Recent Articles

  • Bilateral acute renal infarction treated by endovascular therapy: A case report and literature review

    Renal infarction is a rare emergency and the estimated incidence is extremely low according to the literature. In addition, simultaneous bilateral renal infarction was only about 20% in these rare cases. Herein we reported a case of acute renal failure related to bilateral renal infarction and successfully treated by endovascular therapy including angioplasty and catheter-directed thrombolysis. His renal function also significantly improved after the intervention. This rare case reminds physician that early endovascular therapy might improve renal function and result in better renal outcome for patients with simultaneous bilateral renal infarction.

  • Spirituality and Meditation During a COVID-19 Lockdown

    Spirituality and meditation have been associated with emotional and physical well-being, but studies on their relationships are surprisingly missing from the COVID-19 lockdown literature. In this Survey Monkey study conducted during a COVID-19 lockdown, 72% of 260 respondents reported feeling spiritual and 48% meditated. Correlation analyses suggested that spirituality and meditation were positively correlated. Spirituality was also positively related to health practices and working on projects and negatively correlated with COVID-related stress, anxiety, depression, fatigue, and sleep disturbances. And, meditation was positively correlated with health and working scale scores. Spirituality and meditation may be buffers for these COVID-19 related stressors.

  • Cardiogenic Shock Due to Acute Myocarditis Following AZD1222 Vaccine Administration: a Case Report

    Aim: A number of cases of SARS-CoV-2-related myocarditis have been reported since the outbreak of the Covid-19 pandemia, with autoimmune-mediated damage due to molecular mimicry proposed as the virus’ direct mechanism of injury. After commencing with a worldwide mass vaccination program, there have also been reports of myocarditis in the context of Covid-19 immunization. However, myocarditis is still not recognized as a potential side effect of the AZD1222 (ChAdOx1-S recombinant) vaccine administration by the health authorities. Methods: In this article we report a case of myocarditis and further complications after vaccination for Covid-19 using the AZD1222 vaccine. Conclusion: Even though it is hard to demonstrate the etiology of acute myocarditis, considering the cases reported around the world, the temporal association, the absence of other plausible causes, and the serological pattern described, it seems reasonable to assume that there is a genuine possibility of myocarditis being a side effect of AZD1222 vaccine administration.

  • TRANSLATIONAL MEDICINE AND AUTOLOGOUS FAT TRANSFER: FROM BENCH TO BEDSIDE. REGENERATIVE AND PROLIFERATIVE POTENTIAL OF ADIPOSE TISSUE

    Aim: Autologous fat transfer (AFT) for the correction of maxillofacial defects was first reported at the end of the 19th century. AFT was introduced as a way of improving facial esthetics and in the last few years has expanded into applications in craniomaxillofacial reconstructive surgery and regenerative therapy. This protocol is part of translational medicine. The aim of translational medicine, or translational science, is to combine disciplines, resources, expertise, and techniques based on three main pillars: bench, bedside, and community. The primary goals to coalesce assets of various natures to significantly improve the global healthcare system. AFT is thus part of translational medicine in tissue healing, regeneration and augmentation. Methods: Several techniques have been suggested for harvesting and grafting the fat. The Authors follow Coleman’s technique with centrifugation and infiltration using different types and sizes of cannulas. Conclusion: This review provides a fairly comprehensive summary of the many exciting possibilities that exist in the field of facial fat grafting. Five clinical cases are presented and discussed. Translational medicine is the basis of this new reconstructive and regenerative field of science and research.

  • EXPIRED AIR CARBON MONOXIDE TESTING IS EFFECTIVE FOR PREOPERATIVE SCREENING OF CIGARETTE USE IN ORTHOPAEDIC PATIENTS: A PROSPECTIVE PILOT STUDY OF 70 VETERANS

    Introduction: Screening for cigarette use is standard in the orthopedic pre-operative clinic, however traditional biochemical testing methods, including serum and urine cotinine assays, do not differentiate active smoking from nicotine replacement therapy (NRT). In this prospective pilot study, we hypothesize that exhaled carbon monoxide (eCO) testing will be non-inferior to the gold standard serum cotinine (SC) test in screening for pre-operative cigarette use, will differentiate active smoking from NRT, and will allow for substantial cost savings in a clinic setting. Methods: Adult orthopaedic veterans indicated for elective surgery at our institution were offered inclusion. Self-reported smoking status (SRS), eCO and SC levels were obtained preoperatively. An eCO level of >6 parts per million and a SC level >3 ng/ml were considered positive for recent cigarette use. Agreement between SRS, eCO levels and SC levels, and eCO level test-retest reliability were evaluated. Results: Of the 55 patients enrolled into the study, 4 were self-reported Current Smokers and 51 were self-reported Ex-Smokers or Non-Smokers. Combining SRS with eCO levels as a screening tool for recent cigarette use yielded a sensitivity of 100%, a specificity of 98%, a positive predictive value of 95% and a negative predictive value of 100%. eCO testing differentiated NRT from cigarette use in all non-smoking patients. Test-retest reliability for eCO levels showed perfect agreement for 16 patients that had two or more eCO levels pre-operatively. Conclusion: Exhaled CO testing is as effective as SC testing but can differentiate active smoking from NRT, while maintaining a high level of accuracy and reliability when combined with SRS as a screening tool.

