Haemangioendothelioma of Oral Cavity: A Rare Entity with Unusual Location.

Hemangioendothelioma is a rare, locally aggressive vascular tumor, originating from soft tissue, bone, skin, and organs such as liver or lung and exceptionally the oral cavity. It is usually benign but can show variable grades of malignancy. Most of the cases of oral epithelioid hemangioendotheliomas are asymptomatic, and diagnosis is hampered by the fact that the histological features somewhat overlap with hemangioma and angiosarcoma, with epithelioid cells, intracytoplasmic vacuoles, low mitotic activity, and rarely necrosis.

Simulation-based training in echocardiography.

The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show interest as well, including intensive care, anesthesia, and primary care trainees, in both transesophageal and transthoracic echocardiography. Advances in technology have led to the development of simulation programs accessible to trainees to help gain proficiency in the nuances of obtaining quality images, in a low stress, pressure free environment, often with a functioning ultrasound probe and mannequin that can mimic many of the pathologies seen in living patients.

Wearing the mask of ST-elevation myocardial infarction: postpericardiotomy syndrome.

Introduction: Postpericardiotomy syndrome (PPS) is an inflammatory process, affecting 15% to 20% of patients, after surgery involving pleura, pericardium, or both. The role of electrocardiogram (ECG) in diagnosing PPS is uncertain because ECG is rarely normal (especially after cardiac surgery). We report a case of PPS that presented initially with localized ST-segment elevation and also discuss proposed mechanisms.

Treatment of pulmonary hypertension.

Pulmonary arterial hypertension (PAH) is a chronic progressive disease of the pulmonary vasculature characterized by elevated pulmonary arterial pressure and secondary right ventricular failure. PAH is considered a life-threatening condition unless treated. This article provides a comprehensive review of controlled and uncontrolled trials to define the risk-benefit for different therapeutic options of this clinical disorder.

Adult Onset Still's Disease and Rocky Mountain Spotted Fever.

Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971). George Still in 1896 first recognized this triad of quotidian (daily) fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990). Adult Onset Still's Disease (AOSD) is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias.

Explosive nasofacial cryptococosis.

Cryptococcal skin infection in persons with AIDS has been demonstrated. We describe a patient with nasal and facial infection with cryptococci after traumatic injury with battery acid.

The effect of student training on accuracy of completion of death certificates.

Background: Death certificates are an invaluable source of statistical and medical information, as well as important legal documents. However, few physicians receive formal training on how to accurately complete them.

Purpose: To determine if a simple intervention can improve the accuracy of death certificate completion by medical students.

Resolution of MRI findings in central pontine myelinosis associated with hypokalemia.

We report a case of a 20-year-old African-American female, hospitalized and treated for hyperemesis gravidarum and hypokalemia with a normal serum sodium level. Two to 3 days into her hospitalization, she developed urinary incontinence, weakness, and pain in her lower extremities. An MRI brain scan showed central pontine signal alteration, leading to a diagnosis of CPM.

Health-behavior induced disease: return of the milk-alkali syndrome.

The milk-alkali syndrome is a well-documented consequence of excessive calcium and alkali intake first recognized in association with early 20th century antacid regimens. The syndrome became rare after widespread implementation of modern peptic ulcer disease therapies. With recent trends in osteoporosis therapy coupled with widely available calcium-containing supplements, the milk-alkali syndrome has reemerged as an important clinical entity.

Popular sweetner sucralose as a migraine trigger.

Sucralose (trichlorogalactosucrose, or better known as Splenda) is an artificial sweetener from native sucrose that was approved by the FDA on April 1, 1998 (April Fool's Day). This observation of a potential causal relationship between sucralose and migraines may be important for physicians to remember this can be a possible trigger during dietary history taking. Identifying further triggers for migraine headaches, in this case sucralose, may help alleviate some of the cost burden (through expensive medical therapy or missed work opportunity) as well as provide relief to migraineurs.