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.

 
Journal Information

Title: Clinical Medical Reviews and Case Reports

ISSN: 2378-3656

Editor-in-chief: Wei Wang

NLM title abbreviation: Clin Med Rev Case Rep

ISO abbreviation: Clin Med Rev Case Rep

Other titles: CMRCR

Category: Clinical/Medical

DOI: 10.23937/2378-3656

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email: contact@clinmedjournals.org

 
Articles Search by   Keyword   |   Journal title   |   Author name   |   DOI

 

 Open Access DOI:10.23937/2378-3656/1410242

Efficacy and Safety of GLP-1 Agonists in Chronic Kidney Disease: A Case Series

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

Hyponatraemia Workup Leading to a Diagnosis of Primary Empty Sella Syndrome: A Case Report

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 per...
 

 Open Access DOI:10.23937/2378-3656/1410240

A Case of Necrolytic Migratory Erythema (NME) Initially Misdiagnosed as Subacute Cutaneous Lupus Erythematosus (SCLE)

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410239

Paucisymptomatic Migrated Intrauterine Contraceptive Device to the Sigmoid Colon: A Case Report

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 mig...
 

 Open Access DOI:10.23937/2378-3656/1410238

Prevention and Treatment of CMV Retinitis Related Blindness in Resource-Limited Settings, Myanmar

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 [1], 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...
 

 Open Access DOI:10.23937/2378-3656/1410237

Low Saturation Readings in a Patient with Congenital Methemoglobinemia Exposed to Patent Blue Dye: A Case Report

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

Transfer Factor Revisited: Treatment of Chronic Mucocutaneous Candidiasis in a Child with Autoimmune Polyendocrinopathy Syndrome Type-1

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410235

Painless Thyroiditis Induced by Immune Checkpoint Inhibitors in a Patient with Small Cell Lung Cancer

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

Fatal Side Effect of Treprostinil - Hypoglycemia: A Case Report

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 [1]. Hypoglycemia as a side effect of ...
 

 Open Access DOI:10.23937/2378-3656/1410233

Consecutive Successful Pregnancies after Conservative Management of Early Stage Endometrial Carcinoma

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, especia...
 

 Open Access DOI:10.23937/2378-3656/1410232

Laparoscopic TEP Inguinal Hernia Repair - Are We Overdoing It? A Comprehensive Study of 25 Cases of TEP Inguinal Hernia Repair Done Without the Use of Electrocautery and Without Any Mesh Fixation

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:10.23937/2378-3656/1410231

Hepatic Angiosarcoma in a Patient with Liver Cirrhosis

Eugenia Sanchez Rodriguez, Ignacio Pinilla Pagnon, Raquel Rios Leon, Carolina Gabriela Gonzalez Olivares, Rosa Maria Martin Mateos and Agustín Albillos

Article Type: Case Report | First Published: August 16, 2018

Hepatic angiosarcoma (HAS) is a rare malignancy that accounts for 2% of all hepatic primary tumors. It has been related to exposure to carcinogens (vinyl chloride, radiocontrast material, thorium dioxide, androgenic steroid, arsenic...). The diagnosis is challenging due to the lack of specificity of the symptoms and the heterogeneous appearance on radiologic images, especially if the patient does not have previous history of occupational exposure...
 

 Open Access DOI:10.23937/2378-3656/1410230

A Chronic Precipitant for Acute Intermittent Porphyria

Nick Li

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

An Unspoken Threat Hiding behind the Gall Bladder in Laparoscopic Cholecystectomy - The Middle Hepatic Vein

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 seemingl...
 

 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

Borderline Personality Disorder with Psychopathic Traits: A Critical Review

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

Diagnosis of Tardive Dyskinesia in an Oral Surgical Office

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 con...
 

 Open Access DOI:10.23937/2378-3656/1410225

Placenta Increta at 14 Weeks with Subsequent Hysterectomy: A Case Report

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 cesa...
 

