The Medicine Forum最新文献_第4页

“COVID Nails”

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.022.1.004

Gillian Naro, MD, MEd, Gregory Kane, MD, MACP

引用次数: 0

From the Editors 来自编辑

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.022.1.003

Xuejun Alice Wang, MD, Nivethietha Maniam, MD, Hillary Landon, MD, Jillian Cooper, MD, Joseph Grogg, MD, Akanksha Arya, MD

引用次数: 0

Resident Experiences with Journaling 写日记的居民体验

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/TMF.020.1.016

T. Sunder, G. Diemer, V. Sunder

引用次数: 0

Cardiac Amyloidosis: A Known Disease with an Unknown Presentation 心脏淀粉样变性:一种已知但表现不明的疾病

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.023.1.007

Svenja Schneider, MD, Tudor Sturzoiu, MD, Tanuka Datta, MD, Yevgeniy Brailovsky, DO, FACC, Sung-Hae Cho, MD, FACC, Paulina Gorodin-Kiliddar, MD

{"title":"Cardiac Amyloidosis: A Known Disease with an Unknown Presentation","authors":"Svenja Schneider, MD, Tudor Sturzoiu, MD, Tanuka Datta, MD, Yevgeniy Brailovsky, DO, FACC, Sung-Hae Cho, MD, FACC, Paulina Gorodin-Kiliddar, MD","doi":"10.29046/tmf.023.1.007","DOIUrl":"https://doi.org/10.29046/tmf.023.1.007","url":null,"abstract":"Cardiac amyloidosis is an increasingly recognized entity that causes significant morbidity and mortality. Transthyretin amyloidosis (ATTR) is present in about 16% of patients with severe aortic stenosis and up to 17% of patients with heart failure with preserved ejection fraction 9,10 . Though the screening test of choice, echocardiography is not highly sensitive or specific, and it should not be relied upon to rule out cardiac amyloidosis, especially if clinical suspicion is high. We present a case of a 58-year-old woman with a history of bilateral carpal tunnel syndrome who presented with paresthesia and syncope. Extensive workup for neurologic, infectious, and malignant etiologies was negative. EKG was remarkable for low voltage. Transthoracic echocardiogram (TTE) was not suggestive of infiltrative disease. Subsequent cardiac MRI demonstrated diffuse biventricular late gadolinium enhancement and technetium 99M pyrophosphate scan revealed diffuse (3+) uptake, which was in stark contrast to the TTE. The diagnosis of ATTR amyloidosis allowed for prompt initiation of treatment in this patient. Syncope is an uncommon presentation of cardiac amyloidosis. Such significant cardiac burden of disease without appreciable changes on TTE or clinical heart failure, demonstrates the importance of clinical vigilance and thorough workup when suspicion for amyloidosis is high, particularly if characteristic signs and symptoms consistent with systemic disease are present, as timely treatment can significantly reduce the morbidity and mortality of this disease.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124780904","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

A Case of Patent Foramen Ovale as a Cause of Persistent Hypoxia 卵圆孔未闭致持续性缺氧1例

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.023.1.008

Jaya Janadhyala, MD, Jonathan Foster, MD

引用次数: 0

Achenbach Syndrome: A Classic Presentation of a Not-So-Common Condition 阿肯巴赫综合征:一种不常见疾病的经典表现

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.024.1.005

Brandon Pecchia, MD, MS

引用次数: 0

A Case of Acute Pancreatitis Associated with Empagliflozin 恩格列净所致急性胰腺炎1例

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.023.1.011

Tudor Sturzoiu, MD, Sameep Thapa, MD, E. Solomon, Suchit Bhutani, MD

{"title":"A Case of Acute Pancreatitis Associated with Empagliflozin","authors":"Tudor Sturzoiu, MD, Sameep Thapa, MD, E. Solomon, Suchit Bhutani, MD","doi":"10.29046/tmf.023.1.011","DOIUrl":"https://doi.org/10.29046/tmf.023.1.011","url":null,"abstract":"Sodium-glucose cotransporter 2 (SGLT2) inhibitors are being prescribed increasingly more often for type 2 diabetes mellitus as well as heart failure. They have not typically been associated with acute pancreatitis, but there has been a steady flow of case reports implicating them in acute pancreatitis over the years since they were initially approved. Here, we present the case of an 82-year-old woman with a past medical history of T2DM, COPD, hyperlipidemia, a remote stroke, peripheral arterial disease, and remote breast cancer now with recurrent localized breast cancer on treatment with ademaciclib and letrozole who presented to the emergency department with abdominal pain, weakness, decreased oral intake, and nausea and vomiting. These symptoms started two weeks after the initiation of the SGLT-2 inhibitor empagliflozin for her T2DM. Initial labs were notable for sodium of 129, glucose of 409, a normal anion gap, beta hydroxybutyrate of 4.6, serum creatinine of 0.92, calcium of 9.8, total bilirubin of 3.0 with direct bilirubin 2.6, alkaline phosphatase of 773, AST of 330, ALT of 446, lipase of 1,159, triglycerides of 237, and leukocyte count of 4.9. Following admission, CT and MRCP demonstrated pancreatitis with no intrahepatic or extrahepatic ductal dilation, gallstones choledocholithiasis, or other obvious etiology of her presentation. Her symptoms improved with supportive care following the discontinuation of her SGLT-2 inhibitor and she was discharged to inpatient rehab shortly after presentation. This case highlights the importance of keeping the uncommon diagnosis of SGLT-2 inhibitor associated pancreatitis in mind in patients who present with acute pancreatitis.","PeriodicalId":246494,"journal":{"name":"The Medicine Forum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123313496","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

A Manual for Ultrasound Guided Intravenous Access: Allay your Fears, Alleviate with Humor, Approach with Confidence 超声引导静脉注射手册:减轻你的恐惧，以幽默缓解，以自信接近

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.024.1.016

Michael Dong, MD

引用次数: 0

From the Editors 来自编辑

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.021.1.002

Eitan Frankel, MD, Guy Katz, MD, Rachel Redfield, MD, Navdeep Sangha, DO, Michael Weintraub, MD, Randi Zukas, MD

引用次数: 1

Pulmonary Metastases of Basal Cell Adenocarcinoma Presenting as Hemoptysis 基底细胞腺癌肺转移表现为咯血

The Medicine Forum Pub Date : 1900-01-01 DOI: 10.29046/tmf.023.1.014

Matthew DiMeglio, DO, MBA, Mark Mallozzi, MD, Prarthna Kulandaisamy, MD, Julie Barta, MD, Jennifer Johnson, MD

引用次数: 1