Bioprosthetic valve fracture during valve-in-valve transcatheter aortic valve replacement.
Abstract Transcatheter aortic valve replacement (TAVR) valve-in-valve (VIV) therapy has been approved for select patients with surgically inoperable bioprosthetic valves that need replacement. Bioprosthetic valve fracturing (BVF) used in conjunction with VIV TAVR can reduce transvalvular gradients and increase the aortic valve area. Twelve patients who underwent BVF VIV TAVR at a single center were retrospectively analyzed. Measurements of hemodynamics and aortic valve area were performed at baseline, after VIV TAVR, after BVF, and at 30-day follow-up. The mean Society of Thoracic Surgeons Predicted Risk of Mortal...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Hamandi M, Nwafor I, Hebeler KR, Crawford A, Lanfear AT, Schaffer J, Al-Azizi K, Potluri S, Brinkman WT, Harrington K, Szerlip M, DiMaio JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Usefulness of prolonged renal replacement therapy in patients with acute kidney injury requiring dialysis.
In conclusion, shift CVVHD is effective in treating patients with AKI requiring dialysis and has a survival similar to that of continuous therapies with less intensive use of resources. PMID: 32675946 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Duran P, Concepcion LA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hemophagocytic lymphohistiocytosis in adults.
In conclusion, despite increasing recognition, HLH remains an enigmatic disorder with increased mortality, even more so with malignancy-associated HLH. PMID: 32675947 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Pandey Y, Atwal D, Konda M, Bimali M, Middleton D, Yarlagadda N, Firwana B, Sasapu A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Usefulness of patient-reported outcomes to assess the effectiveness of topical hormonal therapy for gynecologic symptoms after antihormonal treatment for breast cancer.
In this study, the use of topical hormonal replacement was not effective in alleviating vaginal symptoms. PMID: 32675948 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Jain AL, Jamy O, Mullins J, Usman RM, Hare F, Valasareddy P, Chaudhry A, Ryder J, Smith JR, Miller E, Ranganath H, Schwartzberg L, Stepanski E, Walker M, Gatwood J, Vidal GA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Predictive value of lateral soft tissue thickness for complications after total hip arthroplasty with a lateral incision.
Abstract The purpose of this study was to determine the relationship between soft tissue thickness lateral to the greater trochanter, as measured on anteroposterior pelvis radiograph, and postoperative complications following primary total hip arthroplasty. A retrospective review of 1110 consecutive patients treated at a single institution from 2003 to 2011 was conducted. Postoperative complications were divided into surgical site infections, deep wound infections, noninfectious surgical complications, need for revision surgery, and medical complications. Lateral soft tissue thickness (LSTT) was measured as the ho...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Sprowls GR, Allen BC, Wilson TJ, Pruszynski JE, Hammonds KAP Tags: Proc (Bayl Univ Med Cent) Source Type: research

Continuous blood pressure monitoring during high-intensity resistance training after myocardial infarction or percutaneous coronary intervention in a phase 2 cardiac rehabilitation setting.
Abstract The purpose of this study was to investigate the maximum rate-pressure product of cardiac rehabilitation participants after myocardial infarction, percutaneous coronary intervention, or both during high-intensity resistance training (HI-RT) using continuous blood pressure monitoring. Thirty-four individuals exercised on the leg press machine while being monitored with a continuous blood pressure monitor. The maximum rate-pressure product was significantly lower than the established safety threshold of 36,000 (P
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Brown KD, Nguyen HL, Adams J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Implementation of a pilot medical student mentoring program for premedical students and its effects on premedical student attitudes.
Abstract As the medical school admissions process becomes increasingly competitive, there is an increased mental and emotional burden on undergraduate premedical students due to uncertainty about acceptance. Mentors in Medicine is a mentoring program between Texas Tech University Health Sciences Center and Texas Tech University students; the data demonstrate that this program can alleviate some negative emotional aspects faced by premedical students on their journey to medical school. The program interventions include establishing mentor-mentee relationships between medical students and premedical students, hostin...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Maniam G, Dean R, Urban RS, Williams S Tags: Proc (Bayl Univ Med Cent) Source Type: research

