Naman Upadhyay, MD, Gillian Naro, MD, MEd, Gregary Marhefka, MD
aminotransferase of 71 IU/L,creatinine kinase of 17,732 IU/L, c-reactive protein of 4.3 mg/
转氨酶71 IU/L，肌酐激酶17732 IU/L,c反应蛋白4.3 mg/ L
{"title":"STEMI in a Young Patient with COVID-19; Too Great a Burden?","authors":"Naman Upadhyay, MD, Gillian Naro, MD, MEd, Gregary Marhefka, MD","doi":"10.29046/tmf.022.1.018","DOIUrl":"https://doi.org/10.29046/tmf.022.1.018","url":null,"abstract":"aminotransferase of 71 IU/L,creatinine kinase of 17,732 IU/L, c-reactive protein of 4.3 mg/","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"23 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":"128333168","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}
Follicular thyroid cancer (FTC) is the second most common malignancy of the thyroid gland and comprise 10-15% of all thyroid tumors; the usual mode of spread is via hematogenous dissemination with the most common sites of metastases being the lungs and bones. A case is presented to demonstrate the unusual presentation of follicular thyroid cancer as bilateral choroidal metastases. Although exceptional, a diagnosis of choroidal metastases should be considered in any decline in visual acuity in patients with thyroid cancer.
{"title":"Bilateral Choroidal Metastases as Initial Presentation of Widespread Follicular Thyroid Cancer","authors":"Jennifer Hong","doi":"10.29046/tmf.020.1.010","DOIUrl":"https://doi.org/10.29046/tmf.020.1.010","url":null,"abstract":"Follicular thyroid cancer (FTC) is the second most common malignancy of the thyroid gland and comprise 10-15% of all thyroid tumors; the usual mode of spread is via hematogenous dissemination with the most common sites of metastases being the lungs and bones. A case is presented to demonstrate the unusual presentation of follicular thyroid cancer as bilateral choroidal metastases. Although exceptional, a diagnosis of choroidal metastases should be considered in any decline in visual acuity in patients with thyroid cancer.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"78 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":"126120480","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}
Pneumatosis intestinalis (PI) refers to the radiographic finding of gas within the small or large bowel wall. It can be seen in association with gas in the portal venous system. The clinical significance of these findings is variable and depends on the patient's etiology and initial presentation. PI can be seen anywhere in the gastrointestinal tract distal to the stomach and is caused by a myriad of conditions. We present a case of a patient admitted to the intensive care unit with PI and portal vein gas.
{"title":"Pneumatosis Intestinalis in a Patient with Systemic Lupus Erythematosus","authors":"Sean J Dikdan, M. Lake","doi":"10.29046/TMF.020.1.015","DOIUrl":"https://doi.org/10.29046/TMF.020.1.015","url":null,"abstract":"Pneumatosis intestinalis (PI) refers to the radiographic finding of gas within the small or large bowel wall. It can be seen in association with gas in the portal venous system. The clinical significance of these findings is variable and depends on the patient's etiology and initial presentation. PI can be seen anywhere in the gastrointestinal tract distal to the stomach and is caused by a myriad of conditions. We present a case of a patient admitted to the intensive care unit with PI and portal vein gas.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"78 5 Pt 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":"130626602","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}
Recommended Citation Rajaram, MD, Bharaniabirami; Murugesan, MD, Neveda; and Marhefka, MD, Gregary D. (2022) "Another Case of Takotsubo Syndrome: Excluded by the Presence of Significant Coronary Artery Disease, or Caused by Significant Coronary Artery Disease?," The Medicine Forum: Vol. 23, Article 7. DOI: https://doi.org/10.29046/TMF.023.1.006 Available at: https://jdc.jefferson.edu/tmf/vol23/iss1/7
Rajaram, MD, Bharaniabirami;Murugesan，医学博士，内华达州;Marhefka, MD, gregory D. (2022)“Takotsubo综合征的另一例:因存在严重冠状动脉疾病而排除，还是由严重冠状动脉疾病引起?”，《医学论坛》第23卷，第7条。DOI: https://doi.org/10.29046/TMF.023.1.006可在:https://jdc.jefferson.edu/tmf/vol23/iss1/7
{"title":"Another Case of Takotsubo Syndrome: Excluded by the Presence of Significant Coronary Artery Disease, or Caused by Significant Coronary Artery Disease?","authors":"Bharaniabirami Rajaram, MD, Neveda Murugesan, MD, Gregary Marhefka, MD","doi":"10.29046/tmf.023.1.006","DOIUrl":"https://doi.org/10.29046/tmf.023.1.006","url":null,"abstract":"Recommended Citation Rajaram, MD, Bharaniabirami; Murugesan, MD, Neveda; and Marhefka, MD, Gregary D. (2022) \"Another Case of Takotsubo Syndrome: Excluded by the Presence of Significant Coronary Artery Disease, or Caused by Significant Coronary Artery Disease?,\" The Medicine Forum: Vol. 23, Article 7. DOI: https://doi.org/10.29046/TMF.023.1.006 Available at: https://jdc.jefferson.edu/tmf/vol23/iss1/7","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"8 