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Article: Disseminated

Douedi, Steven / Dattadeen, Jaraad / Akoluk, Arda / Liu, Edward

2020 Volume 20, Page(s) e00763

Abstract: Disseminated gonococcal infection (DGI) is seen in about 0.5-3% of patients ... ...

Abstract	Disseminated gonococcal infection (DGI) is seen in about 0.5-3% of patients with
Language	English
Publishing date	2020-04-23
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2745454-X
ISSN	2214-2509
ISSN	2214-2509
DOI	10.1016/j.idcr.2020.e00763
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Gardnerella vaginalis

Alfraji, Nasam / Douedi, Steven / Akoluk, Arda / Dattadeen, Jaraad / Fune, Lito / Liu, Edward

IDCases

2020 Volume 21, Page(s) e00807

Abstract: Gardnerella ... ...

Abstract	Gardnerella vaginalis
Language	English
Publishing date	2020-05-11
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2745454-X
ISSN	2214-2509
ISSN	2214-2509
DOI	10.1016/j.idcr.2020.e00807
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Article: Catastrophic Thromboembolic Syndrome During the COVID-19 Pandemic.

Udongwo, Ndausung / Albayati, Asseel / Akoluk, Arda / Woodford, Amanda / Iglesias, Jose / Singh, Deepak

Cureus

2021 Volume 13, Issue 8, Page(s) e16854

Abstract: Since March 2020, the SARS-CoV-2 virus known to cause COVID-19 has presented in many ways and it seems to affect almost all organ systems. One of its detrimental effects is on the coagulation system. Disruption of the coagulation pathway or ... ...

Abstract	Since March 2020, the SARS-CoV-2 virus known to cause COVID-19 has presented in many ways and it seems to affect almost all organ systems. One of its detrimental effects is on the coagulation system. Disruption of the coagulation pathway or hypercoagulability has been reported extensively in many articles and studies. It seems there is no specific pattern or location of the coagulopathy. The coagulopathy can present as part of the respiratory disease process or as an isolated phenomenon. Many articles had reported that the thrombus can be a venous thromboembolic phenomenon such as deep venous thrombosis (DVT), portal vein thrombosis, pulmonary embolism (PE), or as arterial thrombosis, for instance, coronary artery thrombosis, cerebrovascular thromboembolic disease (i.e., stroke), or an aortic thrombus. One of the disastrous presentations is what is called "catastrophic thrombosis syndrome." This syndrome is characterized by multiple thromboses that take place in different parts of the vascular system at different parts of the body at the same time. In many studies, D-dimer levels have been shown to predict the risk of increased thromboembolism in SARS-CoV-2. However, an appropriate anticoagulation agent, dosage, and duration are yet to be determined. We are presenting an interesting case of a female who suffered catastrophic thrombosis syndrome despite being on prophylactic anticoagulation. She presented with leg pain and was found to have extensive multiple thrombi starting from the ascending/descending aorta and extending to the distal peroneal arteries.
Language	English
Publishing date	2021-08-03
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.16854
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Article: Streptococcus anginosus

Patel, Ishan / Douedi, Steven / Makadia, Shraddhadevi / Upadhyaya, Vandan / Akoluk, Arda / Douedi, Jennifer / Hossain, Mohammad / Liu, Edward

Journal of medical cases

2020 Volume 11, Issue 9, Page(s) 289–291

Abstract: Streptococcus ... ...

Abstract	Streptococcus anginosus
Language	English
Publishing date	2020-08-06
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2586383-6
ISSN	1923-4163 ; 1923-4155
ISSN (online)	1923-4163
ISSN	1923-4155
DOI	10.14740/jmc3547
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Article: Life-Threatening Psoas Hematoma due to Retroperitoneal Hemorrhage in a COVID-19 Patient on Enoxaparin Treated With Arterial Embolization: A Case Report.

