Open Access Case Study

Osteoporosis Reduction in Pre and Postmenopausal Women Using a High Intensity Exercise Program

Cleo D. Stafford, Robert Bowers, Jason Berner, David T. Burke

International Journal of Medical and Pharmaceutical Case Reports, Page 1-6
DOI: 10.9734/IJMPCR/2015/19244

Aim: This manuscript describes how a weekly high intensity weight lifting exercise regimen was able to improve the osteoporotic state in women with a previous diagnosis of low bone mineral density.

Case Presentation: This series reviews the cases of four women (average age of 50) with a previous diagnosis of low bone mineral density (BMD). These women sought out and participated in a high intensity exercise regimen (Gravitational Wellness System) to improve their osteoporotic state. They women had their BMD assessed prior to and after at least 10 weeks of participation. When comparing the assessments we observed that the patients gained an average of 4.92% in the femur BMD.

Discussion: A focused review of literature was performed on the efficacy of high intensity weight lifting programs. Previous studies have demonstrated some improvement in bone mineral density; however, the reduction in osteoporosis seen by utilizing this weight lifting method is higher then previous published work using exercise as a bone loss retardant.

Conclusion: This retrospective study is the first to demonstrate the capacity of the Gravitational Wellness System to improve the bone mineral density on pre and post-menopausal women with a diagnosis of osteoporosis.

Open Access Case Study

Cystoscopy Evaluation Using Hypnosis as Only Anesthetic: A Case Report

Pande Made Wisnu Tirtayasa, Rachmat Budi Santoso

International Journal of Medical and Pharmaceutical Case Reports, Page 1-5
DOI: 10.9734/IJMPCR/2015/19250

Bladder cancer is the most common malignancy of the urinary tract. Cystoscopy evaluation is one of the follow-up procedure to determine the progress of bladder cancer. Hypnosis in many forms has been reported and practiced for millennia and secondarily promoted at the turn of the 19th century by several authors in the clinical arena. Several studies had demonstrated benefits of hypnosis in reducing pain intraoperatively. Here, we report on a 58-year-old man with bladder cancer who underwent cystoscopy evaluation using hypnosis as the only anesthetic.

Open Access Case Study

Visceral Artery Aneurysms: A Complex and Unresolved Issue

Bahaa Arefai, Mariam Perea-Ribis, Benet Gómez, Natalia Rodríguez, Patricia Hernández, Jordi Camps, Jorge Joven, Anna Hernández-Aguilera, Vicente Martín-Paredero

International Journal of Medical and Pharmaceutical Case Reports, Page 1-7
DOI: 10.9734/IJMPCR/2015/19030

Aims: The lack of prospective studies on abdominal non-aortic true or false aneurysms results in insufficient data to predict their natural history and propose a treatment of choice. The experience provided by case reports is important to discuss their management and prevention. This is relevant because abnormal enlargements in superior mesenteric artery are relatively uncommon but associated with specific symptoms and a high incidence of rupture and/or ischemic bowel complications.

Presentation of Case: Open surgery was preferred in a giant true aneurysm with an associated arteriovenous fistula, due to the likely need for revascularization and probable lack of stability for a stent graft. Contrarily in a pseudoaneurysm with a similar size we performed coil embolization. Incidentally, this procedure required a subsequent deployment of a covered stent graft to resolve bleeding.

Discussion: We discuss the outcomes of true and false aneurysms in the superior mesenteric artery, which required urgent treatment due to their high diameter. Their extremely large size also suggests a protracted course and a considerable period of time without proper surveillance through imaging techniques. Endovascular techniques seem to be favored in the elective setting and open surgery in the emergent setting but the challenge for the vascular surgeon to choose a treatment is considerable. Patient’s clinical state, perceived risk of rupture, the size of the lesion and expected quality of life conditioned the choice.

Conclusion: The described cases illustrate the urgent requirement of treatment guidelines and/or screening programs to detect abdominal non-aortic aneurysms at an early stage.

Open Access Case Study

Bilateral Necrotizing Soft Tissue Infection Caused by Pseudomonas aeruginosa in a Renal Transplantation Recipient

Carmen Denise Caldararu, Grigore Dogaru

International Journal of Medical and Pharmaceutical Case Reports, Page 1-5
DOI: 10.9734/IJMPCR/2015/18908

Background: Necrotizing soft tissue infection caused by Pseudomonas aeruginosa in monomicrobian culture is rare. 

Aim: We present the case of a bullous bilateral form of Pseudomonas aeruginosa necrotizing skin infection in a renal transplantation recipient. 

Presentation of Case: A 40 year old female previously treated in a dermatology clinic was admitted for bilateral leg pain and cutaneous ulcers. Investigations led to the diagnosis of necrotizing soft tissue infection. Antimicrobial treatment was started but patient’s condition has worsened with the death few days after admission.

Conclusion: The author draws attention to the need for knowledge of disease characteristics, multidisciplinary team approach and aggressive treatment.

Open Access Case Study

A Case of Acute Kidney Injury after Contrast Imaging and Empiric Nephrotoxic Antibiotherapy

Hatice Ezgi Baris, Nilufer Yalindag-Ozturk, Feyza Incekoy-Girgin

International Journal of Medical and Pharmaceutical Case Reports, Page -5
DOI: 10.9734/IJMPCR/2015/18769

Introduction: Contrast imaging assists with a diagnosis and antibiotics are essential for treatment of complicated infections.  Since empiric antibiotherapy and multiple contrast imaging in critically ill children can cause acute kidney injury (AKI), clinicians must pay special attention in this critical decision process.

Presentation of Case: Six-year-old boy had a penetrating trauma via a scythe to his right eye with resultant orbital cellulitis and endopthalmitis. He received multiple empiric nephrotoxic antimicrobial therapy and his orbit was imaged three times with radio-contrast studies in a week. He admitted to pediatric intensive care unit (PICU) with resultant renal failure. The patient survived with normal renal functions by the help of intensive care support including mechanical ventilation, inotropic therapy, renal replacement therapy, surgical intervention, and proper antibiotic dosage with daily adjustments per calculated glomerular filtration rate.

Conclusion: Special consideration must be given when using empiric antibiotics and imaging with contrast media in sick children. Both may deteriorate renal functions as in our patient. These predictors, however, need further work to validate reliability.