 Open Access DOI:10.23937/2378-3656/1410224

A Case of Rhizopus Keratitis

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 lead...
 

 Open Access DOI:10.23937/2378-3656/1410223

Giant Aneurysm of Ascending Aorta Caused by Chronic Stanford Type A Aortic Dissection with Bicuspid Aortic Valve

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 tomograph...
 

 Open Access DOI:10.23937/2378-3656/1410222

A Rare Case of Symptomatic Factor XII Deficiency Manifesting as Intraventricular Haemorrhage and Hydrocephalus in a Term Neonate

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

Primary Pleiomorphic Liposarcoma of the Colon: A Case Report and Review of Literature

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

Corpus Cavernosum Atypical Metastasis of Renal Cell Carcinoma: Presurgical Therapy and Complete Surgical Resection. Case Report and Review of the Literature

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 pazopan...
 

 Open Access DOI:10.23937/2378-3656/1410219

Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) - A Case Report of Successful SSA Therapy after Failure of Systemic Corticosteroids

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 nodule...
 

 Open Access DOI:10.23937/2378-3656/1410218

Refractory Vasodilatory Shock Induced by Irbesartan's Acute Intoxication

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

Prover Induced Cerebral Sinus Thrombosis in a SLE Patient

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

An Important Differential Diagnosis with Elevated D-Dimer: Acute Pulmonary Embolism or Aortic Dissection

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410215

Silver Nitrate in the Sphenoid Sinus following Nasal Cauterization

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

Aortic Mycotic Aneurysm - A Rare Cause, A Common Clinical Presentation

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

Gallbladder Volvulus: An Uncommon Phenomenon: A Case Report and Review of the Literature

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

Introduction of a Glove-Finger Extraction Option for Laparoscopic Appendectomy

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

Arrhythmogenic Right Ventricular Dysplasia with Phasic Elevation in Troponin Levels

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

A Case of Human Metapneumovirus Associated with Acute Haemorrhagic Oedema of Infancy

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

Pulmonary Hyalinizing Granuloma in the Differential Diagnosis of Pulmonary Carcinoma

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

Sunitinib Induced Cytopenia in Metastatic RCC

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

Rhino-Orbito-Cerebral Mucormycosis in Immunocompetent Young Patient: Case Report

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 pa...
 

 Open Access DOI:10.23937/2378-3656/1410206

Painful Hand Swelling after a Roller Coaster Ride

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 meas...
 

 Open Access DOI:10.23937/2378-3656/1410205

Current Microbiological, Clinical and Therapeutic Aspects of Impetigo

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

Culotte PCI through Arteria Lusoria

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

Urothelial Carcinoma with Intracranial Lesion: Metastasis or Abscess?

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

Necrotizing Neck Mass in a Young Female

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 cer...
 

 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

Alireza Heidari

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410200

Scalp Arteriovenous Fistula following Hair Transplantation: A Case Report and Review of the Literature

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

Disseminated Intravascular Coagulation due to Amniotic Fluid Embolism in an Early Molar Pregnancy

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 eleva...
 

 Open Access DOI:10.23937/2378-3656/1410198

Vesicular Monoamine Transporter Type 2 (VMAT2) Inhibitors in the Management of Tardive Dyskinesia

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

Diagnostic Dilemma of a Mature Parapharyngeal Teratoma in an Infant

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 diag...
 

 Open Access DOI:10.23937/2378-3656/1410196

Management of Congenital Afibrinogenemia: Report of Two Cases

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

Methemoglobinemia after Local Anesthesia with Prilocaine in a Newborn after Aortic Coarctation Repair: A Case Report

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

Tetanus after Application of Traditional Topical on Severe Burn

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

Aggressive Resection of Cervical Desmoid Tumor Invading the Paraspinal Muscles without Recurrence at Eight Year Followup: A Case Report and Review of the Literature

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

Panhypopituitarism in a Case of Newly Diagnosed Lung Cancer with a Concurrent Pituitary Mass