Advanced heart failure with reduced ejection fraction.
Abstract Patients suffering advanced heart failure with reduced ejection fraction (HFrEF) account for a large portion of patients admitted to hospitals worldwide. Mortality and 30-day readmission rates for HFrEF are now a focus of value-based payment models, making management of this disease a priority for hospitals, physicians, and payers alike. Angiotensin-converting enzyme inhibitors have been the cornerstone of therapy for decades. However, with treatment, the prognosis for patients with advanced HFrEF remains poor. Fortunately, advances in medical therapy and mechanical support offer some patients improvement...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Hicks A, Velazco JF, Gohar S, Seliem A, Hall SA, Michel JB Tags: Proc (Bayl Univ Med Cent) Source Type: research

The acute respiratory distress syndrome.
Abstract Acute respiratory distress syndrome (ARDS) is a prevalent cause of acute respiratory failure with high rates of mortality, as well as short- and long-term complications, such as physical and cognitive impairment. Therefore, early recognition of this syndrome and application of well-demonstrated therapeutic interventions are essential to change the natural course of this entity and bring about positive clinical outcomes. In this article, we review updated concepts in ARDS. Specifically, we discuss the current definition of ARDS, its risk factors, and the evidence supporting ventilation management, adjuncti...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Wood C, Kataria V, Modrykamien AM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Cannabidiol primer for healthcare professionals.
This article gives healthcare providers information on cannabidiol and the endocannabinoid system as a foundation on which to build their medical knowledge as the risks and benefits of CBD in various diseases are further evaluated over time. PMID: 32675954 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Cather JC, Cather JC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Zieve syndrome in acute alcoholic hepatitis.
Abstract A 31-year-old woman presented with acute alcoholic hepatitis, jaundice, anemia, and hypertriglyceridemia following ethylene glycol poisoning. She had no previous history of anemia or gastrointestinal bleeding. Laboratory findings were consistent with acute hemolytic anemia. She was diagnosed with Zieve syndrome and was managed with supportive measures. Zieve syndrome is a rare occurrence with only a handful of published case reports. Although rare, the diagnosis should be on the differential in this subgroup of patients to avoid unnecessary and invasive diagnostic interventions. PMID: 32675955 [PubMe...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Achufusi TG, Sandhu J, Chahal J, Shepherd Z, Mirchia K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hepatosplenic sarcoidosis.
We report a case of sarcoidosis of the spleen and liver with minimal pulmonary involvement. PMID: 32675956 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Kopparapu A, Odathil F, Bajaj G, Jarrett D, Kraleti S Tags: Proc (Bayl Univ Med Cent) Source Type: research

Appendiceal sarcoidosis presenting as acute appendicitis.
We present a case of a 49-year-old woman with abdominal pain. An ultrasound of the abdomen was suggestive of acute appendicitis. Laparoscopic appendectomy was performed and the pathology revealed nonnecrotizing granulomas. Biopsy of the mediastinal lymph nodes suggested noncaseating granulomas. She was treated with steroid therapy followed by mycophenolate mofetil. Our case demonstrates the importance of considering appendiceal sarcoid among the differentials in a patient with systemic sarcoidosis presenting with an acute abdomen. PMID: 32675957 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Pendela VS, Munoz A, Chhabria M, Kudaravalli P, Soliman M, Soliman Y Tags: Proc (Bayl Univ Med Cent) Source Type: research

Multiorganism HIV-associated diarrhea and telescoping bowel.
Abstract Diarrhea in individuals with human immunodeficiency virus (HIV) remains a diagnostic challenge. We treated a 53-year-old woman from Africa who presented with acute diarrhea, which yielded a diagnosis of HIV and severe immune deficiency. The patient's diarrhea resulted in hypovolemic shock and acute abdominal pain. Evaluation revealed an intestinal intussusception. Pathology findings were consistent with Cryptosporidium, Entamoeba, Giardia, and cytomegalovirus infections. The actual prevalence of multiple microorganisms causing HIV-associated diarrhea is unknown. A nonmalignant-related adult intussusceptio...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Noor A, Bedi D, Yassin MH Tags: Proc (Bayl Univ Med Cent) Source Type: research

