Increased intratumoral infiltration in IDH wild-type lower-grade gliomas observed with diffusion tensor imaging

Journal of Neuro-Oncology - Diffuse lower grade gliomas (LGG) with isocitrate dehydrogenase (IDH) gene mutations (IDHMUT) have a distinct survival advantage compared with IDH wild-type (IDHWT)...     

Concept,Importance and Practice of Lateral Tucking in Tympanoplasty

The current study aims at observing the technique and results of doing lateral tucking during tympanoplasty surgery. It is intended to provide additional support to the graft and prevent displacement as well. 98 cases included in the study and the graft uptake rate of 97.96% noted. Average pre operative air bone gap (ABG) was 31.12 db and average post operative ABG observed to be 14.01 db. Gain of 17.11 ± 7 db achieved by the procedure. Lateral tucking is a concept that requires to be inculcated in routine tympanoplasty surgeries, especially where canal skin incisions are used. It is easy to practice and the results are good and complications are minimal.     

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study

International Journal of Clinical Pharmacy - Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from...     

Difficulty in LW typing as revealed by a family study

A family is described in which two members of the second generation are of the phenotype LW3. In the course of the investigation the mother of the LW3 propositus was at first believed to be phenotypically LW3 as well. Eventually, it was shown that she is, in fact, phenotypically LW2 but that her R-1 (no D), LWlw, genotype had resulted in less LW being present on her red blood cells than is expected in LW2 persons. This reduced level of LW could not be detected with one example of anti-LW made by an LW3 individual.     

Tumor pharmacokinetics and pharmacodynamics of the CDK4/6 inhibitor ribociclib in patients with recurrent glioblastoma

Journal of Neuro-Oncology - Intracranial meningiomas are relatively rare in young adults, and their specific clinical features remain unclear. The authors analyzed the clinical characteristics of...     

A Case of Spontaneous Coronary Artery Dissection: It is Not Always Plaque Rupture

Background

Spontaneous coronary artery dissection (SCAD) is an extremely rare cause of acute coronary syndrome (ACS). Patients may present with a broad spectrum of clinical scenarios, ranging from angina pectoris to myocardial infarction, cardiogenic shock, and sudden death. Standard therapy has not been established; current treatments range from conservative management to percutaneous revascularization or coronary artery bypass surgery.

Objective

SCAD greatly mimics ACS, and this diagnosis should be considered when evaluating young patients who present with ACS with or without classical risk factors for coronary artery disease.

Case Report

We report a case of a 45-year old man who presented with chest pain typical of ACS. He had no risk factors except for a smoking history of 2.5 pack-years. Once the clinical findings suggested acute inferolateral myocardial infarction, the patient underwent emergent cardiac catheterization, which revealed left anterior descending coronary artery dissection. This in itself is not a common cause of inferolateral ST elevation changes on electrocardiogram.

Conclusion

This case highlights the fact that although SCAD is a rare entity, it is increasingly being recognized as a significant cause of ACS. Urgent angiography should be considered if SCAD is suspected, because early diagnosis and appropriate management significantly improve the outcome in these patients.