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Journal of Community Hospital Internal Medicine Perspectives

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https://www.readbyqxmd.com/read/29046762/a-commentary-on-operamide-and-cardiotoxicity
#1
Salil R Rajayer, Charanya Sivaramakrishnan
No abstract text is available yet for this article.
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046761/loperamide-abuse-and-cardiotoxicity
#2
Nichole A Smith, Matthew Sehring, Jefferson Chambers
No abstract text is available yet for this article.
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046760/an-atypical-subacute-presentation-of-posterior-reversible-encephalopathy-syndrome
#3
Eseosa Bazuaye-Ekwuyasi, Robert Dobbin Chow, Sarah Schmalzle
Posterior reversible encephalopathy syndrome (PRES) characteristically presents with rapid onset of headache, seizure, encephalopathy, and visual changes, along with evidence of parieto-occipital vasogenic edema on magnetic resonance imaging. We describe the case of a 41-year-old female with a protracted presentation of two of the four classic PRES symptoms, which were not immediately recognized as PRES due to the presence of multiple other comorbidities and reasons for encephalopathy. This case highlights the possibility of atypical presentations of PRES and the diagnostic challenges in making this clinical diagnosis when competing diagnoses are present...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046759/copper-deficiency-a-new-triad-anemia-leucopenia-and-myeloneuropathy
#4
Shoaib M Wazir, Ibrahim Ghobrial
Clinical copper deficiency is now more frequently recognized. Hematologically, it can present as anemia (microcytic, normocytic, or macrocytic) and neutropenia. Thrombocytopenia is relatively rare. Neurologically, it can manifest as myelopathy and peripheral neuropathy simulating subacute combined degeneration. Bone marrow findings can mimic myelodysplasia resulting in occasional inappropriate referral for bone marrow transplantation. Other conditions with similar presentations include infections, drug toxicity, autoimmunity, B12 deficiency, folate deficiency, myelodysplastic syndrome, aplastic anemia, and lymphoma with bone marrow involvement...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046758/coronary-artery-ectasia-presenting-with-acute-inferior-wall-myocardial-infarction-in-a-young-adult
#5
Htun Latt, Sammy Aung, Kyaw Kyaw, Richard Seher
Coronary artery ectasia (CAE), a variant of coronary artery anomalies, is a rare clinical entity. Although atherosclerotic coronary artery disease (CAD) is the most common cause of acute coronary syndrome (ACS), CAE also conveys a relatively high risk for potentially life-threatening cardiac events. We report a case of a 35-year-old male with two-vessel CAE, who presented with acute inferior wall ST election myocardial infarction (STEMI). After initiating medical therapy including bivalirudin, emergent percutaneous coronary intervention (PCI) with stenting of postero-lateral branch of right coronary artery (RCA) was performed...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046757/multiple-left-anterior-descending-coronary-artery-to-left-ventricular-fistula-a-case-series-and-literature-review
#6
Praneet Iyer, Rishitha Yelisetti
Coronary artery fistulas (CAFs) are found in 0.3-0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle. In both the cases, No intervention was performed...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046756/pneumatosis-of-the-esophagus-and-intestines-with-portal-venous-air-a-rare-presentation
#7
Mustafa Noor Muhammad, Maryam Sadough, Robert King, Gurkeerat Singh
Pneumatosis intestinalis is a radiographic finding that represents a spectrum of conditions ranging from benign disease to abdominal sepsis and death. Along with portal venous gas, it is generally considered an ominous sign prompting emergency operative intervention. We report a rare case showing that nonoperative therapy can be considered in a seriously ill patient with esophageal, gastric and portal venous air.
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046755/some-neck-swellings-are-serious-a-case-of-lemierre-s-syndrome
#8
Ali Raza Ghani, Mohsin Hamid, Ahsan Raza, Rizwan Naseer, Joseph Crocetti
Lemierre's syndrome also termed post-anginal septicemia, is a disease characterized by internal jugular septic thrombophlebitis leading to Fusobacterium septicemia with multiple metastatic foci following an oropharyngeal infection. Diagnosis and management is challenging and can result in fatal consequences due to potential multisystem involvement and multiple complications. We describe here a case of Lemierre's syndrome with multifocal pneumonia, acute renal failure and protracted course of illness over forty days with successful recovery...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046754/splenic-infarct-in-a-patient-with-infectious-mononucleosis-a-rare-presentation
#9
Mustafa Noor, Maryam Sadough, Stephanie Chan, Gurkeerat Singh
We report a case of a 25-year-old obese, currently smoking, female diagnosed with EBV infectious mononucleosis. The patient complained of sudden onset abdominal pain with progressively increasing intensity in the left upper quadrant. Abdominal CT scan showed a wedge infarct of the spleen. We present this rare case that EBV may cause splenic infarct in young adults.
