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Pathological Conditions, Signs and Symptoms Commons

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Retiform Hemangioendothelioma: A Case Series And Review Of The Literature, Qurratulain Chundriger, Muhammad Usman Tariq, Shabina Rahim, Jamshid Abdul-Ghafar, Nasir Ud Din 2021 Aga Khan University

Retiform Hemangioendothelioma: A Case Series And Review Of The Literature, Qurratulain Chundriger, Muhammad Usman Tariq, Shabina Rahim, Jamshid Abdul-Ghafar, Nasir Ud Din

Department of Pathology and Laboratory Medicine

Background: Retiform Hemangioendothelioma (RH) is an extremely rare vascular tumor of intermediate biological behavior, which is prone to local recurrence but rarely shows metastasis to distant sites. It may harbor areas resembling Dabska tumor in some cases and angiosarcoma, which in its well differentiated form may exhibit similar pathological appearance in some areas, making it problematic to rule out a possibility of a malignant diagnosis on a core biopsy. Therefore, complete surgical resection with negative margins is essential for accurate diagnosis and local control.
Results: In our series, two of the three Pakistani cases were in females, with an age ...


A Surrogate Frax Model For Pakistan, G Naureen, H Johansson, Romaina Iqbal, Lena Jafri, Aysha Habib Khan, Masood Umer, E Liu, L Vandenput, M Lorentzon, N C. Harvey, E V. McCloskey, J A. Kanis 2021 University of Melbourne, Melbourne, Australia

A Surrogate Frax Model For Pakistan, G Naureen, H Johansson, Romaina Iqbal, Lena Jafri, Aysha Habib Khan, Masood Umer, E Liu, L Vandenput, M Lorentzon, N C. Harvey, E V. Mccloskey, J A. Kanis

Community Health Sciences

A surrogate FRAX® model for Pakistan has been constructed using age-specific hip fracture rates for Indians living in Singapore and age-specific mortality rates from Pakistan.
Introduction: FRAX models are frequently requested for countries with little or no data on the incidence of hip fracture. In such circumstances, the International Society for Clinical Densitometry and International Osteoporosis Foundation have recommended the development of a surrogate FRAX model, based on country-specific mortality data but using fracture data from a country, usually within the region, where fracture rates are considered to be representative of the index country.
Objective: This paper describes the development ...


Eccrine Spiradenoma: A Rare Adnexal Tumour With Atypical Presentation: A Case Report, Adnan Salim, Muhammad Usman Tariq, Sana Zeeshan 2021 Aga Khan University

Eccrine Spiradenoma: A Rare Adnexal Tumour With Atypical Presentation: A Case Report, Adnan Salim, Muhammad Usman Tariq, Sana Zeeshan

Section of Neurosurgery

First described in 1934, eccrine spiradenoma (ES) is a rare, benign adnexal tumour arising from eccrine sweat glands. It commonly presents as a slow-growing nodule on the upper trunk, and head and neck region, mostly in the age bracket of 15-35 years, with no gender preference. While no established guidelines exist for optimal management of malignant ES, some therapies have been studied. The diagnosis of this entity is extremely important as it can harbour a malignant component with disastrous outcomes which may be missed due to its strong resemblance to benign lesions, such as a papilloma. Here, we present the ...


40-Year-Old Female With Sudden Onset Dyspnea, Breanna M. Kebort, Aleta Hong, Laura J. Bontempo, Zachary D. W. Dezman 2021 University of Maryland Medical Center

40-Year-Old Female With Sudden Onset Dyspnea, Breanna M. Kebort, Aleta Hong, Laura J. Bontempo, Zachary D. W. Dezman

Open Access Publications by UMMS Authors

A 40-year-old female presented to the emergency department (ED) after the acute onset of dyspnea. The patient was tachypneic with accessory muscle usage and diffuse wheezing on initial examination. Despite aggressive treatment, the patient deteriorated and was intubated. This case takes the reader through the differential diagnosis and systematic workup of a patient presenting to the ED with dyspnea and arrives at the unexpected cause for this patient's presentation.


