Telerehabilitation with a Patient Diagnosed with Acromegaly and Bilateral Total Loss of Vision Secondary to Pituitary Macroadenoma: A Case Report.

Coronavirus disease 2019 (COVID-19) caused unprecedented disruptions in the lives of people, inducing a change in social behavior because of quarantine and physical distancing measures for health safety. It greatly affected not only the general population but also the healthcare system, forcing healthcare providers and consumers to adjust from the traditional mode of in-person consultation to telemedicine to enable safe and prompt delivery of adequate and efficient patient care. A 35-year-old female was diagnosed with acromegaly secondary to pituitary macroadenoma, presenting as a 10-year history of weight gain, amenorrhea, hand and feet enlargement, coarse facial features, and bilateral vision loss.

Development of a surgical/trauma intermediate care unit.

During these times of escalating health care costs and increased demand for critical care beds, hospitals are often unable to provide the intensive level of nursing care that is required. One large urban trauma center found that 36% of the surgical intensive care unit patients required a level of nursing care intermediate between the intensive care unit and the general ward. A multidisciplinary team met to plan and develop a surgical/trauma intermediate care unit to provide this level of care.

Antiphospholipid antibody syndrome: a case study.

Antiphospholipid antibody syndrome includes a spectrum of autoantibody reactions associated with vascular thrombosis, thrombocytopenia and recurrent fetal loss. Neurologic manifestations include strokes, transient ischemic attacks and multi-infarct dementia. Treatment involves prolonged anticoagulation, and prognosis is poor.

Thoracic aortic trauma: role of dynamic CT.

Two protocols were developed to study the efficacy of both chest radiography and dynamic computed tomography (CT) of the thorax in screening for traumatic aortic injury. Both protocols demonstrated a definite role for dynamic CT in excluding aortic injury in patients with normal initial chest radiographs. The authors studied 164 patients, and preliminary results indicated a high reliability for this method.

Contrast media adversely affect oxyhemoglobin dissociation.

Effects of ionic (Hypaque-76) and nonionic (Isovue-370 and Omnipaque-350) contrast media on oxyhemoglobin dissociation of normal human red blood cells were evaluated. In series 1, 4-mL venous blood samples were obtained from 15 normal human volunteers. One blood sample served as control, and 1 mL of either of the three contrast media was added in vitro to the other 4-mL blood samples.

Multiple percutaneous transluminal angioplasties and low dose pulse methotrexate for Takayasu's arteritis.

A 20-year-old woman developed left shoulder and arm claudication and angiographic evidence of Takayasu's arteritis. She obtained temporary relief from percutaneous transluminal angioplasties 6 times. Her symptoms were finally controlled with low dose oral pulse methotrexate.

Involvement of the inferior vena cava in patients with renal cell carcinoma.

Inferior vena cavography plays an important role in the staging of renal cell carcinoma. The renal angiograms and inferior vena cavograms in a series of patients with renal cell carcinoma were reviewed to determine which patients require cavography. Our findings show that renal angiography is of great value in suggesting tumor involvement of the renal vein or vena cava, and that the decision to do cavography can be made from the angiographic findings.

Angiographic patterns in renal oncocytomas.

Renal oncocytomas are benign tumors arising from proximal tubular epithelial cells. They appear radiographically as solid masses which are vascular on angiography. Angiograms of 13 cases of renal oncocytomas were reviewed, as well as those of 155 renal-cell carcinomas.

Replacement lipomatosis of the kidney.

Replacement lipomatosis and renal sinus lipomatosis are parts of a spectrum of fatty replacement of destroyed or atrophic renal tissue. When long-standing inflammation exists in a kidney, especially with calculus disease, replacement lipomatosis may be the end result. Awareness of this process along with the specific radiologic findings will allow a correct preoperative diagnosis.

Hemangiomas of the liver in patients with renal cell carcinoma.

Five patients with renal cell carcinoma were noted at angiography to have vascular hepatic lesions which resembled metastatic renal cell carcinoma but which proved to be benign hepatic hemangiomas. The angiographic differentiation between small hemangiomas and metastatic vascular neoplasms of the liver can be difficult; angiographic characteristics may not be definitive. Surgery to remove the renal tumor should not be deferred solely on the basis of vascular hepatic lesions found at angiography.

Infiltrating neoplasms of the kidney.

Some neoplastic processes which involve the kidney develop not as a distinct localized mass, but rather as an infiltrating process which replaces the renal parenchyma, causes little or no mass effect, and contains little if any neovascularity. These neoplasms include (1) carcinoma of the renal pelvis when it invades the parenchyma (transitional cell and squamous cell); (2) blood-borne metastatic squamous cell carcinoma to the kidney (most frequently from the lung): (3) renal lymphoma of the infiltrating variety; and (4) infiltrating sarcomatous type of hypernephroma. While the urographic and angiographic appearance of these infiltrating lesions can be similar, clinical aspects are usually sufficient to differentiate them.

Pseudocoarctation and mid-arch aortic coarctation.

A 21-year-old woman was found to have a mid-arch aortic coarctation in combination with pseudocoarctation. The angiographic disgnosis was established by left atrial injection after transseptal puncture.

Epinephrine-enhanced renal angiography in renal mass lesions: is it worth performing?

In our experience, properly performed epinephrine-enhanced angiography is a useful technique to improve accuracy in the angiographic diagnosis of renal masses. This pharmacologic enhancement is helpful in establishing the benignity of some lesions, clearly establishing malignancy in those questionable by routine angiography, and actually detecting malignant lesions not seen at all on unenhanced angiograms. Six examples of these situations are illustrated.

Inferior vena caval occlusion: characteristic radiographic changes on excretory urography and barium enema examination.

Acute occlusion of the inferior vena cava produces characteristic radiographic findings on intravenous urogram and barium enema examination. The urinary bladder is compressed anteriorly and superiorly giving an inverted pear-shaped appearance, and the distal ureters are medially displaced. Barium enema examinations demonstrate narrowing and elevation of the rectosigmoid region along with an increase in the presacral space.

The pear-shaped bladder.

The tear-drop or pear-shaped bladder was originally described in cases of pelvic hematoma. It may also be seen, however, with a variety of other entities, including pelvic lipomatosis, inferior vena cava occlusion, lymphocysts, and enlarged pelvic lymph nodes. Pertinent radiographic findings of these conditions are reviewed.

Carcinoma of the gallbladder: a diagnosis aided by endoscopic retrograde and percutaneous hepatic cholangiography.

In a patient with obstructive jaundice, extrinsic compression of the common bile duct (Mirizzi syndrome) due to squamous cell carcinoma of the gallbladder was documented with the combination of endoscopic retrograde cholangiography and pancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC).

New diagnostic and therapeutic techniques in the management of pyogenic liver abscesses.

An unexplained increase in the frequency of pyogenic liver abscesses of unknown etiology has, fourtunately, been paralleled by significant advances in diagnostic and therapeutic methods. This report reviews experience with 14 patients operated upon at NYU Medical Center since 1971. Eight cases (57%) were cryptogenic.