Archive for February, 2008

Express yourself: Wear the JMCR T-shirt!

February 28, 2008

tshirt2For those of you who have published with JMCR, reviewed for us or just enjoy browsing the Open Access case reports online, we hope you will support the journal by word of mouth to your friends and colleagues. Now, you can also show your support by wearing a T-shirt! For every T-shirt purchased, BioMed Central will make a donation to Computer Aid International, a charity which provides refurbished computers for use in the developing world.

You can also spread the word in your university of hospital by downloading a free JMCR poster to display.

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New side-effect of cancer therapy? The author’s perspective

February 14, 2008

gurjal-becavizumbBevacizumab, the popular colorectal cancer and non-small cell lung cancer therapy antibody, has shown signs of a previously unreported side-effect. Dr Dorothy Gujral, St Lukes Cancer Centre, Royal Surrey County Hospital, reports the first case of periodontitis in a patient whilst receiving bevacizumab. She reports, “This case is, to the best of our knowledge, the first report of a patient developing periodontal disease whilst receiving bevacizumab. Although it would be difficult to exclude all other risk factors in this patient, the onset of periodontal disease on commencement of bevacizumab and that the disease remained stable on discontinuation of the drug points to this as the cause.”

We know that bevacizumab has been linked to hypertension and bowel perforations, and that the The Food and Drug Administration voted to reject the use of bevacizumab for breast cancer therapy in December 2007 – but does its safety record need further investigation in light of the new finding of suspected bevacizumab-induced periodontal disease? Trials are underway already; this particular patient was  enrolled  in a randomised, double-blind, multicentre, 2-stage, phase III study: the AVAiL  trial  (AVAstin  In Lung  cancer  – Trial No. BO17704) – a study in which the primary objective is to evaluate safety and efficacy of  two doses  of  bevacizumab  in  combination  with  gemcitabine  and  cisplatin  and determine the optimal dose of bevacizumab. Dorothy Gurjal comments: “We continue to use bevacizumab in this setting but patients now receive pre-treatment and follow up dental examinations and are advised on good dental care.”

Patient follow-up

The patient in question in this new case report has now completed the course of bevacizumab; the periodontal disease has subsequently remained stable. She now continues on a regular two-monthly clinical examination and CT scanning. Read the full case report here.

Case reports and the bid to improve patient care

Sharing reports of side-effects and unusual disease progression is becoming easier  – much of this can be put down to the Open Access model of publishing which allows free information to all. Dr Gurjal adds, “Case reports provide a medium for discussion of possible adverse drug reactions, mechanisms for the adverse reactions and possible prevention steps in the future. This facility is not available through other reporting channels. Journal of Medical Case Reports being an online journal with open access allows rapid dissemination of important information to healthcare professionals around the world. Benefits to patient care can be translated very quickly.”

Focus on: Cardiology

February 13, 2008

Cardiology is one of the busiest areas for publication of case reports in the journal so far, and (fittingly for Valentine’s day) we invite you to take a look at some of our most interesting cardiology case reports:

Atrial fibrillation-related cardiomyopathy: a case report

Following a history of worsening dyspnoea and palpitations, a 58 year-old male was diagnosed with dilated cardiomyopathy. Thyroid function and electrocardiogram tests were normal. Trans-thoracic echocardiography revealed a dilated left ventricle. The patient had been consuming one bottle of a highly caffeinated commercially available beverage (1000 ml) per week for 6 months.

Dilated superficial abdominal veins + bruising

Congenital absence of inferior vena cava and thrombosis: a case report

A 54 year-old male was admitted with abdominal pain and localised swelling over the right flank. Examination revealed palpable ‘snake-like’ tortuous and tender lumps on the abdominal wall. Past history revealed chronic non-healing venous leg ulcers, and varicose vein ligation at a very young age upon which Deep Vein Thrombosis (DVT) was diagnosed. A CT scan was performed to search for intra-abdominal cancer.

Reconstruction of type III endoleak

Endovascular stenting of a chronic ruptured type B thoracic aortic dissection, a second chance: a case report

The first report of endovascular repair of a previously stented, ruptured chronic Stanford type B thoracic aortic dissection re-presenting with a type III endoleak of the original repair in an 82-year-old male.

False aneurysm cavityA pulmonary artery false aneurysm after right middle lobectomy: a case report

A 69-year-old male underwent a right middle lobectomy for a Stage 1A squamous cell carcinoma of his right middle lobe. The patient was readmitted five weeks postoperatively with pyrexia and an episode of haemoptysis. X-ray showed haziness in the right mid-zone and the patient was treated for a presumed chest infection. A week later, he was readmitted with continuing haemoptysis, swinging pyrexia and increasing shortness of breath at rest. Bronchoscopy revealed granulation tissue near the middle lobe bronchial stump, which bled profusely on biopsy. CT scan showed a false aneurysm of the right descending interlobar pulmonary artery and complete lower lobe collapse and consolidation.

As the cardiology section of Journal of Medical Case Reports continues to grow, we are on the look-out for cardiologists to join our pool of reviewers. If you would be interested in reviewing for the journal, please get in touch.

JMCR award – nominate now!

February 4, 2008

Nominations for the JMCR award for best case report are due to close this week – don’t miss your chance toBMC Research Awards put forward your choice!

All case reports published in the journal in 2007 are eligible, and the presentation to the authors of the winning case report will be made at the BioMed Central Research Awards at the Royal Society of Medicine in March.

Nominating is easy – simply fill in the short online form.

Browse the website to remind yourself of the highlights of 2007 – as valued readers, reviewers, editors and authors, we want to hear from you!

Dangers of chicken bones

February 4, 2008

Two new case reports focus on adverse events linked to swallowing chicken bones. chicken-bone

Perforation of Meckel’s diverticulum caused by a chicken bone: a case report” published in JMCR this week reports a 17-year-old man presenting with lower abdominal pain two weeks after an episode of rectal bleeding. Appendicitis was suspected. A diagnostic laparoscopy identified a normal appendix but an inflammatory mass that was diagnosed as a perforated Meckel’s diverticulum.

Acute abdoment caused by ingested chicken wishbone: a case report” published in Cases Journal reports the case of a 50-year-old man presenting with abdominal pain, nausea and vomiting. A mechanical obstruction was identified by radiography and ultrasound of the abdomen. Laparotomy revealed a sharp piece of chicken bone perforating the ileum. The patient later admitted that four days earlier he had rapidly eaten several mouthfuls of chicken meat without chewing, and ingested a chicken bone.

The authors sum up “Overeating, rapid eating, or a voracious appetite may be contributing factors for ingesting chicken bones” – readers beware!