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https://www.readbyqxmd.com/read/29326779/tacrolimus-as-a-rare-cause-of-pericardial-effusion-in-a-renal-transplant-recipient
#1
Rohini Prashar, Diana Stewart, Ankush Moza
Pericardial effusion in a renal transplant recipient represents a diagnostic conundrum with a variety of differential diagnoses. Immunosuppressive medications such as sirolimus have been linked to pericardial effusions in the reported literature. Tacrolimus has been reported to be associated with pleural effusions and ascites. We present a case of a patient with tacrolimus as the likely cause of a recurrent pericardial effusion.
October 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29319254/cavitating-lung-lesions-with-encephalopathy-in-a-patient-with-long-standing-sjogren-s-syndrome-an-elusive-cause
#2
Siddharth Jain, Animesh Ray, Manish Soneja, S Leve Joseph Devarajan, Shyam Madabhushi, Anitha Swamy, T Naveen, S K Sharma
A known case of primary Sjogren's syndrome with chronic kidney disease presented with respiratory symptoms and subsequent altered sensorium. Chest imaging suggested cavitating lung lesions in both the lungs. Serum c-ANCA was positive without any upper respiratory tract involvement or active urinary sediments. Treatment with appropriate anti-microbials produced no improvement in the respiratory or neurological parameters. MRI brain revealed tell-tale signs of CNS vascultis. A diagnosis of GPA was made as per European Medical Agency algorithm and the patient was started on immune-suppressants to which there was dramatic response...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29318903/decoding-oral-cancer-conundrums-from-bad-luck-point-of-view
#3
Sachin C Sarode, Gargi S Sarode, Shankargouda Patil
No abstract text is available yet for this article.
January 10, 2018: Future Oncology
https://www.readbyqxmd.com/read/29314393/global-cerebral-atrophy-detected-by-routine-imaging-relationship-with-age-hippocampal-atrophy-and-white-matter-hyperintensities
#4
Omar M Al-Janabi, Pradeep Panuganti, Erin L Abner, Ahmed A Bahrani, Ronan Murphy, Shoshana H Bardach, Allison Caban-Holt, Peter T Nelson, Brian T Gold, Charles D Smith, Donna M Wilcock, Gregory A Jicha
BACKGROUND AND PURPOSE: Interpreting the clinical significance of moderate-to-severe global cerebral atrophy (GCA) is a conundrum for many clinicians, who visually interpret brain imaging studies in routine clinical practice. GCA may be attributed to normal aging, Alzheimer's disease (AD), or cerebrovascular disease (CVD). Understanding the relationships of GCA with aging, AD, and CVD is important for accurate diagnosis and treatment decisions for cognitive complaints. METHODS: To elucidate the relative associations of age, moderate-to-severe white matter hyperintensities (WMHs), and moderate-to-severe medial temporal lobe atrophy (MTA), with moderate-to-severe GCA, we visually rated clinical brain imaging studies of 325 participants from a community based sample...
January 5, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29305251/cardiac-arrest-during-pregnancy-ongoing-clinical-conundrum-an-expert-review
#5
REVIEW
Carolyn M Zelop, Sharon Einav, Jill M Mhyre, Stephanie Martin
While global maternal mortality has decreased in the last 25 years, the maternal mortality ratio in the United States has actually increased. Maternal mortality is a complex phenomenon involving multifaceted socioeconomic and clinical parameters including inequalities in access to health care, racial and ethnic disparities, maternal comorbidities and epidemiologic ascertainment bias. Escalating maternal mortality underscores the importance of clinician preparedness to respond to maternal cardiac arrest that may occur in any maternal health care setting...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29302043/heme-oxygenase-1-genetic-variants-and-the-conundrum-of-hyperbilirubinemia-in-african-american-newborns
#6
David L Schutzman, Erica Gatien, Samuel Ajayi, Ronald J Wong
BACKGROUND: African-American (AA) infants are known to have, overall, lower bilirubin levels than infants of other ethnicities during their birth hospitalization. However, they are known to have a higher incidence of severe hyperbilirubinemia and are over represented in the US Kernicterus Registry. Heme oxygenase-1 (HO) is the rate limiting enzyme in heme metabolism leading to the equimolar production of bilirubin, carbon monoxide (CO) and free iron (Fe). Short (S) (GT)n repeats (<25) in the promoter region of the gene encoding the inducible HO-1 isozyme augment its expression, while long (L) repeats (>33) lead to an attenuation, modulating the production of bilirubin and CO...
