C.A Hing1, A. Alaga1*, M.K Razul1
1Hospital Sultanah Bahiyah, Alor Setar, Malaysia
Pulmonary crytococcosis is a rare infection in immunocompetent patients. It is caused by encapsulated yeast-like fungus Cryptococcus neoformans. A young healthy gentleman presented with 1 day history of dyspnoea and fever, with 2 weeks history of weight loss.
Clinical examination revealed left lung collapse. CT thorax done showed a mediastinal mass with left lung collapse. Tissue obtained from bronchoscopy confirmed presence of Cryptococcus neoformans. The left main bronchial mass was removed during rigid bronchoscopy to expand the left lung. He was given T fluconazole 400 mg OD for 6 months. He improved significantly after the removal of left bronchial mass.DOI: 10.29245/2689-999X/2017/3.1128 View / Download Pdf
Anomalous Right Coronary Artery Originating from the pulmonary artery. (ARCAPA): A systematic review of literature
H Rawal1*, SS Mehta2
1University of Illinois at Urbana Champaign. 611 west Park Street, Urbana, Illinois 61801, USA
2Carle Foundation Hospital. Senior clinical and Interventional cardiologist. 611 west Park Street, Urbana, Illinois 61801, USA
Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a very rare congenital heart defect. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. Here we highlight the presentation, diagnosis and available treatment modalities for the management of this rare anomaly.DOI: 10.29245/2689-999X/2017/3.1134 View / Download Pdf
Commentary: Association of Anemia with Venous Thromboembolism in Acutely Ill Hospitalized Patients: An APEX Trial Substudy
Anmol Pitliya1, Asrar Ahmad2, Husnain Shaukat1, Eiman Ghaffarpasand1, Sadaf Sharfaei1, Farima Kahe1, Syed Hassan A. Kazmi1, Gerald Chi1*
1Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
2Department of Medicine, Abington Memorial Hospital, Abington, Pennsylvania, USA
Anemia, commonly defined as hemoglobin concentration <12.0 g/dL in women and <13.0 g/dL in men, is a prevalent condition that has been linked to unfavorable prognosis among hospitalized patients. Population-based studies report that low hemoglobin level is associated with various thrombotic disorders including myocardial infarction, stroke, and venous thromboembolism (VTE). A recent study on acutely ill hospitalized patients extends the previous findings and demonstrates that anemic patients were at a greater risk for symptomatic VTE through 77 days of follow-up. Specifically, decreased hemoglobin concentration was associated with a two-fold risk of symptomatic DVT or non-fatal PE, despite the provision of pharmacologic thromboprophylaxis with enoxaparin or betrixaban, an FDA approved direct oral anticoagulant for VTE prevention. Additionally, hemoglobin measurement improved the risk discrimination and reclassification of a well-validated VTE assessment tool (i.e., International Medical Prevention Registry on Venous Thromboembolism [IMPROVE] VTE risk score). Based on these results, future studies should evaluate the use of laboratory biomarkers in conjunction with clinical variables to refine individualized VTE risk assessment.DOI: 10.29245/2689-999X/2017/3.1133 View / Download Pdf
Anania G1, Fabbri N1*, Marino S1, Resta G1, Giaccari S1, Tamburini N1, Fiorica F2, Cavallesco G1
1Department of Morphology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, University of Ferrara, Ferrara, Italy
2Department of Radiation Oncology, University Hospital Ferrara, Ferrara, Italy
Aim: The figure of cancer patient has changed. Some reasons are the increase of the average population and higher incidence of diseases related to old age (cardiovascular diseases, diabetes, etc.), but also diseases such as obesity are increasing in industrialized countries. For these reasons is necessary to choose an adequate and personalized treatment, taking into consideration the different risk of mortality and morbidity in therapeutic choices through a greater interaction between medical specialists.
Experiment: we conducted a retrospective study that took into consideration all the patients who underwent surgery of rectosigmoid junction and rectum in our hospital before and after the institution of a multidisciplinary tumour board (MTB) from January 2007 to April 2017. Furthermore, a recent retrospective single-centre analysis was performed in the same hospital by Tamburini et al. on consecutive patients who underwent surgery for non-small cell lung cancer (NSCLC) between January 2008 and December 2015.
Results: the advantage brought by the multidisciplinary evaluation teams are confirmed for the presence of benefits in terms of reduction of morbidity and improvement of the outcome of MTB patient group.
Conclusions: we find that more study depth of neoplastic disease as well as of each individual patient leads to more accurate staging and to a weighted therapy based on the needs of the individual. According to our experience, multidisciplinary tumour board should be present in all hospitals where cancer diseases are treated.DOI: 10.29245/2689-999X/2017/3.1132 View / Download Pdf
VI Starodubov1, AN Edeleva1, TP Sabgayda1*
1Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation, 11 Dobrolyubova Str., Moscow, 127254, Russia
The article compares the prevalence of pathological changes in different organs and systems among city and rural residents of the next ages: elderly (60-74 years for men and 55-74 years for women), senile (75-84 years) and advanced (85 years and older) ages. The results of the continuous survey of all persons of the retirement age of one urban (7809 people) and two rural areas (14749) of the Nizhny Novgorod region were analyzed. The region is comparatively homogeneous in terms of the national composition of the population.
In the city, the number of chronic pathologies of different organs and systems per one person of elderly age are: 2.83 for man and 2.76 for woman of elderly ages, 3.06 and 3.07 respectively for senile ages, 2.71 and 2.75 of advanced ages. In rural areas, the analyzed indicators for men and women are respectively 1.64 and 1.58 for elderly ages, 1.84 and 1.78 for senile ages, 1.86 and 1.84 for advanced ages.
Demonstrating the difference in the phenotypic manifestations of the genes of predisposition to chronic diseases in old age between the city and village, the results make it possible to produce the following assumptions. First, better access to medical care does not guarantee the better health status of the elderly, while it contributes to an increase in the life expectancy of men. Second, in spite of better access to health care, urban lifestyle contributes to the accumulation of chronic diseases in population of a region. Third, if chronic pathology of three different classes of diseases presented, then the probability of a long life is fundamentally determined by the access to health care. Fourth, the probability of longevity is significantly reduced in result of illness by neoplasms, cardiovascular, respiratory, endocrine or genitourinary diseases in ages of working or beginning of retirement period.DOI: 10.29245/2689-999X/2017/3.1140 View / Download Pdf