Recognizing Belhassen Ventricular Tachycardia and Preventing Its Misinterpretation as Supraventricular Tachycardia: An Unusual Case Report.

Belhassen ventricular tachycardia (BVT), also known as verapamil-sensitive ventricular tachycardia, is an infrequent finding that can be fatal unless recognized early and treated in a prompt manner. Most patients have insignificant presentation suggestive of the disease, but on electrocardiography (EKG), BVT is characterized by a complete right branch block (RBB) and a right axis deviation (RAD). In this case report, we describe an unusual case of a 35-year-old male patient who presented to the emergency department (ED) complaining of acute palpitations of two-hour duration; subsequent diagnostic testing revealed BVT in the patient.

Coagulopathy induced by saw palmetto: a case report.

Saw palmetto is the most popular herbal supplement used to treat symptoms of benign prostatic hyperplasia (BPH). The safety and efficacy of saw palmetto has been established in the literature. While the majority of studies document the efficacy and safety of saw palmetto, some studies document the adverse side effects, including increased risk of bleeding. There are no reports in the literature about increased prothombin time (PT), partial thromboplastin time (PTT) or international normalized ratio (INR) while using saw palmetto. We present a case of hematuria and coagulopathy in a patient who was using saw palmetto.

Perineal endometriosis with anal sphincter involvement

Perineal endometriosis with anal sphincter involvement is a rare occurence with only 11 reported cases so far. This is a case of a 32 year old woman presenting with cyclic perineal pain, abnormal uterine bleeding, and a history of episiotomy. On physical examination, a perineal mass was palpated. There was also finding of an endocervical polyp. Endoanal sonography revealed external anal involvement of the perineal mass. Surgical excision of the endometric mass together with part of the external anal sphincter was carried out. The procedure was followed by anal sphincter reconstruction in an "overlapping" fashion. A fractional curettage with cervical polypectomy was also done. Histopathologic tests confirmed endometriosis and endocervical polyp. She was then given mefenamic acid for the pain. Since then, the patient has been asymptomatic. There were no complications and no anal incontinence. Awareness of the occurence of this rare type of extrapelvic endometriosis is important in the management of patients presenting with perineal pain occurring during menses.

The role of human papilloma virus in the molecular biology of cervical carcinogenesis.

Research exploring the E6-p53 and E7-pRb model has resulted in the identity of the viral gene's actions on numerous cellular proteins and processes normally involved in cell growth and proliferation. Specially, several findings have established the various ways by which the HPV-infected cell may escape controls governing cell growth and proliferation, including the fidelity of the host cell's genome and apoptosis. A large body of knowledge already generated in this area supports the view that high-risk HPV types have the ability to transform cells into a malignant phenotype. Such ability, however, is not sufficient to actually and inevitably produce cervical carcinoma, as indicated by the frequent spontaneous clearance of HPV infection and the long delay between the onset of persistent infection and emergence of the malignancy. Delay in the participation of cofactors has been suggested as explanation in this regard. However, it remains unclear how and when cofactors or factors that are innate in the HPV-infected cells launch the host cells into an irreversible progression to carcinoma.

Thyrotoxic periodic paralysis in mexican mestizo patients: a clinical, biochemical and HLA-Serological study

Background. Thyrotoxic periodic paralysis (TPP) is characterized by episodes of neuromuscular weakness occurring in the context of hypokalemia and hyperthyroidism and has been predominantly described in Oriental populations. Whereas it is uncommon in Caucasians and Blacks, TPP does occur in individuals of Native American descent. The objective was to analyze the clinical, biochemical, and HLA characteristics of group of Mexican mestizo patients with TPP. Methods. The sample was comprised of 14 men with TPP diagnosed since january 1990, based on one or more episodes of flaccid paralysis, accompanied by hypokalemia and occurring in the context of clinical and biochemical hyperthyroidism. Eight were available HLA testing. Results. Hyperthyroidsm was diagnosed before the development of periodic paralysis in five of the patients, whereas in six it occurred afterward. The severity of paralysis did not correlate with the degree of either hypokalemia or hyperthyroidism. An increased frequency of HLA-DR3 was found in Graves' patients without paralysis but not in those with paralysis, as compared to the general population. Conclusions. TPP is more common than previously thoought in Mexicans, in whom it behaves as in other Native American groups. The lack of HLA-DR3 association in Graves' patients with TPP is interesting, but at the moment has no pathophysiological implications