January 4, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29290402/are-lethal-alleles-too-abundant-in-humans
#7
Mallory A Ballinger, Mohamed A F Noor
Across species, many individuals carry one or more recessive lethal alleles, posing an evolutionary conundrum for their persistence. Using a population genomic approach, Amorim et al. studied the abundance of lethal disease-causing mutations in humans and found that, while appearing more common than expected, most may nonetheless persist at frequencies predicted by mutation-selection balance.
December 28, 2017: Trends in Genetics: TIG
https://www.readbyqxmd.com/read/29287043/the-social-media-conundrum
#8
Jennifer Mayhan
No abstract text is available yet for this article.
January 2018: Nursing Management
https://www.readbyqxmd.com/read/29286270/landmark-lecture-on-cardiac-intensive-care-and-anaesthesia-continuum-and-conundrums
#9
Peter C Laussen
Cardiac anesthesia and critical care provide an important continuum of care for patients with congenital heart disease. Clinicians in both areas work in complex environments in which the interactions between humans and technology is critical. Understanding our contributions to outcomes (modifiable risk) and our ability to perceive and predict an evolving clinical state (low failure-to-predict rate) are important performance metrics. Improved methods for capturing continuous physiologic signals will allow for new and interactive approaches to data visualization, and for sophisticated and iterative data modeling that will help define a patient's phenotype and response to treatment (precision physiology)...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29285574/clostridium-difficile-related-postinfectious-ibs-a-case-of-enteroglial-microbiological-stalking-and-or-the-solution-of-a-conundrum
#10
EDITORIAL
Gabrio Bassotti, Lara Macchioni, Lanfranco Corazzi, Pierfrancesco Marconi, Katia Fettucciari
Post-infectious irritable bowel syndrome is a well-defined pathological entity that develops in about one-third of subjects after an acute infection (bacterial, viral) or parasitic infestation. Only recently it has been documented that an high incidence of post-infectious irritable bowel syndrome occurs after Clostridium difficile infection. However, until now it is not known why in some patients recovered from this infection the gastrointestinal disturbances persist for months or years. Based on our in vitro studies on enteric glial cells exposed to the effects of C...
December 28, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/29284541/dotaligner-identification-and-clustering-of-rna-structure-motifs
#11
Martin A Smith, Stefan E Seemann, Xiu Cheng Quek, John S Mattick
The diversity of processed transcripts in eukaryotic genomes poses a challenge for the classification of their biological functions. Sparse sequence conservation in non-coding sequences and the unreliable nature of RNA structure predictions further exacerbate this conundrum. Here, we describe a computational method, DotAligner, for the unsupervised discovery and classification of homologous RNA structure motifs from a set of sequences of interest. Our approach outperforms comparable algorithms at clustering known RNA structure families, both in speed and accuracy...
December 28, 2017: Genome Biology
https://www.readbyqxmd.com/read/29282122/advice-and-care-for-patients-who-die-by-voluntarily-stopping-eating-and-drinking-is-not-assisted-suicide
#12
Andrew McGee, Franklin G Miller
BACKGROUND: A competent patient has the right to refuse foods and fluids even if the patient will die. The exercise of this right, known as voluntarily stopping eating and drinking (VSED), is sometimes proposed as an alternative to physician assisted suicide. However, there is ethical and legal uncertainty about physician involvement in VSED. Are physicians advising of this option, or making patients comfortable while they undertake VSED, assisting suicide? This paper attempts to resolve this ethical and legal uncertainty...
December 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29279593/diagnostic-conundrum-of-a-perineal-tumour-a-rectal-gastrointestinal-stromal-tumour-mimic
#13
R Shi, M H Chew, W Q Leow
Gastrointestinal stromal tumour (GIST) is a common mesenchymal tumour arising in the gastrointestinal tract, but not frequently encountered in the rectum. Herein, we describe a case of a rectal GIST which mimicked histomorphological features of a schwannoma; thus, making intraoperative frozen section evaluation challenging. Although subsequent immunohistochemistry and molecular findings readily confirmed the diagnosis of a GIST, we wish to draw attention to three clues that will help the pathologist steer clear of this potential diagnostic pitfall...