Rectal malakoplakia.
Abstract Malakoplakia is a rare chronic granulomatous disease with potential to affect multiple organs. Gastrointestinal involvement is considered one of the most common locations outside of the urinary tract. Herein, we present the case of a man who presented to our clinic with painless hematochezia. Physical examination findings were unremarkable; however, colonoscopy revealed a frond-like/villous, fungating, and polypoid nonobstructing circumferential mass in the rectum. Histopathological examination of the lesion revealed findings consistent with malakoplakia. PMID: 32675959 [PubMed] (Source: Baylor Unive...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Achufusi TG, Jessamy K, Chebaya P, Rawlins S Tags: Proc (Bayl Univ Med Cent) Source Type: research

Colonic diaphragm disease secondary to nonsteroidal anti-inflammatory drug use.
We report a case of an asymptomatic patient with colonic diaphragm disease secondary to NSAID use. PMID: 32675960 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Saleem N, Marella HK, Ali B, Tombazzi CR Tags: Proc (Bayl Univ Med Cent) Source Type: research

The postcholecystectomy syndrome in morbid obesity.
We report a case of a 64-year-old woman who developed gallstones after undergoing a cholecystectomy>40 years earlier. The potential of retained gallstones, incomplete gallbladder removal, or regeneration of gallstones in the gallbladder remnant or cystic duct remnant after a long time following cholecystectomy is discussed. PMID: 32675961 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Ng C, Ejimakor M, Goldson TM, Forjuoh SN Tags: Proc (Bayl Univ Med Cent) Source Type: research

The Sweet syndrome as a cutaneous manifestation of Crohn's disease.
We present a case of classic Sweet's syndrome in a patient with well-controlled Crohn's disease. PMID: 32675962 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Huda SA, Kahlown S, Jilani MH, Alam SH, Riaz S, Vasigh M, Sharma B Tags: Proc (Bayl Univ Med Cent) Source Type: research

Type 1 diabetes mellitus, familial hypercholesterolemia, and elevated lipoprotein (a).
Abstract Risk factor screening of all youth, including those with high-risk medical conditions such as diabetes mellitus, is important to reduce premature morbidity and mortality attributable to atherosclerotic cardiovascular disease. In those found to have significant hypercholesterolemia and/or elevated levels of lipoprotein (a), reverse cascade screening (child to parent) is recommended. This case demonstrates the benefits of targeted lipid testing. Early detection may provide additional motivation for families to adopt healthier lifestyles and reduce future atherosclerotic cardiovascular disease events in the ...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Hamilton L, McNeal C, Wilson D Tags: Proc (Bayl Univ Med Cent) Source Type: research

The antisynthetase syndrome.
We describe a patient who developed respiratory symptoms following fume exposures. Following a prednisone taper for presumed hypersensitivity pneumonitis, he developed extrapulmonary symptoms suspicious for an autoimmune process discovered to be antisynthetase-associated interstitial lung disease and myositis. This case demonstrates the importance of avoiding anchoring to minimize morbidity and potentially mortality. PMID: 32675964 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Robinson D, Scholz B Tags: Proc (Bayl Univ Med Cent) Source Type: research

Usefulness of extracorporeal membrane oxygenation in status asthmaticus with severe tracheal stenosis.
We present a 30-year-old woman with concomitant life-threatening airway obstruction due to severe tracheal stenosis and status asthmaticus treated effectively with veno-venous extracorporeal membrane oxygenation. PMID: 32675965 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Odigwe C, Krieg J, Owens W, Lopez C, Arya RR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Management of immune checkpoint inhibitor-related acute hypoxic neuromuscular respiratory failure using high-flow nasal cannula.
We describe use of high-flow nasal cannula in a patient with acute hypoxic respiratory failure and psychological distress due to the immune-related adverse event of myasthenic crisis. PMID: 32675966 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Mathews EP, Romito JW Tags: Proc (Bayl Univ Med Cent) Source Type: research

