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https://www.readbyqxmd.com/read/28191384/delayed-temporal-lobe-hemorrhage-after-initiation-of-acyclovir-in-an-immunocompetent-patient-with-herpes-simplex-virus-2-encephalitis-a-case-report
#1
Kyle Mueller, Joshua E Ryan, Alex Tai, Rocco A Armonda
Herpes simplex virus (HSV) is the most common cause of non-epidemic, sporadic, acute focal encephalitis in the United States. Inflammation of the vasculature makes them friable and susceptible to hemorrhage. Massive hemorrhage, though rare, can present in a delayed fashion after initiation of acyclovir and often requires surgical intervention. We report a unique case of delayed temporal lobe hemorrhage after initiation of acyclovir in an immunocompetent patient, specifically for its presentation, virology, and surgical management...
January 15, 2017: Curēus
https://www.readbyqxmd.com/read/28191383/minimally-invasive-direct-lateral-interbody-fusion-mis-dlif-proof-of-concept-and-perioperative-results
#2
Hamid Abbasi, Ali Abbasi
BACKGROUND: Minimally invasive direct lateral interbody fusion (MIS-DLIF) is a novel approach for fusions of the lumbar spine. In this proof of concept study, we describe the surgical technique and report our experience and the perioperative outcomes of the first nine patients who underwent this procedure. STUDY DESIGN/SETTING: In this study we establish the safety and efficacy of this approach. MIS-DLIF was performed on 15 spinal levels in nine patients who failed to respond to conservative therapy for the treatment of a re-herniated disk, spondylolisthesis, or other severe disk disease of the lumbar spine...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#3
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28191381/spontaneous-unilateral-adrenal-hemorrhage-in-pregnancy
#4
Salam Kadhem, Rawaa Ebrahem, Cyrus Munguti, Rami Mortada
Spontaneous adrenal hemorrhage (SAH) is a serious medical condition associated with variable clinical presentation depending on the extent of the hemorrhage. Pregnancy-induced adrenal hemorrhage is poorly understood. A low cortisol level in the peripartum period with radiological findings is sufficient to establish the diagnosis. Prompt hormone replacement and supportive care to ensure good clinical outcomes is crucial. Due to the potentially life-threatening complications, physicians should have a high suspicion for adrenal hemorrhage when they evaluate patients with hypotension, fatigue, and abdominal pain during the peripartum period...
January 13, 2017: Curēus
https://www.readbyqxmd.com/read/28191380/transorbital-approach-for-endovascular-occlusion-of-carotid-cavernous-fistulas-technical-note-and-review-of-the-literature
#5
Ching-Jen Chen, Panagiotis Mastorakos, James P Caruso, Dale Ding, Paul J Schmitt, Thomas J Buell, Daniel M Raper, Avery Evans, Steven A Newman, Mary E Jensen
Carotid-cavernous fistulas (CCFs) pose an anatomically and physiologically challenging problem for clinicians. The most common method of treatment for these lesions is transvenous endovascular embolization via the inferior petrosal sinus or the facial vein. When transvenous access is not possible, an alternate approach must be devised. We describe a case example with bilateral Barrow Type B CCFs, which were inaccessible using the traditional transvenous approach. Hence, a direct transorbital approach, performed under fluoroscopic guidance, was employed to successfully obliterate the CCF...
January 12, 2017: Curēus
https://www.readbyqxmd.com/read/28191379/functional-and-aesthetic-recovery-of-congenital-muscular-torticollis-with-intramuscular-stromal-vascular-fraction-enriched-fat-grafting
#6
Juan Monreal
Congenital muscular torticollis is a well-known pathological condition caused by the contracture and shortening of the sternocleidomastoid muscle. This condition is manifested by a neck postural deformity often accompanied by some kind of facial asymmetry. Once diagnosed, treatment by early physiotherapy is generally successful in a high percentage of patients if performed during the first year of life. Later, especially after the fourth year, conservative treatment is usually far less effective, and surgical techniques remain the only way to improve neck contour and function...
January 12, 2017: Curēus
https://www.readbyqxmd.com/read/28191378/mediterranean-spotted-fever-a-rare-non-endemic-disease-in-the-usa
#7
Joshua Brad Oaks, Glenmore Lasam, Gina LaCapra
We report a case of a 43-year-old Israeli male who presented with an intermittent fever associated with a gradual appearance of diffusely scattered erythematous non-pruritic maculopapular lesions, generalized body malaise, muscle aches, and distal extremity weakness. He works in the Israeli military and has been exposed to dogs that are used to search for people in tunnels and claimed that he had removed ticks from the dogs. In the hospital, he presented with fever, a diffuse maculopapular rash, and an isolated round black eschar...
