Open Access. Powered by Scholars. Published by Universities.®
- Publication Year
Articles 31 - 60 of 148
Full-Text Articles in Medicine and Health Sciences
Coronary Heart Disease And Fish Oil, Talya Spivack, Md
Coronary Heart Disease And Fish Oil, Talya Spivack, Md
The Medicine Forum
Introduction
The benefits of fish consumption on cardiovascular disease has been suggested since the early 1980s in studies that demonstrated Greenland Eskimo’s low rates of death from coronary heart disease.1 This was followed by another observational study that demonstrated the same findings in Japan.2 The proposed linkage between these two groups of people is their propensity to consume fish. Since then many studies have examined the relationship between fish consumption and coronary heartdisease (CHD) mortality rates. Current thinking suggests that the primary benefit of consuming fish is secondary to the omega-3 fatty acids found in fish oil.
Isolated Spontaneous Renal Artery Dissection, Carrie Ng, Ms Iii, Melissa Gitman, Md
Isolated Spontaneous Renal Artery Dissection, Carrie Ng, Ms Iii, Melissa Gitman, Md
The Medicine Forum
Case Report
A previously healthy 37-year-old man presented to an outside hospital with an acute onset of sharp left lower quadrant painthat radiated into his groin while mowing the lawn. The pain was continuous, lasting until the patient presented to the emergency room of his local community hospital. He denied any trauma or sudden changes in position. The patient identified no aggravating or alleviating factors for the pain. The pain was associated with nausea and one episode of bilious, non-bloodyemesis. He also noted urinary hesitancy but denied hematuria.
65-Year-Old Man With Weight Loss, Anorexia, And Distal Extremity Numbness, Leigh Van Vranken, Ms Iii, William Kim, Ms Iii, Darren N. Seril, Md, Toshimasa Okabe, Md
65-Year-Old Man With Weight Loss, Anorexia, And Distal Extremity Numbness, Leigh Van Vranken, Ms Iii, William Kim, Ms Iii, Darren N. Seril, Md, Toshimasa Okabe, Md
The Medicine Forum
Case Report
A 65-year-old Caucasian male with no significant pastmedical history presented to the emergency department with an unintentional 44-pound weight loss over a four-month period. The weight loss was preceded by fatigue and anorexia,which had been increasing for approximately eight months.In addition, he noted numbness and tingling of his hands and feet that began over the same time period. The patient was initially treated for depression with sertraline by his primarycare physician. However, his symptoms persisted without significant improvement. An initial workup at outside hospital one month prior to presentation included an abdominal CTscan, which revealed a mass in …
Idiopathic Ventricular Tachycardia Associated With Av Reciprocating Tachycardia, Charles-Lwanga K. Bennin, Md, Avinash Chandra, Md
Idiopathic Ventricular Tachycardia Associated With Av Reciprocating Tachycardia, Charles-Lwanga K. Bennin, Md, Avinash Chandra, Md
The Medicine Forum
Case Report
A forty-six year old female patient with a medical history of asthma and seasonal allergies presented with a two day history of shortness of breath, associated with palpitations. She denied chest pain or diaphoresis. Patient reported past history of similar complains that usually lasted less than two minutes and were relieved with aspirin. The longest episode of palpitations lasted approximately twenty minutes.
A 30 Year-Old Man Infectious Endocarditis And Cerebrovascular Accident, Neerav G. Sheth, Md, Joseph Desimone, Md
A 30 Year-Old Man Infectious Endocarditis And Cerebrovascular Accident, Neerav G. Sheth, Md, Joseph Desimone, Md
The Medicine Forum
Case Report
A 30 year old male with a remote history of intravenous drugabuse (IVDA) and Hepatitis C was admitted in July 2008 with changes in mental status and a new right sided paresis. According to the family, the patient was in his usual state of health until approximately 2-3 weeks prior to admission when he developed headaches, generalized malaise, and fever to 101 degrees Fahrenheit after swimming in a lake. He was seen in an outside hospital emergency department, diagnosed with otitis media and subsequently discharged on prednisoneand ciprofloxacin. The morning of admission, the patient was found naked, nonverbal, …
A Case Report Of A Pheochromocytoma Presenting With Neurological Manifestations, Nazia Shamsuddin, Md, Whitney Jackson, Md
A Case Report Of A Pheochromocytoma Presenting With Neurological Manifestations, Nazia Shamsuddin, Md, Whitney Jackson, Md
The Medicine Forum
Case Report
A 51 year-old Caucasian female with a past medical history of hypertension, coronary artery disease and cerebrovascular accident presented to the emergency room with acute onsetdysarthria and right-sided hemiparesis. The patient reported that she noticed these symptoms when she woke that morning,but had resolved by the time she reached the emergency room,an hour later. She denied experiencing palpitations, headache,chest pain or shortness of breath.
