Volume 1 Issue 4
Laparoscopic Donor Nephrectomy and Ligation of Duplicate Inferior Vena Cava: A Case Report and Review of Literature
AM Eltweri*, S Khan, ML Nicholson
Laparoscopic donor nephrectomy can be technically challenging in the presence of anomalous vasculature. We report the case of a 24 year old female with a duplicated inferior vena cava (IVC) who successfully underwent laparoscopic donor nephrectomy and division of the left duplicated inferior vena cava in order to lengthen the renal vein with no long term adverse consequences for the donor. The pertaining literature is reviewed.
Acupuncture As a Cause of Pneumothorax: A Case Report
The potential for pneumothorax as a result of acupuncture is minimal. Nevertheless, clinicians need to be aware of the risk. This case report presents an incident that involved a sixty three year old male who developed a pneumothorax several hours after having acupuncture for back pain. This patient required a chest drain when his pneumothorax failed to resolve with high flow oxygen and thoracocentesis. Management of acupuncture pneumothorax remains debated and may differ between clinicians. This case presents acupuncture as a cause of pneumothorax and highlights the importance of history taking especially to include the use of alternative or complementary therapies.
Long-Term Survival without Progression after Treatment Discontinuation in Patient with Metastatic RCC
Agnieszka Badora-Rybicka*, Łukasz Zarudzki, Danuta Starzyczny-Słota, Elżbieta Nowara
Renal cell carcinoma (RCC) development and progression is linked with angiogenesis and both systemic and locoregional immune dysfunction. Targeted agents used in the treatment of metastatic RCC exert both antiangiogenic and immunomodulatory function. We present a case of a man with advanced clear cell RCC, who received sunitynib. The treatment was ended due to significant hepatotoxicity but the disease remains stable.
Breast Lymphoma. Report of 2 Cases and Review of Literature
Fahed Julien, Kamar Francois G*, Nasser Selim M, Faddoul Sami G, Aftimos Georges P, Aftimos Valerie G
Breast lymphoma is an uncommon lymphoma and rare type of breast cancer. Primary breast lymphoma represents 1% of all extranodal lymphomas and close to 0.7% of all lymphomas. Primary breast lymphoma can present as an aggressive disease with aggressive histology and mimics breast carcinoma in age distribution. It is usually unilateral. In pregnant and lactating females, primary breast lymphoma is typically bilateral. DLBCL is the most frequent histopathological subtype. Staging relies on physical exam, CT scan, or better FDG PET scan.
Atypical Presentation of Vertebral Artery Dissection
Humayun Naqvi* , Lianne Marks MD,PhD, FACP, Richard Otto, MD, Murray Snook, MD
Vertebral artery dissections can cause ischemic damage to the brain. It is more common in young individuals and can be caused by minor trauma. The presentation of the disease varies and an atypical presentation can easily be missed and lead to long-term brain injury. Dissection is commonly missed because focal neurological symptoms such as Horner’s syndrome are only present in 20%-58% of carotid artery dissections and occasionally in vertebral artery dissections. The diagnosis can get further clouded if the patient has a history of other neurological problems such as migraines.
A Case of Occult Ectopic ACTH syndrome Treated with Octreotide
Kazuma Ogiso, Nobuyuki Koriyama*, Ayako Ijuin, Yuji Nakamoto, Yoshihiko Nishio
It has been reported that in 19% of patients with ectopic ACTH syndrome, a tumor cannot be identified, despite extensive evaluation. We present a case of a 68-year-old woman admitted to our hospital for examination of moon facies, central obesity, hyperpigmentation, bilateral pretibial edema, hypokalemia and hypertension. Both adrenocorticotropin (ACTH) and cortisol levels were elevated with no circadian rhythm. Administration of corticotropin-releasing hormone (CRH) did not change ACTH and only stimulated serum cortisol to less than 10% of basal values. There was no overnight suppression of cortisol in either the low-dose (0.5 mg) or high-dose (8 mg) dexamethasone (Dex) suppression test, and we diagnosed her with ectopic ACTH syndrome, although she rejected an inferior petrosal sinus sampling.
