Diagnosing and managing peripartum headache.
Abstract A 38-year-old gravida 7 para 5 Hispanic woman at 36 weeks and 4 days gestation presented with a postpartum headache following vaginal delivery complicated by an unintentional dural puncture for epidural analgesia. Due to the positional nature of the headache and its frontal and occipital origin, a postdural puncture headache was diagnosed. After failure of conservative treatment, an epidural blood patch was used, which offered immediate relief. However, shortly following the procedure, the parturient's neurological condition deteriorated due to an unrecognized intraparenchymal and subarachnoid hemorrhage ...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Grant EN, Wang J, Gelpi B, Wortman A, Tao W Tags: Proc (Bayl Univ Med Cent) Source Type: research

A triad of linezolid toxicity: hypoglycemia, lactic acidosis, and acute pancreatitis.
We present a case of suspected linezolid toxicity in a 34-year-old man with sickle cell disease and line-related vancomycin-resistant enterococcal bacteremia and tricuspid valve endocarditis. The patient developed sudden-onset hypoglycemia, lactic acidosis, and acute pancreatitis 11 days after initiation of linezolid. All adverse effects quickly resolved with drug cessation. The pathophysiology underlying this triad of linezolid toxicity is unclear, but may be related to mitochondrial dysfunction. PMID: 26424943 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Johnson PC, Vaduganathan M, Phillips KM, O'Donnell WJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Microscopic polyangiitis causing diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis.
We present a case of a man who presented to our hospital with diffuse alveolar hemorrhage, severe anemia, and rapidly progressive glomerulonephritis. PMID: 26424944 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Lababidi MH, Odigwe C, Okolo C, Elhassan A, Iroegbu N Tags: Proc (Bayl Univ Med Cent) Source Type: research

Noncirrhotic hyperammonemia causing relapsing altered mental status.
We report a man who presented to our hospital with relapsing altered mental status later diagnosed as noncirrhotic hyperammonemia. PMID: 26424945 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Odigwe CC, Khatiwada B, Holbrook C, Ekeh IS, Uzoka C, Ikwu I, Upadhyay B Tags: Proc (Bayl Univ Med Cent) Source Type: research

Synthetic cannabinoids and acute kidney injury.
We report three cases of AKI in the setting of SCB use. The peak serum creatinine levels ranged from 3.0 to 5.7 mg/dL; one patient required hemodialysis. SCB can induce AKI. PMID: 26424946 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Srisung W, Jamal F, Prabhakar S Tags: Proc (Bayl Univ Med Cent) Source Type: research

