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https://www.readbyqxmd.com/read/27815920/intestinal-hemorrhage-caused-by-meckel-s-diverticulum-with-ectopic-gastric-mucosa-on-polypoid-lesion-a-case-report
#1
Toshiyuki Irie, Seiichi Shinji, Hiroki Arai, Hayato Kan, Takeshi Yamada, Michihiro Koizumi, Yasuyuki Yokoyama, Goro Takahashi, Takuma Iwai, Mikihiro Okusa, Keiichiro Ohta, Eiji Uchida
Meckel's diverticulum may sometimes present as an intraluminal polypoid mass causing small bowel obstruction; however, gastrointestinal bleeding due to Meckel's diverticulum with a polypoid lesion is rare. A 14-year-old girl presented with tarry stool and syncope in our hospital. Laboratory examination showed iron-deficiency anemia with a low hemoglobin level of 5.8 g/dl. The bleeding site was detected by neither upper gastrointestinal endoscopy nor colonoscopy. Transanal double-balloon enteroscopy showed a diverticulum with an ulceration at a site approximately 50 cm from the ileocecal valve and a polypoid lesion inside of the diverticulum...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27815358/phase-i-study-of-gdc-0425-a-checkpoint-kinase-1-inhibitor-in-combination-with-gemcitabine-in-patients-with-refractory-solid-tumors
#2
Jeffrey R Infante, Antoine Hollebecque, Sophie Postel-Vinay, Todd M Bauer, Elizabeth Blackwood, Marie Evangelista, Sami Mahrus, Franklin Peale, Xuyang Lu, Srikumar Sahasranaman, Rui Zhu, Yuan Chen, Xiao Ding, Elaine Murray, Jennifer Schutzman, Jennifer O Lauchle, Jean-Charles Soria, Patricia M LoRusso
PURPOSE: Chk1 inhibition potentiates DNA-damaging chemotherapy by overriding cell cycle arrest and genome repair. This Phase I study evaluated the Chk1 inhibitor GDC-0425 given in combination with gemcitabine to patients with advanced solid tumors. EXPERIMENTAL DESIGN: Patients received GDC-0425 alone for a 1-week lead-in followed by 21-day cycles of gemcitabine plus GDC-0425. Gemcitabine was initially administered at 750 mg/m2 (Arm A), then increased to 1000 mg/m2 (Arm B), on Days 1 and 8 in a 3+3+3 dose escalation to establish maximum tolerated dose (MTD)...
November 4, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/27702437/endovascular-repair-versus-open-surgery-in-patients-with-ruptured-abdominal-aortic-aneurysms-12-year-review
#3
Gloria María Novo Martínez, Marta Ballesteros Pomar, Elena Menéndez Sánchez, Eliezer Santos Alcántara, Inés Rodríguez Fernández, Andrés Manuel Zorita Calvo
INTRODUCTION: Rupture of abdominal aortic aneurysm is still a difficult challenge for the vascular surgeon due to the high perioperative mortality. The aim of our study is to describe the characteristics of the population as well as to compare morbidity and mortality in patients undergoing open surgery or endovascular repair in our center. METHODS: Database with 82 rAAA between January 2002-December 2014, studying two cohorts, open surgery and endovascular repair...
October 1, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27446874/a-curious-case-of-iron-deficiency-anemia
#4
Seth Shaffer, Mayur Brahmania, Hemant Shah
A 49-year-old Brazilian male presented to the emergency department with a five-day history of abdominal pain, dark stools, and syncope. Physical examination did not reveal any melena on digital rectal examination and there were no stigmata of chronic liver disease. Laboratory results showed hemoglobin of 47 g/L, MCV of 80 fL, and ferritin of 6 ng/mL. Liver enzymes and liver function tests were normal. Abdominal ultrasound showed a cirrhotic liver with splenomegaly and varices suggestive of portal hypertension...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27428222/unusual-focal-keratin-expression-in-plexiform-angiomyxoid-myofibroblastic-tumor-a-case-report-and-review-of-the-literature
#5
Giuseppe Quero, Teresa Musarra, Alfredo Carrato, Michelangelo Fici, Maurizio Martini, Angelo Paolo Dei Tos, Sergio Alfieri, Riccardo Ricci
BACKGROUND: Plexiform angiomyxoid myofibroblastic tumor (PAMT), also known as plexiform fibromyxoma, is a rare distinctive benign intramural tumor, typical of gastric antrum, commonly causing mucosal ulceration with upper gastrointestinal bleeding and anemia, effectively treated by complete surgical resection usually accomplished by distal gastrectomy. METHODS AND RESULTS: We herein report a 47-year-old man presenting with a syncopal episode, regurgitation and epigastric discomfort, bearing a gastric antral myxoid plexiform tumor positive for α-smooth muscle actin, vimentin and, partially, for caldesmon, desmin, and CD10; CD117, DOG1, CD34, S100, CAM5...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27342573/mechanical-circulatory-assist-devices-a-primer-for-critical-care-and-emergency-physicians
#6
REVIEW
Ayan Sen, Joel S Larson, Kianoush B Kashani, Stacy L Libricz, Bhavesh M Patel, Pramod K Guru, Cory M Alwardt, Octavio Pajaro, J Christopher Farmer
Mechanical circulatory assist devices are now commonly used in the treatment of severe heart failure as bridges to cardiac transplant, as destination therapy for patients who are not transplant candidates, and as bridges to recovery and "decision-making". These devices, which can be used to support the left or right ventricles or both, restore circulation to the tissues, thereby improving organ function. Left ventricular assist devices (LVADs) are the most common support devices. To care for patients with these devices, health care providers in emergency departments (EDs) and intensive care units (ICUs) need to understand the physiology of the devices, the vocabulary of mechanical support, the types of complications patients may have, diagnostic techniques, and decision-making regarding treatment...