A Case Report Of A Patient With Liver, Psoas Muscle And Porta Hepatis Abscesses, Eugene Kofi Essandoh, Md
A Case Report Of A Patient With Liver, Psoas Muscle And Porta Hepatis Abscesses, Eugene Kofi Essandoh, Md
The Medicine Forum
Case Report
A 26-year-old African American male with a history of HIVand CD4 count of 507 on HAART was sent to the Emergency Department after a biopsy of a psoas muscle collection demonstrated pustular drainage. The patient reported that approximately three weeks prior to presentation he was found to have elevated liver function tests on routine labs at his primary care office. Subsequently, the patient was sent for an abdominal ultrasound and CAT scan which showed a confluence of lymphnode surrounding the porta hepatis as well as a psoas muscle collection. In review of systems, he reported chronic left-sidedweakness and …
A Woman With Syncope And Severe, Progressive Headaches, Jennifer Koterwas Ms Iv, Hind Rahmouni Md, Joanna Kipnes Md
A Woman With Syncope And Severe, Progressive Headaches, Jennifer Koterwas Ms Iv, Hind Rahmouni Md, Joanna Kipnes Md
The Medicine Forum
Case Report
A 61 year-old female who was status post-gastrectomy and chemotherapy for gastric cancer presented to the emergency department with complaints of two syncopal episodes and on going headaches for the last month. Her syncopal episodes occurred on the day of admission and five days prior and were preceded by shaking, dizziness, and a feeling of being in a“different dimension.” The losses of consciousnesses lasted for several minutes and were accompanied by shaking, but were not associated with any urinary or bowel incontinence or tongue biting. The patient denied any fevers or new medications,and felt that the episodes were …
A 50 Year-Old Homeless Man With Symptomatic Palpitations, Neerav G. Sheth Md, Daniel R. Frisch, Md
A 50 Year-Old Homeless Man With Symptomatic Palpitations, Neerav G. Sheth Md, Daniel R. Frisch, Md
The Medicine Forum
Case Report
The patient is a 50-year old man with Hepatitis C, HIV, and pneumonia who recently became homeless and presented with 3 days of worsening palpitations and shortness of breath.Initially the palpitations were sporadic; however, they had become more frequent over the three days prior to admission.He had a corresponding increase in shortness of breath along with significant decreases in his exercise tolerance. He presented to the Emergency Department (ED) when he could no long perform his usual activities of daily living. In the ED, patientwas found to have a narrow complex tachycardia with a rate of 234 beats …
Use Of Transpulmonary Thermodilution To Measure Extravascular Lung Water Index In A Ventilated Patient, Gunjan L. Shah, Md, Susan Ndicu, Md
Use Of Transpulmonary Thermodilution To Measure Extravascular Lung Water Index In A Ventilated Patient, Gunjan L. Shah, Md, Susan Ndicu, Md
The Medicine Forum
A 61-year-old morbidly obese woman first presented to a community hospital with complaints of feeling “unwell” for 2 weeks. Her family reported that she had been having increasing fatigue, diarrhea, nausea, and vomiting for that period, as wellas “dusky” fingers and toes. Prior to this time, she had noticed a runny nose, cough, and “bluish” toes for about 3 weeks. On presentation, she was hypotensive with a systolic blood pressurein the 50’s mmHg and tachycardic to 115 beats per minute(bpm), but afebrile. Her creatinine was found to be 12 mg/dL from an unknown baseline. Treatment was initiated in the Emergency …
The “Great Imitator” Presents With Abnormal Liver Enzymes, Ikumi Suzuki, Ms Iv, Nicholas Orfanidis, Md, Stephanie Moleski, Md, Leo C. Katz, Md, David Kastenberg, Md
