keyword
https://read.qxmd.com/read/38618351/development-of-upper-extremity-deep-vein-thrombosis-in-a-patient-with-seronegative-myasthenia-gravis-a-case-report-and-review-of-literature
#1
Nathan E Cohen, Andrew C Cook, Ravish Narvel
We present the case report of a patient with seronegative myasthenia gravis (MG) who was admitted for metabolic encephalopathy and acute on chronic hypoxic respiratory failure secondary to an MG crisis three days after an intravenous immunoglobulin treatment. In the intensive care unit, her MG was managed with intravenous immunoglobulin, plasmapheresis, prednisone, and pyridostigmine. During the course of her visit, she had urosepsis along with a left chest port that had cultured positive for Pseudomonas aeruginosa and developed a right upper extremity deep vein thrombosis (UEDVT) and superficial thrombosis in the left upper extremity despite being on heparin therapy...
March 2024: Curēus
https://read.qxmd.com/read/38586668/acute-non-infectious-cystitis-secondary-to-immune-related-adverse-events-in-a-patient-receiving-pembrolizumab-for-treatment-of-non-small-cell-lung-cancer-a-case-report
#2
Leena Alhusari, Mahmoud Abdallah, Kemnasom Nwanwene, Mina Shenouda
Immune-related adverse events (IrAEs) involving the bladder are seldom reported and tend to be overlooked by oncologists. Cystitis caused by immune checkpoint inhibitors (ICIs) is rarely reported, with only four documented instances in the literature, of which just one case is attributed to pembrolizumab. We present a rare occurrence of pembrolizumab-induced hemorrhagic cystitis in a 71-year-old male with stage II-b lung adenocarcinoma with an chronic indwelling Foley catheter. He presented with persistent hematuria despite the completion of a course of antibiotics for a urinary infection; a cystoscopic examination was also normal...
March 2024: Curēus
https://read.qxmd.com/read/37900378/post-cardiac-injury-syndrome-in-a-systemic-lupus-erythematosus-patient-after-an-open-heart-operation-a-case-report
#3
Aseel Abuhammad, Osayd Nassar, Saed I Atawnah
Post-cardiac injury syndrome (PCIS) is an inflammatory condition caused by a cardiac injury that can affect the pericardium, pleura, or both. We describe a female patient who underwent heart surgery and thereafter developed pericardium and pleural effusion. She was also known to have systemic lupus erythematosus (SLE). Due to the possibility that each of these symptoms could impact the pericardium or pleura, we came to the conclusion that they could be caused by either PCIS, SLE, or both. A 54-year-old woman underwent open heart surgery three weeks ago and required aortic valve replacement and coronary artery bypass grafting (CABG)...
September 2023: Curēus
https://read.qxmd.com/read/37785318/a-phase-i-ii-dose-escalation-study-evaluating-the-safety-of-21-gy-23-gy-and-25-gy-for-high-dose-rate-hdr-prostate-brachytherapy-an-interim-toxicity-report
#4
JOURNAL ARTICLE
D Hong, K H Kang, J M Barnes, B C Baumann, R J Brenneman, Y Huang, J E Zoberi, J L Garcia-Ramirez, D Caruthers, M B Altman, H A Gay
PURPOSE/OBJECTIVE(S): Single-fraction high dose rate (HDR) prostate brachytherapy has shown improved actuarial biochemical control rates from 66% to 82% with dose escalation from 19 to 20.5 Gy, respectively, but is still inferior to the reported low dose rate brachytherapy control rates of over 90%. We aimed to identify whether dose escalation to 21, 23, and 25 Gy can be safely accomplished. MATERIALS/METHODS: Patients with previously untreated, pathologically confirmed, low-risk (cT1-T2a, Gleason ≤6, PSA <10 ng/mL) or favorable intermediate risk (Gleason 3+4, percentage of positive biopsy cores <50%, ≤1 NCCN intermediate risk factor) prostate adenocarcinoma were enrolled from a single institution...
October 1, 2023: International Journal of Radiation Oncology, Biology, Physics
https://read.qxmd.com/read/37425527/cardiac-sarcoidosis-presented-with-hiccups-a-case-report-and-literature-review
#5
Muhammad Ghallab, Ivan Cancarevic, Nicole C Noff, Daniel Miller, Allison Foster, Zakaria Alagha, Ashraf Sliem, Sanjiv Bakshi
Sarcoidosis is a multisystem disorder of unknown etiology commonly associated with hilar lymphadenopathy and granulomas. Cardiac involvement is less common; however, sarcoidosis is a known cause of restrictive cardiomyopathy. It typically presents as new-onset arrhythmias or heart failure, although cases of sudden cardiac death have been reported. We present a case of a 56-year-old male with a known history of pulmonary sarcoidosis, not on active treatment, who presented to the emergency department with a week of continuous hiccups every few seconds associated with non-exertional dyspnea...
