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Osmotic Demyelination Syndrome Revisited: Review With Neuroimaging. 渗透性脱髓鞘综合征重访:神经影像学回顾。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
Krystle Barhaghi, Olga Molchanova-Cook, Michael Rosenburg, Banks Deal, Enrique Palacios, Jeremy Nguyen, Cynthia Hanemann
{"title":"Osmotic Demyelination Syndrome Revisited: Review With Neuroimaging.","authors":"Krystle Barhaghi,&nbsp;Olga Molchanova-Cook,&nbsp;Michael Rosenburg,&nbsp;Banks Deal,&nbsp;Enrique Palacios,&nbsp;Jeremy Nguyen,&nbsp;Cynthia Hanemann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Osmotic demyelination syndrome (ODS) is a general term that has become commonplace in the practice of medicine, encompassing both central pontine myelinolysis and extrapontine myelinolysis. Historically ODS arises as a serious complication of rapid correction of hyponatremia, yet its manifestations seem to be influenced by a multifactorial process. Further understanding of this rare demyelinating disease has elucidated the significant role of other electrolyte disturbances and the presence of chronic comorbidities as disease risk factors. This review discusses the current research regarding the pathophysiology, clinical manifestations, neuroimaging features, patient management, and prognosis of osmotic demyelination syndrome. We hope that this review will further endorse and aid in the proper diagnosis of ODS and its suitable management through the understanding of clinical and imaging correlations and outcomes, and the comorbid factors that may predispose the development of ODS in certain patient populations.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Obturator Hernia, 'The Little Old Lady Hernia'. 闭孔疝，“小老太太疝”。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
Taylor Carter, David H Ballard, Peeyush Bhargava, Navdeep S Samra
{"title":"Obturator Hernia, 'The Little Old Lady Hernia'.","authors":"Taylor Carter,&nbsp;David H Ballard,&nbsp;Peeyush Bhargava,&nbsp;Navdeep S Samra","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Obturator hernia is a rare type of abdominal hernia that classically presents in elderly women. We report the case of 78-year-old woman with progressive vomiting, obstipation, and abdominal pain. Contrast-enhanced computed tomography showed a left-sided obturator hernia, which was confirmed and treated at laparotomy. Demographics, symptoms, imaging findings, and management of obturator hernias is reviewed.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postpartum Coronary Arterial Spasm. 产后冠状动脉痉挛
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
Sameh Askandar, David Flatt, Daniela Rosu, Rami N Khouzam
{"title":"Postpartum Coronary Arterial Spasm.","authors":"Sameh Askandar,&nbsp;David Flatt,&nbsp;Daniela Rosu,&nbsp;Rami N Khouzam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) during postpartum period is rare. In the current manuscript we present a case of a postpartum patient who developed ACS attributed to coronary vasospasm in the absence of vasocontrictive medication or smoking. This condition resolved with intracoronary injection of nitroglycerine and verapamil.</p><p><strong>Case: </strong>A 26-year-old woman, postpartum day five, presented with a sudden onset of chest pain and an acute ST-segment elevation on ECG. Coronary artery catheterization showed multiple areas of spasm, which was relieved by intracoronary injection of nitroglycerine and verapamil. Post-catheterization hospital stay was uneventful and the patient was discharged in a stable condition.</p><p><strong>Conclusions: </strong>Early diagnosis and treatment of ACS in the peripartum period is crucial. Vasospastic coronary disease should be included in the differential diagnosis of peripartum chest pain. Nitrates are still considered the best treatment option with or without calcium channel blockers for both recurrence and prevention.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radiology Case of the Month: TB or Not TB… That is the Question. 本月放射病例:结核病或不是结核病……这是一个问题。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
Kartik Kansagra, Stefan Ploch, Harold R Neitzschman
