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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/28850560/radiology-case-of-the-month-tb-or-not-tb%C3%A2-that-is-the-question
#1
Kartik Kansagra, Stefan Ploch, Harold R Neitzschman
45-year-old female presenting initially with fever, nonproductive cough, night sweats, pleuritic chest pain, fatigue and weight loss over the past month.
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850559/ecg-case-of-the-month-wide-qrs-rhythm-in-a-man-with-a-clotted-dialysis-fistula
#2
Bashar A Ababneh, Pramilla N Subramaniam, D Luke Glancy
A 57-year-old man with diabetes mellitus, systemic arterial hypertension, and end-stage kidney disease came to the hospital because his arteriovenous fistula used for hemodialysis had clotted. His blood hemoglobin level was 12.8 g/dL (reference, 13.5-17.5); and serum chemistry levels were creatinine 6.7 mg/dL (0.7-1.3), sodium 132 mEq/L (136-146), potassium 4.0 mEq/L (3.5-5.1), chloride 94 mEq/L (98-106), carbon dioxide 24 mEQ/L (23-29), calcium 9.1 mg/dL (8.4-10.2), and phosphorus 9.1 mg/dL (2.7-4.5). An electrocardiogram was recorded (Figure 1)...
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850558/clinical-case-of-the-month-abdominal-pain-in-a-39-year-old-man-with-recent-international-travel
#3
Walter Liszewski, Seema Walvekar, Fred A Lopez
No abstract text is available yet for this article.
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850557/postpartum-coronary-arterial-spasm
#4
Sameh Askandar, David Flatt, Daniela Rosu, Rami N Khouzam
BACKGROUND: Acute coronary syndrome (ACS) during postpartum period is rare. In the current manuscript we present a case of a postpartum patient who developed ACS attributed to coronary vasospasm in the absence of vasocontrictive medication or smoking. This condition resolved with intracoronary injection of nitroglycerine and verapamil. CASE: A 26-year-old woman, postpartum day five, presented with a sudden onset of chest pain and an acute ST-segment elevation on ECG...
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850556/an-elderly-man-with-a-swollen-knee-significant-ecchymosis-and-minimal-knee-pain
#5
David Aamodt, Michael Serou, Harold Neitschman
A 72-year-old man presents with left knee pain and swelling over several days. The pain and swelling started after he felt a "pop" when bending to pick up an object off the floor. His past medical history is significant for type 2 diabetes mellitus. Physical exam revealed significant ecchymosis on the anterolateral aspect of the thigh. There was a minimal amount pain upon knee flexion.
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850555/obturator-hernia-the-little-old-lady-hernia
#6
Taylor Carter, David H Ballard, Peeyush Bhargava, Navdeep S Samra
Obturator hernia is a rare type of abdominal hernia that classically presents in elderly women. We report the case of 78-year-old woman with progressive vomiting, obstipation, and abdominal pain. Contrast-enhanced computed tomography showed a left-sided obturator hernia, which was confirmed and treated at laparotomy. Demographics, symptoms, imaging findings, and management of obturator hernias is reviewed.
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850554/pledget-induced-cardiogenic-shock-following-a-minimally-invasive-aortic-valve-replacement
#7
Alexandra E Tedesco, Victor E Tedesco
Within the last decade, minimally invasive valve replacements have become exceedingly popular, and as a result, so has the rise of technology aimed at refining and simplifying these techniques. With new technology, new complications are inevitable. We present a routine Minimally invasive aortic valve replacement through a right anterior minithoracotomy complicated by pledget impaction in a coronary artery.
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28850553/osmotic-demyelination-syndrome-revisited-review-with-neuroimaging
#8
Krystle Barhaghi, Olga Molchanova-Cook, Michael Rosenburg, Banks Deal, Enrique Palacios, Jeremy Nguyen, Cynthia Hanemann
Osmotic demyelination syndrome (ODS) is a general term that has become commonplace in the practice of medicine, encompassing both central pontine myelinolysis and extrapontine myelinolysis. Historically ODS arises as a serious complication of rapid correction of hyponatremia, yet its manifestations seem to be influenced by a multifactorial process. Further understanding of this rare demyelinating disease has elucidated the significant role of other electrolyte disturbances and the presence of chronic comorbidities as disease risk factors...
July 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644158/radiology-case-of-the-month-idiopathic-cd4-lymphocytopenia
#9
Chris Malone, Neel D Gupta, Amit Kothari, Enrique Palacios, Harold Neitzschman
A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested negative for HIV and HTLV 1/2 and had normal immunoglobulin levels. During hospital course the patient underwent a lumbar puncture and multiple imaging exams, including both CT and MR. Except for occasional nausea and vomiting controlled by therapeutic lumbar punctures, phenergan, and dilaudid the patient's hospital course was uncomplicated...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644157/ecg-case-of-the-month-chest-pain-and-ecg-abnormalities
#10
D Luke Glancy
A 27-year-old man was admitted to the coronary care unit because of chest pain and an electrocardiogram (ECG) read by the computer as an inferior infarct and left ventricular hypertrophy (Figure).
