keyword
https://read.qxmd.com/read/38646421/perioperative-care-of-a-child-with-hyperthyroidism
#21
Joseph Bonanno, Timothy Grannell, Gregory Maves, Joseph D Tobias
In pediatric-aged patients, hyperthyroidism generally results from the autoimmune disorder, Graves' disease (GD). Excessive levels of thyroid hormones (triiodothyronine and thyroxine) result in irritability, emotional lability, nervousness, tremors, palpitations, tachycardia, and arrhythmias. The risk of morbidity and mortality is increased when surgical intervention is required in patients with hyperthyroidism due to the potential for the development of thyroid storm (TS). A 3-year, 1-month-old child with a past medical history of GD presented for total thyroidectomy when pharmacologic control with methimazole was not feasible due to intolerance following development of a serum sickness-like illness...
April 2024: Journal of Medical Cases
https://read.qxmd.com/read/38646409/pharmacologic-anisocoria-with-azelastine-the-importance-of-a-good-anamnesis
#22
Margarida Ribeiro, Rita Teixeira-Martins, Jorge Meira
Unilateral pharmacologic mydriasis is one of the differential diagnoses of anisocoria. This is a clinical case of a 37-year-old male patient admitted to the ophthalmology emergency department with unilateral mydriasis, an infrequent side effect of the antihistaminic drug azelastine. A comprehensive medical history including ocular medication was essential to avoid the need for additional tests and to exclude life-threatening conditions responsible for a similar presentation.
March 2024: Curēus
https://read.qxmd.com/read/38646402/surviving-the-storm-cardiac-tamponade-and-effusive-constrictive-pericarditis-complicated-by-pericardial-decompression-syndrome-induced-by-covid-19-infection-in-the-setting-of-newly-diagnosed-acute-myeloid-leukemia-aml
#23
Wassim Abouzeid, Noreen Mirza, Paul Bellafiore, Chrystina Kiwan, Amy Paige, Addi Suleiman, Ahsan Khan, Richard Miller
Coronavirus disease 2019 (COVID-19)-induced pericarditis and pericardial myocarditis are common entities; however, the development of pericardial effusion post-COVID-19 infection has only been reported in about 5% of cases. Rapid and acute progression to pericardial tamponade is uncommon, and progression to effusive constrictive pericarditis (ECP) and pericardial decompression syndrome (PDS) is an even rarer phenomenon. We describe these phenomena in this report to raise awareness and aid clinicians in the early diagnosis and management of these conditions...
March 2024: Curēus
https://read.qxmd.com/read/38646391/renal-lymphangiectasia-the-transcending-of-serendipity
#24
Gina Paola Ricardo Ossio, Diana Marcela Gallo Orjuela, Juanita Salazar Agudelo, Camilo Gonzalez Gomez, Dennys Tenelanda Lopez
Renal lymphangiectasia, a rare entity of the renal lymphatic system affecting both genders and all ages, can manifest bilaterally or unilaterally and has been referred to by various terms, such as renal lymphangiomatosis, renal lymphangioma, and others. Distinguishing this condition from common pathologies, such as polycystic kidney disease or hydronephrosis, is crucial. This article presents an innovative clinical case of unilateral renal lymphangiectasia in a 67-year-old woman with a relevant medical history...
March 2024: Curēus
https://read.qxmd.com/read/38646354/posterior-reversible-encephalopathy-syndrome-presenting-as-delirium-with-psychosis-and-agitation-in-the-postpartum-period
#25
Talitha West, Jason Christopher, Stanislav Arkhipov, Daniel Erickson, Adriana Fitzsimmons
Posterior reversible encephalopathy syndrome (PRES), which was first described in 1996, is a neurologic condition characterized by a combination of clinical and neuroimaging findings. PRES may arise in the context of preeclampsia, eclampsia, renal failure, and sepsis, among other conditions. Neuropsychiatric symptoms of PRES include altered mental status, agitation, and in some cases psychosis. PRES occurring in the postpartum period is understudied, especially with regard to its psychiatric manifestations...