The “Great Imitator” Presents With Abnormal Liver Enzymes, Ikumi Suzuki, Ms Iv, Nicholas Orfanidis, Md, Stephanie Moleski, Md, Leo C. Katz, Md, David Kastenberg, Md
The Medicine Forum
Case Report
A 28 year-old male was referred to the gastroenterology clinic for evaluation of abnormal liver enzymes. Three months prior to presentation he was evaluated at a local emergency department for vomiting and upper abdominal pain. He described pain as epigastric and worse after eating. He denied fever, chills orchanges in his urine. At that time, the patient was not jaundiced but reported having a rash. Laboratory testing was remarkablefor elevated liver enzymes (Table 1). The patient was advised to follow up with his primary care physician. Though his symptoms resolved without medical therapy, liver enzymes obtained a few …
Histiocytic Sarcoma: A Case Of A 52-Year-Old Female With Two Synchronous Primary Malignancies At Presentation, Ryan D. Gentzler, Md, Daron A. Kahn, Md
Histiocytic Sarcoma: A Case Of A 52-Year-Old Female With Two Synchronous Primary Malignancies At Presentation, Ryan D. Gentzler, Md, Daron A. Kahn, Md
The Medicine Forum
Case Report
A 52-year-old female with a past medical history of chronicobstructive pulmonary disease, coronary artery disease, andan 80-pack-year smoking history presented to the emergency room with complaints of right upper extremity weakness and imbalance while walking for the previous two days. She stated that the onset was abrupt and progressively worsening to the point where she could no longer lift her right upper extremityagainst gravity. She maintained the ability to move her hand and grasp, but admitted to decreased strength and decreased dexterity of her right hand. She denied changes in vision. She also denied having bowel or bladder …
Anomalous Origin Of Right Coronary Artery, Neerav G. Sheth Md, Siva K. Kumar, Md
Anomalous Origin Of Right Coronary Artery, Neerav G. Sheth Md, Siva K. Kumar, Md
The Medicine Forum
Introduction
Anomalous coronary arteries are rare but potentially life threatening abnormalities of the coronary circulation. Many ofthe variations can be benign in nature; however, some may lead to myocardial ischemia and/or sudden cardiac arrest.1 The most common anomalies described in the medical literature involve branches of the left coronary artery, with the left circumflexartery originating from the right sinus of Valsalva being the most prevalent. Patients may present at any age with symptoms ranging from syncope to sudden cardiac death. Here we present a case of a patient with anomalous right coronary arterycirculation (RCA) who presented with atypical chest pain.
A 54 Year-Old Male With Cholangiocarcinoma And Biliary Sepsis, Leela Nayak, Md, Bhalaghuru Chokkalingam Mani, Md
A 54 Year-Old Male With Cholangiocarcinoma And Biliary Sepsis, Leela Nayak, Md, Bhalaghuru Chokkalingam Mani, Md
The Medicine Forum
Case Report
A 54 year-old male with a past medical history of cholangiocarcinoma and portal vein thrombosis was admitted to an outside hospital with right-sided abdominal pain, leukocytosis and hyperbilirubinemia. Prior to admission, he received 3 cycles ofgemcitabine however his tumor had increased in size leading to development of obstructive jaundice. At the hospital, his pain was attributed to hepatomegaly and biliary obstruction secondary to tumor size. He was started on Zosyn for presumed diagnosisof pneumonia and leukocytosis. He was then transferred toThomas Jefferson Hospital for a second opinion regarding his malignancy.
