A Workout to Remember: CrossFit-Induced Vertebral Artery Dissection.

Vertebral artery dissection (VAD) is a cause of brain stem stroke in the younger population and is commonly associated with trauma, sudden neck movement, or chiropractic manipulations. In this case, a 28-year-old male with a non-significant past medical history who recently started a CrossFit boot camp presented to the emergency department with right-sided neck pain, dysarthria, mild right gaze paresis, right dysmetria, and right facial droop with symptoms of Horner's syndrome. Imaging results revealed an age-indeterminate left lateral cerebellar infarct with right VAD.

Primary Peritoneal Carcinoma: A Rare Malignancy Presenting a Diagnostic Challenge.

With the advancement in technologies and the development of a vast variety of tests, diagnosing diseases has become relatively easy. However, certain diseases are challenging to diagnose due to their similarities with other disease processes. Primary peritoneal carcinoma (PPC) is one of the infrequent tumors that has a resemblance to an ovarian tumor, often making it hard to diagnose.

Wellens' Syndrome in the Setting of the 2019 Novel Coronavirus (COVID-19).

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov2), is the causative pathogen of coronavirus disease 2019 (COVID-19), which is primarily described as a respiratory illness. However, a wide array of cardiovascular complications has also been described in the setting of COVID-19. Wellens' syndrome, also regarded as a left anterior descending coronary T-wave syndrome, is an electrocardiography (EKG) pattern that indicates critical proximal left anterior descending (LAD) artery stenosis.

Subacute Stent Thrombosis in a Patient With COVID-19 Despite Adherence to Antiplatelets.

The coronavirus disease 2019 (COVID-19) creates a significant burden on the cardiovascular system. Moreover, diagnosing coronary artery disease in patients with COVID-19 may be clinically challenging. Herein, we present a case of in-hospital stent thrombosis and thrombotic occlusion of the right coronary artery after initial revascularization and adherence to antiplatelet therapy.

Hematological manifestations and complications of COVID-19.

The virus SARS-CoV-2 commonly causes self-resolving, flu-like illnesses in the majority of patients, but a critical illness can be seen in 5% of cases - especially in the elderly population or in patients with multiple comorbidities. When COVID-19 is severe, it can cause pneumonia and hypoxemic respiratory failure, and can progress to viremia involving multiple organ systems. It causes significant cytopenia, mainly severe lymphopenia, and excessive exhaustion of CD8+ T cells, resulting in an immunocompromised state and cytokine storm.

Steal and strain: A case of coronary artery fistula presenting with coronary steal syndrome and underlying bronchiectasis.

Background: Coronary artery fistula is a relatively rare disorder with an incidence rate of 0.05-0.9%, and the majority of fistulae are detected incidentally.

The Association Between Anemia of Chronic Inflammation and Alzheimer's Disease and Related Dementias.

Background: Dementia is a spectrum of neurological diseases characterized by memory impairment and cognitive decline with the pathogenesis and effective management remaining elusive. Several studies have identified a correlation between anemia and Alzheimer's disease and related dementias (ADRD); however, anemia subtypes and association with ADRD have yet to be studied conclusively.

Objective: To study an association between ADRD and anemia of chronic inflammation.

Halotherapy for Chronic Respiratory Disorders: From the Cave to the Clinical.

Context: Halotherapy (HT) is a form of speleotherapy, a respiratory therapy involving breathing inside a cave, and its therapeutic environment is similar to that of a natural salt cave. Natural crystallized salt is inhaled via aerosols or from the environment directly to enhance breathing and respiratory health-related quality of life (HRQoL). Clinicians need to be aware of its potential benefits, with relatively few or no adverse effects and consider its use an adjuvant therapy for standard care.

Complicated Isolated Liver Abscess Caused by Viridans Group Streptococci Leading to Right Hepatectomy.

Pyogenic liver abscesses (PLAs) secondary to bacterial etiologies are most often seen in developing countries and are less common in North America. The predominant etiology is infection occurring in the setting of direct extension of hepatobiliary or intestinal infection. The most common pathogen isolated from a PLA in the United States is , whereas is a rare entity in the developed world.

Acute Kidney Injury Caused by Levetiracetam in a Patient With Status Epilepticus.

Levetiracetam is a widely used, effective and usually well-tolerated anti-epileptic medicine. It is mostly excreted by kidneys and requires dose adjustment according to the glomerular filtration rate. Very few case reports have been published in the literature about levetiracetam causing acute kidney injury (AKI).

Disseminated Varicella-Zoster Virus Infection Complicated by Encephalitis and Ramsay Hunt Syndrome in an HIV Patient.

Varicella-zoster virus (VZV) is a human α-herpesvirus which cause primary varicella infection (chicken pox) or herpes zoster infection (shingles) after reactivation of the dormant virus. VZV infection is usually self-limited but disseminated infection can be seen in immunocompromised individuals. It can also get complicated by central nervous system (CNS) involvement.

Multivessel Coronary Artery Fistula Presenting as Coronary Steal Syndrome Leading to Cardiac Arrest.

The coronary steal phenomenon refers to myocardial ischemia caused by the diversion of blood away from normal myocardial circulation. A coronary artery fistula (CAF) is an abnormality of the coronary anatomy characterized by the aberrant termination of a coronary artery or its branches into cardiac chambers or great vessels. Although CAFs are often thought to be asymptomatic, fistulas that diverge a significant amount of blood flow and decrease the normal perfusion of myocardial tissue can cause ischemia and can present with acute coronary syndrome.

