Journal of Community Hospital Internal Medicine Perspectives最新文献_第10页

Thyrotoxicosis in the Setting of Hydatidiform Mole with Subsequent Development of Takotsubo Cardiomyopathy Complicated by COVID-19. 葡萄胎甲状腺毒症并发Takotsubo心肌病合并COVID-19

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-05-08 eCollection Date: 2023-01-01 DOI: 10.55729/2000-9666.1177

Kara E Hensley, Christopher W Fiechter, Alysson Klein, Rhabia Hussein, Henry J Weiss, Mihail Zilbermint

{"title":"Thyrotoxicosis in the Setting of Hydatidiform Mole with Subsequent Development of Takotsubo Cardiomyopathy Complicated by COVID-19.","authors":"Kara E Hensley, Christopher W Fiechter, Alysson Klein, Rhabia Hussein, Henry J Weiss, Mihail Zilbermint","doi":"10.55729/2000-9666.1177","DOIUrl":"10.55729/2000-9666.1177","url":null,"abstract":"We present a rare case of hydatidiform molar pregnancy, which led to the development of thyroid storm, followed by a rare complication of takotsubo cardiomyopathy in the setting of a COVID-19 infection. A 21-year-old female of 22 weeks gestational age presented with heavy vaginal blood loss, brown emesis, tachycardia, and lethargy. Through clinical presentation and ultrasound confirmation, a molar pregnancy was diagnosed. Laboratory data and clinical presentation of thyrotoxicosis supported a diagnosis of thyroid storm. Test for COVID-19 was positive. The patient was treated with dilation and curettage, antithyroid medication, and blood transfusions, resulting in symptom resolution. Thereafter, echocardiography confirmed takotsubo cardiomyopathy. It is suspected that the homology in structure between the human chorionic gonadotropin (hCG) and thyroid stimulating hormone subunits resulted in thyroid storm secondary to receptor cross-reactivity. We speculate that subsequent cardiovascular stress of b-hCG-induced thyroid storm with superimposed COVID-19 infection facilitated the development of Takotsubo cardiomyopathy.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"13 3","pages":"83-87"},"PeriodicalIF":1.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/e1/jchim-13-03-083.PMC10593158.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spontaneous Hemorrhage of Thoracic Cavernous Malformation Leading to Bilateral Lower Extremity Paralysis 胸海绵体畸形自发性出血导致双侧下肢瘫痪

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-05-08 DOI: 10.55729/2000-9666.1180

A. Ashkin, Joshua Parmenter, Keegan Plowman, Ricardo A. Franco-Sadud

引用次数: 0

Pyoderma Gangrenosum as a Harbinger of Adult T-Cell Leukemia-Lymphoma. 神经节皮病是成人T细胞白血病淋巴瘤的先兆。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-03-10 eCollection Date: 2023-01-01 DOI: 10.55729/2000-9666.1167

Syed H B Waqar, Biplov Adhikari, Navid Salahi, Sara Ahmed, Isabel McFarlane

引用次数: 0

Light Chain Myeloma Precipitating Cryoglobulinemic Vasculitis. 轻链骨髓瘤沉淀性冷球蛋白性血管炎。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1143

