3, Issue 10

Equivalence of Boosted Atazanavir Based Regimens and Currently Effective HAART Regimens with Other PI's/NNRTI's in HIV + Children and Adolescents with Elevated Lipid Levels

Janice Piatt, Jeff Foti, Kimberley Bickes, Deborah Frusciano and Laura Clarke-Steffen

Corresponding author: Janice Piatt, MD, Bill Holt Pediatric Infectious Disease Clinic, Phoenix Children's Hospital, Phoenix, AZ 85016, USA

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.

Citation: Piatt J, Foti J, Bickes K, Frusciano D, Clarke-Steffen L (2016) Equivalence of Boosted Atazanavir Based Regimens and Currently Effective HAART Regimens with Other PI's/NNRTI's in HIV + Children and Adolescents with Elevated Lipid Levels. Clin Med Rev Case Rep 3:136.



 Case Report 


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Published Date
October 12, 2016

Vol. 3, Issue 10

Aortoenteric Fistula in Patient with Infected Aortic Endovascular Stent

Giuseppe Grande, Helga Bertani, Angelo Caruso and Rita Conigliaro

Corresponding author: Giuseppe Grande, Gastroenterology and digestive endoscopy unit, NOCSAE hospital, via Pietro Giardini 1355, Baggiovara di Modena, Italy

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 epigastric pain.

Citation: Grande G, Bertani H, Caruso A, Conigliaro R (2016) Aortoenteric Fistula in Patient with Infected Aortic Endovascular Stent. Clin Med Rev Case Rep 3:135.



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Published Date
October 06, 2016

Vol. 3, Issue 10

Right Superior Vena Cava Draining into the Left Atrium

Songul Usalp, Ali Rıza Karaci, Kevser Gulcihan Balci, Volkan Yazicioglu, Murat Baskurt and Nurcan Arat Koc

Corresponding author: Songul Usalp, M.D, Department of Cardiology, Istanbul Bilim University, Sisli, Istanbul, Turkey

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.

Citation: Usalp S, Karaci AR, Balcı KG, Yazıcıoglu V, Baskurt M, et al. (2016) Right Superior Vena Cava Draining into the Left Atrium. Clin Med Rev Case Rep 3:134.



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Published Date
October 04, 2016

Vol. 3, Issue 10

Erythromelalgia in an Infant Caused by Adenovirus Gastroenteritis

Gulsum Alkan, Melike Keser Emiroglu and Huseyin Tokgoz

Corresponding author: Gulsum Alkan, Fellow, MD, Faculty of Medicine, Department of Pediatric Infectious Diseases, Selcuk University, Konya, Turkey

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.

Citation: Alkan G, Emiroglu MK, Tokgoz H (2016) Erythromelalgia in an Infant Caused by Adenovirus Gastroenteritis. Clin Med Rev Case Rep 3:133.



 Original Article 


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Published Date
September 26, 2016

Vol. 3, Issue 9

Cytotoxic Effect of Snake (Echis Carinatus) Venom on Human Embryonic Kidney Cells (HEK 293)

Mahboobeh Balali Bahadorani and Abbas Zare Mirakabadi

Corresponding author: Abbas Zare Mirakabadi, Professor, Biochemistry, Department of Venomous Animals and Antivenom Production, Razi Vaccine and Serum Research Institute, Karaj, Iran

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 embryonic kidney (HEK 293) mono layers as a model to see the cytotoxic effect of Echis carinatus venom.

Citation: Bahadorani MB, Mirakabadi AZ (2016) Cytotoxic Effect of Snake (Echis Carinatus) Venom on Human Embryonic Kidney Cells (HEK 293). Clin Med Rev Case Rep 3:132.



