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Self-Organizing Tangled Magnet Buildings in Plasma tv's.
82 mL (95% CI 9.9-75.7). Conclusion Ultrasound guidance reduces the dosage of local anesthetic drugs to be used and provides surgical anesthesia without any complications or adverse effects.Ventricular assist device (VAD) pump thrombosis is a known complication and while the preferred standard treatment is surgical pump exchange this procedure is not without risk and for some patients the risks are prohibitive. This is a case of a 68-year-old female with bilateral HeartWare ventricular assist devices (HVAD) implanted as destination therapy who presented with signs of recurrent pump thrombosis. Surgical pump exchange was deemed to confer prohibitive risk due to her underlying medical co-morbidities and therefore not an option for treatment. read more After careful consideration of possible options for treatment, she received systemic thrombolysis (Alteplase 5 mg IV bolus followed by 3 mg/hour infusion for 10 hours through a central line) which was successful. This case highlights, not only the rarity of bilateral VADs as destination therapy, but also demonstrates the safety and efficacy of using systemic thrombolytics in patients with bilateral HVADs for treatment of pump thrombosis.Adamantinoma-like Ewing sarcoma (ALES) is a rare variant of Ewing sarcoma. It demonstrates heterogeneous morphologic pattern and complex immunophenotypic profile, with a peculiar combination of epithelial and neuroendocrine differentiation. ALES is rarely reported in the head and neck areas, including the parotid salivary gland. Till now, only 10 cases of ALES have been reported in the salivary glands. Herein, we report two cases of ALES involving the parotid gland, adding some valuable insight to the recently reported cases at this site.This is a report of rare cases of full-term infants born with persistent tunica vasculosa lentis (TVL) with no retinopathy of prematurity (ROP) and no plus disease. This condition can be mistaken with iris vascular enlargement-associated plus disease, leading to unnecessary laser or intravitreal injections. The cases were treated with close observation, which resulted in complete resolution of the TVL. In conclusion, we encourage the diagnosis of TVL and careful monitoring of such cases before the intervention, as the condition may revert completely.Introduction The prevalence of marijuana use has increased by about 16% since 2006, translating to approximately 200 million people worldwide. Being so widely used, long-term effects of marijuana use on cardiovascular health are largely unknown. Previous studies have had conflicting results, either showing marijuana use having a negative impact or no significant impact on cardiovascular health. This study aims to add evidence regarding the impact marijuana use has on the prevalence of cardiovascular disease. Methods This retrospective study was conducted using the Behavioral Risk Factor Surveillance System (BRFSS) database. Patients who completed the questionnaire and answered all questions in relation to marijuana use and the diagnosis of cardiovascular disease in 2017 were a part of this study. Subjects were excluded if they were children ( less then 18 years old) or had missing data for marijuana use or cardiovascular disease. Age, gender, race/ethnicity, body mass index (BMI), income, exercise, tobacco uslends support to the notion that marijuana use does not have an association with cardiovascular disease. A limitation in our study was that there was missing data from the BRFSS questionnaire due to participants not fully answering all questions concerning cardiovascular disease and marijuana use. This decreased our sample size from 67,974 to 56,742 subjects. The missing participants led to a decrease in the power of our odds ratio, which may have impacted statistical significance of our results. Conclusion Although previous literature has shown that marijuana use has a negative impact on cardiovascular health, our study suggests that users and non-users of marijuana did not have an association with the prevalence of cardiovascular disease. Varying levels of support within the literature highlights the need for further research of this association.
We report and analyze eight cases in which patients were referred from gastroenterology (GI) to otolaryngology following esophagogastroduodenoscopy (EGD). We aim to provide specific examples of head and neck pathology encountered by gastroenterologists during upper endoscopy.

A series of eight cases between 2016 and 2019 were analyzed by chart review. In each case, otolaryngology consultation was requested after an abnormality was noticed by a gastroenterologist during EGD. Subsequent laryngoscopy or bronchoscopy was performed in all cases allowing for image comparison.Select images comparing EGD to laryngoscopy findings are included as well as a literature review concerning the nature of communication between the two specialties.

Eight adult patients were referred to otolaryngology for abnormalities noted by a gastroenterologist during EGD at the following anatomic sites soft palate (n=1), base of tongue (n=2), glottis (n=3), and interarytenoid mucosa (n=1). Additionally, a potential airway foreign boder-specialty anatomic knowledge gaps were noted which contributed to occasional unnecessary referrals, procedures, and associated patient anxiety. We hope that the results of this study can inform future research aimed at improving communication and collaboration between the two specialties.Rothmund-Thomson syndrome (RTS) is an exceedingly infrequent genetic disorder characterized by a multitude of skin findings collectively known as poikiloderma. In normal cells, the RECQL4 gene is involved in DNA replication and repair. RTS is caused by a mutation in the RECQL4 gene, which results in increased predilection to develop various malignancies. Osteosarcomas and skin cancers are typically associated with this syndrome. We present a rare case of signet-ring cell gastric adenocarcinoma in a patient with RTS.Pulmonary tuberculosis (TB) is one of the top 10 leading causes of death in the world. Multi-drug resistant TB can lead to short-term and long-term sequelae causing clinical, psychosocial, and financial burden on the diseased. Pregnancy in a woman with compromised pulmonary function is a challenge for the treating obstetrician. A multidisciplinary approach involving a respiratory physician, pre-conceptional counseling, and delivery at a tertiary care center can reduce maternal morbidity and mortality. Compliance with anti-tubercular treatment with regular follow-up can minimize the long term effects of pulmonary TB. We report a case of unilateral lung collapse due to multidrug-resistant pulmonary TB in pregnancy with good maternal and fetal outcomes.
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