ABSTRACT
We described a case of lymphoid follicular hyperplasia that arose from the ileum of a 52-year-old woman. Her colonoscopy revealed a large mass in the cecum associated with multiple polypoid lesions in the ileum. Histologic examination demonstrated severe lymphocytic infiltration and lymphoid follicles with regular germinal centers, without evidence of malignancy. A right hemicolectomy was performed, which confirmed the diagnosis of lymphoid follicular hyperplasia
ABSTRACT
Inflammatory bowel disease [IBD] is a chronic relapsing, idiopathic disorder of the gastrointestinal tract of an unknown etiology. Ulcerative colitis [UC] and Crohn's disease [CD] have become important health problems. Current medical therapy of IBD has advanced dramatically with the introduction of new biologic therapies in addition to the optimization of conventional therapies that include drugs such as immunosuppressors and 5-aminosalicylic acid [5-ASA], and a better identification of factors involved in the pathogenesis of IBD. The aim of this review is to provide a brief historical perspective of the available evidence for the use of various medications in IBD followed by a recent literature update. The intent is to enhance the clinician's perspective regarding IBD treatment.
Subject(s)
Humans , Colitis, Ulcerative , Crohn Disease , Immunomodulation , Immunologic FactorsABSTRACT
Liver enzyme alteration may be an incidental finding in asymptomatic individuals who have undergone routine laboratory tests. lsolated alteration of liver enzymes in a healthy individual often represent a challenge even for experienced clinicians. In this article we decide to provide a guide to interpreting alterations to liver enzyme levels. Liver enzyme alterations are classified to predominantly hepatocellular or predominantly cholestatic patterns. We review abnormal enzymatic activity within the 2 subgroups, and suggested initial investigations.
ABSTRACT
We report the case of a 54-year-old Iranian man who presented with melena from three months prior to admission. Esophagogastroduodenoscopy and colonoscopy were normal. Double balloon enteroscopy showed a pedunculated tumor located in the jejunum. He underwent laparotomy and resection of a 9.5 cm tumor from the distal jejunum. Histopathologic evaluation confirmed the diagnosis of an inflammatory fibroid polyp [IFP].
ABSTRACT
Stress-induced cardiomyopathy or Takotsubo cardiomyopathy is a recently increasing diagnosed disease manifested by transient apical or mid left ventricular dilation and dysfunction. This sign is similar to acute myocardial infarction but without significant coronary artery stenosis. There are important and essential differences between Takotsubo cardiomyopathy and acute myocardial infarction in terms of management, necessitating a good understanding of the pathophysiology, diagnosis, and treatment of the former. We report a case of Takotsubo cardiomyopathy which presented with dizziness and near syncope after an intense emotional stress. Electrocardiogram showed ST-T changes in V1-V3 and echocardiography revealed severe left ventricular systolic dysfunction with marked regional wall motion abnormalities. Coronary angiography demonstrated minimal coronary artery disease. The patient was treated with beta -blockers, angiotensin-converting enzyme inhibitors, Aspirin, Clopidogrel, and diuretics. At the follow-up visit, all the symptoms had disappeared and control echocardiography showed significant improvement in the left ventricular systolic function with a normal ejection fraction and normal wall motion.
ABSTRACT
Bad news disclosure is one of the most complex tasks of physicians. Recent evidences indicate that patients' and physicians' attitude toward breaking bad news has been changed since few years ago. The evidence of breaking bad news is different across cultures. The aim of this study is to evaluate the attitude of medical staff toward breaking bad news to provide a clinical guideline in Iran. A descriptive study was conducted during 2008-2009 on a sample of 100 medical staff [50 physicians and 50 nurses] at Cancer Institute of Imam Khomeini hospital. The subjects' demographic characteristics and their attitudes toward the manner of revealing the diagnosis were registered in a questionnaire. The majority of the physicians [86%, n=43] and nurses [74%, n=37], mostly the older and more experienced, tended to reveal the diagnosis to patients. Only a few physicians [8%, n=4] had been trained how to disclose bad news, which discloused diagnosis more than non trained ones. Physicians and nurses preferred to inform the patients about the diagnosis when either the patients were alone or in the presence of their spouse respectively. Only a few physicians [14%] and nurses [24%] agreed to explain life expectancy to patients. Compared to past, physicians and nurses are more willing to share cancer diagnosis with patients. However, lack of adequate communication skills in caregivers, and their concerns about managing patients' emotional reactions reduce their tendency to disclose bad news to the patients. Therefore, training physicians and nurses to expose bad news to the patients seems to be necessary
ABSTRACT
Irritable bowel syndrome [IBS] is one of the most common functional gastrointestinal disorders characterized by abdominal pain/discomfort in association with altered bowel habits in the absence of any organic cause. The pathophysiology of IBS remains uncertain but hereditary and environmental factors are likely to have a role. The diagnosis of IBS is currently based on the ROME III symptom-based criteria. IBS is subtyped based on predominant bowel habit and pharmacologic treatment is according to this classification, too. In addition to pharmacologic agents, effective patient-physician relationship, diet and psychological treatment are important in management. Nowadays, with improvement in understanding the pathopysiology of IBS, many therapeutic modalities have introduced and new drugs with novel mechanism of action will hopefully be developed