 Review Article 


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Published Date
September 16, 2016

Vol. 3, Issue 9

Advances in the Management of Skin Wounds with Synthetic Dressings

Fletes-Vargas Gabriela, Leon-Mancilla Benjamin and Esquivel-Solis Hugo

Corresponding author: Esquivel-Solis Hugo, DVM, MSc, PhD, Medical and Pharmaceutical Biotechnology, Centro de Investigacion y Asistencia en Tecnologia y Diseno del Estado de Jalisco (CIATEJ), Guadalajara, Mexico

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.

Citation: Fletes-Vargas G, Leon-Mancilla B, Esquivel-Solis H (2016) Advances in the Management of Skin Wounds with Synthetic Dressings. Clin Med Rev Case Rep 3:131.



 Case Report 


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Published Date
September 14, 2016

Vol. 3, Issue 9

A Young Man with Joints Effusion without Trauma: It is a Rheumatic Disease

Cinzia Casu, Francesco Benazzo, Eleonora Bruschi, Franco Combi and Oscar Massimiliano Epis

Corresponding author: Cinzia Casu, S.C. Reumatologia ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy

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.

Citation: Casu C, Benazzo F, Bruschi E, Combi F, Epis OM (2016) A Young Man with Joints Effusion without Trauma: It is a Rheumatic Disease. Clin Med Rev Case Rep 3:130.



 Case Series 


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Published Date
September 10, 2016

Vol. 3, Issue 9

Pseudoxanthoma Elasticum: An Unusual Cause of Hypertension in Child. About Three Cases Reports

A Dibi, M ElFahime, N Mouane, R Dafiri and A Bentahila

Corresponding author: Asmaa Dibi, Pediatrician, Pediatric Cardiology Unit, Children's Hospital, Mohamed V University, Rabat, Morocco

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.

Citation: Dibi A, ElFahime M, Mouane N, Dafiri R, Bentahila A (2016) Pseudoxanthoma Elasticum: An Unusual Cause of Hypertension in Child. About Three Cases Reports. Clin Med Rev Case Rep 3:129.



 Case Report 


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Published Date
September 08, 2016

Vol. 3, Issue 9

A Case of Spontaneous Regression of High-Grade Hepatocellular Carcinoma

Ghufran A, Agni R, Winslow E, Dalvie P and Agarwal PD

Corresponding author: Parul D Agarwal, Department of Gastronterology and Hepatology, University of Wisconsin School of Medicine and Public Health, USA

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.

Citation: Ghufran A, Agni R, Winslow E, Dalvie P, Agarwal PD (2016) A Case of Spontaneous Regression of High-Grade Hepatocellular Carcinoma. Clin Med Rev Case Rep 3:128.



 Case Report 


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Published Date
September 05, 2016

Vol. 3, Issue 9

Malignant Peritoneal Mesothelioma in a Clerk: A Diagnostic Dilemma

Victoria Achaval Rodriguez, Patricia Moreira, Maria Camara, Pilar Rondon, Maria Garrido, Ricardo Hitt and Maria Jose Echarri

Corresponding author: Maria Jose Echarri, Medical Oncology Service, Hospital Universitario Severo Ochoa, Leganes, Madrid, Spain

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.

Citation: Rodriguez VA, Moreira P, Camara M, Rondon P, Garrido M, et al. (2016) Malignant Peritoneal Mesothelioma in a Clerk: A Diagnostic Dilemma. Clin Med Rev Case Rep 3:127.



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Published Date
August 22, 2016

Vol. 3, Issue 8

HIV-Infected Patient with Refractory Giardiasis and Lingua Villosa Nigra: A Case Report

Nina Yancheva, Nina Tsvetkova, Maria Nikolova, Ivo Alexiev and Tatyana Tchervenyakova

Corresponding author: Nina Yancheva, Department for Acquired Immune Deficiency, SHATIPB 'Prof.Ivan Kirov', Medical University, blvd. Akademik Ivan Geshov, 17, Sofia, Bulgaria

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 belching and weight loss.

Citation: Yancheva N, Tsvetkova N, Nikolova M, Alexiev I, Tchervenyakova T (2016) HIVInfected Patient with Refractory Giardiasis and Lingua Villosa Nigra: A Case Report. Clin Med Rev Case Rep 3:126.



