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Acute Hiv, Rhabdomyolysis, Renal Failure, And Hepatitis: A Case Report, Eve R. Merrill, Md

The Medicine Forum

Case Report

A 19 year old African-American male with no significant past medical history presented to an outside hospital with two days of diffuse abdominal pain, myalgias, muscle weakness, and darkurine. Two weeks prior to presentation, the patient was treated as an outpatient with an unknown antibiotic for symptoms of a sore throat, nausea, and non-bloody, non-bilious emesis. The patient denied any sick contacts, recent travel, trauma, strenuousexercise, or the use of non-steroidal anti-inflammatory drugs, acetaminophen, alcohol, or illicit drugs. The patient reported being sexually active with one female partner and had no historyof sexually transmitted infections. The patient was …

Download Entire Issue-The Medicine Forum, Volume 11, 2009

The Medicine Forum

Download entire issue-The Medicine Forum, Volume 11, 2009

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, …

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

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 …

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 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 …

Table Of Contents, The Medicine Forum, Volume 11, 2009

The Medicine Forum

Table of Contents, The Medicine Forum, Volume 11, 2009

Changes In Life History Within An Individual's Lifetime, Eric J. Billman

Theses and Dissertations

A central goal of life history theory is to understand the selective factors that generate the diversity of reproductive patterns observed in nature. Within lifetime changes in reproductive investment will determine an organism's fitness; however, this area of life history theory has received less attention than comparisons among population that characterize life history traits as a single population mean. Reproductive allocation can be affected by multiple cues; the integration of these cues across an organism's lifetime generates the diversity in life history strategies observed in nature. Life history studies should examine the interacting effects of multiple cues on life history …

The Non-Infectious Disease Implications Of Bed Bug Infestations, Christopher T. Balster

Master of Public Health Program Student Publications

The purpose of this study was to determine the prevalence of bed bug infestations throughout Ohio, whether the non-infectious disease implications of infestations are public health concerns, and also determine the perceived ability of public health departments to respond to outbreaks within their jurisdiction. A descriptive study was performed using survey data obtained from 79 local public health departments throughout Ohio. Overall, 79.05% of individuals surveyed agreed that bed bug outbreaks are a public health concern. The mode of responses regarding whether or not the non-infectious disease concerns of infestations are a public health concern was 4 on a scale …

Download Entire Issue-The Medicine Forum, Volume 10, 2008

The Medicine Forum

Download entire issue-The Medicine Forum, Volume 10, 2008.

Man With Swollen Eye, Blurred Vision, And Fevers In The Setting Of Newly Diagnosed Mds, Rory Bowers, Md

The Medicine Forum

Case Presentation

An 82 year-old male with a past medical history of prostatecancer, atrial fibrillation, gout, and recently diagnosed myelodysplasticsyndrome presented with a chief complaint of left eyepain. The patient also reported peri-orbital numbness, swelling,and clear discharge as well as episodic blurry vision of his lefteye. Over the previous two months he had been admitted to thehospital multiple times complaining of cough and high feversand was subsequently treated with several courses of antibioticsfor presumed pneumonia. During the initial admission forpneumonia he was noted to have a relative pancytopenia. Abone marrow biopsy was eventually undertaken revealing adiagnosis of myelodysplastic syndrome (MDS).

A Case Of Severe Anemia In An Aids Patient, Amy K. Slenker, Md, Rahul Anand, Md

The Medicine Forum

Case Presentation

A 49 year-old African-American male presented to ThomasJefferson University Hospital in April of 2008 complaining ofgeneralized weakness and lightheadedness for 4 months. Thepatient had a medical history of HIV/AIDS diagnosed in 2002with a CD4 count of 0 cells/mm3 in 2005 and a history of noncompliancewith highly active retroviral therapy (HAART). InDecember of 2007 the patient was diagnosed with cryptococcalmeningitis and had a concomitant anemia with a hemoglobinof 5.3 g/dL. At that time laboratory studies for parvovirus B19(PB19) showed an IgG of 0.79 units and an IgM of 0.63 units( a value less than 0.89 is considered negative). PB19 …

A 57 Year-Old Man With Prolonged Shortness Of Breath And Fevers, Loren Chen, Md

The Medicine Forum

Case Presentation

A 57 year-old Caucasian male was initially admitted to MethodistHospital from an outside hospital for dehydration, increasedheart rate, and weight loss. He has a past medical history ofcoronary artery disease status post myocardial infarction andcoronary artery bypass graft, congestive heart failure, paroxysmalatrial fibrillation on coumadin, diabetes type II on insulin, andan orthotopic liver transplant in 1997 for end-stage liver diseasesecondary to hepatitis C virus and alpha-1 antitrypsin disorder.

