Inflammatory breast carcinoma.
We present the case of a 49-year-old woman with inflammatory breast carcinoma in her left breast and describe the imaging appearance of this aggressive lesion on the modalities listed above. Because this lesion may be misdiagnosed as infection (i.e., mastitis) or as the sequelae of a dermatologic disorder, proper characterization of inflammatory breast carcinoma is of the utmost clinical and radiologic importance. PMID: 23543972 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Ha KY, Glass SB, Laurie L Tags: Proc (Bayl Univ Med Cent) Source Type: research

Plasmablastic lymphoma following transplantation.
Abstract Posttransplant lymphoproliferative disorder is a serious complication following solid organ as well as hematopoietic stem cell transplantation due to prolonged immunosuppressive therapy. Plasmablastic lymphoma, although classically associated with HIV infection, has since been described in transplant patients as a variant of posttransplant lymphoproliferative disorder with varying clinical presentations. Here we add two additional cases to the literature: one following lung transplantation and one following pancreatic transplantation. In addition, the demographic, therapeutic, and immunophenotypic charact...
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Van Vrancken MJ, Keglovits L, Krause J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Recurrent acute inflammatory demyelinating polyradiculoneuropathy following R-CHOP treatment for non-Hodgkin lymphoma.
We present a case of recurrent acute quadriparesis due to AIDP following chemotherapy for non-Hodgkin lymphoma, which resolved each time following administration of intravenous immunoglobulin. Although many chemotherapeutic agents can cause neurologic side effects, such as peripheral neuropathy, drug toxicity as a cause is a diagnosis of exclusion. PMID: 23543974 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Liang JJ, Singh PP, Witzig TE Tags: Proc (Bayl Univ Med Cent) Source Type: research

Endolymphatic sac tumor and otalgia.
We describe a case of otalgia and ear discharge in which the imaging revealed a rare neoplasm, an endolymphatic sac tumor, which contributed to the patient's symptoms. The primary diagnosis was made via characteristic imaging features that were later confirmed by histology. PMID: 23543975 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Zarghouni M, Kershen ML, Skaggs L, Bhatki A, Gilbert SC, Gomez CE, Opatowsky MJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Inguinal lymphadenopathy as the initial presentation of sarcoidosis.
We describe a case of sarcoidosis presenting with isolated unilateral peripheral edema. PMID: 23543976 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: George J, Graves R, Meador R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Levamisole-induced vasculitis.
We report two cases of this syndrome and review its clinical presentation, course, and prognosis. PMID: 23543977 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Abdul-Karim R, Ryan C, Rangel C, Emmett M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Kayser-Fleischer rings of acute Wilson's disease.
Abstract Here we describe a case of a 22-year-old woman who presented with acute liver failure and Kayser-Fleischer rings suggesting the diagnosis of Wilson's disease. PMID: 23543978 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Mantas AM, Wells J, Trotter J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Ascites with elevated protein content as the presenting sign of constrictive pericardial disease.
Abstract Two men, one 63 and one 52 years old, presented with ascites. Analysis of the ascitic fluid in both patients revealed a high protein content and an elevated serum-ascites gradient. Various studies showed the cause of the ascites to be constrictive pericardial disease. Total excision of their parietal pericardia relieved their symptoms, decreased their cardiac filling pressures, and increased their cardiac indices. These cases highlight the importance of suspecting pericardial constriction as an etiology for high-protein-count ascites. PMID: 23543979 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: George BA, Deprisco G, Trotter JF, Henry AC, Stoler RC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Congenitally bicuspid aortic valve in brothers: coarctation of the aorta with a normally functioning aortic valve in one and no coarctation but severe aortic stenosis in the other.
Abstract Described herein are two brothers, both with a congenitally bicuspid aortic valve-one of which was stenotic and one of which functioned normally-and one with associated aortic isthmic coarctation. Summarized also are previously reported families with more than one member with a congenitally bicuspid aortic valve. PMID: 23543980 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Zafar S, Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

A 21-year-old pregnant woman with congenital heart disease.
PMID: 23543981 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Glancy DL Tags: Proc (Bayl Univ Med Cent) Source Type: research

