the presence of tumor thrombus in the right atrium is frequently the result of direct intraluminal extension of infra-diaphragmatic malignancy into the inferior vena cava (ivc) or supradiaphragmatic carcinoma into the superior vena cava (svc). right atrial tumor thrombus with extension into both svc and ivc has not been reported in the literature. we present a patient who presented with symptom...

Adrenal insufficiency is a life-threatening disorder which must be treated with glucocorticoid replacement and needs permanent dose adjustment during patient's different somatic situations. Insufficient glucocorticoid doses result in adrenal crisis and must be treated with intravenous hydrocortisone. The patient was known with Adrenal insufficiency and was treated optimally with fludrocortisone...

Multiple endocrine neoplasia type IIb (MEN IIb) is an endocrine disorder which can manifest with tumors such as pheochromocytomas and neuromas. We present the case of a patient with MEN IIb, after bilateral adrenalectomies, on maintenance steroid replacement, who underwent a neuroma resection and developed severe hypotension. There is persistent controversy regarding the general administration ...

OBJECTIVE To review current concepts in the diagnosis of adrenocortical disease in the critically ill patient. DATA SOURCES A review of articles reported on adrenocortical insufficiency in the acutely ill patient. SUMMARY OF REVIEW The contribution of adrenal insufficiency to the morbidity of critically ill patients is currently under renewed scrutiny. The debate continues about the role of...

Congenital adrenal hyperplasia comprises a group of disorders resulting from defects in enzymes required for the synthesis of cortisol. The clinical presentation depends on the specific enzyme defect. We report a rare case of congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency. A 26-year-old female patient referred with hypertension and hypokalemia. She also had primary amenor...

background: medical x-rays are the largest man-made source of public exposure to ionizing radiation. it is important to avoid conditions where the amount of radiation used is more than that needed for the procedure. materials and methods: the entrance skin exposure (ese) measurement was conducted for quality control of x-ray machines and survey of operator’s experimental techniques. the eses we...

abstract   background: while the benefits of computed tomography (ct) are well known in accurate diagnosis, those benefits are not risk free. ct is a device with higher patient dose in comparison with other conventional radiological procedures. is the reduction of exposures by requiring optimization of ct procedures [a principle concern in radiological protection]? in this study, the radiation ...