Gastropericardial fistula as a delayed complication of a Nissen fundoplication.
Abstract A 41-year-old man presented to the emergency department with substernal chest pain and was found to have ST elevations in the inferior leads on his electrocardiogram. An emergent cardiac catheterization did not identify significant coronary narrowing. Computed tomography of the thorax demonstrated a pneumopericardium and a hiatal hernia. The patient had a complicated past surgical history, including a Nissen fundoplication and three additional surgeries for postoperative complications. An esophagram later revealed an ulcer and possible fistula, and the patient underwent gastropericardial fistula resection...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Kakarala K, Edriss H, Nugent K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Fatal pulmonary tumor thrombotic microangiopathy caused by undiagnosed metastatic gastric adenocarcinoma.
We present the case of a woman with no previous diagnosis of cancer who presented with rapidly progressive shortness of breath. She was diagnosed with severe pulmonary arterial hypertension and rapidly succumbed to her illness. A postmortem diagnosis of PTTM was established based on autopsy results. PMID: 26424948 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Endicott-Yazdani T, Ghazi A, Armstrong D, Guileyardo J, Schuller D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Transjugular intrahepatic portosystemic shunt creation using a three-dimensional fluoroscopy guidance system in patients with the Budd-Chiari syndrome.
We present three female patients with decompensated BCS in whom TIPS were created using a three-dimensional fluoroscopy guidance system. On a dedicated workstation using three-dimensional volumes of computed tomography imaging, a virtual needle path was created by the operator extending from the needle entry point (hepatic vein stump or inferior vena cava) to the target portal vein. Subsequently, the virtual needle path was overlaid on the fluoroscopy image for guidance of portal venous cannulation. This technology can be used for TIPS procedures in patients with BCS and other complex TIPS cases, as it may help delimit the...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Bell BM, Cura M, Shaw CJ, Rees CR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Late presentation of adenovirus-induced hemorrhagic cystitis and ureteral obstruction in a kidney-pancreas transplant recipient.
We report a late presentation of adenovirus-induced renal allograft and bladder infection causing azotemia and hemorrhagic cystitis in a patient 5 years after simultaneous kidney-pancreas transplantation. Adenovirus has been increasingly recognized as a cause of morbidity and mortality in both solid organ and stem cell transplant recipients. We wish to emphasize the importance of early detection, as treatment options involve reduction of immunosuppression, followed by the addition of antiviral agents and supportive care. PMID: 26424950 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Klein J, Kuperman M, Haley C, Barri Y, Chandrakantan A, Fischbach B, Melton L, Rice K, Saim M, Yango A, Klintmalm G, Rajagopal A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Heart transplantation in the Ehlers-Danlos syndrome.
We describe a woman with Ehlers-Danlos syndrome and aortic aneurysm who experienced a myocardial infarction due to spontaneous left circumflex coronary artery dissection 3 weeks postpartum. She developed end-stage heart failure and subsequently underwent a successful orthotopic heart transplantation. To our knowledge, this is the first report of a heart transplant performed in an individual with Ehlers-Danlos syndrome. PMID: 26424951 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Reinhold SM, Lima B, Khalid A, Gonzalez-Stawinski GV, Stoler RC, Hall SA, Chamogeorgakis T Tags: Proc (Bayl Univ Med Cent) Source Type: research

Iron deficiency and hemolytic anemia reversed by ventricular septal myectomy.
We present the case of a 67-year-old man with recurrent hemolytic anemia and HC, without infective endocarditis. Attempts at iron repletion and augmentation of beta-blocker therapy proved his anemia to be refractory to medical management. Ventricular septal myectomy led to the resolution of hemolysis, anemia, and its coexisting symptoms. PMID: 26424952 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Thotakura S, Costa SM, Cable C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Unruptured sinus of Valsalva aneurysm presenting with concurrent Morgagni hernia.
We describe a patient with dyspnea and intermittent cyanosis who was found to have concurrent right diaphragmatic and right atrial masses, initially thought to have advanced vascular sarcoma. She was ultimately diagnosed with an unruptured sinus of Valsalva aneurysm, a Morgagni hernia, and a patent foramen ovale. Her dyspnea and cyanosis resolved after sequential surgical correction of these defects. PMID: 26424953 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Masor JJ, Davis SS, Chen EP, Henry TS, Book WM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Surgical repair of renal artery aneurysms.
Abstract The pathogenesis of renal artery aneurysms (RAAs) is degenerative, which eventually leads to weakening of the vessel wall and, in extreme cases, rupture. RAAs are a rare occurrence. Patients generally are asymptomatic, with a small number presenting with uncontrollable hypertension or hematuria. Most RAAs are discovered incidentally on imaging and do not pose an immediate health threat. However, the risk of rupture is an indication for prophylactic repair in certain patients. Interest in interventional radiologic procedures in the management of RAAs has recently increased; however, open repair should stil...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Titze N, Ivanukoff V, Fisher T, Pearl G, Grimsley B, Shutze WP Tags: Proc (Bayl Univ Med Cent) Source Type: research

Effectiveness of balloon valvuloplasty for stenosis of a bioprosthesis in the tricuspid valve position.
Abstract A 67-year-old man underwent percutaneous balloon valvuloplasty for bioprosthetic tricuspid stenosis. He had undergone two tricuspid valve replacements over a period of 39 years and became symptomatic. After the valvuloplasty, his symptoms were resolved. Stenosis of a bioprosthetic tricuspid valve can be successfully and safely treated with balloon valvuloplasty. PMID: 26424955 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Falcone AM, Varghese JJ, Stoler RC, Choi JW Tags: Proc (Bayl Univ Med Cent) Source Type: research

