Magnetic resonance urography was also performed in the same patient for better delineation.”
“Objective: To present a case of pituitary apoplexy secondary

to thrombocytopenia associated with dengue hemorrhagic fever (DHF).

Methods: In this case study, we review the presentation, evaluation, diagnosis, and management of a case of pituitary apoplexy in the setting of DHF. We also searched the literature for cases of pituitary apoplexy associated with thrombocytopenia and review their clinical presentation, management, and outcome.

Results: A 53-year-old man presented with fever, lethargy, and worsening headache. Routine investigations revealed thrombocytopenia secondary to dengue fever. He developed symptoms of a cavernous sinus lesion the next day. Urgent magnetic resonance imaging revealed pituitary apoplexy in a pituitary macroadenoma. A transsphenoidal surgery was done and selleck inhibitor histology was consistent with apoplexy in a prolactin/follicle-stimulating hormone macroadenoma. Subsequently, the patient AZD5363 developed permanent deficits of anterior pituitary hormones. We review 8 other cases of pituitary apoplexy associated with thrombocytopenia reported in the literature.

Conclusion: Thrombocytopenia due to various causes may be a predisposing factor for pituitary apoplexy in a patient

with underlying pituitary disease. In view of the tendency for bleeding associated with thrombocytopenia, CA3 in vivo the risks of surgical intervention have to be carefully weighed against the potential benefits. Indications for surgery would include progressive alteration of consciousness, visual disturbances, and opthalmoplegia despite conservative management. Patients with underlying pituitary macroadenomas with optic chiasm compression have a worse prognosis,

and the chances of recovery, even with early surgery, are limited.”
“Background: In most phase I oncology trials, it is often stated that the dose increments follow a “”modified-Fibonacci sequence”". This term, however, is vague.

Methods: To better characterize this sequence, we reviewed 81 phase I trials based on this concept.

Results: Out of 198 phase I oncology trials, 81 (41%) are based on modified-Fibonacci series. Actual incremental ratios varied in a large range from 0.80 to 2.08. The median of actual increments was about 2.00, 1.50, 1.33, 1.33, 1.33, 1.33, 1.30, 1.35…. The “”modified Fibonacci-sequence”" gathers heterogeneous variation of the genuine sequence, which does not tend to a constant number at higher dose-levels.

Conclusion: This confusing term should be avoided.”
“We have described a rare case of Takotsubo cardiomyopathy in pregnancy, which is presented with cardiac arrest (ventricular fibrillation) at onset. In this case, the transient left ventricular ballooning in absence of coronary artery disease, produced a severe impairment of cardiac function with typical echocardiographic and electrocardiographic findings.