Microangiopathic Hemolytic Anemia as the Initial Presentation of Metastatic Signet-Ring Cell Carcinoma of the Colon: A Case Report.

Microangiopathic hemolytic anemia (MAHA) is a condition characterized by intravascular fragmentation of red blood cells, leading to the characteristic finding of schistocytes on a peripheral blood smear. The differential diagnoses of MAHA include thrombotic thrombocytopenic purpura (TTP), hemolytic-uremic syndrome (HUS), disseminated intravascular coagulation (DIC), idiopathic thrombocytopenic purpura (ITP), infections, malignancies, and solid organ transplantation. The commonly associated malignancies with MAHA are gastric, breast, prostate, lung, and lymphoma.

Carcinoma of Unknown Primary: Integrating Timely Interventions and Molecular Advancements for Improved Outcomes.

Carcinoma of unknown primary (CUP) is a diverse group of malignancies characterized by metastatic disease without an identified primary site. It typically presents with a poor prognosis due to widespread metastasis at diagnosis. This report discusses a 58-year-old female patient with advanced CUP and diffuse liver metastasis.

Dentigerous Cyst and Glandular Odontogenic Cyst: A Rare Combination of Coexisting Pathologies.

A dentigerous cyst (DC) is the most common developmental cystic lesion of the jaws. Histologically, these cysts derive from the odontogenic epithelium that includes the reduced enamel epithelium, epithelial cell rests of Serres, and epithelial cell rests of Malassez. Radiographically, DCs are usually presented as well-defined radiolucencies associated with the crown of an unerupted tooth at the level of the cementoenamel junction (CEJ).

A Longitudinal Study on Parent-Infant Rest-Activity Rhythms Using Actigraphy From Late Pregnancy to Eight Months After Birth.

Circadian rhythms develop from an ultradian to a circadian rhythm during a few months in the early human life stage. One of the strong factors in promoting the development of circadian rhythms during infancy is maternal rest-activity rhythms. However, few studies have examined comparing the rest-activity rhythms of parents and infants.

Unusual Presentation: Chronic Gastritis Caused by Sarcina ventriculi Identified via Helicobacter pylori Immunohistochemistry.

This case report presents a rare occurrence of Sarcina ventriculi in a 15-year-old male patient with a clinical history of renal failure due to chronic rejection status post kidney transplantation, with persistent symptoms of diarrhea, nausea, vomiting, and fatigue. Despite exhibiting normal gastrointestinal mucosa upon endoscopy, biopsy analysis revealed chronic gastritis accompanied by the presence of Sarcina ventriculi in a tetrad arrangement across the stomach, duodenum, and distal esophagus. Interestingly, immunohistochemistry (IHC) staining targeting the Helicobacter pylori organism (H.

Neuromodulatory Effect of Lactate on Visual Evoked Potential After Acute Exercise in Healthy Adult Males.

Background Lactate, once considered merely a byproduct of anaerobic metabolism, is now recognized as a crucial neuromodulator in the brain, particularly during high-energy demands. Recent studies have explored its role in neuroprotection, cognitive enhancement, and neural plasticity. This study investigates the effects of elevated blood lactate levels, induced by acute exercise, on visual evoked potentials (VEPs), which reflect neural activity in the visual cortex.

Hemorrhagic Shock Due to a Gastrointestinal Stromal Tumor in a Patient With Neurofibromatosis Type 1: A Case Report.

Gastrointestinal stromal tumors (GISTs), though rare, are associated with neurofibromatosis (NF) type 1 and may cause significant gastrointestinal bleeding. A 42-year-old male with NF1 presented with severe hematochezia and underwent initial non-contrast CT, which was negative for abnormalities. Subsequent endoscopies and PillCam studies also revealed no clear bleeding source.

Bio-Obturation for Internal Root Resorption in Contralateral Mandibular Molars: A Five-Year Case Study.

Internal root resorption (IRR) is a rare but complex condition characterized by progressive destruction of the internal dentin walls, typically resulting from chronic pulp inflammation, trauma, or infection. Managing apical IRR, particularly in teeth with extensive apical lesions, presents significant challenges due to the limitations of traditional root canal treatment (RCT) and obturation techniques. This report discusses the nonsurgical management of two contralateral mandibular first molars in a 49-year-old male patient, both exhibiting apical IRR and large endodontic lesions.

