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https://www.readbyqxmd.com/read/28645902/the-cause-of-the-stroke-a-diagnostic-uncertainty
#1
Abhishek Dattani, Ava Jackson
A 39-year-old man with a history of sickle cell disease (SCD) presented with left leg weakness. He had a normal CT head and CT angiogram, but MRI head showed multiple acute bilateral cortical infarcts including in the right precentral gyrus. The MRI findings were more in keeping with an embolic source rather than stroke related to SCD, although it could not be ruled out. He also had an echocardiogram which revealed a patent foramen ovale. He was treated with antiplatelet therapy and also had red blood cell exchange transfusion...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28616222/a-case-report-of-an-unusual-cause-of-postoperative-leg-pain-after-posterior-lumbar-fusion
#2
R Daureeawoo, S Baliga, W Mohahmed, E B Ahmed
We report the case of a 36-year old man who underwent elective posterior lumbar spinal fusion after presenting with bilateral leg pain with associated back pain. He had undergone a L5/S1 discectomy in 2001, which provided good symptomatic relief. On this admission, he underwent elective L4-S1 posterolateral fusion and bilateral L4/5 and L5/S1 decompression. Intra-operatively a pedicle screw had to be re-inserted after fluoroscopy confirmed a lateral breech. The patient had no major postoperative complications until the sixth day when the patient re-presented with acute leg pain and weakness...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28611162/a-large-chronic-pericardial-effusion-in-an-ultramarathon-runner-with-anti-ccp-positive-rheumatoid-arthritis
#3
Thomas J McClelland, Rose Penfold, Stefan Kluzek, Navraj S Nagra
Pericardial effusions arise as an extra-articular manifestation of rheumatoid arthritis (RA). Pericardial effusions are often asymptomatic, particularly in the early phase, but patients are at risk of cardiac tamponade as the effusion progresses. We discuss the case of a 40-year-old male ultramarathon runner with RA who presented with mild pleuritic chest pain and exertional dyspnoea after a recent long-haul flight. Despite a relative tachycardia, his observations were otherwise unremarkable. His blood tests revealed a C-reactive protein (CRP) of 86 mg/L and an anti-cyclic citrullinated peptide (anti-CCP) titre of 360 units/mL...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28611138/cardiac-arrest-following-arteriovenous-fistula-manipulation-a-cautionary-note
#4
Miles Gandolfi, Bimbi S Fernando
Arteriovenous fistulas can lead to a number of different chronic complications. We describe a case where a patient developed a thrombosis within her brachiobasilic arteriovenous fistula, which was manually manipulated in order to restore fistula flow. This resulted in a pulseless electrical activity cardiac arrest within a few minutes. After ten minutes of chest compressions and intubation, there was return of spontaneous circulation. No epinephrine was given nor shocks administered. Patient was extubated within minutes and was alert, orientated and haemodynamically stable...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28611051/sulfhaemoglobinaemia-caused-by-ferrous-sulfate
#5
Laith Derbas, Mohamed Warsame, Mohannad Abu Omar, Yousaf Zafar, Gregory Howell
A 78-year-old man was referred from his primary care clinic to the emergency department due to bluish discolouration of his lips and decreased oxygen saturation on pulse oximetry. The patient was asymptomatic. Physical exam was normal except for lip cyanosis. A CT pulmonary angiogram was negative for pulmonary embolism. Arterial blood gas (ABG) analysis with co-oximetry showed low oxyhaemoglobin, normal partial pressure of oxygen and methaemoglobinaemia, but an unexplained 'gap' in total haemoglobin saturation...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28607332/massive-ischemic-stroke-due-to-pulmonary-barotrauma-and-cerebral-artery-air-embolism-during-commercial-air-travel
#6
Sara Farshchi Zarabi, Matteo Parotto, Rita Katznelson, James Downar
BACKGROUND Air embolism into the systemic arterial circulation secondary to pulmonary barotrauma has rarely been reported. Herein, we report the clinical course of an extremely rare presentation of cerebral air embolism likely due to ruptured pulmonary bullae during commercial air travel. CASE REPORT A 65-year-old man suddenly became unconscious during an airplane descent. Upon landing, he was immediately transferred to the nearest emergency department where he was intubated for airway protection. His head CT angiogram showed multiple air pockets in the right parietal lobe suspicious for multiple air emboli...
June 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#7
REVIEW
Meena Archie, David Rigberg
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis...
