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https://www.readbyqxmd.com/read/29451432/diagnosing-isolated-hepatosplenic-tuberculosis-in-an-immunocompetent-patient-a-case-report
#1
Om Dawani, Raja Samir Khan, Mujtaba Jamal Syed, Abdul Moid Shehzad, Ahmed Alratoot, Muhammad Faizan Ahmed
For many years, tuberculosis (TB) has been endemic in Pakistan; many rare and unusual presentations have been reported. There is a myriad of non-specific symptoms which always requires a high index of clinical suspicion for TB. World Health Organization data suggest that Pakistan ranks as the fifth highest country burdened with TB and has the fourth highest prevalence of multi-drug resistant TB globally. With an annual incidence of 277 cases per 100,000, the importance of early diagnosis and treatment is self-evident...
January 1, 2018: Tropical Doctor
https://www.readbyqxmd.com/read/29449431/wilson-disease-more-than-meets-the-eye
#2
REVIEW
Claire Kelly, Marinos Pericleous
Wilson disease is a rare but important disorder of copper metabolism, with a failure to excrete copper appropriately into bile. It is a multisystem condition with presentations across all branches of medicine. Diagnosis can be difficult and requires a high index of suspicion. It should be considered in unexplained liver disease particularly where neuropsychiatric features are also present. Treatments are available for all stages of disease. A particularly important presentation not to overlook is acute liver failure which carries a high mortality risk and may require urgent liver transplantation...
February 15, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29443783/giant-gist-of-the-stomach-a-successful-case-of-safe-resection-with-preoperative-simulation-using-three-dimensional-ct-angiography-case-report
#3
Kentaro Matsuo, Masaya Inoue, Yasutsugu Shirai, Tatsuki Kataoka, Shuji Kagota, Kohei Taniguchi, Sang-Woong Lee, Kazuhisa Uchiyama
RATIONALE: We report a very rare case of safely resectable giant gastrointestinal stromal tumor (GIST) with preoperative three-dimensional computed tomography (3D-CT) angiography in spite of no neoadjuvant treatment. PATIENT'S CONCERN: A 71-year-old woman presented to our hospital with an abdominal giant tumor. As this giant tumor could not be accurately diagnosed by preoperative investigation, we had to perform her surgical treatment without neoadjuvant treatment...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29439846/diagnostic-challenge-for-the-rare-lysosomal-storage-disease-late-infantile-gm1-gangliosidosis
#4
Jin Sook Lee, Jong-Moon Choi, Moses Lee, Soo Yeon Kim, Sangmoon Lee, Byung Chan Lim, Jung-Eun Cheon, In-One Kim, Ki Joong Kim, Murim Choi, Moon-Woo Seong, Jong-Hee Chae
BACKGROUND: GM1 gangliosidosis is a rare lysosomal storage disorder caused by GLB1 mutations. Because of its extreme rarity and symptoms that overlap with other neurodegenerative diseases, its diagnosis is sometimes challenging, especially in the late infantile form with less severe phenotype. We aim to expand the clinical and genetic spectrum of late infantile GM1 gangliosidosis. METHODS: We confirmed a diagnosis of GM1 gangliosidosis based on GLB1 mutations and/or the deficiency of β-galactosidase activity...
February 10, 2018: Brain & Development
https://www.readbyqxmd.com/read/29438165/histologic-features-of-gastrointestinal-tract-biopsies-in-iga-vasculitis-henoch-sch%C3%A3-nlein-purpura
#5
Christine Y Louie, Adam J Gomez, Richard K Sibley, Dorsey Bass, Teri A Longacre
Immunoglobulin A (IgA) vasculitis or Henoch-Schönlein purpura (HSP) typically occurs in the pediatric population, although rare cases also occur in adults. Gastrointestinal (GI) involvement is common. The "classic" histologic finding in IgA vasculitis (HSP) is leukocytoclastic vasculitis (LCV); other histologic features in biopsies of IgA vasculitis (HSP) have only been rarely described. The pathology archival files at our institution were searched for GI biopsies from patients with IgA vasculitis (HSP)...
