Bilateral osteochondral defects of the patellae in an 11-year-old girl

Osteochondral defect or osteochondritis dissecans (OCD) of the knee usually affects young, active populations. It is a challenging diagnosis as patients typically present with poorly localised activity-related pain, which is non-specific and covers many differentials. We present an active 11-year-old girl with bilateral osteochondral defects of the patellae: a rare clinical disorder which was affecting her sporting activities. She had a 12-month history of bilateral anterior knee pain before the diagnosis was achieved with appropriate imaging. Her pain significantly improved with activity modification and physiotherapy. Follow-up will require outpatient clinic assessment and imaging to determine if non-operative management continues to be successful or surgery may be required. This case report emphasises the importance of appropriate high index of suspicion when managing patients with non-specific knee pain. It also demonstrates the importance of judicious use of imaging to avoid a missed or delayed diagnosis

Leiomyosarcoma of inferior vena cava and right atrium with Ascites and Jaundice: A case report

Leiomyosarcoma is one of the soft tissue sarcomas that could originate from different parts of body and are mostly presented as retropritoneal mass. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in inferior vena cava (IVC). Here, we report the case of a 35-year-old male patient who presented with ascites and jaundice. Further evaluation revealed large hepatic and cardiac masses with extension to IVC. Since it was not possible to determine the point of origin of leiomyosarcoma, the patient received chemotherapy under diagnosis of metastatic leiomyosarcoma but unfortunately passed away. © 2016, Tehran University of Medical Sciences (TUMS). All rights reserved

Complete improvement in a patient with multiple irreversible defects of the left ventricle on 99m technetium-sestamibi SPECT after percutaneous coronary intervention.

99mTc-sestamibi has been investigated as a potential viability marker; initial studies have shown good concordance between 201Tl and 99mTc-sestamibi activities in both viable and nonviable myocardium. However, assessment of myocardial viability by 99mTc-sestamibi remains controversial for tissue recovery after revascularization. Here, we present a patient with several regions of severely diminished and irreversible (defect persisting in both early and delay images of each set scanning) defects on initial scan which were dissolved completely on the follow up scan after an intervention. In a 75 year-old Asian woman with acute myocardial infarction who received thrombolytic therapy and subjected to percutaneous coronary angiography (PCI) on day 28 after acute myocardial infarction(MI), resting 99mTc-sestamibi SPECT was applied on day 4 (initial scan) and 138 (follow up scan) after acute MI at 30 and 180 min after injection of tracer (740 MBq); Two-dimensional echocardiography was carried out at the same time. On the initial image set, there was irreversible defects in the apex, anteroapical, inferoapical, anteroseptal, septal and also anterior walls, while the follow up image was normal in all regions.The angiography intervention showed just significant stenosis on left anterior descending (LAD) vessel (95). This may highlight the failure of 99mTc-sestamibi as a marker of myocardial viability and also mandate further validating of the procedure with follow up scan or other modalities for myocardial viability investigation

A rare manifestation of extrapulmonary tuberculosis: Left ventricular cardiac tuberculoma in an HIV infected male �case report�

Cardiac tuberculosis (TB) is rare and most commonly manifests itself as tuberculous pericarditis. Involvement of other parts of the heart is unusual and descriptions in the literature are confined to case reports regarding mainly pericardial TB and very few cases of cardiac tuberculoma. Tuberculomas are space occupying lesions most commonly found in the brain of immunocompromised individuals. These space occupying lesions previously described only after autopsies are now more diagnosed with the use of advanced imaging techniques. Herein, we describe a first case of pericardial TB manifesting as left ventricular (LV) cardiac tuberculoma in a 34-year-old human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infected male. Upon presentation the patient complained mainly of progressive dyspnoea over the past month. Primary investigations including chest computed tomography (CT) scan and transthoracic echocardiography (TTE) suggested probable diagnosis of cardiac and pericardial TB which was later confirmed by histopathological modalities. The patient received anti-TB therapy along with surgical subtotal pericardiotomy which resulted in improvement of symptoms, complete resolution of the mass and reduction in the size of pericardial thickening. Although very rare it is crucial to bear in mind the importance of having cardiac tuberculoma as differential diagnosis in patients with a cardiac mass and implement the optimum diagnostic and therapeutic courses. doi: 10.21037/cdt-20-44

Giant congenital left ventricular diverticulum associated with infective endocarditis: A diagnosis made by tissue Doppler echocardiography

Left ventricular (LV) diverticulum is a relatively rare condition, and it is important to differentiate it from pseudoaneurysm. The increasing use of noninvasive imaging modalities can help to demonstrate different types of ventricular outpouching structures. We report a case of congenital LV diverticulum that is much larger than the usual size and is diagnosed with tissue Doppler echocardiography and cardiac magnetic resonance imaging. Although a ventricular diverticulum is mostly asymptomatic, in the case of this particular patient, it has become complicated with infective endocarditis. © 2016 Japanese College of Cardiolog

Bird species involved in west nile virus epidemiological cycle in southern Québec

Despite many studies on West Nile Virus (WNV) in the US, including the reservoir role of bird species and the summer shifts of the Culex mosquito, feeding from birds to mammals, there have been few equivalent studies in the neighboring regions of Canada where WNV is endemic. Here, a priority list of bird species likely involved in WNV transmission in the greater Montréal area is constructed by combining three sources of data: (i) from WNV surveillance in wild birds (2002–2015); (ii) blood meal analysis of Culex pipiens–restuans (CPR), the primary enzootic vectors of WNV in the region, collected from surveillance in 2008 and 2014; (iii) literature review on the sero-prevalence/host competence of resident birds. Each of these data sources yielded 18, 23 and 53 species, and overall, 67 different bird species were identified as potential WNV amplifiers/reservoirs. Of those identified from CPR blood meals, Common starlings, American robins, Song sparrows and House sparrows ranked the highest and blood meal analysis demonstrated a seasonal shift in feed preference from birds to mammals by CPR. Our study indicates that there are broad similarities in the ecology of WNV between our region and the northeastern US, although the relative importance of bird species varies somewhat between regions

Guided random walk calculation of energies and <\sq {r^2} > values of the 1Σg^1\Sigma_g state of H_2 in a magnetic field

Energies and spatial observables for the $^1\Sigma_g$ state of the hydrogen molecule in magnetic fields parallel to the proton-proton axis are calculated with a guided random walk Feynman-Kac algorithm. We demonstrate that the accuracy of the results and the simplicity of the method may prove it a viable alternative to large basis set expansions for small molecules in applied fields.Comment: 10 pages, no figure