June 2023: Curēus
https://read.qxmd.com/read/37025681/case-report-aggressive-progression-of-acute-heart-failure-due-to-juvenile-tuberculosis-associated-takayasu-arteritis-with-aortic-stenosis-and-thrombosis
#6
Wenjie Xuan, Zhaoling Wang, Jinjing Lin, Lixia Zou, Xisheng Xu, Xinghui Yang, Yiping Xu, Yan Zhang, Qi Zheng, Xuefeng Xu, Meiping Lu
BACKGROUND: Takayasu arteritis (TA) is a chronic granulomatous vasculitis with unknown pathophysiology. TA with severe aortic obstruction has a poor prognosis. However, the efficacy of biologics and appropriate timing of surgical intervention remain controversial. We report a case of tuberculosis (TB)-associated TA with aggressive acute heart failure (AHF), pulmonary hypertension (PH), thrombosis, and seizure, who failed to survive after surgery. CASE PRESENTATION: A 10-year-old boy who developed a cough with chest tightness, shortness of breath, hemoptysis with reduced left ventricular ejection fraction, PH, and increased C-reactive protein and erythrocyte sedimentation rate was hospitalized at the pediatric intensive care unit of our hospital...
2023: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/36937124/recurrent-hydropneumothorax-after-covid-19
#7
Vashistha M Patel, Shreya V Patel, Kyle Singletary, Lauren Pacheco
A 60-year-old male with a past medical history of heart failure with reduced ejection fraction, obstructive sleep apnea, atrial flutter, and hypertension initially presented to the emergency department with a chief complaint of shortness of breath. He was diagnosed with COVID-19-induced acute hypoxic respiratory failure. Before his presentation to the emergency department, he was treated with a brief course of hydroxychloroquine, azithromycin, and prednisone. His initial hospitalization was relatively uncomplicated...
March 2023: Curēus
https://read.qxmd.com/read/35514004/effect-of-short-term-corticosteroid-usage-on-acute-urinary-toxicity-following-cs-131-prostate-brachytherapy
#8
JOURNAL ARTICLE
Andrew Keller, Mohamed Abdelhakiem, Ria Mulherkar, Siddharth Ghanta, Ronald Benoit, Ryan P Smith, Sushil Beriwal
PURPOSE: To evaluate short-term patient reported urinary quality of life scores in patients with prostate cancer treated at our institution with and without perioperative prednisone following Cesium-131 (131 Cs) prostate LDR brachytherapy. METHODS AND MATERIALS: We started routinely using a perioperative 7-day course of prednisone at a dose of 5 mg per day, beginning 1 day prior to 131 Cs prostate LDR brachytherapy from 2013 with goal of improving acute urinary symptomatology...
May 2, 2022: Brachytherapy
https://read.qxmd.com/read/35433845/antineutrophil-cytoplasmic-autoantibody-associated-glomerulonephritis-as-a-complication-of-home-parenteral-nutrition
#9
Hana Flogelova, Eva Karaskova, Katerina Bouchalova, Marie Rohanova, Vendula Latalova, Tomas Tichy, Vladimir Tesar
Patients on long-term home parenteral nutrition (HPN) occasionally develop glomerulonephritis due to chronic central venous catheter (CVC)-related infection. Most previously reported cases were membranoproliferative glomerulonephritis (MPGN). This is a case report of a 16-year-old girl receiving HPN for short bowel syndrome. After 11 years on HPN, she developed acute kidney injury with macroscopic hematuria, nephrotic-range proteinuria, and a reduced glomerular filtration rate (GFR). Initially, MPGN associated with chronic bacteremia was suspected with the assumption that the condition would be treated with antibiotics and CVC replacement...
January 2022: Case Reports in Nephrology and Dialysis
https://read.qxmd.com/read/34800025/chronic-catheter-related-bacteremia-of-pseudomonas-stutzeri-etiology-as-the-cause-of-membranous-proliferative-glomerulonephritis-mpgn-a-case-report
#10
JOURNAL ARTICLE
Kamil Krzysztof Cołoś, Weronika Lea Śliwińska, Aleksandra Rymarz, Stanisław Niemczyk
UNLABELLED: Secondary membranous - proliferative glomerulonephritis most often develops in the course of viral infections (HCV, HBV), autoimmune diseases, paraproteinemia, and also in the course of chronic bacterial infections. Infections with Pseudomonas stutzeri (P. stutzeri) are extremely rare and usually mildly symptomatic. The natural habitat of this bacterium is soil and water. Nevertheless, in the case of P. stutzeri infection, especially in patients frequently hospitalized or receiving immunosuppressive medications, environmental contamination in healthcare facilities should be taken into account when looking for the source of the infection...