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

First Report of Geniospasm in a Five-Generation Brazilian Family: Clinical Features, Electromyography Findings and Botulinum Toxin Treatment

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

Hypnosis and Transversus Abdominis Plane Block for Brugada Syndrome Anesthesia: A Case Report

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

Brief Comment on the Challenge and Opportunities for Effective Containment of the Type 2 Diabetes Mellitus Epidemic that Affects the World Population

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

T-Cell Large Granular Lymphocyte Leukemia Diagnosis in a Patient with Felty Syndrome

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

The Role of Fat Soluble Vitamins in Clinical Lipidology

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

Claudication: A Teachable Moment or Missed Opportunity!

Ayad Jindeel

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

An Asymptomatic Case of Hamartoma Located in the Trachea

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

A Case of Refractory Dysphagia in the Context of Polymyositis Treated with Subcutaneous Immunoglobulin and Review of the Literature

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

The Unpredictably Deadly Twist: A Case of Acute Mesenteric Ischaemia after Successful Gastrectomy

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

Brown Adipose Tissue and Disease: New Insights from Historical Data

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

Accidental Ingestion of a Dental Bridge

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

Cervical Subcutaneous Emphysema, Pneumomediastinum, Pneumoperitoneum and Pneumoretroperitoneum after Therapeutic Colonoscopy without Obvious Colon Perforation - A Case Report

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

Endovascular Treatment of Blunt Traumatic Injury to the Brachial Artery: Case Report and Review of the Literature

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

Burkitt's Lymphoma Presenting as Endobronchial Lesion

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

Severe ANCA Associated Vasculitis in the Setting of Cocaine Abuse: A Case Report

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

Evaluation of the Functional and Clinical Outcome of Intramedullary Osteosynthesis with Gamma Nail in Treatment of Unstable Peritrochanteric Fractures

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

Gaisbock's Syndrome: A Case Study

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

Progression from Acute Psychosis to Seizures and Autonomic Instability in an Adolescent with Ovarian Mass

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

Radicular Cysts in Primary Dentition with Different Clinical and Radiographic Characteristics

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

Reactive Granulomatous Dermatitis during Anti-TNF Therapy: A Case Report and Review of the Literature

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

Reactive Arthritis Due to Subcutaneous Abscess: A Possible Correlation?

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

A 54-Year-Old Woman with a Myeloid Neoplasm Associated with Eosinophilia and t(5;12)(q33;p13)/PDFRFB Rearrangement: Case Report and Mini-review of the Literature

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

Shaft Rupture of Ultra-High Pressure Balloons

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

A Case of Mumps Orchitis without Parotitis in a Vaccinated Post Pubertal Male

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

Secondary Adrenocortical Insufficiency as a Result of Chronic Fentanyl Treatment: A Case Report

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

Infectious Diseases Mimicking Ovarian Carcinomatosis

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

Successful Resolution of Uremic Tumoral Calcinosis with Conventional Hemodialysis Using a Low-Calcium Containing Dialysate

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

Anti-HMGCR Necrotizing Autoimmune Myopathy Leading to Identification of Cancer Relapse

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

Continuous Bilateral Brachial Plexus Blockade for Acute Pain Control in Patients with Bilateral Upper Extremity Traumatic Injuries: A Review of Five Cases

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

Blue Fingernails during Treatment with Cyclophosphamide for Minimal Change Disease: A Very Rare Side Effect

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

Extubation Airway Emergency after Spinal Fusion Using Bone Morphogenetic Protein

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

Two Cases of Pseudomalabsorption Treated Successfully with Parenteral Levothyroxine

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

Anesthetic Management of Traumatic Brain Injury

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

Mobility Scooter Accidents - Need for Preventative Action?