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Published Date
August 16, 2016

Vol. 3, Issue 8

Hypothesizing that a Pro-Dopaminergic Regulator (KB220z TM Liquid Variant) can Induce 'Dopamine Homeostasis' and Provide Adjunctive Detoxification Benefits in Opiate/Opioid Dependence

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

Corresponding author: Kenneth Blum, PhD, Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA

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 sleep aids including Gabapentin.

Citation: Blum K, Whitney D, Fried L, Febo M, Waite RL, et al. (2016) Hypothesizing that a Pro-Dopaminergic Regulator (KB220z TM Liquid Variant) can Induce 'Dopamine Homeostasis' and Provide Adjunctive Detoxification Benefits in Opiate/Opioid Dependence. Clin Med Rev Case Rep 3:125.



 Case Report 


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Published Date
August 10, 2016

Vol. 3, Issue 8

A Patient with Rare Heterogenic Histopathological Presentation and Atypical Sites of Metastases in Oropharyngeal/Hard Palate Cancer: A Case Report

Aleksandra Danieluk, Aleksandra Filimoniuk, Joanna Mandziuk, Anna Marczuk, Marek Z Wojtukiewicz and Ewa Sierko

Corresponding author: Ewa Sierko, MD, PhD, Department of Oncology, Medical University of Bialystok, Poland

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 identified the positive margin of resected fragment as squamous cell carcinoma. Subsequent chemoradiation to the tumour bed and regional lymph nodes was administered and locoregional control was achieved.

Citation: Danieluk A, Filimoniuk A, Mandziuk J, Marczuk A, Wojtukiewicz MZ, et al. (2016) A Patient with Rare Heterogenic Histopathological Presentation and Atypical Sites of Metastases in Oropharyngeal/Hard Palate Cancer: A Case Report. Clin Med Rev Case Rep 3:124.



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Published Date
August 08, 2016

Vol. 3, Issue 8

Recovery of an Under-Deployed Renal Artery Stent Responsible for a Complication of Renal Artery Stenosis

Husain Alturkistani, Youri Kaitoukov, Patrick Gilbert and Vincent Oliva

Corresponding author: Vincent Oliva, Department of Radiology, Division of Interventional Radiology, Hospital Notre-Dame, H2L 4M1, Canada

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.

Citation: Alturkistani H, Kaitoukov Y, Gilbert P, Oliva V (2016) Recovery of an Under-Deployed Renal Artery Stent Responsible for a Complication of Renal Artery Stenosis. Clin Med Rev Case Rep 3:123.



 Case Report 


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Published Date
August 06, 2016

Vol. 3, Issue 8

Non-Puerperal Uterine Inversion in a Young Woman: A Case Report, Brief Surgical Review, and Clinical Insights

Leeya F Pinder, Kennedy O Ouma and Brett D Nelson

Corresponding author: Leeya F. Pinder, MD, MPH, Department of Emergency Medicine, Division of Global Health and Human Rights, Massachusetts General Hospital, MA 02114, USA

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.

Citation: Pinder LF, Ouma KO, Nelson BD (2016) Non-Puerperal Uterine Inversion in a Young Woman: A Case Report, Brief Surgical Review, and Clinical Insights. Clin Med Rev Case Rep 3:122.



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Published Date
August 03, 2016

Vol. 3, Issue 8

A Rare Case of Primary Mucosal Melanoma of the Palate

Elzbieta Sierko, Aleksander Nobis, Dominika Hempel, Marek Z Wojtukiewicz and Ewa Sierko

Corresponding author: Ewa Sierko, Department of Oncology, Medical University of Bialystok, 15-025 Bialystok, Poland

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.

Citation: Sierko E, Hempel D, Sierko E, Wojtukiewicz MZ, Nobis A, (2016) A Rare Case of Primary Mucosal Melanoma of the Palate. Clin Med Rev Case Rep 3:121.



