A Serious Diagnosis Lacking Common Symptoms

​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; &AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the region nor any history of fecal or urinary incontinence, IV drug use, or saddle anesthesia.His vital signs were an oral temperature of 98.3°F, a heart rate of 70 bpm, a blood pressure of 113/60 mm Hg, a respiratory rate of 16 bpm, and a pulse oximetry of 98% on room air.The patient also complained of numbness in his left foot and severe pain and weakness upon flexion and extension of his left knee and hip. No other abnormalities were noted. An ECG was negative, as was the cervical, thoracic, and lumbar spine CT without contrast.The patient was given fentanyl 50 mcg IV for pain relief, and reported improvement, but he complained of weakness on flexion and extension of his left hip and left ankle. A stroke code was called, and the teleneurologist said the findings suggested a peripheral defect not related to a CVA.An MRI of the lumbar spine without contrast fou...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
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Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Authors: Musio F Abstract INTRODUCTION: Anemia has and will continue to be a central theme in medicine particularly as clinicians are treating a burgeoning population of complex multi-organ system processes. As a result of multiple randomized controlled trials (RCTs), meta-analyses, and societal recommendations overly restrictive paradigms and under-administration of erythropoiesis stimulating agents (ESAs) have likely been followed by clinicians among all specialties. AREAS COVERED: A review of anemia in the context of chronic kidney disease, hematologic malignancies and cancer is presented with focus on the e...
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