Association Of Presenting Symptoms With Abnormal Laboratory Values For Vector-Borne Illness — Experience In An Urban Gastroenterology Practice, Michael D. Erdman, Niloofar Kossari, Jessica Ye, Kristen H. Reynolds, Emily Blodget, B. Robert Mozayeni, Farshid Sam Rahbar 2021 Los Angeles Integrative Gastroenterology & Nutrition

Association Of Presenting Symptoms With Abnormal Laboratory Values For Vector-Borne Illness — Experience In An Urban Gastroenterology Practice, Michael D. Erdman, Niloofar Kossari, Jessica Ye, Kristen H. Reynolds, Emily Blodget, B. Robert Mozayeni, Farshid Sam Rahbar

Journal of Patient-Centered Research and Reviews

Background: In the clinical setting, it is not common practice to consider a vector bite, such as from a tick or flea, to be a contributing factor to chronic digestive symptoms. This article investigates associations we have observed among symptomatic patients and positive blood tests for vector-borne illness (VBI).

Methods: Patients who visited an urban gastroenterology clinic over a 3-year period were retrospectively reviewed. A total of 270 patients presenting with a constellation of digestive symptoms — and who had no apparent digestive pathology and reported no prior diagnosis or treatments for VBI — were analyzed. Before the initial visit, all patients ...


An Examination Of Loop Diuretic Use In The Setting Of Acute Kidney Injury, Steven Jacobsen 2021 Iowa State University

An Examination Of Loop Diuretic Use In The Setting Of Acute Kidney Injury, Steven Jacobsen

Creative Components

Acute kidney injury is defined as a sudden reduction in GFR and is commonly diagnosed in critically ill patients. A lack of consensus regarding diagnostic criteria has made studying acute kidney injury a difficult task, and no standard of care currently exists in the literature. Historically, loop diuretics have been used as a primary mode of treatment in an attempt to restore normal renal function; however, limited studies have shown that treatment with loop diuretics does not improve renal function and may even increase the risk of in-hospital mortality. The goal of this paper is to review essential renal physiology ...


Goblet Cell Carcinoma Of The Appendix: A Case Report On Goblet Cell Carcinoid, Sheliza Kabani, Aubtin Saedi, Austin Lehr, Lina O'Brien 2020 Menorah Medical Center

Goblet Cell Carcinoma Of The Appendix: A Case Report On Goblet Cell Carcinoid, Sheliza Kabani, Aubtin Saedi, Austin Lehr, Lina O'Brien

HCA Healthcare Journal of Medicine

Goblet cell carcinoid of the appendix is a rare neoplasm with histological features of both neuroendocrine and adenocarcinomas. The combination of its aggressive behavior, infrequent occurrence, and variable clinical presentation convolutes the management of this tumor. We report the case of a 75-year-old female presenting with acute appendicitis. A laparoscopic appendectomy was performed. The pathology report showed goblet cell carcinoid at the base of the appendix with involvement of the proximal surgical margins. At her postoperative visit, the patient’s pathology report and options for management were reviewed, and the patient agreed to proceed with a right hemicolectomy 8-10 weeks ...


Cutaneous Malignant Melanoma: A Synthesis On Updated Guidelines For The Primary Care Perspective, Seetha Venkateswaran, Nicholas D'Angelo 2020 Orange Park Medical Center

Cutaneous Malignant Melanoma: A Synthesis On Updated Guidelines For The Primary Care Perspective, Seetha Venkateswaran, Nicholas D'Angelo

HCA Healthcare Journal of Medicine

Cutaneous malignant melanoma (CMM) is a condition wherein malignant cells form in the melanocytic cells. CMM is a potentially lethal form of skin cancer, commonly found in sun-exposed areas of the body. There are multiple risk factors for disease development, such as genetic mutation and UV radiation among others. Diagnosis and staging is important in determining disease morbidity and mortality. The United States Preventive Services Task Force (USPSTF) and the American Academy of Dermatology (AAD) have their respective guidelines and consensus on diagnosis, staging and treatment. It is imperative to delineate and educate primary care physicians on CMM, as they ...