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Published Date
August 01, 2016

Vol. 3, Issue 8

An Underdiagnosed ARVC Case until the Age of 67-Years with Two Large Aneurysms in the Right Ventricle

Kevser G Balci, Mustafa M Balci, Samet Yilmaz and Ramazan Akdemir

Corresponding author: Samet Yilmaz, MD, Cardiovascular Department, Yozgat State Hospital, 66200, Yozgat, Turkey

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.

Citation: Balci KG, Balci MM, Yilmaz S, Akdemir R (2016) An Underdiagnosed ARVC Case until the Age of 67-Years with Two Large Aneurysms in the Right Ventricle. Clin Med Rev Case Rep 3:120.



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Published Date
July 14, 2016

Vol. 3, Issue 7

Bilateral Clavicle Fracture: A Rare Presentation of a Common Form of Orthopedic Birth Injury

Joana Oliveira, Andreia Abrantes, Raque Gouveia and Graca Oliveira

Corresponding author: Joana Oliveira, Paediatrics Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal

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 were excluded during newborn physical exam screening.

Citation: Oliveira J, Abrantes A, Gouveia R, Oliveira G (2016) Bilateral Clavicle Fracture: A Rare Presentation of a Common Form of Orthopedic Birth Injury. Clin Med Rev Case Rep 3:119.



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Published Date
July 11, 2016

Vol. 3, Issue 7

Pulmonary Alveolar Hemorrhage While on Dual Antiplatelet Therapy

Brian Grondahl

Corresponding author: Brian J Grondahl, Internal Medicine Resident, Michigan State University, East Lansing, Michigan, USA

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.

Citation: Grondahl B (2016) Pulmonary Alveolar Hemorrhage While on Dual Antiplatelet Therapy. Clin Med Rev Case Rep 3:118.



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Published Date
July 08, 2016

Vol. 3, Issue 7

Sequential, Multimodal Treatment of a Refractory Adult-Onset Still's Disease Complicated by Reactive Hemophagocytic Lymphohistiocytosis

Sarah Rosset-Zufferey, Karim Gariani and Carlo Chizzolini

Corresponding author: Sarah Rosset-Zufferey, Service de Medecine interne generale, Hopitaux Universitaires de Geneve, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneve, Switzerland

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 corticosteroids leading to a prolonged remission.

Citation: Rosset-Zufferey S, Gariani K, Chizzolini C (2016) Sequential, Multimodal Treatment of a Refractory Adult-Onset Still's Disease Complicated by Reactive Hemophagocytic Lymphohistiocytosis. Clin Med Rev Case Rep 3:117.



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Published Date
July 06, 2016

Vol. 3, Issue 7

Abrupt Increase in Glucose Intolerance after Smoking Cessation Therapy: A Case Report

Maki Komiyama, Sayaka Shimada, Yuko Takahashi and Koji Hasegawa

Corresponding author: Koji Hasegawa, Director, Division of Translational Research, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa Fushimi-ku, Kyoto 612-8555, Japan

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.

Citation: Rosset-Zufferey S, Gariani K, Chizzolini C (2016) Sequential, Multimodal Treatment of a Refractory Adult-Onset Still's Disease Complicated by Reactive Hemophagocytic Lymphohistiocytosis. Clin Med Rev Case Rep 3:117.



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Published Date
July 04, 2016

Vol. 3, Issue 7

A Preterm Neonate with Coxsackievirus Infection, Supraventricular Arrhythmia and Cerebral Sinus Venous Thrombosis

Friederike Sophie Weber, Antje Heilmann, Gabriele Hahn, Mario Rudiger and Jurgen Dinger

Corresponding author: Dr. med. Friederike Sophie Weber, Department of Neonatology and Pediatric Intensive Care, Universitatsklinikum Carl Gustav Carus, 01307 Dresden, Germany

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.