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644156/clinical-case-of-the-month-a-57-year-old-man-with-an-axillary-mass
#11
Palak Desai, Andrew Myers, Brian Boulmay, Fred A Lopez
A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. The patient did not undergo completion axillary node dissection and was lost to follow-up. The patient was originally from Australia, did not tan but reported multiple sunburns before age 18...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644155/transvenous-before-surgical-hybrid-procedure
#12
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
BACKGROUND: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches. OBJECTIVE: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation. METHODS: 40 patients were followed over a 12 month period...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644154/acute-promyelocytic-leukemia-and-chronic-lymphocytic-leukemia-concomitant-presentation-of-two-molecularly-distinct-entities
#13
Jingdong Su, Diana Veillon, Rodney Shackelford, James Cotelingam, Hazem El-Osta, Glenn Mills, Reinhold Munker, Srinivas Devarakonda
Acute myeloid leukemia (AML) developing in patients with chronic lymphocytic leukemia (CLL) is very uncommon and usually associated with prior treatment. Acute promyelocytic leukemia (APL) accounts for a very small proportion of treatment-associated AML. So far, there has been only one reported case of APL occurring post radiation for prostate cancer in a patient with CLL. We report herein the first case of APL and CLL presenting concomitantly in an untreated patient. Evaluation of peripheral blood and bone marrow aspirate with immunohistochemistry, flow cytometry, and FISH to confirm two morphologically, molecularly and genetically distinct leukemic populations characteristic of APL and CLL is required...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28644153/louisiana-physicians-are-increasing-hpv-vaccination-rates
#14
Donna L Williams, Courtney S Wheeler, Michelle Lawrence, Stacy S Hall, Michael Hagensee
Human papilloma virus (HPV) is a common virus that can cause genital warts and certain cancers. The HPV vaccine is effective in preventing many HPV-associated diseases, however, vaccination rates suggest many remain unprotected. This study examined successful strategies used by physicians to improve HPV vaccination rates. Providers with above average vaccination rates were identified. A representative from each provider participated in an interview to identify strategies used to boost HPV vaccination. Key strategies in ensuring vaccine completion were reminders, education, standing orders, and scheduling future vaccine appointments at time of first dose...
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414689/radiology-case-of-the-month-mental-disturbance-for-4-days
#15
Matthew Brunner, Enrique Palacios, Harold Neitzschman, Jeremy Mguyen
A 56 year old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulders were noted. The patient's history was significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary hypertension and alcoholic cardiomyopathy. He had multi-decade history of heavy alcohol abuse, but quit drinking two years previously.
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414688/ecg-of-the-month-mental-disturbance-for-4-days
#16
D Luke Glancy, Theresa Mills, Fred Lopez
A family brought their 61-year-old mother to the emergency department because for 4 days she had been confused, incoherent, and somnolent. She also had dysphagia, dysarthria, diplopia, and had fallen out of bed. She had been in the hospital 3 weeks earlier for atrial fibrillation and an exacerbation of congestive heart failure. She also carried a diagnosis of chronic obstructive pulmonary disease and used an albuterol inhaler. She was obese (BMI of 45); and had adult-onset diabetes mellitus. She had a 43 pack-year history of cigarette smoking but had recently quit...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#17
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414686/severe-sepsis-and-septic-shock-cases-meeting-guidelines-among-patients-in-a-university-hospital-setting
#18
J A Charrier, C L Steen, E Borrero
BACKGROUND: A diagnosis of severe sepsis or septic shock has been shown to significantly increase mortality rate independent of other factors. Research has revealed all cause hospital case fatality rates have declined yet the percentage of severe sepsis cases continues to increase and age-adjusted mortality rates from severe sepsis and septic shock has significantly increased during the same time period. Patients with severe sepsis demonstrate ongoing mortality rate increases for up to 2 years following hospitalization when compared to aged matched controls of nonseptic patients...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414685/association-of-state-mandated-abstinence-only-sexuality-education-with-rates-of-adolescent-hiv-infection-and-teenage-pregnancy
#19
L M Elliot, M M Booth, G Patterson, M Althoff, C K Bush, M A Dery
INTRODUCTION: Abstinence-only sexuality education (AOSE); is required in the public school systems of many states, raising public health concerns and perpetuating health disparities through school systems. This study aimed to determine the correlations between state-mandated AOSE and the rates of adolescent HIV and teen pregnancy. METHODS: Using publicly available data on all 50 United States' laws and policies on AOSE, states were ranked according to their level of abstinence emphasis on sexuality education (Level 0 - Level 3);...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414684/who-shot-the-cannonballs-extensive-lung-metastases-in-a-39-year-old-man
#20
D Sommerhalder, J Blondin
CASE: A 39 year-old man presented to the emergency department complaining of a cough of 2 months in duration. He also complained of weight loss of 20 pounds in two months and night sweats over the same period. An x-ray of the chest was performed and revealed innumerable lung nodules and masses. Computed tomography of the chest and abdomen were subsequently performed which confirmed the masses, but imaging did not reveal an obvious primary source. A testicular exam was performed but no obvious abnormalities were noted...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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