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Lower extremity edema

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https://www.readbyqxmd.com/read/29766466/concurrent-isolated-igg2-positive-membranous-nephropathy-and-malignant-b-cell-lymphoma
#1
Satoshi Shimada, Takashi Nakamichi, Gen Yamada, Kaori Narumi, Hajime Usubuchi, Tae Yamamoto, Satoshi Ichikawa, Noriko Fukuhara, Mariko Miyazaki, Hideo Harigae, Hiroshi Sato, Sadayoshi Ito
A recent systematic review showed that hematological malignancy is often complicated by membranous nephropathy (MN). Histologically, the deposition of IgG subclasses other than IgG4 may imply secondary MN, such as malignancy-associated MN (M-MN). We describe a very rare case of concurrent isolated IgG2-positive MN and B-cell lymphoma. An 83-year-old woman was hospitalized at our institute for facial and lower extremity edema persisting for 2 months. Laboratory tests showed urinary protein level of 10.8 g/day, serum albumin level of 1...
May 15, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29763252/charcot-foot-clinical-clues-diagnostic-strategies-and-treatment-principles
#2
Valerie S Marmolejo, Jonathan F Arnold, Mario Ponticello, Charles A Anderson
Acute Charcot neuroarthropathy of the foot and ankle is often difficult to diagnose because of limited findings in the patient history, physical examination, imaging, and laboratory studies. Delay in treatment results in the development of rigid foot and ankle deformities, increasing the risk of ulceration, infection, and major lower extremity amputation. Acute Charcot neuroarthropathy should be suspected in any patient 40 years or older with obesity and peripheral neuropathy who presents with an acutely swollen foot following minimal or no recalled trauma and who reports minimal to no pain, particularly if radiography and laboratory markers of infection are normal...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#3
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29743098/impact-of-flow-and-temperature-on-patient-comfort-during-respiratory-support-by-high-flow-nasal-cannula
#4
Tommaso Mauri, Alessandro Galazzi, Filippo Binda, Laura Masciopinto, Nadia Corcione, Eleonora Carlesso, Marta Lazzeri, Elena Spinelli, Daniela Tubiolo, Carlo Alberto Volta, Ileana Adamini, Antonio Pesenti, Giacomo Grasselli
BACKGROUND: The high-flow nasal cannula (HFNC) delivers up to 60 l/min of humidified air/oxygen blend at a temperature close to that of the human body. In this study, we tested whether higher temperature and flow decrease patient comfort. In more severe patients, instead, we hypothesized that higher flow might be associated with improved comfort. METHODS: A prospective, randomized, cross-over study was performed on 40 acute hypoxemic respiratory failure (AHRF) patients (PaO2 /FiO2  ≤ 300 + pulmonary infiltrates + exclusion of cardiogenic edema) supported by HFNC...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29742686/a-rare-case-report-of-one-stage-surgical-treatment-for-left-renal-cell-carcinoma-with-level-iv-intravenous-tumor-thrombus-combined-with-severe-coronary-artery-stenosis
#5
Zhenqing Wang, Keqin Zhang, Hui Zhang, Dingqi Sun, Yong Li, Qi Tan, Qiang Fu
RATIONALE: Renal cell carcinoma (RCC) exhibits a natural tendency to extend from the kidney into inferior vena cava (IVC) and growing into the right atrium is a rare complication. We report a 65-year-old patient with an RCC with intravascular extension through renal vein into the IVC and right atrial combined with severe coronary artery disease. This case has not been described in the literature and there is no treatment guideline for it. PATIENT CONCERNS: A 65-year-old patient was admitted to our clinic with complaints of edema of both lower extremities...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29742184/complex-regional-pain-syndrome-what-the-dermatologist-should-know
#6
Azam A Qureshi, Adam J Friedman
Reflex sympathetic dystrophy is a subtype of complex regional pain syndrome, a condition characterized by persistent post-injury extremity pain. Temperature and sweating changes, edema, mobility changes, and a variety of hair, nail, and skin sequelae have been described. Only 23 articles published since 1990 describe dermatologic changes in CRPS. Given this paucity of literature, we present a case to further elucidate cutaneous manifestations of CRPS. Our patient is a 52-year-old Caucasian woman with a 19-year history of reflex sympathetic dystrophy who has presented with several dermatologic complaints...