Prospective, Multicenter Study Of P4hb (Phasix) Mesh For Hernia Repair In Cohort At Risk For Complications: 3-Year Follow-Up, John Scott Roth, John R. Romanelli, Raymond M. Dunn 2020 University of Kentucky Medical Center

Prospective, Multicenter Study Of P4hb (Phasix) Mesh For Hernia Repair In Cohort At Risk For Complications: 3-Year Follow-Up, John Scott Roth, John R. Romanelli, Raymond M. Dunn

Open Access Publications by UMMS Authors

Background: This study represents a prospective, multicenter, open-label study to assess the safety, performance, and outcomes of poly-4-hydroxybutyrate (P4HB, Phasix) mesh for primary ventral, primary incisional, or multiply-recurrent hernia in subjects at risk for complications. This study reports 3-year clinical outcomes.

Materials and methods: P4HB mesh was implanted in 121 patients via retrorectus or onlay technique. Physical exam and/or quality of life surveys were completed at 1, 3, 6,12, 18, 24, and 36 months, with 5-year (60-month) follow-up ongoing.

Results: A total of n = 121 patients were implanted with P4HB mesh (n = 75 (62%) female) with a mean ...


Screening, Brief Intervention, And Referral To Treatment For Pain Management For Veterans Seeking Service-Connection Payments For Musculoskeletal Disorders: Sbirt-Pm Study Protocol, Steve Martino, Christina Lazar, John Sellinger, Kathryn Gilstad-Hayden, Brenda Fenton, Paul G. Barnett, Brad R. Brummett, Diana M. Higgins, Paul Holtzheimer, Kristin M. Mattocks, Tu Ngo, Thomas E. Reznik, Alicia M. Semiatin, Todd Stapley, Marc I. Rosen 2020 Yale University

Screening, Brief Intervention, And Referral To Treatment For Pain Management For Veterans Seeking Service-Connection Payments For Musculoskeletal Disorders: Sbirt-Pm Study Protocol, Steve Martino, Christina Lazar, John Sellinger, Kathryn Gilstad-Hayden, Brenda Fenton, Paul G. Barnett, Brad R. Brummett, Diana M. Higgins, Paul Holtzheimer, Kristin M. Mattocks, Tu Ngo, Thomas E. Reznik, Alicia M. Semiatin, Todd Stapley, Marc I. Rosen

COVID-19 Publications by UMMS Authors

BACKGROUND: Veterans with significant chronic pain from musculoskeletal disorders are at risk of substance misuse. Veterans whose condition is the result of military service may be eligible for a disability pension. Department of Veterans Affairs compensation examinations, which determine the degree of disability and whether it was connected to military service, represent an opportunity to engage Veterans in pain management and substance use treatments. A multisite randomized clinical trial is testing the effectiveness and cost-effectiveness of Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT-PM) for Veterans seeking compensation for musculoskeletal disorders. This telephone-based intervention is delivered through ...


Molecular Analysis Of A Rare Case Of Low-Grade Primary Peritoneal Serous Carcinoma In A Male, Vladislav V. Makarenko, Dina Kandil, Ediz F. Cosar, Lloyd Hutchinson, Ashraf Khan 2020 University of Massachusetts Medical School

Molecular Analysis Of A Rare Case Of Low-Grade Primary Peritoneal Serous Carcinoma In A Male, Vladislav V. Makarenko, Dina Kandil, Ediz F. Cosar, Lloyd Hutchinson, Ashraf Khan

Open Access Publications by UMMS Authors

Primary peritoneal serous carcinomas (PPSC) are exceedingly rare in male patients. Only a few cases were reported, and mostly with the limited immunophenotypical characterization. No molecular analysis of PPSC in males has been previously performed. We here describe another case of PPSC in a male patient. A comprehensive molecular analysis of the tumor revealed SF3B1 gene mutation as a possible driver.