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

Acute Liver Failure Secondary to AL Amyloidosis

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

Ocular, Nasal and Aural Myiasis in an Intoxicated Patient: A Case Report

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

A Missed Diagnosis

Avinash Aujayeb

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

A Dangerous Triad: Sertraline, Mirtazapine and Methadone

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

Misdiagnosis of Neurobehavoral Disorders Associated with Fetal Alcohol Exposure in Adults

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

Cement Powder Ingestion: Case Report and Review of the Literature

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

Significance of Antiphospholipid Antibodies in Essential Cryoglobulinemia: A Case Report and Review of Literature

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

Dapagliflozin- Induced Severe Ketoacidosis Requiring Hemodialysis

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...
 

 Open Access DOI:10.23937/2378-3656/1410149

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

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...
 

 Open Access DOI:10.23937/2378-3656/1410148

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

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

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

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410146

A Case of Pyonephrosis of an Obstructed Atrophic Kidney

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

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

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 t...
 

 Open Access DOI:10.23937/2378-3656/1410144

Adult Rasmussen's Encephalitis

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 antiep...
 

 Open Access DOI:10.23937/2378-3656/1410143

Acute Disseminated Encephalomyelitis (ADEM) Secondary to Neurosyphilis

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 a...
 

 Open Access DOI:10.23937/2378-3656/1410142

Neonatal Polycythemia: A Review

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410141

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

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...
 

 Open Access DOI:10.23937/2378-3656/1410140

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

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...
 

 Open Access DOI:10.23937/2378-3656/1410139

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

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

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

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 d...
 

 Open Access DOI:10.23937/2378-3656/1410137

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

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

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

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

Aortoenteric Fistula in Patient with Infected Aortic Endovascular Stent

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)...
 

 Open Access DOI:10.23937/2378-3656/1410134

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

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

Erythromelalgia in an Infant Caused by Adenovirus Gastroenteritis

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

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

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...
 

 Open Access DOI:10.23937/2378-3656/1410131

Advances in the Management of Skin Wounds with Synthetic Dressings

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...
 

 Open Access DOI:10.23937/2378-3656/1410130

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

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410129

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

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

A Case of Spontaneous Regression of High-Grade Hepatocellular Carcinoma

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

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

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

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

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,...
 

 Open Access DOI:10.23937/2378-3656/1410125

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

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 clonidi...
 

 Open Access DOI:10.23937/2378-3656/1410124

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

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 wit...
 

 Open Access DOI:10.23937/2378-3656/1410123

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

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410122

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

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

A Rare Case of Primary Mucosal Melanoma of the Palate

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

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

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

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

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 associ...
 

 Open Access DOI:10.23937/2378-3656/1410118

Pulmonary Alveolar Hemorrhage While on Dual Antiplatelet Therapy

Brian Grondahl

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 mas...
 

 Open Access DOI:10.23937/2378-3656/1410117

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

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 combina...
 

 Open Access DOI:10.23937/2378-3656/1410116

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

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

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

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

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

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

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

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 bypas...
 

 Open Access DOI:10.23937/2378-3656/1410112

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

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, ...
 

 Open Access DOI:10.23937/2378-3656/1410111

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

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

Primary Epiploic Appendagitis

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, fev...
 

 Open Access DOI:10.23937/2378-3656/1410109

The Biliary Sinus: A Rare Late-Stage Complication of Cholecystectomy

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 cholangiogr...
 

 Open Access DOI:10.23937/2378-3656/1410108

Left Atrial Appendage Occluder with Recurrent Thrombus Formation Visualized by Three-Dimensional Transesophageal Echocardiography

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

Chemotherapeutic Agents for Brain Metastases in Non-Small Cell Lung Cancer: A Case Report with Eribulin Mesylate and Review of the Literature

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 dr...
 

 Open Access DOI:10.23937/2378-3656/1410106

The Use of the Gallbladder Wall for Reconstruction of the Extrahepatic Bile Ducts in a Case of Agenesis of the Common Bile Duct: A Case Report

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. Intraoper...
 

 Open Access DOI:10.23937/2378-3656/1410105

The Spread of Melanoma to the Adrenal Glands: Historical Cases

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 -...
 

