Volume 2 Issue 2
Endoscopic Appendectomy in a Case of Retroverted Appendix
Montes H*, MD., Ruffo G,MD. ,D´Franca J,MD., Garcia G,MD., Milano M, MD., Dolfo W, MD. Castro Denis, MD
A 65-year old woman presented with dull abdominal pain localized en right lower quadrant, the moderate intensity irradiated to the right leg, for 4 years old duration that had gradually worsened in the past 4 months. She denies fever, weight loss, hematochezia, melena with any alterations of the intestinal habits. She had surgical history of appendectomy 9 years ago during right Oophorectomy. Physical examination revealed a soft, non-distended abdomen with mild right lower quadrant tenderness with normal bowel sounds, no abdominal mass was palpable.
Treatment of Benign Essential Blepharospasm and Idiopathic Hemifacial Spasm with Vimpat® (Lacosamide)
Gary A. Mellick*, DO, Larry B. Mellick, MS, MD, FAAP, FACEP
Benign essential blepharospasm and hemifacial spasm are currently treated with botulinum toxin therapy, eyelid protractor myectomies, and microvascular decompression of the facial nerve or pharmacologic therapies including anticonvulsants. Because of limited treatment success in some patients, another treatment option is needed.
Complex Dysexecutive Syndrome and Agonistic Dyspraxia in a Patient with Bullous Pemphigoid
Marko G. Klissurski*, Mery L. Gantcheva, Nikolay L.Topalov, Ivo Sp. Petrov
We are presenting a difficult diagnostic clinical case of a patient who developed a complex dysexecutive and disconnection syndrome with a rare form of hand apraxia, and bullous pemphigoid (BP). The differential diagnosis included a subacute toxic leukoencephalopathy and autoimmune encephalitis. The patient had a moderate exposure to propane-butane/CO, caused by a gas leak from a faulty household appliance. Reversible diffuse leukoencephalopathy with delayed evolution and toxic-hypoxemic etiology was our final diagnosis. It was made after a detailed study of our patient’s medical history, and the extensive examinations conducted simultaneously.
Metastatic Melanoma of the Urinary Bladder in the Era of Targeted Therapy
Luke L Wang* MBBS, BMedSci; Matthew KH Hong MBBS, PhD; Sree Appu MBBS, FRACS (Urol); James G Huang MBBS, FRACS (Urol)
Metastasis of malignant melanoma to the urinary bladder is a rare clinical entity. Here we present the case of a 78 year-old man with metastatic melanoma in his bladder found on surveillance cystoscopy for previous bladder urothelial carcinoma, in the context of concurrent BRAF and MEK inhibitor therapy for melanoma metastasis to other sites. The bladder lesions were histologically confirmed to be melanoma, but despite lower urinary tract symptoms he was managed expectantly and succumbed to his disease some months later. This is only the second case in the English literature reporting bladder metastases from malignant melanoma with concurrent treatment of targeted therapy.