Utility of Direct Immunofluorescence in Cutaneous Autoimmune Bullous Disorders.

Background Autoimmune bullous disorders (AIBD) are a heterogeneous group of disorders with substantial clinical overlap associated with blistering of skin or mucosa. Aims The present study aimed to study the histopathological spectrum and evaluate the utility of direct immunofluorescence (DIF) on snap-frozen and paraffin-embedded sections in resolving the differential diagnosis of AIBD and connective tissue disorders of the skin. We also compared the efficacy of DIF on paraffin versus the snap-frozen sections in diagnosing AIBD.

Canadian national electrophysiology ablation registry report 2011-2016.

Background/purpose: Interventional cardiac electrophysiology (EP) is a rapidly evolving field in Canada; a nationwide registry was established in 2011 to conduct a periodic review of resource allocation.

Methods: The registry collects annual data on EP lab infrastructure, imaging, tools, human resources, procedural volumes, success rates, and wait times. Leading physicians from each EP lab were contacted electronically; participation was voluntary.

A Case of Metastatic Pancreatic Adenocarcinoma in Complete Remission Using Chemotherapy and Immunotherapy.

Among the various types of cancer, pancreatic cancer is considered to have a particularly grim prognosis. Treatment includes surgery, chemotherapy, or both. While the role of immunotherapy is well-studied in many types of cancer, such is not the case with pancreatic cancer.

Caribbean small ruminant importation requirements in an era of widespread anthelmintic resistance.

Resistance of small ruminant gastrointestinal parasites to available classes of anthelmintic drugs is a widespread problem. As such, use of these drugs needs to be applied in a judicious manner in order to protect animal health. Herein, a case of drug-resistant gastrointestinal nematodes imported to the Cayman Islands is outlined.

A Comprehensive Review of Pharmaceutical and Surgical Interventions of Prostate Cancer.

As the second most common cause of death amongst men in the United States, prostate cancer is a type of cancer that is known to develop and originate in the prostate gland. The main function of the prostate gland is to produce seminal fluid in which the sperm bathes. The seminal fluids are necessary for allowing the sperm to move easily through the urethra and also allows successful fertilization by providing an alkaline environment for the sperm in the acidic nature of the vagina.

COVID-19-Induced Hepatic Injury: A Systematic Review and Meta-Analysis.

Background The current pandemic of the novel coronavirus disease (COVID-19) is a global health challenge. Pulmonary dysfunction is the main outcome of COVID-19 infection. In critically ill patients, however, liver complications have also been reported.

Evaluation of injectate distribution after ultrasound-guided peribulbar injections in canine cadavers.

Objective: To describe a contrast medium distribution pattern after peribulbar injection in cadavers.

Study Design: A cadaveric study.

Animals: A group of eight male dogs and four canine cadaver heads.

Use of CT Scans for Abdominal Pain in the ED: Factors in Choice.

Overutilization of healthcare resources is a threat to long-term healthcare sustainability and patient outcomes. CT is a costly but efficient means of assessing abdominal pain; however, 97 per cent of ED physicians acknowledge its overutilization. This study sought to understand factors that influence ED providers' decision regarding CT use in the evaluation of abdominal pain.

Cytokeratin-Positive Osteosarcoma Simulating Sarcomatoid Metastatic Carcinoma.

Osteosarcoma, the most common primary malignant bone tumor, rarely stains positive for epithelial markers such as cytokeratin on immunohistochemical analysis. We describe a 52-year-old man with a destructive distal femoral metaphyseal lesion who was initially treated for metastatic sarcomatoid carcinoma based on extensive radiographic and histopathologic evaluation. Ultimately, wide resection of the distal femur was performed, revealing high-grade conventional osteosarcoma with intense and diffuse cytokeratin positivity.

A Case of Septum Pellucidum Agenesis in a Patient with Psychotic Symptoms.

Agenesis of the septum pellucidum is a rare congenital defect that has been associated with psychiatric disorders, cognitive deficits, learning disabilities, seizures, and neuropsychiatric disturbances. We present the case of a patient with partial agenesis of the septum pellucidum who exhibits disorganized behavior and paranoid and persecutory delusions. We add to the literature of incidental neuropsychiatric symptoms in patients with partial agenesis of the septum pellucidum which is an area that requires further exploration and study.

Multiple electrolyte imbalances and mixed acid-base disorder posing a diagnostic dilemma: a case report.

Background: In clinical practice, both the history and laboratory testing are paramount to making an accurate diagnosis. Situations in which laboratory findings and patient history are not congruent pose a diagnostic dilemma. We report a case of a young woman presenting with a myriad of electrolyte and acid-base disorders.

Dual-Antithrombotic Therapy With DOACs After Acute Coronary Syndrome or Percutaneous Coronary Intervention in Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials.

