Michael Dong, MD, Frances Mae West, MD, Jillian Cooper, MD, Jonathan Foster, MD, Rebecca Davis, MD
{"title":"A Guide to Point of Care Ultrasound Examination of a Pericardial Effusion","authors":"Michael Dong, MD, Frances Mae West, MD, Jillian Cooper, MD, Jonathan Foster, MD, Rebecca Davis, MD","doi":"10.29046/tmf.024.1.013","DOIUrl":"https://doi.org/10.29046/tmf.024.1.013","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"7 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":"133717412","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}
MD Nivethietha Maniam, Ming Ta Michael Lee, MD Mihir M. Shah, MD Richard Alexander
Primary malignant peritoneal mesothelioma with clear cell subtype is a rare malignancy with few previously reported cases. We present a 63-year-old female who presented with abdominal distention and was diagnosed with clear cell mesothelioma of the peritoneum with an isolated metastasis to the liver. The patient underwent surgical resection of a greater than 50 cm mass with en-bloc partial liver and gastric resection with an uneventful post-operative course. There are established prognostic and treatment recommendations for peritoneal mesothelioma based on histological subtype and patient-specific factors, although they do not explicitly incorporate clear cell subtype. This case report describes the presentation, treatment and early outcome of a rare form of peritoneal mesothelioma.
{"title":"A Rare Presentation of a Clear Cell Variant of Peritoneal Mesothelioma","authors":"MD Nivethietha Maniam, Ming Ta Michael Lee, MD Mihir M. Shah, MD Richard Alexander","doi":"10.29046/tmf.022.1.014","DOIUrl":"https://doi.org/10.29046/tmf.022.1.014","url":null,"abstract":"Primary malignant peritoneal mesothelioma with clear cell subtype is a rare malignancy with few previously reported cases. We present a 63-year-old female who presented with abdominal distention and was diagnosed with clear cell mesothelioma of the peritoneum with an isolated metastasis to the liver. The patient underwent surgical resection of a greater than 50 cm mass with en-bloc partial liver and gastric resection with an uneventful post-operative course. There are established prognostic and treatment recommendations for peritoneal mesothelioma based on histological subtype and patient-specific factors, although they do not explicitly incorporate clear cell subtype. This case report describes the presentation, treatment and early outcome of a rare form of peritoneal mesothelioma.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"10 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":"114418583","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 D Weintraub, Deepika Nandiraju, M. Shirodkar
A 65-year-old male with a history of gout was admitted for evaluation of hematuria. Labs during his admission revealed a venous blood glucose of 43mg/dl. Point of care glucose checks were not ordered on admission as the patient was not diabetic. The patient was fully alert and oriented with no somnolence, diaphoresis or palpitations. He was not taking any antihyperglycemic medications at home, and he had an HbA1c of 6.2%. He was hemodynamically stable with no signs of infection. The only other lab abnormality noted was a leukocytosis of 95,000/μL. Point of care glucose checks were ordered with meals and at bedtime. A subsequent venous blood glucose was 27mg/dL, but the patient remained asymptomatic and a simultaneous point of care glucose was 92mg/dL. A close evaluation of the case revealed a delay between phlebotomy time and processing of the venous sample. Immediate processing of the following venous sample revealed a normal glucose (90mg/dL) that correlated with the simultaneous point of care glucose. Repeat testing with quick processing of the sample clarified that the measurements of low venous blood glucose levels were due to in vitro glucose consumption by leukocytes that occurred between the times of phlebotomy and sample analysis.
