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Hot Aortic Nodules

Alexander Muacevic, John R Adler, Erik Soule, Quoc-Han Nguyen, Mario Dervishi, Jerry Matteo, Savas Ozdemir,

Atherosclerotic cardiovascular disease is the leading cause of death worldwide. Morbidity of the dreaded thrombotic complications of atherosclerosis such as cerebrovascular accident and myocardial infarction may be severe. Early detection of fulminant disease is therefore important for risk stratification and selecting a treatment strategy. In this report we present four ... Read more >>

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Current Knowledge of Breastfeeding Among Health Workers in a Developing Country Setting: A Survey in Calabar, Nigeria

Alexander Muacevic, John R Adler, Joanah M Ikobah, Offiong Ikpeme, Ogban Omoronyia, Nnette Ekpenyong, Ekong Udoh,

Background Health workers are in a strategic position to provide correct information to mothers on breastfeeding practice. This study assessed knowledge of breastfeeding among health workers in health facilities in Calabar. Methods This was a cross-sectional descriptive study. A 45-item self-administered questionnaire was used to obtain data. Ethical clearance for the ... Read more >>

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Global Interest in Telehealth During COVID-19 Pandemic: An Analysis of Google Trends™

Alexander Muacevic, John R Adler, Shajeea Arshad Ali, Taha Bin Arif, Hira Maab, Mariam Baloch, Sana Manazir, Fatima Jawed, Rohan Kumar Ochani,

Background Since the outbreak, healthcare systems across the globe are overcrowded with coronavirus disease (COVID-19) patients. To sustain the response towards the pandemic, many hospitals have adapted to virtual healthcare and telemedicine. Google™ has become the most widely used search engine over the years. Google Trends™ can be used to depict ... Read more >>

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Artificial Intelligence in Various Medical Fields With Emphasis on Radiology: Statistical Evaluation of the Literature

Alexander Muacevic, John R Adler, Emre Pakdemirli, Urszula Wegner,

Background Artificial intelligence (AI) has significantly impacted numerous medical specialties with high emphasis on radiology. Associated novel diagnostic methods have become a rapidly emerging hot topic, and it is essential to provide insights into quantitative analysis of the growing literature. Purpose The purpose of this study is to highlight future ... Read more >>

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Anemia and Cost-Effectiveness of Complete Blood Count Testing Among Pregnant Women at King Abdulaziz University Hospital: A Single Tertiary Center Experience

Alexander Muacevic, John R Adler, Anas M Fallatah, Anas E Bifari, Hisham Z Alshehri, Sahal M Wali, Saleh A Alghamdi, Sultan A Almusallam, Wid S Al-Abbadi, Samera Albasri,

Background Iron deficiency is the most common etiology of anemia among pregnant women. Many studies showed that anemia during pregnancy had been associated with adverse outcomes such as intrauterine growth retardation, preterm delivery, and maternal mortality. However, screening for those pregnant remains controversial.  Objectives To find the prevalence of anemia ... Read more >>

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Wilkie's Syndrome as a Rare Cause of Duodenal Obstruction: Perspicacity Is in the Radiological Details

Alexander Muacevic, John R Adler, Ahmad A Al Faqeeh, Muhammad Khalid Syed, Mohammed Ammar, Talal Almas, Saifullah Syed,

Superior mesenteric artery syndrome, or Wilkie's syndrome, is an unexpected cause of upper gastrointestinal tract obstruction. The exact incidence of the condition remains unknown, and limited case reports are present in the literature. The obstruction results in the compression of the third part of the duodenum between the superior mesenteric ... Read more >>

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The Clinical Characteristics of Multiple Myeloma in the Acute Care Setting: Case Presentation and Clinical Recommendations

Alexander Muacevic, John R Adler, Daniel R Zetter, Tanvir Kabir, Samuel B Reynolds,

The acute complications of multiple myeloma can be varied and devastating, including electrolyte derangements, renal failure, and infections amongst others. The varying pathological mechanisms behind these complications make the management of patients presenting with multiple myeloma a complicated and sometimes tenuous process. The patient compliance can further exacerbate these difficulties. The ... Read more >>

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Returning to Sport After Anterior Cruciate Ligament Reconstruction in Physically Active Individuals

Alexander Muacevic, John R Adler, Muath M Alswat, Osama Khojah, Anas M Alswat, Abdulrhman Alghamdi, Mohab S Almadani, Ammar Alshibely, Albara A Dabroom, Hussam M Algarni, Mohammed S Alshehri,

Background Physically active individuals are susceptible to sports injuries, one of which is anterior cruciate ligament (ACL) injury. ACL injury can be managed conservatively or by surgical reconstruction. Returning to sport (RTS) after ACL injury is one of the main goals of ACL reconstruction (ACLR). However, rates of return vary ... Read more >>