Multivessel transradial percutaneous coronary angioplasty in a single coronary artery originating from the right sinus of Valsalva.
We report a case of successful stent implantation in the right coronary artery and proximal circumflex coronary artery in a patient with a single coronary artery arising from the right sinus of Valsalva. PMID: 26424956 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Jayaprakash K, Madhavan S, Kumary VS, Akhil PC, Cardoz J, George R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Two-time recurrence of a right atrial myxoma.
We report a case of a second recurrence of a right atrial myxoma in a 38-year-old woman who had surgical excision in March 2008 and excision of a recurrence in August 2012. She presented with a similar clinical picture in December 2014 and again underwent surgical excision. The case is unusual both for its location in the right atrium and its multiple recurrences in a sporadic form without any sign of the myxoma complex. PMID: 26424957 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Kumary VS, Madhavan S, Akhil PC, Jayaprakash K, George R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Myxedema coma with cardiac tamponade and severe cardiomyopathy.
We present a rare case of previously undiagnosed hypothyroidism presenting in cardiogenic shock from pericardial tamponade and depressed myocardial contractility in myxedema coma. Here, we focus on cardiovascular complications associated with the condition. PMID: 26424958 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Majid-Moosa A, Schussler JM, Mora A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Myocardial infarction with ventricular septal rupture and cardiogenic shock.
PMID: 26424959 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Glancy DL, Khuri BN, Mustapha JA, Menon PV, Hanna EB Tags: Proc (Bayl Univ Med Cent) Source Type: research

Morphologic demonstration of spontaneous and surgical closure of membranous ventricular septal defect.
This report demonstrates morphologic features of membranous ventricular septal defect that was closed spontaneously in one patient and operatively in the other. PMID: 26424960 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Ko JM, Guileyardo JE, Zhang J, Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

A review of spontaneous closure of ventricular septal defect.
Abstract Ventricular septal defect (VSD) is the most common congenital heart malformation and can be detected during the prenatal and postnatal period, in childhood, and in adulthood. Spontaneous closure of VSD can be determined through a variety of methods-echocardiography, Doppler color flow imaging, angiography, auscultation, and cardiac catheterization-and can be proven by pathological evidence at necropsy. There are two major types of VSD, membranous and muscular, as well as the perimembranous variety, which comprises variable portions of the adjacent muscular septum but lacks the membranous septum. VSD appea...
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Zhang J, Ko JM, Guileyardo JM, Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

What my cancer taught me.
PMID: 26424962 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Cen P Tags: Proc (Bayl Univ Med Cent) Source Type: research

Reflections on Sir Roger Bannister and his autobiography, Twin Tracks.
PMID: 26424963 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Cantwell JD Tags: Proc (Bayl Univ Med Cent) Source Type: research

Feroze Novroji Ghadially, 1920-2014: a personal remembrance.
PMID: 26424964 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Marcus PB Tags: Proc (Bayl Univ Med Cent) Source Type: research

A week in Havana, Cuba, in February 2015.
PMID: 26424965 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Facts and ideas from anywhere.
PMID: 26424966 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - October 1, 2015 Category: Universities & Medical Training Authors: Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