{"title":"A Case Report of Pseudohypoglycemia in a Patient with Leukocytosis","authors":"Michael D Weintraub, Deepika Nandiraju, M. Shirodkar","doi":"10.29046/tmf.020.1.006","DOIUrl":"https://doi.org/10.29046/tmf.020.1.006","url":null,"abstract":"A 65-year-old male with a history of gout was admitted for evaluation of hematuria. Labs during his admission revealed a venous blood glucose of 43mg/dl. Point of care glucose checks were not ordered on admission as the patient was not diabetic. The patient was fully alert and oriented with no somnolence, diaphoresis or palpitations. He was not taking any antihyperglycemic medications at home, and he had an HbA1c of 6.2%. He was hemodynamically stable with no signs of infection. The only other lab abnormality noted was a leukocytosis of 95,000/μL. Point of care glucose checks were ordered with meals and at bedtime. A subsequent venous blood glucose was 27mg/dL, but the patient remained asymptomatic and a simultaneous point of care glucose was 92mg/dL. A close evaluation of the case revealed a delay between phlebotomy time and processing of the venous sample. Immediate processing of the following venous sample revealed a normal glucose (90mg/dL) that correlated with the simultaneous point of care glucose. Repeat testing with quick processing of the sample clarified that the measurements of low venous blood glucose levels were due to in vitro glucose consumption by leukocytes that occurred between the times of phlebotomy and sample analysis.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"24 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":"114959622","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}
Chioma Nwonu, DO, Michael Dong, MD, Dan Kramer, MD
{"title":"An Educational Case for Applying the Alveolar- Arterial Gradient in Hypoxemia: An Underutilized and Underappreciated Clinical Tool","authors":"Chioma Nwonu, DO, Michael Dong, MD, Dan Kramer, MD","doi":"10.29046/tmf.024.1.006","DOIUrl":"https://doi.org/10.29046/tmf.024.1.006","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"21 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":"125384588","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}
Steven Manobianco, MD, William Bradford, MD, Ida Micaily, MD, Adam Binder, MD
HLH is a severe inflammatory syndrome characterized by primary or secondary immune dysregulation causing excess activation of macrophages and cytotoxic lymphocytes, leading to multi-system dysfunction. Diagnosing and managing HLH can be challenging for clinicians, with HLH-2004 criteria for diagnosis requiring a molecular diagnosis or the presence of at least five of the following: fever, splenomegaly, cytopenia involving two or more cell lineages, hypertriglyceridemia and/or hypofibrinogenemia, hemophagocytosis in the bone marrow, spleen or lymph nodes with no evidence of malignancy, low or no NK cell activity, elevated ferritin, or elevated soluble IL-2 receptor. These criteria have been utilized to develop the HScore, a tool used to assist in determining the probability of HLH based on the aforementioned abnormalities. After diagnosis, treatment typically includes chemotherapy and immunosuppression, followed by allogeneic bone marrow transplant.
{"title":"A Slow Burning Diagnosis: A Case Report of Hemophagocytic Lymphohistiocytosis Preceding the Diagnosis of Subcutaneous Panniculitis-Like T-Cell Lymphoma","authors":"Steven Manobianco, MD, William Bradford, MD, Ida Micaily, MD, Adam Binder, MD","doi":"10.29046/tmf.022.1.013","DOIUrl":"https://doi.org/10.29046/tmf.022.1.013","url":null,"abstract":"HLH is a severe inflammatory syndrome characterized by primary or secondary immune dysregulation causing excess activation of macrophages and cytotoxic lymphocytes, leading to multi-system dysfunction. Diagnosing and managing HLH can be challenging for clinicians, with HLH-2004 criteria for diagnosis requiring a molecular diagnosis or the presence of at least five of the following: fever, splenomegaly, cytopenia involving two or more cell lineages, hypertriglyceridemia and/or hypofibrinogenemia, hemophagocytosis in the bone marrow, spleen or lymph nodes with no evidence of malignancy, low or no NK cell activity, elevated ferritin, or elevated soluble IL-2 receptor. These criteria have been utilized to develop the HScore, a tool used to assist in determining the probability of HLH based on the aforementioned abnormalities. After diagnosis, treatment typically includes chemotherapy and immunosuppression, followed by allogeneic bone marrow transplant.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"31 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":"116665694","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":"Can Our Hearts Take the New Guidelines?","authors":"E. Frankel","doi":"10.29046/tmf.020.1.017","DOIUrl":"https://doi.org/10.29046/tmf.020.1.017","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":"123576971","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}
Brendan Gleason, Lisa Matonti, PharmD, BCPS, Xuejun Alice Wang, MD, Bahar Dasgeb, MD
Bullous pemphigoid is an autoimmune blistering condition mediated by autoantibodies 1 . It is categorized as an uncommon disorder 2-4 , with an estimated incidence of 2.4-21.7 cases per million 2-6 but carries significant morbidity and mortality, warranting clinical awareness and investigation 7,8 . A number of medications have been implicated in the development of bullous pemphigoid including loop diuretics, ace inhibitors, and anti-epileptic drugs. This is a case report of carbamazepine-induced bullous pemphigoid in a 49-year-old male after taking the medication for almost 30 years. Diagnosis of bullous pemphigoid was based on biopsy histology and immunofluorescence, as well as the presence of BP 180 antibody. Clinical features of extensive rash and bullae were present on dermatological exam. Upon discontinuation of carbamazepine and appropriate treatment of bullous pemphigoid, the patient’s condition improved. A thorough analysis of the patient’s history and medications did not reveal any other potential triggers of bullous pemphigoid. The only two previous reports of an association between carbamazepine and bullous pemphigoid are limited by lack of immunologic evidence of diagnosis or the identification of a specific causative agent. To address these limitations, we describe what is to our knowledge, the first reported case of clearly documented association between carbamazepine and bullous pemphigoid.