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Efficacy of Granulocyte Colony Stimulating Factor in Severe Alcoholic Hepatitis: A Systematic Review and Meta-Analysis

Alexander Muacevic, John R Adler, Muhammad Baig, Saqib Walayat, Sonu Dhillon, Srinivas Puli,

Background Severe alcoholic hepatitis is a condition with a very high mortality rate and there is a paucity of evidence regarding efficacy and safety of most available therapeutic options. The present systematic review and meta-analysis aims to assess the survival benefit of granulocyte colony stimulating factor (G-CSF) in patients with ... Read more >>

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A Rare Case of Duodenal Melanosis: Case Report

Alexander Muacevic, John R Adler, Navpreet K Rana, Umair Minhas, Thomas Mahl,

Pseudomelanosis (PM) is a rare condition of unknown etiology and pathogenesis, described as speckled black pigmentation of intestinal mucosa. It is usually discovered as an incidental finding during endoscopy. Although, etiology of PM is unclear, it has been associated with different medications and systemic diseases such as chronic renal disease ... Read more >>

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Myxedema Coma: A Forgotten Medical Emergency With a Precipitous Onset

Alexander Muacevic, John R Adler, Roshan Acharya, Ce Cheng, Michael Bourgeois, John Masoud, Edwin McCray,

Myxedema coma is a rare life-threatening disorder characterized by severe hypothyroidism leading to multiorgan failure and even death. This case also reminds clinicians that the misnomer “coma” is misleading, and the patient can present with less severe symptoms. We present a case of a 72-year-old female with a history of primary hypothyroidism who ... Read more >>

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Diagnosis and Treatment of Fasciola Hepatica With Endoscopic Retrograde Cholangiopancreatography in a Child Patient: Case Report

Alexander Muacevic, John R Adler, Mehmet Agin, Yusuf Kayar, Ramazan Dertli,

Fasciola hepatica (FH) is a parasite that causes fever, hepatomegaly, abdominal pain, weight loss, anemia, and eosinophilia in the acute period, and jaundice, pancreatitis, and cholangitis in the chronic period by settling in the bile ducts. A 13-year-old girl admitted with abdominal pain, nausea, and jaundice. In her hemogram, the ... Read more >>

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Post-Extubation Stridor Complicating COVID-19-Associated Acute Respiratory Distress Syndrome: A Case Series

Alexander Muacevic, John R Adler, Joseph V Moran, Sara A Godil, Breanna Goldner, Kareem Godil, Jonaid Aslam,

Post-extubation stridor is a known complication of mechanical ventilation that affects a substantial number of all critical care patients and leads to increased morbidity and mortality. Common risk factors for the development of post-extubation stridor include female gender, older age, and prolonged length of mechanical ventilation. There may be an ... Read more >>

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Intermittent Recovery of Severe Acute Aortic Regurgitation Arising From Infective Endocarditis

Alexander Muacevic, John R Adler, Christopher Cordeiro, Siddhant Trehan, Joseph N Heaton, Prema Bezwada, Samir Garyali,

This case reports a 47-year-old male with a history of IV drug abuse, presenting with one week of left lower back pain. During the initial treatment, the patient became hemodynamically unstable, requiring vasopressor support. Transthoracic echocardiography (TTE) revealed a 1 cm x 1 cm aortic valve vegetation with severe aortic ... Read more >>

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Atypical Psoriatic Arthritis Presenting as Presumed Septic Monoarticular Arthritis

Alexander Muacevic, John R Adler, Zachary Sanford, Ralph W Webb,

The authors present a case of monoarticular psoriatic arthritis affecting the knee of a woman with no previously identified manifestations of psoriasis. At time of symptom onset, joint aspirates were initially sterile with predominantly neutrophilic leukocytosis; however, repeat aspiration and culture was positive for Candida parapsilosis. Despite appropriate antifungal treatment, symptoms continued to worsen ... Read more >>

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Impact of Early Urine Specimen Collection on Emergency Department Time to Disposition: A Randomized Controlled Trial

Alexander Muacevic, John R Adler, Amit Bahl, Ameen M Jamali, Gautam Ramesh,

Background Diagnostic testing in the ED increases the length of stay (LOS). Urinalysis testing is highlighted specifically as a source of delays. We aim to determine whether a triage-initiated urine specimen collection process decreases ED time to disposition (TTD) in ambulatory patients with abdominal pain. Methods This prospective, randomized controlled study ... Read more >>

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A Case of May-Thurner Syndrome

Alexander Muacevic, John R Adler, Harini Lakshman, Mahmoud Barbarawi, Pal Satyajit Singh Athwal, Michele Obeid, Ghassan Bachuwa,

May-Thurner syndrome, which is also known as iliac vein compression syndrome, is caused when an anatomical variant of the left common iliac vein with a lateral or anterior spur is compressed by the right iliac artery, resulting in thrombosis of the vein. It can present as left deep vein thrombosis ... Read more >>

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Does a Secure Attachment Style Predict High Psychological Resilience in Patients With Cancer Receiving Chemotherapy?

