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Article: Ominous Sign of Pneumatosis Intestinalis With Portal Venous Gas.

Miller, Brett / Taj, Sobaan / Pannu, Viraaj S / Tavakolian, Kameron / Joseph, Liz / Hossain, Mohammad A

2023 Volume 15, Issue 2, Page(s) e35605

Abstract: The presence of gas and free air in the extraluminal space of the intestines is known as pneumatosis intestinalis (PI). There are many different causes of this finding, including gastrointestinal, pulmonary, autoimmune, and many more. It is often ... ...

Abstract	The presence of gas and free air in the extraluminal space of the intestines is known as pneumatosis intestinalis (PI). There are many different causes of this finding, including gastrointestinal, pulmonary, autoimmune, and many more. It is often difficult to differentiate the etiology and clinical importance of the radiographic evidence on pneumatosis intestinalis due to the unclear pathophysiology causing the disease. To complicate things further, the ominous sign of portal venous gas poses the question of whether surgical intervention is needed. We report two cases both with clinical and radiographic evidence of secondary pneumatosis intestinalis with an associated sinister finding of portal venous gas. The cases differ by urgent surgical intervention versus observation before surgery. In this case series, we emphasize the importance of recognizing the radiographic finding and stress the need for further research to standardize a plan of care, including indications for surgery. We encourage more cases like this to be reported to aid in diagnosing and treating this condition early on with the aim of improving the mortality associated with it.
Language	English
Publishing date	2023-02-28
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.35605
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Cardiac Sarcoidosis: A Unique Presentation.

Odak, Mihir / Tavakolian, Kameron / Douedi, Steven / Udongwo, Ndausung / Elkherpitawy, Islam / Douedi, Hani / Campbell, Natasha

Cureus

2022 Volume 14, Issue 7, Page(s) e27295

Abstract: Isolated cardiac sarcoidosis is a rare subset of sarcoidosis, a systemic autoimmune condition primarily found in African American females. The manifestations of cardiac sarcoidosis include atrioventricular and bundle branch blocks, arrhythmias, heart ... ...

Abstract	Isolated cardiac sarcoidosis is a rare subset of sarcoidosis, a systemic autoimmune condition primarily found in African American females. The manifestations of cardiac sarcoidosis include atrioventricular and bundle branch blocks, arrhythmias, heart failure, and pericardial effusions, although these complications occur at varying prevalence. The diagnosis of cardiac sarcoidosis requires several different criteria; however, recent literature has focused heavily on imaging modalities such as cardiac magnetic resonance imaging. We present a case of a 42-year-old Caucasian male who was found to have unexplained cardiac arrhythmias and ultimately diagnosed with cardiac sarcoidosis by imaging modalities.
Language	English
Publishing date	2022-07-26
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.27295
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A Rare Case of Superior Vena Cava Syndrome in a Patient With Rheumatoid Arthritis and IgA Nephropathy.

Moore, Colton M / Loichle, Autumn / Tavakolian, Kameron / Odak, Mihir / Nightingale, Savannah / Patel, Swapnil V

Cureus

2022 Volume 14, Issue 8, Page(s) e28198

Abstract: Superior vena cava syndrome (SVCS) is a vascular condition resulting from an impaired venous return to the right atrium. The majority of SVCS cases are caused by mass effect in which extrinsic compression of the vessel leads to obstruction of blood flow. ...

Abstract	Superior vena cava syndrome (SVCS) is a vascular condition resulting from an impaired venous return to the right atrium. The majority of SVCS cases are caused by mass effect in which extrinsic compression of the vessel leads to obstruction of blood flow. In less common cases of SVCS, thrombus formation and luminal narrowing can result in poor return through the SVC. Inflammatory causes of SVCS are even rarer and poorly documented. IgA nephropathy and rheumatoid arthritis (RA) are two autoimmune diseases with the potential to cause vasculitis, thus increasing the likelihood of intraluminal vessel occlusion. We report a rare case of SVCS in a 65-year-old female with a past medical history significant for atrial fibrillation, IgA nephropathy, chronic kidney disease stage IIIA, and RA who presented with headache, dizziness, and neck pain and swelling extending down the left upper extremity for three days. Inflammatory SVCS is uncommon and cases of SVCS secondary to RA and IgA nephropathy are underreported in the literature thus far. Our hope in presenting this case is to encourage a greater degree of suspicion for vascular complications, such as SVCS, in patients with autoimmune and inflammatory conditions.
Language	English
Publishing date	2022-08-20
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.28198
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Methotrexate Failure in the Treatment of Adult-Onset Still's Disease: A Case Report.

Tavakolian, Kameron / Odak, Mihir / Douedi, Steven / Pannu, Viraaj / Patel, Swapnil V

Cureus

2022 Volume 14, Issue 7, Page(s) e27283

Abstract: Adult-onset Still's disease (AOSD) is a rheumatological condition associated with significant morbidity and mortality. Typically a diagnosis of exclusion, the therapeutic management has relied mainly on symptom control and immune suppression. ... ...

