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Full-Text Articles in Medicine and Health Sciences
Esophageal Necrosis As An Unexpected Complication Of Diabetic Ketoacidosis, Hayden Smith, Tricia James
Esophageal Necrosis As An Unexpected Complication Of Diabetic Ketoacidosis, Hayden Smith, Tricia James
Providence Portland Medical Center Internal Medicine 2021
No abstract provided.
A Case Of Vaccine-Preventable Back Pain, Gerald Hutfles, Tricia James
A Case Of Vaccine-Preventable Back Pain, Gerald Hutfles, Tricia James
Providence Portland Medical Center Internal Medicine 2021
The Case 55-year-old male with minimal medical history who presented multiple times over 9 months with progressive and severe gluteal & back pain, ultimately found to be from anal cancer.
HPV - The Bad, Insidious Bug
What is it? •Human Papillomavirus (HPV) is a double-stranded DNA virus of the Papillomaviridaefamily. Its lifecycle is tied to epithelial tissue. Why do we care? •HPV is associated with warts (including condyloma acuminatum) and cancer •Approximately 45,000 HPV-associated cancers occur in the US each year •7,083 -anal cancer •12,143 -cervical cancer •19,975 -oropharyngeal cancer What About Anal Cancer? •Affects ~1.6/100,000 women, and 1.0/100,000 men …
Adding Incapacity To Injury: A Case Of Trauma And Central Cord Syndrome, Christopher Bender, Jesse Powell
Adding Incapacity To Injury: A Case Of Trauma And Central Cord Syndrome, Christopher Bender, Jesse Powell
Providence Portland Medical Center Internal Medicine 2021
Introduction Central cord syndrome occurs with a lesion or soft tissue injury affecting the central anatomy of the spinal cord, causing weakness more prominent in the arms than legs, and sensory abnormalities at the level of the lesion. Here I present a case of central cord syndrome caused by a traumatic fall.
Case Patient A 71 year oldman with history of ESRD, CAD, CHF, and atrial fibrillation HPI Admitted to the hospital after a syncopalevent at home with traumatic falland subsequent development of weakness Exam Weakness was greater in the upper extremities than lower extremitiesand had a left sided predominance. …
Navigating Uncertainty In A Critically Ill Patient, Brandon Tempte, Amy Dechet
Navigating Uncertainty In A Critically Ill Patient, Brandon Tempte, Amy Dechet
Providence Portland Medical Center Internal Medicine 2021
Introduction Aspergillus spores are routinely inhaled.Innate immune defenses prevent fungal growth and disease in immunocompetent individuals.However, immunocompromised patients are at risk of developing invasive aspergillosis. Diagnosis of invasive aspergillus is often difficult as biopsy is not always feasible and relies on the interpretation of non-invasive testing. Early recognition and initiation of therapy is paramount as the mortality rate is high.
Case Presentation Patient is a 59 year oldfemale with a history of alcohol abuse admitted with acute encephalopathy and new onset seizure. History: -Initially presented 3 weeks earlier for jaundice, found to have acute alcoholic hepatitis, started and discharged on …
Double The Battle: Two Cases Of Irreversible Endocrinopathies In Patients Already Fighting Metastatic Cancer., Olesya Petrenko, Nicholas L Stucky
Double The Battle: Two Cases Of Irreversible Endocrinopathies In Patients Already Fighting Metastatic Cancer., Olesya Petrenko, Nicholas L Stucky
Providence Portland Medical Center Internal Medicine 2021
INTRODUCTION: Emergence of cancer immunotherapy has instigated a new era in field of oncology and revolutionized treatment of cancer. In 2011, Immune Checkpoint Inhibitors (ICI) gained approval for treatment of advanced solid and hematological malignancies and have had remarkable results. Since being released, new cases of irreversible endocrine adverse events are increasingly becoming reported and leave patients with a new life-long diagnosis after battling metastatic cancer.
Discussion • 6 Immune Checkpoint Inhibitors (ICIs) approved: •CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) inhibitor Ipilimumab •PD-1 (programmed cell death protein 1) inhibitors nivolumab, pembrolizumab •PD-L1 (programmed cell death ligand 1) inhibitors atezolizumab, avelumab, durvalumab …
Cryptococcoma From Disseminated Cryptococcus Neoformans Infection In An Immunocompetent Patient, Megan Block, David Hotchkin, Amy Dechet
Cryptococcoma From Disseminated Cryptococcus Neoformans Infection In An Immunocompetent Patient, Megan Block, David Hotchkin, Amy Dechet
Providence Portland Medical Center Internal Medicine 2021
Background Cryptococcal infection is an infection caused by encapsulated yeasts of the Cryptococcusfungi that primarily manifests in the CNS or lungs in immunocompromised hosts. Our case describes disseminated Cryptococcus neoformansinfection and cerebral cryptococcomain an immunocompetent individual.
