We describe a rare entity in which acute mitral regurgitation causes asymmetric findings on chest radiograph. The patient presented with rapid-onset respiratory failure from flash pulmonary edema. She had unilateral infiltrates on chest radiograph, which evoked infectious etiology. However, we identified a flail mitral valve leaflet, for which the patient received an emergent mitral valve replacement. Fortunately, she made a full recovery. We discuss the mechanism of the asymmetric chest radiograph findings, which we were able to confirm using a transesophageal echocardiogram
{"title":"Acute Mitral Regurgitation Presenting with Right Upper Lobe Opacification","authors":"John Wallis, MD, Mark Decaro, MD","doi":"10.29046/tmf.022.1.006","DOIUrl":"https://doi.org/10.29046/tmf.022.1.006","url":null,"abstract":"We describe a rare entity in which acute mitral regurgitation causes asymmetric findings on chest radiograph. The patient presented with rapid-onset respiratory failure from flash pulmonary edema. She had unilateral infiltrates on chest radiograph, which evoked infectious etiology. However, we identified a flail mitral valve leaflet, for which the patient received an emergent mitral valve replacement. Fortunately, she made a full recovery. We discuss the mechanism of the asymmetric chest radiograph findings, which we were able to confirm using a transesophageal echocardiogram","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121153974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Dong, MD, Frances Mae West, MD, Jonathan Foster, MD, Rebecca Davis, MD, Jillian Cooper, MD
{"title":"A Guide to Point of Care Ultrasound Lung and IVC Examination of a Volume Overloaded Patient","authors":"Michael Dong, MD, Frances Mae West, MD, Jonathan Foster, MD, Rebecca Davis, MD, Jillian Cooper, MD","doi":"10.29046/tmf.024.1.014","DOIUrl":"https://doi.org/10.29046/tmf.024.1.014","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127975866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Subacute Onset Hand Clumsiness in a Renal Transplant Patient with a Recent ICU Stay","authors":"W. Bradford","doi":"10.29046/TMF.020.1.013","DOIUrl":"https://doi.org/10.29046/TMF.020.1.013","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116547065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Dong, MD, Frances Mae West, MD, Rebecca Davis, MD, Jonathan Foster, MD, Jillian Cooper, MD
{"title":"A Guide to Point of Care Ultrasound Evaluation of Pneumonia","authors":"Michael Dong, MD, Frances Mae West, MD, Rebecca Davis, MD, Jonathan Foster, MD, Jillian Cooper, MD","doi":"10.29046/tmf.024.1.015","DOIUrl":"https://doi.org/10.29046/tmf.024.1.015","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"499 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134288013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case Presentation of Pericarditis Associated with Haemophilus Influenzae Bacteremia","authors":"Risa Goldberg, MD, Harrison Bell, MD","doi":"10.29046/tmf.024.1.008","DOIUrl":"https://doi.org/10.29046/tmf.024.1.008","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133236118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Severe Case of Hypertriglyceridemia in Alcoholic Hepatitis","authors":"Jullian Cooper, MD","doi":"10.29046/tmf.022.1.011","DOIUrl":"https://doi.org/10.29046/tmf.022.1.011","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128833158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ida Micaily, MD, Saveri Bhattacharya, DO, Russell Schilder, MD
However, increasing hCG levels two months after cessation of methotrexate led to concern for residual disease. As such, she was referred to our center for a second opinion. She was classified as FIGO stage I with a WHO score of 6 points, due to: time frame of 12 months since index pregnancy, baseline hCG and previous utilization of single drug (table 1). Her serum hCG increased to 110, leading to the resumption of MTX. She initially responded well to retreatment with MTX, demonstrating undetectable HCG levels for almost three months. After three months, her hCG again began to increase while on treatment (table 2). Possible treatment options at that point included actinomycin-D, EMA/CO, avelumab and radical hysterectomy. The patient had completed child bearing and elected to undergo a radical abdominal hysterectomybilateral salpingectomy. Post-surgical pathology ultimately demonstrated a gestational trophoblastic tumor, most consistent with choriocarcinoma invading into the myometrium. Her post-operative HCG was undetectable. INTRODUCTION
{"title":"A Case of Refractory Gestational Trophoblastic Neoplasia requiring Hysterectomy after Methotrexate","authors":"Ida Micaily, MD, Saveri Bhattacharya, DO, Russell Schilder, MD","doi":"10.29046/tmf.022.1.015","DOIUrl":"https://doi.org/10.29046/tmf.022.1.015","url":null,"abstract":"However, increasing hCG levels two months after cessation of methotrexate led to concern for residual disease. As such, she was referred to our center for a second opinion. She was classified as FIGO stage I with a WHO score of 6 points, due to: time frame of 12 months since index pregnancy, baseline hCG and previous utilization of single drug (table 1). Her serum hCG increased to 110, leading to the resumption of MTX. She initially responded well to retreatment with MTX, demonstrating undetectable HCG levels for almost three months. After three months, her hCG again began to increase while on treatment (table 2). Possible treatment options at that point included actinomycin-D, EMA/CO, avelumab and radical hysterectomy. The patient had completed child bearing and elected to undergo a radical abdominal hysterectomybilateral salpingectomy. Post-surgical pathology ultimately demonstrated a gestational trophoblastic tumor, most consistent with choriocarcinoma invading into the myometrium. Her post-operative HCG was undetectable. INTRODUCTION","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126008906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John Wallis, MD, Naman Upadhyay, MD, Fred Karaisz, MD, Mark Decaro, MD, René Alvarez, MD
A 33-year-old male developed subacute effusive-constrictive pericarditis with recurrent pleural effusions and mediastinal lymphadenopathy. He was found to have poorly differentiated carcinoma of the mediastinum that led to constrictive physiology not amenable to medical or surgical management, ultimately requiring hospice. This case was remarkable for its rare etiology and presentation.
{"title":"Effusive-Constrictive Pericarditis due to Poorly Differentiated Carcinoma of the Mediastinum","authors":"John Wallis, MD, Naman Upadhyay, MD, Fred Karaisz, MD, Mark Decaro, MD, René Alvarez, MD","doi":"10.29046/tmf.022.1.005","DOIUrl":"https://doi.org/10.29046/tmf.022.1.005","url":null,"abstract":"A 33-year-old male developed subacute effusive-constrictive pericarditis with recurrent pleural effusions and mediastinal lymphadenopathy. He was found to have poorly differentiated carcinoma of the mediastinum that led to constrictive physiology not amenable to medical or surgical management, ultimately requiring hospice. This case was remarkable for its rare etiology and presentation.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120898830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Table of Contents: The Medicine Forum Volume 24, 2022-2023","authors":"","doi":"10.29046/tmf.024.1.001","DOIUrl":"https://doi.org/10.29046/tmf.024.1.001","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114710006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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