The number of cases of coronavirus disease 2019 (COVID-19) has been exponentially increasing everyday. It is important to recognize the comorbidities and risk factors associated with this highly contagious and serious disease that has caused thousands of deaths worldwide. Patients with certain conditions like diabetes, hypertension, cardiovascular disease and chronic lung diseases have been reported to develop serious complications from COVID-19. Idiopathic pulmonary fibrosis (IPF) is a disease that is more prevalent in the elderly population, the same group that are more susceptible to serious complications from COVID-19. Our literature search did not reveal any review about COVID-19 in IPF patients. We report a patient with IPF who was exposed to COVID-19 from her spouse and died from its complications. This case would help to raise the awareness among IPF patients to follow the necessary precautions to reduce the risk of contracting the disease.

A transthoracic echocardiogram detected an atrial myxoma (T) in the left atrium (LA) of a 39-year-old woman with a tumor plop heart sound (A and E). Onset of systole (A, left), midsystole (A, middle), and isovolumic relaxation (A, right) are depicted. With onset of diastole (B, left), a high-velocity jet (arrow) occurred when the tumor passed through the mitral orifice, partially occluding it. Jet velocity decreased in mid-diastole (B, middle) and increased with atrial contraction (B, right, asterisks). Both the high-velocity jet on continuous-wave Doppler (C) and the plop sound (P) on phonocardiography (D) occurred right after the second heart sound (S2) (Online Video 1). After excision, the tumor and associated plop were absent (F to J, Online Videos 2 and 3 for 3-dimensional echocardiographic comparison).This case suggests that the cause of the plop sound may relate to tumor obstruction of the mitral orifice with associated high-velocity flow, although this is difficult to distinguish temporally from other reported causes such as sudden tensing of the tumor stalk or impact of the tumor against the septum. LA ϭ left atrium; LV ϭ left ventricle.

Malignant thymoma is rarely associated with giant cell myocarditis. We present a case study that illustrates this association and cardiogenic shock with underlying tamponade. The dramatic presentation of this scenario has not been previously described.

Ovarian vein thrombosis (OVT) is a relatively uncommon but serious postpartum complication. Although infrequent, OVT may progress to involve the inferior vena cava, the renal vein or may cause sepsis and septic pulmonary embolism, all of which are potentially life-threatening. Clinical misdiagnosis is common, and, unfortunately, most affected women undergo laparotomy for possible appendicitis. We present an interesting case of OVT presenting as ureteral obstruction in a postpartum woman who was in her early 20s. Knowledge of this entity and clinical suspicion for its occurrence, in a puerperal patient with fever and abdominal pain not responding to antibiotics, should guide clinicians to appropriate diagnosis and treatment, avoiding misdiagnosis, unnecessary laparotomy and potential complications.

In 2007, a major pet food recall occurred because of an outbreak of kidney failure in cats and dogs that was linked to melamine in pet food[1]. The kidney failure was attributed to stone disease[2]. Notably, similar outbreaks in 2004, with identical findings, implicated a similar causation[3], and pork and poultry from animals fed with melamine-contaminated feed had also been suspected. However, based upon the limited information available at that time, melamine was deemed a very low human risk by the FDA and USDA[4]. Thus, without potential for human toxicity, melamine quickly exited the spotlight. Melamine is used industrially as a plastic resin and is known for its fire-retardant properties. Its high nitrogen content fosters its illicit use as dietary nonprotein nitrogen. Melamine, added to food products, inflates their protein levels on standardized tests that quantify nitrogen content as a surrogate for protein. Now, renewed interest in melamine comes from reports of acute renal failure, resulting in four infant deaths and thousands of hospitalizations in China from melamine in milk and infant formulas. These catastrophes have led to widespread public outcry and prompted product recalls. The exact pathophysiology between melamine and kidney disease is unclear. Kidney biopsies from some animals with pet food-associated kidney failure revealed crystal involvement of distal tubules, fibrotic changes, and inflammation[3]. The presence of a cofactor may be required to induce kidney failure, and cyanuric acid, obtained from the same raw material where melamine is procured, has been proposed as one such factor[5]. However, the presence of cyanuric acid in infant formulas is unknown. Other unknowns remain regarding melamine-induced kidney injury: Is a certain subset of population like infants at an increased risk? Does it require a second trigger? Does cyanuric acid accompany adulterated melamine? Because the toxic dose of melamine is very high (comparable to table salt), the cause of this sudden spurt of cases is undetermined, but the increase in cases is unlikely to result from cumulative melamine burden as the compound is readily cleared by the kidney[6]. Melamine becomes undetectable in rat tissues just 24 hours following exposure to the compound[7]. So, as we await greater scientific understanding of this new man-made disease entity, melamine should be avoided. Melamine is not a bona fide nitrogen-containing nutritional protein, but a mala fide one.