 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-rel...
 

 Open Access DOI:10.23937/2378-3656/1410103

Giant Mucinous Cystadenoma of the Ovary Mimicking Ascites: A Case Report

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410102

Does Breast Feeding Protect from Development of Breast Disease?

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410101

Endometrioma Complicated by a Rare Bleeding Disorder Mimicking Ovarian Cancer

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

Rx for Disaster: When Medication Non-adherence becomes an Emergency

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-adher...
 

 Open Access DOI:10.23937/2378-3656/1410099

Pulmonary Lymphangitic Carcinomatosis due to Metastatic Adenocarcinoma of the Lung: A Case Report

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...
 

 Open Access DOI:10.23937/2378-3656/1410098

Topical Cream Curadermbec5 Treats a Recalcitrant Basal Cell Carcinoma

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410097

Prevention, Detection and Diagnosis of Expressive Oral Language Disorders in Premature Infants

Charollais Aude

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

Spontaneous Spleen Rupture: An Unusual Involvement of the Spleen in Systemic Lupus Erythematosus

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...
 

 Open Access DOI:10.23937/2378-3656/1410095

Socket Reconstruction after Firework Explosion Injury

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 antibiot...
 

 Open Access DOI:10.23937/2378-3656/1410094

Atypical Presentation of Madelung Disease

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...
 

 Open Access DOI:10.23937/2378-3656/1410092

Coronary Artery Imaging in Patients with Congenital Heart Disease: Improved Image Quality Using an Intravascular Contrast Agent and Specific Magnetic Resonance Sequence Design

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

A Case of Macrovascular Complications after Treatment with DPP-4 Inhibitor, Sitagliptin, in a Patient with Type 2 Diabetes Mellitus

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

Multiple Myeloma and Amyloidosis Presenting as a Restrictive Lung Disease with Respiratory Failure

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

Tetanus: A Case Report following an Upper Extremity Injury

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 ant...
 

 Open Access DOI:10.23937/2378-3656/1410089

Aeroportia - A Rare Finding for a Frequent Disease

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 patien...
 

 Open Access DOI:10.23937/2378-3656/1410088

Stevens - Johnson Syndrome and Intestinal Perforation following regorafenib Administration for Metastatic Rectal Cancer: A Case Report

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...
 

 Open Access DOI:10.23937/2378-3656/1410087

Gel Bleed and Rupture of Silicone Breast Implants Investigated by Light-, Electron Microscopy and Energy Dispersive X-ray Analysis of Internal Organs and Nervous Tissue

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...
 

 Open Access DOI:10.23937/2378-3656/1410086

Chronic Stimulant Use: An Upcoming Cause of Neurocognitive Disorder in Later Life?

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

Unusual Early Aortic Valve Bioprosthesis Failure due to Fungal Infection

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

Therapeutic Efficacy of Platelet-Rich Plasma Injections in Treating Chronic High Hamstring Tendinopathy

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...
 

 Open Access DOI:10.23937/2378-3656/1410083

Is Cock-up Splint the Right Choice for All of the Carpal Tunnel Syndrome Patients? A Case Report

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

Non-operative Treatment for Extensive Skin Necrosis of a Neonatal Dorsal Foot caused by Extravasation

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-surgic...
 

 Open Access DOI:10.23937/2378-3656/1410081

Screening For Depressive Symptoms at the Beginning of Outpatient Cardiac Rehabilitation by Assessed Perceived Risk Factors by Patients

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 Im...
 

 Open Access DOI:10.23937/2378-3656/1410080

Massive Urinothorax; A Rare Complication after Percutaneous Nephrolithotomy

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410079

'Dairy-Free' Dietary Substitute, Abdominal Pain, and Weight Loss

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:Ce...
 

 Open Access DOI:10.23937/2378-3656/1410078

Patellar Tendon Rupture. Repair with Suture Anchors and Percutaneous Reinforcement with Semitendinosus and Gracilis Tendons: Two Cases

Manuel Godino

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 [1]. 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 neglect...
 