March 2024: Curēus
https://read.qxmd.com/read/38646340/colonic-angiolipoma-a-rare-cause-of-chronic-anemia-and-rectal-bleeding
#26
Kawkab Alharbi, Ahmad Bilal
Angiolipomas are rare, benign tumors characterized by a mixture of adipose tissue and blood vessels, distinguishing them from lipomas. This case involves a 52-year-old woman with no significant medical history who presented with generalized weakness, fatigue, and intermittent, painless rectal bleeding over six months, initially dismissed as hemorrhoidal. Despite exhibiting mild pallor and trace rectal bleeding upon examination, significant iron-deficiency anemia was diagnosed through laboratory tests. Incorporating colonoscopy and computed tomography, the diagnostic process identified a 2 cm submucosal lesion in the ascending colon, characterized as a well-defined, fat-density mass...
March 2024: Curēus
https://read.qxmd.com/read/38646267/navigating-the-diagnostic-challenges-of-mycoplasma-and-legionella-coinfection-through-serological-testing
#27
Sushma Edara, Sivaprasad Nalluri
Diagnosing community-acquired pneumonia (CAP) is increasingly challenging, especially with the emergence of atypical pathogens such as  Mycoplasma pneumoniae  and  Legionella pneumophila . This report presents the case of a 60-year-old male exhibiting lethargy and decreased oral intake, with a medical history marked by chronic kidney disease and benign prostate hyperplasia. Despite a positive  Legionella  urine antigen, the clinical and radiological profile did not align with  Legionella  pneumonia...
March 2024: Curēus
https://read.qxmd.com/read/38646247/complex-cardiovascular-morbidities-in-prader-willi-syndrome-a-multidisciplinary-approach
#28
Raul Alba, Soroush Omidvarnia, Jared J Bies, Tim Carlson, Qusay Alfaori, Thwe Htay
This case emphasizes the complexity of Prader-Willi syndrome (PWS), the need for a collaborative approach from specialists, and a closer look at the various cardiovascular complexities associated with this syndrome. While current treatments focus on managing symptoms, ongoing genetic research offers hope for more favorable outcomes. Further studies are crucial to gauge the effectiveness of these treatments for PWS patients. We detail a patient with a complex medical history of PWS, further complicated by congenital heart disease with Eisenmenger's syndrome, diabetes mellitus, pulmonary hypertension, venous insufficiency, hypothyroidism, and hyperlipidemia...
March 2024: Curēus
https://read.qxmd.com/read/38646242/human-herpesvirus-8-positive-multicentric-castleman-disease-in-an-immunocompetent-patient-a-diagnostic-challenge
#29
Ana Rita G Magalhães, Marta B Santos, Pedro H Almeida, Ana Maria F Carvalho, Beatriz T Exposito
We present a clinical case of a 79-year-old male admitted to inpatient care for longstanding asthenia and respiratory symptoms. Associated features were polyserositis, multiple enlarged lymphatic nodules, acute kidney injury, and heart failure. The patient's recent medical history revealed SARS-CoV-2 vaccination a week prior and an upper respiratory tract infection. The laboratory results from thoracentesis were compatible with a transudate, with no immunological stain. Epstein-Barr virus polymerase chain reaction (PCR) was positive...
March 2024: Curēus
https://read.qxmd.com/read/38646228/agranulocytosis-associated-with-psychiatric-polypharmacy-lessons-learned-from-a-clinical-case
#30
Nicole Ann E Villa, Dragos G Pausescu, Eduardo D Espiridion
Psychiatric polypharmacy involves the use of two or more psychotropic medications to manage a mental and emotional condition. The prevalence of psychotropic polypharmacy has been increasing since the 1990s and has been attributed to the rise in multiple psychiatric conditions presenting in one patient. However, as the prevalence of polypharmacy increases to maximize therapeutic advantages, so does the adverse effect profile of those drugs used in combination, leading to very life-threatening effects such as agranulocytosis...