Abstract	Adult-onset Still's disease (AOSD) is a rheumatological condition associated with significant morbidity and mortality. Typically a diagnosis of exclusion, the therapeutic management has relied mainly on symptom control and immune suppression. Methotrexate (MTX), a disease-modifying anti-rheumatoid drug (DMARDs), has become a drug of choice in treating several autoimmune conditions, including AOSD. Unfortunately, despite being largely effective, this medication can result in treatment failure, exacerbation, and a flare of symptoms. We present the case of a 31-year-old male who presented to us with weakness and palpitations, who was ultimately found to have a flare of his Still's disease, despite being on MTX therapy. Our hope is to encourage a suspicion for treatment failure in patients with similar symptoms, in order to encourage a faster initiation of alternative therapies to alleviate their discomfort.
Language	English
Publishing date	2022-07-26
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.27283
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Empyema Versus Lung Abscess: A Case Report.

Imburgio, Steven / Tavakolian, Kameron / Mararenko, Anton / Tasnim, Tasfia / Khan, Taimoor / Costanzo, Eric

Journal of investigative medicine high impact case reports

2022 Volume 10, Page(s) 23247096221139268

Abstract: Lung abscesses and empyemas are 2 forms of pulmonary infection that can present with similar clinical features. However, empyemas are associated with higher morbidity and mortality, necessitating the need to distinguish one from the other. Plain ... ...

Abstract	Lung abscesses and empyemas are 2 forms of pulmonary infection that can present with similar clinical features. However, empyemas are associated with higher morbidity and mortality, necessitating the need to distinguish one from the other. Plain radiographs can sometimes provide clues to help differentiate the 2 pathologies but more often than not, a computed tomography scan is required to confirm the diagnosis. Correct diagnosis is essential, as the goal standard therapeutic intervention for empyemas may be contraindicated in patients with lung abscesses. Empyemas require percutaneous or surgical drainage in combination with antibiotics, while lung abscesses are generally treated with antibiotics alone as drainage can be associated with various complications. We present a case of a 65-year-old man with parapneumonic empyema diagnosed with characteristic findings on chest computed tomography and treated with surgical drainage and antibiotics. We hope to improve patient outcomes by highlighting the classical radiographic findings that help distinguish empyema and abscess.
MeSH term(s)	Male ; Humans ; Aged ; Lung Abscess/diagnostic imaging ; Lung Abscess/therapy ; Empyema/diagnosis ; Empyema/therapy ; Empyema/complications ; Drainage/methods ; Tomography, X-Ray Computed/methods ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-11-18
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/23247096221139268
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Acute Liver Failure due to Altered Fontan Circulation in a Patient With Tricuspid Atresia: A Case Report.

Mikhail, Jason / Tavakolian, Kameron / Odak, Mihir / Nightingale, Romany / Douedi, Steven / Elkherpitawy, Islam

Journal of investigative medicine high impact case reports

2022 Volume 10, Page(s) 23247096221114529

Abstract: Tricuspid atresia is a congenital malformation of the tricuspid valve resulting in a lack of blood flow between the right atrium and the right ventricle. Management generally involves staged surgical intervention enabling affected individuals to survive ... ...

Abstract	Tricuspid atresia is a congenital malformation of the tricuspid valve resulting in a lack of blood flow between the right atrium and the right ventricle. Management generally involves staged surgical intervention enabling affected individuals to survive into adulthood. Although surgical intervention greatly improves morbidity and mortality in this patient population, there are many long-term complications associated with the creation of a surgical shunt. We report a case of a 33-year-old male with tricuspid atresia who underwent Fontan surgery as a child and presented to our hospital with acute liver failure.
MeSH term(s)	Adult ; Fontan Procedure/adverse effects ; Heart Ventricles ; Humans ; Liver Failure, Acute/etiology ; Liver Failure, Acute/surgery ; Male ; Tricuspid Atresia/complications ; Tricuspid Atresia/surgery ; Tricuspid Valve/abnormalities ; Tricuspid Valve/surgery
Language	English
Publishing date	2022-07-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2710326-2
ISSN	2324-7096 ; 2324-7096
ISSN (online)	2324-7096
ISSN	2324-7096
DOI	10.1177/23247096221114529
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Article: Atypical Stress Cardiomyopathy: A Case Report.

Tavakolian, Kameron / Odak, Mihir / Miller, Brett / Mararenko, Anton / Nightingale, Savannah / Douedi, Steven / Patel, Swapnil V

Cureus

2022 Volume 14, Issue 8, Page(s) e27786

Abstract: Stress cardiomyopathy is a reversible cause of cardiomyopathy characterized by a transient dysfunction in left ventricular systolic function. It is most common in postmenopausal women and usually occurs following an emotional and/or physical stressor. ... ...

