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Amanda V Jenson, Robert Scranton, Danielle D Antosh, Richard K Simpson
[This corrects the article DOI: 10.7759/cureus.671.].
October 12, 2016: Curēus
Parvaiz M Zunga, Shah Faisal Ahmad Tarfarosh, Omar Farooq, Ishrat H Dar, Samia Rashid, Ummer Yaseen
[This corrects the article DOI: 10.7759/cureus.644.].
September 19, 2016: Curēus
Muhammad W Saif, Melissa Smith, Antonio Maloney
5-Fluorouracil (5-FU) is the backbone of the chemotherapy regimens approved for treatment of many malignancies, especially colorectal cancer (CRC). The incidence of cardiotoxicity associated with 5-FU ranges between 1.5% to 18% and is most commonly manifested as anginal symptoms. Cardiomyopathy is very rarely reported with 5-FU and capecitabine. A 35-year-old Caucasian male with T3, N1, M0 rectal cancer after the initial neoadjuvant chemoradiation with 5FU/LV followed by surgical abdominoperineal resection (APR), began mFOLFOX6 in the adjuvant setting...
September 14, 2016: Curēus
Nishitha Thumallapally, Uroosa Ibrahim, Mayurathan Kesavan, Qing Chang, Lynne Opitz, Meekoo Dhar, Sherif Andrawes
Granular cell tumors (GCTs) are soft tissue neoplasms that originate from Schwann cells. They occur predominantly in the oral cavity, skin, and breast tissues. Gastrointestinal GCTs are very rare, accounting for only eight percent of all GCTs, most of which are located in the esophagus. Endoscopic ultrasound has been a breakthrough in diagnosing GCTs because it provides precise information on the depth of tumor invasion, thus narrowing the differential diagnosis of subepithelial lesions in the esophagus. However, the definitive diagnosis requires histological confirmation of the lesion...
September 14, 2016: Curēus
Atman A Dave, Susan E Gutschow, Christopher M Walker
Erdheim-Chester disease (ECD) is a rare multisystemic non-Langerhans cell histiocytosis that may be clonal and inflammatory in origin. The hallmark of the disease is infiltration of various organ systems by CD68+/CD1a- histiocytes containing foamy lipid-laden inclusions. The manifestations and course of the disease are variable and depend on the organ systems that are affected. Patients may be asymptomatic or may develop life-threatening complications, including myocardial infarction. The most common clinical manifestation is lower extremity bone pain...
September 13, 2016: Curēus
Raju Vaishya, Ahmad Tariq Azizi, Amit Kumar Agarwal, Vipul Vijay
Osgood-Schlatter disease (OSD) is a condition in which the patellar tendon insertion on the tibial tuberosity becomes inflamed. It is a well-known condition in late childhood characterized by pain and a bony prominence over the tibial tuberosity. The pain is usually exacerbated by physical activities like running, jumping, and climbing stairs. In the acute stage, the margins of the patellar tendon become blurred in radiographs due to the soft tissue swelling. After three to four months, bone fragmentation at the tibial tuberosity is viewed...
September 13, 2016: Curēus
Gabrielle G Tardieu, Christian Fisahn, Marios Loukas, Marc Moisi, Jens Chapman, Rod J Oskouian, R Shane Tubbs
The epidural space contains the internal vertebral venous plexus, adipose, and other connective tissues. In the anatomical literature, there are nonspecific descriptions of varying fibrous connective tissue bands in the epidural space, mainly mentioned in the lumbar region, that tether the dural sac to the posterior longitudinal ligament, the vertebral canal, and the ligamentum flavum. These ligaments have been termed as Hofmann's ligaments. This review expands on the anatomy and function of Hofmann's ligaments, increasing the awareness of their presence and serves as an impetus for further study of their histology, innervation, and function...
September 13, 2016: Curēus
Lawrence Lechuga, Georg A Weidlich
A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities-fan beam and cone beam-was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation...
September 12, 2016: Curēus
Talayesa Buntinx-Krieg, Jeffrey Greenwald
We report a case of a 39-year-old healthy male presenting with an eruption consisting of evenly spaced, well-circumscribed, round, petechial macules over a discrete region on his back. A detailed history revealed that the man participated in a high-intensity combination workout routine and post-exercise massage. He reported using a regulation-sized dimpled softball in order to massage the musculature of his back. A diagnosis of traumatic petechiae was established. A growing fitness culture encouraging high-intensity training and post-exercise massage coupled with the high costs of professional masseuse services has led to the increased use of self-massage techniques using both traditional and non-traditional massage equipment...
September 12, 2016: Curēus
Daniel R Felbaum, Kyle Mueller, Ai-Hsi Liu, Rocco A Armonda
Preoperative embolization of meningiomas can be safely performed using a variety of embolic agents. Most commonly, the vascular supply from branches of the external carotid artery is the target of embolization. In our report, we detail the treatment of a patient with a parafalcine meningioma that received its supply via branches of the anterior cerebral artery. One of the feeder vessels appeared to contain a dysplastic aneurysmal dilatation of the vessel. Due to patient circumstances, embolization was performed using standard microcatheterization techniques to minimize intraoperative blood loss...
September 11, 2016: Curēus
Peter C Gerszten, Erin Paschel, Hazem Mashaly, Hatem Sabry, Hasan Jalalod'din, Khaled Saoud
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three- and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three- and four-level ACDF. METHODS: Two cohorts of patients who underwent ACDF for the treatment of three- and four-level disease were compared...
