The American journal of the medical sciences
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Although neurocysticercosis is pleomorphic in its presentation, neurocysticercosis of the pituitary gland and hypothalamus is so uncommon that less than 10 cases have been reported in the literature. Hypopituitarism as a complication of neurocysticercosis is exceedingly rare with only 2 cases described in the literature. ⋯ Clinical experience with management of these cases is lacking, and there are no studies confirming the efficacy of cysticidal drugs in intrasellar or suprasellar cysts. Because most of single enhancing cystic lesions may disappear spontaneously and risk may outweigh the benefit of treatment, conservative management may be indicated in these cases.
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Psoriasis is associated with an increased risk of cardiovascular disease, a principal cause of which is atherosclerosis caused by hyperlipidemia. However, it is not known whether treatment of hyperlipidemia in patients with psoriasis lead to clinical improvement in psoriasis condition. In this study, the authors summarize the existing literature relevant to this inquiry. ⋯ Others indicated a decreased risk of psoriasis associated with intake of cholesterol-lowering drugs such as "statins." Treatment with statins increased lactate dehydrogenase level and diminished Psoriasis Area and Severity Index score, ie, reduced cutaneous lesion in psoriasis. Beneficial effects of statin therapy on psoriasis included downregulation of lymphocyte function-associated antigen-1, inhibition of leukocyte endothelial adhesion, extravasation and natural killer cell activity, inhibition of proinflammatory cytokines such as tumor necrosis factor-alpha and interleukin 1 and 6, lowering of C-reactive protein, promotion of a T(H)1 to T(H)2 cells and inhibition of T(H)1 cytokine receptors on T cells, leading to inhibition of activation of lymphocytes and infiltration into the inflammation sites. Taken together, current literature indicates clinical improvement in psoriasis condition with treatment of associated hyperlipidemia, particularly with statins of which the mechanisms could be attributed to immunomodulatory and anti-inflammatory effects.
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Review Case Reports
Prognostically important molecular markers in cytogenetically normal acute myeloid leukemia.
Cytogenetically normal acute myeloid leukemia (CN-AML) is a heterogeneous disease with variable clinical outcomes. Emerging data has identified molecular markers that provide additional prognostic information to better classify these patients into those with a more favorable prognosis and those with an unfavorable prognosis who may require more aggressive or investigational therapies. ⋯ In this article, the authors discuss the classical clinical features of AML and the importance of cytogenetics that predict prognosis in AML. They review the best-described molecular markers in CN-AML and their significance to clinical decision making in CN-AML.
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Diaphragmatic hernias caused or exacerbated by colonoscopy are rare with only few cases reported. The author reports here an unusual case of herniation and incarceration of the colon into the left thoracic cavity without bowel perforation after an uneventful screening colonoscopy, through an occult focal diaphragmatic weakness from the patient's prior trauma.