Pub Date : 2022-01-01DOI: 10.25270/con.2022.07.000022
K. Carmichael
Q. How common is diabetic retinopathy in patients with diabetes, and when does it occur? A. Diabetic retinopathy is the most common cause of blindness among persons aged 20 to 74 years in developed countries.1,2 The prevalence is greatest among Hispanic adults overall, between 8% and 19% among those aged 75 years or older.3 Retinopathy is present in 5.4% of Black individuals and 5.1% among White individuals with diabetes.3 There is no significant difference between men and women with diabetes. The total number of persons with diabetic retinopathy is projected to double between 2010 and 2050 from 7.7 million to 14.6 million.3 A pooled worldwide meta-analysis of data from 1980 to 2008 indicated a prevalence of 35.4% of all persons with diabetes, with 7.5% having proliferative retinopathy.2
{"title":"How Do We Best Care for the Eyes of People With Diabetes?","authors":"K. Carmichael","doi":"10.25270/con.2022.07.000022","DOIUrl":"https://doi.org/10.25270/con.2022.07.000022","url":null,"abstract":"Q. How common is diabetic retinopathy in patients with diabetes, and when does it occur? A. Diabetic retinopathy is the most common cause of blindness among persons aged 20 to 74 years in developed countries.1,2 The prevalence is greatest among Hispanic adults overall, between 8% and 19% among those aged 75 years or older.3 Retinopathy is present in 5.4% of Black individuals and 5.1% among White individuals with diabetes.3 There is no significant difference between men and women with diabetes. The total number of persons with diabetic retinopathy is projected to double between 2010 and 2050 from 7.7 million to 14.6 million.3 A pooled worldwide meta-analysis of data from 1980 to 2008 indicated a prevalence of 35.4% of all persons with diabetes, with 7.5% having proliferative retinopathy.2","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418520","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.07.00003
Reem Ichoa, Rajesh Savargaonkar, V. Jones
Background. Choledochal cysts are congenital anomalies of the biliary duct. The most common site for the development of cystic dilation is the common bile duct. Although choledochal cysts are a rare disease in children, complications such as perforation of the cyst have been reported. In this literature review, we discuss a case of a choledochal cyst with rupture and pseudocyst formation. Complete excision of the cyst and pseudocyst yields an excellent outcome with a 90% 5-year survival rate postoperatively.
{"title":"Choledochal Cyst With Rupture and Pseudocyst Formation","authors":"Reem Ichoa, Rajesh Savargaonkar, V. Jones","doi":"10.25270/con.2022.07.00003","DOIUrl":"https://doi.org/10.25270/con.2022.07.00003","url":null,"abstract":"Background. Choledochal cysts are congenital anomalies of the biliary duct. The most common site for the development of cystic dilation is the common bile duct. Although choledochal cysts are a rare disease in children, complications such as perforation of the cyst have been reported. In this literature review, we discuss a case of a choledochal cyst with rupture and pseudocyst formation. Complete excision of the cyst and pseudocyst yields an excellent outcome with a 90% 5-year survival rate postoperatively.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418522","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.11.000004
R. Rubin
{"title":"A 58-Year-Old Man in Severe Abdominal Pain","authors":"R. Rubin","doi":"10.25270/con.2022.11.000004","DOIUrl":"https://doi.org/10.25270/con.2022.11.000004","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69421323","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.11.000014
R. Rubin
{"title":"A 70-Year-Old Man With Back, Buttock, and Thigh Pain","authors":"R. Rubin","doi":"10.25270/con.2022.11.000014","DOIUrl":"https://doi.org/10.25270/con.2022.11.000014","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69422225","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.01.00004
Iris Hunt, Christina T. Hanos, Tara Paolini, T. Helm
{"title":"What Is This Reticulated, Erythematous Eruption on a Woman’s Buttocks?","authors":"Iris Hunt, Christina T. Hanos, Tara Paolini, T. Helm","doi":"10.25270/con.2022.01.00004","DOIUrl":"https://doi.org/10.25270/con.2022.01.00004","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417130","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.03.00002
Sean Sims, Matt Snow
{"title":"Cervical Ribs in a Teenaged Athlete","authors":"Sean Sims, Matt Snow","doi":"10.25270/con.2022.03.00002","DOIUrl":"https://doi.org/10.25270/con.2022.03.00002","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417423","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.02.00007
Ahish Chitneni, Annina Giannuzzi, Kaushik Manthani, S. Gandhi
Diagnostic testing Initial abdominal radiography scans showed diffuse bowel ileus vs distal large bowel obstruction. A computed tomography scan of the abdomen and pelvis showed a mildly distended, fluid-filled stomach and small bowel, suggestive of enterocolitis (Figure). Laboratory study findings were significant for an elevated white blood cell count of 14.67 × 109/L. Initial blood cultures resulted in growth of gram-positive cocci in pairs and chains, but no growth was seen in the urine culture. The patient was initially started on ceftriaxone and vancomycin. Three days after hospital admission, blood cultures grew Granulicatella adiacens, and the patient underwent an echocardiography scan, results of which revealed bacterial endocarditis on the aortic valve. The patient was educated on the need for outpatient colonoscopy and dental follow-up and was discharged on 4 weeks of intravenous ceftriaxone outpatient parenteral antibiotic therapy.
