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Proc (Bayl Univ Med Cent) 2018 Jul 1;31(3):389-400. Epub 2018 Jun 1.

Proc (Bayl Univ Med Cent) 2018 Jul 17;31(3):386-387. Epub 2018 May 17.

Piedmont Heart Institute, Atlanta, Georgia.

A young Amerasian woman developed transient ischemic attacks related to a patent foramen ovale. Her background personal story, involving being willed from her dying grandmother to a US photographer and attempting to find her serviceman father, has led to a book and a TED talk. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 18;31(3):385. Epub 2018 May 18.

Division of Cardiology, Scott and White Medical Center, Temple, Texas.

Proc (Bayl Univ Med Cent) 2018 Jul 14;31(3):380-384. Epub 2018 May 14.

Department of Medicine, Texas A&M Health Science Center College of Medicine, Temple, Texas.

Most teams in hospital medicine are ad hoc, meaning that the teams vary in participants. Ad hoc teams can be found in academic teaching hospitals where team members change across shifts and rotations. Due to varying team membership, these teams face significant hurdles, because they lack an opportunity to develop a team identity, shared mental models, and trust. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 17;31(3):378-379. Epub 2018 May 17.

Division of Cardiology, Scott & White Memorial Hospital, Temple, Texas.

Proc (Bayl Univ Med Cent) 2018 Jul 1;31(3):376-377. Epub 2018 Jun 1.

Proc (Bayl Univ Med Cent) 2018 Jul 14;31(3):372-374. Epub 2018 May 14.

TOC Eye and Face, Austin, Texas.

We present a case of a 36-year-old man who developed rapid onset of proptosis and orbital compartment syndrome resulting in no light perception vision. He was treated with surgery and subsequent rituximab therapy with some recovery of vision and motility. Though the range of presentations of idiopathic orbital inflammation is broad, such rapid evolution of proptosis with complete vision loss is very uncommon. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):370-371. Epub 2018 May 9.

Department of Anesthesiology, Baylor Scott and White Health, Temple, Texas.

Chronic refractory angina pectoris (AP) affects 600,000 to 1,800,000 Americans, with approximately 50,000 new cases annually. A recent study revealed long-term mortality of refractory AP to be lower than previously reported, with >70% of patients living >9 years. Treating AP can improve quality of life. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):367-369. Epub 2018 May 9.

Department of Family and Community Medicine, Baylor Scott & White Health, and College of Medicine, Texas A&M Health Science Center, Temple, Texas.

A previously healthy 3-month-old girl was admitted to the hospital after 1 day of fever, decreased oral intake, irritability, lethargy, and decreased activity. Examination disclosed a bulging anterior fontanelle, tachycardia (heart rate of 160 beats/minute), and urate crystals in her diaper. Lumbar puncture revealed meningitis. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 22;31(3):364-366. Epub 2018 May 22.

Division of Rheumatology, Department of Medicine, University of Florida, Jacksonville, Florida.

Chemotherapy-induced acral erythema has been a known side effect of intravenous dosing but has not been reported with oral therapy. Herein we describe two patients receiving treatment with low-dose oral methotrexate who presented with acral erythema. Clinicians and rheumatologists should be aware of this potentially serious side effect of oral chemotherapy in various patient populations. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 26;31(3):362-363. Epub 2018 Apr 26.

Department of Nursing, University of San Francisco School of Nursing, San Francisco, California.

Malignant tumors composed of both epithelial and melanocytic populations are exceedingly rare. Because the etiology of these malignant tumors is not yet defined, several authors have argued for the continued cataloging of these lesions. We present a 67-year-old man with a suspicious-appearing lesion on the right forearm; initial biopsy was consistent with a pigmented basal cell carcinoma. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 14;31(3):359-361. Epub 2018 May 14.

Department of Pathology, Baylor University Medical Center, Dallas, Texas.

Secondary involvement of the gastrointestinal (GI) tract by renal cell carcinoma is rare. We undertook a retrospective review of our institution's pathology records from January 2006 to July 2017 and identified eight cases of GI tract involvement by renal cell carcinoma. Sites of involvement included stomach, duodenum, jejunum, ileum, and cecum. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 10;31(3):355-358. Epub 2018 May 10.

Department of Graphic Communications, McGovern Medical School, UT Health, Houston, Texas.

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):352-354. Epub 2018 May 9.

Texas A&M College of Medicine, Temple, Texas.

Neuroendocrine tumors are a rare subset of breast carcinomas. Commonly, platinum-based doublet is used as a systemic treatment option for high-grade neuroendocrine carcinomas from lung, gastrointestinal, and genitourinary origins. In comparison to other breast cancers, neuroendocrine carcinomas have unique genomic features and different treatment strategies. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 25;31(3):350-351. Epub 2018 Apr 25.