A Man With Invasive Community Acquired-Mrsa Infection In The Icu Setting, Jason Korenblit, Md, Mba

The Medicine Forum

Case Presentation

A 66 year-old male presented to the emergency department (ED)with complaints of two days of shortness of breath and pruritis.The patient claimed that he had not had regular medical care formore than 15 years and admitted to no past medical history orchronic medications. One week prior, he reported an itchy rashon both his forearms. He sought treatment at a local free clinicand received a low-potency steroid cream which he used withoutrelief. While at a family event, he became increasingly dyspneicand was brought to the ED by his family. He reported no surgicalhistory and no drug allergies or food …

Case Reports A 31 Year-Old Man With Chest Pain, Rash, And Ekg Changes, Neerav Sheth, Md,, Rahul Anand, Md, Matthew Stopper, Md

The Medicine Forum

Case Presentation

A 31 year-old Caucasian male with no significant past medicalhistory presents with increasing dizziness, chest pain, andshortness of breath of one day duration. On returning from acamping trip to Northern Pennsylvania three weeks prior toadmission, he noted high fevers, “joint pains all over,” and a pinkblotchy rash all over his chest and back. He did not recall anyinsect, tick or animal bites. His primary physician, who clinicallysuspected Lyme disease, ordered Lyme serologies and offered aprescription for doxycycline which the patient declined. Twoweeks later, the patient presented to the emergency departmentafter the onset of chest pain that he described …

Tjuh Adherence To Idsa Guidelines For The Treatment Of Cryptococcal Meningitis, Matthew Grant, Md

The Medicine Forum

Introduction

Cryptococcal meningitis is an infectious complication of immunecompromised states that carries a high rate of mortality orrelapse. Although Infectious Disease Society of America (IDSA)guidelines outline the recommended treatment regimen forcryptococcal meningitis, clinicians take a heterogenous clinicalapproach. This study examines the use of antifungal regimens intreating cryptococcal meningitis at a tertiary care hospital.

Modeling Techniques For The High-Resolution Interpretation Of Cryo-Electron Microscopy Reconstructions, Mirabela Rusu

Dissertations and Theses (Open Access)

Essential biological processes are governed by organized, dynamic interactions between multiple biomolecular systems. Complexes are thus formed to enable the biological function and get dissembled as the process is completed. Examples of such processes include the translation of the messenger RNA into protein by the ribosome, the folding of proteins by chaperonins or the entry of viruses in host cells. Understanding these fundamental processes by characterizing the molecular mechanisms that enable then, would allow the (better) design of therapies and drugs. Such molecular mechanisms may be revealed trough the structural elucidation of the biomolecular assemblies at the core of these …

Building Bridges From Incarceration To Community College: Personal And Professional Reflections On Young Black Men’S Journey From The ‘Inside’ Out, Jeff Mcgoy

Research Papers

No abstract provided.

Man With Malaria In Delaware, Benjamin Ngo, Md

The Medicine Forum

Case Presentation

A 37-year-old African American male presented to the hospital complaining of high fevers over the past two weeks associated with severe posterior headache. He described having had a very poor appetite recently, but denied any cough, abdominal pain, diarrhea, or urinary symptoms. He did not recall sustaining any head trauma. He did relate, however, that he had recently returned from a three-month trip to Kenya ~1 month prior to this presentation. He had no past medical history and was not on any medications. He did not use IV drugs. Physical exam confirmed a fever of 102.1o F though …

Woman With Aids And Status Epilepticus, Bonnie Callahan, Md

The Medicine Forum

A 42 year-old female with a medical history of HIV presented to the Emergency Department with nausea and vomiting for the past five days. Six days prior to presentation, she had one week of symptoms of progressive dyspnea and non-productive cough which were evaluated by her primary care physician. At that time, blood work revealed a CD 4 count of 150 cells/mm3 and a chest x-ray was suggestive of pneumonia. She was given a prescription of trimethoprim-sulfamethoxazole (TMP/SMX) and guaifenesin with codeine. Within twenty-four hours of starting the prescribed medications, she developed nausea and vomiting, and she stopped taking both …