Abstract	Stress cardiomyopathy is a reversible cause of cardiomyopathy characterized by a transient dysfunction in left ventricular systolic function. It is most common in postmenopausal women and usually occurs following an emotional and/or physical stressor. The classical imaging finding is described as left ventricular apical ballooning. However, several rare variants have been reported with a strikingly different regional distribution of wall motion abnormalities. We describe a case of a 65-year-old female who was found to have stress cardiomyopathy with variant wall motion abnormality on the left ventriculogram without a preceding stressor event. We postulate that there may be a link between stress-induced cardiomyopathy without a preceding stressor event and variant wall motion abnormality patterns.
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.27786
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Article ; Online: Idiopathic Pleuroparenchymal Fibroelastosis.

Tavakolian, Kameron / Udongwo, Ndausung / Douedi, Steven / Odak, Mihir / Ilagan, Justin / Khan, Taimoor / Salam, Noor / Chaughtai, Saira / Asif, Arif

Journal of medical cases

2022 Volume 13, Issue 5, Page(s) 235–239

Abstract: Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a rare form of idiopathic interstitial pneumonia. The disease is characterized by fibrosis of the pleura and subpleural lung parenchyma predominantly affecting the upper lobes. Various triggers have ... ...

Abstract	Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a rare form of idiopathic interstitial pneumonia. The disease is characterized by fibrosis of the pleura and subpleural lung parenchyma predominantly affecting the upper lobes. Various triggers have been proposed as inciting factors in the development of the disease. Diagnosis is made clinically in conjunction with radiographic findings and histopathology when available. There are no known effective treatment options and several cases of lung transplantation have been reported. We report a case of an 86-year-old female who presented to the emergency department with worsening dyspnea and hypoxia. She had a history of unexplained pneumomediastinum and a 20 - 25 pounds unintentional weight loss over 10 months. Computed tomography (CT) of the chest without contrast revealed radiographic evidence of IPPFE. Despite symptomatic management with antibiotics, diuretics, and steroids, her condition continued to deteriorate. Unfortunately, our patient was not a candidate for a lung transplant. She was transitioned to hospice care and succumbed to her disease. IPPFE is a rare disease with an unknown prevalence. It has a median survival rate of 2 years. Usually, there is an overlap with interstitial lung diseases, making it challenging to diagnose. There are only a few cases reported in the literature, and there are currently no guidelines available on the appropriate management of this debilitating disease. We recommend more cases be reported, and further research is done to establish better criteria for diagnosis and management.
Language	English
Publishing date	2022-05-07
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2586383-6
ISSN	1923-4163 ; 1923-4163
ISSN (online)	1923-4163
ISSN	1923-4163
DOI	10.14740/jmc3927
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Anti-MDA5 Associated Clinically Amyopathic Dermatomyositis With Rapidly Progressive Interstitial Lung Disease.

Tavakolian, Kameron / Odak, Mihir / Mararenko, Anton / Ilagan, Justin / Douedi, Steven / Khan, Taimoor / Al Saoudi, Ghadier

Journal of medical cases

2022 Volume 13, Issue 8, Page(s) 374–379

Abstract: Anti-melanoma differentiation-associated protein 5 (anti-MDA5) associated clinically amyopathic dermatomyositis (CADM) is a rare entity that is frequently associated with rapidly progressive interstitial lung disease. The disease is characterized by its ... ...

Abstract	Anti-melanoma differentiation-associated protein 5 (anti-MDA5) associated clinically amyopathic dermatomyositis (CADM) is a rare entity that is frequently associated with rapidly progressive interstitial lung disease. The disease is characterized by its association with a distinct myositis specific antibody, the lack of muscle involvement seen with other inflammatory myopathies, and a strong correlation with the development of rapidly progressive interstitial lung disease. Diagnosis is based on clinical findings and the presence of autoantibodies. Management generally involves combination immunosuppression therapy. However, the disease course is often aggressive and lends a poor prognosis. We report a case of a healthy 55-year-old male who presented with dyspnea, dry cough, and joint pain for 1 month. The patient was diagnosed with anti-MDA5 associated CADM with interstitial lung disease after a complete rheumatological workup found elevated titers of MDA5 antibodies and computed tomography of the chest without contrast revealed radiographic evidence of interstitial lung involvement. Disease course was complicated by the development of
Language	English
Publishing date	2022-08-19
Publishing country	Canada
Document type	Case Reports
ZDB-ID	2586383-6
ISSN	1923-4163 ; 1923-4163
ISSN (online)	1923-4163
ISSN	1923-4163
DOI	10.14740/jmc3965
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Safety of endoscopic pancreatic necrosectomy compared with percutaneous and surgical necrosectomy: a nationwide inpatient study.

Ramai, Daryl / McEntire, Dan M / Tavakolian, Kameron / Heaton, Joseph / Chandan, Saurabh / Dhindsa, Banreet / Dhaliwal, Amaninder / Maida, Marcello / Anderloni, Andrea / Facciorusso, Antonio / Adler, Douglas G

Endoscopy international open

2023 Volume 11, Issue 4, Page(s) E330–E339

Abstract: Background and study ... ...

Abstract	Background and study aims
Language	English
Publishing date	2023-04-04
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-1994-6214
Database	MEDical Literature Analysis and Retrieval System OnLINE

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