West Nile virus and the 2012 outbreak: The Baylor University Medical Center experience.
Abstract West Nile virus (WNV) has been responsible for multiple outbreaks and has shown evolution in its clinical manifestation. The Centers for Disease Control and Prevention has provided diagnostic criteria in classifying the variety of WNV infection; however, application of these criteria can prove challenging during outbreaks, and understanding the array of presentations and patient population is clinically important. In this article, we present the challenges encountered during the 2012 outbreak at one institution. PMID: 26130870 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Mora A, Arroyo M, Gummelt KL, Colbert G, Ursales AL, Van Vrancken MJ, Snipes GJ, Guileyardo JM, Columbus C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Comparison of long-term follow up of laparoscopic versus open colectomy for transverse colon cancer.
Abstract Clinical Outcomes of Surgical Therapy (COST) was a landmark study demonstrating that laparoscopic-assisted colectomy had oncologic outcomes similar to those of open colectomy for colon cancer, but transverse colon cancers (TCCs) were excluded from that study. Oncologic results of a laparoscopic resection for TCC are unknown. This single-institution retrospective 3:1 case-matched review examined patients treated for TCC from January 1, 1996, to April 15, 2009. Laparoscopic colectomy (LC) and open colectomy (OC; extended right, extended left, and total abdominal) cases completed for Stage I to III adenocarc...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Agarwal S, Gincherman M, Birnbaum E, Fleshman JW, Mutch M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Mortality by treatment in patients ≥80 years of age with gastroesophageal cancer seen in a 20-year period at a single medical center.
Mortality by treatment in patients ≥80 years of age with gastroesophageal cancer seen in a 20-year period at a single medical center. Proc (Bayl Univ Med Cent). 2015 Jul;28(3):300-3 Authors: Barnett T, Mason J, Maldonado YM, Wong L Abstract The treatment approach to patients 80 years of age and older with gastroesophageal cancer at Baylor Scott and White in Temple, Texas, has historically favored conservative measures in the form of palliation and observation. To evaluate this trend in practice, the administered treatments and subsequent patient outcomes of this group were retrospectively reviewed....
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Barnett T, Mason J, Maldonado YM, Wong L Tags: Proc (Bayl Univ Med Cent) Source Type: research

Trends in the neonatal mortality rate in the last decade with respect to demographic factors and health care resources.
Abstract To understand factors contributing to the neonatal mortality rate (NMR), we studied trends in the NMR during 2000 to 2009 with respect to demographic factors and health care resources. Birth- and death-linked mortality data for 14,168 neonatal deaths that occurred between 2000 and 2009 were obtained from the Texas Department of Health and Human Services. Demographic factors and health care resource data were analyzed using analysis of variance, chi-square tests, and linear regression analysis. The average NMR increased from 3.37 in 2000 to 3.77 in 2009. The NMR in blacks ranged from 6.57 to 8.97 during th...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Govande V, Ballard AR, Koneru M, Beeram M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Effect of adding tetracaine to bupivacaine on duration of analgesia in supraclavicular brachial plexus nerve blocks for ambulatory shoulder surgery.
In conclusion, there was no significant difference in duration of postoperative analgesia with the addition of 1% tetracaine to 0.25% bupivacaine in supraclavicular brachial plexus nerve blockade. No differences were identified in postoperative pain medications, pain scores, or complications. PMID: 26130874 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Pearson LT, Lowry BP, Culp WC, Kitchings OE, Meyer TA, McAllister RK, Roberson CR, Burnett CJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Comparison of documentation and evidence-based medicine use for non-ST-segment elevation myocardial infarction among cardiology, teaching, and nonteaching teams.
Abstract Non-ST-segment elevation myocardial infarctions (NSTEMI) are common and cause significant morbidity and mortality. Following evidence-based medicine (EBM) guidelines is one way to ensure that these patients are cared for appropriately. This pilot study examined data from patients with NSTEMI to assess both documentation quality and use of EBM across multiple teams. Medical records were reviewed for significant differences in documentation quality in areas including history and physical exam, treatment, and inpatient mortality. While total documentation quality and mortality were not significantly differen...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Metting A, Binz D, Colbert CY, Song J, Chiles C, Mirkes C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital.
Abstract Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Fraser TN, Blumenthal DM, Bernard K, Iyasere C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Abstracts from the First Annual Scholarly Day.
This article reprints a selection of the abstracts. PMID: 26130877 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Tags: Proc (Bayl Univ Med Cent) Source Type: research

Uses, limitations, and complications of endobronchial ultrasound.
This article reviews the indications and contraindications of EBUS, with emphasis on the technique and complications encountered during the procedure. PMID: 26130878 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Jalil BA, Yasufuku K, Khan AM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Recurrent hospitalization for self-injuries and suicide attempts: case study of a super-utilizer.
Abstract Super-utilizers, patients who amass disproportionately large occurrences of emergency department visits and hospital admissions, are increasingly recognized as a significant and potentially preventable resource consumer. A comprehensive understanding of these individuals and their situations may prove useful in preventing unnecessary admissions and improving patient care and outcomes. While most super-utilizers suffer from chronic medical issues, this patient is an unusual variant, as his super-utilization stemmed from mental health problems leading to serial self-injury. Between January 2010 and October ...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Roden-Foreman JW, Warren AM, Reynolds M, Foreman ML Tags: Proc (Bayl Univ Med Cent) Source Type: research

