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Proceedings of the Baylor University Medical Center

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https://www.readbyqxmd.com/read/27695191/facts-and-ideas-from-anywhere
#1
William Clifford Roberts
No abstract text is available yet for this article.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695190/epipericardial-fat-necrosis-as-a-cause-of-acute-chest-pain
#2
Ankit H Shah, Vivek Bogale, David Hurst, Gregory dePrisco
Acute chest pain is one of the most common reasons for presentation to the emergency department. Although most etiologies of chest pain are easy to clinically ascertain with routine history, physical, and laboratory examinations, we present an important benign cause of acute chest pain that may mimic acute coronary syndrome.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695189/new-onset-retrosternal-chest-pressure
#3
D Luke Glancy, Elias B Hanna
No abstract text is available yet for this article.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695188/melanoma-to-the-heart
#4
Charis G Durham, James A Hall, Erica J Fidone, Ryan Mack, Austin L Metting
Malignant melanoma is the third most common skin cancer yet has the highest mortality rate due to its predilection for metastasis. While the diagnosis of antemortem melanoma with cardiac metastasis is relatively uncommon, diagnosing malignant melanoma itself by first identifying a cardiac metastasis is even more rare. This vignette describes an antemortem diagnosis of melanoma in a 50-year-old woman through identification of metastasis to multiple sites, including the tricuspid valve.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695187/left-atrial-myxoma-masquerading-as-viral-flu
#5
Ossama Elsaid, Lovely Chhabra, Francis Kiernan
Atrial myxoma is a rare cardiac tumor that may be diagnosed incidentally on cardiac imaging or may present with life-threatening cardiac symptoms. We present a case of giant left atrial myxoma that presented as a flulike illness.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695186/frequency-and-potential-consequences-of-origin-of-the-left-vertebral-artery-or-the-arteria-thryoidea-ima-directly-from-the-aortic-arch
#6
Junlin Zhang, Joseph M Guileyardo, William C Roberts
Described herein are findings in a 58-year-old man in whom necropsy disclosed origin of the left vertebral artery (or the arteria thryoidea ima) directly from the aortic arch. No functional consequences resulted. Study of previous publications disclosed the frequency of this anomaly in adults to be approximately 3.5%. Dissection has been reported to be more frequent in the left vertebral artery when it arises directly from the aorta than when it arises from the left subclavian artery.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695185/origin-of-the-left-subclavian-artery-as-the-first-branch-and-origin-of-the-right-subclavian-artery-as-the-fourth-branch-of-the-aortic-arch-with-crisscrossing-posterior-to-the-common-carotid-arteries
#7
Junlin Zhang, Joseph M Guileyardo, William C Roberts
We describe an aortic arch anomaly consisting of the origin of the left subclavian artery as the fourth branch and the right subclavian artery as the first branch off the aortic arch with crisscrossing of these two arteries anterior to the trachea without clinical consequences. This anomaly, to our knowledge, has not been reported previously.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695184/placement-of-the-abbvie-peg-j-tube-for-the-treatment-of-parkinson-s-disease-in-the-interventional-radiology-suite
#8
Mark L Montgomery, Noel K Miner, Michael J Soileau, Douglas K McDonald
The primary treatment for Parkinson's disease is dopaminergic stimulation. Although levodopa has historically been administered orally, maintaining a predictable plasma concentration of the drug is challenging. As a result, enteral administration of carbidopa/levodopa (Duopa) has emerged as a promising tool in the treatment of the disease. This requires placement of an enteric catheter, two of which have been approved by the Food and Drug Administration for delivery of Duopa. The approved tubes are placed using the "peroral" or "pull" technique, a method traditionally requiring endoscopy...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695183/lymphogranuloma-venereum-proctitis
#9
Tucker Harrison, Mo Som, Jeff Stroup
We describe a 60-year-old man who presented with rectal pain and bleeding of a month's duration. His presentation was highly suggestive of lymphogranuloma venereum (LGV) proctitis. Nucleic acid amplification for chlamydia and gonorrhea via rectal swab revealed evidence supportive of anorectal chlamydia. Treatment with doxycycline resulted in complete resolution of his symptoms.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695182/management-of-a-renal-fungal-bezoar-caused-by-multidrug-resistant-candida-glabrata
#10
Gemma A Berlanga, Graham L Machen, Patrick S Lowry, Karen B Brust
We describe our management of an immunocompetent individual who developed obstructive uropathy and candidemia as a result of a fungal bezoar in the kidney. These sequelae arose from candiduria, provoked after several courses of antibiotics. Successful treatment included therapy with both culture-appropriate intravenous antifungals and operative intervention, including direct irrigation of the affected kidney with amphotericin B, relief of renal obstruction with a ureteral stent, a percutaneous nephrostomy tube, and ultimately endoscopic removal of the fungal bezoar...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695181/hemopericardium-with-tamponade-following-rivaroxaban-administration-and-its-attenuation-by-cyp3a4-inhibitors
#11
Denisse Menendez, Jeffrey Michel
