MedRophine Science

2022-06-20 06:17:04 Patient presentined with intractable back pain. Had a procedure four months ago. Radiologist called me concerned about these lesions. Let’s see who can nail the diagnosis first باز کردن / نظر دهید

2022-06-19 22:11:21 A 65-year-old patient diagnosed in another surgical service with lower rectal adenocarcinoma (approximately 3 cm from the external anal orifice) with mixt pattern (mucin + ring cells ), stenotic, cT4bN1M0, where she follows the following therapeutic route. In the first therapeutic time, surgery is performed in another center, laparoscopically with a Mayo-Reeves colostomy. On the oncological line it was performed FOLFOX regim and radiotherapy , with imaging reassessment (appreciates stable disease). Surgery is performed by median laparotomy and pelvic-abdominal peritoneal carcinomatosis is found (PCI Sugarbacker Index = 18), an unresectable pelvic tumor block, mucinous ascites; Second line of chemotherapy (Irinotecan+FOLFIRI) is instituted with subsequent imaging reassessment (PR> 30%); The patient is transferred to our surgery department, where we decide according to the MDT the following therapeutic approach: باز کردن / نظر دهید

2022-06-19 14:01:38 casos interesantes de clínicas con buenos profesionales!! Síndrome de preexcitacion ventricular y septal bulgle en un gato persa de 3 años. باز کردن / نظر دهید

2022-06-19 09:43:36 Looking for thoughts on management of this patient. 53 year old pathologist with BMI 32 who presented to me 3 months ago with acute onset knee pain. Plain films showed some patellofemoral arthrosis. MRI at that time showed what looked like major stress reaction in medial femoral condyle and some changes in the medial meniscus and mild cartilage wear in the medial compartment. We unloaded him for 6 weeks and he did well with almost normal resumption of activity. Then recurrent acute onset of severe weight bearing pain medially. Repeat MRI shows what looks like a subchondral insufficiency fracture, worsening medial compartment cartilage thinning and patellofemoral arthritis. ACL intact. Full range of motion.
Question?????
Is he a good candidate for a medial uni with the patellofemoral cartilage loss of all of his oain is medial and he did no باز کردن / نظر دهید

2022-06-19 09:28:59 A 35 yo woman who presented greater saphenous Varicose veins. Ablation with foam asclerotherapy. باز کردن / نظر دهید

2022-06-18 17:36:34 An 80-year-old woman complained of breathlessness and frequent attacks of dizziness. This was her ECG when she attended the clinic. What does the ECG show, what might the dizziness be due to, and how would you manage her?

*Detailed Answer
The ECG shows:
• Sinus rhythm, rate 90 bpm
• Right axis deviation
• Right bundle branch block (RBBB).

*Clinical interpretation
The right axis deviation suggests left posterior hemiblock, and, combined with RBBB, this suggests bifascicular block. The patient is therefore at risk of complete (third degree) block, which could cause a Stokes–Adams attack.

What to do?
Ambulatory monitoring is required to confirm bradyarrhythmias. This woman was in fact admitted to hospital and monitored, and had a severe attack of dizziness and fainting. During this attack, another ECG was recorded (see below). This ECG shows complete heart block with a ventricular rate of about 15 bpm. The patient was immediately given a permanent pacemaker. باز کردن / نظر دهید

2022-06-18 11:35:39 An interesting rare case of CSF leak after valsalva maneuver (heavy metal pot lifting)!

A 38 years old woman complaining of 5 months persistent headache after lifting a heavy metal pot was referred to our ORL-HNS clinic. The headache was aggravated by being upright (standing or seated) and subsided by lying. There was no symptoms or signs of intermittent CSF rhinorrhea. On PNS CT there was a bony defect in the right lateral lamella (red arrow) and T2 MRI shows retention of secretions in the right posterior ethmoidal cells and right sphenoid sinus (yellow arrow).
CSF: cerebrospinal fluid
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Thanks to Dr. Ehsan Arjmandzadeh ( resident of otorhinolaryngology head and neck surgery at Tehran) to share this case whit us . باز کردن / نظر دهید

2022-06-18 05:36:57 A 32yrs old female patient referred from the teaching hospital for an obstetric scan for a confirmation of a fetal abnormality.
26wks 2d pregnancy

Your thoughts......
will be doing updates on the images باز کردن / نظر دهید

2022-06-17 19:46:44 CAS Filter-protection neurointervention

Real evidence of filter protection. After balon dilatation, a part of the fibrolipid plaque protrude through the stent, then detached after 2nd dilatation and catched by the filter basket. باز کردن / نظر دهید

2022-06-16 21:21:23 What is your explanation for the repeating pattern observed here? باز کردن / نظر دهید