Headache and abdominal pain in a young woman.
PMID: 27365879 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Glancy DL, Atluri P Tags: Proc (Bayl Univ Med Cent) Source Type: research

Diffuse large B-cell non-Hodgkin's lymphoma and osteosclerotic myeloma with features of POEMS syndrome.
Abstract Multiple myeloma is a clonal hematopoietic neoplasm characterized by the proliferation of malignant plasma cells and associated end-organ damage, most notably lytic lesions in the bones. Osteosclerotic myeloma is an unusual variant of the disease in which the skeletal involvement is characterized by sclerotic lesions instead of classical lytic lesions. The disease can be associated with paraneoplastic symptoms, which have been given the acronym POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes). In addition to clonal plasma cell dyscrasias, some cases of POEMS syndrome ...
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Ngamdu KS, Torabi A, Badri N, Teleb M, Gaur S Tags: Proc (Bayl Univ Med Cent) Source Type: research

Unrecognized hemoglobin SE disease as microcytosis.
Abstract Hemoglobin SE disease was first described during the 1950s as a relatively benign microcytosis, but increasing prevalence has revealed a predisposition towards vasoocclusive sickling. Recognition of SE hemoglobinopathies' potential complications is crucial so medical measures can be utilized to avoid multiorgan injury. PMID: 27365881 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Smith A, Cooper B, Guileyardo J, Mora A Tags: Proc (Bayl Univ Med Cent) Source Type: research

A case of erythropoietic protoporphyria.
Abstract A 53-year-old Texas rancher developed a blistering skin rash that was sensitive to exposure to sunlight. He was referred to hematology with a presumptive diagnosis of porphyria. His peripheral blood counts were within normal limits, and a bone marrow examination revealed erythroid dyspoiesis and ringed sideroblasts. Serum, plasma, and erythrocyte protoporphyrin levels were elevated, the findings of which are consistent with a diagnosis of erythropoietic protoporphyria. This paper discusses the diagnosis and etiology of the porphyrias. PMID: 27365882 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Lindsey K, Burch M, Krause JR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Lactate levels with glioblastoma multiforme.
Abstract A 37-year-old woman with known glioblastoma multiforme was admitted for treatment of new deep vein thrombosis. Anion gap and plasma lactate levels were found to be elevated. Magnetic resonance imaging of the brain showed a stable, advanced glioblastoma multiforme. All causes of lactic acidosis, including infections and medications, were ruled out. Aggressive tumors have been shown to produce lactate levels in minute quantities in their microenvironment, which helps them metastasize and evade immune response and even radiation. PMID: 27365883 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Kahlon AS, Alexander M, Kahlon A, Wright J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Operative management of dermatofibrosarcoma protuberans of the breast.
Abstract Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous tumor with a tendency towards local recurrence. A 26-year-old woman presented with a 3 × 2 cm raised, purple-hued lesion on her left breast. Excisional biopsy identified the lesion as a DFSP. She underwent two additional operations to achieve widely clear margins. Operative excision is the primary treatment of dermatofibrosarcoma protuberans of the breast. PMID: 27365884 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Kinney MH, Knox SM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Mammary-type myofibroblastoma with the nephrotic syndrome.
We describe a 23-year-old white man who presented with anasarca and a new periumbilical mass. He had preserved kidney function and laboratory findings consistent with nephrotic syndrome, including 9.7 g/day albuminuria. Serum serologies were positive for anti-SSa and anti-SSb and low complements but were negative for antinuclear antibody. Pathologic findings of the abdominal mass showed a mammary-type myofibroblastoma. A kidney biopsy revealed a diffuse proliferative and membranous immune-mediated glomerulonephritis with 10% interstitial fibrosis. This is a novel case of mammary-type myofibroblastoma associated with nephro...
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Colbert GB, Vankawala P, Kuperman MB, Mennel RG Tags: Proc (Bayl Univ Med Cent) Source Type: research

Radiologic and histologic presentation of male mammary myofibroblastoma.
We present a case of a large mammary myofibroblastoma in a male patient and discuss the typical imaging and histologic makeup of these tumors. PMID: 27365886 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Omar LA, Rojanapremsuk T, Saluja K, Merchant KA, Sharma PB Tags: Proc (Bayl Univ Med Cent) Source Type: research