Anuric Acute Kidney Injury due to Bladder Tamponade in a patient with acquired Hemophilia A
Taichi Ikebe*, Yoshio Saburi, Masao Ogata, Kuniaki Shirao
Acquired hemophilia A is a rare, but potentially life-threatening bleeding disorder caused by autoantibodies for coagulation factor VIII. Major bleeding symptoms include subcutaneous and muscle bleeding, while hematuria is observed in less than 10% of patients. We report a case of a 49-year-old man presenting with severe and sustained hematuria without subcutaneous bleeding. He developed postrenal acute kidney injury resulting from bladder tamponade of blood clots and required temporary hemodialysis. Acquired hemophilia A was diagnosed, and he was successfully treated with recombinant factor VIIa and steroids without adverse effect including thrombotic event.
Performance of the Transcatheter LotusTM Valve System in Patients at High Risk of Paravalvular Regurgitation
Mounir Riahi MD, Jean-Bernard Masson MD, Charbel Naim MD, Jean-François Gobeil MD, Nicolas Noiseux MD, Louis-Mathieu Stevens MD, Marco Spaziano MD, Nicolo Piazza MD, Giuseppe Martucci MD, Benoit de Varennes MD, Kevin Lachapelle MD, Jeannot Potvin MD*
Transcatheter aortic valve implantation (TAVI) is now a proven and recognized alternative to surgical aortic valve replacement (SAVR) for high-risk or inoperable patients with severe symptomatic aortic stenosis. However, current devices and techniques have been associated with a higher risk of paravalvular regurgitation (PVR) compared to SAVR and more-than-mild PVR has been linked to adverse outcomes in TAVI patients. Multiple factors have been identified as potential causes for PVR including annular eccentricity, lack of oversizing, non-symmetric distribution and/or high burden of calcification and malpositioning.
Vaginal Giant Condyloma in Pregnancy Mimicking Carcinoma: Case Report
Soheila Aminimoghaddam*, Fatemeh Abbasi,Fatemeh Mahmoudzadeh, Andisheh Maghsoudnia, Fatemeh Ghaemmaghami
Genital warts is one of the most prevalent sexually transmitted disease in the world. Both, the incidence and the prevalence of genital HPV infection are increasing. The viral nature of genital was first known in 1907 when ciuffo induced warts after auto inoculation of free-cell wart extracts. The DNA of the first genital wart was characterized in 1980. now, at least 100 HPV types have been identified; about 40 type of them affect the male and female anogenital tract. Estimates indicate, about 1 % of the sexually active populations have clinically apparent genital warts.
Managing Parkinsonism in a Schizophrenic Patient
G. Bryan Young, MD, FRCPC*#, Brendan Mulroy#, MD, MA, FCFP and Rizwan Rafiq#, MBBS, MRCPsych, DPM, DCP, MDH, MDCH, CDp in CBT
The receptor profile of rotigitine patch may be favorable for patients who have both Parkinsonism and schizophrenia. The dopamine hypothesis for schizophrenia proposes that activation of the D2 receptor is especially important; indeed, D2 receptor partial antagonists have been a mainstay in the treatment of schizophrenia. Bromocriptine, a fairly specific D2 receptor agonist, is notorious for precipitating psychoses in patients with schizophrenia or schizoaffective disorder. There is emerging evidence that the D1 receptor antagonists may also play a role in the treatment off schizophrenia.
Improved PAH in a Patient with Large Granular Lymphocyte Leukemia under Methotrexate
Séverine Müller-Mottet, Rudolf Speich and Silvia Ulrich*
We report the case of a 39 year old woman who developed pulmonary hypertension (PH) associated to T-cell large granular lymphocyte leukemia (LGL leukemia). Initial therapy with sildenafil did not improve the patient’s symptoms sufficiently. Methotrexate (MTX) therapy was started 20 mg s.c./week. The patient’s symptoms rapidly improved, exercise capacity increased and pulmonary hemodynamics ameliorated.
A Videod Case of a Lethal Anaphylactic Myocardial Infarction Occurring During Endovascular Aortic Repair
Yasuyuki SHIMADA*, MD, FAHA, Yasushi TERADA, MD, and Hitoshi SAKUDA, MD
We report a case of an acute coronary syndrome mediated by an allergic reaction (Kounis syndrome) and present a video of the coronary angiogram performed while the patient was having a heart attack. The angiogram shows spastic and embolic lesions that are typical of the syndrome.