Persistent giant U wave inversion with anoxic brain injury.
Abstract Various electrocardiographic changes have been reported in the setting of acute neurological events, among them large, upright U waves. In contrast, the occurrence of inverted U waves is strongly suggestive of cardiovascular disease, most commonly hypertension, coronary artery disease, or valvular abnormalities. Presented herein is the case of a 29-year-old man with previous anoxic brain injury (but without apparent cardiovascular disease) whose electrocardiogram demonstrated persistent giant inverted U waves. PMID: 23543982 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Peters MN, Katz MJ, Howell LA, Moscona JC, Turnage TA, Delafontaine P Tags: Proc (Bayl Univ Med Cent) Source Type: research

The calcium-alkali syndrome.
We describe a 78-year-old woman who presented with weakness, malaise, and confusion. She was found to have hypercalcemia, acute renal failure, and metabolic alkalosis. Upon further questioning, she reported use of large amounts of calcium carbonate tablets to treat recent heartburn symptoms. Calcium supplements were discontinued, and she was treated with intravenous normal saline. After 5 days, the calcium and bicarbonate levels normalized and renal function returned to baseline. In this article, we review the pathogenesis of the calcium-alkali syndrome as well as the differences between the traditional and modern syndrome...
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Arroyo M, Fenves AZ, Emmett M Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hepatitis C and recurrent treatment-resistant acute ischemic stroke.
Abstract Since the introduction of recombinant tissue plasminogen activator and thrombolysis, acute ischemic stroke has become a treatable disorder if the patient presents within the 4.5-hour time window. Typically, sporadic stroke is caused by atherosclerotic disease involving large or small cerebral arteries or secondary to a cardioembolic source often associated with atrial fibrillation. In the over-65-year age group, more rare causes of stroke, such as antiphospholipid syndromes, are unusual; such stroke etiologies are mostly seen in a younger age group (65 years with hepatitis C-associated antiphospholipid an...
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Saxsena A, Tarsia J, Dunn C, Aysenne A, Shah B, Moore DF Tags: Proc (Bayl Univ Med Cent) Source Type: research

Diagnosis and management of delayed hemoperitoneum following therapeutic paracentesis.
Abstract Abdominal paracentesis is a frequently employed diagnostic and therapeutic procedure for patients with refractory ascites, typically in patients with cirrhosis. It is generally regarded as a safe procedure with significant complications occurring in
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: Katz MJ, Peters MN, Wysocki JD, Chakraborti C Tags: Proc (Bayl Univ Med Cent) Source Type: research

Facts and ideas from anywhere.
PMID: 23543986 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - April 1, 2013 Category: Universities & Medical Training Authors: William CR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Results of an educational program to promote the use of pooled instead of single-donor platelet transfusions.
Abstract Transfusion of platelets is commonly indicated in the inpatient oncology setting. These platelets are obtained either through apheresis from a single donor or pooled from the whole blood of several donors. The amount of transfused platelets, infection risk, incidence of alloimmunization, and increases in posttransfusion platelet count are similar for these two platelet products. Although single-donor platelets are preferred over pooled platelets in some instances, single-donor platelets are often given regularly, despite a higher cost and more limited donor supply. Oncology fellows at Baylor University Me...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Burch M, Schneider R, Barakat A, Abushahin L, Cao Y, Ewing J, Stone MJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Lessons learned from study of depression in cardiovascular patients in an acute-care heart and vascular hospital.
Abstract Depression is highly prevalent in patients with cardiovascular disease, but questions about the effectiveness of screening and intervention remain unanswered. To evaluate the effects of proactive intervention at an acute-care heart and vascular hospital, patients who reported depressive symptoms on admission were randomized to an active, counseling-based depression intervention plus standard care (referral to a primary or psychiatric care physician) or to standard care alone. Despite early termination of patient enrollment because of lower-than-expected recruitment rates, the project had a positive impact...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Davis M, Brennan JM, Vish N, Adams J, Muldoon M, Renbarger T, Garner J Tags: Proc (Bayl Univ Med Cent) Source Type: research

Depression and cardiovascular disease: association, causation, and the right thing to do.
PMID: 23382600 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Schussler JM Tags: Proc (Bayl Univ Med Cent) Source Type: research

Intestinal perforation caused by insertion of a nasogastric tube late after gastric bypass.
Abstract A 57-year-old woman, who had undergone Roux-en-Y gastric bypass surgery 9 years earlier, was admitted to the intensive care unit because of pneumonia. Despite antibiotic therapy, she died 40 days later, apparently because of sepsis and organ failure related to the pneumonia. However, the patient's family requested an autopsy, which revealed that her death was due to perforation of the Roux limb of her gastric bypass, which had resulted in severe peritonitis. The perforation was caused by a nasogastric tube inserted for enteral nutrition. We discuss ways nasogastric tubes might be inserted more safely afte...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Van Dinter TG, John L, Guileyardo JM, John S F Tags: Proc (Bayl Univ Med Cent) Source Type: research

