Case Report of a Missed Small Bowel Adenocarcinoma on an Upper Endoscopy-A Review of Small Bowel Diagnostic Modalities.

Background: Small bowel neoplasms (SBN) are rare but pose a significant diagnostic challenge. The routine upper endoscopy delays the diagnosis, and most cases require multiple investigations increasing the health care burden.

Case Summary: A 74-year-old man presented with two months of progressively worsening postprandial bilious emesis and epigastric abdominal pain.

Fish Bone-Induced Pancreatitis.

Fish bone-induced pancreatitis is an uncommon cause of pancreatitis, with only a few reported cases in the literature. The patients with the highest risk for fish bone-induced pancreatitis include those from cultures where unfilleted fish is a culinary delicacy. The etiology of foreign body-induced pancreatitis is very common, secondary to inflammation of the duodenal papilla or bile duct obstruction.

Strongyloides stercoralis Infection in Immunocompromised Host.

is a soil-dwelling roundworm that causes an intestinal infection, Strongyloidiasis. In the United States, this helminth generally causes chronic asymptomatic infection, and severe symptomatic infections are reported in immunocompromised hosts like patients undergoing chemotherapy, receiving long-term corticosteroids, transplant patients, or patients with HIV. The clinicians should have a high index of suspicion to diagnose this infection, as the exposure is usually remote and symptoms are non-specific.

What Happens When the Digested Screw Does Not Come Out of Ileum?

Adults with foreign body ingestion are mainly secondary to psychiatric disorders, alcoholic intoxication, and secondary gains. Conservative management without any intervention is successful in 80% of the ingested foreign bodies. Risk factors for complication include sharp objects, objects larger than 6 mm, recurrent ingestion, and previous gastrointestinal tract surgeries.

Case of Stroke from Cerebral Vasculitis following Carfilzomib, Lenalidomide, and Dexamethasone Therapy in a Patient with Relapsing Multiple Myeloma.

Lenalidomide, a synthetic derivation of thalidomide, in recent years, has been the backbone of multiple myeloma treatment leading to improved survival. Common adverse effects from lenalidomide-based regimens include hypertension, heart disease, and venous thromboembolism. Hence, thromboprophylaxis is recommended to reduce the risk of stroke.

Changes in left and right ventricular function of donor hearts during the first year after heart transplantation.

Objective: Expected values of tissue Doppler imaging (TDI) velocities and myocardial performance index (MPI) after heart transplantation (HTx) have not been evaluated. This study assessed left and right ventricular (LV and RV) structure and function during the first year after HTx using these indexes.

Methods And Results: Echocardiography including MPI and TDI systolic (S'), early (E') and late (A') diastolic velocities of RV and LV were performed in 20 donors (mean age 35 ± 13 years) and serially in 20 recipients (mean age 59 ± 9 years) during the first year after HTx.

Coronary revascularization alone or with mitral valve repair: outcomes in patients with moderate ischemic mitral regurgitation.

We sought to evaluate retrospectively the outcomes of patients at our hospital who had moderate ischemic mitral regurgitation and who underwent coronary artery bypass grafting (CABG) alone or with concomitant mitral valve repair (CABG+MVr).A total of 83 patients had a reduced left ventricular ejection fraction and moderate mitral regurgitation: 28 patients underwent CABG+MVr, and 55 underwent CABG alone. Changes in mitral regurgitation, functional class, and left ventricular ejection fraction were compared in both groups.

Induction therapy with thymoglobulin after heart transplantation: impact of therapy duration on lymphocyte depletion and recovery, rejection, and cytomegalovirus infection rates.

Background: This retrospective single-center study compared lymphocyte depletion in 144 heart transplant recipients using 2 different induction protocols with Thymoglobulin (Genzyme Transplant, Cambridge, MA).

Methods: Thymoglobulin (1.5 mg/kg) was given to 105 patients for 7 days (Thymo7) and 39 patients for 5 days (Thymo5).