No abstract

Congenital absence of the internal carotid artery is a rare occurrence. Even more infrequent are cases where the patient has a bilateral absence of the internal carotid arteries. Reported is a case of a 52-year-old woman who presented with optic nerve neuropathy, and was incidentally discovered to have a congenital bilateral absence of her internal carotid arteries. During computed tomography angiography imaging looking for cerebral venous thrombosis, related to her preexisting condition of bilateral elevated optic discs and residual left optic neuropathy, the findings were made. The absence of the arteries is not always recognizably symptomatic, with most findings being incidental through imaging studies only. This is because collateral flow allows for sufficient cerebral circulation. However, this condition puts such patients at higher risk for conditions such as aneurysms and subsequently strokes where the collateral flow exists.

Early diagnosis of cancer clearly reduces morbidity and mortality, and a sizable number of cancers could be prevented at the secondary level with appropriate diagnostic tools. In early detection, biochemical analyses are highly supportive of the cytological and/or histopathological assessments. Among children, cancers probably originate from altered signaling pathways attributable to developmental genetic disorders. In adults, generally preventable risk factors, e.g., cigarette smoking, infections, unhealthy lifestyle and obesity, create a state of inflammation and associated oxidative imbalance, which may progress to malignancy. Pathological mechanisms of cancer are associated with abnormal expressions of various endogenous molecules that can be used as tumor biomarkers. Evaluation of such markers in different phases along the disease course plays a crucial role in clinical management and prognosis. Definitely, the current trend of active research on neoplastic mechanisms will help the clinical biochemistry laboratories to provide a better service.

A 17‐year‐old male sustained a blunt thoracic trauma after he had a dirt bike accident. He was admitted for the management of multiple fractures, was hemodynamically stable, and presented without any cardiac symptoms. The patient underwent transthoracic echocardiography and CT angiogram of the thorax as the workup of possible cardiac injury as he had a new aortic regurgitation murmur, troponin rise, and a new RBBB. Imaging showed aortic root rupture, type A aortic dissection involving aortic root and proximal ascending aorta, and acute severe aortic regurgitation, not typically seen with blunt thoracic trauma. The patient was immediately taken to the operating room, underwent a surgical aortic valve and root replacement with the Bentall procedure, and had a good outcome.

Purpose: To study and provide an update on utilization of vertebroplasty and kyphoplasty procedures among Medicare beneficiaries and analyze the changing trends in total volumes and payments by physician specialty for a recent eight-year period.