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  • ISSN: 2373-9819
    Volume 2, Issue 4
    Yenamandra A*, Gardner-Hollis A, Zhao K and Barba E
    Over the past several years Cancer cytogenetics involving recurring chromosome abnormalities has evolved in the understanding of hematologic malignancies. Recurring non-random clonal cytogenetic changes have been identified in specific morphologic tumor types. In a multidisciplinary approach to patient care, Cytogenetics, Fluorescence in Situ Hybridization (FISH) and Chromosomal Microarray (CMA) play a crucial role in contributing to diagnosis, prognosis, and genotype-specific therapy decisions for clinicians in the management of hematological neoplasm.
    Clinical Image
    Tariq Khurram1*, Farhangi Arezo2 and Rana Fauzia1
    Abstract: Psoriasis is an immune mediated, chronic inflammatory, incurable condition of the skin that affects 2-3% of the population globally. It is associated with red, thick, scaly lesions [1], is more common in patients on higher latitudes, in Caucasians and may manifest itself with an underlying arthropathy. Psoriasis has a spectrum of presentations ranging from localized, mild disease to involvement of more than 90% of the body's surface called erythrodermic form [2].
    Case Report
    George Mansou1, Hamza Tantoush1, Ahmad Abuzaid1, Haitham Al Ashry1 and Pallavi Bellamkonda2*
    Abstract: Transient Global Amnesia is an acute onset of Anterograde and retrograde memory loss, with unknown etiology [1]. Attacks can occur during stressful periods, exertion, or with emotional circumstances, as long as some other aggravators such as immersion into cold water, and sexual intercourse [2]. Cognitive functions other than memory, specifically self-awareness, are spared [3].
    Marijuana use has been linked to transient global amnesia in some cases [4-6], presumably through the effect of Δ9- Tetrahydrocannabinol (THC) on the Cannabinoid receptors (CB1) that are located presynaptically in the lipid membranes of neurons, which results in neuromodulation with changing the number of neurochemicals such as glutamergic, GABAergic, and cholinergic systems, all of which end up affecting the memory [7].
    Charles A Cefalu* and Jean E Cefalu
    Abstract: John Foster, a 59 year old Caucasian male and highly successful businessman, was sitting in his home office one afternoon in late September 2012 when he developed a rapid heartbeat. Waiting to see if it would stop, he noted it to be in the range of 150 beats per minute. He decided to go to the emergency room in his local town but the tachycardia abated prior to his getting out of his car. He also at the same time began having increased anxiety.
    Timo Stübig*, Sebastian Decker, Stephan Brand, Martin Panzica, Christian Krettek and Christian W Müller
    Object: We describe the surgical treatment of a 44 year old woman presenting with spondylodiscitis from C4 to C6 and incomplete tetraparesis. She was transferred to our hospital after incomplete cervical decompression from C3-6 in a county hospital. Our therapy regimen was performed in 3 stages: First wie performed an implant removal and external fixation using a halofixateur with microbial eradication followed by anterior fusion and finally navigated posterior stabilization and fusion from C3 to C7. This is the first documented case of computer navigated posterior CT-based fusion in multilevel cervical spondylodiscitis. The postoperative CT showed a correct implant positioning, the initial neurological symptoms decreased during the admission in our hospital and thereafter.
    Wendy Gu1, Adam Cheng2, Heather Barnes1, Brooks Kuhn1, Michael Schivo1*
    Vitamin C deficiency generally results from little to no intake of ascorbic acid, and it often presents with small-volume bleeding. Rarely vitamin C deficiency causes hemodynamically significant bleeding. Here we present a middle-aged man who was admitted to the hospital several times for hypotension, recurring lower extremity ecchymoses, and persistent anemia. Extensive workup from previous hospitalizations did not identify the etiology of his recurrent bleeds. Ultimately a detailed dietary history uncovered a lack of fresh fruit and vegetable intake. Vitamin C deficiency was suspected and subsequently confirmed. After receiving multiple blood transfusions to correct his hypovolemic hypotension, he was treated with high-dose ascorbic acid. This case highlights the potential damage of vitamin C deficiency in the industrialized world, and it reminds clinicians to be vigilant of this rare but significant cause of anemia.
    Carmen Luraschi-Monjagatta1*, Mohammed Alzoubaidi2, Varun Takyar3, Seth Assar3, Farhad Sahebjam3 and Linda Snyder2
    Abstract: Cryptococcus neoformans is encapsulated yeast, which causes significant infections in immune compromised individuals, with a very high morbidity and mortality. We present a case of disseminated cryptococcal infection with peritonitis in a 33 year-old female patient with a history of alcoholic liver cirrhosis, complicated by hepato-renal syndrome. She presented to the Emergency Department with altered mental status and was found to have spontaneous peritonitis, with elevated leukocyte count in the ascitic fluid. She developed septic shock requiring significant vasopressor support and renal replacement therapy. She had multiple recent admissions for treatment of hepatic encephalopathy and her Model for End Stage Liver Disease score on admission was 38. She was initially started on broad-spectrum antibiotics with vancomycin and imipenem as well antifungal therapy with fluconazole. The blood and peritoneal fungal cultures grew Cryptococcus neoformans. The patient developed multi-organ failure with refractory shock, acute respiratory distress syndrome and disseminated intravascular coagulopathy. Given the grave prognosis, the patient's family decided on a palliative care approach and the patient died.
    Cryptococcal peritonitis is a rare manifestation of disseminated cryptococcal infection and its clinical presentation may be similar to that of spontaneous bacterial peritonitis. The ascitic fluid cell count can be either polymorphonuclear or lymphocyte predominant. Early clinical suspicion, isolation of the organism and timely initiation of appropriate antimicrobial therapy are crucial.
    Neonatal Appendicitis – an Uncommon Diagnosis, not to be Forgotten
    Abstract: Acute appendicitis is a common disease in older children, but extremely rare in the neonate. Nevertheless, the true incidence might be underestimated, given the difficulty of the diagnosis. Subtle clinical signs and symptoms usually result in high morbidity and mortality due to delayed diagnosis and surgical intervention. The presentation of neonatal appendicitis can be identical to necrotizing enterocolitis, leading to misdiagnosis. Appendicitis should therefore be considered in the differential diagnosis for necrotizing enterocolitis and needs strong clinical suspicion.
    We report a case of a premature newborn who presented with vomiting, abdominal distension and free intra-peritoneal air on plain x-ray. He was initially diagnosed and treated as necrotizing enterocolitis, but the absence of clinical improvement with standard treatment led to exploratory laparotomy. Surgical exploration revealed an acutely inflamed appendix with normal small and large intestines and appendectomy was performed. The post-operatory period was uneventful and the infant was discharged home. Follow-up confirmed a normal growth and neurodevelopment.
    We herein report this case in order to raise awareness to this unusual pathology, so that an early diagnosis and treatment can lead to a better outcome, improving survival rate and reducing long term morbidity. We believe uncommon pathologies, like neonatal appendicitis, should be reported to facilitate proper epidemiologic studies.
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