January 12, 2017: Curēus
https://www.readbyqxmd.com/read/28191377/diagnosis-and-management-of-cervical-thymic-cysts-in-children
#8
Joshua J Sturm, Kavita Dedhia, David H Chi
We present the case of a 10-year-old boy with the sudden onset of a large, painless left neck mass. Findings on magnetic resonance imaging (MRI) and fine needle aspiration (FNA) biopsy suggest a cystic lesion, most likely of thymic origin. Cervical thymic cysts are a rare form of cervical mass, which are easily overlooked in the differential diagnosis of children presenting with painless neck masses. A combination of CT and MRI investigations can be helpful in differentiating thymic cysts from other congenital and neoplastic masses, but the definitive diagnosis of thymic cyst requires histopathological documentation of thymic tissue...
January 11, 2017: Curēus
https://www.readbyqxmd.com/read/28191376/when-nothing-else-works-fresh-frozen-plasma-in-the-treatment-of-progressive-refractory-angiotensin-converting-enzyme-inhibitor-induced-angioedema
#9
Gerard Chaaya, Faraz Afridi, Arfa Faiz, Ali Ashraf, Mahrukh Ali, Analia Castiglioni
Angioedema is a severe form of an allergic reaction characterized by the localized edematous swelling of the dermis and subcutaneous tissues. Angiotensin-converting enzyme inhibitor-induced angioedema (ACEI-IA) is an allergic reaction that can be severe in some cases requiring advanced management measures. Fresh frozen plasma has been used off-labeled in some case reports to improve and to prevent worsening of the angioedema in a few cases of ACEI-IA. We are reporting this case to increase the awareness of physicians and to widen their therapeutic options when encountering this clinically significant condition...
January 11, 2017: Curēus
https://www.readbyqxmd.com/read/28191375/self-inflicted-cardiac-injury-with-nail-gun-without-hemodynamic-compromise-a-case-report
#10
Simon Ho, Bo Liu, Nicholas Feranec
Pneumatically powered nail guns have been used in construction since 1959. Penetrating injuries to the heart with nail guns have a wide range of presentations from asymptomatic to cardiac tamponade and exsanguination. Mortality related to cardiac nail gun injuries is similar to knife injuries, estimated at 25%. Surgical exploration is the treatment of choice. We describe a case of self-inflicted nail gun injury to the chest without hemodynamic compromise in a 51-year-old man. Computed tomography (CT) imaging confirmed nail penetrating the right ventricle, with the tip adjacent to but not violating the abdominal aorta...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28191374/klebsiella-pneumoniae-liver-abscess-a-case-report-and-review-of-literature
#11
Faisal Kamal, George Williams, Hina Akbar, Muhammad Ali Khan, Dipen Kadaria
Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Several groups of patients are particularly susceptible to infection, including patients with diabetes mellitus, those from Southeast Asia and those with the preexisting hepatobiliary disease. We present a case of K.pneumoniae PLA with bacteremia. A 39-year-old Vietnamese male with no previous medical history who presented with complaints of abdominal pain, nausea, vomiting, diarrhea and fever...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28191373/capecitabine-associated-loss-of-fingerprints-report-of-capecitabine-induced-adermatoglyphia-in-two-women-with-breast-cancer-and-review-of-acquired-dermatoglyphic-absence-in-oncology-patients-treated-with-capecitabine
#12
Philip R Cohen
Capecitabine, an oral 5-fluorouracil prodrug, is currently used in the treatment of metastatic colorectal carcinoma and breast cancer. Fingerprints, also referred to as dermatoglyphics and characterized by the pattern of ridges and furrows on the fingertips, are used for identification by government agencies and personal electronic devices. Two women with breast cancer who were treated with capecitabine and developed drug-associated loss of their fingerprints are described. PubMed was used to search the following terms separately and in combination: absence, adermatoglyphia, breast, cancer, capecitabine, carcinoma, colon, colorectal, dermatoglyphics, fingerprint, fluorouracil, foot, hand, loss, malignancy, nasopharyngeal, oncology, reaction, rectal, skin, syndrome, tumor, and xeloda...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191372/richter-transformation-of-chronic-lymphocytic-leukemia-a-review-of-fluorodeoxyglucose-positron-emission-tomography-computed-tomography-and-molecular-diagnostics
#13
REVIEW
Faiq Shaikh, Amna Janjua, Frederick Van Gestel, Adeel Ahmad
Chronic lymphocytic leukemia (CLL) is a low-grade B-cell proliferative disease with a generally indolent course. In a few cases, it undergoes transformation and becomes a more aggressive malignancy, such as diffuse large B-cell lymphoma (DLBCL). This process, which is called Richter transformation (RT), is often detected too late and is associated with a poor prognosis. There are multiple molecular diagnostic approaches to detect RT in preexisting CLL. Metabolic imaging using 18-fluorine fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) can be a very useful tool for early detection of RT and which can hence allow for timely intervention, thereby improving the patient's chances of survival...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191371/the-effect-of-medical-student-volunteering-in-a-student-run-clinic-on-specialty-choice-for-residency
