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Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society

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https://www.readbyqxmd.com/read/27797351/radiology-case-of-the-month-persistent-lateral-foot-pain
#1
Chris Stark, Neel D Gupta, Michael Serou, Harold Neitzschman
A 33-year-old female presents with persistent lateral foot pain. Patient does not recall prior trauma that may have led to injury. Symptoms are significantly improved with rest and nonsteroidal anti-inflammatory medications.
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797350/ecg-case-of-the-month-heart-failure-in-a-man-from-chile
#2
D Luke Glancy, Glenn A Cochran, Frederick R Helmcke
A 49-year-old man visiting New Orleans from Chile comes to the hospital complaining of exertional dyspnea for 2 months with the more recent onset of ankle edema. He is a slender man with a blood pressure of 91/60 mmHg, crackles at both lung bases, and markedly distended neck veins. His cardiac rhythm is irregular. A soft murmur of mitral regurgitation and a soft S-3 are heard at the left ventricular apex. All four pedal pulses are easily palpable. Epigastric tenderness is noted on palpation; although the patient has a history of peptic ulcer disease, the tenderness is probably due to an enlarged left lobe of his liver, the result of hepatic congestion from his heart failure...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797349/clinical-case-of-the-month-a-64-year-old-woman-presenting-with-fever-confusion-ophthalmoplegia-and-pneumonia
#3
Daniel H Johnson, Michael Modica, Rachel Coleman, Charles V Sanders, Fred A Lopez
Legionella pneumophila is a major cause of atypical community-acquired pneumonia, which is commonly severe enough to require hospitalization. Though primarily a respiratory infection, Legionellosis involves the central nervous system (CNS) in up to 50% of patients, and diagnosis can be obscured by the absence of obvious respiratory symptomatology. A reversible diffuse encephalopathy is the most common neurologic complication, but focal CNS involvement can sometimes be the initial presentation. We report a case of a woman infected with Legionella pneumophila presenting with vague symptomatology and focal neurologic findings...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797348/telemedicine-and-telepsychology-a-medicolegal-dilemma-clarifying-standard-of-care-for-the-physicians-emergency-certificate-a-case-report
#4
Lynn W Aurich
Physicians and psychologists are often the front-line professionals who examine and treat individuals who are in suicidal crisis. Murphy comments "the clinical conditions that predispose to suicide frequently occasion visits to physicians, mostly nonpsychiatrists." When suicide appears imminent, physicians and psychologists take the necessary steps to hospitalize the patient to ensure their safety. If the patient refuses to voluntarily submit to examination and hospitalization, La.R.S.28:53 provides the legal means for effecting examination and treatment...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797347/medical-student-journals-teaching-the-peer-review-process-and-promoting-academic-mentorship
#5
Nadine M Kaskas, David H Ballard, Jeffery A Weisman, John A Vanchiere
Early exposure to research and longitudinal academic mentorship encourages medical student interest in academic careers and postgraduate research productivity. There are various ways for students to gain exposure to research in medical school; however, there are very few opportunities for medical students to participate in the peer-review process as a reviewer or editor for an academic journal. One potential method to supply such educational experiences is the creation of scientific journals specifically for medical students...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797346/physician-pipeline-production-peak-or-plateau
#6
Perry G Rigby, Ramnarayan P Gururaja
The peak number of graduate medical education (GME) appointees in Louisiana was in 2013, as was the peak number of graduating senior medical students. This was followed in the next three years by a pause or plateau in each physician pipeline category, and preceded by a slow, steady rise during the six years after Hurricane Katrina 2006-2012. Katrina made a large impact in destruction, disruption, and displacement; but the acute subsided and the chronic recovery is ongoing. For a more inclusive total of GME, the National Resident Matching Program (NRMP) Fellowship match numbers were added to the main NRMP match...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797345/fdg-pet-imaging-of-extremities-in-rheumatoid-arthritis
#7
Richa Dhawan, Kyla Lokitz, Stephen Lokitz, Gloria Caldito, Amol M Takalkar
BACKGROUND: The primary objective of this study was to evaluate the utility of fluorodeoxyglucose positive emission tomography imaging in assessing the degree of joint inflammation and response to therapy in patients with rheumatoid arthritis using standard PET parameters. METHODS: Five subjects with newly diagnosed RA were enrolled in this IRB-approved prospective study. After standard conventional workup that included clinical and laboratory evaluation and disease activity score (DAS3v) calculation, subjects underwent baseline FDG PET scans of their hands and feet prior to initiation of treatment and after six months of standard treatment...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797344/objective-basis-for-chronic-pain-in-patients-with-adult-sickle-cell-disease
#8
Samip Master, Abhishek Patel, Glenn Mills, Richard Mansour
Sickle Cell Disease (SCD) affects approximately 100,000 Americans and due to lack of an organized treatment approach, patients with SCD pose a high economic burden on medical services. The patients with SCD have chronic bone damage from bone marrow infraction and vaso-occulsive events. These bone damages lead to chronic pain in patients with SCD. The inadwquate treatment of chronic pain in adult patients with SCD can lead to pseudo-addictive behavior and also affect their psycho-social life. There are certain barriers to adequate pain management in adult patients with SCD, namely, limited knowledge among the clinicians, inadequate assessment, concerns about addiction, and biases against opioid use...