Background: The choice of antithrombotic therapy for atrial fibrillation (AF) patients who have an acute coronary syndrome (ACS) or have undergone percutaneous coronary intervention (PCI) is challenging. We aimed to assess outcomes between dual-antithrombotic therapy with the use of direct-acting oral anticoagulants (DOACs) plus an antiplatelet agent (dual therapy) compared with warfarin plus 2 antiplatelet agents (triple therapy) for AF patients after PCI or with ACS.

Methods: Systematic searches of multiple major databases were performed from their inception through September 2019.

Chronic Atypical Depression as an Early Feature of Pituitary Adenoma: A Case Report and Literature Review.

Pituitary adenomas are often diagnosed as incidental findings on brain imaging. We present the case of a 52-year-old African American female patient with long standing depressed mood prior to the incidental finding of a pituitary adenoma. We explore the possibility of certain mood symptoms prompting an early diagnosis of pituitary adenoma.

Bilateral native knee septic arthritis due to ; a case report and review of literature.

should be considered in any case of indolent septic arthritis. Cultures should be followed for 2 weeks as our cultures were negative for 7 days before growing . Irrigation and debridement followed by antibiotics is the standard of care.

Medical ethics and the trolley Problem.

The so-called Trolley Problem was first discussed by Philippa Foot in 1967 as a way to test moral intuitions regarding the doctrine of double effect, Kantian principles and utilitarianism. Ever since, a great number of philosophers and psychologists have come up with alternative scenarios to further test intuitions and the relevance of conventional moral doctrines. Given that physicians routinely face moral decisions regarding life and death, the Trolley Problem should be considered of great importance in medical ethics.

Cecal bascule as a cause of postoperative nausea and abdominal pain.

Cecal bascule is a unique form of large bowel volvulus in which the cecum folds anterior to the ascending colon and generates a flap valve which impairs cecal emptying and results in cecal dilation [1]. Presenting symptoms include nausea, vomiting, abdominal pain, distension, and constipation. We report a case of a 74-year-old male who developed abdominal pain and nausea after a coronary artery bypass graft surgery.

Prevalence of heartworm infection in the feral cat population of Grand Cayman.

Objectives: The aim of this study was to determine the presence and prevalence of heartworm infection in the feral cat population of Grand Cayman.

Methods: During the study period, feral cats were routinely trapped and euthanized for population control by the municipal animal shelter. Cats older than 6 months of age were obtained for post-mortem examination shortly after euthanasia.

A Unique Case of Severe Anemia Secondary to Copper Deficiency in an Adult Patient.

Anemia is a frequently encountered problem in the healthcare system. Common causes of anemia include blood loss, followed by impaired red blood cell production and red blood cell destruction. This case demonstrates the need for cognizance of the less frequent causes of anemia.

The Role of Immunotherapy and Radiation Therapy in Tumor Chemosensitivity in Advanced Head and Neck Cancer.

BACKGROUND Cancer is the second leading cause of death internationally, resulting in millions of deaths each year. While treatment in the past has heavily relied on surgery and radiotherapy, chemotherapy and immunotherapy are being increasingly utilized depending on disease presentation. CASE REPORT A 56-year-old male presented to the Emergency Department with a 3-week history of a rapidly enlarging left supraclavicular neck mass.

Vitamin C: A Preventative, Therapeutic Agent Against Helicobacter pylori.

The treatment of () induced infections using antibiotic therapies is clinically well accepted; however, using a noninvasive approach with the implementation of therapeutic agents such as vitamin C is not well investigated. Vitamin C has certain characteristics, which allow for it to be considered as a potential treatment option for patients with infections. Vitamin C's hostility and mechanism of action towards infection in peptic ulcer disease can be classified into two categories: as a preventative agent and alternatively as a therapeutic agent.

Investigating the Atherogenic Risk of Lipoprotein(a) in Type 2 Diabetic Patients.

Type 2 diabetes mellitus (T2DM) has high morbidity and results in increased risk of mortality mainly due to cardiovascular diseases. Different factors have been found to be responsible for the increased prevalence of coronary artery disease (CAD) in T2DM. One of these factors includes raised serum levels of lipoprotein(a) (Lp(a)).

Medical Students' Perception of the Usage of Lecture Recording Software.

Background: Lecture recording software is a useful reference tool that allows students to revisit lectures and understand complicated concepts in higher education. It is also a useful tool for students with learning difficulties, allowing them to reference and learn the material at their own pace. A significant advantage of this tool is the accessibility of course material to the students off campus.

Xylitol Toxicosis in Dogs: An Update.

Xylitol ingestions in dogs may result in severe hypoglycemia followed by acute hepatic failure and associated coagulopathies. Aggressive treatment may be needed, but the prognosis is generally expected to be good for dogs developing uncomplicated hypoglycemia. Because of increased availability of xylitol-containing products in the market and in the dog's environment, it is likely that there will continue to be increased exposures and toxicity in dogs.