Oxygen, the Link between Intracranial Aneurisms Disruption and the Atmospheric Environment?
Article Type: LETTER TO EDITOR | First Published: May 22, 2019
The general purpose of research either clinical or basic is to describe links existing between an identified disease and its whole environment from the surrounding tissues and the patient, to his ecosystem. From this point of view berry aneurisms are extremely interesting: They develop from normal tissues, their cause is largely unknown, and their evolution is barely predictable but dramatic in case of disruption. Subarachnoid hemorrhage (SAH) from a ruptured aneurysm accounts for around 5% of all strokes. It has a high rate of mortality comprised between 40 and 60% according to studies and am...
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 frustration, abandonment and isolation. To address these issues and facilitate discussion, a shared conceptu...
Management of Fetal Supraventricular Tachycardia: Three Cases at a Single Institution
Rahel Ghenbot, MD, Veronica Gonzalez-Brown, MD and Kara Markham, MD
Article Type: Case Report | First Published: May 18, 2019
Fetal tachycardia complicates 1-2% of pregnancies, and a large percentage of these arrhythmias are supraventricular. Sustained fetal tachycardia can have serious complications for the fetus, including cardiovascular failure, nonimmune fetal hydrops, and fetal death. Management of fetal tachycardia depends on multiple factors. Here we present three different cases of fetal supraventricular tachycardia (SVT) and their management at a single institution....
Adult Glioblastoma and the Role of DAXX (Death Domain Associated Protein) Tumor Biomarker
Sean M Hacking, Cao Jin, Seungjun Ahn, Deepika Savant and Mansoor Nasim
Article Type: Retrospective Study | First Published: May 18, 2019
Glioblastoma, also known as glioblastoma multiforme (GBM), is the most aggressive primary brain cancer. GBM comprises 16% of all primary brain neoplasms with an incidence rate of 3.2 per 100,000 people. Patients with GBM have a poor prognosis, less than 5% of them survive for more than 5 years. In the treatment of GBM there is currently insufficient information to improve disease management because conventional treatments universally fail. Currently there is a crucial need to identify relevant targets in GBM in order to design new therapeutic agents....
Lupus Miliaris Disseminatus Faciei Treated By Isotretinoin and Platelet Rich Plasma
A Lahrichi, F Hali, K Baline, F Marnissi and S Chiheb
Article Type: Case Report | First Published: May 17, 2019
An 18-year-old patient presented with lupoid papulonodular lesions in the face. The diagnosis of disseminated lupus of the face was retained after eliminating other diagnoses including sarcoidosis, syphilis and leprosy. An antibacillary treatment was started without improvement for 3 months with onset of lesions. A 0.5 mg/kg/day isotretinoin treatment was started with improvement of the lesions. Thereafter, the patient benefited from 6 sessions of injection of platelet-rich plasma (PRP) with sagging scars....
An Investigation of Various Inspiratory Times and Inflation Pressures during Airway Pressure Release Ventilation
Tim W Gilmore, Robert E Walter, Patrick C Hardigan, Clifton F Frilot II and Guy M Nehrenz
Article Type: Original Research Article | First Published: May 16, 2019
There are few recommendations how best to apply certain modes of mechanical ventilation, and the application of Airway Pressure Release Ventilation (APRV) requires strategic implementation of specific inspiratory (I-time) and expiratory times (E-time) and particular mean airway pressures (MAWP), neither of which is standardized. We sought to identify whether an ideal I-time or MAWP could be identified to favor more positive clinical outcomes. A retrospective analysis of archived electronic health record data to evaluate the clinical outcomes of adult patients that had been placed on APRV for a...
Changes in Connectivity between Caudate and Frontal Lobe in Patient with Psychosis Induced for Cannabis - Case Report
Hernandez JF, Marin JH, Naranjo L, Rodriguez and Ramirez SF
Article Type: Case Report | First Published: May 16, 2019
The use of marihuana is becoming more frequent in young people, the association between psychosis and cannabis has been described, especially in young people, we present a clinical case of psychosis associated with cannabis in a young man with normal Brain Magnetic resonance, but abnormalities in tractography mainly in the connectivity between cuadate nucleus and frontal lobe. Several longitudinal population studies strongly association between cannabis and psychosis, particularly in individuals who begin consumption before adulthood....
Fatal Systemic Mucormycosis after Rabbit Anti-Thymocyte Globulin Therapy in a Severe Aplastic Anemia Patient
Haruko Tashiro MD, PhD, Yasutoshi Oshima, Ritsu Sumiyoshi, Takuji Matsuo, Tadashi Yamamoto, Kensuke Matsumoto, Jun Ooi, Naohisa Matsunaga, Yoshinao Kikuchi and Naoki Shirafuji
Article Type: Case Report | First Published: May 16, 2019
Survival rates for patients with severe aplastic anemia have greatly improved with the development of better supportive care including transfusion strategies and the availability of anti-fungal agents. However, invasive fungal infection remains the main cause of death and increases mortality in severe aplastic anemia patients. Among invasive fungal infections, mucormycosis is one of the fatal diseases in immunocompromised patients. We report the case of a 72-year-old man with severe aplastic anemia treated with immunosuppressive therapy consisting of rabbit anti-thymocyte globulin, cyclosporin...