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Oxford Medical Case Reports

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https://www.readbyqxmd.com/read/27812374/pok%C3%A3-mon-go-cardiovascular-benefit-or-injury-risk
#1
Pranev Sharma, Vassilios Vassiliou
No abstract text is available yet for this article.
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27721981/polyarteritis-nodosa-with-a-chronic-relapsing-course
#2
Ashok Kumar, Anshul Goel, Mehul Lapsiwala
Polyarteritis nodosa is a medium artery vasculitis that can cause fatal complications. It commonly follows an acute monophasic course that may remit after treatment or cause serious morbidity or death. A 24-year-old patient described here had many vasculitic episodes in the past 16 years causing infarction of different organs. The last episode was most serious which caused mononeuritis multiplex, digital gangrene, bowel gangrene and subsequent perforations. There was strong clinical suspicion of this disease right from the beginning...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27713831/potential-perils-of-peri-pok%C3%A3-mon-perambulation-the-dark-reality-of-augmented-reality
#3
Bellal Joseph, David G Armstrong
Recently, the layering of augmented reality information on top of smartphone applications has created unprecedented user engagement and popularity. One augmented reality-based entertainment application, Pokémon Go (Pokémon Company, Tokyo, Japan) has become the most rapidly downloaded in history. This technology holds tremendous promise to promote ambulatory activity. However, there exists the obvious potential for distraction-related morbidity. We report two cases, presenting simultaneously to our trauma center, with injuries sustained secondary to gameplay with this augmented reality-based application...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27699056/management-of-anthracycline-extravasation-into-the-pleural-space
#4
Rachael Chang, Nick Murray
Anthracycline extravasation is a feared complication of intravenous (i.v.) chemotherapy due to the tissue toxicity of this group of drugs. We describe a 54-year-old woman with history of stage IIIa breast cancer, receiving adjuvant chemotherapy consisting of doxorubicin and cyclophosphamide. The chemotherapy was administered through a Poweport(®) device, the position of which was confirmed with fluoroscopy and function confirmed by flushing the line. Urgent intervention was required as patient was symptomatic and experienced severe right-sided pleuritic chest pain...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27699055/a-rare-presentation-of-spontaneous-internal-carotid-artery-dissection-with-horner-s-syndrome-viith-xth-and-xiith-nerve-palsies
#5
Azer Majeed, Nuno Pedro Lobato Ribeiro, Asem Ali, Mohsen Hijazi, Hina Farook
Spontaneous internal carotid artery dissection (sICAD) is an uncommon cause of isolated cranial nerve palsies. Commonly patients present with stroke, headache, facial pain and Horner's syndrome, with upto 16% having cranial nerve palsies. We present the case of a 55-year-old man who presented with hoarseness, dysphagia and tongue swelling, mimicking a tongue base tumor. He was found to have unilateral VIIth, Xth and XIIth nerve palsies with Horner's syndrome. Magnetic resonance imaging showed high signal changes and loss of signal void in right internal carotid artery, later confirmed by Angiography as a dissection with pseudo-aneurysm...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27699054/opsoclonus-myoclonus-ataxia-syndrome-in-an-hiv-infected-child
#6
Noella Maria Delia Pereira, Ira Shah, Shilpa Kulkarni
Opsoclonus-myoclonus-ataxia (OMA) syndrome typically presents with chaotic eye movements and myoclonus with some patients exhibiting ataxia and behavioural disturbances. The pathogenesis may be inflammatory with an infectious or paraneoplastic trigger. We present a 13-year-old HIV-infected girl who was initially started on highly active antiretroviral therapy (HAART) in March 2013 with a CD4 count of 79 cells/cumm. Initially, the patient did not comply with treatment, resulting in a CD4+ count of 77 cells/mm(3) in November 2015 and prompting a new HAART scheme comprising lamivudine, tenofovir and ritonavir-boosted atazanavir...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27699053/lessons-from-treatment-resistant-hyperlipidaemia
#7
Elizabeth Parsons, Pankaj Gupta, Prashanth Patel, Faizanur Rahman
A 68-year-old woman was referred to Lipid Clinic with sudden deterioration of previously well-controlled primary hyperlipidaemia. Investigations revealed nephrotic range proteinuria, leading to urgent renal biopsy and a diagnosis of amyloidosis. Chemotherapy was successful in stabilising renal function, reducing proteinuria and eliminating serum paraprotein. The resistant hyperlipidaemia subsequently resolved. Whilst hyperlipidaemia is pathognomonic of nephrotic syndrome, it is rarely the first characteristic identified by clinicians, often preceded by the identification of oedema or proteinuria...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27699052/induction-treatment-of-previously-undiagnosed-anca-associated-vasculitis-in-a-renal-transplant-patient-with-rituximab
#8
M P M Graham-Brown, R Aljayyousi, R J Baines, J O Burton, N J Brunskill, P Furness, P Topham
We report the case of a 40-year-old female transplant patient with undiagnosed ANCA-associated vasculitis (AAV) and renal allograft dysfunction who achieved disease remission with restoration of transplant function following induction therapy with rituximab. There are currently no trial data looking at the use of rituximab for induction of remission of renal transplant patients with AAV. Although recurrence of AAV following renal transplantation is rare, such patients have invariably had multiple previous exposures to induction and maintenance immunosuppressive regimens, often limiting treatment options post-transplantation...
