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Proceedings of the Baylor University Medical Center

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https://www.readbyqxmd.com/read/28405100/facts-and-ideas-from-anywhere
#1
EDITORIAL
William Clifford Roberts
No abstract text is available yet for this article.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405099/tba-for-ot-hhc-vs-opc-f-u
#2
EDITORIAL
Herbert L Fred
No abstract text is available yet for this article.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405098/from-my-little-black-notebook-lessons-for-young-physicians-and-medical-students
#3
EDITORIAL
John Davis Cantwell
No abstract text is available yet for this article.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405097/tribute-to-dr-john-hyland
#4
Peter A Alivizatos
No abstract text is available yet for this article.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405096/cardiac-rehabilitation-for-a-skydiver-after-aortic-valve-replacement-for-pure-aortic-regurgitation-and-resection-of-the-ascending-aorta-complicated-by-active-infective-endocarditis-and-heart-block-requiring-a-pacemaker
#5
Tonja R Solomon, Sandra DeJong, Tim Bilbrey, Pasquale Carbone, Mark Campbell, Robert D Parker, Alessandra Lira, Diogo Amarante, Jeffrey M Schussler, Jenny Adams
A professional skydiver underwent aortic valve and ascending aorta replacement complicated by infective endocarditis with root abscess and pacemaker implantation. He then enrolled in the Baylor Heart and Vascular Hospital cardiac rehabilitation (CR) program as part of its specificity of testing and exercise training facility. He performed specific skydiving cardiovascular and muscular strength tests at the beginning and the end of the CR program. His pacemaker was interrogated to ascertain any arrhythmias or lead displacement over the course of the CR program...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405095/atrial-fibrillation-50-years-after-acute-rheumatic-fever-as-the-first-manifestation-of-rheumatic-mitral-stenosis
#6
D Luke Glancy
No abstract text is available yet for this article.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405094/successful-treatment-of-a-cardiac-resynchronization-therapy-nonresponder-by-identifying-lead-malpositioning
#7
Karthik Venkatesh Prasad, Krittapoom Akrawinthawong, Scott Wayne Ferreira, Ali Akbar Mehdirad
This case describes some of the commonly overlooked device-related issues in patients who have reportedly failed to respond to cardiac resynchronization therapy (CRT). The case demonstrates voltage-dependent right ventricular capture instead of right atrial capture by a subtly malpositioned right atrial lead. CRT therapy failed to improve symptoms of heart failure and the diagnosis of "CRT nonresponder" was made. With a detailed fact-finding approach, the mechanism behind this nonresponse was identified, and the outcome of CRT was significantly improved with rectification of the problems...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405093/two-causes-in-one-patient-for-extremely-low-voltage-on-the-electrocardiogram
#8
William C Roberts, Melody Joy Sherwood, Paul A Grayburn
An 80-year-old woman is described with two different causes (pericardial effusion and cardiac amyloidosis) for low QRS voltage on the electrocardiogram. Total 12-lead QRS voltage (from the peak of the R wave to the nadir of either the Q or the S wave, whichever is deeper) was only 34 mm (10 mm standard in all leads), the lowest we have encountered among 331 previously reported patients with 10 different cardiac conditions.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405092/use-of-a-mitraclip-for-severe-mitral-regurgitation-in-a-cardiac-transplant-patient
#9
Fayez S Raza, Paul A Grayburn, James W Choi
Severe mitral regurgitation (MR) in patients after cardiac transplant has not been well studied. Traditionally, patients have undergone corrective surgery. We report a 64-year-old man who presented with new heart failure symptoms 6 months after cardiac transplantation. He was found to have severe MR and underwent successful implantation of a MitraClip® with reduction of his MR to mild as well as improvement in his symptoms. Six months later he was still doing well, and a repeat echocardiogram showed good results...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405091/ambulatory-extracorporeal-membrane-oxygenation-with-subclavian-venoarterial-cannulation-to-increase-mobility-and-recovery-in-a-patient-awaiting-cardiac-transplantation
#10
Samuel Jacob, Juan C MacHannaford, Themistokles Chamogeorgakis, Gonzalo V Gonzalez-Stawinski, Joost Felius, Aldo E Rafael, Rajasekhar S Malyala, Brian Lima
Venoarterial extracorporeal membrane oxygenation (ECMO) can provide temporary cardiopulmonary support for patients in hemodynamic extremis or refractory heart failure until more durable therapies-such as cardiac transplantation or a left ventricular assist device-can be safely implemented. Conventional ECMO cannulation strategies commonly employ the femoral artery and vein, constraining the patients to the supine position for the duration of ECMO support. We have recently adopted a modified cannulation approach to promote patient mobility, rehabilitation, and faster recovery and to mitigate complications associated with femoral arterial cannulation, such as limb ischemia and compartment syndrome...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405090/bilateral-respiratory-epithelial-adenomatoid-hamartomas-originating-from-the-anterior-olfactory-clefts
#11
Jeffrey J Falco, Brandon S Peine, David W Clark
A respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon benign lesion often found in the sinonasal tract. We present a case of bilateral REAH originating from the anterior olfactory cleft treated with endoscopic surgical resection without recurrence. We highlight the characteristics of REAH and necessary steps to ensure proper diagnosis and treatment.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405089/right-hemispheric-reversible-cerebral-vasoconstriction-syndrome-in-a-patient-with-left-hemispheric-partial-seizures
#12
Gina S Perez, Justin McCaslin, Sadat Shamim
