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https://www.readbyqxmd.com/read/28465876/correction-rapidly-progressing-myelodysplastic-syndrome-initially-presenting-as-acute-leukemia
#1
Sara Parylo, Adarsh Vennepureddy, Terenig Terjanian
[This corrects the article DOI: 10.7759/cureus.1096.].
April 27, 2017: Curēus
https://www.readbyqxmd.com/read/28540143/association-between-coronary-artery-disease-and-microrna-literature-review-and-clinical-perspective
#2
Rehan Malik, Raja S Mushtaque, Usman A Siddiqui, Adnan Younus, Muhammad A Aziz, Choudhry Humayun, Kanaan Mansoor, Muhammad A Latif, Salman Waheed, Salman Assad, Idrees Khan, Syed M Bukhari, Daniel DelCampo, Ali Adus, Swetha Gannarapu
BACKGROUND: Until recently, circulating micro-RNAs (miRNAs) have attracted major interest as novel biomarkers for the early diagnosis of coronary artery disease (CAD). This review article summarizes the available evidence on the correlation of micro-RNAs with both the clinical and subclinical coronary artery disease and highlights the necessity for exploring miRNAs as a potential diagnostic and prognostic biomarker of early CAD in an adult population. METHODS: A systematic literature analysis and retrieval online systems Public/Publisher MEDLINE/ Excerpta Medica Database /Medical Literature Analysis and Retrieval System Online,(PUBMED/EMBASE/MEDLINE) search were conducted for relevant information...
April 23, 2017: Curēus
https://www.readbyqxmd.com/read/28536669/disparate-presentations-of-localized-cystic-disease-of-kidney-a-review-with-an-objective-of-correct-approach-for-accurate-treatment-plan
#3
Sachin Khanduri, Mriganki Chaudhary, Tushar Sabharwal, Aakshit Goyal, Gaurav Katyal
BACKGROUND: Localized cystic disease of the kidney is a rare, non-familial condition. Its imaging and clinical features are unique and need to be differentiated from autosomal dominant polycystic kidney disease and focal cystic masses such as multicystic nephroma and cystic renal cell carcinoma. It is always restricted to one kidney and is characterized by multiple cysts of varying sizes separated by residual normal renal tissue. MATERIALS AND METHODS: This study reports 12 cases of localized cystic disease of the kidney based on imaging findings and clinical histories...
April 22, 2017: Curēus
https://www.readbyqxmd.com/read/28534001/frequency-of-acute-hepatitis-following-acute-paraphenylene-diamine-intoxication
#4
Rizwan Ishtiaq, Sadaf Shafiq, Ali Imran, Qazi Masroor Ali, Raheel Khan, Hassan Tariq, Daniyal Ishtiaq
INTRODUCTION: Paraphenylene diamine (PPD) ingestion is manifesting as one of the more common ways of committing suicide in Southern Punjab, Pakistan, especially Bahawalpur. PPD is an ingredient of a compound commonly known "Kala Pathar" which means "Black Stone" in Urdu. It is readily available in the market at low cost and is used to dye hair and fur. Its intoxication inhibits cellular oxidation and affects the muscles causing rhabdomyolysis. This leads to myoglobinuria followed by renal failure and edema of face and throat resulting in respiratory difficulty...
April 21, 2017: Curēus
https://www.readbyqxmd.com/read/28534000/improving-therapeutic-ratios-with-the-oncotype-dx%C3%A2-ductal-carcinoma-in-situ-dcis-score
#5
Nafisha Lalani, Eileen Rakovitch
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer comprising nearly 25% of breast cancer diagnoses in the mammographic era. Current guidelines recommend breast-conserving surgery followed by adjuvant radiotherapy; however, controversy exists regarding the appropriateness of these recommendations. Some women with DCIS will never recur, which raises the concern of over-treatment. Conversely, a small number of women will develop invasive recurrences, raising concerns of under-treatment. Currently, several clinical and pathologic factors have been identified as prognostic markers for recurrence; however, these variables alone have been unable to identify low-risk and high-risk subgroups...