March 2024: Curēus
https://read.qxmd.com/read/38646137/benefit-of-intrapleural-fibrinolytic-therapy-in-the-treatment-of-complicated-parapneumonic-effusion-and-empyema
#31
Takoua Merhabene, Souheil Zayet, Amira Jamoussi, Samia Ayed, Salwa Mansouri, Jalila Ben Khelil, Mohamed Besbes
Our study aimed to assess the benefit of intrapleural fibrinolysis before resorting to surgery to treat complicated parapneumonic effusion and empyema. We conducted a retrospective and descriptive study, including all patients hospitalized in the intensive care unit (ICU) of the Abderhaman Mami hospital, Tunisia for empyema treated with instillation of intrapleural fibrinolytic therapy between the 1st January 2000 and 31st December 2016. In all patients, empyema was diagnosed on clinical features, imaging findings (chest X-ray, thoracic echography and/or computed tomography (CT), and microbiological data...
2024: Pan African Medical Journal
https://read.qxmd.com/read/38645942/an-unusual-cause-of-syncope-inferior-vena-cava-compression-by-a-massive-renal-cyst
#32
Matthew Silbergleit, Brooks Keene
Syncope is a commonly encountered symptom that accounts for up to 3% of all emergency department visits in the United States [1]. The differential diagnosis for patients presenting with syncope is often broad and can involve multiple distinct organ systems. This case details the hospital course of an 83-year-old male with a complicated past medical history who initially presented for syncope. Following an extensive work up it was eventually elicited that this patient had an unusual etiology of syncope, a 19 cm x 24 cm renal cyst that was compressing the inferior vena cava (IVC)...
July 2024: Radiology Case Reports
https://read.qxmd.com/read/38645828/optimizing-patient-selection-for-physiological-pacing-in-bradyarrhythmia-factors-associated-with-high-ventricular-pacing-burden
#33
JOURNAL ARTICLE
James Mannion, Kathryn L Hong, Amy Hennessey, Anna Cleary, Anand Subramaniyan, Conor Sheahan, Kathleen E Bennett, Richard Sheahan
BACKGROUND: Right ventricular (RV) pacing is established as the most common ventricular pacing (VP) strategy for patients with symptomatic bradyarrhythmia. Some patients with high VP burden suffer deterioration of left ventricular (LV) function, termed pacing-induced cardiomyopathy (PICM). Patients who pace > 20% of the time from the RV apex are at increased risk of PICM, but independent predictors of increased RV pacing burden have not been elucidated in those who have a permanent pacemaker (PPM) inserted for bradyarrhythmia...
April 2024: Cardiology Research
https://read.qxmd.com/read/38644309/-a-case-of-advanced-gastric-cancer-treated-with-conversion-surgery-followed-by-nivolumab-combination-chemotherapy
#34
JOURNAL ARTICLE
Nobufumi Sekino, Toshiyuki Natsume, Hajime Tanaka, Osamu Kainuma, Yayoi Sato, Hiromasa Note, Takafumi Yoshioka, Toshiki Kamata, Hikaru Odera, Mariko Uchiyama, Takashi Maruyama, Hidekazu Takahashi, Satoshi Hirano
The use of nivolumab as first-line therapy for unresectable advanced gastric cancer has now become a standard practice, and its efficacy has been established. This is the first report of a patient with advanced gastric cancer who underwent conversion surgery after first-line nivolumab combination chemotherapy. The patient was a 58-year-old woman. Her medical history included hypertension and dyslipidemia. She had advanced gastric cancer with extensive lymph node metastasis in the left supraclavicular fossa and around the abdominal aorta...
April 2024: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://read.qxmd.com/read/38643683/chronic-idiopathic-urinary-retention-comorbidity-and-outcome-in-102-individuals
#35
JOURNAL ARTICLE
Fintan Milligan, Charlotte Whittingham, Voula Granitsitotis, Helen Simpson, Julie Woodfield, Alan Carson, Jon Stone, Ingrid Hoeritzauer
OBJECTIVES: Chronic Idiopathic urinary retention is poorly understood. One small study suggests higher than expected rates of functional neurological disorder and pain comorbidity which may have implications for understanding the disorder. We investigated the frequency of functional neurological disorder, chronic pain other medical and psychiatric comorbidity, triggers of urinary retention, results of urodynamic assessment, medication history, management, and outcome in patients with chronic idiopathic urinary retention...
