Journal of Clinical Research and Medical Reports

  jcmr@medcavepublications.com

Current Issues.

Volume 1  Issue 1
   Case Report         Month : 10 (2018)

Multiple Renal Capillary Hemangiomas in a Patient with End-Stage Renal Disease

  Roozbeh Houshyar

Renal capillary hemangiomas are rare, often underrecognized, benign vascular tumors [1]. In small case series, these lesions have been associated with other diseases including end-stage renal disease, acquired cystic kidney disease, polycythemia, and Renal Cell Carcinoma (RCC) [2-6]. Patients may present with abdominal pain and hematuria, but are more commonly asymptomatic. Therefore, these tumors are often initially discovered incidentally on imaging. Renal hemangiomas pose diagnostic and clinical dilemmas because of similar radiologic characteristics to other lesions including RCC and angiosarcoma. Surgical excision is often indicated due to the similar appearance to malignant lesions or in cases of significant symptoms such as hemorrhage [7-9]. Definitive diagnosis is based on pathology demonstrating aggregates of capillary-sized vascular channels with CD31+ endothelial cells [1,6]. We present a rare case of multiple renal capillary hemangiomas in a patient with end-stage renal disease
   Research Article         Month : 10 (2018)

Ischemia Effect on Lean and Steatotic Liver in Rats: Evaluating Levels of Lactic Acid and Transaminases

  Konstantinos Kostoulas

Introduction: Major hepatic surgery includes techniques of controlled ischemia and reperfusion in order to control bleeding and minimize blood loss. Fatty liver disease is considered to be an independent prognostic factor in major hepatic surgery, with negative impact on the outcome of patients. The aim of our experimental study was to evaluate the variance of concentration levels of Lactic Acid (LA) in liver tissue, as well as serum Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) levels, after the effect of different periods of liver ischemia followed by reperfusion in rats with lean and in rats with steatotic liver. Materials and methods: Eighty male Wistar rats aged 12-14 weeks were included. Forty of them were fed a regular laboratory diet, while the other forty were specially fed (choline-free diet) for 12-14 weeks in order to develop severe liver steatosis. Each of the groups was further divided into 4 subgroups: control group (sham-operated), 15, 30 and 45 minutes of surgically induced ischemia. After completion of the ischemic manipulation partial hepatectomy was performed for non-ischemic lobes and reperfusion for ischemic liver lobes. Rats were euthanized and liver tissue was used to measure LA. Blood samples were obtained and used to measure AST and ALT. Results: LA and aminotransferases levels were higher in steatotic rats than in lean rats in every subgroup (including control groups). Values of LA, AST and ALT increased within the same group (steatotic or lean rats) as the ischemia was prolonged (among different subgroups). Conclusion: Steatotic rats undergoing ischemia appear to elevate LA, AST and ALT significantly more than lean rats under the same manipulation, related to the time of exposure to hepatic ischemia. This suggests that the steatotic liver is less tolerant to ischemia than the lean one.
   Case Report         Month : 10 (2018)

Modified IV Ketamine Infusion Protocol for Treatment-Resistant Depression and Suicidal Ideation - A Case Report

  Hanna AF

The evidence supporting the use of ketamine for treating depression has grown rapidly in recent years. However, infusion protocols used in clinical practice have not yet been optimized. This manuscript describes the clinical course of a patient with treatment-resistant depression and suicidal ideation, who was treated using a modified ketamine infusion protocol at the Florida Spine Institute (Clearwater, FL, USA). The severity of this patient’s depression was evaluated using the Hamilton Depression Scale at each visit throughout the treatment period. Throughout the initial five-day infusion protocol her depressive symptoms were resolved (89% decrease from baseline). This treatment response was sustained over the course of 5 months with periodic booster ketamine infusions. Given this clinical observation, systematic controlled trials may be warranted using this modified infusion protocol for depression. Keywords: Antidepressants; Esketamine; Ketamine hydrochloride; Ketamine infusion protocol; Suicidality; Treatment resistant depression Abbreviations: Treatment Resistant Depression (TRD), Intravenous (IV), United States Food and Drug Administration (FDA), Hamilton Depression Scale (HAM-D), Montgomery-Åsberg Depression Rating Scale (MADRS)
   Research Article         Month : 10 (2018)