Hodgkin lymphoma transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma.
We report a case of CLL/SLL in which a transformation to Hodgkin lymphoma occurred, and we review previously published reports of this transformation. Transformation to Hodgkin lymphoma in CLL/SLL has a poor outcome compared to de novo cases of Hodgkin lymphoma. PMID: 23382602 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Krause JR, Drinkard LC, Keglovits LC Tags: Proc (Bayl Univ Med Cent) Source Type: research

T-cell prolymphocytic leukemia.
We report the case of a man with de novo T-cell prolymphocytic leukemia and discuss the distinctive clinical, morphologic, immunophenotypic, and cytogenetic features of this entity. PMID: 23382603 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Graham RL, Cooper B, Krause JR Tags: Proc (Bayl Univ Med Cent) Source Type: research

Breast fibromatosis mimicking breast carcinoma.
We present the case of a 30-year-old white woman who presented with a palpable mass within the medial portion of her right breast. She reported breast carcinoma in both her paternal grandmother and maternal aunt. Subsequent mammographic and sonographic evaluation demonstrated an irregular solid mass within the posteromedial portion of the right breast. Ultrasound-guided core needle biopsy revealed low-grade myofibroblastic proliferation consistent with breast fibromatosis. The lesion was surgically resected via wide local excision. Follow-up mammograms performed 1 and 2 years after resection demonstrated no radiographic ev...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Ha KY, Deleon P, Hamilton R Tags: Proc (Bayl Univ Med Cent) Source Type: research

Synovial metastasis from lung cancer.
We present a case of metastatic disease in the synovium in a patient with a history of lung cancer. Lung carcinoma is the most common primary malignancy to metastasize to synovial tissue, and the knee joint is the most common joint to be affected. PMID: 23382605 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Levine HR, Tingle E, Carter B, Dockery D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Percutaneous tattoo pigment simulating calcific deposits in axillary lymph nodes.
We present a patient with isolated axillary lymph node densities on mammography and chest computed tomography, which were subsequently proven to represent deposition of tattoo pigment. PMID: 23382606 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Yactor AR, Michell MN, Koch MS, Leete TG, Shah ZA, Carter BW Tags: Proc (Bayl Univ Med Cent) Source Type: research

Combined congenitally bicuspid aortic valve and mitral valve prolapse causing pure regurgitation.
Abstract Described herein is a patient with a purely regurgitant congenitally bicuspid aortic valve and a purely regurgitant prolapsing mitral valve. Although it is well established that the bicuspid aortic valve is a congenital anomaly, it is less well appreciated that mitral valve prolapse is almost certainly also a congenital anomaly. The two occurring in the same patient provides support that mitral valve prolapse is also a congenital anomaly. PMID: 23382607 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Roberts WC, Zafar S, Ko JM, Carry MM, Hebeler RF Tags: Proc (Bayl Univ Med Cent) Source Type: research

Massive bloody pericardial effusion as an initial manifestation of chronic kidney disease.
We describe a 35-year-old man with a massive bloody pericardial effusion, which was his initial manifestation of chronic kidney disease. Pericardiocentesis and hemodialysis restored cardiac function and relieved the associated massive anasarca. PMID: 23382608 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Fazel P, Vallabhan RC, Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Primary Streptococcus pneumoniae pericarditis.
Abstract Although commonly fatal, bacterial pericarditis is often not diagnosed antemortem due to its infrequent occurrence and fulminant course. Historically, Streptococcus pneumoniae has been the most common cause of bacterial pericarditis. Over the past 70 years, however, it has become largely eliminated and now occurs almost exclusively in immunocompromised individuals with a preceding primary site of infection. Herein, we present a case of primary S. pneumoniae pericarditis that developed over the course of 3 to 4 weeks in an immunocompetent 45-year-old man. The patient, who developed cardiac tamponade shortl...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Peters MN, Hesterman KS, Katz MJ, Barnes MB, Brown RR, Nijjar VS, Bisharat MB, Irimpen AM Tags: Proc (Bayl Univ Med Cent) Source Type: research

