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Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion
We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips.Patients and MethodsFrom March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombosis inside the IVC; we perfor...
Source: Annals of Surgical Oncology - October 1, 2018 Category: Cancer & Oncology Source Type: research

Teaching NeuroImages: Posterior reversible encephalopathy syndrome resulting in hydrocephalus
A woman with prior lung transplantation presented with headaches, seizure, and obtundation. Head MRI (figure) revealed obstructive hydrocephalus and hyperintensity on T2-weighted imaging in the bilateral thalami and brainstem. Management included antiepileptic medications, ventriculostomy placement, and cessation of tacrolimus for concern of atypical posterior reversible encephalopathy syndrome (PRES). Infectious and paraneoplastic etiologies were ruled out. An autoimmune process was unlikely due to immunosuppression. There was rapid clinical improvement with repeat MRI revealing resolution of hydrocephalus and T2 changes....
Source: Neurology - June 5, 2016 Category: Neurology Authors: Paolini, S., Jadhav, A. P. Tags: Hydrocephalus, Secondary headache disorders, Other cerebrovascular disease/ Stroke RESIDENT AND FELLOW SECTION Source Type: research

Persistent (patent) foramen ovale (PFO): implications for safe diving.
Authors: Germonpré P Abstract Diving medicine is a peculiar specialty. There are physicians and scientists from a wide variety of disciplines with an interest in diving and who all practice 'diving medicine': the study of the complex whole-body physiological changes and interactions upon immersion and emersion. To understand these, the science of physics and molecular gas and fluid movements comes into play. The ultimate goal of practicing diving medicine is to preserve the diver's health, both during and after the dive. Good medicine starts with prevention. For most divers, underwater excursions are not a profess...
Source: Diving and Hyperbaric Medicine - December 11, 2015 Category: Sports Medicine Tags: Diving Hyperb Med Source Type: research

Persistent hypoxemia and platypnea-orthodeoxia after left single-lung transplantation: a case report
Conclusions Our case demonstrates that an open patent foramen ovale leading to massive right-to-left shunting is a possible complication after lung transplant, with significant morbidity, and that it can be treated successfully using a percutaneously placed occlusion device. Through this case report, we aim to improve pre-transplant procedures by demonstrating that a bubble contrast transesophageal echocardiogram can be performed pre-operatively to detect a patent foramen ovale.
Source: Journal of Medical Case Reports - June 12, 2015 Category: Journals (General) Source Type: research

Statins side effects are minimal, study argues
ConclusionThis meta-analysis pooled results from 29 studies and has shown a very small increased risk of newly diagnosed diabetes mellitus. This is the same as the decreased risk of any cause of death in people taking statins, compared to placebo, to prevent a heart attack or stroke.The researchers point out some limitations to the meta-analysis: Each study did not report on all of the side effects, meaning that for each category of side effect, the number of participants differed. The side effect categories were only included if at least 500 people had reported suffering from it. This means there may be numerous other si...
Source: NHS News Feed - March 13, 2014 Category: Consumer Health News Tags: Heart/lungs Medication Source Type: news

Severe systemic vasospasm causing recurrent cardiac arrest after orthotopic heart transplantation
We report a case of refractory coronary and systemic vasospasm in a cardiac transplant recipient 10 years after transplantation, which ultimately required re-transplantation.
Source: The Journal of Heart and Lung Transplantation - October 17, 2013 Category: Transplant Surgery Authors: Rajiv Tayal, Janice Pieretti, David A. Baran Tags: Case Anecdotes, Comments and Opinions Source Type: research

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