An atypical presentation of blue rubber bleb nevus syndrome.
Abstract A 69-year-old white man presented with several episodes of hematochezia. Colonoscopy demonstrated multiple colonic blebs localized mainly in the distal transverse colon. Esophagogastroduodenoscopy, capsule endoscopy, and computed tomography of the abdomen did not reveal any abnormalities. The patient required several blood transfusions and eventually required a subtotal colectomy with ileosigmoid anastomosis for definitive bleeding control. Pathology was remarkable for multifocal vascular ectasia, consistent with the diagnosis of blue rubber bleb nevus syndrome. PMID: 27365887 [PubMed] (Source: Baylo...
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Gonzalez-Hernandez J, Lizardo-Sanchez L Tags: Proc (Bayl Univ Med Cent) Source Type: research

Amphetamine-related ischemic colitis causing gastrointestinal bleeding.
Abstract A 43-year-old woman presented with acute lower intestinal bleeding requiring blood transfusion. Multiple initial investigations did not reveal the cause of the bleeding. Colonoscopy performed 2 days later showed features suggestive of ischemic colitis. On detailed history, the patient admitted to using amphetamines, and her urine drug screen was positive for them. She was managed conservatively and advised not to use amphetamines again. She did not have any recurrence on 2-year follow-up. PMID: 27365888 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Panikkath R, Panikkath D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Syphilitic proctitis.
We report a 31-year-old man who had a hard, ulcerated mass that occupied the rectal and sigmoid colon wall and mimicked a tumor. Fortunately, a biopsy of the mass demonstrated Treponema pallidum organisms consistent with syphilitic proctitis. The patient was successfully treated with intravenous benzyl penicillin, resulting in improvement in his proctitis. PMID: 27365889 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Yang JF, Peng L, Siddiqui AA, Mayorga CA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Pulmonary embolism following celiac plexus block and neurolysis.
We present a case of pulmonary embolism following a celiac plexus block and neurolysis procedure. Further study is required to determine if celiac plexus ablation, alone or in combination with other risk factors, may contribute to increased risk for pulmonary embolism in patients seeking treatment for chronic upper abdominal pain conditions. PMID: 27365890 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: McAninch SA, Raizada MS, Kelly SM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Alcohol neurolysis of digital nerves.
We describe a 76-year-old woman with chronic toe neuritis who failed multiple treatments, including oral and topical analgesics, nerve blocks, and radiofrequency ablations. Alcohol neurolysis was performed via digit block of the toe resulting in 100% pain relief. PMID: 27365891 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Walker EL, Wright GK, Burnett CJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Complex regional pain syndrome.
We report a case of CRPS and review the clinical findings, appropriate workup, and treatment options for the patient. The patient we describe went through an extensive workup before receiving the correct diagnosis. Delay in diagnosis leads to prolonged suffering for the patient and, at times, unnecessary invasive debridement procedures. Raising awareness of this entity may help physicians make the correct diagnosis early, as well as initiate a collaborative effort between neurology, anesthesiology, and dermatology to provide the patient the most favorable outcome. PMID: 27365892 [PubMed] (Source: Baylor University Med...
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Carr ES, De La Cerda A, Fiala K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Bevacizumab-induced pityriasis rubra pilaris-like eruption.
We present a 70-year-old man who developed erythroderma both clinically and histologically consistent with pityriasis rubra pilaris 10 days after intravitreal injection of bevacizumab for age-related macular degeneration. As immune-modulating drugs grow in their application for a host of diseases, recognition of associated medication complications is important. PMID: 27365893 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Brown S, Fletcher JW, Fiala KH Tags: Proc (Bayl Univ Med Cent) Source Type: research

William Osler and Seymour Thomas, "the boy artist of Texas".
William Osler and Seymour Thomas, "the boy artist of Texas". Proc (Bayl Univ Med Cent). 2016 Jul;29(3):337-41 Authors: Bryan CS Abstract Critics consider the 1908-1909 portrait of William Osler by S. Seymour Thomas the best of six oil-on-canvas portraits of Osler done from life, including those by the more acclaimed US artists John Singer Sargent and William Merritt Chase. Osler called it "the best pictorial diagnosis I have ever seen" and told Thomas "I am at your service." A reappraisal of Seymour Thomas explains why his portrait makes us feel much as the artist did in ...
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Bryan CS Tags: Proc (Bayl Univ Med Cent) Source Type: research

