Endovascular Management of Refractory Puerperal Hematomas: A Case Report and Review of the Literature
Simon Bradette, MD, FRCPC, Melissa Marien, MD, PGY-3, Melanie Rousseau, MD, FRCPC, Mathieu Beland, MD, FRCPC and Catherine Lalonde, MD, FRCPC
Article Type: Case Report | First Published: November 06, 2019
Pelvic hematomas can be a serious complication of vaginal delivery. They can be associated with significant morbidity related to blood loss, infection, surgery and blood product transfusion. Reported incidence varies from 1/300 to 1/1500. Operative vaginal delivery and episiotomy are among the most common risk factors associated with puerperal hematomas, but they may also occur in the absence of laceration of the surrounding tissue. They are classified as vulvar, vaginal, vulvovaginal or retroperitoneal. The majority of puerperal hematomas are vulvovaginal and can involve either branches of th...
Refractory Hyperemesis Gravidarum in a Patient with Type 1 Diabetes Treated with Laparoscopically Assisted Feeding Jejunostomy Tube Placement
Melissa Chu Lam, MD, Briana Baxter, MD, Farrah Naz Hussain, MD, Kristina Martimucci Feldman, MD and Barak Rosenn, MD
Article Type: Case Report | First Published: November 04, 2019
Severe Hyperemesis gravidarum (HG) is a debilitating condition that affects less than 1% of pregnant women. Management of HG is further complicated in women with type 1 diabetes due to oscillations between hypo and hyperglycemia, often exacerbated by the presence of gastroparesis. We report a 25-year-old G1P0 with longstanding uncontrolled type 1 diabetes mellitus (HbA1C 10.5%), who presented to our service multiple times with hyperemesis and ketosis. On each of these admissions, she was diagnosed with starvation ketosis due to inability to tolerate any oral intake since the start of pregnancy...
A Review of Radiographic Imaging Findings of Ependymal Tumors
Maria Habib Hanna, MD, Bansal A, MD and Belani P, MD
Article Type: Review Article | First Published: October 24, 2019
Ependymomas are glial tumors that typically arise from the lining of the ventricles or the central canal of the spinal cord. The most common site of occurrence is within the posterior fossa. Subtypes of ependymomas include anaplastic ependymoma, myxopapillary ependymoma, and subependymoma. Its characteristic imaging features include findings of a heterogeneous mass with necrosis, calcifications, cystic changes, and hemorrhage. Treatment options includes partial resection with or without irradiation. Intracranial ependymomas are more commonly WHO Grade II and occur in both children and adults. ...
Cerebellar Liponeurocytoma Presenting with Fatal Tumor Hemorrhage
Elia Guadagno, MD, Lorenzo Ugga, MD, Annarita Gencarelli, MD, Valentina Orlando, MD, Sergio Corvino, MD, Maria Rosaria Cervasio, MD, Sara Pignatiello, MD, Andrea Elefante, MD, Francesco Maiuri, MD and Maria Laura Del Basso De Caro, MD
Article Type: Case Report | First Published: October 18, 2019
Liponeurocytoma is a very rare tumor of the nervous system, with only 63 reported cases, mainly in the cerebellum and ventricular system. The key-points for the diagnosis are the histological findings of neurocytic cells with lipidic accumulation, with positivity for S-100 and synaptophysin and negativity for IDH-1, and the MR finding of hyperintensity areas on T1Wi corresponding to fatty tissue within the tumor. This article reports a case of cerebellar liponeurocytoma presenting with acute ictal onset due to significant tumor hemorrhage and resulting in poor outcome with death, after urgent ...
