Hyponatremia as the Initial Presentation of Cryptococcal Meningitis After Liver Transplantation
Conclusions: Symptomatic hyponatremia secondary to SIADH remains a rare complication of cryptococcal meningitis.,Case Presentation: A 67-year-old male with liver transplantation due to hepatitis C (HCV) related liver cirrhosis developed severe hyponatremia four months after liver transplantation, which was discovered during routine clinic visit. Patient was referred to the emergency department, treated and discharged with normal serum sodium level. Few days later, he presented with dizziness, confusion, ataxia, abnormal muscle movements and leg pain. Laboratory investigations were consistent with SIADH and revealed a sodium level of 115 mmol/L. Brain MRI showed a leptomeningeal enhancement in the superior cerebellar sulci suspicious for infection. Lumbar puncture was performed and consistent with Cryptococcus neoformans infection; therefore, cryptococcal meningitis was diagnosed. Amphotericin B was started for the patient for six weeks followed by fluconazole for one year. His level of consciousness improved significantly, and his serum sodium level slowly returned to its normal baseline over three weeks after starting amphotericin B.,Introduction: Meningoencephalitis is the most common clinical manifestation of cryptococcal infection, as the organism has a propensity to invade the CNS. Patients often present with elevated intracranial pressure, focal motor deficits, altered mentation and internal hydrocephalus. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)...
Authors: Ordak M, Nasierowski T, Pawlik K, Muszynska E, Bujalska-Zadrozny M Abstract Objectives: The purpose of this research was to investigate the effectiveness of the methadone programme in a group of patients taking mephedrone with heroin.Methods: The research involved 230 people who took part in the methadone programme between 2010 and 2019: 101 people on a mephedrone binge and taking heroin and 129 people addicted to heroin.Results: Number of re-hospitalisations was higher in a group of patients on a mephedrone binge taking heroin in comparison to heroin dependent patients (91.9 vs 79.8%, p
Publication date: Available online 3 June 2020Source: Pharmacology Biochemistry and BehaviorAuthor(s): Yasunori Haranishi, Koji Hara, Tadanori Terada
CONCLUSION: Quality of life and social support were identified as protective factors for depressive symptoms while being at risk of malnutrition, living alone, reporting pain and being female are predictors. PMID: 32490955 [PubMed - in process]
Renal angiomyolipoma (AML) is the most common benign solid renal neoplasm seen in daily clinical practice, with an estimated prevalence of 0.2% to 0.6%.1 It is a triphasic mesenchymal neoplasm composed of varying amounts of dysmorphic vasculature, smooth muscle, and mature adipocytes. Pathologically, AML is now considered among the family of perivascular epithelioid cell tumors. Approximately 80% of cases are sporadic, with mean age at presentation being 43 years and most cases identified at fourth to sixth decades of life. There is also a strong female predilection, with female-to-male ratio of 4:1 in sporadic cases.1 Twe...
CONCLUSIONS: The present meta-analysis suggests that aflatoxin exposure is associated with a higher risk of liver cirrhosis. PMID: 32487162 [PubMed - in process]
With a potential match arising at the height of the COVID-19 pandemic, Upstate and the patient, Lonel Woods, had to take many extra steps to ensure everyone ’s safety.
Publication date: Available online 4 June 2020Source: Journal of the Formosan Medical AssociationAuthor(s): Walis Ruiy, Shih-Yung Hsu, Hsien-Lung Tsai, Chen-Te Chen, Chih-Peng Tseng, Wei-Teing Chen
CONCLUSION: The multiprofessional protocol qualifies the care provided to critically ill patients with delirium, improving clinical outcomes. PMID: 32491148 [PubMed - as supplied by publisher]
This study was conducted to compare the anesthetic and analgesic efficacy of bupivacaine with other local anesthetic agents routinely used for mandibular third molar surgery.Method and materials: Four electronic databases (PubMed, Scopus, Cochrane, and Web of Science) were explored to isolate randomized controlled trials up to 10 February 2019. The anesthetic and analgesic efficacies were assessed using six evaluation outcomes: onset of anesthesia, success of anesthesia, duration of anesthesia, duration of analgesia, pain score on the fourth postoperative hour, and number of analgesics consumed. Stata software (version 13,...
Publication date: Available online 3 June 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Patrick Stelmach, Klaus Wethmar, Christoph Groth, Daniela V. Wenge, Jörn Albring, Jan-Henrik Mikesch, Christoph Schliemann, Christian Reicherts, Wolfgang E. Berdel, Georg Lenz, Matthias Stelljes