Clinicopathological And Immunohistochemical Study Of 29 Cases Of Solid-Pseudopapillary Neoplasms Of The Pancreas In Patients Under 20 Years Of Age Along With Detailed Review Of Literature, Nasir Ud Din, Shabina Rahim, Jamshid Abdul-Ghafar, Arsalan Ahmed, Zubair Ahmad 2020 Aga Khan University

Clinicopathological And Immunohistochemical Study Of 29 Cases Of Solid-Pseudopapillary Neoplasms Of The Pancreas In Patients Under 20 Years Of Age Along With Detailed Review Of Literature, Nasir Ud Din, Shabina Rahim, Jamshid Abdul-Ghafar, Arsalan Ahmed, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: Pancreatic Solid Pseudopapillary Neoplasms (SPNs) are rare low-grade malignant tumors with a marked preponderance for young females. Objective was to describe the morphology, differential diagnosis, and prognosis of SPNs in patients under 20 years of age and present a detailed review of literature.
Methods: A total of 29 cases in patients under 20 years of age reported as SPN during the period January 2014 to December 2019, were included in the study. These included 19 resection specimens, 4 incision biopsies and 6 cases received as blocks for second opinion. Hematoxylin and eosin (H&E) slides as well as immunohistochemistry ...


Evaluating The Association Between Vasopressin Use And In-Hospital Mortality In Patients With Septic Shock, Michael Pasqualicchio, Heidi Clarke, Jonathan Kline, Payal Patel 2020 Baptist Hospital of Miami

Evaluating The Association Between Vasopressin Use And In-Hospital Mortality In Patients With Septic Shock, Michael Pasqualicchio, Heidi Clarke, Jonathan Kline, Payal Patel

All Publications

No abstract provided.


Bacteremia And Endocarditis, Steven C. Hatch 2020 University of Massachusetts Medical School

Bacteremia And Endocarditis, Steven C. Hatch

PEER Liberia Project

This presentation provides an overview of the pathogens that cause bacteremia and endocarditis. Manifestations, pathology and treatment are discussed. The goals of the presentation are: Consider major pathogens that cause bacteremia and endocarditis in both adults and children; Discuss pathogenesis; Review clinical manifestations; Discuss basic treatment strategies; and Highlight useful sources of information.


Exploring Peer Mentoring In Pediatric Transition: Perspectives Of Different Stakeholders About Accompanying Patients In Gastroenterology, Guillaume Dumais-Lévesque, Marie-Pascale Pomey 2020 Laval University, Quebec city

Exploring Peer Mentoring In Pediatric Transition: Perspectives Of Different Stakeholders About Accompanying Patients In Gastroenterology, Guillaume Dumais-Lévesque, Marie-Pascale Pomey

Patient Experience Journal

The literature identifies several issues in the pediatric transition, such as the lack of coordination between pediatric and adult settings and young patients who are not exercising independence in the self-management of their disease. The objective of this study is to explore the potential for a pediatric transition program in gastroenterology, introducing an accompanying patient program to support the transition. A qualitative case study was conducted, including semi-structured focus groups and individual interviews with each group involved in the pediatric transition between two centres in Quebec. A thematic analysis of the collected data was performed using QDA Miner v5.1 ...


Delirium In Older Patients With Covid-19 Presenting To The Emergency Department, Maura Kennedy, Benjamin K.I. Helfand 2020 Harvard Medical School

Delirium In Older Patients With Covid-19 Presenting To The Emergency Department, Maura Kennedy, Benjamin K.I. Helfand

COVID-19 Publications by UMMS Authors

Importance: Delirium is common among older emergency department (ED) patients, is associated with high morbidity and mortality, and frequently goes unrecognized. Anecdotal evidence has described atypical presentations of coronavirus disease 2019 (COVID-19) in older adults; however, the frequency of and outcomes associated with delirium in older ED patients with COVID-19 infection have not been well described.

Objective: To determine how frequently older adults with COVID-19 present to the ED with delirium and their associated hospital outcomes.

Design, setting, and participants: This multicenter cohort study was conducted at 7 sites in the US. Participants included consecutive older adults with COVID-19 presenting ...


Thinprep Cytopathology Of Cutaneous Meningioma With Histologic Correlation, Ahmed M. Alhusseiny, Rukmini M. Kashikar 2020 University of Massachusetts Medical School

Thinprep Cytopathology Of Cutaneous Meningioma With Histologic Correlation, Ahmed M. Alhusseiny, Rukmini M. Kashikar

University of Massachusetts Medical School Publications

Cutaneous (extracranial) meningioma is a rare entity that arises from arachnoid cells. It can be ectopic or metastatic. The incidence of cutaneous meningiomas is 1-2% of all meningiomas. This tumor most commonly occurs on the scalp or along the vertebral axis as a firm, generally painless, subcutaneous nodule, and it invokes a wide clinical differential diagnosis. So, a definitive diagnosis is based on tissue microscopy. This is a rare entity with a broad differential diagnosis on cytology that can pose a diagnostic challenge to a cytopathologist. Literature review revealed few cases reporting the cytology of this tumor and most reported ...