Novel oral anticoagulants including the factor Xa inhibitor rivaroxaban are important alternatives to warfarin for the prevention of thromboembolic stroke in patients with nonvalvular atrial fibrillation. The pharmacology and metabolism of these agents differ from those of the vitamin K antagonists used over the decades preceding their introduction. We present a case of spontaneous hemopericardium and cardiac tamponade following administration of rivaroxaban. A review of the patient's medications revealed a total of seven agents known to be metabolized through cytochrome P450 3A4 (CYP3A4), the major pathway for rivaroxaban metabolism...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695180/acute-renal-failure-due-to-vancomycin-toxicity-in-the-setting-of-unmonitored-vancomycin-infusion
#12
Shagufta Vora
Vancomycin-induced nephrotoxicity is a commonly feared and largely preventable adverse effect of vancomycin therapy. We present the case of a 56-year-old woman who developed acute renal failure requiring hemodialysis as a result of unmonitored vancomycin infusions for the treatment of osteomyelitis.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695179/isolated-naratriptan-associated-ischemic-colitis
#13
Asra Akbar, George Nissan, Priyanka Chaudhry, Priya Rangasamy, Steven Mudrovich
We report a 41-year-old woman who developed histology- and colonoscopy-proven ischemic colitis with the use of naratriptan not exceeding the maximum 2 doses a day and 3 days per week and without a known medical or cardiovascular history. By exclusion of other causes of colonic ischemia, naratriptan was considered the sole causal agent. Discontinuation of naratriptan resulted in a complete clinical recovery. To date, our patient is the youngest known patient to develop ischemic colitis on isolated naratriptan in the setting of no known medical risk factors or predisposing medical condition...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695178/fulminant-ulcerative-colitis-complicated-by-treatment-refractory-bacteremia
#14
Michael Krease, Jeff Stroup, Mousumi Som, Benjamin Shepard
Severe ulcerative colitis is defined by more than six bloody stools daily and evidence of toxicity, demonstrated by fever, tachycardia, anemia, or an elevated erythrocyte sedimentation rate. Fulminant disease represents a subset of severe disease with signs and symptoms suggestive of increased toxicity. Treatment of severe colitis includes intravenous corticosteroid administration, with consideration of intravenous infliximab 5 mg/kg. Failure to show improvement after 3 to 5 days is an indication for colectomy or treatment with intravenous cyclosporine...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695177/abdominal-apoplexy-resulting-in-small-bowel-obstruction
#15
Avery Smith, Don Le, Joseph Guileyardo, Mark Casanova
Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695176/partial-annular-pancreas
#16
Shallini Mittal, Gunjan Jindal, Amit Mittal, Rikki Singal, Samita Singal
Annular pancreas is a developmental anomaly that can be associated with other conditions such as Down syndrome, duodenal atresia, and Hirschsprung disease. A band of pancreatic tissue, in continuity with the pancreatic head, completely or incompletely encircles the descending duodenum, sometimes assuming a "crocodile jaw" configuration. We present the case of an adult who presented with epigastric pain and vomiting and was found to have annular pancreas.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695175/vanishing-lung-syndrome
#17
Yunhee Im, Saad Farooqi, Adan Mora
Giant bullae often mimic pneumothorax on radiographic appearance. We present the case of a 55-year-old man admitted to a referring hospital with dyspnea, cough, and increasing sputum production; he refused thoracotomy for tension pneumothorax and presented to our hospital for a second opinion. A computed tomography (CT) scan at our hospital revealed a giant bulla, which was managed conservatively as an exacerbation of chronic obstructive pulmonary disease. Thoracic surgery was consulted but advised against bullectomy...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695174/acute-promyelocytic-leukemia-after-renal-transplant-and-filgrastim-treatment-for-neutropenia
#18
Jaime A Campbell, John R Krause
Prolonged immunosuppression in solid organ transplant recipients has been considered a risk for developing opportunistic infections and malignancies. Acute leukemia is a rare complication. We report a case of acute promyelocytic leukemia (APL) (FAB M3) after cadaveric renal transplant for focal segmental glomerulosclerosis in a 24-year-old woman. Her immunosuppressive therapy included tacrolimus, mycophenolate mofetil, and prednisone. Approximately 2 years after transplant, she became pancytopenic, prompting administration of filgrastim...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695173/acute-myeloid-leukemia-presenting-as-galactorrhea
#19
K Rakul Nambiar, Sreejith G Nair, R Nandini Devi
Acute myeloid leukemia (AML) presents with symptoms related to pancytopenia (weakness, infections, bleeding diathesis) and organ infiltration with leukemic cells. Galactorrhea is an uncommon manifestation of AML. We report a case of AML presenting with galactorrhea.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27695172/extreme-anemia-hemoglobin-1-8-g-dl-secondary-to-colon-cancer
#20
Rob E Schmitt, Clifford J Buckley
We present the case of a 34-year-old man who presented to the emergency department with complaints of generalized fatigue and palpitations, with a heart rate of approximately 100 beats per minute and an orthostatic blood pressure of 80/30 mm Hg upon standing. A hemoglobin of 1.8 g/dL was discovered. A positive fecal occult blood test led to the diagnosis of colon cancer. Once the cancer was resected, the patient's anemia resolved.
October 2016: Proceedings of the Baylor University Medical Center
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