Clinical Conundrums in Diagnosis and Management of Multisystem Langerhans Cell Histiocytosis
Jun Park, MD and Vishal Sehgal, MD
Article Type: Case Report | First Published: September 26, 2019
Langerhans Cell Histiocytosis (LCH) is a rare disorder with an incident of 1.8 cases per 1,000,000. It involves granulomatous deposits in multiple organs, leading to a wide variety of manifestations such as bone lesions, pulmonary nodules, pituitary lesions, and skin lesions. With mucocutaneous manifestation, it is often diagnosed in childhood, typically making LCH a childhood disease. However, due to the involvement of multiple organ systems and variable clinical courses, if not diagnosed durin...
The Relation between Helicobacter Pylori Density and Gastritis Severity
Article Type: Research Article | First Published: September 21, 2019
Helicobacter pylori affects many individuals in developing countries. Inflammation caused by helicobacter pylori differs depending on the virulence factors, density and host tissue response of the bacteria. This study is intended to investigate the relation between density of helicobacter pylori colonization in gastric mucosa in biopsy specimens and gastric mucosal inflammation severity. Helicobacter pylori (H. pylori/Hp) is a microaerophilic gram negative bacilli initially detected in the antra...
A Review of the Most Common Dermatologic Conditions and their Debilitating Psychosocial Impacts
Madeeha Mian, BA, Annika S Silfvast-Kaiser, MD, So Yeon Paek, MD, Dario Kivelevitch, MD and Alan Menter, MD
Article Type: Review Article | First Published: July 22, 2019
The majority of skin conditions are not life-threatening; however, many can be severe and disfiguring enough to devastate a patient's quality of life. Skin diseases can significantly impact not only a patient's physical appearance, but also their social and emotional well-being. Even the smallest skin lesions have been shown to disrupt a person's level of overall wellness. Here, we aim to address the potential psychological and emotional impact of the most common and debilitating dermatologic co...
Effect of Vitamin D on Novel Ventricular Repolarization Indices
Article Type: Research Article | First Published: July 19, 2019
Vitamin D deficiency may be the underlying cause of most health issues and diseases. There are few studies investigating the effect of low vitamin D levels on the cardiac arrhythmias. The electrocardiographic Tpeak to Tend (Tpe) interval and Tpe/QT ratio may associate with increased ventricular arrhythmias. The goal of this study was to evaluate the relationship between ventricular repolarization and vitamin D levels in apparently healthy individuals by using Tpe interval, Tpe/QT ratio and Tpe/c...
Disclosure: Possibility to Discuss Medical Error
Vitor S Mendonca and Maria Luisa S Schmidt
Article Type: Research Article | First Published: July 03, 2019
The study intended to analyze physician's post medical error disclosure process. This is a qualitative understanding research with ten Brazilian physicians from a private hospital. Participants were interviewed following a semi-structured script. From the data obtained in this research, results indicated that the surgical specialties or those in related fields had a higher error incidence. Classical medical training further reinforces a specific behavior by physicians that makes it difficult to ...
Phases of the Diagnostic Journey: A Framework
Linda N Geng, Oliver Sum Ping and Yong-Jian Geng
Article Type: Commentary Article | First Published: May 20, 2019
Diagnostic journeys begin when patients first present to a healthcare provider for their symptoms and end when they receive the correct diagnosis for these symptoms. In many cases, the diagnosis can be made promptly, but patients with rare, complex, or unusual conditions often embark on odysseys spanning years to sometimes even decades in search of a diagnosis. This prolonged process can often result in excessive costs, preventable medical errors and iatrogenesis, as well as feelings of frustrat...
Acute Epiploic Appendagitis: Report of Six Cases and Review of Literature
Antoine El Khoury, Majd Roustom, Henri Azar, Georges Chaer and Tony El Murr
Article Type: Case Report | First Published: May 01, 2019
Appendagitis has always been considered as a diagnosis of exclusion. Most of the times it is diagnosed incidentally. The majority of patients present flank pain, right and/or left iliac fossa pain with few other symptoms. These findings lead usually the physician toward a surgical disease. Imaging is very important to confirm the diagnosis of appendagitis and to avoid unnecessary hospitalizations and surgeries. In this article, we present five cases of acute appendagitis that have had nearly sim...
Spontaneous Coronary Artery Dissection: An up to Date
Dario Buccheri and Daniele Adorno
Article Type: Commentary article | First Published: February 20, 2019
Spontaneous dissection of the coronary artery (SCAD) is an uncommon cause of acute coronary syndrome (ACS) and is defined as a dissection of the coronary artery not associated with an atherosclerotic process, plaque rupture and/or thrombus formation and, by definition, not iatrogenic. The resulting myocardial damage is determined not by the rupture of a plaque indeed, but by the formation of an intramural hematoma (IMH) or intimal/medial disruption that determines the dissection of the arterial ...