May 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29731477/unilateral-lower-extremity-edema-and-lymphorrhea-as-manifestations-of-a-ruptured-iliac-artery-aneurysm-and-arteriovenous-fistula
#7
Shinsuke Nishimura, Takashi Murakami, Hiromichi Fujii, Yosuke Takahashi, Akimasa Morisaki, Toshihiko Shibata
An arteriovenous fistula is a rare complication of ruptured abdominal aortic or iliac artery aneurysms (IAAs). Its clinical symptoms depend on its size, with signs of heart failure dominating if the fistula is large. Herein, we present a case of arteriovenous fistula with an unusual presentation. An 86-year-old male patient presented with extreme lower extremity edema, skin erosion, and continuous lymphorrhea (starting 3 months prior). Despite the large fistula between the right common IAA and the left common iliac vein after the rupture of the aneurysm, he did not develop heart failure symptoms, as the large shunt was predominantly directed toward the left lower extremity due to iliac vein compression...
May 2, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29727888/-heart-failure-despite-low-bnp-level-paradoxon-or-pathfinder-a-case-of-pericarditis-constrictiva
#8
Henning Dopp, Petra Maagh, Axel Meissner
HISTORY AND CLINICIAL FINDINGS:  We elaborate a case of a 48-year old patient of indian descent who presented with shortness of breath, lower extremity edema and ascites in our emergency unit.One year beforehand tuberculous pleuritis was diagnosed and treated in accordance with guidelines. INVESTIGATIONS:  CT-Scan of the heart revealed a pericardial thickening with calcifications. Echocardiographic examination and invasive pressure measurement did not provide any clear evidence of pericarditis constrictiva...
May 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29703002/embolic-retinal-and-choroidal-vascular-occlusion-after-peribulbar-triamcinolone-injection-a-case-report
#9
Gang Li, Dongdong Xu, Zhirou Hu, Hui Li
RATIONALE: Retinal and choroidal vascular occlusion is a vision-threatening complication of therapeutic injections in the facial region. The early identification and early treatment are necessary to reduce the risk of harm to the patient. PATIENT CONCERNS: We report an extremely rare case of embolic retinal and choroidal vascular occlusion after peribulbar triamcinolone injection in a patient with thyroid-associated ophthalmopathy. DIAGNOSES: Central retinal artery occlusion...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29694969/clinical-features-of-hereditary-angioedema-in-korean-patients-a-nationwide-multicenter-study
#10
Jae-Woo Jung, Dong In Suh, Hye Jung Park, Sujeong Kim, Hyouk Soo Kwon, Min Suk Yang, Chan Sun Park, Joo-Hee Kim, Sae-Hoon Kim, Yong Won Lee, Gyu Young Hur, Young-Min Ye, Yong Eun Kwon, Hye-Kyung Park, Cheol Woo Kim, Young-Il Koh, Jung Wong Park, Jong-Myung Lee, Kyung-Up Min, Paige Wickner, Hye-Ryun Kang
BACKGROUND: Hereditary angioedema (HAE) is a genetically heterogeneous autosomal dominant disorder characterized by recurrent episodes of nonpruritic, nonpitting edema increasing after puberty. It can be fatal due to laryngeal or gastrointestinal (GI) involvement with varied and changing frequency of mortality according to studies published from the Western countries. Epidemiological and clinical data of HAE in Asian countries are sparse. We sought to examine the clinical characteristics of HAE patients in Korea...