June 10, 2017: Diagnostics
https://www.readbyqxmd.com/read/28603715/contrast-induced-nephropathy-in-renal-transplant-recipients-a-single-center-experience
#8
Bassam G Abu Jawdeh, Anthony C Leonard, Yuvraj Sharma, Swapna Katipally, Adele R Shields, Rita R Alloway, E Steve Woodle, Charuhas V Thakar
BACKGROUND: Contrast-induced nephropathy (CIN) in native kidneys is associated with a significant increase in mortality and morbidity. Data regarding CIN in renal allografts are limited, however. We retrospectively studied CIN in renal allografts at our institution: its incidence, risk factors, and effect on long-term outcomes including allograft loss and death. METHODS: One hundred thirty-five renal transplant recipients undergoing 161 contrast-enhanced computed tomography (CT) scans or coronary angiograms (Cath) between years 2000 and 2014 were identified...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28602955/etiological-diagnoses-of-out-of-hospital-cardiac-arrest-survivors-admitted-to-the-intensive-care-unit-insights-from-a-french-registry
#9
Guillaume Geri, Olivier Passouant, Florence Dumas, Wulfran Bougouin, Benoit Champigneulle, Michel Arnaout, Jonathan Chelly, Jean-Daniel Chiche, Olivier Varenne, Lucie Guillemet, Frederic Pène, Victor Waldmann, Jean-Paul Mira, Eloi Marijon, Alain Cariou
BACKGROUND: Respective proportions of final etiologies are disparate in cohorts of cardiac arrest patients, depending on examined population and diagnostic algorithms. In particular, prevalence and characteristics of sudden unexplained death syndrome (SUDS) are debated. We aimed at describing etiologies in a large cohort of aborted out-of-hospital cardiac arrest (OHCA) patients, in order to assess prevalence and outcome of SUDS. PATIENTS AND METHODS: We analyzed data from our prospective registry of successfully resuscitated OHCA patients admitted to a cardiac arrest centre between January 2002 and December 2014...
June 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28569123/diffusion-weighted-imaging-or-computerized-tomography-perfusion-assessment-with-clinical-mismatch-in-the-triage-of-wake-up-and-late-presenting-strokes-undergoing-neurointervention-with-trevo-dawn-trial-methods
#10
Tudor G Jovin, Jeffrey L Saver, Marc Ribo, Vitor Pereira, Anthony Furlan, Alain Bonafe, Blaise Baxter, Rishi Gupta, Demetrius Lopes, Olav Jansen, Wade Smith, Daryl Gress, Steven Hetts, Roger J Lewis, Ryan Shields, Scott M Berry, Todd L Graves, Tim Malisch, Ansaar Rai, Kevin N Sheth, David S Liebeskind, Raul G Nogueira
Rationale Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h of time last seen well has not been demonstrated in randomized trials. Aim To establish whether subjects considered to have substantial areas of salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6-24 h from time last seen (TLSW) well have better outcomes at three months compared to subjects treated with standard medical therapy alone...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28554887/portomesenteric-venous-thrombosis-complicated-by-a-haemorrhagic-shock-a-rare-complication-of-laparoscopic-gastrectomy
#11
Eddie Copelin, Rosann Cholankeril, Ponnandai Somasundar, George Cholankeril
Portomesenteric venous thrombosis is a rare complication reported in only a few cases involving laparoscopic bariatric surgery. We report a case of a 44-year-old woman who presented 14 days after recent laparoscopic sleeve gastrectomy with the chief complaint of abdominal pain and associated nausea. Abdominal CT demonstrated thrombi in her superior mesenteric, portal and splenic veins. She was initiated on therapeutic heparin but developed haemorrhagic shock shortly afterwards. Subsequent CT angiogram failed to localise the source of her haemorrhage...
May 29, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28545474/a-retrospective-study-to-assess-the-evaluation-of-living-related-kidney-donors-and-their-outcomes-following-nephrectomy-at-kenyatta-national-hospital
#12
A Muturi, V Kotecha, S Kanyi
BACKGROUND: Kidney transplantation is the renal replacement therapy of choice for end stage renal disease. To ensure safety regular audit of the donation process is necessary. The aim of this study was to assess the evaluation of potential living related kidney donors and document their outcomes following nephrectomy. METHODS: This was a retrospective descriptive study involving all living related kidney donors seen at Kenyatta National Hospital (KNH) renal unit from 2010 to 2014...