{"title":"Carbamazepine Induced Bullous Pemphigoid in a 49 Year Old Male","authors":"Brendan Gleason, Lisa Matonti, PharmD, BCPS, Xuejun Alice Wang, MD, Bahar Dasgeb, MD","doi":"10.29046/tmf.022.1.009","DOIUrl":"https://doi.org/10.29046/tmf.022.1.009","url":null,"abstract":"Bullous pemphigoid is an autoimmune blistering condition mediated by autoantibodies 1 . It is categorized as an uncommon disorder 2-4 , with an estimated incidence of 2.4-21.7 cases per million 2-6 but carries significant morbidity and mortality, warranting clinical awareness and investigation 7,8 . A number of medications have been implicated in the development of bullous pemphigoid including loop diuretics, ace inhibitors, and anti-epileptic drugs. This is a case report of carbamazepine-induced bullous pemphigoid in a 49-year-old male after taking the medication for almost 30 years. Diagnosis of bullous pemphigoid was based on biopsy histology and immunofluorescence, as well as the presence of BP 180 antibody. Clinical features of extensive rash and bullae were present on dermatological exam. Upon discontinuation of carbamazepine and appropriate treatment of bullous pemphigoid, the patient’s condition improved. A thorough analysis of the patient’s history and medications did not reveal any other potential triggers of bullous pemphigoid. The only two previous reports of an association between carbamazepine and bullous pemphigoid are limited by lack of immunologic evidence of diagnosis or the identification of a specific causative agent. To address these limitations, we describe what is to our knowledge, the first reported case of clearly documented association between carbamazepine and bullous pemphigoid.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"31 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120822740","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":"Heart Failure with Preserved Ejection Fraction: A Review of the ACC/AHA Guidelines and Evidence-Based Management Strategy","authors":"V. Sunder","doi":"10.29046/TMF.020.1.019","DOIUrl":"https://doi.org/10.29046/TMF.020.1.019","url":null,"abstract":"","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"25 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":"125718859","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}
Book file PDF easily for everyone and every device. You can download and read online No Hard Feelings file PDF Book only if you are registered here. And also you can download or read online all Book PDF file that related with No Hard Feelings book. Happy reading No Hard Feelings Bookeveryone. Download file Free Book PDF No Hard Feelings at Complete PDF Library. This Book have some digital formats such us :paperbook, ebook, kindle, epub, fb2 and another formats. Here is The Complete PDF Book Library. It's free to register here to get Book file PDF No Hard Feelings.
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{"title":"No Hard Feelings","authors":"Colin Thomas","doi":"10.29046/TMF.020.1.021","DOIUrl":"https://doi.org/10.29046/TMF.020.1.021","url":null,"abstract":"Book file PDF easily for everyone and every device. You can download and read online No Hard Feelings file PDF Book only if you are registered here. And also you can download or read online all Book PDF file that related with No Hard Feelings book. Happy reading No Hard Feelings Bookeveryone. Download file Free Book PDF No Hard Feelings at Complete PDF Library. This Book have some digital formats such us :paperbook, ebook, kindle, epub, fb2 and another formats. Here is The Complete PDF Book Library. It's free to register here to get Book file PDF No Hard Feelings.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"5 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":"128914166","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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