A Diagnostic Dilemma: Sometimes You ’ ll Never Know

Patient Presentation A 9-year-old male came to clinic with a 1 month history of painful joint swelling. One month ago he started having right ankle pain that was intermittent but consistent. One day ago his right wrist, right ankle and bilateral knees had some swelling but no erythema or warmth. He says that he has pain in them when he moves but not when he is resting and he denies any joint stiffness or gelling. He also had 1-2 days of multiple red skin lesions on his extremities and trunk, not overlying the affected joints. The skin lesions do not come and go and do not itch. They are mainly discrete circular lesions with no central clearing and did not change since they noticed them. The father and patient deny any recent infections but his sibling had a strep throat a few weeks ago. They had used ibuprofen and diphenhydramine orally once each without any symptom changes. They denied any contact with animals, ticks bites or non-city water supply. They deny any travel or contact with others from oversees, military personnel or institutionalized persons. They denied any history of trauma, no medication or other drug use and the child was not under unusual stress. In the review of systems he denies any fever, chills, no eye changes, muscle aches, no pain in general and sore throat or ear pain specifically, and weight changes or clothing fitting differently. He has no problems with breathing or swallowing, problems on exertion, heart palpitations, syncope or any gastrointesti...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news

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Molecular Mechanisms of Notch Signaling in Lymphoid Cell Lineages Development: NF-κB and Beyond. Adv Exp Med Biol. 2020;1227:145-164 Authors: Tsaouli G, Barbarulo A, Vacca A, Screpanti I, Felli MP Abstract Notch is a ligand-receptor interaction-triggered signaling cascade highly conserved, that influences multiple lineage decisions within the hematopoietic and the immune system. It is a recognized model of intercellular communication that plays an essential role in embryonic as well as in adult immune cell development and homeostasis. Four members belong to the family of Notch receptors (Notch1-4...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Unfortunately I manage and fill about 30 IT pumps in my current gig. I feel like I have a good system down to make extra sure I am always through the port and in the pump before I ever inject any medicine. I accessed a patient's Medtronic pump earlier today, took out the old medicine without any problems. Needle stays firmly in pump, never moves. I go to inject the new medicine (40ml pump so difficult to inject as per usual tactile feedback) and after about 3-4 cc's the patient says that she... Weird Pump Reaction
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): F. Matsunaga, N. Azar
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): K. Ringe, F. Wacker, C. von Falck
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): R. Cobb, S. Abdulla, S. Lee, N. Liss, G. Cohen, M. Gibbons, D. Yu, X. Lu
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): C. Carney, Z. Bhatti, C. Guevara
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: March 2020Source: Journal of Vascular and Interventional Radiology, Volume 31, Issue 3, SupplementAuthor(s): J. Hui, R. Goldman, T. Mabud, V. Arendt, W. Kuo, R. Hofmann
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
No abstract available
Source: The American Journal of Dermatopathology - Category: Pathology Tags: Clinical Pathologic Challenge Answer Source Type: research
No abstract available
Source: The American Journal of Dermatopathology - Category: Pathology Tags: Clinical Pathologic Challenge Source Type: research
Conclusions: Sufficient deltoid tensioning is vital to the stability of a reverse prosthesis as well as patient range of motion and outcomes; however, increased deltoid lengthening during reverse total shoulder arthroplasty increases the risk of postoperative tension-related complications. These data suggest that lengthening more than 26 mm is a risk factor for deltoid-related complications after reverse total shoulder arthroplasty. Level of Evidence: Level III.
Source: Current Orthopaedic Practice - Category: Orthopaedics Tags: Original Research Source Type: research
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