April 25, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29682437/adult-onset-minimal-change-disease-with-iga-nephropathy-and-hepatitis-c
#11
Waliul Chowdhury, Tahira Sabeen Saleem, Muhammad Uzair Lodhi, Intekhab Askari Syed, Hafiz Imran Iqbal, Mustafa Rahim
Minimal change disease (MCD) is one of the most common causes of nephrotic syndrome in children, leading to heavy proteinuria and edema. However, it is not as common in adults. Adult-onset minimal change disease with IgA nephropathy is rare. The initial presentation of heavy proteinuria and edema with effacement of podocytes on electron microscopy (EM) should lead the physician to suspect minimal change disease regardless of age. We present a 44-year-old male patient with a history of hepatitis C virus (HCV) who presented with sudden onset of lower extremity edema and 6...
February 19, 2018: Curēus
https://www.readbyqxmd.com/read/29670797/recurrent-migratory-transient-bone-marrow-edema-of-the-knees-associated-with-low-vitamin-d-and-systemic-low-bone-mineral-density-a-case-report-and-literature-review
#12
Omar Alsaed, Mohammad Hammoudeh
Transient bone marrow edema (TBME) is a self-limiting disease characterized by joint pain with localized bone marrow edema by MRI and has been reported in many case series and case reports. It is well known that joints of the lower extremity including hips, knees, ankles, and feet are the classical sites for TBME. Many theories have been proposed for the pathogenesis of TBME. Systemic osteopenia and vitamin D deficiency is one of the theories that have been suggested in the last few years. In this case report, we present a middle-aged male patient, who presented with 4 attacks of TBME in both knees between September 2016 and August 2017...
2018: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/29620659/individualized-pelvic-lymphadenectomy-should-follow-neoadjuvant-concurrent-chemoradiotherapy-for-locally-advanced-cervical-cancer
#13
Li-Chun Wei, Xin Li, Ying Zhang, Yun-Zhi Dang, Wei-Wei Li, Jian-Ping Li, Li-Na Zhao, Shu-Juan Liu, Xia Li, Mei Shi
To study the outcomes following concurrent chemoradiotherapy (CCRT) and subsequent radical surgery for locally advanced cervical cancer (LACC), analyze the relationship between imaging-diagnosed and postoperative-diagnosed lymph node (LN) involvement, and identify patients who would benefit from individualized pelvic lymphadenectomy.We retrospectively reviewed records of 410 patients who underwent CCRT followed by radical surgery for International Federation of Gynecology and Obstetrics Stage Ib2-IIIb disease...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29606104/study-protocol-randomized-controlled-trial-reducing-symptom-burden-in-patients-with-heart-failure-with-preserved-ejection-fraction-using-ubiquinol-and-or-d-ribose
#14
Janet D Pierce, Diane E Mahoney, John B Hiebert, Amanda R Thimmesch, Francisco J Diaz, Carol Smith, Qiuhua Shen, Dinesh Pal Mudaranthakam, Richard L Clancy
BACKGROUND: Heart failure (HF), the leading cause of morbidity and mortality in the US, affects 6.6 million adults with an estimated additional 3 million people by 2030. More than 50% of HF patients have heart failure with preserved left ventricular ejection fraction (HFpEF). These patients have impaired cardiac muscle relaxation and diastolic filling, which investigators have associated with cellular energetic impairment. Patients with HFpEF experience symptoms of: (1) fatigue; (2) shortness of breath; and (3) swelling (edema) of the lower extremities...
April 2, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29600129/severe-pleuritis-and-pericarditis-associated-with-very-late-onset-systemic-lupus-erythematosus
#15
Hiroaki Ikushima, Akihiko Mitsutake, Takuto Hideyama, Tatsuya Sato, Junko Katsumata, Tomonari Seki, Risa Maekawa, Yukiko Kishida, Yasushi Shiio
Systemic lupus erythematosus (SLE) is a multisystem disorder, which occurs mostly in young women. However, late-onset SLE does exist and sometimes presents with an atypical, diversified course. We describe an 85-year-old woman who was admitted to our hospital for lower extremity edema and hand grip weakness. Chest computed tomography scan 4 days after admission demonstrated rapid accumulation of pleural and pericardial effusions, which did not exist on admission. She was diagnosed with pleuritis and pericarditis associated with very-late-onset SLE...
