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https://www.readbyqxmd.com/read/28713599/lyme-carditis-buried-beneath-st-segment-elevations
#1
Basia Michalski, Adrian Umpierrez De Reguero
Lyme disease is caused by the spirochete Borrelia burgdorferi and is carried to human hosts by infected ticks. There are nearly 30,000 cases of Lyme disease reported to the CDC each year, with 3-4% of those cases reporting Lyme carditis. The most common manifestation of Lyme carditis is partial heart block following bacterial-induced inflammation of the conducting nodes. Here we report a 45-year-old gentleman that presented to the hospital with intense nonradiating chest pressure and tightness. Lab studies were remarkable for elevated troponins...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28707783/aggressive-necrotizing-pseudomonal-sinonasal-infections
#2
Edward C Kuan, Bobby A Tajudeen, Kevin C Welch, Rakesh K Chandra, Ben J Glasgow, Jeffrey D Suh
BACKGROUND: Pseudomonas aeruginosa is a gram-negative bacterium frequently implicated in recalcitrant sinonasal infections, especially in immunocompromised hosts. We report 6 cases of rapidly progressive pseudomonal acute rhinosinusitis producing tissue necrosis and, in certain cases, cranial nerve palsies. METHODS: Retrospective review of 6 patients with aggressive necrotizing sinonasal infections treated at 4 tertiary academic medical centers with sinonasal cultures growing P...
July 14, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28705685/-fungal-sinusitis
#3
REVIEW
E Lafont, C Aguilar, P Vironneau, R Kania, A Alanio, S Poirée, O Lortholary, F Lanternier
Although sinusitis affects about 20 % of the population, fungal sinusitis is rare. Aspergillus sp. are most frequently implicated. Fungal sinusitis represents a wide spectrum of disorders, including acute or chronic and invasive or non-invasive forms. Invasive fungal sinusitis may develop in an immunocompromised or diabetic patient, whereas non-invasive fungal sinusitis should be considered in a chronic situation, resistant to antibiotics in immunocompetent patients. Allergic fungal sinusitis is related to hypersensitivity of the host to the fungus...
July 10, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#4
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#5
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28694637/isolated-intracranial-myeloid-sarcoma-occurring-as-relapse-in-acute-myeloid-leukemia
#6
Geetha Narayanan, Lali V Soman, Lakshmi Haridas, Harish Sugathan
Myeloid sarcoma (MS) or chloroma is a rare extramedullary tumor composed of extramedullary proliferation of blasts of granulocytic, monocytic, erythroid, or megakaryocytic lineage occurring at sites outside the bone marrow. MS occurs in 2%-8% of patients with acute myeloid leukemia (AML), sometimes it occurs as the presenting manifestation of relapse in a patient in remission. We describe the case of a young male with AML in remission for 6 years presenting with central nervous system symptoms. Magnetic resonance imaging showed an extra-axial altered intensity lesion in the parasagittal parietal region, infiltrating anterosuperiorly into anterior falx, and posterosuperior aspect of the superior sagittal sinus...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28690945/pacemaker-placement-in-persistent-left-superior-vena-cava
#7
Murtaza Sundhu, Mubbasher Syed, Sajjad Gul, Bilal Saqi, Robert Mosteller
Persistent left superior vena cava (PLSVC) is a rare disorder which is asymptomatic and hence is usually discovered while performing interventions through the left subclavian vein. We present a case of a 78-year-old male who was undergoing elective placement of a permanent pacemaker for tachycardia - bradycardia syndrome with post-conversion pauses of up to nine seconds. After achieving access through the left subclavian vein the wire kept on going on the left side of the chest instead of crossing the midline to the right side...
June 5, 2017: Curēus
https://www.readbyqxmd.com/read/28690292/atrial-fibrillation-on-admission-is-related-with-higher-mortality-in-st-segment-elevation-myocardial-infarction-patients
#8
Kyung-Kuk Hwang, Sang-Yong Eom, Sang Yeub Lee, Sang Min Kim, Myeong-Chan Cho, Young Jo Kim, Ki Bae Seung, Myung Ho Jeong, Jang-Whan Bae
The prognostic significance of atrial fibrillation (AF) on mortality in ST-segment elevation myocardial infarction (STEMI) patients is not clearly understood. To elucidate the clinical significance of AF on mortality for 1 year in STEMI patients, we retrospectively analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) database, which spans January 2008 to September 2010 and includes 14,329 patients with acute myocardial infarction. We selected 5,556 patients with marked ECG rhythm (NSR, normal sinus rhythm or AF) on emergency room arrival, < 12 hours of symptom onset, and who underwent primary percutaneous coronary intervention (PCI) within 90 minutes of arriving at the hospital...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28680302/eosinophilic-granulomatosis-with-polyangiitis-presented-as-acute-polyneuropathy-and-cerebral-vasculitis
#9
Il-Han Yoo, Sang Tae Choi, Seong-Ho Choi, Jeong-Min Kim, Suk-Won Ahn
Eosinophilic granulomatosis with polyangiitis (EGPA) is an immune related systemic disease that is caused by vasculitis affecting multiple organ systems. It is characterized by asthma, fever, eosinophilia, cardiac problems, renal injury, and peripheral neuropathy. In this report, we describe a patient with EGPA with concurrent cerebral infarction and acute polyneuropathy mimicking a Guillain-Barre syndrome (GBS). A 46-year-old man presented with rapidly progressing gait disturbance, muscular weakness, and tingling sensation in all four limbs...