Patel, Ishan / Akoluk, Arda / Douedi, Steven / Upadhyaya, Vandan / Mazahir, Usman / Costanzo, Eric / Flynn, Daniel

Journal of clinical medicine research

2020 Volume 12, Issue 7, Page(s) 458–461

Abstract: Respiratory failure is presumptively caused by microvascular thrombosis in some patients with coronavirus disease 2019 (COVID-19) requiring therapeutic anticoagulation. Anticoagulation treatment may cause life-threatening bleeding complications such as ... ...

Abstract	Respiratory failure is presumptively caused by microvascular thrombosis in some patients with coronavirus disease 2019 (COVID-19) requiring therapeutic anticoagulation. Anticoagulation treatment may cause life-threatening bleeding complications such as retroperitoneal hemorrhage. To the best of our knowledge, we report first case of a COVID-19 patient treated with therapeutic anticoagulation resulting in psoas hematoma due to lumbar artery bleeding. A 69-year-old patient presented with fever, malaise and progressive shortness of breath to our hospital. He was diagnosed with COVID-19 by RT-PCR. Due to an abnormal coagulation profile, the patient was started on enoxaparin. Over the course of hospitalization, the patient was found to have hypotension with worsening hemoglobin levels. Computed tomography scan of the abdomen and pelvis revealed a large psoas hematoma. Arteriogram revealed lumbar artery bleeding which was treated with embolization. Anticoagulation therapy, while indicated in COVID-19 patients, has its own challenges and guidelines describing dosages and indications in this disease are lacking. Rare bleeding complications such as psoas hematoma should be kept in mind in patients who become hemodynamically unstable, warranting prompt imaging for diagnosis and treatment with arterial embolization, thus eliminating need of surgical intervention.
Keywords	covid19
Language	English
Publishing date	2020-06-25
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2548987-2
ISSN	1918-3011 ; 1918-3003
ISSN (online)	1918-3011
ISSN	1918-3003
DOI	10.14740/jocmr4256
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Article ; Online: Sentinel Lymph Node Sampling in Robot-Assisted Staging of Endometrial Cancer.

Curcio, Erin / Miller, Briana / Giglio, Alexandra / Akoluk, Arda / Erler, Brian / Bosscher, James / Borowsky, Mark / Hicks, Verda / ElSahwi, Karim

Southern medical journal

2021 Volume 114, Issue 11, Page(s) 680–685

Abstract: Objective: Sentinel lymph node (SLN) sampling in endometrial cancer staging has become an acceptable standard. Indocyanine green dye injected into the cervix and detected by near-infrared light is technically simple and sensitive. We aimed to evaluate ... ...

Abstract	Objective: Sentinel lymph node (SLN) sampling in endometrial cancer staging has become an acceptable standard. Indocyanine green dye injected into the cervix and detected by near-infrared light is technically simple and sensitive. We aimed to evaluate SLN sampling in robot-assisted surgical staging of endometrial cancer at a university-affiliated teaching hospital. Methods: A retrospective chart review, from January 2016 to December 2017, of patients who underwent robot-assisted surgical staging with cervical injection of indocyanine green dye detected by near-infrared light. The map rate, sensitivity, false negatives, and negative predictive value were calculated. Results: A total of 105 charts were reviewed; 79 patients met inclusion criteria. The mean age was 65 (range 38-93) and the mean body mass index was 33.3 (range 16-49). Most patients (72.2%) had stage I disease and grade 1 or 2 histology (77.1%). Eight (10.1%) patients had lymph node metastasis. Seventy-two (91.1%) patients had positive mapping to at least 1 SLN. Sixty-two (78.5%) patients had bilateral mapping. Forty-four patients had concurrent pelvic ± para-aortic lymph node dissection and were included in the sensitivity analysis. Five of 44 cases had LN metastasis. The sensitivity was 80%, and the negative predictive value of SLN sampling was 97.5%. Conclusions: SLN mapping and sampling at a university-affiliated teaching hospital have comparable map rate, sensitivity, and negative predictive value as demonstrated in multiple trials. The technique has the potential to standardize endometrial cancer staging across different practice settings.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/pathology ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Robotic Surgical Procedures/statistics & numerical data ; Sentinel Lymph Node Biopsy/methods ; Sentinel Lymph Node Biopsy/statistics & numerical data
Language	English
Publishing date	2021-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000001319
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Article: Recurrence of Paget-Schroetter Syndrome: A Rare Case Report and Review of Literature.