Luteolin: target validation in Babesia bovis by reverse transcription polymerase chain reaction and in vivo inhibition of Babesia microti

  Mahmoud Rezk AbouLaila

Luteolin, a naturally occurring plant flavonoid, has antioxidant, anti-amoebic, antitrypanosomal, and antimalarial activities. In this study, the inhibitory effects of luteolin were microscopically evaluated against three Babesia species and Theileria equi in vitro and against B. microti in mice. Reverse-transcription PCR was used to evaluate the effect of luteolin on transcription of DNA gyrase subunits A and B genes. Luteolin significantly inhibited the growth from an initial parasitemia of 1 % for Babesia bovis, Babesia bigemina, Babesia caballi, and Theileria equi with IC50 values of 81, 79, 90, and 99 nM, respectively. Parasite regrowth was inhibited at 100 μM in the subsequent viability test. Luteolin treatment of B.bovis cultures inhibited the transcription of the DNA gyrase subunit B gene. Luteolin at a dosage of 5 mg/kg resulted in a 77.5 % inhibition of Babesia microti growth in BALB/c mice. Luteolin might be used for drug therapy in babesiosis
   Review Article         Month : 10 (2018)

HIV Pre-Exposure Prophylaxis: Efficacy and Safety of Approved Therapeutic Regimens and Promising Drugs

  Ricardo Ney Cobucci

Background: Pre-Exposure Prophylaxis (PrEP) has emerged as a strategy for the prevention of HIV infection by antiretroviral drug use in seronegative individuals with continuous exposure to the virus. PrEP was approved in 2012 in the United States of America, by combining tenofovir disoproxil fumarate with emtricitabine (TDF/FTC). PrEP is based on TDF 300mg/FTC 200mg daily oral use, proposed to prevent infection in HIV-seronegative individuals with high risk of acquiring HIV. Methods: A review was performed of major clinical trials and observational studies evaluating the efficacy of this approved treatment and others underway that propose new treatments and different routes of administration with the aim of improving the effectiveness of prophylaxis. In addition, protocols approved in some countries and those that are still under evaluation to be applied are presented. Results and Conclusion: PrEP with TDF/FTC is effective and safe. However, the efficacy of other regimens is still being evaluated in clinical trials, preventing its recommendation
Volume 2  Issue 1
   Case Report         Month : 06 (2019)

Unusual Case of Mastoid Osteoma

  Navarrete ML

We present a case of mastoid osteoma in a 31-year-old female patient who consulted us for a left retroauricular tumor that had a progressive growth from 8 years of evolution, previously diagnosed with Chiari malformation type I as an incidental finding on MRI. Symptoms indicated only was by intermittent disturbances and aesthetic discomfort in the area of the tumor; no associated withotic history or hearing loss, earache, otorrhea, or dizziness.
   Case Report         Month : 06 (2019)

Adventitial Cystic Disease of the Common Femoral Artery

  Eulàlia Ballester Vázquez

Arterial Adventitial Cystic Disease (AACD) is an uncommon type of peripheral vessel disease and its etiology is still unknown. Most cases occur in the popliteal arteries; however, a few cases have been reported in the femoral arteries. This arterial disease consists of an accumulative mucinous substance in the arterial adventitial layer. This cystic growth produces a clinical claudication or a symptomatic ischemia in the inferior extremity. The most effective treatment is a block resection, with inclusion of the affected arterial segment. This surgical resection should be associated with a posterior arterial reconstruction with a prosthetic by-pass
  

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