Old Woman Research Articles

Small Doses of Lorazepam Given at 3:30AM and at Bedtime Significantly Decrease early Morning Malignant Blood Pressure Spikes in Patients 65 Years and Older

This study builds upon a 9 year daily case study of a 71-80 year old Caucasian woman who documented at least 6 daily blood pressure readings per day, with a focus on the early morning malignant blood pressure spikes and the variety of blood pressure medications given to her by various physicians in several states. The documentation included time of day, duration of spike, and her perseverance in finding a prophylactic that ended these spikes. The pathophysiology of early morning malignant blood pressure spikes is not completely understood, but the primary cause of malignant blood pressure spikes in the morning may be a misdirected activation of the sympathetic nervous system due to a genetic mutation or deterioration due to age. There are contradictory opinions on the percentage of the elderly experiencing these spikes. Some research reports that these spikes are rare and usually found in men, African Americans and the poor. Other reports contradict these findings and state that malignant early morning spikes are common, but patients are not aware of them. All agree, however, that these early morning malignant spikes had a significant increased risk of cardio vascular event, stroke, heart attacks and death. This study was conducted because the older woman researched was knowledgeable about the human body [studied science, anatomy and physiology, and was a competitive athlete in her youth]. She was trained to know her body and could easily identify when the spikes began in early morning, timed the amount of time blood pressure went from normal to very high [2 minutes], and measured time it took for blood pressure to return to normal. Her way of coping with the 9 years of these stressful spikes was to conduct a research project and hopefully be able to help other senior citizens prolong their own lives.

Intersectional Oppressions, Resistance, and Privileges: Three Stories of Iranian Women

An old woman states her demands, too: “Some people plundered a grocery store on Saturday. I don’t agree with these actions. This is the right of the people [haqul nas].” She suddenly bursts into tears: “I always say my prayers, but I entered the store that day and took a 10-kilo bag of rice! God forgives me! We haven’t had rice for two months. I couldn’t afford it. God forgives me….” (Khosravi Olya, 2019, my translation)

Een onbekende procedure: double-barreled wet colostomy

SamenvattingEen 62-jarige vrouw onderging een double barreled wet colostomy (DBWC) na een bekkenexenteratie. De DBWC is een relatief onbekende ingreep, waarbij een colostoma wordt aangelegd met twee openingen, waardoor urine en ontlasting via gescheiden compartimenten naar buiten worden geleid. Het doel van dit artikel is de DBWC te vergelijken met een gescheiden urostoma en colostoma aan de hand van een casus en een review van de beschikbare literatuur. Er werden drie retrospectieve studies gevonden die een DWBC vergeleken met een gescheiden uro- en colostoma, met in totaal 267 patiënten. Daaruit bleek geen verhoogde mortaliteit en morbiditeit bij een DBWC ten opzichte van een gescheiden urinestoma en colostoma. De conclusie luidt dat een DBWC kan worden overwogen na een bekkenexenteratie.

Pituicitoma hipofisario, un hallazgo diagnóstico inusual: Reporte de caso

Los pituicitomas son tumores infrecuentes de la región selar y supraselar, originados de la neurohipófisis, que suelen ser confundidoscon otros tumores al compartir características imaginológicas. Se reporta el caso de una mujer de 36 años de edad, con un pituicitoma en la región selar, que fue diagnosticado como un adenoma hipofisario debido a los hallazgos clínicos e imaginológicos preoperatorios y se realiza una revisión de la literatura.

Intra-Articular Cartilage Calcification Associated with Type II Pro-Collagen Accumulation in Chondrocytes and Abnormal Fibrils in the Extra Cellular Matrix (ECM): Case Report