Citation: Weber FS, Heilmann A, Hahn G, Rüdiger M, Dinger J (2016) A Preterm Neonate with Coxsackievirus Infection, Supraventricular Arrhythmia and Cerebral Sinus Venous Thrombosis. Clin Med Rev Case Rep 3:115.



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Published Date
June 30, 2016

Vol. 3, Issue 6

Acute Diarrhea Secondary to Pseudomembranous Colitis in the Adulthood, a Diagnostic Challenge: Case Report

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

Corresponding author: Maria Valeria Jimenez Baez, Research Health Coordinator, Division of Health Sciences, University of Quintana Roo, Av. Politecnico Nacional s/n, Mexico

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.

Citation: Hernandez FAR, Lamont GB, Chavez CPV, Alva CAA, Andrade LAM, et al. (2016) Acute Diarrhea Secondary to Pseudomembranous Colitis in the Adulthood, a Diagnostic Challenge: Case Report. Clin Med Rev Case Rep 3:114.



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Published Date
June 27, 2016

Vol. 3, Issue 6

Three-Vessel Spontaneous Coronary Artery Dissection in an Old Woman

Huseyin Bozbas, Tugba Kayhan Altuner, Ezgi Polat Ocakli, Mehmet Sanser Ates, Murat Kurtoglu and Mehmet Emin Korkmaz

Corresponding author: Huseyin Bozbas, MD, FESC, Department of Cardiology, Guven Hospital, Kavaklıdere, Ankara, Turkey

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 three-vessel SCAD. She was admitted with acute coronary syndrome. By angiography, SCAD was identified in all three coronary arteries.

Citation: Bozbas H, Altuner TK, Ocakli EP, Ates MS, Kurtoglu M, et al. (2016) Three-Vessel Spontaneous Coronary Artery Dissection in an Old Woman. Clin Med Rev Case Rep 3:113.



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Published Date
June 25, 2016

Vol. 3, Issue 6

Successful Treatment of Insomnia with Melatonin in a Patient with Malignant Glioma after Radiotherapy-Involving the Pineal Gland

Andrea Reim, David Strobl, Gerda Saletu-Zyhlarz, Matthias Preusser, Maria Theresia Schmook, Karin Dieckmann, Christoph C Zielinski and Christine Marosi

Corresponding author: Prof. Christine Marosi, Department of Medicine I and Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria

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, insomnia is under diagnosed and undertreated.

Citation: Reim A, Strobl D, Saletu-Zyhlarz G, Preusser M, Schmook MT, et al. (2016) Successful Treatment of Insomnia with Melatonin in a Patient with Malignant Glioma after Radiotherapy-Involving the Pineal Gland. Clin Med Rev Case Rep 3:112.



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Published Date
June 24, 2016

Vol. 3, Issue 6

Variant Angina Induced Life-Threatening Ventricular Arrhythmias: does Dual Calcium Channel Blocker Eliminates the Indication for Implantable Cardioverter Defibrillator?

Maroun Matar, Elie Chammas and Samer Nasr

Corresponding author: Maroun Matar, Past President, Lebanese Society of Cardiology, Lebanon

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.

Citation: Matar M, Chammas E, Nasr S (2016) Variant Angina Induced Life-Threatening Ventricular Arrhythmias: does Dual Calcium Channel Blocker Eliminates the Indication for Implantable Cardioverter Defibrillator? Clin Med Rev Case Rep 3:111.



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Published Date
June 10, 2016

Vol. 3, Issue 6

Primary Epiploic Appendagitis

Neha Gupta, Tony A Abdel Maseeh, Leyden Standish-Parkin and Yekaterina Sitnitskaya

Corresponding author: Neha Gupta, Department of Pediatrics, Lincoln Medical Center, 234 E 149th street, Bronx, New York 10451, USA

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-contributory.

Citation: Gupta N, AbdelMaseeh TA, Standish-Parkin L, Sitnitskaya Y (2016) Primary Epiploic Appendagitis. Clin Med Rev Case Rep 3:110.



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