Facts and ideas from anywhere.
PMID: 27365895 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2016 Category: Universities & Medical Training Authors: Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

The characteristics of Mohs surgery performed by dermatologists who learned the procedure during residency training or through postgraduate courses and observational preceptorships.
This report presents the results of a multicenter prospective cohort study evaluating 1834 consecutive Mohs surgery cases performed during the same 6-month period by 9 Mohs surgeons who learned the technique in residency or in postresidency courses and observational preceptorships. One major complication was reported, a hematoma requiring outpatient drainage in an emergency room. There were 54 (2.9%) short-term complications, including 20 (1.1%) infections, 17 (0.9%) wound dehiscences, 9 (0.5%) cases of skin flap necrosis, and 8 (0.4%) hematomas or postoperative bleeding episodes. These complication rates and the data eval...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Steinman HK, Clever H, Dixon A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Virtual reality and brain computer interface in neurorehabilitation.
Abstract The potential benefit of technology to enhance recovery after central nervous system injuries is an area of increasing interest and exploration. The primary emphasis to date has been motor recovery/augmentation and communication. This paper introduces two original studies to demonstrate how advanced technology may be integrated into subacute rehabilitation. The first study addresses the feasibility of brain computer interface with patients on an inpatient spinal cord injury unit. The second study explores the validity of two virtual environments with acquired brain injury as part of an intensive outpatien...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Salisbury DB, Dahdah M, Driver S, Parsons TD, Richter KM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Safety and efficacy of packed red blood cell transfusions at different doses in very low birth weight infants.
Abstract This double-blinded, randomized, crossover study evaluated the safety and effectiveness of 20 mL/kg aliquots of packed red blood cell (PRBC) transfusions versus 15 mL/kg aliquot transfusions in very low birth weight (VLBW) infants with anemia. The study enrolled 22 hemodynamically stable VLBW infants requiring PRBC transfusions, with a mean gestational age of 25.7 ± 2.2 weeks and birth weight of 804 ± 261 g. Each infant was randomized to receive one of two treatment sequences: 15 mL/kg followed by 20 mL/kg or 20 mL/kg followed by 15 mL/kg. The infants were monitored during and after transfus...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Mallett LH, Govande VP, Shetty A, Beeram MR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region.
Abstract The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population ...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Jolly JB, Fluet NR, Reis MD, Stern CH, Thompson AW, Jolly GA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Invited Commentary.
PMID: 27034544 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Couch C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Medical and surgical care during the American Civil War, 1861-1865.
Abstract This review describes medical and surgical care during the American Civil War. This era is often referred to in a negative way as the Middle Ages of medicine in the United States. Many misconceptions exist regarding the quality of care during the war. It is commonly believed that surgery was often done without anesthesia, that many unnecessary amputations were done, and that care was not state of the art for the times. None of these assertions is true. Physicians were practicing in an era before the germ theory of disease was established, before sterile technique and antisepsis were known, with very few e...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Reilly RF Tags: Proc (Bayl Univ Med Cent) Source Type: research