Swimming-induced pulmonary edema.
We report a case of a 58-year-old female athlete presenting with acute dyspnea during the swimming portion of a half-triathlon competition. She had complete resolution within 24 h of presentation. PMID: 32675967 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Paz P, Makram J, Mallah H, Mantilla B, Ball S, Nugent K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Ophiasis alopecia areata treated with microneedling.
We present a case of a 58-year-old white man with AA, ophiasis pattern, who was treated with clobetasol 0.05% solution and four treatments of microneedling with triamcinolone over 6 months. He underwent gradual improvement, most notably on his left occipital scalp where his hair loss was most prominent, with near complete hair regrowth on his left occipital scalp. Microneedling with triamcinolone can be considered as a promising treatment in cases of ophiasis AA. PMID: 32675968 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Asad U, Wallis D, Tarbox M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Punctate porokeratosis-pruritic and hyperkeratotic papules on the palms and feet.
Abstract Porokeratosis is an uncommon cutaneous condition with multiple clinical variants that is defined by round patches with a raised, fine scaling border. Punctate porokeratosis is a rare variant of porokeratosis that is characterized by elevated, seed-like lesions of the palms and soles. While variants of porokeratosis may be associated with an increased risk of squamous cell carcinoma within the lesion, punctate porokeratosis does not increase the risk of squamous cell carcinoma. However, punctate porokeratosis may mimic other dermatoses affecting the palms and soles including spiny keratoderma, arsenical ke...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Jedlowski PM, Rainwater G, Paek SY Tags: Proc (Bayl Univ Med Cent) Source Type: research

Ixekizumab and herpes zoster in an erythrodermic patient.
We present what we believe is the first case of herpes zoster (shingles) in a patient 12 weeks after starting ixekizumab for presumed erythrodermic psoriasis. It is important to be aware of potential side effects of immunomodulatory medications, particularly those that are new to the market. PMID: 32675970 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Pruneda CC, Austin BA, Wallis DT, Paulger BR, Tarbox MB Tags: Proc (Bayl Univ Med Cent) Source Type: research

Diffuse dermal angiomatosis localized to abdominal striae.
We present a case of a 40-year-old woman with ulcerated plaques on her abdomen consistent with diffuse dermal angiomatosis on histopathological evaluation. Unique to our patient was localization of the lesions to the abdominal striae. PMID: 32675971 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Frizzell MR, Shah S, Parekh P Tags: Proc (Bayl Univ Med Cent) Source Type: research

Malignant melanoma of the cecum and small intestine.
We present a case of metastatic melanoma in a 61-year-old man with initial symptomatic cecal melanoma and subsequent jejunal involvement discovered during endoscopy. PMID: 32675972 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Tan C, Yanchak T, Ramirez J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Cutaneous signet-ring cell squamous cell carcinoma.
We report a case of a 66-year-old transgender woman with an ulcerated growing facial mass measuring 5.6 × 4.0 × 2.0 cm. Histological analysis showed features consistent with SRCSCC. Immunohistochemical analysis showed positive staining for high-molecular-weight cytokeratin, estrogen receptor (1-2+ in 10%), E-cadherin (mostly positive with partial loss), and p40 and negative staining for Ber EP-4, cytokeratin 7, low-molecular-weight cytokeratin, mucicarmine, Alcian blue PAS, HER2, and MUC4. The tumor had invaded the perineurium, lymphovascular spaces, and subcutaneum. Additionally, microsatellite i...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Findeis SK, Readinger A, Mitchell J, Agarwal A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Quadruple therapy for gastric high-grade B-cell lymphoma.
Abstract Most low-grade gastric lymphomas arising from the mucosa-associated lymphoid tissue (MALT) are directly related to Helicobacter pylori infection. Most cases of MALT lymphoma limited to the stomach can be cured with H. pylori eradication and remain in remission for years. In contrast, high-grade lymphomas of the stomach, although potentially related to H. pylori, do not usually respond to H. pylori eradication. Here, we present the case of a woman with high-grade diffuse large B-cell lymphoma who achieved complete remission following H. pylori eradication. PMID: 32675974 [PubMed] (Source: Baylor Unive...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Achufusi TG, Jessamy K, Zamora E, Ozden N Tags: Proc (Bayl Univ Med Cent) Source Type: research

