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Homa Timlin, Abrahim Syed, Uzma Haque, Brittany Adler, Genevieve Law, Kirthi Machireddy, Rebecca Manno
[This corrects the article DOI: 10.7759/cureus.2098.].
May 1, 2018: Curēus
Ruhi Sonaye, Shaheen Sombans, Kamleshun Ramphul
Congenital non-spherocytic hemolytic anemia (CNSHA) is a rare autosomal recessive condition that presents as a congenital hemolytic anemia. The absence of vital enzymes required for glycolysis such as homozygous glucose phosphate isomerase (GPI) and red blood cell (RBC) nucleotide metabolism predisposes the RBCs to hemolysis. No spherocytosis is seen on peripheral smear as well as no signs of immune-mediated destruction of RBCs. We present a rare case of a previously healthy 21-year-old female patient with CNSHA from India...
April 13, 2018: Curēus
Rabail Raza, Kumail Khandwala, Hafsa Qayyum, Muhammad Anwar Saeed, Anwar Ahmed
Crossed or "crisscross" pulmonary arteries (CPA) are a result of an anomalous origin and course of both the pulmonary arteries from the main pulmonary trunk in which the left pulmonary artery (PA) ostium usually lies directly superior and to the right PA ostium after which they cross each other and supply their respective lungs. This condition is usually associated with conotruncal malformations and genetic syndromes. We describe a case report of an infant, suspected to have Down syndrome, who was diagnosed with CPA and coarctation of aorta on computed tomography (CT) angiography...
April 13, 2018: Curēus
Arumugom Archana, Sathasivam Sureshkumar, Chellappa Vijayakumar, Chinnakali Palanivel
Introduction Only a few studies compare the efficacy of the harmonic scalpel and electrocautery in performing mastectomies, and these have mainly compared their intraoperative parameters. But the main concern with electrocautery is the incidence of flap necrosis and seroma formation. Therefore, this study was done to determine if the harmonic scalpel has any advantages over electrocautery in reducing postoperative flap necrosis and seroma formation in patients undergoing a modified radical mastectomy (MRM)...
April 13, 2018: Curēus
Vincent Weidlich, Georg A Weidlich
Artifical Intelligence (AI) was reviewed with a focus on its potential applicability to radiation oncology. The improvement of process efficiencies and the prevention of errors were found to be the most significant contributions of AI to radiation oncology. It was found that the prevention of errors is most effective when data transfer processes were automated and operational decisions were based on logical or learned evaluations by the system. It was concluded that AI could greatly improve the efficiency and accuracy of radiation oncology operations...
April 13, 2018: Curēus
Sukesh Manthri, Sindhura Bandaru, Abdisamad Ibrahim, Chaitanya K Mamillapalli
Acute pericarditis as a presenting sign of adrenal insufficiency is rarely reported. We present a rare case that highlights pericarditis as a clinical presentation of secondary adrenal insufficiency later complicated by cardiac tamponade. A 44-year-old lady who presented to the hospital with a one-day history of pleuritic chest pain and shortness of breath. In the emergency room, she had a blood pressure of 70/35 mmHg. Laboratory evaluation revealed white blood cell count of 16.08 k/cumm with neutrophilia, normal renal function and elevated troponin (0...
April 13, 2018: Curēus
Rafik Shereen, Rod J Oskouian, Marios Loukas, R Shane Tubbs
The arrow is one of the oldest weapons invented that has ties back to ancient civilization. With the advancement of modern weaponry, literature concerning the management of this traumatic wound has dwindled.  However, there are older written accounts that have led to our understanding of how we manage injuries inflicted by the arrow. One of the more comprehensive accounts was produced in the 19th century by a United States (US) Lieutenant Colonel named JH Bill. Recent cases in forensic pathology, as well as instances of trauma concerning arrowhead injuries, have documented a lack of comprehensive literature for the management of such injuries...
April 13, 2018: Curēus
Awais Abbas, Mohammad Raza, Aamina Majid, Yumna Khalid, Syed Hamza Bin Waqar
Hemophagocytic lymphohistiocytosis (HLH) secondary to an infection is a great impersonator. It is caused by hyperimmune activation, which leads to a wide array of hematological abnormalities. If the disease is untreated, it is usually fatal. We report the case of a four-year-old girl who presented to our tertiary care hospital with high-grade fever, frequent loose stools, and bleeding from the lips and gums. Investigations showed pancytopenia, hyperferritinemia, hypofibrinogenemia, and hypertriglyceridemia whereas the bone marrow biopsy revealed hemophagocytosis with trilineage suppression...
April 12, 2018: Curēus
Seok-Joo Chun, Seung Hyuck Jeon, Eui Kyu Chie
The stomach is one of the most deforming organs caused by respiratory motions and daily variation by food intake. Applying radiotherapy has been quite a challenge due to the high risk of missing the target as well as radiation exposure to large volumes of normal tissue. However, real-time magnetic resonance (MR)-guided radiotherapy with adaptive planning could focus the high dose radiation to the target area while minimizing neighboring normal tissue exposure and compensate for not only daily but real-time variation...
April 12, 2018: Curēus
Jessica Y Ng, Justin Y Ng
Leptomeningeal metastases from the prostate are extremely rare, with few cases described in the medical literature (antemortem prevalence of less than 0.03%). Prostatic leptomeningeal metastases harbour a poor prognosis with a median survival after diagnosis of 15.7 weeks. We present the case of an 82-year-old male with a history of hormone-refractory prostate cancer who presented to the emergency department with neurological symptoms.