{"title":"Infective Endocarditis Secondary to Granulicatella adiacens","authors":"Ahish Chitneni, Annina Giannuzzi, Kaushik Manthani, S. Gandhi","doi":"10.25270/con.2022.02.00007","DOIUrl":"https://doi.org/10.25270/con.2022.02.00007","url":null,"abstract":"Diagnostic testing Initial abdominal radiography scans showed diffuse bowel ileus vs distal large bowel obstruction. A computed tomography scan of the abdomen and pelvis showed a mildly distended, fluid-filled stomach and small bowel, suggestive of enterocolitis (Figure). Laboratory study findings were significant for an elevated white blood cell count of 14.67 × 109/L. Initial blood cultures resulted in growth of gram-positive cocci in pairs and chains, but no growth was seen in the urine culture. The patient was initially started on ceftriaxone and vancomycin. Three days after hospital admission, blood cultures grew Granulicatella adiacens, and the patient underwent an echocardiography scan, results of which revealed bacterial endocarditis on the aortic valve. The patient was educated on the need for outpatient colonoscopy and dental follow-up and was discharged on 4 weeks of intravenous ceftriaxone outpatient parenteral antibiotic therapy.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417491","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.04.00004
R. Rubin
{"title":"A 72-Year-Old Woman With an Abnormality on Incidental Blood Testing","authors":"R. Rubin","doi":"10.25270/con.2022.04.00004","DOIUrl":"https://doi.org/10.25270/con.2022.04.00004","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417788","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}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.06.00011
Lucas M. Walden, J. Prescott, V. Jain
A 67-year-old man who developed new-onset neurological symptoms was found to have bilateral internal carotid artery (ICA) pseudoaneurysms on computed tomography angiography. Pseudoaneurysms of the ICA are a rare diagnosis and can lead to significant morbidity and mortality including infarcts and, in some cases, hemorrhagic transformation of infarcts. The primary risk factors for the formation of ICA pseudoaneurysms are trauma and surgery. Other causes include infiltrating metastatic disease, infection, fibromuscular dysplasia, Ehlers-Danlos syndrome, Marfan syndrome, irradiation, and Behçet disease. Endovascular repair with stenting is a highly effective treatment option and preferred in patients with large symptomatic pseudoaneurysms. Depending on the etiology, open repair may be necessary. Individuals with smaller asymptomatic lesions are managed nonoperatively with antithrombotic therapy and are followed with serial imaging for significant changes in aneurysm size, which would necessitate procedural intervention.
{"title":"Bilateral Cervical Internal Carotid Artery Pseudoaneurysms","authors":"Lucas M. Walden, J. Prescott, V. Jain","doi":"10.25270/con.2022.06.00011","DOIUrl":"https://doi.org/10.25270/con.2022.06.00011","url":null,"abstract":"A 67-year-old man who developed new-onset neurological symptoms was found to have bilateral internal carotid artery (ICA) pseudoaneurysms on computed tomography angiography. Pseudoaneurysms of the ICA are a rare diagnosis and can lead to significant morbidity and mortality including infarcts and, in some cases, hemorrhagic transformation of infarcts. The primary risk factors for the formation of ICA pseudoaneurysms are trauma and surgery. Other causes include infiltrating metastatic disease, infection, fibromuscular dysplasia, Ehlers-Danlos syndrome, Marfan syndrome, irradiation, and Behçet disease. Endovascular repair with stenting is a highly effective treatment option and preferred in patients with large symptomatic pseudoaneurysms. Depending on the etiology, open repair may be necessary. Individuals with smaller asymptomatic lesions are managed nonoperatively with antithrombotic therapy and are followed with serial imaging for significant changes in aneurysm size, which would necessitate procedural intervention.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418376","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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