Bilal Saeed, Samah A Omar, Robert Jones, Christopher J Haas

{"title":"Light Chain Myeloma Precipitating Cryoglobulinemic Vasculitis.","authors":"Bilal Saeed, Samah A Omar, Robert Jones, Christopher J Haas","doi":"10.55729/2000-9666.1143","DOIUrl":"https://doi.org/10.55729/2000-9666.1143","url":null,"abstract":"Multiple Myeloma (MM) is characterized by monoclonal immunoglobulin production leading to widespread skeletal destruction and renal dysfunction. Light chain multiple myeloma (LCMM) affects 15% of individuals with MM and has an overall poor prognosis. Cutaneous manifestations are uncommon and it is rarely complicated by Type I Cryoglobulinemia (CG). Here we present an atypical case of κ-predominant LCMM complicated by Type I CG in an 80-year-old man who presented with a progressive non-blanching necrotic rash and ulcers involving his face, distal extremities, and oropharynx of two months duration prior to his admission at our facility. On admission to our facility, workup showed an overabundance of κ-light chains, elevated free κ/λ ratio, cryoglobulins, and an acute kidney injury. Marrow biopsy demonstrated 60% plasma cells with κ-light chain predominance. Cutaneous manifestations such as acral cyanosis and distal gangrene in LCMM indicate late stages of the disease, and such findings should raise suspicion for additional comorbid pathologies, including cryoglobulinemia, which could help direct earlier initiation of treatment.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"13 1","pages":"42-47"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/a9/jchim-13-01-042.PMC9924627.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10760835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute Diarrhea Isn't Always Infectious: An Atypical Presentation of Adrenal Insufficiency. 急性腹泻并不总是传染性的:肾上腺功能不全的不典型表现。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1146

Ariana Tagliaferri, Arielle Aiken, Madhav Patel, Monisha Singhal

引用次数: 0

Before Blaming Legionella for Severe Rhabdomyolysis, Consider Alternative Triggers. 在将严重的横纹肌溶解归咎于军团菌之前，请考虑其他触发因素。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1148

Josef Finsterer, Fulvio A Scorza, Antonio-Carlos M de Almeida

引用次数: 0

The Spanish Flu of 1918: A Historical Reflection and Lessons from Masonic Lodges. 1918年的西班牙流感:历史反思和共济会的教训。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1067

Jonathan Kopel

引用次数: 0

A Case of Candida Empyema in a Patient With Esophagopleural Fistula. 食道胸膜瘘并发念珠菌性脓胸1例。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1158

Ramez Alyacoub

{"title":"A Case of Candida Empyema in a Patient With Esophagopleural Fistula.","authors":"Ramez Alyacoub","doi":"10.55729/2000-9666.1158","DOIUrl":"https://doi.org/10.55729/2000-9666.1158","url":null,"abstract":"Fungal empyema is a rare entity, particularly in immunocompetent patients. It has been noted to occur in a patient with esophageal perforation. Esophageal perforation has a wide range of clinical presentations and associated complications depending on the size and site of perforation. Although the classic presentation of esophageal perforation, also known as Boerhaave syndrome, is often dramatic with hemodynamic instability and mediastinitis. Smaller perforations and esophageopleural fistula can lead to more indolent presentation in the form of complications such as necrotizing pneumonia and pleural effusions. Here we present a 42-year-old patient with alcohol withdrawal and aspiration pneumonia, later found to have loculated pleural effusions and empyema with pleural culture growing candida and staph Epidermidis. After his mental recovery, the initiation of oral feeding led to the discovery of esophageal perforation, further complicated by esophageopleural fistula formation. He had a prolonged hospital course but remained hemodynamically stable. He was treated with an esophageal stent and feeding tube placement, as well as antifungals for candida empyema.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"13 2","pages":"37-40"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/15/jchimp-13-02-037.PMC10166211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Challenging Situation: Empirical Treatment with Therapeutic Plasma Exchange in a Patient with Sickle Cell Disease. 一个具有挑战性的情况:治疗性血浆置换治疗镰状细胞病患者的经验治疗。