February 12, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29437805/food-protein-induced-enterocolitis-syndrome-a-challenging-diagnosis
#6
Andreia Ribeiro, Diana Moreira, Cristina Costa, Isabel Pinto Pais
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity triggered by food proteins. It may present acutely, with repetitive vomiting, diarrhoea and lethargy leading to dehydration and eventually shock or insidiously with intermittent emesis, chronic diarrhoea or failure to thrive. We describe a paediatric male patient with recurrent sepsis-like episodes of fever, lethargy, ashen-grey skin colouration and vomiting followed by diarrhoea. These episodes were triggered by cow's milk formula and grains...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29437078/mi-not-a-heart-attack-but-a-gut-attack
#7
Rosemary K Lee, Ana M Cabrera
Mesenteric ischemia and infarction are infrequent but often deadly conditions in acute and critically ill patients. Mesenteric ischemia may be a primary admission diagnosis or may develop secondary to another diagnosis. Having a high index of suspicion for patients at risk of mesenteric ischemia and mesenteric infarction can alter a poor outcome. This article reviews the pathophysiology, risk factors, assessment, medical and nursing diagnoses, as well as collaborative management for mesenteric ischemia. Early identification of patients at risk and the appropriate diagnostic testing are stressed...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29436443/diagnosis-and-management-of-cerebral-venous-thrombosis
#8
Roya Behrouzi, Martin Punter
Cerebral venous thrombosis (CVT) is rare and accounts for 0.5% of all strokes. Its clinical presentation is variable and diagnosis requires a high index of clinical suspicion in conjunction with neuroradiological diagnostic support. Treatment options are limited and are mostly based on consensus. Therefore, familiarity with international guidelines is important. Outcome is often good and most patients make a full recovery, although a small proportion suffers death or disability. Here, we describe the clinical features, risk factors, acute imaging features, management and complications of CVT...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29435387/systemic-mastocytosis-the-difficult-patient-with-a-rare-disease-case-presentation-and-brief-review
#9
Daniel H Desmond, Mark G Carmichael
Mastocytosis is a rare process involving the activation and accumulation of clonal mast cells categorized by cutaneous or systemic involvement. Although the diagnosis of cutaneous disease can be straightforward and confirmed via skin biopsy, systemic disease mimics more common disease processes making diagnosis a challenge. The widespread physiologic distribution of mast cells causes a variety of symptoms with aberrant expression including fatigue, headache, depression, dyspnea, dyspepsia, nausea, and abdominal pain...
February 2018: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/29430630/does-needle-biopsy-cause-an-increased-risk-of-extracapsular-extension-in-the-diagnosis-of-metastatic-lymph-node-in-melanoma
#10
Gilles Claro, Nicolas Meyer, Thomas Meresse, Dimitri Gangloff, Jean-Louis Grolleau, Benoit Chaput
BACKGROUND: Needle biopsy is a rapid, reliable, and reproducible procedure for histological confirmation of metastatic melanoma localization. Nonetheless, this procedure presents a theoretical risk of a mechanical weakening of the lymph node capsule with perinodal tumor seeding. The objective of the study was to evaluate the incidence of extracapsular extension after needle biopsy in comparison with surgical adenectomy in patients suspected of metastatic lymph node of melanoma. METHODS: We conducted a retrospective study of 1056 patients who underwent lymphadenectomy for melanoma between 2000 and 2016 in our unit...
February 12, 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29430469/posttransplant-lymphoproliferative-disorder-isolated-to-the-adrenal-gland-in-a-liver-transplant-patient
#11
Tara T Ghaziani, Joy J Liu, Zhenghui G Jiang, Imad Nasser, Khalid Khwaja, Robert A Fisher, Myrna Nahas, Michael P Curry
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication that accounts for up to 20% of malignancies after solid organ transplantation. We describe a rare case of isolated PTLD in the adrenal gland occurring 7 months after liver transplant in a patient who developed a primary Epstein-Barr virus infection. He was treated with rituximab and his immunosuppression regimen was minimized. We review the incidence, pathogenesis, presentation, and management of PTLD in the liver-transplant population...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29429749/total-renal-artery-occlusion-recovery-of-function-after-revascularization
#12
Sandhya Manohar, Abdurrahman Hamadah, Sandra M Herrmann, Stephen C Textor
Current trends in managing atherosclerotic renal artery stenosis favor medical therapy, on account of negative results from prospective trials of revascularization, such as CORAL and ASTRAL. One result of this trend has been encountering occasional patients with progressive disease, sometimes leading to total arterial occlusion. We illustrate a case of accelerated hypertension with complete renal artery occlusion in which the patient recovered function after surgical bypass and we review the clinical approach used and the advanced imaging modalities available to us...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29428985/literature-review-and-a-case-report-of-spontaneous-subscapular-abscess-in-a-child
#13
REVIEW
Hany Mourkus, Ramanan Vadivelu, James Phillips
Subscapular space is an uncommon site for abscess formation. There are only seven reports of subscapular abscesses in the literature. Only three of these cases are reported in children. We recently treated a child with subscapular abscess. We performed the literature search using a combination of the keywords: subscapular, scapular, abscess and infection. One case was diagnosed on post-mortem autopsy, and only three of these cases are reported in children. The organism was Staphylococcus aureus in five cases (two were methicillin-resistant S...