Upon transfer, patient noted right upper quadrant abdominal …
A 67 Year-Old Man With Fatigue, Sam Barasch, Ms Iv, Ajay Wagh, Md
A 67 Year-Old Man With Fatigue, Sam Barasch, Ms Iv, Ajay Wagh, Md
The Medicine Forum
Case Report
A 67 year-old male with a past medical history of hypertensionand insulin-dependent type II diabetes complicated byneuropathy, retinopathy, and chronic kidney disease presentedto the hospital with a complaint of fatigue. The patient notedgeneralized weakness that had begun the morning of admissionafter two days of malaise and subjective fever. This weaknessprevented him from being able to rise from a sitting position,resulting in a fall off the couch. He denied injury from this fallalong with shortness of breath or chest pain, however, he didadmit to two episodes of vomiting the day prior to admission.
The patient was taking the following …
A 19 Year-Old Man With Chest Pain, Sam Barasch, Ms Iv, Sugeet Jagpal, Md
A 19 Year-Old Man With Chest Pain, Sam Barasch, Ms Iv, Sugeet Jagpal, Md
The Medicine Forum
Case Report
A 19-year-old man with no past medical history presented tothe ER with a sore throat, cough, and pleuritic chest pain. Thepatient had been well until 1 month before admission, whenhe developed a sore throat and felt ill. He presented to theemergency department twice for these symptoms. On the first visit, the patient had a positive rapid strep test. He was diagnosedwith strep throat and treated with penicillin IM. However, hissore throat persisted. Five days before admission, the patientdeveloped a non-productive cough. One day prior to admissionhe developed severe right sided chest pain that was throbbing,pleuritic, and radiated to …
A Case Of Babesiosis Complicated By Hepatic And Renal Failure, Steven Krawitz Ms Iv, Nilay Kavathia Md, Pratik Choksy Mbbs
A Case Of Babesiosis Complicated By Hepatic And Renal Failure, Steven Krawitz Ms Iv, Nilay Kavathia Md, Pratik Choksy Mbbs
The Medicine Forum
Case Report
A 67-year-old male with a past medical history of chronic kidneyinsufficiency, splenectomy, and recurrent babesiosis infectionwas transferred to with jaundice and abdominal pain.The patient initially presented to an outside hospital (OSH) withgeneralized weakness, chills, and gastrointestinal symptoms andwas found to have Babesia on peripheral blood smears. The patient received seven days of azithromycin and atovaquone,followed by three days of clindamycin and quinine sulfate.The patient was discharged home with improved symptomsand a negative peripheral blood smear. Less than 24 hourslater he returned to the OSH with worsening myalgias andabdominal pain. Physical exam was significant for jaundiceand hepatomegaly. Laboratory data …
A Case Of Acute Spontaneous Tumor Lysis Syndrome And New Diagnosis Of Burkitt’S Lymphoma, Ryan D. Gentzler, Md
A Case Of Acute Spontaneous Tumor Lysis Syndrome And New Diagnosis Of Burkitt’S Lymphoma, Ryan D. Gentzler, Md
The Medicine Forum
Introduction
Tumor lysis syndrome is a well-described phenomenoncharacterized by elevated serum levels of calcium, uric acid,potassium, phosphate, and lactate dehydrogenase due to lysis oftumor cells and release of intracellular contents. Acute kidneyinjury may occur as the result of precipitation of intrarenalcalcium phosphate salts related to the rapid destruction ofa large number of tumor cells.1 Tumor lysis syndrome mostoften occurs during induction chemotherapy for aggressiveleukemia or lymphoma, particularly those with large tumorburden.1 While tumor lysis syndrome is more commonly seenin patients receiving chemotherapy, it can occur spontaneouslyand has been described in aggressive malignancies, such asAML,2 Burkitt’s lymphoma in children1 and adults,3 …
Images In Clinical Medicine: Erythema Migrans, Jack Stewart Md, Luis Taboada Md, Joanne Kim Md
Images In Clinical Medicine: Erythema Migrans, Jack Stewart Md, Luis Taboada Md, Joanne Kim Md
The Medicine Forum
Case Report
Patient is a 30 year old male, with no significant past medicalhistory, who was attending an outdoor party in a wooded areaof New Jersey two weeks prior to this hospital admission. Threedays following the party, patient noted several papules on hislateral left calf with surrounding erythema. The following dayhe went to the emergency department and was diagnosed withbacterial cellulitis (Figure 1).