Objective: The purpose of this case-study was to perform morphological and molecular analysis of articular cartilage biopsies from the femoral condyle of a 33 year old woman with intra-articular calcification in the right knee joint and compare the findings with those of normal cartilage. Methods: Femural condyle cartilage biopsies were used for Light Microscopy (LM), Transmission Electron Microscopy (TEM), explant culturing and DNA mutation analysis of the COL2A1 gene. Results: X-ray of the affected knee joint showed intra-articular calcifications on the femur condyle, tibia and meniscus. Pathological LM and TEM examination of cartilage biopsies revealed calcified islands morphologically identical to calcium pyro-phosphate dehydrate (CPPD) and hydroxyapatite (HA)-like crystals. In addition, chondrocytes showed accumulation of pro-collagen molecules. With explant culturing and immunochemistry, it was confirmed that matrix calcification correlated with high intracellular matrix accumulation and expression of type X collagen. The induction of hypertrophy in chondrocytes was further associated with matrix vesicle (MV) release and a prominent calcification zone. Surprisingly, TEM showed crystal development on thick abnormal type II collagen fibrils suggesting that these ECM components might nucleate and contribute to calcification. Conclusions: We suggest that intra-articular calcification may be associated with type II pro-collagen accumulation in chondrocytes. In particular, we hypothesize that matrix accumulation may induce hypertrophy and type X collagen expression in cartilage cells and release of MV’s into the ECM, which together with thick abnormal type II collagen hetero-fibrils, are responsible for crystal deposition in the ECM.

Case Report: Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma with a Rare Anomaly of Celiac Trunk Originating from Superior Mesenteric Artery

Identifying the vascular anatomical variations of the operating region is essential in carrying out successful surgery, and decreasing the rate of both intraoperative and postoperative complications. Surgeons must keep in mind that arterial variation may be present in the vascular structures intraoperatively, even though it was not revealed in preoperative imaging. The present study report a case of a 51 year old woman who was diagnosed with pancreatic ductal adenocarcinoma (PDAC) with a rare variation of celiaco-mesenteric trunk originating at the level of L1. The patient underwent pancreaticoduodenectomy. The postoperative course was favorable and the patient was discharged on postoperative day 15.

ACTIVE THERAPEUTIC MOVEMENT IMPROVES PAIN-FREE RANGE OF MOTION IN A 53 YEAR OLD WOMAN WITH REFRACTORY BILATERAL FROZEN SHOULDER

Event Abstract Back to Event ACTIVE THERAPEUTIC MOVEMENT IMPROVES PAIN-FREE RANGE OF MOTION IN A 53 YEAR OLD WOMAN WITH REFRACTORY BILATERAL FROZEN SHOULDER David J. Clark1* 1 Carrick Institute, United States Background: A 53 year old woman presented with 18 month history of bilateral frozen shoulder refractory to previous treatment of steroid shots and physical therapy. In addition to a history of chronic migraines, she also complained of frequent headaches that originated from both her cervical spine and muscles including the trapezius and levator scapulae. Four years prior she was diagnosed with Hashimoto’s. She was taking daily Topamax®, Voltaren®, tizanidine, trazadone, synthroid, Wellbutrin®, estradiol and Dexilant®. On an as-needed basis, she was taking meperidine and cyclobenzaprine. Methods: Neurological and physical examination revealed limited active range of motion in lateral abduction, external rotation, extension and flexion of both glenohumeral joints. She displayed head forward posture and rounded shoulders. Form closure passive retraction of her shoulders allowed her to elevate both shoulders significantly higher in abduction and with less pain. She was treated twelve times over three months using the ATM2 (Backproject, Sunnyvale, California) utilizing passive positioning of shoulder retraction and isometric contractions of the pectoralis minor and deltoid. Each treatment session lasted approximately 10 minutes. Results: Over the course of the treatments the patient demonstrated improved active range of motion in shoulder abduction. At the twelfth treatment she had normal pain-free active range of motion in abduction and flexion of the glenohumeral joints. The patient reported almost 100% subjective improvement in her bilateral shoulder pain and significant improvement in the frequency and intensity of her headaches. Her sleep quality had significantly improved. She had stopped using the Voltaren®, mepiridine and cyclobenzaprine. Conclusion: The author recommends further investigation into the use of Active Therapeutic Movement in the treatment of refractory frozen shoulder. Keywords: Frozen shoulder (adhesive capsulitis), Hashimoto's autoimmune thyroiditis, Isometric exercise, Posture abnormalities, active therapeutic movement Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Clark DJ (2019). ACTIVE THERAPEUTIC MOVEMENT IMPROVES PAIN-FREE RANGE OF MOTION IN A 53 YEAR OLD WOMAN WITH REFRACTORY BILATERAL FROZEN SHOULDER. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00036 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 02 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Mx. David J Clark, Carrick Institute, Cape Canaveral, Florida, 32920, United States, mail@doctordavidclark.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers David J Clark Google David J Clark Google Scholar David J Clark PubMed David J Clark Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