Optimum treatment for primary intracranial Ewing sarcoma.
This report discusses a unique presentation of an adult extraosseous ES arising from the pineal region with extension into the third and fourth ventricles and multiple drop metastases to the spine. This case demonstrates the application of current chemotherapeutic and adjuvant management and offers insight into possible treatment modalities for metastasis in an atypical extraosseous ES involving the brain and spine. PMID: 32675975 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Howell SG, Lyon KA, Garrett D, Huang JH, Fonkem E Tags: Proc (Bayl Univ Med Cent) Source Type: research

Disseminated Burkitt lymphoma presenting as massive gastrointestinal bleed.
Abstract Burkitt lymphoma is a rare, highly aggressive non-Hodgkin lymphoma with increasing incidence. Here we present a 26-year-old man with a history of a recent root canal who presented with 2 days of black, tarry stools, persistent tooth pain, and 2 weeks of fatigue, night sweats, and a 20-pound weight loss. He developed massive hematemesis while hospitalized and an esophagogastroduodenoscopy revealed innumerable, doughnut-shaped masses with central umbilication throughout the stomach, which were also the source of bleeding. Targeted biopsies revealed Burkitt lymphoma. After prompt chemotherapy treatment, repe...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Harne PS, Macklin J, Muniraj T Tags: Proc (Bayl Univ Med Cent) Source Type: research

IgA negative immunofluorescence in diagnoses of adult-onset Henoch-Sch ├Ânlein purpura.
We describe two cases of young adult men presenting with diffuse petechial rash and gastrointestinal disturbances. They were found to have leukocytoclastic vasculitis without immunoglobulin A findings under direct immunofluorescence on skin biopsy histopathology performed over a week after the appearance of lesions. Henoch Schönlein purpura (HSP) was diagnosed based upon the clinical presentation as well as the leukocytoclastic vasculitis biopsy findings. PMID: 32675977 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Poudel P, Adams SH, Mirchia K, Jain H, Eranki A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Mycobacterial spindle cell pseudotumor in a woman with HIV.
We report a case of MSP occurring in a woman with human immunodeficiency virus and a tumor-like mass in the abdomen. A subsequent biopsy revealed MSP, which was successfully treated with antimycobacterial therapy. PMID: 32675978 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Krause JR, Findeis SK Tags: Proc (Bayl Univ Med Cent) Source Type: research

Cat scratch disease causing encephalitis.
We present a case of a 22-year-old man with a 3-week history of an enlarged inguinal lymph node who presented with status epilepticus. PMID: 32675979 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Fan J, Ali H Tags: Proc (Bayl Univ Med Cent) Source Type: research