Exercise-induced acute compartment syndrome in a young man, occurring after a short race.
We describe a case of exercise-induced acute compartment syndrome (ACS) in a 23-year-old man who presented to his primary care physician 48 hours after he attempted to run a 5K race. He noticed searing pain in his left leg after the first half mile but had no other symptoms. He was referred to the emergency department and diagnosed with ACS, and a fasciotomy was done. A presentation of limb pain that is out of proportion to a known or suspected injury should prompt consideration of ACS. Early recognition and surgical management are essential to achieving the best possible outcome. PMID: 27034546 [PubMed] (Source: Bayl...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Basnet B, Matar M, Vaitilingham S, Chalise S, Irooegbu N, Bang J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Table tipping and a near-miss fall after unlocking a surgical table holding a morbidly obese patient.
We present the importance of recognizing the change in fulcrum location on a Steris 4085 operating table when the bed is in the unlocked versus the locked position. This small change, in the presence of morbid obesity and reverse orientation of the table, can lead to an unsafe situation in which the patient's weight can cause the table to tip. We present potential ways to avoid this complication. PMID: 27034547 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Booth RT, McAllister RK, Bittenbinder TM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Use of ultrasound guidance to remove entrapped stimulating popliteal catheters.
We present two cases where ultrasound guidance provided significant assistance in the safe removal of entrapped peripheral nerve catheters without neurologic sequelae. One of the catheters was adhered to nearby tissue, and one had become uncoiled and anchored in place by the distal tip. Guidelines for the safe management of entrapped catheters are suggested, including the use of saline injections through the catheter under ultrasound guidance to assist in the evaluation and removal of the catheters. PMID: 27034548 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: McAllister RK, Hulin JB, Daniels DJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Baclofen-responsive hiccups after esophageal stenting for malignancy-related dysphagia.
We report a patient who developed hiccups after insertion of a stent for squamous cell carcinoma of the proximal esophagus. The hiccups responded only to the initiation of baclofen therapy. PMID: 27034549 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Sharma V, De A, Lamoria S, Lamba BM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Specificity of testing in a cardiac rehabilitation setting resulting in a patient's return to high-intensity outdoor activity following aortic dissection repair.
Abstract A 66-year-old man who had undergone aortic dissection repair a year earlier sought to assess the feasibility of returning to the high-intensity outdoor activities he had long enjoyed. In response to his inquiry, the cardiac rehabilitation staff at Baylor Hamilton Heart and Vascular Hospital designed a comprehensive testing plan that simulated the specific movements and anticipated cardiac requirements associated with his goal activities. The activities included 1) lifting and manipulating a 50-pound suitcase, 2) hiking to the top of Half Dome in California's Yosemite National Park, and 3) scuba diving. To...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Bartee S, Shrestha S, Ramos B, Bilbrey T, Carbone P, Schussler JM, Deutsch R, Adams J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Invited Commentary: Simulated performance testing to determine the aortic dissection patient's potential for vigorous physical activity.
PMID: 27034551 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Franklin BA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Cardiovascular autonomic neuropathy.
We present a case of a 22-year-old man with multiple manifestations of this disease, including weakness, dizziness, fatigue, tachycardia, abnormal QTc, and orthostasis, which occurred 2 years after his type 1 diabetes diagnosis. He exhibited parasympathetic denervation with resting tachycardia and exercise intolerance but also had evidence of orthostatic hypotension, which suggests sympathetic denervation. He did not have complete cardiovascular autonomic reflex testing, which would have been helpful, but improved with aggressive diabetes treatment and the increase of beta-blockade. It is important to identify these patien...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: McCarty N, Silverman B Tags: Proc (Bayl Univ Med Cent) Source Type: research

Cardiac arrest refractory to standard intervention in atypical Timothy syndrome (LQT8 type 2).
We present a case of a 12-day-old newborn who presented with respiratory distress and cyanosis. Diagnostic workup was notable for multiple cardiac abnormalities, and genetic analysis was consistent with an exon 8 mutation of the CACNA1C gene, which is diagnostic for TS type 2 (atypical TS). This patient presented with a novel constellation of symptoms, without dysmorphic features, and with a more moderate QTc interval. The heterogeneity of phenotypes suggests that this disorder may be characterized by variable expressivity or a spectrum of disease rather than a clearly defined syndrome. PMID: 27034553 [PubMed] (Source...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Philipp LR, Rodriguez FH Tags: Proc (Bayl Univ Med Cent) Source Type: research

Holter monitor recordings in a man who snores.
PMID: 27034554 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Glancy DL, Vijitbenjaronk P Tags: Proc (Bayl Univ Med Cent) Source Type: research

An interesting electrocardiogram.
PMID: 27034555 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: McClure HH Tags: Proc (Bayl Univ Med Cent) Source Type: research