Alexander Muacevic, John R Adler, Fatma Basal, Seda Onur, Deniz Yamac, Cengiz Karacin, Guliz Zengin, İrem Bilgetekin, Umut Demirci, Berna Oksuzoglu,

Introduction To investigate the level of psychological resilience and the impact of attachment styles on the degree of resilience to distress in patients with cancer receiving chemotherapy. Methods Patients with cancer receiving chemotherapy were included in the study. Participants were requested to complete the Relationship Scales Questionnaire (RSQ), Resilience Scale ... Read more >>

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Role of Low Molecular Weight Heparin in the Management of Unexplained Recurrent Pregnancy Loss: A Review of Literature

Alexander Muacevic, John R Adler, Oluwatayo J Awolumate, Ayesha Kang, Rhutuja Khokale, Ivan Cancarevic,

Recurrent pregnancy loss remains a significant challenge in gynecological practice, accounting for about 2%-4% of pregnancies. In some patients, the etiology is unknown. Unexplained recurrent pregnancy loss (URPL) refers to the spontaneous loss of three or more consecutive pregnancies without an identifiable risk factor, accounting for about 40%-50% of pregnancy ... Read more >>

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A Novel Case of Severe Respiratory Symptoms and Persistent Pulmonary Hypertension in a Saudi Neonate With SARS-CoV-2 Infection

Alexander Muacevic, John R Adler, Kumail B Algadeeb, Haider H AlMousa, Sajjad M AlKadhem, Mohammed O Alduhilan, Yameen Almatawah,

Coronavirus disease 2019 (COVID-19) is an emergent disease that has spread rapidly to infect more than 210 countries across the world. With the increasing number of infected pregnant women, many physicians hypothesized the perinatal transmission as a potential route of transmission. Some cases of perinatal transmission have been described, but ... Read more >>

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Behavioral Changes Without Respiratory Symptoms as a Presenting Sign of COVID-19 Encephalitis

Alexander Muacevic, John R Adler, Tania Rebeiz, Krista Lim-Hing, Shahab Khazanehdari, Karim Rebeiz,

The clinical presentation, diagnosis, and treatment of coronavirus disease 2019 (COVID-19) encephalitis are still being characterized. Few case reports describing COVID-19 encephalitis are available in the literature. We present a case of COVID-19 encephalitis who presented with behavioral disturbances without respiratory symptoms. ... Read more >>

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Unraveling the Mysteries of Restless Leg Syndrome

Alexander Muacevic, John R Adler, Mohammad D Memon, Sadaf Faiz, Mitul P Zaveri, Jamal C Perry, Tayná M Schuetz, Ivan Cancarevic,

Restless leg syndrome (RLS) or Willis-Ekbom disease (WED) is an under-diagnosed, chronic, and progressive primary sensory-motor disorder. It is characterized by an uncontrollable urge to move the legs due to uncomfortable and sometimes painful sensations, with a diurnal variation. RLS can lead to severe sleep disturbances, a usual cause of ... Read more >>

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Chronic Liver Disease and the Risk of Osteoporotic Fractures: A Meta-Analysis

Alexander Muacevic, John R Adler, Diego F Hidalgo, Boonphiphop Boonpheng, Sehrish Sikandar, Lubna Nasr, Jessica Hidalgo,

Introduction Chronic liver disease (CLD) causes more than 1 million deaths every year and remains a pandemic in the last decade affecting more than 600,000 patients in the United States. Previous studies found patients with CLD had increased risk of osteoporosis, so fractures were inferred to be complications of this ... Read more >>

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Brevibacillus Laterosporus Bacteremia in an Adult

Alexander Muacevic, John R Adler, Anna K Curtis, Christian Lamb, Wail M Hassan, John Foxworth,

Brevibacillus laterosporus (B. laterosporus) is an aerobic gram-positive bacillus that is rarely associated with human infection. A review of multiple online databases revealed no other cases of bacteremia in an adult involving this organism. Historically, this “canoe-shaped” microbe has been characterized as a pathogen in invertebrates, and information regarding human infection is ... Read more >>

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Distal Renal Tubular Acidosis in Sjögren's Syndrome: A Case Report

Alexander Muacevic, John R Adler, Scarlet Louis-Jean, Patrick R Ching, Allison Wallingford,

Sjögren’s syndrome is an autoimmune lymphocytic infiltrative disease that leads to chronic inflammatory and degradatory changes to exocrine glands and extra-glandular systemic organs. It rarely affects children and adolescents. In cases where adolescents are affected, a paucity of sicca symptoms, xerostomia, and xerophthalmia often leads to a missed diagnosis. Consequently, the ... Read more >>

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