March 2018: Journal of General and Family Medicine
https://www.readbyqxmd.com/read/29566731/deep-vein-thrombosis-and-pulmonary-embolism-secondary-to-urinary-retention-a-case-report
#16
Tatsushi Kawada, Takashi Yoshioka, Motoo Araki, Hiroyuki Nose, Tadashi Oeda
BACKGROUND: Pulmonary embolism occurs when a blood thrombus forms and travels from a vein in the body to an artery in the lung. Thrombi often develop in one of the deep veins of the legs, thighs, or pelvis, a condition known as deep vein thrombosis. In this report, we describe a rare instance of a patient who developed deep vein thrombosis and pulmonary embolism secondary to urinary retention, and we also review some of the literature. CASE PRESENTATION: A 75-year-old Japanese man visited our hospital with the complaint of lower extremity weakness...
March 23, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29558304/case-252-acute-hyperammonemic-encephalopathy-resulting-from-late-onset-ornithine-transcarbamylase-deficiency
#17
Michelle Hershman, Raymond Carmody, Unni K Udayasankar
History A 19-year-old woman with no pertinent medical history was brought to the emergency department after being found unconscious on her bathroom floor by her roommate. In the preceding weeks, she had reported intractable nausea and vomiting, for which she had been taking ondansetron. No other medications had been prescribed. The day prior to presentation, she had contacted her mother and described increasing confusion. Glasgow coma scale score on arrival in the emergency department was 4. Intravenous naloxone was administered, without immediate response...
April 2018: Radiology
https://www.readbyqxmd.com/read/29545957/refractory-abdominal-pain-in-a-patient-with-chronic-lymphocytic-leukemia-be-wary-of-acquired-angioedema-due-to-c1-esterase-inhibitor-deficiency
#18
Abdullateef Abdulkareem, Ryan S D'Souza, Joshua Mundorff, Pragya Shrestha, Oluwaseun Shogbesan, Anthony Donato
Acquired angioedema due to C1 inhibitor deficiency (C1INH-AAE) is a rare and potentially fatal syndrome of bradykinin-mediated angioedema characterized by episodes of angioedema without urticaria. It typically manifests with nonpitting edema of the skin and edema in the gastrointestinal (GI) tract mucosa or upper airway. Edema of the upper airway and tongue may lead to life-threatening asphyxiation. C1INH-AAE is typically under-diagnosed because of its rarity and its propensity to mimic more common abdominal conditions and allergic reactions...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29507277/light-chain-deposition-disease-associated-with-multiple-myeloma-developing-in-late-pregnancy
#19
Min Jeong Kim, Joo Hui Kim, Il Young Kim, Soo Bong Lee, In Seong Park, Mi Yeun Han, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak, Dong Won Lee
Preeclampsia is the most common cause of proteinuria with hypertension during pregnancy. Primary kidney disease and kidney disease secondary to systemic disorders may rarely occur during pregnancy, resulting in proteinuria. A 34-year-old woman was admitted to our hospital with abdominal distention and lower extremity edema. The pregnancy was terminated at the 24th week of gestation due to preterm labor. Even after the delivery, proteinuria and renal deterioration continued to progress. The M-peak was not found on serum and urine protein electrophoresis...
March 2018: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/29503136/foot-and-ankle-osteoid-osteomas
#20
Volkan Gurkan, Ozgur Erdogan
Foot and ankle osteoid osteomas (OOs) are often cancellous or subperiosteal and rarely present with a periosteal reaction. Additionally, the large number of disorders included in the differential diagnosis and the nonspecific findings on radiographs complicate the diagnosis. We performed a manual search of the senior surgeon's hospitals' operating room records for the terms "benign bone tumor," "foot," "ankle," and "osteoid osteoma" from January 2003 until December 2014...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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