Radiographic findings in the nail-patella syndrome.
Abstract Nail-patella syndrome is a rare disorder characterized classically by the tetrad of nail hypoplasia or aplasia, aplastic or hypoplastic patellae, elbow dysplasia, and the presence of iliac horns. Iliac horns are considered pathognomonic, and the presence of hypoplastic or aplastic patellae in conjunction with nail abnormalities is a cardinal feature of diagnosis. Elbow dysplasia is present in most cases and can exhibit features typical of the syndrome. Herein we present the radiographic findings of the elbows, knees, and pelvis of a woman with nail-patella syndrome. PMID: 26130880 [PubMed] (Source: B...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: West JA, Louis TH Tags: Proc (Bayl Univ Med Cent) Source Type: research

Solitary supratentorial Listeria monocytogenes brain abscess in an immunocompromised patient.
We describe an 81-year-old man receiving azacitidine monotherapy for myelodysplastic syndrome who was improving from Listeria monocytogenes bacteremia after receiving antibiotic therapy during an earlier hospital admission. Shortly after discharge he developed new-onset seizure activity, with brain imaging on subsequent admissions demonstrating a posterior right frontal lobe mass. Specimen cultures after resection of the mass revealed this to be a cerebral abscess related to L. monocytogenes. Brain abscesses related to this organism are rare. PMID: 26130881 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: West JA, Onofrio AR, Martinez LC, Opatowsky MJ, Spak CW, Layton KF Tags: Proc (Bayl Univ Med Cent) Source Type: research

Asplenia and fever.
Abstract A 45-year-old-man presented with the abrupt onset of a fever over 30 years after surgical splenectomy. He presented with symptoms and findings that seemed consistent with influenza. He rapidly developed fulminant meningitis that resulted in his death. PMID: 26130882 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Huebner ML, Milota KA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Myroides odoratimimus bacteremia in a diabetic patient.
We present a patient with a diabetic foot ulcer who subsequently developed Myroides odoratimimus bacteremia and bone abscess. PMID: 26130883 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Endicott-Yazdani TR, Dhiman N, Benavides R, Spak CW Tags: Proc (Bayl Univ Med Cent) Source Type: research

Right-sided hydropneumothorax as a presenting symptom of Boerhaave's syndrome (spontaneous esophageal rupture).
We present the case of a 59-year-old man with spontaneous esophageal rupture. His clinical presentation is of interest since he had no inciting event for spontaneous esophageal rupture and had a delayed presentation with a right-sided hydropneumothorax. PMID: 26130884 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Rassameehiran S, Klomjit S, Nugent K Tags: Proc (Bayl Univ Med Cent) Source Type: research

Pneumomediastinum in inflammatory bowel disease.
Abstract A 28-year-old man with a history of inflammatory bowel disease (IBD) developed sudden-onset chest pain and dyspnea 9 days after esophagogastroduodenoscopy and colonoscopy. A chest radiograph demonstrated pneumomediastinum tracking along the left heart border. The spontaneous pneumomediastinum was presumed to be a complication of his severe colitis. The severity of our patient's symptoms ultimately necessitated a subtotal colectomy, a decision unrelated to the pneumomediastinum. IBD-associated pneumomediastinum can be attributed to retroperitoneal air leakage from severe colitis and usually resolves with c...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Mihatov N, Fenves AZ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Pulmonary veno-occlusive disease as a cause of pulmonary arterial hypertension.
We present a young patient hospitalized with progressive dyspnea, with initial workup suggestive of pulmonary hypertension and unexplained noncardiogenic pulmonary edema. His subsequent clinical course was consistent with the diagnosis of PVOD. PMID: 26130886 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Porres-Aguilar M, Al-Bayati I, Porres-Muñoz M, Padilla O, Syed SH, Lowder K, Azimova K, Fan J, Mukherjee D, Abbas A Tags: Proc (Bayl Univ Med Cent) Source Type: research