CLINCIAL NUTRITION PROGRAM IMPROVES FATIGUE, STOMACH PAIN, CONSTIPATION AND WIDESPREAD PAIN IN 39 YEAR OLD WOMAN

Event Abstract Back to Event CLINCIAL NUTRITION PROGRAM IMPROVES FATIGUE, STOMACH PAIN, CONSTIPATION AND WIDESPREAD PAIN IN 39 YEAR OLD WOMAN David J. Clark1* 1 Carrick Institute, United States Background: A 39 year old woman presented with a thirteen year history of gastrointestinal complaints originally diagnosed as diverticulitis. In the few years prior to presentation she developed stomach pain within twenty minutes of eating, bloating, constipation and malodorous gas. She complained of severe exhaustion between 2:00 PM and 4:00 PM. She was so tired that would fall asleep at 7:00 pm. She had developed aches and pains throughout her joints and muscles. She has been diagnosed with Factor V Leiden clotting disorder. She had to take senna in order to have any kind of bowel movement. In addition, she took ibuprofen and peppermint oil. She was following a reduced gluten diet. Methods: Ingestion of Th1 cytokine boosters provoked her symptoms. Laboratory examination revealed a positive urea breath for Helicobacter pylori as well as clinically significantly low levels of calcium (8.9), vitamin D (30.1 ng/ml), and clinically significantly high levels of B12 (1234 pg/mL) despite not using any B12 supplements. She was placed on an anti-anti-inflammatory diet and supplement protocol utilizing vitamin D, turmeric, resveratrol, omega 3 fatty acids, sublingual glutathione, a multi-nutrient formula for glucose support and multi-nutrient formula for eradication of the Helicobacter pylori. Results: After 30 days of her protocol, the patient reported her stomach pain was completely resolved, as was the bloating and constipation. She no longer needed the senna to have a bowel movement. The fatigue was essentially resolved as she no longer experienced the evening crash and was able to go to sleep at 10:00 PM. The aches and pains had completely resolved. Conclusion: The author recommends further investigation into the use of diet and supplementation in the treatment of patients with chronic fatigue, pain and gastrointestinal complaints. Keywords: Helicobacter pylori, Clinical Nutrition, supplementation, Anti-inflammatory diet, Stomach pain Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Clark DJ (2019). CLINCIAL NUTRITION PROGRAM IMPROVES FATIGUE, STOMACH PAIN, CONSTIPATION AND WIDESPREAD PAIN IN 39 YEAR OLD WOMAN. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00048 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 02 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Mx. David J Clark, Carrick Institute, Cape Canaveral, Florida, 32920, United States, mail@doctordavidclark.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers David J Clark Google David J Clark Google Scholar David J Clark PubMed David J Clark Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

CLINICAL NUTRITION IMPROVES CHRONIC FATIGUE, SLEEP DISTURBANCE, MENTAL FOG AND NAUSEA IN 45 YEAR OLD WOMAN WITH HASHIMOTO’S

Event Abstract Back to Event CLINICAL NUTRITION IMPROVES CHRONIC FATIGUE, SLEEP DISTURBANCE, MENTAL FOG AND NAUSEA IN 45 YEAR OLD WOMAN WITH HASHIMOTO’S David J. Clark1* 1 Carrick Institute, United States Background: A 45 year old woman presented with severe fatigue, poor appetite, mental fog and nausea. She also suffered sleep disturbances characterized by waking after 4 to 5 hours of sleep, and alternately, difficulty falling asleep until 2:00 AM. Her history was significant for previous diagnosis of alopecia universalis and hypothyroidism. She was taking Concerta®, Zoloft® and levothyroxine. Her diet was unrestricted and notable for appearing hypocaloric. Methods: Ingestion of Th1 cytokine boosters provoked her symptoms. Blood chemistry revealed low vitamin D (21.7 ng/mL), vitamin B12 (226 pg/mL) and high thyroid peroxidase antibodies (220 IU/mL), eosinophil percentage (17%), absolute eosinophils (0.9), cholesterol (236 mg/dL), HDL (105 mg/dL), homocysteine (16.8 umol/L) as well as clinically significantly low folate (7.6 ng/mL), T3 (87 ng/dL), and ferritin (47 ng/mL). She was placed on an anti-inflammatory diet and supplement protocol utilizing turmeric, resveratrol, sublingual vitamin D, sublingual glutathione, folinic acid, hydroxocobalamin, and a multi-nutrient formula to support glucose utilization. Results: After 30 days, she reported 80% improvement in sleep, 60% improvement in fatigue, 90% improvement in appetite (reduction in nausea). She continued on the same protocol for an additional 30 days, and reported complete resolution of fatigue, mental fog and poor appetite. She began running for exercise. Blood chemistry retest showed normal levels of vitamin B12, folate, ferretin and vitamin D. Conclusion: The author recommends further investigation into the use of diet and supplementation in the treatment of patients with chronic fatigue and sleep problems. Keywords: Hashimoto's autoimmune thyroiditis, chronic fatigue, Anti-inflammatory diet, supplementation, Sleep disturbance Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Clark DJ (2019). CLINICAL NUTRITION IMPROVES CHRONIC FATIGUE, SLEEP DISTURBANCE, MENTAL FOG AND NAUSEA IN 45 YEAR OLD WOMAN WITH HASHIMOTO’S. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00037 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 02 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Mx. David J Clark, Carrick Institute, Cape Canaveral, Florida, 32920, United States, mail@doctordavidclark.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers David J Clark Google David J Clark Google Scholar David J Clark PubMed David J Clark Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