December 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/29279053/unraveling-the-conundrum-of-asthma-phenotypes-and-endotypes
#14
Joseph A Bellanti, Russell A Settipane
No abstract text is available yet for this article.
January 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29278551/the-recurrent-pleomorphic-adenoma-conundrum
#15
Patrick J Bradley
PURPOSE OF REVIEW: Recurrent pleomorphic adenoma (RPA) is uncommon. Treatment selection is based on the likely possibility of minimizing the risk of tumour recurrence, avoiding local functional and cosmetic sequelae, and eradicates the possibility of metastatic or malignant transformation. Much has changed since the topic was reviewed in 2001, and this manuscript comments on clinical progress and discusses patient treatment options. RECENT FINDINGS: Surgery is the preferred treatment for head and neck pleomorphic adenoma...
December 22, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29275543/biophotonics-the-big-picture
#16
Laura Marcu, Stephen A Boppart, Mark R Hutchinson, Jürgen Popp, Brian C Wilson
The 5th International Conference on Biophotonics (ICOB) held April 30 to May 1, 2017, in Fremantle, Western Australia, brought together opinion leaders to discuss future directions for the field and opportunities to consider. The first session of the conference, "How to Set a Big Picture Biophotonics Agenda," was focused on setting the stage for developing a vision and strategies for translation and impact on society of biophotonic technologies. The invited speakers, panelists, and attendees engaged in discussions that focused on opportunities and promising applications for biophotonic techniques, challenges when working at the confluence of the physical and biological sciences, driving factors for advances of biophotonic technologies, and educational opportunities...
December 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29259786/necessity-to-evaluate-pi3k-akt-signalling-pathway-in-proarrhythmia
#17
REVIEW
Martin Ezeani, Sunday Elom
The incidence of QT prolongation and torsades de pointes is on the rise due to the use of cardiovascular and non-cardiovascular drugs. Robust efforts have been made and are still ongoing to understand the underlying mechanisms that can enhance or prevent the development of drug-induced proarrhythmia. A caveat in the use of antiarrhythmic drugs is the ability to obtain safe action potential prolongation therapeutic effects, through IKr blockade. This remains as yet completely unachievable, as blockers of the potassium channel have not provided complete safe measures...
2017: Open Heart
https://www.readbyqxmd.com/read/29258894/the-conundrum-of-allogeneic-bone-marrow-transplantation-for-epidermolysis-bullosa
#18
Jouni Uitto
Epidermolysis bullosa (EB) is a heterogeneous group of heritable blistering disorders with considerable morbidity and mortality. Currently, there is no effective treatment or cure for EB, but bone marrow transplantation (BMT) has been suggested to improve the clinical presentation and quality of life in some patients with the recessive dystrophic subtype of EB. In this issue, Hünefeld et al. (pp.000) address the issue whether BMT could be applied to patients with EB simplex with intra-epidermal blistering...
December 16, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/29243716/oral-surgery-ii-part-5-chronic-orofacial-pain
#19
T Renton
Chronic orofacial pain syndromes represent a diagnostic challenge for any practitioner. Patients are frequently misdiagnosed or attribute their pain to a prior event such as a dental procedure, ENT problem or facial trauma. Psychiatric symptoms of depression and anxiety are prevalent in this population and compound the diagnostic conundrum. Treatment is less effective than in other pain syndromes and thus often requires a multidisciplinary approach to address the many facets of these conditions.
December 15, 2017: British Dental Journal
https://www.readbyqxmd.com/read/29234548/steroid-responsive-encephalopathy-associated-with-autoimmune-thyroiditis-presenting-with-fever-and-confusion
#20
Chiranthi Kongala Liyanage, Tilak Manthi Janake Munasinghe, Adsareswary Paramanantham
Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) is a diagnostic conundrum as it may present with a myriad of nonspecific clinical features and laboratory and neuroimaging investigations are not diagnostic. We report a case of a 65-year-old female who presented with an acute febrile illness associated with headache and confusion, tangential thoughts, and loose association. Based on neutrophil leukocytosis in the full blood count and elevated inflammatory markers, she was commenced on empirical intravenous antibiotics suspecting meningoencephalitis...
2017: Case Reports in Neurological Medicine
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