October 22, 2021: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://read.qxmd.com/read/33942420/role-of-immunosuppressive-therapy-in-the-management-refractory-post-procedural-pericarditis
#11
JOURNAL ARTICLE
Bharat Narasimhan, Mohit K Turagam, Jalaj Garg, Domenico G Della Rocca, Rakesh Gopinathannair, Luigi Di Biase, Jorge Romero, Sanghamitra Mohanty, Andrea Natale, Dhanunjaya Lakkireddy
BACKGROUND: A significant rise in epicardial based interventions over the past two decades has been associated with a proportionate rise in complications - most notably, pericarditis. Post procedural pericarditis is often particularly refractory to conventional therapies with no current consensus regarding its optimal management. OBJECTIVE: To assess the safety and efficacy of a novel immunosuppressive regimen - combination Methotrexate / Prednisone (cMtx/P) - in the management of severe refractory post-procedural pericarditis (rPPP)...
May 3, 2021: Journal of Cardiovascular Electrophysiology
https://read.qxmd.com/read/33586483/use-of-single-bed-rooms-may-decrease-the-incidence-of-hospital-acquired-infections-in-geriatric-patients-a-retrospective-cohort-study-in-central-denmark-region
#12
JOURNAL ARTICLE
Merete Gregersen, Anders Mellemkjær, Catherine H Foss, Sif Blandfort
OBJECTIVE: Patients accommodated in single-bed rooms may have a reduced risk of hospital-acquired infections (HAIs) compared to those in multi-bed rooms. This study aimed to examine the effect of single-bed accommodation on HAIs in older patients admitted to a geriatric ward. METHODS: A retrospective cohort study of patients admitted to geriatric wards in a university hospital in Central Denmark Region linked to a move to a newly built hospital, involving all consecutively admitted patients aged 65 years and over from 15 September to 19 December 2016 and a similar cohort admitted in the same three months in 2017...
February 14, 2021: Journal of Health Services Research & Policy
https://read.qxmd.com/read/33552798/iatrogenic-hypothalamus-injury-after-resection-of-subependymoma-within-the-left-brain-ventricle
#13
Jing Bao, Zhenjiang Pan, Shepeng Wei
Damage to the hypothalamus may result from direct surgical injury or from hemorrhage and ischemia caused by the procedure. Patients with hypothalamus damage can be comatose and exhibit hyperthermia. Here, we present a patient whose hypothalamus was directly damaged by a drainage catheter. His clinical manifestations included diabetes insipidus, hyperthermia and adrenocorticotropic hormone (ACTH) deficiency. The patient was a 48-year-old male and had a body weight of 95 kg. He was admitted to the hospital on August 31, 2019 for memory impairment and nonspecific dizziness that persisted for four months...
January 31, 2021: Curēus
https://read.qxmd.com/read/30711778/limited-utility-of-outpatient-surveillance-blood-cultures-in-hematopoietic-cell-transplant-recipients-on-high-dose-steroids-for-treatment-of-acute-graft-versus-host-disease
#14
JOURNAL ARTICLE
Erica Stohs, Victor A Chow, Catherine Liu, Lori Bourassa, Arianna Miles-Jay, Julie Knight, Ania Sweet, Barry E Storer, Marco Mielcarek, Steven A Pergam
BACKGROUND: Steroids used to treat acute graft-versus-host-disease (GVHD) are thought to blunt clinical symptoms of infection. We aimed to assess the value of weekly surveillance blood cultures (SBCs) drawn in an outpatient setting from hematopoietic cell transplant (HCT) patients receiving high-dose steroids. We hypothesized that most positive outpatient surveillance cultures would be low-pathogenicity gram positive organisms and would lead to excess vancomycin therapy. METHODS: We conducted a retrospective review of blood cultures collected from a cohort of adult HCT patients enrolled in a clinical trial of acute GVHD therapy with high-dose steroids (prednisone-equivalent doses ≥ 0...
January 31, 2019: Biology of Blood and Marrow Transplantation
https://read.qxmd.com/read/30619613/bacteraemia-due-to-microbacterium-paraoxydans-in-a-patient-with-chronic-kidney-disease-refractory-hypertension-and-sarcoidosis
#15
JOURNAL ARTICLE
Matthew S Chorost, Nancy C Smith, Jack N Hutter, Ann C Ong, Jason A Stam, Patrick T McGann, Mary K Hinkle, Kurt E Schaecher, Edwin Kamau
Introduction: Microbacterium spp. are yellow-pigmented Gram-positive coryneform rods found in various environmental sources, such as soil and water samples. They rarely cause human infection, mostly infecting immunocompromised patients and catheter insertion sites, making them challenging to identify in clinical settings. Case presentation: We report a case of a 61-year-old female on long-term prednisone therapy for sarcoidosis with minimal exposure to environmental sources, who presented with an overtly infected Hickman catheter site and presyncope...
