Background: There is lack of knowledge on the epidemiological characteristics of brain tumors in Middle Eastern countries. The objective of this study was to study the epidemiological features of primary brain tumors in Jordan. Methods: We conducted a prospective cohort study incorporating data from 16 hospitals in Jordan during a 1 year period (May 1, 2011-April 30, 2012). All primary brain tumors diagnosed in Jordan during the study period were identified. The following parameters were retrieved from patients' files: age, gender, histological type, and location. The demographic data of the country was obtained from the National Department of Statistics. Results: A total of 313 primary brain tumors were identified during the study period. The incidence of primary brain tumors in Jordan among the general population was 5.01 per 100,000 person-years (5.38 in females and 4.65 in males). The incidence in pediatric, adult, and elderly patients was 2.09, 7.29, and 14.38 per 100,000 person-years, respectively. The most common histological types were meningioma (26.2%), glioblastoma (18.9%), astrocytoma (14.1%), and pituitary adenoma (9.3%). Conclusions: The incidence of primary brain tumors in the Jordanian population is relatively low, in part due to the young age of the general population.
Physiologic assessment of coronary lesions can effectively guide complete revascularization in patients undergoing CABG. Moreover, FFR/iFR-guided CABG was associated with significantly higher rates of three-vessel anastomoses, venous grafting, and graft distribution to the circumflex system.
A case of delayed signs of intracranial hypertension following closed head injury with a depressed cranial fracture and superior sagittal sinus thrombosis is reported. Conservative treatment of intracranial hypertension, including just repeated lumbar puncture and oral acetazolamide, was performed. Spontaneous recanalization of the superior sagittal sinus was observed. Pathogenesis and different modalities of treatment are discussed.
Introduction. Stress cardiomyopathy, or takotsubo cardiomyopathy, is an acute, reversible left ventricular dysfunction usually initiated by a psychological or physical stress. We report this case of stress cardiomyopathy following a chronic obstructive pulmonary disease exacerbation and the subsequent treatment. Case Description. A 49-year-old white female with a history of chronic obstructive pulmonary disease presented to the emergency room via emergency medical services with worsening severe shortness of breath and productive cough for 2 weeks but denied any chest pain on arrival. On presentation, she was noted to be tachypneic, using her accessory muscles and with bilateral coarse expiratory wheezing on lung auscultation. Initial electrocardiogram demonstrated sinus tachycardia. She was treated with multiple albuterol treatments. Soon afterwards, the course was complicated by hypoxic respiratory failure eventually requiring intubation. Her repeat electrocardiogram showed acute changes consistent with myocardial infarction, and an echocardiograph demonstrated apical akinesia with an ejection fraction of 25% to 30%. The patient was urgently taken for cardiac catheterization, which showed no angiographic evidence of coronary artery disease. Three days after initial presentation, a repeat transthoracic echocardiogram showed overall left ventricular systolic function improvement. Discussion. This case provided a unique look at the difficulty of balancing catecholamines in a patient with bronchospasm and stress cardiomyopathy.
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