The Rose-Colored Glasses Of Geriatric Fall Patients: Inconsistencies Between Knowledge Of Risk Factors For And Actual Causes Of Falls, Courtney E. Collins, Arnav Chandra, Bryan Nguyen, Kurt Schultz, Pawan Mathew, Tiffany Chen, Savannah Renshaw, Karen M. Rose, Heena P. Santry 2020 Ohio State University

The Rose-Colored Glasses Of Geriatric Fall Patients: Inconsistencies Between Knowledge Of Risk Factors For And Actual Causes Of Falls, Courtney E. Collins, Arnav Chandra, Bryan Nguyen, Kurt Schultz, Pawan Mathew, Tiffany Chen, Savannah Renshaw, Karen M. Rose, Heena P. Santry

Open Access Publications by UMMS Authors

Background: Falls are the leading cause of fatal injury, and most common cause of non-fatal trauma, among older adults. We sought to elicit older patient's perspectives on fall risks for the general population as well as contributions to any personal falls to identify opportunities to improve fall education.

Methods: Ten patients with a history of falls from inpatient trauma and outpatient geriatric services were interviewed. Transcripts were analyzed independently by five individuals using triangulation and constant comparison (NVivo11, QSR International) to compare fall risks to fall causes.

Results: All patients reported that either they (9/10 participants) or someone ...


Prevalence Of Pain On Admission By Level Of Cognitive Impairment In Nursing Homes, Catherine E. Dube, Reynolds A. Morrison, Deborah Mack, William M. Jesdale, Anthony P. Nunes, Shao-Hsien Liu, Kate L. Lapane 2020 University of Massachusetts Medical School

Prevalence Of Pain On Admission By Level Of Cognitive Impairment In Nursing Homes, Catherine E. Dube, Reynolds A. Morrison, Deborah Mack, William M. Jesdale, Anthony P. Nunes, Shao-Hsien Liu, Kate L. Lapane

Open Access Publications by UMMS Authors

Purpose: To provide contemporary estimates of pain by level of cognitive impairment among US nursing home residents without cancer.

Methods: Newly admitted US nursing home residents without cancer assessed with the Minimum Data Set 3.0 at admission (2010-2016) were eligible (n=8,613,080). The Cognitive Function Scale was used to categorize level of cognitive impairment. Self-report or staff-assessed pain was used based on a 5-day look-back period. Estimates of adjusted prevalence ratios (aPR) were derived from modified Poisson models.

Results: Documented prevalence of pain decreased with increased levels of cognitive impairment in those who self-reported pain (68.9 ...


Precursor Lymphoblastic Lymphoma In The Extramedullary Tissue: A Rare Manifestation Of Chronic Myeloid Leukemia In Blast Crisis, Huma Mansoori, Maria Faraz, Hira Qadir, Anila Rashid, Maria Ali 2020 Dow University of Health Sciences, Karachi, PAK.

Precursor Lymphoblastic Lymphoma In The Extramedullary Tissue: A Rare Manifestation Of Chronic Myeloid Leukemia In Blast Crisis, Huma Mansoori, Maria Faraz, Hira Qadir, Anila Rashid, Maria Ali

Department of Pathology and Laboratory Medicine

Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by immature granulocytes in peripheral blood and bone marrow. In 95% of cases, it is always due to the presence of Philadelphia chromosome characterized by the presence of reciprocal translocation between chromosome 9 and 22. However, in 7% -17% of individuals, extramedullary proliferation also occurs, either in skin, lymph nodes, bone or central nervous system (CNS), which could be either myeloid, lymphoid or mixed progenitor in origin. The present case is of a 23-year-old male who presented with lower limb weakness, bowel and urinary incontinence. His complete blood count (CBC) findings ...


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