November 2018: JMM Case Reports
https://read.qxmd.com/read/30574505/peritoneal-dialysis-exit-site-pyoderma-gangrenosum-a-case-report
#16
Salman Anwar, Karen Holfeld, Bhanu Prasad
BACKGROUND: Pyoderma gangrenosum (PG) is a rare, chronic inflammatory condition exhibiting mucopurulent or hemorrhagic exudates. The majority of cases are associated with inflammatory bowel disease, rheumatological diseases, and hematological malignancies. In the absence of typical serological markers and specific histopathological changes, the diagnosis is often clinical. Being rare, it is frequently misdiagnosed, which leads to a delay in instituting appropriate therapy. CASE PRESENTATION: We present a 53-year-old male of Aboriginal descent with end-stage renal disease due to diabetes who underwent insertion of a peritoneal dialysis (PD) catheter...
September 2018: Case Reports in Nephrology and Dialysis
https://read.qxmd.com/read/30262330/complications-associated-with-dose-adjusted-epoch-rituximab-therapy-for-non-hodgkin-lymphoma
#17
JOURNAL ARTICLE
Rachel J David, Andrea Baran, Kah Poh Loh, Carla Casulo, Paul M Barr, Jonathan W Friedberg, Patrick M Reagan
INTRODUCTION: Certain aggressive non-Hodgkin lymphoma subtypes are increasingly being treated with infusional DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab), which requires a central venous catheter. This study aims to identify the rates and predictors of line-associated complications (LACs) associated with DA-EPOCH-R therapy in NHL. PATIENTS AND METHODS: We retrospectively identified all patients treated with DA-EPOCH-R at our institution between March 2011 and July 2016...
December 2018: Clinical Lymphoma, Myeloma & Leukemia
https://read.qxmd.com/read/29983718/heat-induced-necrosis-after-bronchial-thermoplasty-a-new-concern
#18
Francesco Menzella, Mirco Lusuardi, Carla Galeone, Gloria Montanari, Alberto Cavazza, Nicola Facciolongo
BACKGROUND: Bronchial thermoplasty (BT) is an endoscopic procedure for the treatment of severe refractory asthma, based on the local airways delivery of radio-frequency at 65 °C. Several controlled clinical studies demonstrated the effectiveness of BT on clinical outcomes, particularly the reduction of asthma exacerbations. During procedure or shortly after, significant but transient respiratory adverse events have been reported. CASE REPORT: We describe the case of a male, caucasian, 56-year-old, non-smoker patient with non-allergic severe asthma...
2018: Allergy, Asthma, and Clinical Immunology
https://read.qxmd.com/read/29481922/recurrent-iliofemoral-venous-thrombosis-in-the-setting-of-may-thurner-syndrome-as-the-presenting-symptom-of-behcet-s-disease
#19
JOURNAL ARTICLE
Sameer Lakha, Chien Yi Maximilian Png, Kevin Chun, Windsor Ting
BACKGROUND: Vascular manifestations including pulmonary artery aneurysms and venous thrombosis are seen in up to 14% of patients with Behcet's disease. We report a patient who had recurrent deep vein thrombosis (DVT) as the presenting symptom of Behcet's Disease. METHODS: A 19-year-old male who presented with acute iliofemoral DVT, confirmed by intravascular ultrasound (IVUS) and venogram. May-Thurner syndrome was also observed. Repeated catheter-based pharmacomechanical thrombolysis, thrombectomy, and subsequent iliac vein stenting were performed...
May 2018: Annals of Vascular Surgery
https://read.qxmd.com/read/29437733/cough-as-the-sole-manifestation-of-pericardial-effusion
#20
JOURNAL ARTICLE
Hee Kong Fong, Obai Abdullah, Sandeep Gautam
A 59-year-old woman with paroxysmal atrial fibrillation (AF) presented with severe non-productive cough, malaise, low-grade fever and AF flare-up 3 weeks following pulmonary vein isolation with radiofrequency catheter ablation. She denied chest pain or dyspnoea. Patient was haemodynamically stable. There was no pulsus paradoxus. Laboratories showed leucocytosis and elevated C-reactive protein. ECG showed sinus tachycardia. CT abdomen and pelvis showed a large pericardial effusion (PE). Shortly after admission, she developed AF with rapid ventricular response, responsive to intravenous amiodarone...
February 5, 2018: BMJ Case Reports
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