Takotsubo cardiomyopathy after administration of norepinephrine.
We present a case of a patient who developed stress-induced cardiomyopathy after she was administered norepinephrine due to a nursing error. PMID: 27034556 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Sherif K, Sehli S, Jenkins LA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Acute myocardial infarction with isolated congenitally corrected transposition of the great arteries.
Abstract Congenital cardiac abnormalities diagnosed at the time of acute coronary syndrome are rare. A 43-year-old man presented to the emergency department complaining of recurring, severe chest pain. Subsequent emergent coronary angiography demonstrated unusual coronary anatomy: 1) one small caliber bifurcating vessel originating from the right sinus of Valsalva; 2) one very large vessel arising from the posterior sinus; and 3) no coronary artery from the normal left sinus of Valsalva. The large vessel from the posterior sinus was totally occluded in its midportion and was treated with intravascular ultrasound-g...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Zimmermann J, Altman JR, Gantt DS Tags: Proc (Bayl Univ Med Cent) Source Type: research

Isolated congenitally corrected transposition of the great arteries with dextroversion discovered incidentally in a patient with cocaine-induced acute myocardial infarction.
Abstract Complex cardiac congenital anomalies can occasionally be found in adult patients who have no knowledge of their condition. Here we present the case of a 27-year-old man with cocaine-induced acute myocardial infarction in whom an isolated congenitally corrected transposition of the great arteries with dextroversion was discovered incidentally. PMID: 27034558 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Tandon A, Bose R, Yoon AD, Schussler JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Invited Commentary: The specialty of adult congenital heart disease.
PMID: 27034559 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Cedars AM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Surgical considerations for the explantation of the Parachute left ventricular partitioning device and the implantation of the HeartMate II left ventricular assist device.
Abstract Chronic heart failure is the leading cause of death in the world. With newer therapies, the burden of this disease has decreased; however, a significant number of patients remain refractive to existing therapies. Myocardial infarction often leads to ventricular remodeling and eventually contributes to heart failure. The Parachute™ (Cardiokinetix, Menlo Park, CA) is the first device designed for percutaneous ventricular restoration therapy, which reduces left ventricular volume and minimizes the risk of open surgical procedures. For the first time, we report a case of explantation of the Parachute ve...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Ravi Y, Bansal S, Rosas PC, Mazzaferri EL, Sai-Sudhakar CB Tags: Proc (Bayl Univ Med Cent) Source Type: research

Intracranial aneurysm and sildenafil.
We report a 49-year-old hypertensive and diabetic patient who presented with acute pulmonary edema and loss of consciousness following ingestion of 100 mg of sildenafil prior to sexual intercourse. He was not previously aware of the presence of an aneurysm and had no family history of it. Computed tomography of his head revealed a subarachnoid hemorrhage due to rupture of a saccular aneurysm with subsequent repeat hemorrhage within a few hours of presentation. A sudden increase in blood pressure led to pulmonary edema. Studies have shown that sildenafil acts on phosphodiesterase-1, -2 and -5 receptors and leads to a second...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Adiga A, Edriss H, Nugent K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Infective endocarditis caused by Klebsiella oxytoca in an intravenous drug user with cancer.
We report the case of a 24-year-old intravenous drug user with newly diagnosed seminoma who developed K. oxytoca endocarditis. In addition to having K. oxytoca isolated from blood culture, cultures of that species were obtained from a retroperitoneal metastasis found on original presentation. PMID: 27034562 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Mohamed A, Hall C, Hatch M, Ayan M, Winn R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Rapidly enlarging neck mass in a neonate causing airway compromise.
We describe a 5-week-old neonate with increasing stridor secondary to a rapidly growing neck mass. Imaging and surgical excision confirmed the mass to be an infected fourth branchial cleft cyst. PMID: 27034563 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Schmidt K, Leal A, McGill T, Jacob R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Serendipitous discovery of peritoneal mesothelioma.
We present the case of a 64-year-old patient with a history of Birt-Hogg-Dube syndrome, polycystic kidney disease treated with renal transplantation in May 2013, and multiple types of skin cancers, including malignant melanoma. He presented for lymphoscintigraphy for sentinel lymph node identification of the melanoma. Subsequent biopsy of the right axillary sentinel lymph node yielded a diagnosis of epithelial type malignant mesothelioma without a known primary tumor. Follow-up positron emission tomography with 2-deoxy-2-(fluorine-18)fluoro-D-glucose integrated with computed tomography (F-18 FDG PET/CT) demonstrated severa...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Jaster A, Wachsmann J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Pneumomediastinum, pneumorrhachis, and subcutaneous emphysema in Pneumocystis jiroveci pneumonia in AIDS.
We report the case of a 28-year-old man with previously undiagnosed HIV who was diagnosed with extensive pneumomediastinum, pneumorrhachis, and subcutaneous emphysema secondary to Pneumocystis jiroveci pneumonia after presenting with chest pain, dyspnea, and central cyanosis. Surgical consultation was requested, but a conservative approach of observation proved sufficient as the free air was resorbed into the surrounding tissues. PMID: 27034565 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Saleem N, Parveen S, Odigwe C, Iroegbu N Tags: Proc (Bayl Univ Med Cent) Source Type: research