Traumatic Bilateral Bronchial Injury Requiring Pneumonectomy.

High-energy blunt thoracic trauma is a highly morbid condition. When a pneumonectomy is required in such a setting, the mortality rate increases significantly. Here, we present a case of a motor vehicular crash (MVC) in which the patient suffered bilateral bronchial injuries requiring emergent thoracotomy, pneumonectomy, bronchial stenting, and initiation of venovenous extracorporeal membrane oxygenation (VV ECMO).

Complex Genetic Framework in Familial Amyotrophic Lateral Sclerosis With a C9ORF72 Mutation: A Case Report.

A significantly diverse clinical presentation of amyotrophic lateral sclerosis (ALS), even in its best-studied familial form, continues to hinder current efforts to develop effective disease-modifying drugs for the cure of this rapidly progressive, fatal neuromuscular disease. We have previously shown that clinical heterogeneity of sporadic ALS (sALS) could be explained, at least in part, by its polygenic nature as well as by the presence of mutated genes linked to non-ALS neurological diseases and genes known to mediate ALS-related pathologies. We hypothesized that a similar genetic framework could also be present in patients with familial ALS (fALS).

Common Problems Encountered During the Delivery of New Dentures Constructed by Dental Clinical Students at University Sains Islam Malaysia (USIM).

Background Dentures are one of the main treatments dentists deliver to restore the oral function and aesthetics of individuals with missing teeth. Clinical denture fabrication and manufacturing is one of the main training modules for undergraduates during dental clinical training. However, students often face problems during denture delivery due to multiple factors causing discomfort to patients, affecting the quality of the denture and the patient's adaptation period to the denture.

Experiences of Asian American College Students During the COVID-19 Pandemic.

The purpose of this study is to examine experiences among Asian American college students during the COVID-19 pandemic. Six focus groups were held online via Zoom (Zoom Video Communications, Inc., San Jose, USA) with a total of 21 participants in October and November 2020.

An Unusual Case of Chylous Ascites.

Chylous ascites occur when the lymphatic flow is blocked or disrupted, causing a leakage of fluid into the peritoneal space. It can be caused by a number of etiologies and identifying the exact cause can be challenging. We present the case of a 77-year-old man who presented with chylous ascites.

Spontaneous Coronary Artery Dissection as an Uncommon Case of Non-ST-Elevation Myocardial Infarction: A Case Report and Review.

Spontaneous coronary artery dissection (SCAD) is a rare condition that frequently goes undiagnosed. Still, it is becoming an increasingly recognized cause of acute coronary syndrome (ACS), predominantly in middle-aged women with few or no cardiovascular risk factors. We present a case of a 53-year-old female with traditional cardiovascular risk factors, who presented with typical anginal symptoms and was diagnosed with SCAD in the mid to distal left anterior descending artery (LAD).

Challenges in the Management of Severe Serotonin Syndrome: A Case Report.

Serotonin syndrome (SS) is a potentially life-threatening condition that can result from excessive serotonergic activity, often due to SSRIs, formally known as selective serotonin reuptake inhibitors. The syndrome and its effects are often secondary to drug-drug interactions or dose-related. This case highlights a 47-year-old female who presents with a history of major depressive disorder, generalized anxiety disorder, and severe alcohol use disorder.

Sepsis-Associated Acute Kidney Injury: Pathophysiology and Treatment Modalities.

Sepsis-associated acute kidney injury (S-AKI) is a critical complication that significantly contributes to the morbidity and mortality of sepsis patients. This narrative review explores the complex and multifactorial pathophysiology of S-AKI, which involves hemodynamic alterations, microcirculatory dysfunction, endothelial damage, inflammatory responses, oxidative stress, and direct tubular injury. Conventional perspectives linking S-AKI primarily to reduced renal blood flow are now being reconsidered, with growing insights highlighting the significance of microcirculatory dysfunction and endothelial activation as key contributors.

Unnecessary Needling: A Case of Iatrogenic Pneumothorax Following Dry Needling Procedure for Chronic Myofascial Pain.