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046753/melioidosis-the-great-mimicker
#10
Mandeep Singh, Mehvish Mahmood
Melioidosis is an infectious disease endemic in Northern Australia and South East Asia. It is associated with high degrees of morbidity and mortality. On average, around five cases are diagnosed annually in the USA. Diagnosis remains a challenge, as it mimics many other conditions, especially tuberculosis, hence its other name, the 'great mimicker.' The present case involves a recent traveler to the Philippines, who presented with episodic fevers and weight loss to his primary care physician. Blood cultures ordered grew Burkholderia pseudomallei...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046752/an-exceedingly-rare-adrenal-collision-tumor-adrenal-adenoma-metastatic-breast-cancer-myelolipoma
#11
Dongyan Liu, Sahayini A Kumar
Adrenal collision tumors (ACTs), in which distinct tumors coexist without histological intermingling in the same adrenal gland, are rare and their actual prevalence is unknown. ACTs commonly consist of adrenal cortical adenoma, myelolipoma, or metastatic malignant tumor. We report a 58-year-old woman with a past history of breast cancer, who presented with a 1 month history of fevers, chills, and abdominal fullness. The physical examination and the laboratory data including endocrine studies were unremarkable...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046751/case-series-of-multiple-primary-cancers-in-single-individuals-diagnostic-and-therapeutic-dilemmas
#12
Faizan Malik, Naveed Ali, Jibran Durrani, Syed Imran Mustafa, Crystal Denlinger
Background and Objectives: Cancer recurrence represents treatment failure; the development of new primary tumors is suggestive of persistent exposure to etiological risk factors or genetic predisposition due to mutations in multiple cell lines. Case presentation/Design/Methods: The first case is a 65-years-old Caucasian male who presented with esophageal and lung cancer diagnosed synchronously. Smoking was the common risk factor for both cancers, underscoring field cancerization. The diagnosis and management was a challenge and different from either cancer presenting alone...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046750/metastasis-to-the-pancreas-and-stomach-from-a-breast-cancer-primary-a-case-report
#13
Jason Kliiger, Mayer Gorbaty
A 60-year-old female with an unknown family history initially presented with signs and symptoms concerning for gastrointestinal cancer. Regular breast cancer screening and subsequent work-up around this time demonstrated the presence of T2N1 stage II triple positive ductal adenocarcinoma of the left breast. Follow-up imaging for her gastrointestinal symptoms demonstrated a 3.5 cm solitary mass in the pancreas and diffuse thickening of the stomach wall. Biopsies of the gastrointestinal lesions were identified as metastatic foci of the breast cancer primary...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046749/an-unusual-case-of-chronic-lymphocytic-leukemia-multiple-myeloma-and-cardiac-amyloidosis
#14
Dongyan Liu, Hakim T Uqdah, Alisha D Gordy
Light chain amyloidosis has very rarely been reported in association with chronic lymphocytic leukemia (CLL). We reported on a 76-years-old female who presented with simultaneous kappa-restricted chronic lymphocytic leukemia (CLL) and a lambda-restricted multiple myeloma with plasma cells causing AL amyloidosis involving the heart. While monoclonal immunoglobulins occasionallyproduced by CLL have previously been implicated in AL amyloidosis, there only a few cases reported of AL amyloidosis resulting from a distinct plasma cell dyscrasia that is not clonally related to the concurrent CLL...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046748/%C3%AE-thalassemia-minor-carbohydrate-malabsorption-and-histamine-intolerance
#15
Wolfgang J Schnedl, Michael Schenk, Sonja Lackner, Sandra J Holasek, Harald Mangge
Background: β-thalassemia minor is characterized by reduced β-haemoglobin chain synthesis and sometimes mild anaemia, although carriers of β-thalassemia minorare usually clinically asymptomatic.Nonspecific abdominal complaints may be caused by gastrointestinal carbohydrate malabsorption (lactose and fructose) and/or malabsorption of biogenic amines (histamine), or proteins (gluten). Objectives: We report on two patients with β-thalassemia minor suffering nonspecific abdominal symptoms due to a carbohydrate and histamine malabsorption...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046747/ventricular-fibrillation-due-to-overdose-of-loperamide-the-poor-man-s-methadone
#16
Amr Salama, Yana Levin, Pramod Jha, Richard Alweis
Loperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 38-year-old female presenting with cardiac arrest thought to be secondary to abuse of the loperamide that she was using to alleviate the heroin withdrawal symptoms. Cardiac ischemia and other drug toxicities were ruled out...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046746/perspectives-on-non-neoformans-cryptococcal-opportunistic-infections
#17
REVIEW
Nichole Smith, Matthew Sehring, Jefferson Chambers, Preeti Patel
Non-neoformans Cryptococcus species, including C. laurentii and C. albidus, have historically been classified as exclusively saprophytic. However, recent studies have increasingly implicated these organisms as the causative agent of opportunistic infections in humans. Herein, the case is presented of C. laurentii meningitis in a critically ill patient receiving corticosteroids. C. laurentii has been implicated in an additional 18 cases of opportunistic infection, predominantly of the skin, bloodstream, and central nervous system...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046745/the-bedside-index-for-severity-in-acute-pancreatitis-a-systematic-review-of-prospective-studies-to-determine-predictive-performance
#18
Subhash Chandra, Arvind Murali, Reena Bansal, Dipti Agarwal, Adrian Holm
Background: predicting the development of severe disease has remained a major challenge in management of acute pancreatitis. The Bedside Index for Severity in Acute Pancreatitis (BISAP) is easy to calculate from the data available in the first 24 hours. Here, we performed a systematic review to determine the prognostic accuracy of the BISAP for severe acute pancreatitis (SAP). Methods: major databases of biomedical publications were searched during the first week of October 2015. Two independent reviewers searched records in two phases...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046744/clinical-and-epidemiological-characteristics-of-patients-with-acute-drug-intoxication-admitted-to-icu
#19
Jose Orsini, Nanda Din, Ershad Elahi, Anthony Gomez, Salil Rajayer, Ryan Malik, Elie Jean
Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March)...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28808518/evolocumab-to-reduce-cardiovascular-events-results-of-the-fourier-multinational-trial
#20
Syed Raza Shah, Mohd Faisal Uddin, Noman Lateef, Amin Muhammad Dharani, Waqas Shahnawaz, Ahmed Nabeel Kazi, Syed Arbab Shah
No abstract text is available yet for this article.
July 2017: Journal of Community Hospital Internal Medicine Perspectives
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