June 2017: Experimental Neurobiology
https://www.readbyqxmd.com/read/28675080/radiodensity-of-the-ostiomeatal-complex-in-recurrent-acute-rhinosinusitis
#10
Sean M Johnson, Adam L Honeybrook, Vaibhav H Ramprasad, Ralph Abi Hachem, David W Jang
Objective Recurrent acute rhinosinusitis (RARS) can be an elusive diagnosis due to the lack of clinical and radiographic findings in between acute episodes. This study aims to identify objective computed tomography (CT) characteristics in RARS. Study Design Case series with chart review. Setting Tertiary academic medical center. Subjects and Methods Patients meeting diagnostic criteria for RARS were identified retrospectively from the senior author's practice. Patients were diagnosed with RARS if they experienced 3 or more episodes of acute sinusitis within the past year with complete resolution of symptoms in between episodes...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28673669/cerebral-venous-sinus-thrombosis-complicated-with-acute-development-of-dural-arteriovenous-fistula-a-case-report
#11
Ji-Gang Chen, Zhen-Xing Li, Dan-Feng Zhang, Jun-Yu Wang, Li-Jun Hou
Development of dural arteriovenous fistula (dAVF) after cerebral venous sinus thrombosis (CVST) was very uncommon and for all these reported cases, the dAVF was a chronic complication. We present a case of acute development of dAVF after CVST. A 40-year-old female was admitted into our department with 2day's headache and vomiting for 9h. Head computed tomography (CT) scan showed only scattered minor hematomas over the right frontal lobe. Blood test indicated an elevated D-dimer. The patient experienced transient paralysis (Todd's paralysis) after intermittent focal epilepsy from day 3, which progressed into sustained epilepsy on day 6...
June 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28671393/top-20-research-studies-of-2016-for-primary-care-physicians
#12
Mark H Ebell, Roland Grad
This article summarizes the top 20 original research studies and four practice guidelines of 2016, based on regular literature surveillance and as selected by members of the Canadian Medical Association. The studies, known as POEMs (patient-oriented evidence that matters), were rated highly because of their relevance, validity, and potential to change practice. Key hypertension treatment findings include reduced mortality (a benefit not demonstrated in lower-risk persons or persons with diabetes mellitus) but also an increase in harms with a more aggressive blood pressure target in high-risk persons with hypertension and without diabetes...
May 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28669706/sinoatrial-node-toxicity-after-stereotactic-ablative-radiation-therapy-to-lung-tumors
#13
Yushen Qian, Han Zhu, Erqi L Pollom, Ben Y Durkee, Aadel A Chaudhuri, Michael F Gensheimer, Maximilian Diehn, David B Shultz, Billy W Loo
PURPOSE: Stereotactic ablative radiation therapy (SABR) is an established treatment for selected lung tumors. Sinoatrial node (SAN) toxicity after thoracic SABR has not been reported in the literature. We sought to understand the risk of SAN toxicity owing to incidental dose to the SAN from SABR. METHODS AND MATERIALS: We conducted a retrospective review of patients with early-stage lung cancer or limited pulmonary metastases who underwent thoracic SABR to a right-sided central lung tumor (within 2 cm of the mainstem bronchus or other mediastinal structures) between January 2008 and December 2014, analyzed a subset whose treatment imparted dose to the SAN exceeding 10% of the prescription dose, and examined patient and treatment dosimetric characteristics...
April 13, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28669043/the-xpress-multi-sinus-dilation-system-for-the-treatment-of-chronic-sinusitis-a-nice-medical-technology-guidance
#14
REVIEW
Michelle Jenks, Iain Willits, Emily Eaton Turner, Neil Hewitt, Mick Arber, Helen Cole, Joyce Craig, Andrew Sims
The XprESS multi-sinus dilation system (XprESS) is a minimally invasive alternative to functional endoscopic sinus surgery (FESS) used in the treatment of people with chronic or recurrent acute sinusitis refractory to medical treatment. The manufacturer of XprESS, Entellus Medical, claims the technology is as effective as FESS in improving quality of life and is associated with quicker recovery times and reduced costs. The Medical Technologies Advisory Committee (MTAC) at the National Institute for Health and Care Excellence (NICE) selected XprESS for evaluation...