A Revisit of Open Repair for Zenker's Diverticulum Compared to Endoscopic Repair
Ryan Marshall, MD, Gobind Gill, MD, Mohamad Babi, MD, Kirk Withrow, MD and Do-Yeon Cho, MD
Article Type: Research Article | First Published: November 04, 2019
The purpose of our study is to prove open repair (OR) for Zenker's diverticulum can result in similar lengths of stay in the hospital, and similar convalescent periods when compared to endoscopic repair (ER). Retrospective chart review was performed between 2013-2018 for those patients who had surgical repair of Zenker's diverticulum by two surgeons. After discussing all risks, benefits, and alternatives, patient made a decision whether to have ER vs OR of Zenker's diverticulum. These findings suggest OR and ER have a similar length of hospital stay although the operative time is longer with a...
Metatropic Dysplasia - Description of a Newborn with Suspected Epiphyseal Dysplasia
Agnieszka Byrwa, Izabela Michalus, Paulina Adamiecka and Elzbieta Jakubowska-Pietkiewicz
Article Type: Case Report | First Published: October 21, 2019
The paper presents a female neonate with a suspected skeletal defect that was eventually diagnosed as metatropic dysplasia. This is the first case of this disease in our Clinic. Clinical course of the disease was discussed as well as findings of additional examinations and the differentiation from other diseases with a similar clinical picture. Newborns have a narrow and elongated chest with extremely short limbs, with bones resembling dumbbells. Other problems associated with dysplasia involve the spine - the vertebrae are excessively flattened, and any excessive movement of the cervical spin...
Muscle Magnetic Resonance Imaging versus Clinical Function in Duchenne Muscular Dystrophy
Yingyin Liang, PhD, Jie Li, MD, Chen Yang, MD, Xue Xu, MD, Guidian Li, MD, Rongxing He, Dr and Cheng Zhang, PhD
Article Type: Original Article | First Published: October 17, 2019
Impairment in patients with Duchenne muscular dystrophy (DMD) has been evaluated primarily by muscle fiber microscopy examination. Pathologic examination is limited by the choice of muscle and the invasiveness of muscle biopsy. Magnetic resonance imaging (MRI) of the muscle is a noninvasive method of evaluating muscle preservation. To compare muscle MRI and clinical function in patients at different stages (from early to terminal stage) of DMD, and to evaluate the correlation between fatty infiltration grade on MRI and clinical functional scale....
Climate Variability and Its Impact on the Incidence by Dengue in Six Endemic States of the Mexican Republic
Perez Contreras Irma, Alvarado Bravo Krystel Mariel, Barragan Gonzales Alin and Velasco Perez Daniel Alejandro
Article Type: Research Article | First Published: November 04, 2019
Climate variables are one of the main drivers of dengue epidemics and the proliferation of their vectors. Significant relationships have been found between fluctuations in temperature, rainfall, and the incidence of dengue. The interaction between high levels of these variables significantly influences the increase in the incidence after at least one month of this event. The confirmed cases of dengue reported in the epidemiological bulletins of the Epidemiology General Directorate were collected. Seven states with the highest incidence in the Mexican Republic during the years 2016- 2018 throug...
Hepatitis C in Adults and Children: A Cross-Sectional Review from a Tertiary Hospital, Northeast Nigeria during the Period 2008-2015
Isaac Warnow Elon, Ajani Ayomikun, Jalo Iliya, Alkali Yaya, Oyeniyi Christianah, Okolie Henry, Saidu Abubakar, Jibrin Bara, Aremu John, Kudi Ayuba, Danlami Halilu and Charanchi Musa
Article Type: Original Article | First Published: November 04, 2019
HCV is a leading cause of liver cirrhosis, hepatocellular carcinoma and liver failure related deaths among children, adolescents and adults worldwide. Sub-Saharan Africa suffers disproportionately from lack of access to both screening for HCV and treatment services with a resultant high rate of chronic hepatitis C related morbidity and mortality. Nigeria is considered among countries with high Hepatitis C burden and the national prevalence average in 2013 was estimated to be 2.2%. Routine screening for hepatitis C antibody in the country is however sub-optimal. The present study sought to dete...