CLINICAL NUTRITION PROGRAM IMPROVES FATIGUE IN A 33 YEAR OLD WOMAN WITH HASHIMOTO’S AND INTRINSIC FACTOR ANTIBODIES

Event Abstract Back to Event CLINICAL NUTRITION PROGRAM IMPROVES FATIGUE IN A 33 YEAR OLD WOMAN WITH HASHIMOTO’S AND INTRINSIC FACTOR ANTIBODIES David J. Clark1* 1 Carrick Institute, United States Background: A 33 year old woman presented with chronic fatigue. Her symptoms seemed to begin after cessation of breastfeeding her child. She had been diagnosed with hypothyroidism and prescribed levothyroxine. Her diet was unrestricted. She was taking only levothyroxine and no supplements. Methods: Ingestion of Th2 cytokine boosters provoked her symptoms. Initial blood chemistry revealed high cardiac c-reactive protein (5.99), thyroid peroxidase antibodies (357 IU/L), thyroglobulin antibodies (17.9 IU/L), vitamin B12 (1163 pg/mL), and low vitamin D (14.1 ng/mL), a normal thyroid panel as well as clinically significantly high MCV (96 fL). Methods: She was placed on an anti-inflammatory diet and supplement protocol utilizing sublingual vitamin D, turmeric, resveratrol, omega 3 fatty acids, glutathione, and a multi-multi-nutrient formula to support glucose utilization. Results: After 60 days she reported 90% improvement in her fatigue. Her MCV at that time was 97 fL. Methylfolate was added but the MCV did improve significantly. Further testing revealed abnormal levels of intrinsic factor antibodies (along with autoantibodies for 21-hydroxylase, glutamic acid decarboxylase and platelet glycoprotein). Sublingual hydroxocobalamin was added to her protocol. Thirty days later the MCV had normalized (94 fL) and the patient reported no fatigue. Conclusion: The author recommends further investigation into the use of diet and supplementation in the treatment of chronic fatigue in patients diagnosed with hypothyroidism. Keywords: Hashimoto's autoimmune thyroiditis, Chronic fatigue disorder, Intrinsic factor antibodies, supplementation, Anti-inflammatory diet Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Clark DJ (2019). CLINICAL NUTRITION PROGRAM IMPROVES FATIGUE IN A 33 YEAR OLD WOMAN WITH HASHIMOTO’S AND INTRINSIC FACTOR ANTIBODIES. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00041 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 02 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Mx. David J Clark, Carrick Institute, Cape Canaveral, Florida, 32920, United States, mail@doctordavidclark.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers David J Clark Google David J Clark Google Scholar David J Clark PubMed David J Clark Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