#14
Ashley Brown, Rahim Ismail, Glenn Gookin, Caridad Hernandez, Grace Logan, Magdalena Pasarica
INTRODUCTION:  Student-run free clinics (SRFCs) are a recent popular addition to medical school education, and a subset of studies has looked at the influence of SRFC volunteering on the medical student's career development. The majority of the research done in this area has focused on understanding if these SRFCs produce physicians who are more likely to practice medicine in underserved communities, caring for the uninsured. The remainder of the research has investigated if volunteering in an SRFC influences the specialty choice of medical school students...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191370/overestimating-overdiagnosis-in-breast-cancer-screening
#15
EDITORIAL
Alan Hollingsworth
Overdiagnosis in breast cancer has been a focus of increasing concern with wide ranges of calculations made indirectly through the study of prospective randomized trials and analyses of large registries. While most admit that some degree of overdiagnosis is inherent with ductal carcinoma in situ (DCIS), the rate of overdiagnosis with invasive disease is highly controversial. Although it is generally accepted that overdiagnosis is calculated through indirect means and deductive reasoning, this is not entirely the case...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191369/follow-up-visits-and-changes-in-pain-scores-reported-by-oncology-outpatients-after-initial-presentation-with-severe-pain
#16
Brett Hill, Dwight Moulin, Michael Sanatani
BACKGROUND: In addition to tumour treatment, the management of symptoms such as pain is an important component of cancer care. Pain management is a complex field and prior studies have highlighted many different clinical care responses to a cancer patient presenting with severe pain. We explored follow-up and how pain screening scores changed over time, among a cohort of cancer outpatients, and how follow-up was scheduled after the initial visit. METHODS: The care provided to 96 patients seen at the London Regional Cancer Program was reviewed for the 12-week period following presentation with severe pain >7/10...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191368/a-rare-case-of-adult-onset-intussusception-complicated-by-narcotic-dependence
#17
Saira J Khan, Ashley M Desmarais, Bellal Joseph, Richard Amini
This report describes a rare case of adult intussusception in a patient with a history of a Roux-en-Y gastric bypass procedure; complicated by a history of narcotic abuse, methadone dependence, and methamphetamine abuse. Adult patients who have undergone a Roux-en-Y gastric bypass procedure may be at an increased risk of developing intussusception, and clinicians involved in their care should be aware of this potential complication.
January 8, 2017: Curēus
https://www.readbyqxmd.com/read/28191367/composite-diffuse-large-b-cell-and-mantle-cell-lymphoma-a-case-report
#18
Farhan Mohammad, Gwenalyn Garcia, Shiksha Kedia, Juan Ding, Matthew Hurford, Alexander Bershadskiy
Composite lymphoma is an extremely rare clinical entity and is characterized by the presence of two different subtypes of lymphoma in the same lymph node. We report a case of composite lymphoma in a 57-year-old male presenting with leg and groin pain. The right inguinal lymph node biopsy showed large and small cells. Immunohistochemistry was consistent with large cells staining for diffuse large B-cell lymphoma (DLBCL) and small cells positive for mantle cell lymphoma (MCL). Polymerase chain reaction (PCR) analysis of immunoglobulin heavy (IGH) chain and immunoglobulin kappa (IGK) light chain gene rearrangements confirmed that the two were clonally unrelated neoplasms...
January 8, 2017: Curēus
https://www.readbyqxmd.com/read/28191366/radiological-and-functional-outcome-of-displaced-colles-fracture-managed-with-closed-reduction-and-percutaneous-pinning-a-prospective-study
#19
Sagar Panthi, Kishor Khatri, Krishna Kharel, Subin Byanjankar, Jay R Sharma, Rahul Shrestha, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
BACKGROUND: Displaced Colles' fractures are treated by manipulation and below elbow cast application. Malunion is a common complication, resulting in pain, mid-carpal instability, and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique that helps prevent displacement of the fracture, thereby minimizing complications. This study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with Kirschner wires (K-wires) and its correlation with the functional outcome of the wrist after union...
January 6, 2017: Curēus
https://www.readbyqxmd.com/read/28168139/video-laryngoscopy-vs-direct-laryngoscopy-in-teaching-neonatal-endotracheal-intubation-a-simulation-based-study
#20
Srikumar Nair, Eric J Thomas, Lakshmi Katakam
BACKGROUND: Neonatal endotracheal intubation is a life-saving procedural skill where best practices have been developed from expert opinion. Few empirical studies have examined how this skill should be taught. OBJECTIVE: To determine whether a video laryngoscope (VL) assisted intubation training curriculum compared to a traditional direct laryngoscope (DL) assisted curriculum improves neonatal intubation performance of novice intubators in a simulated setting. METHODS: A randomized trial of novice intubators was conducted at the University of Texas-Houston from 6/2013-8/2013...
January 6, 2017: Curēus
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