April 21, 2017: Curēus
https://www.readbyqxmd.com/read/28533999/synchronous-inflammatory-myofibroblastic-tumor-in-lung-and-brain-a-case-report-and-review-of-literature
#6
Maham Jehangir, Aisha Jang, Imaad Ur Rehman, Nadira Mamoon
Inflammatory myofibroblastic tumor (IMT) is a rare entity and a diagnostic challenge with myriad clinical presentations and pathogenetic mechanisms. Isolated occurrences can be at any site in the body; however, only a few cases of IMT with the concomitant appearance of different organs have been published. We report a unique occurrence of bilateral inflammatory myofibroblastic tumor of the lungs with synchronous brain parenchymal lesions in an 11-year-old male, detailing clinical presentation with the emphasis on imaging and review of the literature...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#7
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#8
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28540142/rapid-cycle-deliberate-practice-in-medical-education-a-systematic-review
#9
REVIEW
Jillian Taras, Tobias Everett
Rapid Cycle Deliberate Practice (RCDP) is a novel simulation-based education model that is currently attracting interest, implementation, exploration and research in medical education. In RCDP, learners rapidly cycle between deliberate practice and directed feedback within the simulation scenario until mastery is achieved. The objective of this systematic review is to examine the literature and summarize the existing knowledge on RCDP in simulation-based medical education. Fifteen resources met inclusion criteria; they were diverse and heterogeneous, such that we did not perform a quantitative synthesis or meta-analysis but rather a narrative review on RCDP...
April 19, 2017: Curēus
https://www.readbyqxmd.com/read/28536668/brugada-syndrome-in-a-patient-with-vascular-ehlers-danlos-syndrome-sudden-death-risk-amplified
#10
Jason D'Souza, Divyanshu Malhotra, Aditya Goud, Chanukya Dahagam, George Everett
The vast majority of sudden cardiac arrests occur in patients with structural heart disease and in approximately 10% of the cases, it can occur in those with structurally normal hearts. Brugada syndrome is an autosomal dominant sodium channelopathy that has been implicated in sudden deaths. Given their low prevalence, our knowledge about Brugada syndrome is still evolving. Apart from schizophrenia, there have been no reports of associated medical conditions. We recently encountered a patient with vascular Ehlers-Danlos syndrome who was also found to have Brugada syndrome...
April 19, 2017: Curēus
https://www.readbyqxmd.com/read/28533996/gastric-varices-in-absence-of-splenic-vein-thrombosis-a-rare-entity-of-idiopathic-non-cirrhotic-portal-hypertension
#11
Vivek Choksi, Binna Chokshi, Andrew Chu, Deepa Mandale, Daniel L Wolfson, Steven Kaplan, Hamid Feiz
Idiopathic non-cirrhotic portal hypertension (INCPH) is portal hypertension (PHT) without cirrhosis and other identifiable causes. Esophageal and gastric varices are seen in INCPH which are mostly asymptomatic. We present a rare case of symptomatic isolated gastric varices (IGV) in the setting of INCPH. We report a case of a 60-year-old man who presented with an acute onset of hematemesis and no identifiable history. Upon further evaluation, he was found to have non-bleeding dilated gastric varices on esophagogastroduodenoscopy (EGD) and PHT without cirrhosis...
April 19, 2017: Curēus
https://www.readbyqxmd.com/read/28533995/crohn-s-disease-and-ulcerative-colitis-show-unique-cytokine-profiles
#12
Zoltan H Nemeth, Dorian A Bogdanovski, Patricia Barratt-Stopper, Samantha R Paglinco, Luca Antonioli, Rolando H Rolandelli
INTRODUCTION: Networks of cytokines have been implicated in both forms of inflammatory bowel disease (IBD): Crohn's disease (CD) and ulcerative colitis (UC). While CD has associated with T-helper type 1 (Th1) immune responses, UC shows Th2 patterns. Recent studies reported that the inflamed intestinal regions in both CD and UC are significantly infiltrated with a newly described set of T helper, the Th17 cells. These cells have unique cytokine responses. These findings prompted us to further explore the cytokine profiles of CD and UC with a special focus on the Th2 and Th17 related mediators...
April 19, 2017: Curēus
https://www.readbyqxmd.com/read/28533994/infective-endocarditis-presenting-as-subarachnoid-hemorrhage-an-appeal-for-caution
#13
Talal Asif, Amena Mohiuddin, Badar Hasan, Amgad Masoud
Spontaneous subarachnoid hemorrhage (SAH) as the presenting feature of infective endocarditis (IE) is rare. It has classically been described in association with the rupture of intracranial mycotic aneurysms (ICMA). Here we describe a very rare case of non-aneurysmal spontaneous SAH in a patient with IE. The patient originally presented with a headache and low-grade fever. Neuroimaging including computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed SAH. She was eventually diagnosed with streptococcus gallolyticus (formerly streptococcus bovis) IE...