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1152

Arielle Aiken, Brooke Kania, Riddhi Amin, Moutaz Ghrewati, Patrick Michael

{"title":"A Challenging Situation: Empirical Treatment with Therapeutic Plasma Exchange in a Patient with Sickle Cell Disease.","authors":"Arielle Aiken, Brooke Kania, Riddhi Amin, Moutaz Ghrewati, Patrick Michael","doi":"10.55729/2000-9666.1152","DOIUrl":"https://doi.org/10.55729/2000-9666.1152","url":null,"abstract":"Sickle Cell Disease (SSD) can present with acute painful crises, most commonly manifesting as diffuse bony pain; however, rare presentations of acute coronary syndrome, acute papillary necrosis, or multi-organ failure may also present in these patients. TTP has been rarely described in conjunction with sickle cell pain crisis (SS crisis). In both TTP and sickle cell crises, widespread platelet activation is present with thrombocytopenia as a result. Thrombocytopenia can be utilized as a poor prognostic indicator in patients with SS crisis. Multi-organ failure may appear similar to TTP and patients may benefit from similar therapy. Here, we present a 27-year-old female with a history of SSD who presented with a painful crisis who was found to have worsening renal failure and thrombocytopenia and was treated empirically with therapeutic plasma exchange (TPE), later discovered to have SS crisis with multi-organ failure with unremarkable ADAMSTS13 values. Given the high fatality risk of TTP, the benefits outweighed the risks for empiric TPE therapy, and our patient benefited from the treatment, as patients with both TTP and/or SS crisis multi-organ failure have demonstrated improvement following this treatment. Given the severity of multi-organ failure in SSD patients, additional research is warranted for improvement in the diagnosis and management of these patients.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"13 2","pages":"24-27"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/75/jchimp-13-02-024.PMC10166222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

COVID-19 Viral Infection Presenting With Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Syndrome, or Mixed Hyperglycemic Crisis: A Case Series. COVID-19病毒感染表现为糖尿病酮症酸中毒、高渗性高血糖综合征或混合性高血糖危机:一个病例系列

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Journal of Community Hospital Internal Medicine Perspectives Pub Date : 2023-01-01 DOI: 10.55729/2000-9666.1163

Dhruv Patel, Brooke Kania, Ahmed Salem, Wadah Akroush, Minha Naseer, David McNamara, Carlos Perez

{"title":"COVID-19 Viral Infection Presenting With Diabetic Ketoacidosis, Hyperosmolar Hyperglycemic Syndrome, or Mixed Hyperglycemic Crisis: A Case Series.","authors":"Dhruv Patel, Brooke Kania, Ahmed Salem, Wadah Akroush, Minha Naseer, David McNamara, Carlos Perez","doi":"10.55729/2000-9666.1163","DOIUrl":"https://doi.org/10.55729/2000-9666.1163","url":null,"abstract":"Cardiovascular disease, COPD, and diabetes (DM) are associated with increased complications with COVID-19. A correlation between COVID-19 and diabetic ketoacidosis (DKA) or Hyperosmolar Hyperglycemic Syndrome (HHS) has been suggested; however, the precise mechanism remains unclear. We present a case series of six patients with COVID-19 infections who were found to have DKA, HHS, or mixed picture. Wedescribe an association between COVID-19 and hyperglycemic emergencies. Six patients (50% male, 50% female, mean age 47.667 ± 18.747) were identified from November 2021 to February 2022. Comorbidities included DM (83.3%), HTN (50%), as well as ESRD, A-Fib, ISLD, HIV, and dementia (each 16.7%). Common review of systems included nausea and vomiting (50%), abdominal pain (33.3%), dyspnea (33.3%), and decreased appetite (33.3%). Additional findings were dysarthria, facial droop, generalized weakness, productive cough, myalgias, and increased urinary frequency (16.7%). Patients were diagnosed with DKA (50%), mixed process (33.3%), andHHS(16.7%). In terms of COVID-19 symptoms, most patients were asymptomatic (83.3%), with one patient developing hypoxia. The survival rate was 100%. Infections can incite DKA/HHS; yet, COVID-19 may have factors that amplify this process, in the setting of pancreatic beta-cell dysfunction from the virus itself. This may contribute to why diabetic patients have a ten times higher risk of death if they develop COVID-19. This virus binds to ACE2 receptors in the pancreas and damages the islets, ultimately decreasing insulin release. Here, we introduce cases of DKA/HHS in the setting of COVID-19, to understand the relationship between how COVID-19 infections may exacerbate diabetic complications.","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"13 2","pages":"76-83"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/9b/jchimp-13-02-076.PMC10166223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0