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  • ISSN: 2373-9819
    Volume 4, Issue 3
    Case Report
    Wei Feng*
    The annual incidence of sudden cardiac death (SCD) in the general population is 0.1%. SCDs in the young are mainly caused by genetic heart disorders which can lead to inherited arrhythmia syndromes, such as long QT, short QT and Brugada syndromes. One of the most effective therapies for this disease is implantable cardioverter defibrillators (ICD). In this article, we reported a case of 46 years old patient with repeated syncope. Investigation of the family history we found a familial SCDs and the members died in 28.5 years old on average and all of them were male.
    Ali S. Haider BS, Maryam Alam, Ebun Adetutu, Richa Thakur, Caleb Gottlich, Danielle L. DeBacker, and Lianne Marks*
    Hashimoto's encephalopathy (HE) , also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), can be a debilitating manifestation of an autoimmune reaction against the thyroid that is often under diagnosed due primarily to a lack in definitive diagnostic criteria. This is a case of a 52 year old woman who has been diagnosed with HE after presenting with recurrent and severe psychosis in conjunction with paranoia and a thyroidopathy. Her symptoms are chronic, having been first documented as presenting 15 years earlier and showing progressive worsening in both frequency and severity. The patient's paranoia often manifested as delusions involving family members or close friends and introduced opportunity for injury for herself and others, such as self-mutilation or brandishing a gun. She showed great conviction with self-diagnoses that were proved incorrect, resulting in occasional non-compliance. Between episodes the patient did not show evidence of symptoms. This patient struggled with several incorrect diagnoses and treatments for years before the correct diagnosis of HE was made, and demonstrated extreme improvement upon corticosteroid administration. This case illustrates the importance of increasing awareness of HE as well as including HE in a differential diagnoses when any patient that presents with psycosis and concurrent thyroidopathy. Hahimoto's encephalopathy follows putative charactieristics of autoimmune diseases, exhibiting a higher incidencein women as compared to men, presenting with increased titers of auto-antibodies, and showing amelioration when treated with corticosteroids.
    Ronald Jaison Melit*, Siju V. Abraham, Krishna Das, Vivek Gopinathan, and Vimal Krishan S
    We report a case of an 85 year old female, with signs of neurotoxicity following snake bite who later developed an acute myocardial infarction. This unusual case highlights the importance of diagnosis and management of myocardial infarction that simultaneously present in a victim of snake bite.
    Luis Fernando Gonzalez-Ciccarelli*, Sofia Esposito, Antonio Bevere, and Pier Cristoforo Giulianotti
    Background: Gold standard treatment for Primary hyperparathyroidism (PHPT) is surgical resection of the adenoma, which in nearly 22-25% of the cases is ectopic. The evolution of preoperative imaging techniques, in association with the intraoperative PTH measurement (IOPTH) have led to the development of minimally invasive targeted approaches for the management of PHPT. We hereby report a case of a mediastinal parathyroid adenoma removed using the robotic-assisted transaxillary approach.
    Case presentation: A 46-year-old female presented with PHPT caused by a parathyroid ectopic adenoma located in the upper mediastinum, adjacent to the left sternal notch. We performed a robotic transaxillary parathyroidectomy, with IOPTH measurement. Total operative time was 97 minutes, with no complications. The patient was discharged the next day. At one month follow up total serum calcium was between normal ranges.
    Discussion: The Robotic transaxillary approach for parathyroid adenoma has been recently described in literature providing promising results. This procedure completely avoids a scar in a visible area such as the neck and can be performed without the need for gas insufflation. This procedure is particularly recommended in selected patients with history of keloid or hypertrophic scar formation or deeply concerned about the cosmetic outcomes. Robotic-assisted surgery allows fine dissection with better control of the instruments even in narrow spaces.
    Conclusion: The role of the transaxillary approach in ectopic mediastinal parathyroid adenoma is still under evaluation, but in our opinion, it represents a valid option in case of a well localized single adenoma in the upper mediastinum.
    Case Series
    Omer Bayir, Tugba Karagoz*, Unsal Han, Guleser Saylam, Emel Cadalli Tatar, Ali Qzdek, and Mehmet Hakan Korkmaz
    Sarcomas account for a very small percentage of the head and neck malignancies in adults Laryngeal sarcomas represent 1% of all laryngeal malignancies. Chondrosarcoma is the most common laryngeal sarcoma, and originates mostly from the cricoid cartilage. Less than 3% of all cervicocephalic rhabdomyosarcomas is located in the larynx and laryngeal rhabdomyosarcoma is characterized by less aggresive spread than other rhabdomyosarcomas. Pleomorphic variant of rhabdomyosarcoma is usually encountered in adults. Laryngeal sarcomas have different prognosis and treatment approaches than squamous cell cancers. In this presentation, we discussed the clinical and histopathological features of four laryngeal sarcoma cases; which 2 were diagnosed as chondrosarcoma of arytenoid and cricoid cartilage, and 1 was as spindle cell rhabdomyosarcoma originating from aryepiglottic fold, and 1 pleomorfic variant of rhabdomyosarcoma.
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