CLINICAL NUTRITION AND MULTIMODAL NEUROREHABILITATION IMPROVE CHRONIC POST-CONCUSSION SYMPTOMS IN 22 YEAR OLD WOMAN

Event Abstract Back to Event CLINICAL NUTRITION AND MULTIMODAL NEUROREHABILITATION IMPROVE CHRONIC POST-CONCUSSION SYMPTOMS IN 22 YEAR OLD WOMAN David J. Clark1* 1 Carrick Institute, United States Background: A 22 year old woman presented with a 5 month history of fatigue, forgetfulness, difficulty concentrating, depression, irritability, light and sound sensitivity, dizziness/motion sickness, problems with balance and depth perception subsequent to a motor vehicle accident. She was on medical leave from University. Prior to presentation she had completed some vision therapy and primitive reflex remediation that worsened her symptoms. At time of prevention she was following a gluten-free, vegan diet. She was taking B12, Vitamin D, MCT oil, flax, ginkgo biloba and magnesium. Methods: Neurological examination revealed decreased left arm swing that improved with dual-tasking, horizontal and vertical pursuit testing at bedside elicited excessive sway, slowed vertical saccades tested at bedside, vertical saccades tested with VOG showed marked hypometria downwards and average latency greater than 200 ms, vertical optokinetics tested with VOG showed low gain in both directions, drowsiness and hippus during the VOG assessment. Ingestion of Th1 and Th2 boosters provoked her symptoms. Laboratory examination revealed low ferritin (8 ng/mL), clinically significantly low LDH (119 IU/L) , folate (10.7 ng/mL), magnesium (1.9 mg/dL). Initially, her diet was modified to increase her total protein and calorie intake, as well as the frequency of calorie intake. She was placed on supplemental folate, iron, turmeric, resveratrol, vitamin, magnesium, and a multi-nutrient to support normal tissue glucose levels. After 5 months of this program she was enrolled in a 4 day multi-modal neurorehabilitation program utilizing active gaze stabilization, Interactive Metronome, proprioceptive exercises, progressive balance exercises, and coupled reduction manipulation. Results: Due to improvement in her original presenting complaints, 2 months after her finishing her initial program, she re-enrolled in University. At last follow up she reported only some difficulty in cognitive set shifting. She continued to take Vitamin D, folate, iron, and the multi-nutrient formula to support normal tissue glucose levels. Conclusion: The author suggests further investigation into comprehensive, multimodal forms of neurorehabilitation and clinical nutrition in the treatment of chronic post-concussion symptoms. Keywords: post concussion syndrome (PCS), Neurorehabilitation, Clinical Nutrition, supplementation, Anti-inflammatory diet Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019. Presentation Type: Poster Presentation Topic: Clinical Neuroscience Citation: Clark DJ (2019). CLINICAL NUTRITION AND MULTIMODAL NEUROREHABILITATION IMPROVE CHRONIC POST-CONCUSSION SYMPTOMS IN 22 YEAR OLD WOMAN. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00013 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 02 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Mx. David J Clark, Carrick Institute, Cape Canaveral, Florida, 32920, United States, mail@doctordavidclark.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers David J Clark Google David J Clark Google Scholar David J Clark PubMed David J Clark Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Antiphospholipid syndrome as a cause of acute myocardial faction in an old woman

Antiphospholipid syndrome as a cause of acute myocardial faction in an old woman

A Curious Case of Sweet Smelling Urine

Maple Syrup Urine Disease (MSUD) is an autosomal recessive inborn error of metabolism characterized by decreased enzymatic activity of branched-chain alpha-ketoacid dehydrogenase which leads to an inability to break down branched chain amino acids. It is critical for physicians to make a prompt diagnosis of metabolic disorders to decreased metabolic decompensations and mitigate long-term complications A 33 year old G2 P2 Indian woman with no known family history of MSUD gave …

Simultaneous pulmonary and inferior vena cava tumor thromboembolism secondary to retroperitoneal pleomorphic liposarcoma.

Retroperitoneal pleomorphic liposarcoma (RPLS) is the least common but the most aggressive subtype of liposarcoma. We herein report a case of tumor embolism (TE) to the inferior vena cava (IVC) and pulmonary arteries in a 54 years old woman with RPLS. The case suggests that fusion fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can accurately detect occult TE. It also illustrates the usefulness of computed tomography (CT) and high 18F-FDG uptake by PET/CT imaging for diagnosing such findings as filling defect in the veins and beaded pulmonary arteries as TE. To our knowledge, this is the first reported case of simultaneous pulmonary and inferior vena cava thromboembolism secondary to RPLS. And occult TE from RPLS has not been reported previously by 18F-FDG PET/CT.