High-intensity cardiac rehabilitation training of a police officer for his return to work and sports after coronary artery bypass grafting.
Abstract A 39-year-old male police officer with coronary artery disease enrolled in our cardiac rehabilitation (CR) program after coronary artery bypass grafting. He wanted to return not only to his job but also to playing ice hockey and outdoor soccer, and his responses to a self-assessment scale confirmed that he identified strongly as an athlete. On the basis of this unique profile, the CR staff designed an occupation- and sport-specific exercise program that was symptom limited and enabled the patient to train safely, but earlier and at a higher intensity than is typically allowed in conventional CR programs. ...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Adams J, Berbarie RF Tags: Proc (Bayl Univ Med Cent) Source Type: research

Labor complicated by mitral stenosis.
Abstract A case where a 28-year-old woman presented in labor complicated by mitral stenosis is described. Mitral stenosis is the most commonly encountered valvular lesion in pregnancy. PMID: 23382611 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Grant EN, Williams KC, Perez BJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Electrocardiogram in a man who drove off the road.
PMID: 23382612 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Glancy DL, Ali RZ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Bioprosthetic aortic valve changes late after insertion of a left ventricular assist device.
Abstract A 60-year-old man had his aortic valve replaced and a HeartMate II ventricular assist device (VAD) inserted; 18 months later, he received a heart transplant. The explanted heart had a grossly fibrotic appearance on the ventricular side, with scar tissue extending onto the cusps. VAD therapy can lead to both acute and chronic changes in the valves, which may be clinically significant. PMID: 23382613 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Khvilivitzky K, Gonzalez-Stawinski GV Tags: Proc (Bayl Univ Med Cent) Source Type: research

Endovascular treatment of stent fracture and pseudoaneurysm formation in arteriovenous fistula dialysis access.
We present a case of stent fracture complicated by pseudoaneurysm formation with concomitant stenosis of the cephalic arch treated successfully with single-procedure placement of endovascular stent grafts. PMID: 23382614 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Kershen LM, Marichal DA Tags: Proc (Bayl Univ Med Cent) Source Type: research

Persistent bilateral proatlantal type II artery.
We report a rare case of persistent type 2 bilateral proatlantal arteries, in which the patient presented with dizziness. PMID: 23382615 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Zarghouni M, Marichal D Tags: Proc (Bayl Univ Med Cent) Source Type: research

Fourth ventricular subependymoma presenting as worsening headache.
We describe a 47-year-old man with worsening headaches who was found to have a subependymoma, with a focus on the imaging findings, differential diagnoses, pathology, and treatment. PMID: 23382616 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Saad AF, Bidiwala SB, Layton KF, Snipes GJ, Opatowsky MJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

Vibrio vulnificus necrotizing fasciitis preceding herpes zoster.
Abstract A 74-year-old white man presented with unilateral radicular pain extending across the left side of his chest and back. A diagnosis of postherpetic neuralgia, a sequela of herpes zoster, was made. Herpes zoster represents a reactivation of the varicella zoster virus that lies dormant in patients with past chickenpox. Risk factors for the disease include advanced age, stress, immunodeficiency, and immunosuppression. Treatment of herpes zoster entails traditional antiviral medications, while prevention may be achieved with a new prophylactic vaccine. PMID: 23382617 [PubMed] (Source: Baylor University Me...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Ha KY, Tyring SK Tags: Proc (Bayl Univ Med Cent) Source Type: research

Identification of designer drug 2C-E (4-ethyl-2, 5-dimethoxy-phenethylamine) in urine following a drug overdose.
Abstract In recent years, access to information regarding acquisition and synthesis of newer designer drugs has been at an all-time high due largely to the Internet. As these drugs have become more prevalent, laboratory techniques have been developed and refined to identify and screen for this burgeoning population of drugs. This provides a unique opportunity for learning about many of these methods. Laboratory testing techniques and instrumentation are obscure to many health care professionals, yet their results are crucial. Here, we present a case of an overdose of an uncommon designer drug (2C-E) and discuss th...
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Van Vrancken MJ, Benavides R, Wians FH Tags: Proc (Bayl Univ Med Cent) Source Type: research

My surgical heroes.
PMID: 23382619 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: O'Brien JC Tags: Proc (Bayl Univ Med Cent) Source Type: research

Facts and ideas from anywhere.
PMID: 23382620 [PubMed] (Source: Baylor University Medical Center Proceedings)
Source: Baylor University Medical Center Proceedings - January 1, 2013 Category: Universities & Medical Training Authors: Roberts WC Tags: Proc (Bayl Univ Med Cent) Source Type: research