Non-traumatic Thoracic Aortic Dissection in a Healthy Patient.

Aortic dissection (AD) is a serious condition, which typically affects men more than women. Strongly established risk factors include uncontrolled hypertension, connective tissue disorders, advanced age, cocaine use, and aortic injury. We believe it's important to report this case due to the occurrence of Stanford type A AD in a healthy 40-year-old male devoid of genetic, medical, family, and environmental risk factors. This patient presented with a tearing anterior chest pain radiating to the back and was promptly diagnosed and managed with surgical replacement and grafting of the diseased aorta and its involved branches. Therefore, it is imperative to include AD as a differential in atypical case scenarios and case presentations, as missed and delayed diagnosis and management would worsen the clinical outcomes.

Meniscus Tear: Pathology, Incidence, and Management.

Meniscus tears are a common orthopedic pathology and planning a single, effective treatment is challenging. The diagnosis of meniscal tears requires detailed history-taking, physical examinations, special diagnostic tests, and most likely magnetic resonance imaging (MRI) to confirm the lesion. A good understanding of the meniscal structure including vascularity, zones, function, and affected movements with associated symptoms plays a crucial role in establishing an optimal management plan. A careful assessment of the patient's characteristics, comorbidities, post-repair rehabilitation, and patient's overall function and satisfaction are also important for ideal management. While conservative management is commonly implemented and the only option for certain patients, partial meniscectomy remains to be the most performed treatment procedure. However, partial meniscectomy is no longer the first-line therapy due to the limitation of certain patient characteristics and side effects in the long run. Instead, meniscal repair has been shown to have better long-term outcomes and is therefore recommended for all tears, especially for young patients with acute traumatic lesions. Tissue engineering has been of high interest in the current research with promising therapeutic results. This review critically evaluates and compares the management of meniscal tears with surgical versus comprehensive management using the current literature.

Lupus Cerebritis as a Rare Neuropsychiatric Manifestation of Systemic Lupus Erythematosus.

Mixed connective tissue disease (MCTD) is a rare autoimmune condition that shows an overlap of at least two connective tissue diseases (CTD) including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma, Sjögren's syndrome, polymyositis, or dermatomyositis. From a laboratory standpoint, MCTD is associated with high titers of anti-U1-RNP antibodies, which makes it difficult to determine whether it is a variant of each of the respective CTDs or a different entity altogether. Our objective is to report the case of a patient with MCTD presenting with status epilepticus who was ultimately diagnosed with lupus cerebritis. The case also highlights the development of complications unrelated to MCTD that made the management even more challenging. Overall, the authors emphasize the rareness of lupus cerebritis as a presentation, the diagnostic challenges faced due to the lack of classical manifestations of SLE, and how the complicated clinical course makes a downhill prognosis more likely.