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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/28045692/radiology-case-of-the-month-acute-onset-of-dizziness-and-paresthesias-in-an-elderly-woman
#1
Mohammed J Shaikh, Jagan D Gupta
61-year-old woman with a past medical history of dementia and Meniere's disease presents with acutely worsening dizziness and headache. The patient additionally complains of left greater than right upper extremity weakness and paresthesias.
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045691/ecg-of-the-month-wide-qrs-tachycardias
#2
D Luke Glancy, Theresa A Mills
A 61-year-old man came from out of state to attend a football game. He felt well during the game, but when he stood up to leave, he became dizzy and dyspneic. The symptoms lasted 15 to 20 minutes, and when the paramedics arrived, they diagnosed an idioventricular rhythm and brought the patient to the emergency department where a 12-lead electrocardiogram (ECG) was recorded (Figure 1).
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#3
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045689/racial-differences-in-response-to-tilt-table-testing-in-patients-refered
#4
Jameel Ahmed, Peerawut Deeprasertkul, Kevin M Monahan, Paul LeLorier
BACKGROUND: Syncope is a common problem in the general population and results in significant societal and patient costs. Several small studies have demonstrated differences in orthostatic response, and possibly tolerance, between blacks and whites. Based on these observations, we retrospectively reviewed results from our tilt table database to identify potential differences in response to tilt-table testing with regards to race, between black and white patients. METHODS: The reports of 446 tilt-table tests performed on adults, older than 18 years of age, at Boston Medical Center, an urban, tertiary-care, academic hospital, were reviewed...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045688/pseudo-thrombotic-thrombocytopenic-purpura-due-to-severe-vitamin-b12-deficiency
#5
Paul A Trubin, Justin A Edward, Monica Hand
As a subset of microangiopathic hemolytic anemia, thrombotic thrombocytopenic purpura can present with a constellation of symptoms similar to the hemolytic anemia attributed to severe vitamin B12 deficiency. There have been few case reports in the medical literature concerning the development of a clinical syndrome consistent with microangiopathic hemolytic anemia attributable to B12 deficiency. We report a case of B12 deficiency leading to microangiopathic hemolytic anemia that was corrected solely with a ten-day course of intramuscular cobalamin replacement...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045687/irreducible-indirect-inguinal-hernia-in-premature-infant-with-ectopic-uterus-and-bilateral-adnexa
#6
Hassan Ibrahim, Mohga Khaled, Thomas Gates, Hilary Trice, Guillermo Sangster
Indirect inguinal hernia is one of the most common congenital anomalies in children, with a reported prevalence of 0.8-4.4%.1 About 15-20% of hernias in female infants contain ovary, and in rare cases a fallopian tube.2 However, only a few cases contain the uterus and both ovaries in the hernia sac.3 The normal anatomy is altered when an ovary is trapped in a hernia sac, and these changes make torsion more likely and increase the risk of infertility. Although an irreducible ovary is not at great risk of compression of its blood supply, in these occurrences, ovarian torsions have been reported in 2%-33%, emphasizing the importance of early surgical repair in irreducible hernias, even in asymptomatic patients...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045686/vibrio-mimicus-as-the-rare-cause-of-acute-diarrheal-illness
#7
Samuel Muller, Heather Chau, Kristi Boudreaux
Vibrio mimicus, although named for having many of the same virulent factors as Vibrio cholera, is a rare cause of significant gastrointestinal illness. Like many of the Vibrio species, the strongest risk factor for V. mimicus infection is seafood consumption. After consuming crabs, a 64-year-old male presented with a three day history of voluminous, non-bloody, water diarrhea. The severity of the diarrhea caused the patient to have orthostatic hypotension and acute kidney injury, which improved with fluid resuscitation...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28045685/the-history-of-otolaryngology-in-new-orleans
#8
George D Lyons
George D. Lyons, MD, now becoming "an elder statesman," he decided summarize the early history of otolaryngology as it developed in New Orleans. Francis LeJeune, MD, Sr., a much admired and loved otolaryngologist, has afforded a great insight through his memoirs in the early development of our specialty in his report of Otolaryngology in the South. Dr. LeJune, Sr. began his brief paper just before his death. Excerpts from this paper have been used by the American Laryngological Association. There will be no bibliography...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27797351/radiology-case-of-the-month-persistent-lateral-foot-pain
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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