Case History •A 64 year-oldmale with no pertinent medical history presented to his PCP for worsening headaches for the past 2 months. •MRI: new ring enhancing lesion of the left thalamus •CT chest: bilateral upper lobe tree-in-bud nodules and a right upper lobe nodule with stippled calcification. •Lung biopsy, complicated by pneumothorax, was unremarkable. •2 days later developed headaches and nausea, became non-verbal, and …
The Peculiar Case Of Purulent Pericarditis, Laura Bennetts, Meera Jain
The Peculiar Case Of Purulent Pericarditis, Laura Bennetts, Meera Jain
Providence Portland Medical Center Internal Medicine 2021
Introduction
Purulent pericarditis is a localized purulent infection in the pericardial space •Before the era of antibiotics, purulent pericarditis was related to complications of pneumococcal pneumonia. Now more frequently associated with thoracic surgeries, immunocompromised hosts and nosocomial blood infections.1 •This case is an unusual presentation of acute methicillin-resistant staphylococcus aureus (MRSA) purulent pericarditis with a course complicated by cardiac tamponade, opiate withdrawal, and a right ventricle (RV) laceration.
Case Presentation
History of Present Illness •Patient is a 30-year-old M active intravenous drug use (IDU) with a recent history of MRSA bacteremia, endocarditis, parasternal abscess s/p I&D, and sternal osteomyelitis with …
Hormone Wars: The Thyroid Strikes Back! A Case Of Hashimoto Encephalopathy Manifesting As Diffuse Extremity Weakness And Confusion, Cody Paiva, Brinton Clark
Hormone Wars: The Thyroid Strikes Back! A Case Of Hashimoto Encephalopathy Manifesting As Diffuse Extremity Weakness And Confusion, Cody Paiva, Brinton Clark
Providence Portland Medical Center Internal Medicine 2021
Case Presentation
A 42-year-old female with a past medical history of schizoaffective disorder recently discontinued on multiple psychiatric medications, stable HIV, and hypothyroidism presented with a chief complaint of diffuse extremity weakness and Parkinsonism-like symptoms. History of Present Illness •4-month history of jerking leg movements bilaterally •2-week history of ”feeling paralyzed” with difficulty ambulating •Recent long-term hospitalization at a psychiatric facility as a ward of the state •Multiple changes to psychiatric medication regimen, including abrupt discontinuation of clozapine and risperidone •Abrupt onset confusion at facility and decreased level of interaction at facility prior to admission Exam •T 98.8F, BP 114/66, …
The Deadly Hoover: A Curiouser And Curiouser Case Of Disappearing Platelets, Rachael Starcher
The Deadly Hoover: A Curiouser And Curiouser Case Of Disappearing Platelets, Rachael Starcher
Providence Portland Medical Center Internal Medicine 2021
No abstract provided.
Fentanyl-Induced Wooden Chest Syndrome Masquerading As Severe Respiratory Distress Syndrome In Covid-19, Grace Judd, Rachael Starcher, David Hotchkin
Fentanyl-Induced Wooden Chest Syndrome Masquerading As Severe Respiratory Distress Syndrome In Covid-19, Grace Judd, Rachael Starcher, David Hotchkin
Providence Portland Medical Center Internal Medicine 2021
Case Presentation
History •47 yo M with no PMH presented with fever and respiratory distress •Admitted for COVID-19 pneumonia Hospital Course •Intubated for moderate acute respiratory distress syndrome (ARDS) on hospital day 11 •Fentanyl infusion started •Hypoxia improved within 36 hrsbut plateau pressures consistently >30 cm H2O despite minimizing dead space •Trial of airway pressure release ventilation worsened hypercarbia •Bronchoscopy w/o mucous plugging, airway collapse, or purulent secretions •Lung compliance worsened (Pplat=50 on 4 cc/kg) w/o change in oxygenation •Developed suspicion for wooden chest syndrome (WCS) and discontinued fentanyl Outcome •Pplatnadired at 16 within one hour after stopping fentanyl •Pt …