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Georgi P Georgiev, Alexandar Iliev, Georgi Kotov, Violeta K Nedialkova, Vidin Kirkov, Boycho Landzhov
[This corrects the article DOI: 10.7759/cureus.3812.].
March 7, 2019: Curēus
Alexander Romagna, Christoph Schwartz, Barbara Ladisich, Wolfgang Hitzl, Sarah-Charlotta Heidorn, Peter A Winkler, Alexander Muacevic
[This corrects the article DOI: 10.7759/cureus.3741.].
March 5, 2019: Curēus
Shawana Kamran, Sara A Awan, Kamran N Ahmad, Yasir Iqbal
Acute myeloid leukemia (AML) with balanced translocation t (8;21) is one of the most frequent chromosomal abnormalities and carries a favorable clinical outcome. However, according to a literature review, additional chromosomal aberrations can affect the overall disease prognosis. Trisomy 4 is a rare numerical abnormality in AML patients with t (8;21), which can be associated with c-KIT gene involvement. In adults, c-KIT mutation carries an unfavorable clinical outcome; however, its incidence and clinical importance in the pediatric population are still under scrutiny...
January 14, 2019: Curēus
Luwei Tao, Jingxin Sun, Akriti Jain, Jie Ouyang, Daniel Tambunan
Fibrous dysplasia (FD) is a benign bone disorder, in which normal bone structure is replaced by fibrous connective tissue. Polyostotic FD is also related to McCune-Albright syndrome with possible endocrine disorder and Cafe-au-lait macules. Although FD commonly presents as craniofacial bone abnormality, atypical presentation can be misleading and pose a difficulty in clinical diagnosis. Here we report a case of polyostotic FD, who presented as an accidental finding of multiple spinal osseous lesions, leading to clinic workup for metastatic cancer...
January 14, 2019: Curēus
Wen Wang, Emily Emmet, Alexander Leyva, John V Dennison, Sean Dodson
Cerebrospinal fluid (CSF) rhinorrhea is most commonly associated with preceding trauma. Spontaneous CSF rhinorrhea has rarely been documented. Clinical, biochemical, and radiological examination are necessary to establish its diagnosis. Detection of beta-2 transferrin in watery nasal discharge is diagnostic for the presence of CSF. Computed tomography (CT) cisternography or magnetic resonance imaging (MRI) cisternogram are confirmatory radiologic modalities for localization of the leakage site.
January 14, 2019: Curēus
Branten J Page, Oliver D Mrowczynski, Russell A Payne, Sarah E Tilden, Hector Lopez, Elias Rizk, Kimberly Harbaugh
In peripheral nerve surgery, repair of the femoral nerve (FN) requires identification of normal nerve elements both proximal and distal to the level of the injury. We identified FN branches to the sartorius (SRT) and quadriceps muscles in 16 embalmed specimens and calculated the length of each branch to its point of entry into its respective muscle. The SRT and rectus femoris (RF) muscles were mobilized but not transected to mimic the surgical approach. Ratios of the length of each motor branch as a unit of the total length of the thigh, defined as the FN at the inguinal ligament to the superior margin of the patella were also calculated...
January 14, 2019: Curēus
Karim O Elkholy, Hamza Akhtar, Eric Landa, Yury Malyshev, Sonu Sahni
Tracheostomy is a common procedure seen in critically ill patients that require long term ventilatory support. As with all airway access procedures, tracheotomy with prolonged tracheal tube placement comes with possible risks such as tracheal scarring, tracheal rupture, pneumothorax, tracheoesophageal fistula among others. Another possible complication, though rare, is escape of free air into the surrounding tissue, as well as pneumomediastinum (PM). This may occur due to various reasons, some of them being tracheal rupture, barotrauma or tracheal tube mispositioning...