Fool, Marshall Fleurant, Md

The Medicine Forum

They say God protects fools and the innocent

They say God protects the innocent and the souls of children

Unfortunately the years of childhood has passed me

I doubt that God looks upon me as innocent

So I pray to be the fool

Woman With Relapsing Fevers, Mary Kate Mccullen, Md

The Medicine Forum

A 50 year-old Nigerian woman with a past medical history significant for type II diabetes and hypertension presented to the ED with a chief complaint of recurrent fevers and chills. The patient was in her usual state of health until approximately 6 weeks prior to admission, while during a visit with family in Nigeria she noted the onset of high fevers and general malaise. Initially, her fevers occurred daily for a period of one week, and were associated with chills, fatigue, loss of appetite, and myalgias. During this time, she was not evaluated by a physician, nor did she take …

Herpes Zoster Ophthalmicus With Third Nerve Palsy, Bonnie Callahan, Md, Utpal Sagar, Md, Ted Martynowicz, Do

The Medicine Forum

Introduction

Herpes zoster is a recurrent infection of the varicella-zoster virus. When it infects the periorbital region, the virus often involves the ocular structures, and may lead to more disastrous sequelae, including blindness. Despite advancements, including immunization and antiviral therapy, zoster ophthalmicus persists in the population. Therapy mitigates, but does not obviate, many of the complications of infection. Our paper describes a patient with herpes zoster ophthalmicus that presented from the community.

Structures Of Poliovirus And Antibody Complexes Reveal Movements Of The Capsid Protein Vp1 During Cell Entry, Jun Lin

Theses and Dissertations

In the infection process, native poliovirus (160S) first converts to a cell-entry intermediate (135S) particle, which causes the externalization of capsid proteins VP4 and the N-terminus of VP1 (residues 1-53). The externalization of these entities is followed by release of the RNA genome, leaving an empty (80S) particle. Three antibodies were utilized to track the location of VP1 residues in different states of poliovirus by cryogenic electron microscopy (cryo-EM). "P1" antibody binds to N-terminal residues 24-40 of VP1. Three-dimensional reconstruction of 135S-P1 showed that P1 binds to a prominent capsid peak known as the "propeller tip". In contrast, our initial …

Exome-Wide Dna Capture And Next Generation Sequencing In Domestic And Wild Species, Albano Beja-Pereira, Shanyuan Chen, Theodore F. Cosart, Gordon Luikart, Sarah B. Ng, Jay Shendure

Biological Sciences Faculty Publications

Our understanding of the molecular, genetic basis of adaptations and phenotypic differentiation among individuals will advance quickly thanks to new molecular techniques. This understanding is crucial given that accelerating environmental change and human population growth are increasingly threatening natural populations of fish and wildlife as well as increasing demands for agricultural production in domesticated species. This makes it urgent in many wild and domestic species to investigate the genetic basis of fitness, adaptation, and disease resistance [1], and to discover adaptive genes and speciation genes, i.e., the "loci of evolution" [2].

Bjc Today

BJC Today

No abstract provided.

Medical School Watercooler Newsletter - July 3, 2011, Lindsey Lyle

Watercooler Newsletter

This is the July 3, 2011 edition of the Frederick P. Whiddon College of Medicine's newsletter, Watercooler

Contents Include

• USA College of Medicine Hosts Inaugural Crampton Trust Lecture in Geriatric Medicine

• Students, Residents and Faculty Named to USA Chapter of Gold Humanism Honor Society

• USA College of Medicine Welcomes Dr. Haidee Custodio

• Dr. Frye Retires After 17 Years of Service

Clinic Connection: Summer 2012, Centracare Clinic

Clinic Connection

• President’s Message: "Are you different or am I?"
• Medical issues are more than adherence and affordability
• Preparing for the transition from ICD-9 to ICD-10
• Introducing our new CentraCare Clinic Specialists
• Balancing religious beliefs with health needs
• Immunization refusal brings challenges to physicians
• Clinic provides follow-up care for at-risk infants, children

Prescribed Reading: July 2011, Centracare Clinic

Prescribed Reading

• Health Care Matters: “Oh, the places you’ll grow!”
• Sharing Common Values
• Patient Satisfaction Scorecard
• Welcome to these new employees
• Recognition for years of service
• Congratulations and best wishes!
• Welcome to our new providers
• Reminder for employees
• Welcome to our new Sauk Centre providers
• Dr. Johnson recognized for excellence
• River Campus is getting a facelift!