 Open Access DOI:10.23937/2378-3656/1410077

Long-Segment Slide Tracheo-Bronchoplasty (LSTB) with Contralateral Lung Agenesis: Case Report and Review of the Literature

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 resu...
 

 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) [1]. 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. W...
 

 Open Access DOI:10.23937/2378-3656/1410075

Coxofemoral Arthritis Caused by Mycobacterium Bovis after Bacillus Calmette-Guerin Therapy

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

Reactive Edema after Endoscopic Polipectomy Simulating a polypoid Lesion: A New Pitfall in CT Colonography

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...
 

 Open Access DOI:10.23937/2378-3656/1410073

Trapped in a Breathless Condition - A Case Report and Discussion of a Malignant Pleural Effusion and Trapped Lung

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 effusi...
 

 Open Access DOI:10.23937/2378-3656/1410072

Use of Infraclavicular Temporary Perineural Catheter in the Exercise for Range of Joint Motion - Case Report

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 system...
 

 Open Access DOI:10.23937/2378-3656/1410071

False-Positive Radioactive Iodine Uptake in Uterine Fibroids

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410070

Gemella Prosthetic Aortic Valve Endocarditis Treated Successfully with Vancomycin and Gentamicin

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 pe...
 

 Open Access DOI:10.23937/2378-3656/1410069

Gastrointestinal Stromal Tumor near Gastroesophageal Junction with Concomitant Hiatal Herni

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...
 

 Open Access DOI:10.23937/2378-3656/1410068

Case Series and Proposed System of Nomenclature for Aneurysms of the Portal Venous System

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410067

Interferon and Ribavirin-Induced Oral Hyperpigmentation in Two Taiwanese Patients: Case Report and Literature Review

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-I...
 

 Open Access DOI:10.23937/2378-3656/1410066

A Case of Acute Pancreatitis without Enzyme Elevation - A Rare Presentation of a Common Condition

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 in...
 

 Open Access DOI:10.23937/2378-3656/1410065

Steal Syndrome in a Patient with Heart and Kidney Transplantation Caused by Arterio-Venous Fistula

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

Isolated Ovarian Metastasis in a Woman with Prior History of Superficial Bladder Cancer

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 ce...
 

 Open Access DOI:10.23937/2378-3656/1410063

Ultra-High Resolution Optical Coherence Tomography Imaging of Unilateral Drusen in a 31 Year Old Woman

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

Spondyloepiphyseal Dysplasia Tarda with Progressive Arthropathy Associated with Osteoporosis and Cataract: A Case was Misdiagnosed as Juvenile Idiopathic Arthritis

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 y...
 

 Open Access DOI:10.23937/2378-3656/1410061

A Rare Case of Bilaterale Ureterohydronephrosis due to Cystitis Cystica Et Glandularis and Review of the Literature

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...
 

 Open Access DOI:10.23937/2378-3656/1410060

Untreated Chiari 1 Malformation in Adulthood with Massive Hydrosyringomyelia and Hydrocephalus

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

Posterior Uterine Wall Rupture of an Unscarred Uterus in a Woman with History of Congenital Diaphragmatic Hernia Repair

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410058

The Challenge of Infections in Frail Elderly: The Story of Mr. Nilsson

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 o...
 

 Open Access DOI:10.23937/2378-3656/1410057

Breast Cancer Adjacent to Nodular Fasciitis: A Case Report

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 ul...
 

 Open Access DOI:10.23937/2378-3656/1410056

Some Comparation Aspect of Determination of Overall Scoring Indexes between Osteoarticular Scores, Sharp's Radiographic Indexes in Patients with Rheumathoid Arthritis

Dejan Spasovski

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

Some Aspect of Clinical Assessment of Carpal Unstability and Colapsus in Untreated Rheumatoid Arthritis

Dejan Spasovski

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 r...
 