Akoluk, Arda / Douedi, Steven / Dattadeen, Jaraad / Patel, Ishan / Mushtaq, Arman / Levitt, Michael / Asif, Arif / Hossain, Mohammad

Journal of medical cases

2020 Volume 11, Issue 1, Page(s) 22–25

Abstract: Paget-Schroetter syndrome (PSS) is a primary upper extremity deep vein thrombosis (DVT) that occurs with no significant risk factors, mostly in a young and healthy patient. Treatment of this disease is discussed heavily in the literature and the optimal ... ...

Abstract	Paget-Schroetter syndrome (PSS) is a primary upper extremity deep vein thrombosis (DVT) that occurs with no significant risk factors, mostly in a young and healthy patient. Treatment of this disease is discussed heavily in the literature and the optimal treatment method is still being debated. Here, we present a patient with PSS treated with balloon angioplasty, thrombolysis and treatment with an oral thrombin inhibitor (apixaban) who developed recurrence of PSS. A 38-year-old white male with no past medical history, presented to an urgent care center with sudden onset axillary pain and an axillary lump that was treated with outpatient antibiotics. Extensive deep venous thrombosis was diagnosed with computed tomography (CT) and ultrasound. He underwent percutaneous pharmacomechanical thrombectomy. Postprocedural angiogram showed significant improvement in the caliber of the axillary and subclavian veins where they crossed the first rib. He was discharged on apixaban and underwent removal of his first rib 1 month later. He returned 3 weeks later with recurrence of right arm pain and swelling. Repeat ultrasound showed thrombus in the right arm and venogram confirmed 80% stenosis at the subclavian vein as it enters the innominate vein. He was again treated with placement of a thrombolytic catheter and overnight thrombolysis of the central venous circulation on the right-side upper extremity balloon angioplasty of the subclavian vein, axillary vein, and basilic vein. He is disease-free for 6 months. Recurrence of PSS after surgical removal of rib, thrombectomy, thrombolysis while using apixaban is very rare. This is the first case to our knowledge presented with recurrent PSS treated with apixaban, early rib resection, balloon angioplasty and thrombectomy.
Language	English
Publishing date	2020-01-31
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2586383-6
ISSN	1923-4163 ; 1923-4155
ISSN (online)	1923-4163
ISSN	1923-4155
DOI	10.14740/jmc3416
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Article ; Online: "Do Not Ignore Musculoskeletal Pain"-Initial Presentation of a Rare Malignant Disease: Case Report and Literature Review.

Patel, Ishan / Akoluk, Arda / Upadhyaya, Vandan / Makadia, Shraddhadevi / Douedi, Steven / Farooq, Taliya / Flynn, Daniel / Levitt, Michael / Hossain, Mohammad A

Journal of investigative medicine high impact case reports

2020 Volume 8, Page(s) 2324709620941316

Abstract: Gray zone lymphoma, also known as B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, is a rare malignancy with overlapping features of both diffuse large B-cell lymphoma and ... ...

Abstract	Gray zone lymphoma, also known as B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, is a rare malignancy with overlapping features of both diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Most commonly mediastinal involvement is seen. Extranodal involvement is rare. In this case report, we present the case of a 59-year-old male who presented with stress-related left shoulder pain, ultimately diagnosed with gray zone lymphoma. The patient was treated with etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin-rituximab (EPOCH-R) regimen followed by consolidation radiotherapy resulting in complete response. We are highlighting this case as rare and atypical presentation of a rare disease.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Cyclophosphamide/administration & dosage ; Doxorubicin/administration & dosage ; Etoposide/administration & dosage ; Hodgkin Disease/diagnosis ; Hodgkin Disease/pathology ; Hodgkin Disease/therapy ; Humans ; Lymphoma, Large B-Cell, Diffuse/diagnosis ; Lymphoma, Large B-Cell, Diffuse/pathology ; Lymphoma, Large B-Cell, Diffuse/therapy ; Male ; Middle Aged ; Prednisone/administration & dosage ; Radiotherapy ; Rare Diseases ; Remission Induction ; Rituximab/administration & dosage ; Shoulder Pain/etiology ; Vincristine/administration & dosage
Chemical Substances	Rituximab (4F4X42SYQ6) ; Vincristine (5J49Q6B70F) ; Etoposide (6PLQ3CP4P3) ; Doxorubicin (80168379AG) ; Cyclophosphamide (8N3DW7272P) ; Prednisone (VB0R961HZT)
Language	English
Publishing date	2020-07-30
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/2324709620941316
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Article ; Online: Prevalence of abnormalities in electrocardiogram conduction in dialysis patients: a comparative study.