September 10, 2016: Curēus
Tia Renouf, Megan Pollard
Rural and remote places like Sable Island (Nova Scotia) or François (Newfoundland) pose a challenge in delivering both health care and appropriate education that today's learners need to practice in a rural setting. This education can be difficult to deliver to students far from academic centers. This is especially true for learners and practitioners at offshore locations like ships, oil installations, or in the air when patients are transported via fixed wing aircraft or helicopter. The following editorial provides a snapshot of the setting and the challenges faced while working as a physician on a ship, in remote regions...
September 9, 2016: Curēus
Tiffany Y Loh, Philip R Cohen
BACKGROUND: Tumor necrosis factor-α (TNF-α) inhibitors, such as infliximab, adalimumab, and certolizumab pegol are effective agents in the treatment of inflammatory bowel disease. Some individuals undergoing anti-TNF-α therapy for Crohn's disease or ulcerative colitis develop psoriasiform lesions. This is a paradoxical finding, as classical psoriasis is known to respond to these agents. PURPOSE: The clinical features of anti-TNF-α-induced psoriatic dermatitis are described...
September 9, 2016: Curēus
Bibek K Rai, Raju Vaishya, Amit Kumar Agarwal
Open segmental fractures of both bones of the forearm with the loss of the middle segment of the radius is a rare injury in children. An eight-year-old boy presented to our clinic four days following a road traffic accident. The child's mother was carrying a 12-cm long extruded and soiled segment of the radius bone. The extruded bone segment seemed necrotic, and we decided not to use it for replantation. The wound over the forearm fracture was infected. It was debrided and regularly dressed until it became healthy...
September 8, 2016: Curēus
Saisindhu Narala, Philip R Cohen
Basal cell carcinoma (BCC) typically occurs in sun-exposed sites. Only 16 individuals with umbilical BCC have been described in the literature, and the characteristics of patients with umbilical BCC are summarized. PubMed was used to search the following terms: abdomen, basal cell carcinoma, basal cell nevus syndrome, and umbilicus. Papers with these terms and references cited within these papers were reviewed. BCC of the umbilicus has been reported in five men and 11 women; one man had two tumors. Two patients had basal cell nevus syndrome (BCNS)...
September 7, 2016: Curēus
Christin Giordano, David Hutchinson, Richard Peppler
PURPOSE: The United States Medical Licensing Examination (USMLE) Step 1 plays a pivotal role in one's residency application. While prior literature has investigated which factors influence performance on the examination, the authors sought to include factors such as performance on a well-used question bank and financial need to develop a predictive model. METHOD : After obtaining institutional review board approval, the authors surveyed two consecutive second-year medical school classes and correlated the data to the students' Step 1 and National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) scores...
September 7, 2016: Curēus
Faisal Inayat, Hafeez Ul Hasan Virk
Exertional heatstroke (EHS) is a life-threatening disease characterized clinically by central nervous system dysfunction and severe hyperthermia. It frequently occurs among athletes, soldiers, and laborers. While cardiopulmonary symptoms are common in patients undergoing EHS, irreversible acute liver failure is a rarely described phenomenon. When managing cases of EHS complicated by acute liver failure, it is crucial to act promptly with aggressive total body cooling in order to prevent progression of the clinical syndrome...
September 6, 2016: Curēus
Stephanie Casey, Lara Best, Olga Vujovic, Kevin Jordan, Barbara Fisher, Deborah Carey, Deborah Bourdeau, Edward Yu
PURPOSE : Non-melanotic skin cancers remain the most commonly diagnosed cancers. Radiotherapy and surgery are the most common treatment options. Radiotherapy has a recurrence rate of up to 20% for basal or squamous cell cancers. One of the difficulties is to determine the extent of disease for poorly demarcated tumors. This study utilizes protoporphyrin (PpIX) fluorescence to provide information on the extent of subclinical disease for poorly demarcated tumors treated with radiotherapy...
September 4, 2016: Curēus
Simon Ho, Bo Liu, Raul Loya, Ibrahim Koury
Aortoenteric fistulas (AEFs) are deadly, abnormal connections between the aorta and gastrointestinal (GI) tract. While secondary aortoenteric fistulas (SAEFs) are more common and arise after aortic reconstruction, primary aortoenteric fistulas (PAEFs) are generally caused by abdominal aortic aneurysms (AAAs). PAEFs may present with self-limited GI bleeds called "herald bleeds," and the fistula often goes undiagnosed until patients undergo laparotomy for a massive GI bleed. We describe a case of a PAEF in a 79-year-old man with known AAA...
September 1, 2016: Curēus
Esther Kim, Tiffanie Do, Katie Peacock, Prisca T Takundwa
Patients with antiphospholipid syndrome (APS) are at increased risk of recurrent thromboembolic events due to the pathology of the disease. While prolonged anticoagulation is the treatment of choice for patients with thrombosis, much debate remains about the optimum intensity of anticoagulation. Anticoagulation with warfarin has been shown to decrease rates of thrombosis recurrence, but definitive evidence regarding targeted therapy to an INR of moderate (2.0 - 3.0) or high (3.1 - 4.0) intensity is lacking.
September 1, 2016: Curēus
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