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":"115323252","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":"Challenges of Managing Giant Cell Myocarditis: A Case Report on the Mechanical Support Perspective","authors":"Adul Kazi, MD, MBA, Harsh Doshi, MD","doi":"10.29046/tmf.023.1.005","DOIUrl":"https://doi.org/10.29046/tmf.023.1.005","url":null,"abstract":"","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":"130752629","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":"Serum Ammonia and Folate Levels: Opportunities for High Value Care","authors":"R. Jones, Sean J Dikdan, Bracken Babula","doi":"10.29046/tmf.021.1.014","DOIUrl":"https://doi.org/10.29046/tmf.021.1.014","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"30 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":"114085879","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}
Celiac disease (CD) is an immune mediated condition that results from a reaction to dietary gluten and primarily affects the small intestine. Genetically predisposed individuals develop a chronic inflammatory state of the small intestine which leads to malabsorption. The disease is mediated by HLA DQ2 or DQ8 haplotypes, which bind the gliadin peptides of gluten, present the peptides to CD4+ T lymphocytes and trigger cytokine and B lymphocyte responses.
{"title":"Sealing the Diagnosis of Celiac Disease in Pregnancy","authors":"R. Nahar, A. Aman","doi":"10.29046/tmf.020.1.008","DOIUrl":"https://doi.org/10.29046/tmf.020.1.008","url":null,"abstract":"Celiac disease (CD) is an immune mediated condition that results from a reaction to dietary gluten and primarily affects the small intestine. Genetically predisposed individuals develop a chronic inflammatory state of the small intestine which leads to malabsorption. The disease is mediated by HLA DQ2 or DQ8 haplotypes, which bind the gliadin peptides of gluten, present the peptides to CD4+ T lymphocytes and trigger cytokine and B lymphocyte responses.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"175 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":"115918907","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}
A. Majeed, Nicholas Noverati, MD, Christine Kurian, MD, Shirin Jaggi, DO
Opioid misuse is a national public health crisis that has contributed to a decrease in life expectancy in men and women in the US. From 1999-2017, the rate of drug overdose deaths tripled, largely due to the rise in opioid use. Despite widespread misuse, chronic opioid therapy still has a role in the clinical setting. Adverse effects include dizziness, nausea, vomiting, respiratory depression, and dependence. While these side effects are welldocumented, other effects of opioids are less explored, including opioidinduced adrenal insufficiency. The typical presentation of adrenal insufficiency from any cause can include fatigue, nausea, vomiting, weight loss, abdominal pain and muscle aches. Laboratory findings might include hyponatremia and hyperkalemia. This case, however, presents a patient with atypical presentation but confirmed diagnosis of adrenal insufficiency in the setting of chronic opioid use. Ultimately, given chronic opioid use both prescribed and unprescribed, it is imperative that healthcare providers understand the endocrine effects of opioids as adrenal insufficiency is associated with higher morbidity and mortality.
{"title":"Opioid-Induced Secondary Adrenal Insufficiency in a Young Patient with Chronic Pancreatitis","authors":"A. Majeed, Nicholas Noverati, MD, Christine Kurian, MD, Shirin Jaggi, DO","doi":"10.29046/tmf.022.1.012","DOIUrl":"https://doi.org/10.29046/tmf.022.1.012","url":null,"abstract":"Opioid misuse is a national public health crisis that has contributed to a decrease in life expectancy in men and women in the US. From 1999-2017, the rate of drug overdose deaths tripled, largely due to the rise in opioid use. Despite widespread misuse, chronic opioid therapy still has a role in the clinical setting. Adverse effects include dizziness, nausea, vomiting, respiratory depression, and dependence. While these side effects are welldocumented, other effects of opioids are less explored, including opioidinduced adrenal insufficiency. The typical presentation of adrenal insufficiency from any cause can include fatigue, nausea, vomiting, weight loss, abdominal pain and muscle aches. Laboratory findings might include hyponatremia and hyperkalemia. This case, however, presents a patient with atypical presentation but confirmed diagnosis of adrenal insufficiency in the setting of chronic opioid use. Ultimately, given chronic opioid use both prescribed and unprescribed, it is imperative that healthcare providers understand the endocrine effects of opioids as adrenal insufficiency is associated with higher morbidity and mortality.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"14 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":"128923973","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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