April 12, 2018: Curēus
Htoo Kyaw, Felix Raju, Atif Z Shaikh, Aung Naing Lin, Aye T Lin, Joseph Abboud, Sarath Reddy
Infective endocarditis (IE) secondary to Staphylococcus lugdunensis has been increasingly recognized since 1988. IE-related thromboembolism represents an associated complication of the disease and carries a dismal prognosis. However, the incidence of cerebrovascular accident secondary to S. lugdunensis IE is relatively uncommon and its treatment has not been clearly elucidated yet. We performed an extensive literature search using Pubmed, Medline, Scopus, and Google Scholar to identify the articles using the following keywords: 'Staphylococcus lugdunensis', 'infective endocarditis', 'stroke', and 'cerebrovascular accident...
April 12, 2018: Curēus
Franz Hell, Thomas Köglsperger, Jan Mehrkens, Kai Boetzel
Deep brain stimulation (DBS) is an established therapeutic option for the treatment of various neurological disorders and has been used successfully in movement disorders for over 25 years. However, the standard stimulation schemes have not changed substantially. Two major points of interest for the further development of DBS are target-structures and novel adaptive stimulation techniques integrating feedback signals. We describe recent research results on target structures and on neural and behavioural feedback signals for adaptive deep brain stimulation (aDBS), as well as outline future directions...
April 12, 2018: Curēus
Nakul Katyal, Ather M Taqui, Deborah Tepper, Jonathan M Beary, Christopher R Newey
Herpes simplex-1 virus encephalitis (HSE) is the most commonly recognized cause of sporadic encephalitis in the United States. Historically HSE has been considered extremely detrimental given the associated relentless neurological deterioration secondary to cerebral edema and status epilepticus. With recent advances in antiviral therapeutics in past decades, the majority of complications can be managed effectively although the associated morbidity and mortality still remains high. The key modifiable factor determining recovery is the rapid initiation of antiviral therapy...
April 12, 2018: Curēus
David G Li, Katherine M Krajewski, Arash Mostaghimi
Cellulitis is a common skin and soft tissue infection with substantial misdiagnosis rates due to its nonspecific clinical characteristics. In this report, we present a patient with recurrent metastatic diffuse large B-cell lymphoma (DLBCL) masquerading as a unilateral lower extremity cellulitis. A 62-year-old man with a history of DLBCL, in remission for two years, presented with a two-week history of swelling and erythema of the right thigh and leg. Despite treatment with clindamycin and cephalexin, the redness and swelling continued to progress...
April 12, 2018: Curēus
Hans Ligtenberg, Tim Schakel, Jan Willem Dankbaar, Lilian N Ruiter, Boris Peltenburg, Stefan M Willems, Nicolien Kasperts, Chris H J Terhaard, Cornelis P J Raaijmakers, Marielle E P Philippens
In radiotherapy treatment planning, tumor delineation based on diffusion-weighted imaging (DWI) by magnetic resonance imaging (MRI) is a promising technique. MR-only-based target definition becomes important with the recent development of MRI integrated radiotherapy treatment modalities. In this case series, DWI-based gross tumor volume (GTV) was validated using pathology and compared with a clinical GTV based on computed tomography (CT) imaging and MRI. This case series includes three patients with a laryngeal tumor...
April 11, 2018: Curēus
Javeria N Syeda, Ian H Rutkofsky, Adnan S Muhammad, Tarig H Balla Abdalla, Zahid Saghir
The association of major depressive disorder (MDD) with myocardial infarction (MI) and vice versa is not unknown. Depression, along with many other systemic factors like atherosclerosis, obesity, diabetes and vascular dysfunction, contributes to the development of adverse cardiac events in the future and, has always been a topic of interest in the fields of cardiology and psychosomatics. We wrote this review article to elaborate this relationship in detail. This article suggests that the individuals with type D personality who already had cardiovascular disease had undergone more serious myocardial damage...
April 11, 2018: Curēus
Kantha R Kolla, Simon Maltais, Naveen L Pereira, Hari P Chaliki
Microbubble formation occurs due to the cavitation phenomenon. We report a rare echocardiographic finding of microbubbles in a patient's aorta and left ventricle due to pump thrombosis in the left ventricle assist device, requiring pump exchange surgery.
April 11, 2018: Curēus
Neelam Khetpal, Sameen Khalid, Ranjeet Kumar, Manuel F Betancourt, Akash Khetpal, Christopher Wasyliw, Seema Patel
Musculoskeletal tuberculosis accounts for 1%-3% of all cases of tuberculosis (TB) worldwide with elbow involvement being even less common. The most cases of tuberculous arthritis occur in patients born in and emigrated from endemic regions, especially in patients who are co-infected with human immunodeficiency virus (HIV). We present a rare case of tuberculous septic arthritis of the elbow joint in a 78-year-old African-American female from the United States, with no history of travel abroad. Her presenting symptoms included pain, swelling, and decreased range of motion of the right elbow for six months...
April 11, 2018: Curēus
Eugene F Stautberg Iii, Jose Romero, Sean Bender, Marc DeHart
Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education...
April 11, 2018: Curēus
Mayank Patel, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs
Counterintuitive to anatomic organization is the communication between a dorsal ramus and a ventral ramus, which are traditionally taught as serving specific anatomical fields. Herein, we discuss the cadaveric findings of such an example of neural intercommunication between the dorsal and ventral rami and review the potential embryology. While these two nerves are complementary in their function, it is not understood as to the reason for such an anatomical connection that breaches normal anatomical "laws...
April 10, 2018: Curēus
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