April 6, 2024: Journal of Psychosomatic Research
https://read.qxmd.com/read/38643178/a-case-of-pulmonary-visceral-subpleural-hematoma-treated-by-hematoma-evacuation-during-care-of-post-cardiopulmonary-resuscitation
#36
JOURNAL ARTICLE
Yutaka Funaki, Kyoji Hirai
BACKGROUND: The occurrence of pulmonary visceral subpleural hematoma during care of post-cardiopulmonary resuscitation including chest compressions and anticoagulant and antiplatelet therapies is extremely rare. Also, there are few reports of treatment of visceral subpleural hematoma, most of which are treated by lung resection. Here we describe a rare case that pulmonary visceral subpleural hematoma arose during post-cardiopulmonary resuscitation care and was treated by hematoma evacuation...
April 20, 2024: Journal of Cardiothoracic Surgery
https://read.qxmd.com/read/38642577/challenging-diagnosis-of-resistance-to-thyroid-hormone-in-a-patient-with-covid-19-pituitary-microadenoma-and-unusual-response-to-octreotide-long-acting-release-test
#37
JOURNAL ARTICLE
Cristian Petolicchio, Sara Brasili, Stefano Gay, Francesco Cocchiara, Irene Campi, Luca Persani, Lara Vera, Diego Ferone, Federico Gatto
SUMMARY: The resistance to thyroid hormone syndrome (RTHβ) occurs uncommonly and requires a high level of clinical suspicion and specific investigations to reach a precise diagnosis and to avoid unnecessary and potentially harmful therapies. We report a case of a young male patient referred to our unit for SARS-CoV-2 infection and atrial fibrillation with elevated thyroid hormones and non-suppressed thyroid-stimulating hormone (TSH), for which antithyroid therapy was prescribed...
April 1, 2024: Endocrinology, Diabetes & Metabolism Case Reports
https://read.qxmd.com/read/38641978/prevalence-of-pre-hypertension-hypertension-and-its-associated-factors-among-adults-in-the-wolaita-zone-of-southern-ethiopia-a-cross-sectional-study
#38
JOURNAL ARTICLE
Eshetu Elfios Endrias, Teketel Tesfaye Mamito, Temesgen Geta Hardido, Bizuayehu Atinafu Ataro
Preventing the development of high blood pressure and resulting complication requires estimating the prevalence of prehypertension/hypertension and identifying associated risk factors. Information about pre-hypertension/hypertension in Ethiopia, especially in the southern region, is scarce, and limited knowledge exists regarding the prevalence and risk factors associated with pre-hypertension/hypertension. Objective of this study was to assess prevalence of pre-hypertension/hypertension and its associated factors among adults in Wolaita Zone of Southern Ethiopia, 2023...
2024: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://read.qxmd.com/read/38640306/diagnosis-and-rescue-of-malignant-hyperthermia-induced-by-anesthesia-during-radical-surgery-in-a-cervical-cancer-patient-using-the-national-remote-emergency-system-a-case-report
#39
JOURNAL ARTICLE
Yang Xiao, Rou Yu, Juan Gu
RATIONALE: Malignant hyperthermia (MH) is a rare yet serious medical complication that typically arises following general anesthesia or the administration of specific anesthetics. Due to the infrequency of MH, anesthesiologists often lack sufficient expertise in identifying and managing it, leading to misdiagnosis and inappropriate treatment. There is an urgent need to enhance the diagnosis and management of MH through the utilization of relevant tools. PATIENT CONCERNS: In this case, a 52-year-old woman underwent radical cervical cancer surgery under general anesthesia, with no family or significant medical history...
April 19, 2024: Medicine (Baltimore)
https://read.qxmd.com/read/38640009/atypical-healing-of-an-endodontic-lesion-following-emergency-treatment-a-case-report
#40
JOURNAL ARTICLE
Saeed Asgary, Bita Talebzadeh
This case report examines the atypical healing of an endodontic lesion without standard endodontic treatment, influenced by the patient's failure to attend treatment appointments. A 50-year-old woman with no notable medical history presented with a deep carious lesion on her mandibular right first molar, accompanied by localized pain. Citing forgetfulness as a reason, the patient missed her initially scheduled root canal treatment, necessitating an emergency intervention. The emergency treatment included access cavity preparation, irrigation with 5...
2024: General Dentistry
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