September 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598900/ecg-of-the-month-subtle-ecg-change-in-a-31-year-old-man-with-recent-chest-pain
#9
D Luke Glancy
A 31-year-old man had an hour of pain across the upper portion of his chest anteriorly, and it radiated down the inner aspects of both arms. The pain came while he was walking and gradually disappeared as he sat quietly. Six Rolaid tablets did not seem to alter the pain. The pain was unaccompanied by dyspnea, sweating, nausea or vomiting. The night before the patient had had similar pain relieved by Rolaids and belching. After the second episode of pain, he went to the emergency department of a local hospital where an ECG was recorded...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598899/clinical-case-of-the-month-a-54-year-old-woman-with-fever-and-chills-of-four-days-duration
#10
Jessica M Rosselot, James N Mansfield, Cody R Hill, Nirmala Tumarada, Shane E Sanne, Fred A Lopez
A 54 year-old woman with diabetes mellitus type two and end-stage renal disease on hemodialysis presented to the emergency department with a four day history of generalized malaise, fever, and chills. Her symptoms were also associated with occasional dyspnea without a cough. She reported intermittent chronic diarrhea with hemodialysis which was currently unchanged. On the day of admission, she could not tolerate hemodialysis due to her symptoms. Over the past year she admitted to night sweats and a 40 pound weight loss...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598898/spontaneous-spinal-epidural-hematoma-report
#11
Sunil Kukreja, Anil Nanda
We report a case of spontaneous spinal epidural hematoma in a 12-year-old female, who presented with significant upper and lower extremities weakness preceded by pain around the neck and shoulder girdle. Magnetic resonance imaging revealed epidural hematoma extending from C6-T2 with characteristic heterogeneously hyperintensity on T2 and homogenously isointensity on T1. Emergent spinal decompression was performed. However, the patient remained substantially weak in her lower extremities and was wheelchair bound at 3 months postoperatively...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598897/retroperitoneal-hematoma-causing-peritoneal-dialysis-catheter-malfunction
#12
Alison A Smith, Adam N Fonseca, Mihran V Naljayan, Anil S Paramesh
BACKGROUND: We present the unusual complication of peritoneal dialysis catheter dysfunction in a patient who developed a retroperitoneal hematoma following an endoscopic procedure and review the existing literature regarding this rare complication. CASE REPORT: A 60-year-old male with end stage renal disease presented with PD catheter dysfunction. A computerized tomography scan of his abdomen showed a large left retroperitoneal hematoma. He underwent a diagnostic laparoscopy and PD catheter revision...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598896/katrina-kinetics-the-physician-supply
#13
Perry Gardner Rigby, Ramnaryan Paragi Gururaja
In the aftermath of Hurricane Katrina 10 years ago, acute changes were recognized and reported; acute kinetic destruction and desperation. Physicians performed heroically, but after the flood and the closing of hospitals, most left at least briefly. The chronic recovery began with spirit, but was uncharted and unplanned with the recognition that individual decisions were a necessity. The documentation of physician numbers of practicing doctors, residents and fellows, from the AMA as related to geography, population, and other circumstances tells an additional story of renewal, more objectively without the hype...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598895/decreasing-orthopaedic-surgical-site-infections-a-new-perioperative-protocol
#14
Murphy P Martin, Michael J O'Brien, Felix H Savoie