October 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27617106/progressive-foot-drop-caused-by-below-knee-compression-stocking-after-spinal-surgery
#9
Karan Malhotra, Joseph S Butler, Adam Benton, Sean Molloy
Foot drop is a debilitating condition, which may take many months to recover. The most common cause of foot drop is a neuropathy of the common peroneal nerve (CPN). However, similar symptoms can be caused by proximal lesions of the sciatic nerve, lumbar plexus or L5 nerve root. We present a rare and unusual case of a patient undergoing spinal surgery at the level of L5/S1 and presenting 4 weeks postoperatively with progressive foot drop. Although the initial concern was a postoperative lesion at L5, the cause for this delayed presentation was extrinsic compression of the CPN at the level of the fibular head by a tight-fitting below-knee thromboembolic deterrent stocking...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27617105/an-unusual-pain-in-the-hip
#10
Sachin Bangera, Paul Dunkow, Suboda Weerasinghe, Senthil V Murugesan
A 68-year-old previously healthy man presented with increasing right hip pain of 6 months duration. On examination he was found to have a hard mass in the right hip arising from the pelvic bone. Imaging studies were in keeping with a sarcoma arising from the right iliac bone. However, biopsy of this bony lesion confirmed this to be a metastatic adenocarcinoma rather than a primary bone malignancy. Further imaging and a subsequent colonoscopy revealed the primary to be a colonic adenocarcinoma. The unique and unusual nature of this case was the presentation as a solitary bony metastasis from a colonic primary...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27617104/tough-decisions-in-pulmonary-embolism-thrombolysis-or-embolectomy
#11
EDITORIAL
Alphonsus Liew, Tamir Malley
No abstract text is available yet for this article.
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27617103/leptomeningeal-carcinomatosis-in-non-small-cell-lung-cancer-initial-response-to-erlotinib-followed-by-relapse-despite-continuing-radiological-resolution-of-disease
#12
Alvin J X Lee, Rachel Benamore, Monika Hofer, Meenali Chitnis
A 60-year-old male was diagnosed with T3, N3, M1b epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma. Five months later he developed significant headaches, weakness and numbness of the left leg, and unsteadiness of gait. Magnetic resonance imaging (MRI) brain demonstrated subtle gyral enhancement indicative of early leptomeningeal infiltration. He was commenced on second-line erlotinib which improved his lower limb symptoms. Three months later he developed increased urinary frequency and redeveloped leg symptoms...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27606070/diagnosis-and-implications-in-the-therapeutic-management-of-patient-with-afebrile-neurolepctic-malignant-syndrome
#13
Rafael Quintes Ducasble Gomes, Amilton Dos Santos-Júnior, Gabriel Augusto de Araujo Silva Dias, Carlos Filinto da Silva Cais
This report aims at raising clinical awareness for the diagnosis of atypical presentations of neuroleptic malignant syndrome (NMS). We describe the case of a female patient with NMS symptoms, except fever, after starting the use of chlorpromazine. The afebrile condition delayed the consideration of NMS by the emergency clinicians who provided her initial assessment. Before this consideration, an anticholinergic agent, not recommended at this condition, was inadvertently prescribed. This might have contributed to the worsening of symptoms...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27606069/when-not-to-trust-therapeutic-drug-monitoring
#14
Mathew Westergreen-Thorne, Sook Yan Lee, Nilesh Shah, Alan Dodd
Therapeutic drug monitoring (TDM) is the measurement of serum or plasma drug concentration to allow the individualization of dosing. We describe the case of a patient who was prescribed inappropriately large doses of vancomycin due to inaccurate TDM. Specifically, our laboratory reported progressively lower vancomycin concentrations despite dose increases. Eventually, when duplicate samples were sent to a different laboratory vancomycin concentrations were found to be in the toxic range. We hypothesize this was due to the patient generating immunoglobulin antibodies against her infection that interfered with the original TDM immunoassay...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27679725/takotsubo-cardiomyopathy-with-left-ventricular-thrombus-presenting-as-critical-limb-ischaemia
#15
Gaurav Gulsin, Solange Serna, Clare Morris, Abutariq Taher, Ian Loke
Takotsubo cardiomyopathy (TC) is a rare condition, characterized by acute left ventricular (LV) dysfunction in the absence of flow-limiting coronary artery disease, usually provoked by a physical or emotional stressor. The condition is far more common in women. The commonest presenting symptoms in patients with TC are chest pain and shortness of breath, often mimicking an acute coronary syndrome. A number of complications of TC are recognized, and very rarely patients experience cardioembolic phenomena secondary to LV thrombus formation in TC...
