Bilateral Renal Hypoperfusion Following Motor Vehicle Accident.

Renal hypoperfusion noted on abdominal computed tomography (CT) scan without any underlying comorbid condition is a rare finding. Most reported cases of renal hypoperfusion have an association with an underlying cardioembolic problem, such as atrial fibrillation, endocarditis, cardiomyopathies, or artificial valve thrombi. We present a case of transient renal hypoperfusion evident on abdominal CT scan following blunt trauma.

: An Emerging Cause of Nosocomial Pneumonia.

Gram-negative infections are a rising concern faced by the medical community. Approximately 30% of nosocomial bloodstream infections in intensive care units in the United States are caused by these gram-negative species. Emergence of multidrug-resistant organisms further complicate this issue.

A Rare Case of Meningitis in the Absence of Cerebrospinal Fluid Pleocytosis.

is a nonfermentative gram-negative of low pathogenicity. The organism has been involved in causing a wide range of infections in community and hospital settings. Only 3 cases of meningitis caused by this organism have been reported so far.

Opana ER (Oxymorphone)-Induced Thrombotic Microangiopathy: An Atypical Presentation in a Patient With Hepatitis C.

Oxymorphone is a semisynthetic extended release opiate used to treat moderate to severe chronic pain. The Food and Drug Administration approved the oral form of oxymorphone available as Opana and Opana ER (extended release) since 2006. The Food and Drug Administration and the Centers for Disease Control and Prevention issued warning against intravenous use of Opana ER.

Daptomycin-Vancomycin-Resistant Enterococcus faecium Native Valve Endocarditis: Successfully Treated With Off-Label Quinupristin-Dalfopristin.

Multidrug-resistant enterococcal nosocomial invasive infections are a rising concern faced by the medical community. Not many options are available to treat these highly virulent organisms. Risk factors for developing these highly resistant organisms include prolonged hospital stay, previous antibiotic use, and immunosuppression.

Prosthetic Arteriovenous Graft Contact Dermatitis Masquerading as an Arteriovenous Graft Infection in a Hemodialysis Patient.

Prosthetic arteriovenous (AV) graft is the second most common vascular access of choice in hemodialysis patients. Rare complications of such grafts are increasingly seen due to rising population of patients on hemodialysis. Infections and thrombosis are the most common complications.

Common bile duct MALT lymphoma: case report and review of the literature.

We report a rare case of common bile duct mucosa-associated lymphoid tissue (MALT) lymphoma treated with pancreatico-duodenectomy with a partial gastrectomy. MALT lymphoma involving the biliary tree is extremely rare. Diagnosis is difficult and treatment options are controversial.

Therapeutic options for occult breast cancer: a survey of the American Society of Breast Surgeons and review of the literature.

Background: Axillary presentation of occult breast cancer (OBC) is uncommon, and continues to be a diagnostic and therapeutic challenge to physicians. After our recent experience with a similar patient, a survey of the American Society of Breast Surgeons (ASBS) was conducted to assess the Society's member's opinions on treatment.

Methods: A survey was sent by mail to 1837 members of the ASBS.

Traumatic subarachnoid hemorrhage and QTc prolongation.

Objective: Spontaneous subarachnoid hemorrhage (SAH) causes a prolonged corrected QT interval (QTc) in 25% to 90% of patients, but whether this occurs with traumatic SAH (tSAH) is unknown. This investigation was conducted to determine whether QTc prolongation occurs with tSAH and to evaluate QTc prolongation with respect to severity of tSAH.

Design: Records of 104 consecutive tSAH patients were reviewed.

Clinical rib fractures: are follow-up chest X-rays a waste of resources?

Rib fractures (RFs) are estimated to be present in 10 per cent of all traumatic injuries. However, up to 50 per cent of all fractures go undetected on the screening chest X-ray (CXR). The purpose of this study was to identify the incidence of clinical (CRFs) and objective rib fractures (ORFs) as well as to examine the utility of the routine follow-up CXR with regard to patient recovery and healthcare cost.

Laparoscopic cholecystectomy in the elderly.

Background: Few studies have examined the results of laparoscopic cholecystectomy (LC) in the elderly. We reviewed our experience with the procedure in 194 patients age 65 and older.

Methods: A chart review was performed on patients who underwent attempted LC over a 4-year period.

Experimental thoracoabdominal airgun wounds in a porcine model.

Unlabelled: The Consumer Product Safety Commission estimates that there are 31,000 airgun injuries annually, 19,000 of which occur in children under 14 years of age. Case reports in the literature include 235 serious and nine lethal pediatric injuries. No experimental model of thoracoabdominal airgun pellet perforation exists.

Cyclosporine-induced worsening of hepatic dysfunction in a patient with Crohn's disease and enterocutaneous fistula.

Cyclosporine recently has become part of the treatment regimen for patients with refractory inflammatory bowel disease, though it is still considered investigational for that purpose. However, little attention has been given to the potential hepatotoxicity associated with cyclosporine administration. This can be especially significant in patients with preexisting abnormalities of liver function, including those induced by total parenteral nutrition.