{"title":"Radiology Case of the Month: TB or Not TB… That is the Question.","authors":"Kartik Kansagra,&nbsp;Stefan Ploch,&nbsp;Harold R Neitzschman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>45-year-old female presenting initially with fever, nonproductive cough, night sweats, pleuritic chest pain, fatigue and weight loss over the past month.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Case of the Month:: Abdominal Pain in a 39-year-old Man with Recent International Travel. 本月临床病例:一名最近有国际旅行的39岁男子腹痛。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
Walter Liszewski, Seema Walvekar, Fred A Lopez
{"title":"Clinical Case of the Month:: Abdominal Pain in a 39-year-old Man with Recent International Travel.","authors":"Walter Liszewski,&nbsp;Seema Walvekar,&nbsp;Fred A Lopez","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ECG Case of the Month: Wide-QRS Rhythm in a Man with a Clotted Dialysis Fistula. 本月心电图病例:男性凝血透析瘘的宽qrs节律。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
Bashar A Ababneh, Pramilla N Subramaniam, D Luke Glancy
{"title":"ECG Case of the Month: Wide-QRS Rhythm in a Man with a Clotted Dialysis Fistula.","authors":"Bashar A Ababneh,&nbsp;Pramilla N Subramaniam,&nbsp;D Luke Glancy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 57-year-old man with diabetes mellitus, systemic arterial hypertension, and end-stage kidney disease came to the hospital because his arteriovenous fistula used for hemodialysis had clotted. His blood hemoglobin level was 12.8 g/dL (reference, 13.5-17.5); and serum chemistry levels were creatinine 6.7 mg/dL (0.7-1.3), sodium 132 mEq/L (136-146), potassium 4.0 mEq/L (3.5-5.1), chloride 94 mEq/L (98-106), carbon dioxide 24 mEQ/L (23-29), calcium 9.1 mg/dL (8.4-10.2), and phosphorus 9.1 mg/dL (2.7-4.5). An electrocardiogram was recorded (Figure 1).</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Elderly Man with a Swollen Knee,Significant Ecchymosis, and Minimal Knee Pain. 老年男性膝关节肿胀，明显瘀斑，轻微膝关节疼痛。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-07-01 Epub Date: 2017-08-28
David Aamodt, Michael Serou, Harold Neitschman
{"title":"An Elderly Man with a Swollen Knee,Significant Ecchymosis, and Minimal Knee Pain.","authors":"David Aamodt,&nbsp;Michael Serou,&nbsp;Harold Neitschman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 72-year-old man presents with left knee pain and swelling over several days. The pain and swelling started after he felt a \"pop\" when bending to pick up an object off the floor. His past medical history is significant for type 2 diabetes mellitus. Physical exam revealed significant ecchymosis on the anterolateral aspect of the thigh. There was a minimal amount pain upon knee flexion.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35354782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Promyelocytic Leukemia and Chronic Lymphocytic Leukemia: Concomitant Presentation of Two Molecularly Distinct Entities. 急性早幼粒细胞白血病和慢性淋巴细胞白血病:两种不同分子实体的同时表现。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-05-01 Epub Date: 2017-06-23
Jingdong Su, Diana Veillon, Rodney Shackelford, James Cotelingam, Hazem El-Osta, Glenn Mills, Reinhold Munker, Srinivas Devarakonda
{"title":"Acute Promyelocytic Leukemia and Chronic Lymphocytic Leukemia: Concomitant Presentation of Two Molecularly Distinct Entities.","authors":"Jingdong Su,&nbsp;Diana Veillon,&nbsp;Rodney Shackelford,&nbsp;James Cotelingam,&nbsp;Hazem El-Osta,&nbsp;Glenn Mills,&nbsp;Reinhold Munker,&nbsp;Srinivas Devarakonda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute myeloid leukemia (AML) developing in patients with chronic lymphocytic leukemia (CLL) is very uncommon and usually associated with prior treatment. Acute promyelocytic leukemia (APL) accounts for a very small proportion of treatment-associated AML. So far, there has been only one reported case of APL occurring post radiation for prostate cancer in a patient with CLL. We report herein the first case of APL and CLL presenting concomitantly in an untreated patient. Evaluation of peripheral blood and bone marrow aspirate with immunohistochemistry, flow cytometry, and FISH to confirm two morphologically, molecularly and genetically distinct leukemic populations characteristic of APL and CLL is required. APL is a hematologic emergency, and aggressive management is vital to a successful therapeutic outcome. Standard treatment is with All-trans retinoic acid (ATRA) and anthracycline-based regimen, whether the process is de novo or therapy-related. Due to increased incidence of secondary malignancies in CLL patients, active surveillance is necessary.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35114039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transvenous Before Surgical Hybrid Procedure. 术前经静脉混合程序。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-05-01 Epub Date: 2017-06-23