Pulmonary artery catheter-induced perforation treated with coil embolization.
Abstract The past 40 years have taught us much about the use of pulmonary artery catheters and their complications. Pulmonary artery rupture carries high morbidity and mortality, and therefore a high index of suspicion and timely management are key to the survival of patients who suffer from this rare complication. While surgical therapy has been considered the mainstay of treatment, endovascular therapy is feasible when surgery is not possible or desirable, as demonstrated in our patient. It is unknown which approach is optimal. PMID: 26130887 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Kumar DS, Trotter C, McDonald D, Mixon TA Tags: Proc (Bayl Univ Med Cent) Source Type: research

A hybrid repair of a superior mesenteric artery pseudoaneurysm using open mesenteric bypass and endovascular exclusion.
We present a repair of an SMA pseudoaneurysm via a hybrid approach with common hepatic artery to SMA bypass, exclusion of the pseudoaneurysm with ligation of the SMA proximal to the bypass, plug occlusion of the proximal SMA, and coil embolization of the pseudoaneurysm. PMID: 26130888 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Cumbie TA, Kedora JC, Pearl GJ, Shutze WP Tags: Proc (Bayl Univ Med Cent) Source Type: research

Allergic acute coronary syndrome (Kounis syndrome).
We present three cases of anaphylactic acute coronary syndrome that display different clinical variants of this phenomenon. The main pathophysiological mechanism of the allergic anginal syndromes is the inflammatory mediators released during a hypersensitivity reaction triggered by food, insect bites, or drugs. It is important to appropriately recognize and treat Kounis syndrome in patients with exposure to a documented allergen. PMID: 26130889 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Memon S, Chhabra L, Masrur S, Parker MW Tags: Proc (Bayl Univ Med Cent) Source Type: research

Blood cyst of the anterior mitral leaflet causing severe mitral regurgitation.
We report a case of blood cyst of the anterior mitral leaflet leading to severe mitral regurgitation and heart failure in a 70-year-old woman with no other factors that could explain the severe mitral regurgitation. PMID: 26130890 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Madhavan S, Jayaprakash K, Jayaprasad N, Sathish G, George R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Right-sided superior vena cava draining into the left atrium in a patient with persistent left-sided superior vena cava emptying into the right atrium diagnosed by echocardiography.
We present a patient with an isolated right-sided superior vena cava draining into the left atrium with a persistent left-sided superior vena cava emptying into the right atrium. During an agitated saline injection into the patient's right upper extremity intravenous line, the patient suffered an acute transient ischemic attack. To our knowledge, this is the only reported case of this rare anomaly incidentally uncovered during an echocardiogram with saline contrast study. PMID: 26130891 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Clark C, MacDonald L Tags: Proc (Bayl Univ Med Cent) Source Type: research

Spontaneous coronary artery dissection in a 22-year-old man on lisdexamfetamine.
We present a case of a 22-year-old man on lisdexamfetamine and no other significant medical history who presented with SCAD and was successfully treated with medical management. PMID: 26130892 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Afzal AM, Sarmast SA, Weber NA, Schussler JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Worsening dyspnea in a 38-year-old woman.
PMID: 26130893 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Glancy DL, Mendoza DK, Nair RG Tags: Proc (Bayl Univ Med Cent) Source Type: research

Chronic pulmonary embolism in a young athletic woman.
Abstract Exercise-induced dyspnea (EID) is a common complaint in young athletes. Exercise-induced bronchospasm (EIB) is the most common cause of EID in healthy athletes, but it is important to recognize more serious pathology. Herein we present the case of an 18-year-old woman with a 1.5-year history of EID. She had been treated for EIB without relief. Her arterial oxygen saturation was 88% during exercise testing. Computed tomographic angiography to assess for vascular abnormalities identified a large thrombus in the main pulmonary trunk. Symptoms markedly improved with therapeutic anticoagulation. Massive pulmon...
Source: Baylor University Medical Center Proceedings - July 1, 2015 Category: Universities & Medical Training Authors: Larsen TR, Ball TC Tags: Proc (Bayl Univ Med Cent) Source Type: research