July 1, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28667368/-puberty-is-a%C3%A2-major-factor-in-pilonidal-sinus-disease-gender-specific-investigations-of-case-number-development-in-germany-from-2007-until-2015
#15
M Ardelt, U Dennler, R Fahrner, G Hallof, H-M Tautenhahn, F Dondorf, F Rauchfuss, U Settmacher
BACKGROUND: Pilonidal sinus disease is an acute abscess-forming or chronic subacute inflammation, characterized by a fistula system with typical ostia. Treatment is primarily surgical. OBJECTIVE: This study aimed to investigate and evaluate the evolution of pilonidal sinus disease in Germany on the basis of data provided by the Federal Statistical Office in Germany (Statistisches Bundesamt). MATERIAL AND METHODS: From the diagnosis data of hospital inpatients generated by the Federal Statistical Office in Germany the data on the International Classification of Diseases (ICD) code L05 for pilonidal sinus from 2007 to 2015 were extracted and processed...
June 30, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28664704/human-infections-caused-by-free-living-amoebae
#16
REVIEW
Katarzyna Król-Turmińska, Alina Olender
[b]Abstract Introduction[/b]. Among free-living amoebae that are widely distributed in nature only four genera/species are known as agents of human infections:[i] Acanthamoeba spp., Naegleriafowleri, Balamuthia mandrillaris[/i] and[i] Sappiniapedata[/i]. These amoebae are not well adapted to parasitism, and could exist in the human environment without the need for a host. Infections due to these amoebae, despite low morbidity, are characterized by relatively high mortality rate and pose serious clinical problems...
May 11, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28664480/usefulness-of-left-ventricular-speckle-tracking-echocardiography-and-novel-measures-of-left-atrial-structure-and-function-in-diagnosing-paroxysmal-atrial-fibrillation-in-ischemic-stroke-and-transient-ischemic-attack-patients
#17
Kristoffer Grundtvig Skaarup, Hanne Christensen, Nis Høst, Masti Mahdy Mahmoud, Christian Ovesen, Flemming Javier Olsen, Jan Skov Jensen, Tor Biering-Sørensen
Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination...
June 29, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28660695/cerebral-sinus-venous-thrombosis-during-childhood-acute-lymphoblastic-leukemia-therapy-risk-factors-and-management
#18
Khaled M Ghanem, Raghida M Dhayni, Carol Al-Aridi, Nidale Tarek, Hani Tamim, Anthony K C Chan, Raya Saab, Miguel R Abboud, Hassan El-Solh, Samar A Muwakkit
BACKGROUND: Cerebral sinus venous thrombosis (CSVT) is a rare but serious complication of childhood acute lymphoblastic leukemia (ALL) therapy. No available consensus exists regarding its risk factors and appropriate management due to the rarity of cases. PROCEDURES: Out of 209 ALL patients aged 1-21 years treated at the Children's Cancer Center of Lebanon between May 2002 and May 2015, 13 developed CSVT during therapy. Patient characteristics, clinical management, and outcomes were studied...
June 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28658829/acute-ischaemic-stroke-as-a-manifestation-of-pituitary-apoplexy-in-a-young-lady
#19
Shaik Afsar Pasha, Laxmi Narasimhan Ranganthan, Vamsi Krishna Setty, Ramakrishna Reddy, Deepika Ananda Ponnuru
Pituitary Apoplexy (PA) is defined as a clinical syndrome comprising headache, visual deficits and altered sensorium, which can result from haemorrhage or infarction of the pituitary gland. Acute ischaemic stroke following PA is very rare. We are presenting a 35-year-old young otherwise healthy lady who presented with neuro ophthalmological and vascular symptoms on a background of PA. Imaging revealed a pituitary macro adenoma with parasellar extension with internal bleed. Cerebral angiography revealed that the mass compressed the bilateral cavernous sinuses (left more than right), resulting in obliteration of the cavernous portion of the left Internal Carotid Artery (ICA)...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28650313/molecular-mechanisms-and-epidemiology-of-resistance-in-streptococcus-pneumoniae-in-the-middle-east-region
#20
Grace El Moujaber, Marwan Osman, Rayane Rafei, Fouad Dabboussi, Monzer Hamze
PURPOSE: Streptococcus pneumoniae is a commensal bacterium that normally colonizes the human nasopharyngeal cavity. Once disseminated, it can cause several diseases, ranging from non-invasive infections such as acute otitis media and sinusitis through to invasive infections with higher mortality, including meningitis and septicaemia. Since the identification of the first S. pneumoniae strain with decreased susceptibility to penicillin in the 1960s, antibiotic resistance among S. pneumoniae has increased disturbingly and the mechanisms of resistance have begun to unfold...
June 26, 2017: Journal of Medical Microbiology
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