Management Of An Unresponsive Patient With Severe Acidosis, Nnaemeka Anyadike, Md, Christie Crawford, Md
Management Of An Unresponsive Patient With Severe Acidosis, Nnaemeka Anyadike, Md, Christie Crawford, Md
The Medicine Forum
Case Report
Congestive heart failure (CHF) is a chronic medical condition whoseincidence is rising. The prevalence of CHF is approximately 1% to3% in Western countries.1 Despite innovations in medical therapy,CHF is associated with high morbidity and mortality rates.2
CHF patients commonly experience muscle weakness andfatigue as two major symptoms. An altered intracellularhandling of ionized calcium has been suggested to play a vitalrole in impaired myocardial contraction.3 In isolated myocytesfrom patients with end stage heart failure, systolic ionizedcalcium levels were markedly decreased, while diastolic levelswere elevated as compared to healthy controls.4 In addition,digitalis and beta-blocker medical therapy is frequently usedin CHF …
Acquired Hemophilia A: A Case Report, Gunjan Shah, Md, Ajay Kandra, Md, Douglass A. Drelich, Md
Acquired Hemophilia A: A Case Report, Gunjan Shah, Md, Ajay Kandra, Md, Douglass A. Drelich, Md
The Medicine Forum
Case Report
A 61-year-old African American male, with a past medicalhistory of asthma and benign prostatic hypertrophy, presentedfrom an outside hospital with complaints of hematuria andhematemesis. He had initially noted increased bruising twomonths prior to admission. He also had symptoms suggestive ofa non-traumatic thigh hematoma the month prior. He developedhematuria one month prior to admission and underwent anoutpatient cystoscopy one week prior to admission whichwas non-diagnostic. Cystoscopy was repeated on the day ofadmission localizing the hemorrhage to his right kidney with abiopsy specimen suggesting a low-grade papillary neoplasm. Thepatient subsequently developed hemetemesis. Emergent esophagogastroduodenoscopy(EGD) at the outside hospital revealeda Mallory-Weiss …
A Case Of An Atypical, Community Acquired Pneumonia: A Case Summary And Topic Review, David P. Cork Ms Iv, Joanne Kim Md, Jie Cui, Md
A Case Of An Atypical, Community Acquired Pneumonia: A Case Summary And Topic Review, David P. Cork Ms Iv, Joanne Kim Md, Jie Cui, Md
The Medicine Forum
Case Report
A 59 year old gentleman with a past medical history ofhypertension, hyperlipidemia, anxiety, depression, arthritis,and hypothyroidism presented with a five day history of feverto 102º F. He complained of a three-day history of nausea,vomiting, and non-bloody, loose diarrhea, all of which hadbeen persistent and worsening over the past week. Over thepast two days, the patient had felt short of breath, and presentedin a state of severe dyspnea. He had experienced an indolentcourse of illness, but was now concerned with his tachynpea andwheezing, and he had developed a productive cough with a smallamount of yellow-brown sputum. He denied any …
Perioperative Beta-Blockers: Where Do We Stand?, Li Shien Low, Md, Jennifer Heckman, Ms Iii, Matthew Decaro, Md
Perioperative Beta-Blockers: Where Do We Stand?, Li Shien Low, Md, Jennifer Heckman, Ms Iii, Matthew Decaro, Md
The Medicine Forum
Introduction
Cardiovascular disease is a significant cause of morbidityand the leading cause of mortality in both the United Statesand worldwide.1,2 Given the considerable burden of disease,cardiac risk assessment is an especially important elementof preoperative evaluation prior to noncardiac generalsurgery.3 Globally, an estimated 100 million adults undergononcardiac surgery each year,4 more than one third of whomhave underlying coronary artery disease (CAD).5 Cardiaccomplications, including cardiac death, nonfatal myocardialinfarction (MI), and nonfatal cardiac arrest, represent majorcauses of peri- and postoperative morbidity and mortality.6The incidence of such cardiac complications is an estimated1.4% in relatively unselected patients,7 with an even greaterincidence (2.4 – 5.8%) among …
Acute Pancreatitis With Normal Amylase And Lipase, Kichul Ko, Md, Luz Catherine Tello, Md, Jessica Salt, Md
Acute Pancreatitis With Normal Amylase And Lipase, Kichul Ko, Md, Luz Catherine Tello, Md, Jessica Salt, Md
The Medicine Forum
Introduction
Acute pancreatitis is diagnosed by clinical history and physicalexamination with concurrent elevations in serum amylase andlipase levels; occasionally radiographic findings are of furtherassistance. We report a case of radiographically proven acutepancreatitis with normal serum amylase and lipase levels.