 Open Access DOI:10.23937/2378-3656/1410054

Prognostic Significance of Tumor Regression in Locally Advanced Rectal Cancer after Preoperative Radiochemotherapy

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

New Onset Nephropathy in a Patient with Psoriatic Skin and Joint Disease

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 potentiall...
 

 Open Access DOI:10.23937/2378-3656/1410052

A Case of Psoriasis in an HIV Positive Male

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 antiretro...
 

 Open Access DOI:10.23937/2378-3656/1410051

Mycotic Aneurysm of Native Renal Artery: Case Report and Review of the Literature

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...
 

 Open Access DOI:10.23937/2378-3656/1410050

General and Oral Aspects in Apert Syndrome: Report of a Case

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 ano...
 

 Open Access DOI:10.23937/2378-3656/1410049

Sural and Radial Sensory Responses in Patients with Sensory Polyneuropathy

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

Hepatic Arterioportal Fistulae: Two Case Reports and Review of the Literature

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 i...
 

 Open Access DOI:10.23937/2378-3656/1410047

Does Assessment of Self-Regulated Learning and Metacognition in Surgical Residents Provide Insight to Performance on High Stakes Standardized Examinations? A Pilot Study

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

Some Diagnostic Aspect on Abnormal Nitric Oxide Metabolism and Some Pharmacological Aspects of the most used Drugs in Rheumatoid Arthritis

Dejan Spasovski

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 Method...
 

 Open Access DOI:10.23937/2378-3656/1410045

Chorioretinitis as a Rare Presentation of Cat Scratch Disease: A Case Report

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

Potentiating the Adverse Effects of Zolpidem in a Patient with Alcohol Dependence and SSRI use

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 delusi...
 

 Open Access DOI:10.23937/2378-3656/1410043

Left Atrial Versus Biatrial Maze Procedures in Atrial Fibrillation: Initial Institutional Randomized Trial with Literature Overview

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 atria...
 

 Open Access DOI:10.23937/2378-3656/1410042

An Unusual Foreign Body in the Neck: A Case of Sternal Wire Migration

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 adj...
 

 Open Access DOI:10.23937/2378-3656/1410041

Challenges of Fertility Sparing Ovarian Surgery Imposed by Krukenberg Tumors in Pregnancy

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

Acute Ovarian Insufficiency and Uterine Infarction Following Uterine Artery Embolization for Postpartum Hemorrhage

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...
 

 Open Access DOI:10.23937/2378-3656/1410039

Adult with Ileocolic Intussusceptions

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

Intercostal Lung Hernia: A Case for Conservative Treatment

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

Descending Necrotizing Mediastinitis due to the Third Branchial Sinus: A Case Report

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

Intravenous Immunoglobulins Efficacy in a Case of ALS with Myasthenic Symptoms

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

Lymphoma or Pseudolymphoma, that is the Question

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

Giant Cell Arteritis of the Lower Limb Presenting as Peripheral Arterial Disease and Mantle Cell Lymphoma Two Years Later

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410033

Progressive Course of Infective Endocarditis Complicated with Basilar Artery Aneurysm: Serial Cranial Magnetic Resonance Imaging Findings

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 p...
 

 Open Access DOI:10.23937/2378-3656/1410032

The Contribution of Susceptibility-weighted Imaging (SWI) in Occult Cerebral Vascular Malformations in Pediatric Patients

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 informatio...
 

 Open Access DOI:10.23937/2378-3656/1410031

Right Sided Approach for a Pacemaker Insertion in the presence of Persistent Left Sided Superior Vena Cava: A Pacing Challenge

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410030

Symptomatic Cervical Perineural (Tarlov) Cyst: A Case Report

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...
 

 Open Access DOI:10.23937/2378-3656/1410029

Ruptured Intracranial Teratoma: A Case Report and Literature Review

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

Application of Multiple Novel Imaging Modalities for Guidance and Treatment of the Patient with Subaortic Stenosis

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...
 