Department of Hematology-Oncology, Baylor Scott and White Temple, Temple, Texas.

Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of widespread inflammation due to massive amounts of cytokines released from activated macrophages. The most common trigger for HLH is infection from a virus, most commonly Epstein-Barr virus. Here we report an adult case of this rare and life-threatening syndrome. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):347-349. Epub 2018 May 9.

Department of Dermatology, Baylor University Medical Center, Dallas, Texas.

We report the first case of a 34-year-old woman with histiocytoid Sweet syndrome (HSS) that was successfully treated with etanercept. HSS is a rare histological variant of acute febrile neutrophilic dermatosis that was described by Requena et al in 2005. It is distinguished by dermal infiltration by mononuclear cells with a histiocytic morphology. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 16;31(3):345-346. Epub 2018 May 16.

Department of Internal Medicine, State University of New York Upstate Medical University, Syracuse, New York.

A 61-year-old woman with rheumatoid arthritis on chronic immunosuppression presented with fever. Laboratory studies demonstrated multiorgan failure with pancytopenia, elevation in liver function studies, and an elevated ferritin level, with a diagnosis of hemophagocytic lymphohistiocytosis confirmed on bone marrow biopsy. After initial treatment with chemotherapy, fungal blood cultures grew , prompting initiation of antifungal therapy, which resulted in successful treatment of -associated hemophagocytic lymphohistiocytosis. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 15;31(3):342-344. Epub 2018 May 15.

Department of Radiology, Baylor University Medical Center, Dallas, Texas.

Though hemorrhaging pelvic arteries can be treated with transcatheter arterial embolization, difficulty in selection of injured arteries can lead to increased morbidity and mortality due to embolization of untargeted vasculature and prolonged time to hemostasis, resulting in unnecessary ischemic injury and prolonged hemorrhage. This report describes a balloon occlusion technique utilized in the setting of an unselectable hemorrhaging obturator artery. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 25;31(3):339-341. Epub 2018 Apr 25.

Department of Radiology, Baylor University Medical Center, Dallas, Texas.

A 40-year-old woman presented to our stroke center for a left middle cerebral artery embolic occlusion. This was successfully treated with mechanical thrombectomy using a stent retriever and balloon guide catheter aspiration. The patient was discharged home in good condition on clopidogrel but returned 2 months later with a contralateral right middle cerebral artery embolic occlusion. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 11;31(3):337-338. Epub 2018 Apr 11.

Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana.

Proc (Bayl Univ Med Cent) 2018 Jul 15;31(3):334-336. Epub 2018 May 15.

Division of General Medicine, Department of Internal Medicine, Texas Tech University Health Science Center Paul L. Foster School of Medicine, El Paso, Texas.

The abuse of anabolic androgenic steroids (AAS) has remained on the rise despite their well-known deleterious effects. We describe a case of AAS-induced multisystem failure following an extensive history of abuse in a 41-year-old bodybuilder. Furthermore, we review pertinent literature and discuss the different pathophysiologic mechanisms through which AAS affect the heart and other organs. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):331-333. Epub 2018 Apr 9.

Cardiovascular Sciences Department, Catholic University of The Sacred Heart, Agostino Gemelli Policlinic, Rome, Italy.

An association between atrial myxoma and left ventricular failure is rarely described, is not completely understood, and may have multiple etiologies. We present a 49-year-old man with no history of cardiovascular disease who was admitted to our hospital with pulmonary edema. He was in atrial fibrillation with rapid ventricular response. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):328-330. Epub 2018 May 9.

Department of Cardiology, State University of New York Upstate Medical University, Syracuse, New York.

Flecainide, a class Ic antiarrhythmic, is used for the prevention of paroxysmal supraventricular tachycardia, paroxysmal atrial fibrillation/flutter, and sustained ventricular tachycardia. Flecainide is primarily metabolized by the liver and to a lesser extent (30%) is excreted unchanged in the kidney. We present a case of flecainide toxicity in the setting of renal impairment that was successfully treated with intravenous sodium bicarbonate. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 26;31(3):326-327. Epub 2018 Apr 26.

Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York.

Chylous ascites is an uncommon finding of triglyceride-rich lymph in the peritoneal cavity. There are a variety of reported etiologies for chylous ascites; however, the reporting of chylous ascites among AIDS/HIV-positive patients is quite uncommon. This finding as a complication of immune reconstitution inflammatory syndrome is even more unusual. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):324-325. Epub 2018 May 9.