Table Of Contents, The Medicine Forum, Volume 11, 2009
Table Of Contents, The Medicine Forum, Volume 11, 2009
The Medicine Forum
Table of Contents, The Medicine Forum, Volume 11, 2009
From The Editors, Anastasia Shnitser, Md, Ankitkumar Patel, Md, Tina Shah, Md, Andrew Foy, Md, Sameh Gaballa, Md, Laura Setlur, Md, Whitney Jackson, Md, Andrew Lerner, Md, Bhala Chokkalingam Mani, Md
From The Editors, Anastasia Shnitser, Md, Ankitkumar Patel, Md, Tina Shah, Md, Andrew Foy, Md, Sameh Gaballa, Md, Laura Setlur, Md, Whitney Jackson, Md, Andrew Lerner, Md, Bhala Chokkalingam Mani, Md
The Medicine Forum
As the Jefferson Forum embarks on its 11th issue a number of additions have beeninstituted. First, we are proud to announce new faculty collaborators with Dr. StevenHerrine, Dr. Danielle Duffy, Dr. Daniel Frisch, Dr. Anjali Avadhani, Dr. JosephDesimone and Dr. Edward Ruby.
Our faculty has helped us with creating a new section of outstanding articles thatwe introduce in this issue. The “Best Of” designation allows us to highlight articlesthat were chosen by peer and faculty review as the best example of academic worksubmitted in each field of medicine. We hope that this addition will inspire moreresidents and faculty to get …
From The Desk Of The Residency Program Director, Gregory C. Kane Md, Facp, Fccp
From The Desk Of The Residency Program Director, Gregory C. Kane Md, Facp, Fccp
The Medicine Forum
To Friends of the Department of Medicine:
The Thomas Jefferson University Hospital Internal Medicine Residency Program wasinformed this past February by the RRC that it has received Continued Accreditationwith a 5 year cycle length – the longest cycle length awarded for compliance withessential elements of training in Internal Medicine as mandated by the ACGME.The program’s next visit will be in 2015. This is the third straight highly successfulaccreditation review for the program and the third straight 5 year cycle awarded.
Download Entire Issue-The Medicine Forum, Volume 10, 2008
Download Entire Issue-The Medicine Forum, Volume 10, 2008
The Medicine Forum
Download entire issue-The Medicine Forum, Volume 10, 2008.
Painless Jaundice, Nilay Kavathia, Md
Painless Jaundice, Nilay Kavathia, Md
The Medicine Forum
When dealing with jaundice that is painless,
Your thinking should not be aimless.
Clinical Images: Colorectal Foreign Body, Stephen Koczirka, Msiv, Anastasia Shnitser, Md, Dina Halegoua-De Marzio, Md
Clinical Images: Colorectal Foreign Body, Stephen Koczirka, Msiv, Anastasia Shnitser, Md, Dina Halegoua-De Marzio, Md
The Medicine Forum
Case Presentation
A 42 year-old male was admitted to the hospitalwith a known retained foreign body. A can ofshaving cream was inserted into the patient’srectum several days prior to presentation. Onadmission, an abdominal radiograph (Figure1) was taken to confirm the position of theforeign body and the absence of free air inthe abdomen. The patient was taken to theoperating room and under local anesthesiaunderwent successful transanal removal ofthe aerosol can using tenaculum forceps.There was no evidence of bowel perforation.The patient was transferred to the recoveryroom in stable condition.