Spontaneous sphenoid meningoencephalocele with sepsis.
ust K Abstract Streptococci bacteremia is an unusual source of sepsis from spontaneous cerebrospinal fluid (CSF) rhinorrhea due to sphenoid meningoencephalocele. A spontaneous cause of CSF rhinorrhea should be on the differential along with trauma and congenital and neoplastic lesions. Moxifloxacin 400 mg daily for 2 weeks has a satisfactory CSF penetration to treat Streptococcus viridans bacteremia due to CSF rhinorrhea. PMID: 32675980 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Shah M, Tadeo Berm├║dez Borjas MA, Brust K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Actinomyces lymphadenitis.
Abstract Actinomyces is a gram-positive anaerobe that colonizes the human oral cavity. Its pathogenesis involves the disruption of the mucosal membrane, leading to suppuration and subsequent abscess formation, most commonly in the cervicofacial region. The bacteria form masses consisting of aggregates of branching, filamentous bacilli. They typically spread by direct tissue invasion and less commonly through hematogenous spread. Lymphatic spread is extremely uncommon. To the best of our knowledge, only two cases have been reported with lymph node involvement. Clinically, lymphadenopathy associated with Actinomyces...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Kim J, Wood C, Sandkovsky U, Rokadia H Tags: Proc (Bayl Univ Med Cent) Source Type: research

Effects of radiation and MediPort placement on the development of thoracic outlet syndrome.
We present a patient who exemplifies the interplay of factors contributing to the development of venous-type thoracic outlet syndrome. The patient was treated with both radiation and chemotherapy for squamous cell carcinoma in the head and neck region; radiation and chemotherapy have been known to damage the vascular system. Multimodality treatment is necessary to achieve good long-term results in these complex patients. PMID: 32675982 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Grimsley C, Corn R, Hohmann S, Eidt J, Smith B, Pearl G, Grimsley BR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Embolization of a hemorrhaging abdominal plexiform neurofibroma.
Abstract In rare instances, neurofibromas may spontaneously bleed. In this case, a 21-year-old woman with a known cutaneous neurofibroma presented with a rapidly enlarging right abdominal wall mass. After embolization of a focal pseudoaneurysm and the right internal mammary artery, her hemoglobin continued to decline. The right internal mammary artery and inferior epigastric artery were then embolized. The patient eventually underwent mass resection, hematoma evacuation, and flap reconstruction. Final surgical pathology confirmed the expected diagnosis of plexiform neurofibroma. The Schwann cells of plexiform neur...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Azhar AF, Bittle JSH, Kwarcinski TJ, Hinshelwood JR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Successful endovascular removal of a chondroblastic osteosarcoma embolus within the left middle cerebral artery.
Abstract A 57-year-old woman with metastatic chondroblastic osteosarcoma developed sudden-onset right-sided weakness and aphasia. She was found to have an occluded left middle cerebral artery (M1 segment) and underwent endovascular stroke intervention with return to a normal neurological exam within 24 h. Histologic analysis of the embolus was consistent with chondroblastic osteosarcoma. PMID: 32675984 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Soto JM, Reed LK, Benardete EA Tags: Proc (Bayl Univ Med Cent) Source Type: research

A leaking spontaneous coronary artery pseudoaneurysm.
Abstract A 78-year-old man presented with chest pain and ST segment elevation. Coronary angiography showed no significant coronary artery disease. A saccular pocket of contrast material was found outside of the distal right posterior descending coronary artery consistent with a pseudoaneurysm. Echocardiography showed a pocket of pericardial fluid behind the left atrium concerning for a hemopericardium. The pseudoaneurysm was treated urgently with two coils successfully deployed to obtain complete exclusion of the pseudoaneurysm sac and occlusion of the distal portion of the posterior descending coronary artery. ...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Cai Q, Gilani S Tags: Proc (Bayl Univ Med Cent) Source Type: research

