A rare disease of Kallmann syndrome: A case report.

Kallmann syndrome (KS) is a rare genetic disorder that refers to the association between hypogonadotropic hypogonadism and anosmia or hyposmia due to abnormal migration of olfactory axons and gonadotropin-releasing hormone-producing neurons. Here, we present a case of a 40-year-old man who presented with psychological problems (emotional disturbance) as the chief complaint. Physical examination revealed gynecomastia, absence of facial and axillary hair, and sparse pubic hair, micropenis, undescended right testicle, low libido and lack of sexual function. A related finding is anosmia, a high-pitched voice. Hormonal analysis revealed hypogonadotropic hypogonadism profile, and chromosomal examination revealed a normal male karyotype. Abdominal ultrasound showed normal organs, and scrotal ultrasound showed an undescended right testicle (UDT) and small testes. Brain MRI revealed pituitary gland hypoplasia and olfactory bulb agenesis. These findings are characteristic of KS. He underwent orchidopexy dextra. He is now on a regular follow-up. Hormone replacement therapy is planned. Thus, besides medical treatments, psychological care is an integral component of the treatment strategy for this patient.

Drug-Coated Balloon Versus Drug-Eluting Stent in Patients With Femoropopliteal Artery Disease: A Systematic Review and Meta-Analysis.

OBJECTIVE: In this systematic review and meta-analysis, we aimed to compare drug-coated balloon (DCB) to drug-eluting stent (DES) in patients with femoropopliteal lesions in terms of restenosis, target lesion revascularization (TLR), and mortality. METHODS: A comprehensive literature search was performed through PubMed, Scopus, and Embase databases. The intervention group was patients receiving percutaneous balloon angioplasty using the DCB. The control group was patients receiving percutaneous intervention using the DES. The primary outcome was restenosis, and the secondary outcomes were TLR and mortality. RESULTS: There were 4 studies comprising 812 patients (906 lesions) included in this systematic review and meta-analysis. The rate of restenosis was .19 [.13, .26] in DCB and .24 [.20, .28] in DES. There was a trend toward lower rate of restenosis (OR .73 [.52, 1.03], P = .074; I2: 46.3%) for DCB use compared to DES use. The rate of TLR was .11 [.08, .14] in DCB and .17 [.14, .21] in DES. TLR was lower (OR .61 [.41, .92], P = .017; I2: 1.2%) in the DCB group compared to the DES group. There were no significant differences in mortality (OR 1.38 [.78, 2.44], P = .268; I2: 0%) among the two groups. Meta-regression analysis showed that the rate of restenosis in DCB in this pooled analysis was affected by sex (reference: male, coefficient -.004, P = .009), smoking (coefficient: .003, P = .010), and total occlusion (coefficient: .008, P = .004). CONCLUSION: DCB use in patients with femoropopliteal lesion was associated with similar rate of restenosis, lower TLR, and similar mortality rate compared to DES use.

Third Ventricular Floor Bowing Indicates Surgical Success in Patients Undergoing Endoscopic Third Ventriculostomy-Systematic Review and Meta-Analysis.

OBJECTIVE: This meta-analysis aimed to evaluate the prognostic performance of third ventricular floor bowing (TVFB) as a marker for surgical success in patients undergoing endoscopic third ventriculostomy (ETV). METHODS: We performed a comprehensive literature search for studies comparing ETV success in patients with TVFB compared with those without using PubMed, SCOPUS, Embase, and EuropePMC. TVFB was defined as inferior bowing or bulging deformation or convex third ventricular floor. Surgical success was defined as resolution of symptoms post surgery and requires no further intervention for hydrocephalus. The outcome was surgical success in patients with TVFB compared with those without TVFB. The effect estimate was reported as odds ratio (OR). RESULTS: Five studies comprising 439 patients were included in this meta-analysis. The prevalence of overall surgical success was 42%. The prevalence of surgical success was 85% in patients with TVFB. TVFB was associated with increased success rates (OR 5.94 [95% confidence interval 3.07, 11.5], P < 0.001; I2: 26.04%, P = 0.248). TVFB was associated with sensitivity 0.83, specificity 0.54, positive likelihood ratio 1.8, negative likelihood ratio 0.32, diagnostic OR 6, and area under curve 0.81 (0.77-0.84) for surgical success. Presence of TVFB confers to a 56% rate of surgical success, and no TVFB confers to a rate of 19% surgical success. The association between TVFB and surgical success was not affected by age (coefficient: -0.03, P = 0.474) and aqueductal stenosis (P = -0.05, P = 0.237). CONCLUSIONS: This meta-analysis showed that the presence of TVFB was associated with increased ETV success.