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27574561/an-unusual-presentation-of-carcinomatous-meningitis
#16
Chuan T Foo, Louise M Burrell, Douglas F Johnson
A 67-year old previously well male presented with a 1 week history of confusion on a background of 3 weeks of headache. Past history included two superficial melanomas excised 5 years ago. Treatment for meningoencephalitis was commenced based on lumbar puncture (LP) and non-contrast brain magnetic resonance imaging (MRI) results. Lack of a clinical response to antibiotics resulted in a second LP and contrast brain MRI which demonstrated hydrocephalus and leptomeningeal disease. Ongoing deterioration led to a whole-body computed tomographic and spinal MRI that showed widespread metastatic disease and extensive leptomeningeal involvement of the spinal cord...
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27574560/undifferentiated-vasculitis-or-an-evolving-systemic-autoimmune-rheumatic-disease
#17
Nafeesah Fatimah, Ahmad Ussaid, Aflak Rasheed
Undifferentiated connective tissue diseases usually present with arthralgias, sicca symptoms, Raynaud's phenomenon and leucopenia. This case presents the atypical presentation of an undifferentiated connective tissue disease with extensive cutaneous involvement of fingers and toes leading to gangrene with absence of typical rheumatological symptoms. The autoimmune profile showed positive ANA and anti-Ro/SS-A. Thromboembolism was ruled out on the basis of transthoracic and transesophageal echo. She was treated with I/V corticosteroids and cyclophosphamide that halted the disease progression...
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27516895/the-intriguing-triangle-of-cancer-chemotherapy-and-takotsubo-syndrome
#18
John E Madias
No abstract text is available yet for this article.
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27516894/halo-naevi-vitiligo-and-diffuse-alopecia-areata-associated-with-tocilizumab-therapy
#19
Kavitha Nadesalingam, Mark Goodfield, Paul Emery
We present a follow-up case report of a 33-year-old lady with juvenile onset arthritis who developed halo naevi while on treatment with tocilizumab. This case report describes the development of halo naevi, vitiligo and diffuse alopecia areata associated with tocilizumab therapy following infection with Methicillin-resistant Staphylococcus aureus (MRSA) and Panton-Valentine leukocidin positivity. This is the first case that describes these events and supports previous theories on cellular and humoral immunity as causative factors...
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27471599/an-unusual-presentation-of-xanthogranulomatous-pyelonephritis-psoas-abscess-with-reno-colic-fistula
#20
Hassan M Ghoz, Martin Williams, Aleksandr Perepletchikov, Nicholas James, Abdulrahman A Babeir
Xanthogranulomatous pyelonephritis (XGP) is a rare histological subset of pyelonephritis characterized by being a chronic destructive granulomatous inflammation of the renal parenchyma. XGP is classified according to the extent of disease into two entities: within the renal cortex (focal or segmental XGP) or diffuse spread with pelvic communication (diffuse XGP). Although rare, XGP can have fatal complications including perinephric, psoas abscess, nephro-cutaneous fistula and reno-colic fistula. Only few studies have reported XGP complicated with psaos abcess and reno-colic fistula...
July 2016: Oxford Medical Case Reports
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