We report a right-handed 19-year-old girl who developed reversible cerebral vasoconstriction syndrome (RCVS) lateralized to the right hemisphere with simultaneous new-onset left hemispheric seizures. RCVS, typically more diffuse, was lateralized to one of the cerebral hemispheres.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405088/dural-arteriovenous-fistula-as-a-treatable-dementia
#13
Ikponmwosa Enofe, Ike Thacker, Sadat Shamim
Dementia is a chronic loss of neurocognitive function that is progressive and irreversible. Although rare, dural arteriovenous fistulas (DAVFs) could present with a rapid decline in neurocognitive function with or without Parkinson-like symptoms. DAVFs represent a potentially treatable and reversible cause of dementia. Here, we report the case of an elderly woman diagnosed with a DAVF after presenting with new-onset seizures, deteriorating neurocognitive function, and Parkinson-like symptoms.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405087/leukocytoclastic-vasculitis-drug-reaction-to-certolizumab-pegol
#14
Meghan Woody, Donald Warren, Laura Speck, Julie Jackson
Tumor necrosis factor (TNF)-alpha antagonists are a common treatment modality for autoimmune disorders, but their use can be associated with many side effects, including various dermatologic conditions. Certolizumab pegol, a newer TNF antagonist that lacks the Fc portion of the IgG antibody, has recently been approved to treat psoriatic arthritis, rheumatoid arthritis, and Crohn's disease. Though other TNF antagonists have been associated with leukocytoclastic vasculitis, this finding has not yet been reported with certolizumab pegol...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405086/evaluation-and-management-of-an-unusual-congenital-nevus
#15
K Blaire Kerwin, M Alan Menter
Abnormal findings on routine skin exams are common and can be a source of unnecessary medical workup if a clinician is unfamiliar with the finding. Sebaceous nevi are rare skin lesions that are most often benign but may be associated with a multiorgan syndrome or local skin cancer. Dermatologists and primary care physicians may encounter these on routine exams and thus must be comfortable with diagnosis and management. We present the clinical characteristics of a benign sebaceous nevus to help aid in diagnosis of these lesions and outline suggestions for appropriate management options...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405085/giant-cystic-umbilical-cord-associated-with-patent-urachus-and-intrauterine-fetal-demise
#16
Kira Brooks, Joseph Guileyardo, Don Le, Jesy Joykutty
True cystic structures within the umbilical cord are rare, and when they persist into the second and third trimester, they are often associated with an abnormal karyotype or other developmental abnormalities. Clinically significant pseudocysts resulting from massive edema of the umbilical cord have been associated with a congenitally patent urachus. We present a case of intrauterine fetal demise at 28 weeks' gestation in which cystic dilatation of the umbilical cord was diagnosed prenatally by ultrasound imaging...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405084/primitive-neuroectodermal-tumors-of-the-kidney
#17
Geetha Narayanan, Varun Rajan, T R Preethi
Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) rarely occurs as a primary renal tumor. The disease affects young adults and children and has an aggressive course. The clinical presentation and imaging of these tumors are nonspecific, and they often present at an advanced stage. We present the clinical features, imaging, diagnosis, and treatment of 7 cases of renal PNET (4 men, 3 women; median age, 32 years). Common presenting symptoms were flank or abdominal pain and a mass in the abdomen. On imaging, a large heterogenous infiltrating renal mass with areas of calcification, hemorrhage, and necrosis and tumor thrombus can give a clue to the diagnosis of renal PNET...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405083/plasmablastic-plasmacytoma-of-the-breast
#18
Don K Le, David Metter, John R Krause
Breast plasmacytomas are extremely rare entities that can be seen as primary malignant neoplasms in the absence of bone involvement or as secondary neoplasms from disseminated multiple myeloma. Clinicians should be aware of this entity, as it may mimic benign and malignant lesions in the breast. Microscopically, immature plasmacytomas may mimic other neoplasms, so caution should be made on histological examination to ensure the correct diagnosis and corresponding therapy. Here we present a case of a plasmablastic plasmacytoma of the breast in a 55-year-old woman that was originally thought to be an angiosarcoma...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405082/primary-small-cell-carcinoma-of-the-breast
#19
Benjamin Raber, Tuoc Dao, Evan Howard, Arthur Bredeweg
Early diagnosis of rare breast cancers is expected to occur more frequently as screening compliance improves and diagnostic modalities become more sensitive. Well-defined treatment algorithms exist for the management of ductal and lobular carcinomas; however, less information is available to guide the treatment of atypical breast cancers. This case report describes a 38-year-old African American woman with primary small cell carcinoma of the breast and her treatment.
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28405081/diagnosis-of-sarcoidosis-from-a-biopsy-of-a-dilated-mammary-duct
#20
Callan Mason, Robert Yang, Raynal Hamilton, Metin Punar, Zeeshan Shah, Joseph Spigel, Jean Wang
Sarcoidosis is an immunologic disease of unknown etiology that manifests most frequently within the lungs or associated lymph nodes. Sarcoidosis involving the breast is seen in <1% of cases and usually is diagnosed in patients with multisystem disease. The clinical and imaging presentations of sarcoidosis of the breast can be variable. Though uncommon, sarcoidosis should be considered in the differential diagnosis of a breast lesion, and given that imaging characteristics cannot distinguish between sarcoidosis and malignancy, all breast lesions in patients with sarcoidosis should be biopsied...
April 2017: Proceedings of the Baylor University Medical Center
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