BACKGROUND: Little data exist regarding the effects of prophylactic perioperative protocol on reducing surgical site infections. Based on national efforts to prevent SSIs and current evidence in the literature supporting the importance of perioperative prophylaxis, it would seem logical that expanding upon current perioperative protocol would help prevent SSIs. HYPOTHESIS: Multiple variables present risk factors in the development of SSIs in the perioperative period, and optimization of patient management during this time with a series of non-invasive and inexpensive protocols may help prevent SSIs...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598894/a-case-of-isolated-coronary-artery-ectasia-in-the-setting-of-chronic-inflamation-from-human-immunodeficiency-virus-infection
#15
Mark R Heckle, Raza Askari, Mohamed Morsy, Uzoma N Ibebuogu
Coronary artery ectasia also known as dilated coronopathy is a relatively rare finding that is most commonly associated with atherosclerosis. Several alternative reasons including congenital malformations and chronic inflammation have been identified as a cause of CAE. In this case, we discuss a 61-year-old male with postoperative chest pain who was found to have localized CAE in the absence of significant atherosclerosis. We also elucidate the recently proposed markers of chronic inflammation that might be associated with coronary artery ectasia...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598893/reconsidering-olanzapine-as-a-possible-culprit-for-drug-fever-defying-incomplete-neuromalignant-syndrome
#16
Alan Georges, Mary Jo Fitz-Gerald
This case is important because it is the first time Olanzapine-induced fever has been described in the absence of neuroleptic malignant syndrome. In the context of the available antipsychotics with the atypical agents dominating the pool, only few of those are known to be well tolerated among the patients. Fever may be looked at by the physicians as a minor problem yet, it can be disabling to the large set of patients. Fever was not considerably listed as one of the side effects for Olanzapine and should not be confused with the incomplete neuromalignant syndrome...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27598892/radiology-case-of-the-month-gliomatosis-cerebri
#17
Radia Ksayer, Jeremy B Nguyeni, Enrique Palacios, James Vu, Mandy Weidenhaft, Harold Neitzschman
A 71 year-old female with a past medical history significant for hypertension, hyperlipidemia, diabetes, and strokes, presented initially to the stroke service with a sudden onset of right facial droop, right-sided weakness, dysarthria, and seizures that had gotten progressively worse for six weeks.
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27389385/radiology-of-the-month-spontaneous-bilateral-pneumothoraces-in-an-hiv-infected-patient
#18
Megan Curtis, Anish Patel, Kyle Degeyter, Harold Neitzschman
A 36-year-old woman with past medical history of HIV/AIDS not on HAART therapy (CD4 count of 34) and recurrent Pneumocystis jiroveci pneumonia presented to the emergency room for cough, chest pain, and worsening shortness of breath over the past 72 hours.
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27389384/clinical-case-of-the-month-a-35-year-old-woman-with-abdominal-pain
#19
Melissa Spera, Camille Thelin, Abby Gandolfi, Nicholas Clayton, Karl M Nettles, Michael E Hagensee, John J Hutchings, Fred Lopez
A 35 year old woman with past medical history of hypertension presented to the emergency department with chief complaint of severe abdominal pain for one week. The abdominal pain was located in the epigastrium and described as "cramping" and "intermittent". The pain intensity was quantified initially as 6 out of 10 on the pain scale. As the week progressed the pain became constant and radiated to the back. The intensity of the abdominal pain increased to 10 out of 10. The patient reported some relief from her pain while lying in the prone position...
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27389383/ecg-of-the-month-sepsis-ards-and-tracheal-intubation
#20
D Luke Glancy, Prashanthi Atluri
A furuncle on the leg of a 23-year-old woman led to methicillin-resistant staphylococcus aureus sepsis and adult respiratory distress syndrome (ARDS) requiring tracheal intubation in the intensive care unit (ICU). Initially her electrocardiograms (ECGs) showed sinus tachycardia, but otherwise were unchanged from prior ECGs. A week into her ICU stay a different rhythm occurred.
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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