January 14, 2019: Curēus
Nazish Butt, M Ali Khan, Farhan Haleem, Sehrish Butt, Sehrish Reema, Talha Qureshi, Amanullah Abbasi
Background Hepatitis B virus (HBV) infection is a serious health problem in Pakistan. In view of the serious socioeconomic consequences, identifying patient characteristics and the current treatment for the disease will enhance HBV regulation and its medical management. Aims To describe the epidemiology, clinical characteristics, and current management status of patients infected by HBV. Methods We undertook an observational, cross-sectional, and epidemiological study at the Jinnah Postgraduate Medical Centre, Karachi, during the period from January 2014 to November 2017...
January 14, 2019: Curēus
Philip R Cohen
Amyloid deposition has been observed in tissue specimens of basal cell carcinomas. A 68-year-old man with a nodular basal cell carcinoma on his left arm near the elbow is described; microscopic evaluation of the biopsy tissue specimen shows not only nodular aggregates and strands of atypical basaloid tumor cells but also marked deposition of amorphous amyloid material in the stroma between the aggregates of basal cell carcinoma. Including the man in this report, there are additional individual descriptions of patients whose basal cell carcinomas have amyloid deposits in the adjacent stroma or within the tumor aggregates or both...
January 14, 2019: Curēus
Adam Y Li, Jennifer B Dai, Alexander F Post, Tanvir F Choudhri
Flexion-extension magnetic resonance imaging (MRI) in the cervical spine is not universally used in cervical spine surgery. However, flexion-extension MRIs can identify previously undetected spinal stenosis, improve surgical decision-making, and maybe a better tool to evaluate postoperative outcomes. One uncommon complication after laminectomy, to treat cervical spinal stenosis, is muscle weakness due to subsequent dynamic cord compression by posterior paraspinal musculature. We present a case of a 41-year-old male who underwent posterior cervical decompression and developed subsequent neurological deficits and muscle weakness...
January 14, 2019: Curēus
Paul P Yen, Sam M Wiseman
Background Established guidelines recommend that patient educational materials should be set at no higher than a sixth-grade reading level to be considered adequately comprehensible to the general public. Our study objective was to assess the readability of online patient resources related to sentinel lymph node biopsy (SLNB) as part of treatment for melanoma. Materials and methods The top 50 results from a Google search (search terms: "sentinel lymph node biopsy melanoma") were analyzed using seven established readability formulae in order to determine their level of adherence to current guidelines...
January 13, 2019: Curēus
Phillip Knouse, Christie Hancock, Suzanne Iwaz, Pamela Kaiser
Metastatic carcinomatosis cirrhosis is a pattern of metastasis in which malignancy infiltrates the liver and provokes hepatic fibrosis. It is an especially rare complication of several malignancies, including breast cancer. We report a case of a 61-year-old woman with lobular carcinoma of the breast who presented with confusion and rising serum tumor markers without evidence of disease recurrence on imaging. She subsequently developed clinical evidence of hepatic dysfunction and a liver biopsy revealed diffuse infiltration of the liver by breast carcinoma with surrounding fibrous tissue deposition, consistent with metastatic carcinomatosis cirrhosis...
January 13, 2019: Curēus
Muhammad Awais, Basit Salam, Naila Nadeem, Abdul Rehman, Noor U Baloch
BACKGROUND: Rib fractures are a major source of morbidity in patients with chest trauma. Computed tomography (CT) scout film is a low-dose image that is obtained prior to a complete chest CT study for all patients undergoing a CT scan. In this study, we evaluated the diagnostic performance of CT scout film vis-à-vis that of chest X-ray for detection of rib fractures using chest CT scan as the reference standard. METHODS: A cross-sectional study was performed at the radiology department of Aga Khan University Hospital (Karachi, Pakistan) from October 1, 2013 to September 31, 2014...