Joseph J Tiano, Robert Drennan, John Novella, Rafael Squiteri, Malcolm Robinson, Albert DiMeo, Lindsey Scierka, Paul LeLorier
{"title":"Transvenous Before Surgical Hybrid Procedure.","authors":"Joseph J Tiano,&nbsp;Robert Drennan,&nbsp;John Novella,&nbsp;Rafael Squiteri,&nbsp;Malcolm Robinson,&nbsp;Albert DiMeo,&nbsp;Lindsey Scierka,&nbsp;Paul LeLorier","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches.</p><p><strong>Objective: </strong>We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation.</p><p><strong>Methods: </strong>40 patients were followed over a 12 month period. The procedure was performed in a single center. Patients had a mean duration of atrial fibrillation of 6.0 ± 4.5 years with 22.5% having undergone prior ablations. Mean age was 61.7 ± 7.9 years with a mean left atrial volume of 131.5 ± 46.9 mL. The endovascular procedure remained uniform with antral pulmonary vein isolation, posterior left atrial roof and right atrial cavo-tricuspid isthmus (CTI) linear lesions with mapping and ablation of left atrial complex electrograms (CFAEs) and prior existing atrial arrhythmias. The epicardial procedure included a thorascopic approach with ganglionated plexus (GP) mapping and ablation, left atrial posterior wall ablation, directed CFAE ablation and left atrial appendage ligation. All patients received implantable cardiac monitoring.</p><p><strong>Results: </strong>All 40 patients remained in sinus rhythm at their 12 month follow-up. During the monitoring period, episodes of paroxysmal atrial arrhythmias including fibrillation were documented, without persistence, after discontinuation of oral antiarrhythmic medications.</p><p><strong>Conclusion: </strong>The endo-before-epi approach resulted in improved management of persistent and long standing persistent atrial fibrillation over reported results for conventional approaches with no procedural complications, making this a promising option for the management of these arrhythmias.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35114041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Louisiana Physicians Are Increasing HPV Vaccination Rates. 路易斯安那州的医生正在提高HPV疫苗接种率。
The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society Pub Date : 2017-05-01 Epub Date: 2017-06-23
Donna L Williams, Courtney S Wheeler, Michelle Lawrence, Stacy S Hall, Michael Hagensee
{"title":"Louisiana Physicians Are Increasing HPV Vaccination Rates.","authors":"Donna L Williams,&nbsp;Courtney S Wheeler,&nbsp;Michelle Lawrence,&nbsp;Stacy S Hall,&nbsp;Michael Hagensee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Human papilloma virus (HPV) is a common virus that can cause genital warts and certain cancers. The HPV vaccine is effective in preventing many HPV-associated diseases, however, vaccination rates suggest many remain unprotected. This study examined successful strategies used by physicians to improve HPV vaccination rates. Providers with above average vaccination rates were identified. A representative from each provider participated in an interview to identify strategies used to boost HPV vaccination. Key strategies in ensuring vaccine completion were reminders, education, standing orders, and scheduling future vaccine appointments at time of first dose. Other successful strategies included coupling the HPV vaccine with adolescent vaccines, administering during well-visits, and recommending the vaccine as protection against cancer and genital warts. Findings suggest successful and widely used methods among high performing providers in Louisiana, the majority of which should be easily reproducible with minimal resources to improve HPV vaccination rates.</p>","PeriodicalId":22855,"journal":{"name":"The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757236/pdf/nihms910662.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35112931","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
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