 Open Access DOI:10.23937/2378-3656/1410027

Clinical Test of Pyrroles: Usefulness and Association with Other Biochemical Markers

Nina Mikirova

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

Paediatric Hodgkin Lymphoma and Radiation Therapy: 3DCRT vs VMAT. A Case Report

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

Features of Colon Cancer with Liver Metastasis: A Case Report and Literature Review

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

Metastatic Gallbladder Cancer Masquerading as Primary Colon Malignancy

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 a...
 

 Open Access DOI:10.23937/2378-3656/1410023

Experimental Use of Transcranial Magnetic Stimulation (TMS) to Treat Tinnitus in a Deaf Patient

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...
 

 Open Access DOI:10.23937/2378-3656/1410022

Effect of Cardiac Resynchronization Therapy on Left Ventricular Diastolic Function

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

Ocular Lyme Disease Simulating Acute Posterior Multifocal Placoid Pigment Epitheliopathy

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

Combined Lensectomy with Vitrectomy for Secondary Glaucoma and Traumatic Iridocyclitis after Ocular Blunt Trauma

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

Idiopathic Granulomatous Mastitis - A Great Mimic

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

Can Genetic Testing Provide Information to Develop Customized Nutrigenomic Solutions for Reward Deficiency Syndrome?

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 (Dopamin...
 

 Open Access DOI:10.23937/2378-3656/1410017

A Case of Hematogenous Spread of E. coli causing Clinical Chorioamnionitis

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 diffe...
 

 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

Spindle Cell Carcinoma of the Oral Cavity: A Case Report

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 metast...
 

 Open Access DOI:10.23937/2378-3656/1410014

Atrial Fibrillation Triggered by Theophylline: a Case Report Treated with 'Pill in the Pocket'

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410013

Recurrent Ischemic Strokes as the First Manifestation of A Pancreatic Cancer

Rosaria Renna

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

Monitoring of the Left Recurrent Laryngeal Nerve during Mediastinoscopy is Feasible and Safe

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 en...
 

 Open Access DOI:10.23937/2378-3656/1410011

Cancer Disease: A New Hypothesis of Interpretation and Therapeutic Approach

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 n...
 

 Open Access DOI:10.23937/2378-3656/1410010

Breast Augmentation by Vaseline Oil: A Case Report of Still a Dangerous Practice

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 wi...
 

 Open Access DOI:10.23937/2378-3656/1410009

Symptomatic Phytobezoar Presenting 5 Years after laparoscopic Rouxen-Y Gastric Bypass

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 pa...
 

 Open Access DOI:10.23937/2378-3656/1410008

First Bite Syndrome: An Underestimated Complication of Carotid Body Tumor Surgery

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

General Practitioners' Willingness to Pay for Continuing Medical Education in A Fee-for-Service Universal Coverage Health Care System

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 al...
 

 Open Access DOI:10.23937/2378-3656/1410006

Effect of Yogic Practices on Mental Health of Orphans Children

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 ...
 

 Open Access DOI:10.23937/2378-3656/1410005

Cerebellar Stroke in Children, Case report from Qatar & Brief Literature Review

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 sh...
 

 Open Access DOI:10.23937/2378-3656/1410004

Anti Citrullinated Protein / Peptide Antibody Assay, Rheumathoid Factor or Both as Shifted Test in Diagnostic and Prognostic Evaluation in Patients with Rheumathoid Arthritis

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 anti...
 

 Open Access DOI:10.23937/2378-3656/1410003

Status of Bilateral Cochlear Implantation in Malaysia

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 Nucleu...
 

 Open Access DOI:10.23937/2378-3656/1410002

Expanding Access to Higher Education for Rural, Latina/o Students: Lessons from a Pilot Distance Degree Program in Family Science

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 universit...
 

 Open Access DOI:10.23937/2378-3656/1410001

Validity of Creatine Kinase as an Indicator of Muscle Injury in Spine Surgery and its Relation with Postoperative Pain

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 Metho...

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