January 13, 2019: Curēus
Mohammad Alomari, Hunter Bratton, Ahmad Musmar, Laith A Al Momani, Mark Young
The P2Y12 inhibitor, ticagrelor, has been shown to prevent thrombotic events and hence, improve morbidity and mortality in patients with acute coronary syndrome following coronary artery stent placement. Despite many clinical benefits, ticagrelor has been associated with several adverse effects, including dyspnea, easy bruising, and gastrointestinal bleeding. We report the case of a 67-year-old patient with an acute coronary artery syndrome requiring percutaneous coronary artery intervention with stenting who developed ticagrelor-induced diarrhea...
January 12, 2019: Curēus
Ramiah R Vickers, Jane S Gibson
This review describes the clinical criteria of developmental delay (DD)/intellectual disability (ID) as well as the various techniques that are currently implemented to diagnose neurodevelopmental disorders that typically present with associated dysmorphic features such as Angelman syndrome, Prader-Willi syndrome, and DiGeorge syndrome. These analyses include various forms of chromosomal microarray (CMA), which have proven to be superior to previously implemented techniques such as G-banded karyotyping and fluorescent in situ hybridization (FISH) analysis, as well as whole exome sequencing (WES), which is implemented as a secondary examination when CMA analysis is unrevealing...
January 12, 2019: Curēus
Solomon Feuerwerker, Nick Rankin, Brittany Wohler, Henry Gemino, Zachary Risler
The emergency department (ED) serves a pivotal role in the healthcare system, but it is often a source of anxiety and confusion for patients at a time already shrouded by fear of illness and uncertainty. Common patient needs include receiving information about different stages of their care, assurance that they are safe, and knowledge of a plan for proper follow-up care prior to discharge. Due to well-known restraints on the clinician's time, meeting this level of patient satisfaction has often fallen short...
January 12, 2019: Curēus
Allan R Escher, Jonathan B Cohen
In this case report, we present a patient who developed anaphylaxis immediately after sugammadex administration. A 67-year-old female with the diagnosis of papillary serous carcinoma was scheduled for an exploratory laparotomy exam under anesthesia and total abdominal hysterectomy. At the end of the operation, sugammadex was administered; it was rapidly accompanied with marked hypotension and bradycardia. Multiple boluses of phenylephrine were administered with minimal effect. Boluses of epinephrine and vasopressin were given and the patient's hemodynamic instability rapidly abated...
January 12, 2019: Curēus
Jojo James, Ajay Belgaumkar, Ameet Patel
A case of blunt pancreatic trauma during a soccer match is presented in a young adult female. Following diagnosis, a laparotomy was performed and multiple abdominal drains placed. A controlled pancreatic fistula occurred, which was treated conservatively. Spontaneous drain migration into the duodenum created a therapeutic iatrogenic internal fistula.
January 11, 2019: Curēus
Ryan Stefancik
Thromboangiitis obliterans (TAO), otherwise known as Buerger's Disease, is a rare, small-vessel vasculitis strongly associated with cigarette smoking, that when left untreated can cause vessel destruction and necrosis of the distal extremities leading to amputation. The patient being presented is a 46-year-old Caucasian female who has been smoking since the age of fifteen and shows characteristics of TAO on angiography. The uniqueness of this case lies in the epidemiology; the typical TAO patient is a 20 to 40-year-old Asian male...
January 11, 2019: Curēus
Nuruna Lovely Nishuty, Md Mehedi Hasan Khandoker, James Regun Karmoker, Sumiya Ferdous, Mohammad Shahriar, M M A Shalahuddin Qusar, Md Saiful Islam, Mohammad Fahim Kadir, Md Rabiul Islam
Background Major depressive disorder (MDD) is a disabling health problem with a very high global prevalence and burden. Alteration of inflammatory markers in depression is of growing interest to many psychiatry researchers. This study aimed to examine the serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in MDD patients to find out their association with depression. Materials and methods The present study recruited 88 MDD patients and 86 control subjects matched by age, gender, and body mass index (BMI)...
January 11, 2019: Curēus
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