Libman-Sacks Endocarditis Presenting as Acute Coronary Syndrome, Acute Heart Failure and Multiple Embolic Strokes.

Libman-Sacks endocarditis is a rare cardiovascular manifestation of systemic lupus erythematosus. It is described as sterile vegetative lesions which can damage heart valves resulting in complications such as acute coronary syndrome and heart failure and can embolize to cause cerebral and renal infarcts. We present the case of a young African American female presenting with pleuritic chest pain.

Insulin edema after initiation of hybrid closed-loop insulin pump therapy with continuous glucose monitoring: a case report.

Background: Insulin edema is a rare complication which can present after initiation or intensification of insulin therapy in people with diabetes. Initiation of closed-loop hybrid insulin pump therapy can result in rapid improvement in glycemic control for people with diabetes. We present a case in which transition to a closed-loop hybrid insulin pump system, followed by significant improvement in glycemic control, led to development of insulin edema in a person with type 1 diabetes.

Right Heart Failure With Recurrent Pericardial Effusion Mimicking Effusive-Constrictive Pericarditis Several Years After Renal Transplantation.

Pericardial disease is a rare complication after renal transplantation. We present a patient who developed high-output cardiac failure from a large arteriovenous (AV) fistula with recurrent pericardial effusion resulting in a constrictive hemodynamic pattern that was revealed during cardiac catheterization. Pericardiectomy was considered for recurrent effusive pericarditis, but per cardiac surgery recommendations, closure of the AV fistula dramatically cured the patient's heart failure, and no recurrence of pericardial effusion was seen during follow-up almost a year later.

Catheter-Directed Thrombectomy: An Alternative in Massive Pulmonary Embolism.

Massive pulmonary embolism (PE) is a life-threatening condition. The mainstay treatment is thrombolysis. Catheter-directed thrombectomy involves a group of new techniques that appear to have relatively low complications and mortality.

The Importance of Early Pericardiectomy in Mulibrey Nanism Syndrome, a Case Report.

Mulibrey (scle-er-ain-e) Nanism syndrome is an extremely rare genetic disorder with multiorgan involvement. Constrictive pericarditis and diastolic dysfunction are the most common causes of mortality. We present a case of a patient with Mulibrey nanism syndrome who underwent pericardiectomy at 12 years old and was able to live 44 years more with relatively stable and asymptomatic diastolic congestive heart failure (CHF).

Insulin Edema With Use of U-500 Regular Insulin in a Hybrid Closed-Loop Insulin Pump.

Insulin edema is a rare complication of insulin therapy which has been described in known or newly diagnosed people with diabetes, following initiation or intensification of insulin treatment. Here we present a 63-year-old man with complaints of weight gain, shortness of breath, and lower extremity edema starting two weeks after the change of his insulin pump to the hybrid closed-loop insulin pump system and substitution of U-100 aspart insulin with U-500 regular insulin. Laboratory studies, imaging, and electrocardiogram (EKG) were performed to evaluate the cause of acute edema and were all normal.

A Case of Recurrent Coronary Subclavian Steal Syndrome.

Coronary subclavian steal syndrome (CSSS) is one of the rare complications of coronary artery bypass graft surgery (CABG). This phenomenon is a potential complication after left internal mammary artery (LIMA) to left anterior descending artery (LAD) CABG. A proximal stenosis of the left subclavian artery (SA) could cause retrograde flow from LIMA to left SA, which characterizes the mechanism of CSSS.

The Sweet syndrome as a cutaneous manifestation of Crohn's disease.

Crohn's disease is an inflammatory bowel disease associated with many extraintestinal manifestations involving multiple organs, including the skin, eyes, liver, and joints. Classic Sweet's syndrome is a cutaneous manifestation of Crohn's disease, characterized by sudden onset of painful plaques or nodules of the skin associated with fever and neutrophilia. We present a case of classic Sweet's syndrome in a patient with well-controlled Crohn's disease.

Acute Myocardial Infarction Due to Spontaneous Coronary Artery Dissection and Plaque Rupture.

Myocardial infarction (MI) can be secondary to atherosclerotic coronary artery disease (ACAD) and non-atherosclerotic coronary artery disease (NACAD). The common cause of NACAD in young females is spontaneous coronary artery dissection (SCAD). We present a case of SCAD and plaque rupture leading to MI.

Vitamin D supplementation in the treatment of atopic dermatitis: a clinical trial study.

Background: The role of vitamin D in Atopic Dermatitis (AD) is ambiguous and clinical trials are needed to assess the role of vitamin D in the treatment of AD. The aim of this clinical trial study to evaluate the effect of vitamin D supplementation on patients with AD.

Material And Methods: sixty AD patients were included in a randomized, double-blind, placebo-controlled trial study.

A single blind randomized clinical study: the efficacy of isotretinoin plus narrow band ultraviolet B in the treatment of psoriasis vulgaris.

In this randomized clinical trial, 39 patients with psoriasis vulgaris were randomized in two groups. Intervention group received narrow band ultraviolet B (NBUVB)+isotretinoin (0.5 mg/kg/day), control group received NBUVB+placebo.