This case report highlights a complication of pneumothorax associated with dry needling (DN), a technique used for the treatment of myofascial pain syndrome and musculoskeletal disorders. Despite its growing popularity and efficacy in relieving pain, dry needling can lead to adverse events. We present a case of a 35-year-old female who developed pneumothorax following a dry needling session.

Asymptomatic Empty Sella: A Literature Review and Suggestions for Evaluation in Clinical Practice.

Empty sella (ES) is a radiographic finding defined by the presence of cerebrospinal fluid in the sella turcica, with associated compression of the pituitary gland. Empty sella syndrome (ESS) is the combination of this radiographic finding with endocrine, ophthalmological, and/or neurological symptoms. The focus of this literature review is to synthesize information about asymptomatic or incidental ES specifically, meaning the radiologic finding of an empty sella without symptoms.

Strongyloides Hyperinfection Syndrome (SHS) in a Patient With Prolonged Intensive Care Unit (ICU) Exposure: A Case Report.

Strongyloides hyperinfection syndrome (SHS) is a severe manifestation of the Strongyloides parasite, often occurring in immunocompromised patients due to the inability to subdue larvae autoinfection. As the parasitic burden increases, the patient can develop worsening respiratory symptoms that mimic common pathologies such as chronic obstructive pulmonary disease (COPD). The parasite is endemic to the Appalachian region as well as subtropical and tropical areas worldwide.

Evaluation of Risk Factors for Dupilumab-Associated Ocular Sequelae in the Treatment of Atopic Dermatitis.

Dupilumab is a monoclonal antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling and is used in the treatment of moderate-to-severe atopic dermatitis (AD) in those six months or older who are uncontrolled on or cannot tolerate topical treatments. Ocular surface disease is a recognized adverse effect of dupilumab, yet few studies describe the risk factors for developing ocular adverse effects. There are no standardized recommendations for monitoring patients on this medication.

Acute Pancreatitis Caused by Tirzepatide.

Glucagon-like peptide-1 (GLP-1) receptor agonists, including tirzepatide (Mounjaro), are widely used to manage type 2 diabetes mellitus (T2DM) and obesity. While gastrointestinal side effects are common, acute pancreatitis remains a rare but significant complication. Limited evidence exists on the risks associated with switching between GLP-1 agonists, emphasizing the need for clinical awareness.

Prediction of Preeclampsia Using Machine Learning: A Systematic Review.

Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality. Early prediction is the need of the hour so that interventions like aspirin prophylaxis can be started. Nowadays, machine learning (ML) is increasingly being used to predict the disease and its prognosis.

Re-optimizing the Time Frame for Classifying Cerebral Venous Sinus Thrombosis: An Unmet Need.

Cerebral venous thrombosis (CVT) is a rare and complex form of stroke, representing a small percentage of all stroke cases. The disease's clinical presentation is highly variable, involving a wide range of medical specialists due to its diverse manifestations. Over the past decade, significant advancements in understanding CVT have been made, particularly in light of the COVID-19 pandemic and subsequent vaccination efforts.

Gemcitabine-Based Chemotherapy for Advanced Soft Tissue Sarcoma: Identifying the Appropriate Dose and Schedule.

Background In 2024, reimbursement for gemcitabine-docetaxel therapy (GEM-DOC; gemcitabine 900 mg/m on days 1 and 8 and docetaxel 70 mg/m on day 8 every 21 days, GEM 900-DOC 70) to treat recurrent/metastatic soft tissue sarcoma (STS) was made in Japan. Methods We retrospectively reviewed clinical records of advanced/metastatic STS patients who underwent off-label gemcitabine-containing chemotherapy at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research between February 2007 and October 2019. Results Of 115 enrolled patients, 51 were treated with GEM-DOC (26 patients received the dose as previously stated) and the other 64 with gemcitabine monotherapy.

Head to Toe: A Perioperative Surgical Home Approach to Sepsis and Airway Obstruction in a Geriatric Patient.

The perioperative surgical home (PSH) is a care delivery model designed to improve the perioperative and long-term outcomes of patients undergoing surgery by promoting holistic care and seamless cooperation between different services and subspecialties. An aging population and increased surgical complexity have led to renewed interest in PSH models. An 86-year-old female with diabetes and critical limb ischemia presented with sepsis due to right calcaneal gangrene.