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5 kg. We can therefore say that caesarean myomectomy can be safely performed in carefully selected cases.A 36-year-old primigravida female from a birthing center was referred for elevated blood pressure to the hospital two days after normal spontaneous vaginal delivery with nausea, vomiting, and diarrhea. During this two-day period, she was experiencing persistent vaginal bleeding and lower abdominal pains for which she took six doses of 600 mg ibuprofen. Further laboratory evaluation reflected leukocytosis, anemia, thrombocytopenia, elevation of liver enzymes, and renal failure with hyperkalemia requiring emergent hemodialysis once in the Medical Intensive Care Unit (MICU). She was diagnosed with HELLP syndrome with underlying preeclampsia. A week later, due to hypertension controlled with medications and nonoliguric renal failure with no active urine sediments, a renal biopsy was indicated to direct management. The renal biopsy supported the diagnosis of diffuse severe acute tubulointerstitial nephritis with hypereosinophilia and thin basement membrane nephropathy (see figures). She was subsequently treated with high-dose steroids which resulted in the normalization of blood pressures and renal function returning to baseline. We report the first case of acute tubulointerstitial nephritis in an individual with thin basement membrane nephropathy secondary to postpartum complications.Blast crisis (BC) continues to be the major challenge in the treatment of chronic myeloid leukemia. Best results have been observed in a few patients who were successfully transplanted after returning to chronic phase. Recent studies focus on the combination of chemotherapy with imatinib, but results remain unsatisfactory. Since dasatinib induces deeper and faster responses, a reasonable strategy might be to combine it with chemotherapy, taking into account the alterations in T-cell response induced by dasatinib. However, there are no published studies or case reports supporting the use of dasatinib as first line treatment for initial myeloid BC, and very little is known about infectious complications associated with this drug. Based on this, we present the case of a patient diagnosed with an initial nonlymphoid phenotype BC, who achieved molecular response (MR4.5) with dasatinib and FLAG-IDA, but he suffered a pulmonary aspergillosis, CMV infection, and a CMV reactivation, prior to an allogeneic hematopoietic stem cell transplantation (HSCT). In conclusion, dasatinib and FLAG-IDA is an effective therapy for initial BC. However, a warning call is needed owing to the high risk of opportunistic infections, such as CMV.The clinical management of severely ill patients with COVID-19-related acute respiratory distress syndrome (ARDS) presents significant challenges. Many COVID-19 patients with ARDS also present with laboratory findings significant for derangement in coagulation function. In this report, we describe acute pulmonary embolism in three patients with COVID-19. We assessed the role of D-dimer assay and anticoagulation treatment in these patients. The aim of this case report is to increase awareness about the use of D-dimer in addition to patient's clinical status for making treatment decision in COVID-19 patients.A 72-year-old male was diagnosed with a duodenal mass and underwent extensive surgical resection. The patient's post-op course was complicated by an anastomotic leak that was first treated conservatively; however, his condition continued to deteriorate. selleck compound An upper endoscopy was performed, which showed misplacement of drain forming a fistulous track through the lumen of the bowel. We removed the drain and used argon plasma coagulation to de-epithelize the lumen and closed the fistula with hemostasis clips. The patient's clinical status improved significantly. Our case emphasizes the success of endoscopic techniques as an alternative option in the management of postsurgical anastomotic leaks and fistulas in the right clinical setting and patient population.

While the endocrine manifestations of pseudohypoparathyroidism are well known, less is known about the associated brain and spine abnormalities. These abnormalities may present with nonspecific symptoms in the paediatric population, and lack of awareness to these uncommon manifestations of the disease may result in a delay in necessary intervention.

. We herein present a case of known pseudohypoparathyroidism type 1a who presented initially with minor head injury. She later developed progressive worsening headache, increased irritability, and vomiting. Repeated imaging showed hydrocephalus and Chiari malformation type 1 necessitating emergency craniectomy.

Growth hormone deficiency, a common manifestation of pseudohypoparathyroidism type 1a, results in underdevelopment of the posterior cranial fossa and may account for the higher incidence of Chiari malformation in this group of patients. Other associated neurological features reported in pseudohypoparathyroidism type 1a include spinal stenosis, syringomyelia, and craniosynostosis. While less commonly seen, awareness to these associations is important in order to optimize the multidisciplinary care to this group of patients.

Growth hormone deficiency, a common manifestation of pseudohypoparathyroidism type 1a, results in underdevelopment of the posterior cranial fossa and may account for the higher incidence of Chiari malformation in this group of patients. Other associated neurological features reported in pseudohypoparathyroidism type 1a include spinal stenosis, syringomyelia, and craniosynostosis. While less commonly seen, awareness to these associations is important in order to optimize the multidisciplinary care to this group of patients.Since 2015, the cancer treatment lenvatinib has been used for patients with advanced radioactive iodine- (RAI-) refractory thyroid differentiated cancer; however, the drug's long-term effects have not been fully investigated. We report three cases in which lenvatinib treatment initially improved the patients' conditions, although they all died approximately 2 months after leukocytosis due to very aggressive disease progression with anaplastic thyroid carcinoma transformation. Serum interleukin-6 (IL-6) was elevated in all three cases, and granulocyte-colony stimulating factor (G-CSF) was elevated in two cases. The patients had a similar clinical course, with multiorgan metastasis and aggressive disease progression. Even with advanced cancer, lenvatinib has provided control of the disease. However, as long-term use of lenvatinib grows, it is possible that similar cases will increase, and we report our findings as an alert to other clinicians.