Pap screening as preventive tool against cervical cancer: a report of carcinoma in-situ in a woman with family history of cancer in Ilorin

The incidence of cervical cancer in the developed countries has significantly reduced as a result of well-organized and coordinated Pap screening program, which is aimed at detection of pre-invasive lesions that are then promptly treated. We report a 45-year old woman whose immediate elder sister had breast carcinoma, and she presented for routine breast and cervical cancer screening. Pap smears on 2 occasions revealed a high grade squamous intraepithelial lesion (HSIL). Histopathological evaluation of the cervix after hysterectomy revealed carcinoma in-situ. We discussed the need for early screening for malignancies in persons with significant family history of cancer.Keywords: Pap smear, Cervical cancer, Ilorin

Anal Canal Duplication in a 40-Year-Old Adult

Anal canal duplication (ACD) is the rarest congenital malformation of the digestive tract and is associated with other congenital malformations. The clinical case reports a 40 years old woman who had two episodes of anal abscesses treated with surgical drainage within 1 year. In proctology consultation, the examination revealed a structure in the midline, posterior to the native anus. Pelvic magnetic resonance imaging and anal echoendoscopy confirmed the presence of a tubular structure posterior to the anal canal, compatible with duplication of the anal canal. The patient was proposed for surgical excision but refused. Seven years later, the patient had another anal abscess. She was again proposed for surgery and refused. Around 60 cases of ACD are currently described worldwide. The diagnosis is usually made at an early stage of life. Our patient was diagnosed at the age of 40 years, constituting one of the most elderly patient diagnosed with ACD. J Med Cases. 2018;9(2):61-63 doi: https://doi.org/10.14740/jmc2902w

Asymptomatic Nodular Lesion Over the Neck in an Old Woman.

Asymptomatic Nodular Lesion Over the Neck in an Old Woman.

Cemento-osseous dysplasia in the anterior mandible: A case of misdiagnosis

Osseous dysplasia (Cemento-osseous dysplasias) is relatively common form of fibro osseous lesions (FOLs) in the tooth-bearing regions of the jaw bones. Clinically, most of the Osseous dysplasias (ODs) are asymptomatic and are accidently discovered during routine radiographic examinations. A proper diagnosis of OD is very crucial to avoid misdiagnosis and mismanagement. The histological appearance is similar to other fibro osseous lesions (FOLs) and in numerous cases; Osseous dysplasias have been misdiagnosed as periapical lesions (Periapical abscess, granuloma or cyst), and/or mismanaged by initiation of unnecessary endodontic and surgical interventions. We report a misdiagnosed case of Focal Cemento-Osseous Dysplasia and unnecessary endodontic treatment in a 48 years old woman due to similar radiographic appearance of the lesions during the osteolytic phase of Osseous Dysplasia. This unnecessary invasive treatment could have been minimized or avoided if standard protocols of pulp vitality and a radiographic interpretation were performed carefully.

Asymptomatic vesical stone randomly discovered in a 78 years old woman admitted for femoral neck fracture. A case report

Background : Urinary tract stones originate from a variety of conditions, including metabolic and inherited disorders, medical devices, anatomical defects with or without chronic urinary infection. Most cases are idiopathic, in which there is undoubtedly a genetic predisposition, but where environmental and lifestyle factors play an important role. We report a case of a 78 years old woman who underwent arthroplasty in which an asymptomatic bladder stone were discovered and left untreated purposely. French Version Resume: Les calculs urinaires sont de diverses etiologies, notamment des troubles metaboliques et hereditaires, materiel medical, des anomalies anatomiques avec ou sans infection urinaire chronique. La plupart des cas sont idiopathiques, dans lesquels il existe indubitablement une predisposition genetique, mais ou les facteurs environnementaux et de style de vie jouent un role important. Nous rapportons le cas d'une femme de 78 ans qui a subi une arthroplastie chez qui un calcul vesical asymptomatique a ete decouvert et volontairement laisse non traite.

A Case Report: Vaginal Cystolithotomy on a Patient with Pelvic Organ Prolapse and Multiple Vesical Calculi

Vesical calculi are not commonly seen with pelvic organ prolapse. We report a case of a 64 years old multiparous woman, who presented with history of vaginal mass in the last 2 years. Gritty sensation was felt on palpating the cystocele and multiple calculi were suspected intraoperatively. A transvaginal hysterectomy was done followed by vaginal cystolithotomy, an anterior colporrhapy and posterior colpoperineorrhapy (Mc call culdoplasty technique). Multiple vesical calculus was removed. Post-operative course was unremarkable.