  • Use of Ketamine as a Date Rape Drug: a Systematic Scoping Review

    Background and Objectives: The interdependence of ketamine and rape represent an emerging issue for both the developed and the developing countries. Ketamine is rarely used in human surgery nowadays, but there is a range of traits concerning the aforementioned drug making it the most appropriate one for committing a sexual assault. Methods: An advanced search in Medline, CINAHL, PsychINFO, Scopus and Cohrane Library and ScienceDirect was conducted. Identified articles were published between 2005 and 2020. Results: Eight empirical studies were included that comprised the number of victims who had consumed unwillingly ketamine leading to rape. Conclusion: Ketamine as a rape drug is an emerging issue, the extent of which we do not yet acknowledge. Community based informative programs for the public should be implemented, concerning the hazards following the consumption of ketamine.

  • Extracurricular Types and Academic Success

    Previous research has already determined that there is a positive correlation between extracurriculars and academic performance. Extracurriculars establish personal connections with others and increase motivation for many. However, there is limited research on the individual types of extracurriculars. Not all extracurriculars are the same. Therefore, I have decided to examine this issue through my research question: “Which extracurricular types were the most beneficial to academic success for 9th through 12th graders in School X in the 2020-2021 school year?” To ensure that I do not explain connections between variables, I establish an explore approach through a non-experimental survey. I ask students to list their top three extracurriculars to prevent an influx of data. After collecting my data, I organize my results into ten categories and explore recurring trends and themes. I examine mean GPA, mean class rank, personal connections with peers and adults, time spent, skills, passion, and correlating academic classes. In the end, I conclude that activities focused on leadership resulted in the highest scores overall. Student government and youth development programs may have been the most beneficial to overall academic success due to this leadership. I also determined that academic or professional organizations, the arts, and school sports may have been the most beneficial to academic success in correlating academic courses due to increased knowledge and passion. Overall, this is an essential issue to consider because over half of American students today are involved in at least one extracurricular. By establishing which extracurriculars are the most beneficial to one’s success, they can better understand which activities they should be joining to make the best use of their time.

  • Spontaneous Oculomotor and Abducens Nerve Palsy as Initial Presentation of Lymphoma of the Cavernous Sinus: Case Report

    Primary lymphomas of the skull base are rare (1% of lymphomas in adults); they can originate from the cavernous sinus and the parasellar region. Diffuse large B-cell lymphoma is the most common histologic subtype. Currently, the origin of these lymphomas is controversial, and their clinical characteristics are not very specific. There are various treatments for these lesions with a variable response; therefore, the prognosis of these lesions is variable. Clinical case: We present the case of a 52-year-old man who spontaneously presented with diplopia. Physical examination revealed a limitation in adduction of the right eye, right palpebral ptosis, and limitation in the abduction of the left eye. Brain magnetic resonance imaging revealed a well-defined and homogeneous extra-axial lesion at the cavernous sinus level. The patient was biopsied and diagnosed with B-cell lymphoma; received chemotherapy and radiotherapy. In this article, we present a clinical case that considers the characteristics of the diagnosis and is the first B-cell lymphoma at the cavernous sinus level reported in Mexico. Conclusion: Skull base lymphomas have a broad clinical spectrum. Minimally invasive surgery for biopsy purposes is the gold standard for diagnosis, and the treatment with the best results is chemotherapy.

  • Frequently affected teeth by different types of iatrogenic perforations made during dental training in Bulgaria

    Background: One of the reasons for endodontic treatment failure is iatrogenic perforation. That is why it is important to provide adequate endodontic education for graduating young practitioners. Aim: The aim of this study is to determine the most common locations of the iatrogenic perforations made by last year students in the Dental Faculty in Sofia, Bulgaria, to note the association of particular errors with particular teeth and to determine how this information can improve their education. Methods: All patient records of last-year students for 2015 and 2016 were examined. Perforations were diagnosed by radiography, and also confirmed clinically. Results: From all 778 teeth 30 incidents of root perforations were found: 10 in 2015 and 20 in 2016. More perforations were found in upper posterior teeth- 80% of all the perforations made in 2015, and 45% of all registered perforations in 2016. For the entire period of the research perforation frequency in upper molars, and in upper anterior teeth were found to be significantly higher than in other group of teeth. In academic 2015 year, 8 of the perforations (80%) were furcal. In 2016 year, 11 (55%) of all perforations were apical. Conclusions: More in-depth knowledge of endodontic anatomy , and also more strict supervision on students’ tasks are needed, especially regarding standard root canal treatment on molar teeth.

  • Non-resolving acute sinusitis due to nasal hamartoma: a case report

    The paranasal sinuses are closely related to vital structures, and therefore, rhinosinusitis may lead to various dangerous complications. Nasal chondromesenchymal hamartoma is a rare benign lesion of the sinonasal tract in children and adolescents. We report the case of a 15-year-old patient with antibiotic-refractory acute sinusitis in whom a nasal tumor was identified and histopathologically diagnosed as a hamartoma. Therefore, the tumor was removed surgically to alleviate the patient’s symptoms. This case highlights the necessity of investigating the underlying cause if conventional treatment fails to resolve a mild disease like acute sinusitis. To the best of our knowledge, this is the first reported case of a chondro-osseous respiratory epithelial adenomatoid hamartoma presenting with acute sinusitis.