Debris-Filled Duodenal Diverticulum and Lemmel’s Syndrome

Digestive Diseases and Sciences - We report a case of a 73-year-old woman affected by Lemmel’s syndrome, a rare type of obstructive jaundice caused by a periampullary duodenal diverticulum....     

Mesenteric Cyst with GI Symptoms: A Fluid Approach to Treatment—Case Report and Literature Review

Digestive Diseases and Sciences - Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the...     

Cardiac tuberculoma presenting as thrombotic thrombocytopenic purpura-hemolytic uremic syndrome

Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) is a unique multisystem syndrome. It can present with either chronic or subacute infections. Tuberculosis (TB) is a chronic infection that has been reported to present with TTP-HUS as tuberculous endocarditis in the presence of immunodeficiency and implanted medical devices in regions where TB is endemic. Tuberculomas are space occupying lesions most commonly found in the brain in immunocompromised individuals. Herein, we present a rare association of tuberculosis with endocarditis manifesting as a tuberculoma and presenting as TTP-HUS in an immunocompetent patient and resident of the United States.     

Thyroid hormones therapy: A review of their effects in the treatment of psychiatric and medical conditions

Although thyroid hormones are indicated for hypothyroidism, their therapeutic benefit in treating other medical and psychiatric conditions has not been adequately studied. We review the use of thyroid hormones in treating psychiatric and medical conditions in the euthyroid patients. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors acknowledge discussing the off-label (which includes unlabeled or unapproved) use of T3 and T4 supplementation in the treatment of psychiatric and medical conditions in euthyroid patients.     

The antidepressant sertraline: a review of its uses in a range of psychiatric and medical conditions

Although sertraline was initially introduced as an antidepressant, it can be prescribed for a wide range of psychiatric and medical conditions. We review the pharmacology, the adverse effects, the dosing guidelines, as well as the indications of sertraline.     

Alcohol septal ablation for symptomatic hypertrophic obstructive cardiomyopathy in patients with prior coronary revascularization

Alcohol septal ablation has become an acceptable alternative to surgical myectomy in patients with hypertrophic obstructive cardiomyopathy who remain significantly symptomatic after optimized medical management and meet strict anatomic criteria. Given the prevalence of coronary artery disease and the variable phenotypic penetrance and age at first diagnosis of hypertrophic cardiomyopathy (HCM), patients may undergo coronary revascularization before a firm diagnosis of HCM is made. Patients with prior revascularization in the form of percutaneous coronary intervention or coronary artery bypass grafting pose unique challenges when contemplating and performing alcohol septal ablation. We present two cases of alcohol septal ablation after prior coronary revascularization, and discuss relevant concerns regarding patient selection, procedural technique and consequent durability of clinical outcome.