June 25, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27052396/-jejunal-duplication-in-an-adult-presenting-with-hematochezia
#7
Kazuhiko Inoue, Toshio Sakiyama, Kanae Setoyama, Yuji Iwashita, Seiya Saito, Norihisa Hanada, Yoshihiro Komohara, Fumisato Sasaki, Masatsugu Numata, Akio Ido
A 56-year-old man was admitted to our hospital with appetite loss, palpitations, orthostatic syncope, and hematochezia. Contrast-enhanced abdominal computed tomography (CT) revealed a proximal jejunal diverticulum with contrast extravasation. We immediately performed transoral double balloon enteroscopy (DBE) to treat the bleed in the jejunum, and this revealed a small ulcer with an exposed vessel at the opening of the jejunal diverticulum. Hemostasis was achieved endoscopically with argon plasma coagulation (APC) and hemoclips...
April 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/26653694/aortocavitary-fistula-as-a-complication-of-infective-endocarditis-and-subsequent-complete-heart-block-in-a-patient-with-severe-anemia
#8
Jose N Galeas, Irving E Perez, Pedro A Villablanca, Harjit Chahal, Robert Jackson, Cynthia C Taub
Infective endocarditis has different presentations depending on the involvement of valvular and perivalvular structures, and it is associated with high morbidity and mortality. Aortocavitary fistula is a rare complication. We introduce the case of a 48-year-old female with native valve endocarditis, complicated by aortocavitary fistula to the right atrium, and consequently presented with syncope.
2015: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/26342395/observation-vs-admission-in-syncope-can-we-predict-short-length-of-stays
#9
COMPARATIVE STUDY
Margaret Lin, Richard E Wolfe, Nathan I Shapiro, Victor Novack, Yotam Lior, Shamai A Grossman
BACKGROUND: Rising health care costs demands justifying prolonged hospitalization for syncope, yet predictors of shorter length of stay (LOS) have not been identified. OBJECTIVE: The objective of this study is to identify independent predictors of LOS for syncope patients presenting to the emergency department (ED). METHODS: We performed an analysis of a prospectively collected cohort of ED syncope patients. We examined risk factors from the patient's ED presentation and workup and used Spearman rank correlation to evaluate the relationship between these risk factors and LOS in a logistic regression model for prediction of hospitalization less than 1 day...
November 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26332546/telomerase-inhibitor-imetelstat-in-patients-with-essential-thrombocythemia
#10
MULTICENTER STUDY
Gabriela M Baerlocher, Elisabeth Oppliger Leibundgut, Oliver G Ottmann, Gary Spitzer, Olatoyosi Odenike, Michael A McDevitt, Alexander Röth, Michael Daskalakis, Bart Burington, Monic Stuart, David S Snyder
BACKGROUND: Imetelstat, a 13-mer oligonucleotide that is covalently modified with lipid extensions, competitively inhibits telomerase enzymatic activity. It has been shown to inhibit megakaryocytic proliferation in vitro in cells obtained from patients with essential thrombocythemia. In this phase 2 study, we investigated whether imetelstat could elicit hematologic and molecular responses in patients with essential thrombocythemia who had not had a response to or who had had unacceptable side effects from prior therapies...
September 3, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/26120311/metastatic-breast-cancer-with-extensive-osseous-metastasis-presenting-with-symptomatic-immune-thrombocytopenic-purpura-and-anemia-a-case-report-and-review-of-the-literature
#11
Jiaxin Niu, Teresa Goldin, Maurie Markman, Madappa N Kundranda
BACKGROUND: Immune thrombocytopenic purpura (ITP) is a rare acquired bleeding disorder with an estimated incidence of 1 in 10,000 people in the general population. The association of ITP with breast cancer is an even rarer entity with very limited reports in the English literature. CASE PRESENTATION: We report a case of a 51-year-old female with no significant past medical history who presented with sudden onset of malaise, syncope, gingival bleed and epistaxis...
