Gastric Sarcoidosis: A Difficult to Diagnose Rare Disease

Abstract Gastrointestinal sarcoidosis is a rare clinical entity. Diagnosis of isolated gastric sarcoidosis is difficult as it is usually asymptomatic; when symptomatic it presents with non-specific symptoms such as abdominal pain, nausea and vomiting. We here present a case of a 32-year-old black lady who presented with non-specific abdominal complaints; a diagnosis gastric sarcoidosis was established following endoscopic biopsy. Here symptoms resolved promptly with steroidal therapy as with most cases. Gastric sarcoidosis should be suspected in sarcoid patients who present with nonspecific abdominal complaints. This case serves as an important clinical reminder of the atypical manifestations of sarcoidosis

Pickering Syndrome precipitated by Angiotensin Converting Enzyme Inhibitor

Abstract Pickering syndrome is an under recognised cardio-renal syndrome where life threatening flash pulmonary edema develops in the setting of diastolic dysfunction of the heart. Renal artery stenosis induced activation of sympathetic nervous system and renin-angiotensin-aldosterone system result in fluid retention; such fluid retention in the setting of diastolic dysfunction results in flash pulmonary edema. Most patients who present with pickering syndrome have normal coronary circulation and left ventricular systolic function. We here present a case of pickering syndrome that was precipitated by initiation of angiotensin converting enzyme inhibitor therapy in a patient with undiagnosed unilateral renal artery stenosis. The incidence of flash pulmonary edema decreases on revascularization of renal artery stenosis. Underlying renal artery stenosis should be suspected in a patient with recurrent flash pulmonary edema as such patients merit from revascularization of renal artery stenosis. To the best of our knowledge we are the first to report angiotensin converting enzyme inhibitors as a precipitator of pickering syndrome

Severe Myopericarditis in Diabetic Ketoacidosis—All Troponin are Not Myocardial Infarction

Uncontrolled diabetes and acute coronary syndrome share a complex dynamic that results in significant ambiguity when interpreting biomarker elevations in this setting. This is concerning because myocardial infarction has been shown to be the most common cause of death in the first 24 hours of admission for uncontrolled diabetes. Literature shows that elevation in cardiac biomarkers in patients with uncontrolled diabetes could be from viral myopericarditis, although a clear clinical significance is still lacking. 1 It is, however, clear that elevation in cardiac biomarkers portends a poor long-term prognosis in patients with uncontrolled diabetes mellitus. We present a rare case of myopericarditis in a middle-aged patient with uncontrolled diabetes. The patient had elevated troponin I level reaching a peak of 7.3 ng/mL with associated ST elevations on electrocardiography. Coronary angiogram was subsequently done revealing clean coronaries. To our knowledge, this is the first description of myopericarditis in uncontrolled diabetes without a known cause

Analysis of biased language in peer-reviewed scientific literature on genetically modified crops

Social, political, and economic forces may inadvertently influence the stance of scientific literature. Scientists strive for neutral language, but this may be challenging for controversial topics like genetically modified (GM) crops. We classified peer-reviewed journal articles and found that 40% had a positive or negative stance towards GM crops. Proportion of positive and negative stance varied with publication date, authors' country of origin, funding source, and type of genetic modification. Articles with a negative stance were more common at the beginning of the millennium. Authors from China had the highest positive:negative ratio (8:1), followed by authors from the USA (12:5) and the EU (5:7). Positive stance articles were six times more likely to be funded by private sources compared to those with a neutral or negative stance. Articles about glyphosate were more likely to be negative compared to articles about Bacillus thuringiensis. Linguistic features of articles with positive and negative stances were used to train a random forest classifier that predicts stance significantly better than random chance. This suggests the possibility of an automated tool to screen manuscripts for unintended biased language prior to publication