May 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28538960/diagnostic-accuracy-of-computed-tomography-derived-fractional-flow-reserve-a-systematic-review
#13
Christopher M Cook, Ricardo Petraco, Matthew J Shun-Shin, Yousif Ahmad, Sukhjinder Nijjer, Rasha Al-Lamee, Yuetsu Kikuta, Yasutsugu Shiono, Jamil Mayet, Darrel P Francis, Sayan Sen, Justin E Davies
Importance: Computed tomography-derived fractional flow reserve (FFR-CT) is a novel, noninvasive test for myocardial ischemia. Clinicians using FFR-CT must be able to interpret individual FFR-CT results to determine subsequent patient care. Objective: To provide clinicians a means of interpreting individual FFR-CT results with respect to the range of invasive FFRs that this interpretation might likely represent. Evidence Review: We performed a systematic review in accordance with guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
May 24, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#14
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28500460/prophylactic-temporary-occlusion-of-the-cystic-artery-using-a-fibered-detachable-coil-during-90-y-radioembolization
#15
Jin Woo Choi, Min Young Yoo, Hyo-Cheol Kim, Jin Chul Paeng, Yoon Jun Kim, Jin Wook Chung
PURPOSE: To address the feasibility of prophylactic temporary occlusion of the cystic artery using a detachable coil during (90)Y radioembolization. MATERIALS AND METHODS: From January 2012 to October 2016, nine patients underwent temporary occlusion of the cystic artery during (90)Y radioembolization. Based on the planning hepatic angiography, a detachable coil was deployed into the cystic artery, which arose from a more distal level (e.g., right anterior hepatic artery) than its usual origin, but the proximal 1 cm was left inside the microcatheter...
May 12, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28499664/stemi-with-fluctuating-closing-of-lad-and-cx-do-not-concentrate-on-the-finger
#16
Mario Sadaba, Asier Subinas, Jose Ramón Rumoroso
Case report of the male with an anterior STEMI to whom a primary PCI is performed. The angiogram shows a fluctuating close of the LAD and Cx than when an OCT is performed does not clearly see any pathological findings but when the IVUS is performed, it is clearly seen as a coronary haematoma at the LM, LAD and Cx. Stent at the LM-LAD and proximal Cx are implanted with final good result. After exchanging the guiding catheter for a diagnostic catheter to visualize the RCA, there is an aortic flap; the coronary haematoma was coming from an ascending aortic dissection...
March 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28497381/deep-benign-fibrous-histiocytoma-of-the-anterior-mediastinum-mimicking-malignancy
#17
Angelica Puopolo, William Newmarch, Brian Casserly
The following report describes the case of a 43-year-old male smoker that was referred to the rapid access lung clinic with haemoptysis, chest pain, and axillary lymphadenopathy-a clinical picture that raised concern for a possible underlying malignancy. Preliminary investigations revealed elevated D-dimers, low-volume haemoptysis, and a normal chest X-ray, which lowered the index of suspicion. However, computed tomography (CT) pulmonary angiogram identified a right hilar mass, several parenchymal cysts, and a large mediastinal mass...
May 11, 2017: Lung
https://www.readbyqxmd.com/read/28497186/microwave-ablation-of-the-lung-in-a-porcine-model-vessel-diameter-predicts-pulmonary-artery-occlusion
#18
George A Carberry, Elisabetta Nocerino, Mircea M Cristescu, Amanda R Smolock, Fred T Lee, Christopher L Brace
PURPOSE: To determine the size of pulmonary artery (PA) at risk for occlusion during percutaneous microwave ablation and to assess the effect of vessel diameter, number, and patency, on ablation zone volume. MATERIALS AND METHODS: Computed tomography (CT) fluoroscopy-guided percutaneous microwave ablations were performed in 8 pigs under general anesthesia. All ablations were performed at 65 W for 5 min with a single 17-gauge antenna positioned in the central third of the lungs...
May 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28491172/acquired-uterine-arteriovenous-fistula-following-dilatation-and-curettage-an-uncommon-cause-of-vaginal-bleeding
#19
Adam Evans, Roland E Gazaille, Richard McKenzie, Meghan Musser, Robert Lemming, Jarrod Curry, William Meyers, Nicholas Austin
Dysfunctional uterine bleeding is a common presentation of women in the emergency department. We describe the case of a 33-year-old female who presented with intermittent spotting due to an acquired uterine AVF. The patient underwent a transvaginal pelvic ultrasound as well as a CT angiogram. The patient was treated conservatively and elected to undergo uterine artery embolization in an effort to preserve fertility. She successfully delivered a healthy baby boy at 39-week gestation via an emergent caesarian section due to a prolapsed umbilical cord 17 months after undergoing the uterine artery embolization...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489534/dynamic-2-d-3-d-rigid-registration-framework-using-point-to-plane-correspondence-model
#20
Jian Wang, Roman Schaffert, Anja Borsdorf, Benno Heigl, Xiaolin Huang, Joachim Hornegger, Andreas Maier
In image-guided interventional procedures, live 2-D X-ray images can be augmented with preoperative 3-D CT or MRI images to provide planning landmarks and enhanced spatial perception. An accurate alignment between the 3-D and 2-D images is a prerequisite for fusion applications. This paper presents a dynamic rigid 2-D/3-D registration framework, which measures the local 3-D-to-2-D misalignment and efficiently constrains the update of both planar and non-planar 3-D rigid transformations using a novel point-to-plane correspondence model...
May 8, 2017: IEEE Transactions on Medical Imaging
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