Paraneoplastic Pemphigus: An Indication for Treatment in Chronic Lymphocytic Leukemia.

Paraneoplastic disorders are rare multiorgan diseases associated with hematological malignancies such as chronic lymphocytic leukemia (CLL). Some of these paraneoplasms manifest as cutaneous lesions, appearing as a simple rash, ulcers or skin thickening. The pathogenesis for this process has been described as development of certain autoimmune reactions against cell wall antigens and proteins.

Giant Left Main Coronary Artery Aneurysm Presenting as Multiple Implantable Cardioverter Defibrillator Shocks.

Giant aneurysms of the left main coronary artery are one of the rarest findings in cardiology, encountered in less than 0.02% of patients. The presentation is usually the same as coronary artery disease since most coronary aneurysms in the western world are associated with atherosclerosis.

Narrow Escape: A Novel Approach to the Endovascular Treatment of Superior Vena Cava Syndrome Secondary to Pacemaker Leads with Excellent Long-term Outcomes.

Pacemaker or defibrillator placement is a common procedure done in more and more patients due to increased longevity and the prominence of cardiac disease. With more indications for cardiac implantable electrode devices, the devices themselves have evolved into more complex structures with more leads. The mechanical stress, risk of infection, and decreased blood flow through the superior vena cava (SVC) put patients at risk for SVC obstruction.

Perceptions of the osteopathic profession in New York City's Chinese Communities.

Objective: The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City (NYC).

Design: A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine.

Setting: Data collection occurred in the municipal delineations for the Chinatown neighbourhood within the New York, New York borough of Manhattan.

A Broken Heart: Cardiac Arrest As the Initial Presentation of Myasthenic Crisis.

Myasthenic crisis is a life-threatening condition commonly associated with respiratory failure and may present in unusual ways. However, there is paucity in the literature about the cardiac manifestations of myasthenia gravis. We present a case of a 61-year-old male who presented to the emergency room with upper respiratory infection symptoms who soon thereafter suffered sudden cardiac arrest.

Wellens' Syndrome Presenting as Epigastric Pain and Syncope: An Unusual Presentation.

Wellens' syndrome, also regarded as left anterior descending coronary T-wave syndrome, is an electrocardiography (EKG) pattern that indicates critical proximal left anterior descending artery (LAD) stenosis. It is characterized by deeply inverted T-waves or biphasic T-waves in the anterior precordial chest leads in a patient with unstable angina. Patients typically present with symptoms consistent with acute coronary syndrome.

Cholangiocarcinoma Presenting as Humoral Hypercalcemia of Malignancy: A Case Report and Literature Review.

Humoral hypercalcemia of malignancy (HHM) is most commonly encountered in squamous cell carcinoma (SCC) of different organs, and It is characterized by elevated parathyroid hormone-related peptide (PTHrP) levels. It may be seen as a manifestation of cholangiocarcinoma (CCC) at presentation and later in the course of the disease. However, HHM due to intrahepatic cholangiocarcinoma is a rare association and is associated with a poor prognosis.

De Novo CD5+ Primary Gastrointestinal Diffuse Large B-Cell Lymphoma: Challenges With Treatment and Clinical Course.

The gastrointestinal tract is a common extranodal site for lymphomas. However, primary gastrointestinal lymphomas are rare. Diffuse large B-cell lymphomas (DLBCL) are the most commonly encountered type in the gastrointestinal tract.

Cannabis-induced Acute Coronary Syndrome: A Coincidence or Not?

Marijuana, derived from the plant, is the most commonly abused illicit drug in the United States. Now, more than ever, due to changing regulations, marijuana is more readily available and is known to be habitually used by millions. The neuropsychiatric effects of marijuana are well-known which include chronic fatigue syndrome and polyphagia.

Resistant hypertension: Renal denervation or pharmacovigilance? Insights from a renal denervation screening program.

Background: With emerging new therapeutic concepts including renal denervation (RDN), there is a renewed interest in resistant hypertension (ResH). Among patients suspected of having ResH, a definitive diagnosis needs to be established.

Objectives: This study presents observations from a standardized single-center screening program for RDN candidates, including medical therapy modification and reassessment.

Unexplained chronic cytopenia: is it idiopathic cytopenia of undetermined significance or myelodysplastic syndrome.

Idiopathic cytopenia is a condition where there is a decrease in peripheral blood counts causing either anaemia, leucopoenia and thrombocytopaenia. Most cases of cytopenia reveal a cause on further workup. But very rarely, in some cases, a definitive cause could not be identified.

Conversion Disorder (Functional Neurological Symptom Disorder) Masquerading as Multiple Sclerosis: A Case Report.

Conversion disorder, also referred to as functional neurological symptom disorder, is a DSM-5 identified somatic disorder that presents with one or more neurological symptoms that does not clinically correlate with recognized neurological or medical conditions brought on by intense stress, emotions, or an associated psychiatric disorder. Multiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system and usually presents in young adults with clinical manifestations that range from cognitive abnormalities, eye movement problems, motor and sensory impairments such as weakness and numbness, bowel/bladder dysfunction, fatigue, and/or pain. This case report presents a patient with functional neurological symptom disorder presenting with clinical signs associated with MS.