May 2015: Case Reports in Oncology
https://www.readbyqxmd.com/read/26085728/anaphylactic-shock-secondary-to-intravenous-iron-sucrose-in-chronic-kidney-disease
#12
Vineet Behera, Rajeev Chauhan, Smriti Sinha, Velu Nair
Intravenous (IV) iron is an essential component of therapy of anemia of chronic kidney disease (CKD). We present a rare case in which iron sucrose was infused to a patient of CKD and resulted in severe anaphylaxis and cardiac arrest minutes after starting the infusion. He was aggressively resuscitated with adrenaline and other measures following which he recovered. The use of parenteral iron is associated with several adverse drug reactions (ADR) which were seen with preparations like iron dextran but became rare with the use of newer safe preparations like iron sucrose or gluconate...
September 2015: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/26013470/guideline-on-the-clinical-use-of-apheresis-procedures-for-the-treatment-of-patients-and-collection-of-cellular-therapy-products-british-committee-for-standards-in-haematology
#13
C Howell, K Douglas, G Cho, K El-Ghariani, P Taylor, D Potok, T Rintala, S Watkins
No abstract text is available yet for this article.
April 2015: Transfusion Medicine
https://www.readbyqxmd.com/read/25676645/breath-holding-spells-in-infants
#14
Ran D Goldman
QUESTION: I have children in my clinic who experience seizurelike episodes in which they cry and hold their breath to the point of cyanosis and loss of consciousness. Their examination or investigation findings are normal and referral to a pediatric specialist results in no further investigation. Are breath-holding spells common, and what type of investigation is needed? ANSWER: A breath-holding spell is a benign paroxysmal nonepileptic disorder occurring in healthy children 6 to 48 months of age...
February 2015: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/25502304/dilated-arrhythmogenic-cardiomyopathy-in-emery-dreifuss-muscular-dystrophy-due-to-the-emerin-splice-site-mutation-c-449-1g-a
#15
Josef Finsterer, Claudia Stöllberger, Ernst Sehnal, Helga Rehder, Franco Laccone
OBJECTIVE: Cardiac involvement in X-linked Emery-Dreifuss muscular dystrophy (X-EDMD) usually includes arrhythmias but not dilative cardiomyopathy (dCMP). Here, we report an X-EDMD patient with severe dCMP and life-threatening ventricular arrhythmias associated with other phenotypic features unusual for X-EDMD. CASE REPORT: A 46-year-old patient with X-EDMD due to the known splice-site mutation c.449 + 1G>A in the emerin gene experienced palpitations for the first time at the age of 21 years, and a first syncope at the age of 23 years...
2015: Cardiology
https://www.readbyqxmd.com/read/25309738/chief-s-seminar-turning-interns-into-clinicians
#16
Christopher Dittus, Vanya Grover, Georgia Panagopoulos, Kenar Jhaveri
BACKGROUND: Recent changes in healthcare delivery have necessitated residency education reform. To adapt to these changes, graduate medical education can adopt a chief resident-led clinical curriculum. Chief residents are ideal clinical instructors, as they are recent graduates who have excelled in their residency programs. To effectively use the limited time available for education, chief residents can implement active learning techniques. We present a chief resident-led, small-group, problem-based curriculum for teaching first-year internal medicine residents, and provide preliminary data supporting the efficacy of this approach...
2014: F1000Research
https://www.readbyqxmd.com/read/25266160/-acute-atrio-ventricular-block-in-sickle-cell-anemia
#17
P-H Gacon, P Jourdain, N Heba, W Amara
BACKGROUND: Even though sickle cell disease has a high prevalence amongst the black race and despite its well known potential of micro infarction, there have been only a few reports regarding the acute myocardial damage during vaso-occlusive crisis. The risk of atrio ventricular block during these crises has never been described in a large survey. PATIENTS AND RESULTS: Ten patients (six men and four women, mean age 39 years old) were hospitalized for an acute atrio ventricular block...
November 2014: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/25134104/a-student-with-macrocytic-anaemia
#18
W Thomas, F d'Orey, G Turner
No abstract text is available yet for this article.
2014: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/24837084/fainting-as-an-unusual-presentation-of-a-large-inferior-vena-cava-leiomyosarcoma
#19
Giuseppe Massimiliano De Luca, Angela Gurrado, Andrea Marzullo, Giuseppe Piccinni, Riccardo Memeo, Angelo Vacca, Mario Testini
OBJECTIVES: Primary tumors of the inferior vena cava are rare, with leiomyosarcoma representing the vast majority. METHOD: A 60-year-old man was admitted in emergency for fainting and mild anemia. A whole-body computed tomography revealed a retroperitoneal mass of approximately 8 cm in diameter, invading the lumen of the inferior vena cava, extending to the renal vein confluence. An en bloc resection of the solid mass was performed. Macroscopically the tumor did not seem to insist on the resection margin...
August 2015: Phlebology
https://www.readbyqxmd.com/read/24581882/spur-cell-anemia-in-end-stage-liver-disease-a-zebra
#20
Rushikesh Shah, Arpan Patel, Savio John
No abstract text is available yet for this article.
August 2014: American Journal of Emergency Medicine
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