Multiple dural-based hemangiopericytomas.
Abstract Here we report the case of a 57-year-old man who underwent resection of a dural-based hemangiopericytoma (HPC) in the left frontoparietal region. The patient was treated with radiation therapy and remained symptom-free for 10 years. At 67 years of age, he presented with a mass in the left frontal region near the same area as the first tumor, in addition to a separate smaller mass in the right middle cranial fossa. Resection of the larger left frontal mass revealed an HPC. Follow-up imaging 9 months later showed a significant increase in size of the right middle cranial fossa mass. This third mass was rese...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Stroberg E, Uhrbrock DH, Harris F, Mutyala S, DiPatre PL, Fonkem E Tags: Proc (Bayl Univ Med Cent) Source Type: research

Colorectal cancer implant in an external hemorrhoidal skin tag.
We present the case of a 61-year-old man with metastasis to an external hemorrhoidal skin tag from a midrectal primary adenocarcinoma. This case report highlights the importance of close examination of the anus during surgical planning for colorectal cancers. Abnormal findings of the perianal skin suggesting an implant or metastatic disease warrant biopsy, as distal spread and seeding can occur. In our patient, this finding appropriately changed surgical management. PMID: 27034567 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Liasis L, Papaconstantinou HT Tags: Proc (Bayl Univ Med Cent) Source Type: research

Bilateral synchronous plasmacytoma of the testis.
We present herein the second such report in a 70-year-old man who underwent bilateral orchidectomy. PMID: 27034568 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Narayanan G, Joseph R, Soman LV Tags: Proc (Bayl Univ Med Cent) Source Type: research

Presentation of epidermolytic acanthomas as multiple tan papules on the vulva.
Abstract Epidermolytic hyperkeratosis is a histological reaction pattern seen in a variety of disease processes, including epidermolytic ichthyosis, Vorner's epidermolytic palmoplantar keratoderma, epidermal nevus, and solitary epidermolytic acanthoma. Here we present the case of a 59-year-old woman with multiple asymptomatic papules on her vulva. Clinical differential diagnoses included condyloma acuminata, seborrheic keratoses, bowenoid papulosis, adnexal tumors, and papular acantholytic dyskeratosis. Shave biopsy revealed findings consistent with epidermolytic hyperkeratosis. This case represents an interesting...
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Fletcher JW, Ramamurthi A, Parekh P Tags: Proc (Bayl Univ Med Cent) Source Type: research

Rumpel-Leede phenomenon presenting as a hypertensive urgency.
We report a 57-year-old woman who presented with hypertensive urgency and experienced R-L phenomenon during blood pressure cuff inflation. PMID: 27034570 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Varela D, Tran D, Ngamdu KS, Trullender B, Mukherjee D, Abbas A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Arm pain and erythema.
We describe a case of pyomyositis of the right arm. PMID: 27034571 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Barth BM, Juergens AL Tags: Proc (Bayl Univ Med Cent) Source Type: research

Rheumatoid meningitis associated with infliximab.
We present a patient who had rheumatoid meningitis while on infliximab, a tumor necrosis factor alpha (TNF-α) inhibitor, which initially presented as transient ischemic attacks. Although our patient had been stable on infliximab for several years, her neurologic symptoms improved when her infliximab was held due to active infection and then recurred after reinitiation of therapy. Rheumatoid meningitis is exceedingly rare; however, there have been several other reports of rheumatoid meningitis developing in patients on TNF-α inhibitor therapy. PMID: 27034572 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2016 Category: Universities & Medical Training Authors: Seago S, Stroberg E, Metting A Tags: Proc (Bayl Univ Med Cent) Source Type: research