February 10, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29428409/transplant-tourism-and-invasive-fungal-infection
#14
I Al Salmi, A M Metry, F Al Ismaili, A Hola, M Al Riyami, F Khamis, S Al-Abri
BACKGROUND: Deceased and live-related renal transplants (RTXs) are widespread approved methods throughout the world. In addition, commercial RTX has become popular in certain places driven by financial greed. METHOD: This is a retrospective, descriptive study was done at the Royal Hospital (RH) from 2013 to 2015. The data have been collected from the national Oman kidney transplant registry. All transplant cases retrieved were divided into two groups, Live-related-RTX performed in Oman and commercial-unrelated-RTX performed abroad...
February 8, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29423164/cutaneous-metastasis-of-a-primary-oesophageal-adenocarcinoma-to-the-right-cheek
#15
Emily Higgins, Liam Monaghan, Raghu R Mani
This case report details of a case of cutaneous metastasis from a primary adenocarcinoma of the oesophagus to the right cheek. A 67-year-old male was referred to the maxillofacial department with a 2-3 week history of non-painful swelling of the cheek. A diagnosis of infected sebaceous cyst was made and drainage was attempted with adjunctive antibiotic therapy. Follow up appointments showed no improvement a biopsy was taken. Histology reported presence of metastatic adenocarcinoma, suggesting the gastrointestinal tract as the primary site...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29423152/suppurative-appendicitis-presenting-acute-scrotal-pain-a-rare-condition-may-confuse-surgeons
#16
Shahriar Najafizadeh-Sari, Hamidreza Mehdizadeh, Mohammad Sadegh Bagheri-Baghdasht, Shahram Manoochehry
Scrotal pain presentation has many differential diagnoses such as testicular torsion is surgical emergency. For this reason, it is necessary for surgeons to differentiate between diseases for choosing the best treatment approach. We have reported a rare condition of 19-year-old male case had an atypical scrotal pain presentation of appendicitis. He was admitted to emergency service with 4 days history of pain in abdomen and testis. In physical examination, there is tenderness in right lower quadrant, right inguinal region and scrotum...
October 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29419420/diaphragmatic-flutter
#17
Dean Walton, Michael Bonello, Malcolm Steiger
A 78-year-old woman presented with involuntary movements of her abdomen, which started after a right hemispheric stroke. She had irregular, variable, hyperkinetic predominantly right-sided abdominal wall movements. MR scan of brain confirmed a recent infarct in the right occipitotemporal lobe and the right cerebellum. Diaphragmatic fluoroscopy confirmed high-frequency flutter as the cause of her abdominal movements and confirmed the diagnosis of van Leeuwenhoek's disease. Anthonie van Leeuwenhoek first described this condition in 1723 and had the condition himself...
February 1, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29417030/hansen-s-disease-an-unusual-presentation
#18
Tina George, M Venkataraman, Sramana Mukhopadhyay, I Ramya
Hansen's disease can present with varied and subtle symptoms which can be missed. A middle-aged gentleman presented with swelling of face and hands. Detailed examination and investigations confirmed borderline tuberculoid leprosy with lepra reaction. A high index of suspicion with vigilance can help to make an early diagnosis in this potentially treatable condition.
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29415981/acute-exertional-compartment-syndrome-with-rhabdomyolysis-case-report-and-review-of-literature
#19
Brandon McKinney, Christopher Gaunder, Ross Schumer
BACKGROUND Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. CASE REPORT We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. He was diagnosed with compartment syndrome and rhabdomyolysis. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure...
February 8, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29415746/ground-glass-opacity-heralding-invasive-lung-adenocarcinoma-with-prodromal-dermatomyositis-a-case-report
#20
Andrew J Beel, David S Demos, Alfred Chung, Charles Liao, Natalie S Lui
BACKGROUND: Dermatomyositis, an inflammatory myopathy with cutaneous involvement, is associated with malignancy and often manifests paraneoplastically. While co-occurrence with small cell carcinoma is well attested, primary lung adenocarcinoma, which may present as focal ground-glass opacification on computed tomography of the thorax, is less frequently coincident. CASE PRESENTATION: We report the case of a 72-year-old female patient with dermatomyositis - treated with a combination of prednisone, methotrexate, and intravenous immunoglobulin - and an indolent, subsolid, non-hypermetabolic pulmonary lesion, which was determined to be invasive primary lung adenocarcinoma...
February 7, 2018: Journal of Cardiothoracic Surgery
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