The American journal of the medical sciences
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Microscopic polyangiitis (MPA), Wegener's granulomatosis and Churg-Strauss syndrome are known as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Cerebrovascular diseases have been rarely reported to be associated with MPA. In this study, we reported a 72-year-old man with MPA showing an initial presentation of pontine infarction, mononeuropathy multiplex and progressively deteriorating renal function. ⋯ After receiving an aggressive treatment consisting of plasma exchange, his neurological deficit dramatically improved. For stroke patients with acute nephritis, the possibility of ANCA vasculitis should be considered. Early diagnosis may improve the prognosis.
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Neurocysticercosis (NCC) is endemic in the developing world but is becoming more common in the United States because of immigration. Although NCC is pleomorphic in its presentation, extraparenchymal NCC may be challenging to diagnose and treat. ⋯ Neurologists and neuroradiologists in the United States are often unaware of the pretreatment/post-treatment radiographic patterns of extraparenchymal NCC and the potentially poor prognosis if not correctly diagnosed and managed. The review of this condition is important given increasing incidence in the United States.
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Percutaneous core needle biopsy (CNB) has been widely performed as a standard technique for initial histological diagnosis of suspicious breast lesions. There have been an increased number of atypical lesions diagnosed on CNB as a consequence of the advances in breast imaging techniques. The authors aim to identify if any of the radiological and histopathological criteria evaluated in this study can predict the presence of malignancy associated with atypical hyperplasia (AH) diagnosed on CNB. ⋯ Upgrade rate to cancer after surgical excision was 11.3% of AH patients diagnosed on CNB. However, none of the variables are significant in determining the presence of malignancy associated with AH diagnosed by CNB.
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Despite the widespread use of illegal synthetic cannabinoids, report of serious toxicity following its use of is rare. The authors report a case of severe toxicity after intentional inhalation of the synthetic cannabinoid JWH-018.
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Idiopathic pulmonary fibrosis (IPF) is a devastating progressive lung disease with an average survival of only 3 to 5 years. The mechanisms underlying the initiation and progression of IPF are poorly understood, and treatments available have only modest effect on disease progression. Interestingly, the incidence of IPF is approximately 60 times more common in individuals aged 75 years and older, but the mechanism by which aging promotes fibrosis is unclear. The authors hypothesized that aged lungs have a profibrotic phenotype that render it susceptible to disrepair after injury. ⋯ Altogether, aged lungs manifest a profibrotic phenotype characterized by enhanced fibronectin extracellular domain A and MMP expression and increased TGF-β1 expression and signaling and are populated by Thy-1-negative fibroblasts, all implicated in the pathogenesis of lung fibrosis.