April 19, 2017: Curēus
https://www.readbyqxmd.com/read/28533993/bilateral-external-ventricular-drain-placement-and-intraventricular-irrigation-combined-with-concomitant-serial-prone-patient-positioning-a-novel-treatment-for-gravity-dependent-layering-in-bacterial-ventriculitis
#14
Andrew K Chan, Harjus S Birk, John K Yue, Ethan A Winkler, Michael W McDermott
A feared complication of ventricular access for drainage or shunting is ventriculitis. Early diagnosis and treatment is vital to prevent morbidity and mortality. Efficacy of directed antibiotic therapy in ventriculitis is limited by increasing multidrug resistant microorganisms and insufficient systemic antibiotic absorption into the cerebrospinal fluid. Treatment may involve intravenous and/or intrathecal antibiotics as well as external ventricular drainage. We present the first case report suggesting a potential role of a novel technique - direct ventricular catheter-mediated continuous saline irrigation and serial prone patient positioning - to treat a fulminant bacterial ventriculitis...
April 18, 2017: Curēus
https://www.readbyqxmd.com/read/28533992/ambulatory-heart-failure-monitoring-a-systemic-review
#15
REVIEW
Muhammad A Mangi, Hiba Rehman, Muhammad Rafique, Michael Illovsky
Heart failure (HF) is one of the leading causes of morbidity and mortality and has a large effect on the country's economy. Although there have been major advances in HF monitoring, including more advanced pharmacological management and device-based therapy, HF-related mortality remains high. It is important to monitor HF so that HF-related hospitalization and mortality can be prevented. Due to the lower sensitivity of clinical features and biochemical markers, as well as the failure of telemonitoring in early detection of HF, more advanced techniques have been sought to more accurately predict impending HF, in order to address timely pharmacological management and prevent heart failure hospitalization (HFH)...
April 18, 2017: Curēus
https://www.readbyqxmd.com/read/28533991/multivariable-analysis-of-factors-affecting-length-of-stay-and-hospital-charges-after-atlantoaxial-fusion
#16
Jian Guan, Michael Karsy, Meic Schmidt, Andrew T Dailey, Erica Bisson
BACKGROUND: Atlantoaxial fusion is an effective procedure for treating degenerative, traumatic, and congenital abnormalities that result in upper cervical instability; however, data on which factors affect the length of stay and hospitalization-related charges are limited. The purpose of this study was to evaluate the pre-, intra-, and postoperative variables that affect these healthcare cost factors for patients undergoing posterior atlantoaxial fusion. METHODS: We retrospectively identified from a clinical database 59 patients who underwent isolated posterior atlantoaxial fusion at a single institution from 2010 to 2015...
April 18, 2017: Curēus
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#17
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28533989/iatrogenic-spinal-subdural-extra-arachnoid-hygroma-following-uncomplicated-lumbar-decompression
#18
Benjamin D Elder, Wataru Ishida, Rory C Goodwin, Ali Bydon
Intradural spinal arachnoid cysts (ISACs) have been reported in the current literature as either an idiopathic disease or exceedingly rare sequelae after lumbar puncture, spinal trauma, or meningitis. Other studies have more appropriately termed the iatrogenic pathology as a spinal subdural extra-arachnoid hygroma (SSEH), as there is not often a clear cyst wall as in a true arachnoid cyst. However, to the best of our knowledge, none of the previous studies described an SSEH following uncomplicated posterior lumbar surgery, as they have previously involved clear durotomies during the initial operation...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28516005/caffey-s-disease-sans-mandibular-and-clavicular-involvement-a-rare-case-report
#19
Sachin Khanduri, Gaurav Katyal, Aakshit Goyal, Shreshtha Jain, Tushar Sabharwal, Mriganki Chaudhary
Caffey's disease, also known as Infantile Cortical Hyperostosis, is a rare, self-limited, benign, inflammatory gene-related disorder of infants that causes bone changes, soft tissue swelling, and irritability. The mandible (75%), clavicles, and ulnae are the bones most frequently involved, others being long bones, lateral ribs, ilia with skull being the rarest. However, we report a case of a 5-month-old male diagnosed with Infantile cortical hyperostosis but with absent mandibular and clavicular involvement, thus depicting the unusual presentation of this disease...
April 16, 2017: Curēus
https://www.readbyqxmd.com/read/28516004/endoscopic-ultrasound-reaching-where-others-can-t
#20
Fady G Haddad, Magda Daoud, Ying Liu, Sherif Andrawes
Endoscopic ultrasound (EUS) has been increasingly used for the diagnosis and staging of pancreatic cancer. It has recently become the modality of choice in assessing pancreatic lesions overcoming other traditional modalities. Typically lesions located at the tail of the pancreas are best accessed through the stomach. We present a patient with pancreatic tail mass occurring in the setting of a large hiatal hernia, intrathoracic stomach, and severe lumbar levoscoliosis. Due to altered anatomy and extensive vascular connections of the mass, any surgical or radiological intervention was considered high risk for the patient...
April 15, 2017: Curēus
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