HeartMate 3 left ventricular assist device implant after excision of a large apical aneurysm.
We describe implantation of a HeartMate III LVAD under cardioplegic arrest. A ventricular aneurysmectomy was performed and the LVAD was implanted at the left ventricular apex at the level of the transition zone between the scar tissue and the viable myocardium. Two pursestring 2-0 Prolene Fontan sutures were placed circumferentially at the transition zone to make up for the size discrepancy between the left ventricular opening and the HeartMate 3 pump. The echocardiographic analysis demonstrated optimal inflow cannula orientation, and the patient had an uneventful recovery. PMID: 32675986 [PubMed] (Source: Baylor Univ...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Chamogeorgakis T, Kostopanagiotou K, Behler A, Apostolou D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hanging by a thread-urgent coronary artery bypass grafting for ST elevation myocardial infarction in a patient with isolated left main coronary artery disease.
Abstract A 78-year-old man presented with a left main stenosis as the culprit lesion in an acute myocardial infarction. He had no significant narrowing in any other coronary territory. This case describes findings in an isolated left main myocardial infarction and discusses appropriate treatment strategies. PMID: 32675987 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Selbst MA, Roberts CS, Schussler JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Rectus sheath hematoma following enoxaparin administration.
Discussion of this case may assist clinicians in the recognition and treatment of similar cases. PMID: 32675988 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Dean RE, Maniam G, Vo T Tags: Proc (Bayl Univ Med Cent) Source Type: research

Substernal goiter excision in a Jehovah's Witness.
We report a case of a substernal goiter excised on a Jehovah's Witness without the use of blood transfusion, in accordance with the patient's beliefs. Additionally, we review the literature on the care of this patient population, focusing on preoperative optimization, perioperative management, and postoperative care. PMID: 32675989 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Kholaki O, Wentland TR, Kim RY Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hydrodissection as a therapeutic and diagnostic modality in treating peroneal nerve compression.
Abstract A 51-year-old man presented with pain in the region of his left patellar tendon and fibular head. He had previously undergone three L5 epidural steroid injections and physical therapy without relief. Prior magnetic resonance imaging was significant only for fat pad impingement, and electromyography and nerve conduction studies were negative. Ultrasound demonstrated an enlarged peroneal nerve suggestive of peroneal nerve entrapment. Three ultrasound-guided hydrodissection procedures offered symptomatic improvement and identified an area posterior to the fibular head that was unable to be hydrodissected, in...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Song B, Marathe A, Chi B, Jayaram P Tags: Proc (Bayl Univ Med Cent) Source Type: research

Role of interventional pain management in patients with chronic pelvic pain.
We describe a 51-year-old woman with long-standing chronic pelvic pain secondary to endometriosis who was successfully treated with superior hypogastric plexus blocks. Physicians should consider referring patients to interventional pain specialists for assistance with pain control after thorough diagnostic evaluation. PMID: 32675991 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Hasoon J, Urits I, Orhurhu V, Viswanath O, Aner M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Effectiveness of pregabalin as a secondary treatment for neuropathic pain from postherpetic neuralgia.
Abstract Herpes zoster or shingles causes a severe painful rash that spreads along dermatomes in the face or chest wall, which leads to a condition known as postherpetic neuralgia (PHN). There is no cure for PHN, but there are many treatments to reduce pain duration and severity. In this case report, we describe a patient treated for PHN using pregabalin (Lyrica) after failure with gabapentin. Despite being listed as a controlled substance by the Food and Drug Administration, pregabalin may be an effective first-line therapy for PHN and other forms of neuropathic and chronic pain. PMID: 32675992 [PubMed] (Sou...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Kopel J, Brower GL Tags: Proc (Bayl Univ Med Cent) Source Type: research

Valproic acid rechallenge after valproate-induced hyperammonemic encephalopathy.
Abstract A 24-year-old man with a past medical history of behavioral disturbances and spastic tetraplegia secondary to traumatic brain injury presented to the psychiatry consult service with acute exacerbation of agitation and aggression. The patient's behavioral disturbances were previously reduced with 1500 mg daily of valproic acid (VPA). Prior to admission, VPA was discontinued due to elevated serum ammonia levels of 96 μmol/L and clinical findings consistent with valproate-induced hyperammonemic encephalopathy (VIHE), such as lethargy, confusion, frank delirium, and ataxia. Current guidelines for treating ...
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Mithani F, Cullum S, Chacko R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Takotsubo cardiomyopathy and its implications in the setting of acute manic attack.
PMID: 32675994 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - June 30, 2020 Category: Universities & Medical Training Authors: Yalta K, Yalta T Tags: Proc (Bayl Univ Med Cent) Source Type: research