Weekend Case

You're called by Ortho for a washout of infected knee hardware. They warn you the guy is a little sick. You review the record... 90 yo M with a PMHx of CHF (EF 25%), AFib, and 3rd degree AV block (all presumed due to amyloidosis) and COPD. He was admitted to an OSH a month ago for infected knee hardware and underwent arthroscopy x 3 and grew out pseudomonas. Went to SNF on cefepime, but redeveloped infected knee and got admitted to your hospital. He now has fluid overload with... Weekend Case
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums

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Anesthesia, Sedation, and Pain Control
Source: Clinics in Perinatology - Category: Perinatology & Neonatology Source Type: research
You've done a bowel case for a perfed DU in an otherwise young healthy guy who took too much naproxen... At the end of the case, you put in a triple lumen with ultrasound, but still manage to get a little hole in the pleura... Patient extubated and in PACU, develops shortness of breath... can anyone walk me through the physiology of how this patient could develop a tension PTX if he's spontaneously breathing and not positive pressure ventilated... ? [URL... Tension PTX
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums
We present a case of a patient with lateral knee pain and subjective instability sensation after a low-energy trauma secondary to a lateral meniscus tear, with absence of the PCL on MRI examination and thickened meniscofemoral ligaments, with anterior and superior insertion at the femur, in the footprint of PCL. The patient had a menisci repair, without PCL reconstruction. At the 6-month follow-up, the patient did not report any instability symptoms during his daily work and sports activities. There are therapeutic implications in distinguishing a chronic PCL tear from an aplasia, so it is important to detect some signs in...
Source: Skeletal Radiology - Category: Radiology Source Type: research
We present two cases of patients with chronic obstructive lung disease (COPD) who developed different forms of pulmonary amyloidosis. In both cases malignancy was considered as primary diagnosis. Transthoracic biopsy confirmed pulmonary amyloidosis.In the first case the patient presented with progressive dyspnoea over a two years period. Initial assessment was consistent with a diagnosis of COPD but progressive changes in symptoms and lung functions and subsequently CT Thorax revealed possible airway obstruction. Bronchoscopy confirmed an obstructive lesion initially considered to be malignant but was found to be due to tr...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Daratumumab is a human IgG1k monoclonal antibody targeting the CD38 surface antigen on plasma cells with proven efficacy in multiple myeloma. While biology of clonal plasma cells in AL amyloidosis is distinct from myeloma, clonal plasma cells in AL amyloidosis express surface CD38, providing a rationale for using daratumumab. Infusion-related reactions (IR) of 48% were reported in patients who had daratumumab as monotherapy for relapsed multiple myeloma. Therefore, we designed a clinical trial to study tolerability of daratumumab in those with relapsed AL amyloidosis (clinicaltrials.gov identifier: NCT02841033). The primar...
Source: Blood - Category: Hematology Authors: Tags: 653. Myeloma: Therapy, excluding Transplantation: Poster I Source Type: research
Publication date: Available online 26 February 2018 Source:Respiratory Medicine Case Reports Author(s): Amos Lal, Jamal Akhtar, Mohammad Saud Khan, Yayan Chen, Yaron Goldman Primary localized endobronchial amyloidosis is a rare entity, as pulmonary amyloidosis most commonly occurs as a part of systemic AL amyloidosis. It can be asymptomatic or can present with nonspecific symptoms such as progressive dyspnea, cough, wheezing and rarely respiratory failure. It is frequently misdiagnosed as asthma, COPD or pneumonia. Solitary endobronchial amyloidosis having a nodular appearance can mimic endobronchial tumor. The diagnosis ...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
We report a colonic adenocarcinoma associated with diffuse submucosal deposition of a peculiar spheroid‐type amyloid identified in the colon, terminal ileum, and appendix. A 65‐year‐old woman with past medical histories of hypertension, and chronic obstructive pulmonary disease, presented to the emergency room with cramping abdominal pain and nausea. A computed tomography (CT) scan of abdomen showed right colonic volvulus. Emergency right hemicolectomy was performed. The specimen showed colonic adenocarcinoma with focal submucosal invasion (pT1) arising from a villotubular adenoma. A diffuse submucosal spheroid‐typ...
Source: Pathology International - Category: Pathology Authors: Tags: Case Report Source Type: research
Ö Abstract Although the pathophysiology of gastroesophageal reflux disease (GERD) remains unclear, it is accepted as a multifactorial disease. It is thought that some of the interventions that might cause alterations in the normal gastrointestinal tract anatomy and diseases that affect the lower esophageal sphincter, esophageal clearance, and stomach motility (gastric emptying) might lay a foundation for GERD development. Moreover, it is common knowledge that GERD might cause various extraesophageal symptoms and complications. A possible connection between GERD and sarcoidosis, amyloidosis, hypothyroidism, r...
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
We examined associations between mortality and accelerometer-measured PA using age-relevant intensity cutpoints in older women of various ethnicities. The results support the hypothesis that higher levels of accelerometer-measured PA, even when below the moderate-intensity threshold recommended in current guidelines, are associated with lower all-cause and CVD mortality in women aged 63 to 99. Our findings expand on previous studies showing that higher self-reported PA reduces mortality in adults aged 60 and older, specifically in older women, and at less than recommended amounts. Moreover, our findings challenge th...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
We report two cases of idiopathic nodular glomerulosclerosis, one in obese hypertensive male and the other in nonhypertensive, nonobese female patient.
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
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