Department of Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Acute pancreatitis is an inflammatory condition of the pancreas manifesting with abdominal pain and elevated serum levels of pancreatic enzymes. Gallstones and chronic alcohol use are the most commonly described causes. A less studied cause is cholesterolosis, gallbladder polyps that cause mechanical obstruction of the sphincter of Oddi. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):321-323. Epub 2018 May 9.

Department of Family and Community Medicine, Baylor Scott & White Health and College of Medicine, Texas A&M Health Science Center, Temple, Texas.

Dabigatran, a new oral anticoagulant, is a direct thrombin inhibitor used as an alternative to warfarin to reduce the risk of stroke and systemic embolism with nonvalvular atrial fibrillation. We report a case of a man who resumed dabigatran after 6 weeks of prior therapy and began experiencing hematuria with worsening kidney function. Renal biopsy with immunofluorescence and electron microscopy showed mesangial deposits consistent with immunoglobulin A nephropathy. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 14;31(3):319-320. Epub 2018 May 14.

Department of Emergency Medicine, Scott & White Medical Center, Temple, Texas.

Gastroenteritis is a common illness in the pediatric population. Clinicians must be able to recognize severe disease in the milieu of common presentations. All forms of gastroenteritis can lead to significant dehydration and sequelae when considering causes. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 25;31(3):317-318. Epub 2018 Apr 25.

Department of Medicine, Baylor Scott and White Temple, Temple, Texas.

We present a case of splenic abscess as a probable complication following endoscopic retrograde cholangiopancreatography (ERCP). Based on a literature review, there have been 11 documented cases of splenic injury following ERCP; however, only one of those involved splenic abscess. Proposed mechanisms of injury and abscess are likely a combination of complicating factors, including manipulation of the endoscope in patients with a history of chronic pancreatitis and/or previous abdominal surgeries. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 21;31(3):310-316. Epub 2018 May 21.

Department of Pathology, Baylor University Medical Center, Dallas, Texas.

It is generally assumed that blind insertion of nasogastric tubes for enteral nutrition in patients admitted to medical intensive care units is safe; that is, does not result in life-threatening injury. If death occurs in temporal association with insertion of a nasogastric tube, caregivers typically attribute it to underlying diseases, with little or no consideration of iatrogenic death due to tube insertion. The clinical and autopsy results in three recent cases at Baylor University Medical Center challenge the validity of these notions. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 10;31(3):307-309. Epub 2018 May 10.

Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas.

Proc (Bayl Univ Med Cent) 2018 Jul 1;31(3):303-306. Epub 2018 Jun 1.

Gulfstream Diagnostics, LLC, Dallas, Texas.

AH-7921 is a synthetic opioid that was developed in the early 1970s. It has resulted in several fatal and nonfatal intoxications, despite not having approval from the US Food and Drug Administration. To date, AH-7921 is listed as a schedule I drug, and there have been no clinical trials exploring the safety of AH-7921. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 1;31(3):297-302. Epub 2018 Jun 1.

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

Ascites is a debilitating condition affecting patients with end-stage liver disease and advanced abdominal malignancies. Serial paracentesis can reduce symptoms in these patients; indwelling peritoneal catheters provide an alternative approach that allows patients to manage their symptoms at home. A literature search was conducted to identify studies with at least 20 patients published in the last 15 years that reported indwelling catheter placement in patients with chronic ascites. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 26;31(3):294-296. Epub 2018 Apr 26.

School of Public Health, University of North Texas, Fort Worth, Texas.

A community clinic in Puerto Rico, the Bantiox Clinic, was developed to serve the medical needs of Toa Baja and the surrounding communities after Hurricanes Irma and Maria in response to an urgent need for medical treatment of the community residents. Within 4 months, the clinic had 4941 total visits. The Toa Baja residents used the clinic more than the offsite residents. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):289-293. Epub 2018 Apr 9.

Department of Obstetrics and Gynecology, Scott & White Medical Center, Temple, Texas.

To determine intraabdominal pressure (IAP) in women during CrossFit and to determine whether parity, age, or CrossFit experience affects IAP during CrossFit exercises, we evaluated 10 women: 5 experienced and active CrossFitters and 5 who were not regularly engaged in CrossFit. A Laborie urodynamics abdominal pressure probe with the Goby wireless system measured IAP during 10 repetitions of 13 different CrossFit exercises. Women had a mean age of 36 years. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 21;31(3):284-288. Epub 2018 May 21.

Baylor Heart and Vascular Institute, Dallas, Texas.

Familial chylomicronemia syndrome (FCS) is a rare lipid disorder posing significant clinical burdens on patients. Due to its rarity, variety of presentations, and lack of universal diagnostic criteria, patients see an average of five physicians before diagnosis. We screened adults for a triglyceride level ≥1000 mg/dL from September 2015 to September 2016 and a history of pancreatitis and performed a thorough chart review on those who met the criteria. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 14;31(3):280-283. Epub 2018 May 14.

