10 research outputs found
Making a Quality Endoscopy Report
No full textIn 2012, the Canadian Association of Gastroenterology (CAG) published guidelines to address a broad range of issues pertaining to the safety and quality of endoscopic service provision in Canada, including reporting standards for endoscopic procedures. In the current issue of the Canadian Journal of Gastroenterology, Beaulieu et al (pages 286-292) discuss the selection criteria and rationale underlying the specific elements recommended for inclusion in endoscopic
reports.Memorial University Open Access Author's Fun
Melanoma Extracted from the Common Bile Duct
No full textA 54-year old woman presented to hospital with two days of epigastric pain, nausea and vomiting. Her history was significant for malignant melanoma of the right leg, diagnosed five years earlier, with subsequent endometrial, breast, lung and cerebral metastases. Liver enzyme levels were elevated (aspartate aminotransferase 230 IU/L, alanine aminotransferase 336 IU/L), with a total bilirubin level of 178 μmol/L. Computed tomography scanning demonstrated biliary dilation and a distal common bile duct (CBD) mass.Memorial University Open Access Author's Fun
FIT to be Tried
No full textColorectal cancer (CRC) screening has come of age in Canada, with every province now having a screening program either implemented or well underway. These programs are based on the detection of fecal occult blood, with positive results triggering colonoscopy for definitive diagnosis. This approach is supported by high-level evidence demonstrating a mortality benefit for individuals screened in this manner. Fecal occult blood testing (FOBT) uses indirect methods to test for
the presence of hemoglobin, which can be affected by chemicals, such as vitamin C, or heme from other sources such as red meat. In contrast, fecal immunochemical tests (FIT) use an antibody to detect human globin directly. These assays may offer advantages of greater specificity
and sensitivity, and improved adherence. Most FITs produce a visual colour change on a strip to indicate a positive result, but some are analyzed using automated systems in a laboratory to provide a quantitative result.Memorial University Open Access Author's Fun
Refractory vasospasm of the left anterior descending artery causing hemodynamic instability after percutaneous coronary intervention
No full textRefractory coronary vasospastic angina is prone to fatal outcomes. Therefore, it is crucial that the most suitable treatment strategy be promptly elected so as to avert further cardiac complications. Here, authors present the clinical course of profound refractory coronary vasospastic angina in a 50-year-old man. Authors elected to manage the patient through stent implantation. Despite, a complication of perforation followed by refractory coronary vasospasm, authors elected to implant a second stent to relieve the patient from all symptoms
Growth rate of Chir pine ( Pinus roxburghii) trees in Kumaun area in relation to regional climatology.
No full textTemperature range and minimum temperature show highly significant correlations with tree growth parameters during 1924-75.-from Author
Chromosomal variation in man a catalog of chromosomal variants and anomalies
No full textOver 1200 entries to literature (mostly English-language journal articles). Intended for human cytogeneticists. Sources were Current contents, various genetics journals from 1970 to the present, and Excerpta medica and Index medicus for afew earlier references. Entries arranged under sections titled Structural variations and anomalies, Numerical anomalies, and Chromosomal breakage syndromes. Author, selected syndrome indexes
A Case of Collagenous Gastroenteritis with Pseudomembranes
No full textA 51-year-old woman was admitted to hospital with a two-month history of watery diarrhea and 9 kg weight loss. Stool frequency was eight to 10 per day but without blood, steatorrhea or abdominal pain. There was no history of recent antibiotic use or infectious contacts. Her history was significant for type I diabetes mellitus treated with insulin. She was a lifelong nonsmoker who consumed no alcohol. The family history was unremarkable. Physical examination was normal. Laboratory data showed an elevated white blood cell count of 13.3×109/L (normal
range 4.8×109/L to 10.8×109/L), a C-reactive protein level of 15.4 mg/L (normal range 0 mg/L to 8 mg/L) and an albumin level of 19 g/L (normal range 33 g/L to 45 g/L). Her tissue transglutaminase level was 0 U/mL (normal range 0 U/mL to 10 U/mL) with a normal immunoglobulin A
level. Stool testing was negative for bacterial and parasitic pathogens, while Clostridium difficile testing was negative on three separate occasions.Memorial University Open Access Author's Fun
Myriad manifestations of Williams syndrome
No full textAbstract4 months male child presented with failure to thrive. On general examination child had normal O2 saturation with characterstic elfin facies. Further evaluation of the patient showed major manifestations of Williams syndrome in form of supravalvar aortic stenosis, branched pulmonary artery stenosis along with cardiomyopathy. Although the entity is known, this article shows comprehensive diagnostic workup with the aid of multimodality imaging techniques. The genetic diagnosis of Williams syndrome was confirmed using fluroscent in situ hybridisation techniques (FISH). In this patient most of the manifestations of elastin vasculopathy were noted in the form of involvement of ascending aorta, pulmonary arteries and myocardium. We also want to emphasis the importance of echocardiography in newborn patients with dysmorphic facies as Williams syndrome can be easily missed in neonatal period
Anomalous origin of coronary artery from the opposite aortic sinus of Valsalva-a single center experience with a therapeutic conundrum
No full textBackground: Coronary artery anomalies are rare congenital abnormalities, most often found incidentally on conventional coronary angiography and CT angiography (CTA). CTA better delineates the origin and course of anomalous coronaries. Anomalous origin of coronary artery from the opposite aortic sinus of Valsalva (ACAOS) has a prevalence of 1% with a very few having an interarterial (malignant) course. There is limited literature, especially in the Indian population, dealing with this topic.Methods: In this retrospective observational study, angiographic data of 8500 consecutive patients from June 2011 to December 2019 at a large tertiary care hospital in western India was analyzed. Patients diagnosed with ACAOS underwent CTA for delineation of the exact anatomy. Those with a non-malignant course with evidence of ischemia clinically or on stress myocardial perfusion imaging (MPI), underwent PCI. Others with a non-malignant course were medically managed. Patients with malignant (interarterial) course were revascularized by coronary artery bypass graft (CABG) surgery in case of LCA involvement or positive MPI test. Asymptomatic patients with negative MPI were managed medically. Clinical follow-up over 12 months of patients undergoing PCI and those with a malignant course showed no major adverse cardiovascular events (MACE).Results: Of the 8500 patients studied, 74 (0.87%) had ACAOS. Of these, 51 (68.9%) patients had anomalous origin of right coronary artery (RCA) from the left aortic sinus, 21 (28.4%) had anomalous origin of the circumflex artery (Cx) from the right aortic sinus and two patients (2.7%) had an anomalous origin of the left main coronary artery (LCA) from the right aortic sinus. Interarterial course was found in five (6.7%) patients. Of these, four patients underwent CABG-one asymptomatic patient with LCA from right aortic sinus and three with positive MPI in anomalous RCA. All five patients with malignant course and ten patients who underwent PCI were free of MACE over 12 months’ clinical follow up.Conclusions: ACAOS is a rare anomaly and if interarterial course is excluded, then PCI is feasible in selected cases with significant stenosis. Patients with malignant course with inducible ischemia or LCA involvement should undergo surgical revascularisation