Ajam, Firas / Akoluk, Arda / Alrefaee, Anas / Campbell, Natasha / Masud, Avais / Mehandru, Sushil / Patel, Mayukumar / Asif, Arif / Carson, Michael P

Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia

2020 Volume 42, Issue 4, Page(s) 448–453

Abstract: Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data ... ...

Abstract	Background: The electrocardiogram (ECG) can aid in identification of chronic kidney disease (CKD) patients at high risk for cardiovascular diseases. Cohort studies describe ECG abnormalities in patients on hemodialysis (HD), but we did not find data comparing ECG abnormalities among patients with normal kidney function or peritoneal dialysis (PD) to those on hemodialysis. We hypothesized that ECG conduction abnormalities would be more common, and cardiac conduction interval times longer, among patients on hemodialysis vs. those on peritoneal dialysis and CKD 1 or 2. Methods: Retrospective review of adult inpatients' charts, comparing those with billing codes for "Hemodialysis" vs. inpatients without those charges, and an outpatient peritoneal dialysis cohort. Patients with CKD 3 or 4 were excluded. Results: One hundred and sixty-seven charts were reviewed. ECG conduction intervals were consistently and statistically longer among hemodialysis patients (n=88) vs. peritoneal dialysis (n=22) and CKD stage 1 and 2 (n=57): PR (175±35 vs 160±44 vs 157±22 msec) (p=0.009), QRS (115±32 vs. 111±31 vs 91±18 msec) (p=0.001), QT (411±71 vs. 403±46 vs 374±55 msec) (p=0.006), QTc (487±49 vs. 464±38 vs 452±52 msec) (p=0.0001). The only significantly different conduction abnormality was prevalence of left bundle branch block: 13.6% among HD patients, 5% in PD, and 2% in CKD 1 and 2 (p=0.03). Conclusion: To our knowledge, this is the first study to report that ECG conduction intervals are significantly longer as one progresses from CKD Stage 1 and 2, to PD, to HD. These and other data support the need for future research to utilize ECG conduction times to identify dialysis patients who could potentially benefit from proactive cardiac evaluations and risk reduction.
MeSH term(s)	Electrocardiography ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Prevalence ; Renal Dialysis ; Retrospective Studies
Language	Portuguese
Publishing date	2020-07-27
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2057873-8
ISSN	2175-8239 ; 2175-8239
ISSN (online)	2175-8239
ISSN	2175-8239
DOI	10.1590/2175-8239-JBN-2020-0018
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Article: Coincidence of follicular lymphoma and hurtle cell thyroid carcinoma in a patient at presentation: which one is the source of bone metastasis? Case report and review of the literature.

Ozkan, Hasan Atilla / Akoluk, Arda / Ozler, Turhan / Ekici, Isin Dogan / Selcuk, Nalan Alan

Clinical case reports

2017 Volume 5, Issue 6, Page(s) 801–804

Abstract: Thyroid incidentaloma is defined as a new identified thyroid lesion occasionally detected during imaging studies. Incidence of thyroid incidentalomas is relatively rare in patients with lymphoma. Because of high rate of malignancy, these lesions with ... ...

Abstract	Thyroid incidentaloma is defined as a new identified thyroid lesion occasionally detected during imaging studies. Incidence of thyroid incidentalomas is relatively rare in patients with lymphoma. Because of high rate of malignancy, these lesions with high intensity focal
Language	English
Publishing date	2017-04-12
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.942
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