Division of Cardiology, Baylor University Medical Center, Dallas, Texas.

Radiofrequency catheter ablation of the cavotricuspid isthmus is a proven therapy for typical atrial flutter (AFl); however, in some patients, new atrial arrhythmias (AA) may occur after AFl ablation. This study explored the difference in the occurrence of spontaneous AA after AFl ablation as a function of the patient's presenting rhythm on the day of the AFl ablation. A retrospective study of consecutive patients who underwent AFl ablation at Baylor University Medical Center at Dallas was performed. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 10;31(3):276-279. Epub 2018 Apr 10.

Department of General Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.

Elevated serum pancreatic enzymes have been described among patients with small bowel obstruction (SBO) initially misdiagnosed as having pancreatitis. We studied whether serum lipase elevation carries prognostic value in patients with SBO. Patients with SBO and at least one serum lipase level measured were included. Read More

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):269-275. Epub 2018 May 9.

Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor Scott & White Health, Temple, Texas.

Acid-base status is frequently assessed in severe sepsis and septic shock. Venous blood gas sampling is proposed as a less-invasive modality but lacks evidence within this population. The objective of this study was to evaluate the correlation and agreement between arterial blood gas (ABG), peripheral venous blood gas (pVBG), and central venous blood gas (cVBG) in severe sepsis and septic shock. Read More

Proc (Bayl Univ Med Cent) 2018 Apr 11;31(2):257-267. Epub 2018 Apr 11.

Proc (Bayl Univ Med Cent) 2018 Apr 11;31(2):255-256. Epub 2018 Apr 11.

Proc (Bayl Univ Med Cent) 2018 Apr 11;31(2):253. Epub 2018 Apr 11.

Piedmont Heart Institute, Atlanta, GA.

Proc (Bayl Univ Med Cent) 2018 Apr 11;31(2):253. Epub 2018 Apr 11.

Dr DY Patil University, Navi Mumbai, India.

Proc (Bayl Univ Med Cent) 2018 Apr 20;31(2):250-252. Epub 2018 Mar 20.

From Leesburg, Virginia.

Proc (Bayl Univ Med Cent) 2018 Apr 11;31(2):244-249. Epub 2018 Apr 11.

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

The have a significant role in mythology, religion, folklore, and literature. In the 1800s, the word was used to describe reanimated corpses in the Caribbean who often worked on plantations doing long, arduous field work. The movie was released in 1932 and exploited this folklore, but it ignored the fact that zombies represent one outcome in Vodou religious beliefs regarding death and the migration of spirits following death. Read More

Proc (Bayl Univ Med Cent) 2018 Apr 20;31(2):240-243. Epub 2018 Mar 20.

Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.

Primary health care provided by an integrated treatment team (e.g., physician, nurse, behavioral health specialist) is becoming increasingly common. Read More

Proc (Bayl Univ Med Cent) 2018 Apr 15;31(2):238-239. Epub 2018 Mar 15.

Division of Cardiology, Baylor Heart and Vascular Hospital, Baylor University Medical Center, and Texas A&M College of Medicine, Dallas, Texas.

Proc (Bayl Univ Med Cent) 2018 Apr 1;31(2):235-237. Epub 2018 Mar 1.

Division of Cardiology, The Texas Heart Hospital Baylor Plano, The Texas Heart Hospital Baylor Plano, The Texas Heart Hospital Baylor Denton, and Baylor University Medical Center and Baylor Heart and Vascular Hospital, Dallas, Texas.

Proc (Bayl Univ Med Cent) 2018 Apr 20;31(2):231-234. Epub 2018 Mar 20.

Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

Fading from the vernacular, the Latin phrase is a quaint, mystifying, and fascinating term that is translated as . There is a fulminating paucity of published information regarding the meaning of this term and the etymology. Trauma surgeons, military surgeons, and scholars of the medical aspects of the civil war may be familiar with the term. Read More

Proc (Bayl Univ Med Cent) 2018 Apr 11;31(2):229-230. Epub 2018 Apr 11.

Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

Proc (Bayl Univ Med Cent) 2018 Apr 12;31(2):227-228. Epub 2018 Mar 12.

Department of Hematology and Oncology, Utica Park Clinic Oncology, Tulsa, Oklahoma.

Vitamin C deficiency may be common in third-world countries due to malnutrition, but it is currently rare in the USA. Initially, nonspecific symptoms like exhaustion and depression may make this disease difficult to diagnose until classical dermatological manifestations appear. Diagnosis mainly relies on clinical presentation, dietary history to identify risk factors, and dramatic recession of symptoms and signs following vitamin C therapy. Read More