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Rhode Island medical journal (2013)最新文献

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Pushing for IV Push Medications: Cost-Effectiveness Model of Switching from IV Piggyback to IV Push for Frequently Used Emergency Department Medications. 静脉推注药物：急诊科常用药物从静脉回输转为静脉推注的成本效益模型。
Rhode Island medical journal (2013) Pub Date : 2024-02-01
Alison Hayward, Lawrence Huang, Jessica Nagy, Katelyn Moretti
{"title":"Pushing for IV Push Medications: Cost-Effectiveness Model of Switching from IV Piggyback to IV Push for Frequently Used Emergency Department Medications.","authors":"Alison Hayward, Lawrence Huang, Jessica Nagy, Katelyn Moretti","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In considering the potential to reduce the carbon footprint of our emergency department (ED) via decreasing plastic waste, we aimed to evaluate the effects of changing certain common emergency department medications from an intravenous (IV) piggyback administration route to IV push. Our team queried hospital pharmacy data to determine the number of doses of several frequently utilized antibiotics administered over a six-month time period, then calculated the resultant cost savings of a switch to IV push. Based upon our modeling calculations, switching certain medication administration routes to IVP can have significant impacts on cost, with an estimated cost savings of about $47,000 every six months. Maximizing the use of push administration could result in even more dramatic cost savings. In some scenarios, using IVP administration results in less than half the amount of plastic waste generated. Future research including a full life-cycle analysis is needed in order to precisely determine the impact on carbon footprint created by making this change.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 2","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576900","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 Pituitary Apoplexy Following Leuprolide Injection for Prostate Cancer. 一例注射利丙瑞林治疗前列腺癌后出现垂体性脑瘫的病例。
Rhode Island medical journal (2013) Pub Date : 2024-02-01
Kang Woo Kim, Sora Chee, Naveena Sunkara, Margaret Hayes Baker
{"title":"A Case of Pituitary Apoplexy Following Leuprolide Injection for Prostate Cancer.","authors":"Kang Woo Kim, Sora Chee, Naveena Sunkara, Margaret Hayes Baker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pituitary apoplexy is a rare but potentially life-threatening complication of androgen deprivation therapy for prostate cancer. We present a case of a 70-year-old African American male with prostate cancer who developed symptoms of pituitary apoplexy, including hot flashes, nausea, vomiting, and cranial nerve III palsy, following the initiation of leuprolide therapy. Imaging revealed a pituitary adenoma with hemorrhage, and prompt multidisciplinary management was initiated. The patient was managed conservatively with improvement in symptoms. This case highlights the importance of recognizing the potential for pituitary apoplexy in patients receiving GnRH agonist therapy. We discuss the clinical presentation of GnRH agonist induced pituitary apoplexy, emphasizing that clinicians should maintain a high index of suspicion and promptly investigate any new neuro- ophthalmic symptoms in this group of patients. Ultimately, prompt diagnosis and treatment are crucial to mitigate the severity of this complication in patients with prostate cancer undergoing androgen deprivation therapy.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 2","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577315","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
Malignancy Associated Type B Lactic Acidosis: A Rare, yet Fascinating Oncological Emergency. 恶性肿瘤相关 B 型乳酸酸中毒：罕见而迷人的肿瘤急症
Rhode Island medical journal (2013) Pub Date : 2024-02-01
Yashvin Onkarappa Mangala, Nancy J Freeman
{"title":"Malignancy Associated Type B Lactic Acidosis: A Rare, yet Fascinating Oncological Emergency.","authors":"Yashvin Onkarappa Mangala, Nancy J Freeman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Type B lactic acidosis has been described infrequently in hematologic malignancies, but even less often in solid tumors. Since 1978, there have been only 58 cases of solid tumor associated Type B lactic acidosis described in the literature. Lung cancer (neuroendocrine) is the most common tumor; others frequently have a poorly/undifferentiated histology. The prognosis is dismal. Malignancy associated type B lactic acidosis is not associated with hypoxemia. The most highlighted pathogenetic mechanism is the Warburg effect (aerobic glycolysis of tumor cells causing excess lactate). We describe a patient with metastatic GI neuroendocrine carcinoma with profound lactic acidosis, who died within 24 hours. When extremely ill cancer patients present with lactic acidosis, sepsis is usually a primary concern. This case highlights the need for providers to consider malignancy associated lactic acidosis (MA-LA) in the differential diagnosis, particularly in patients with advanced malignancies, of lung origin, of neuroendocrine or poorly/undifferentiated histologic subtypes. The implications and approach are distinct from Type A/D lactic acidosis, and would involve treatment of the underlying malignancy at the earliest.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 2","pages":"10-12"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576570","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
Postherpetic Neuralgia After Herpes Zoster Ophthalmicus. 眼带状疱疹后遗神经痛
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Mary M Kelly, Sokunvichet Long, Celine Saade, Glenn A Tung
{"title":"Postherpetic Neuralgia After Herpes Zoster Ophthalmicus.","authors":"Mary M Kelly, Sokunvichet Long, Celine Saade, Glenn A Tung","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081164","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 Diagnostic Dilemma: Metastatic Neuroendocrine Tumor Mimicking Hepatocellular Carcinoma. 诊断难题：转移性神经内分泌瘤模仿肝细胞癌。
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Franklin Iheanacho, Kuntal Bhowmick, Akindele Olagunju, Weibiao Cao, Alice Chu, Kathryn DeCarli
{"title":"A Diagnostic Dilemma: Metastatic Neuroendocrine Tumor Mimicking Hepatocellular Carcinoma.","authors":"Franklin Iheanacho, Kuntal Bhowmick, Akindele Olagunju, Weibiao Cao, Alice Chu, Kathryn DeCarli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Carcinoid syndrome arises from neuroendocrine tumors, characterized by the presence of neurosecretory granules. The diagnosis of carcinoid syndrome involves biochemical testing and various imaging techniques. We report the case of a 62-year-old man with Parkinson's Disease who was found to have new-onset cirrhosis and multiple hepatic lesions with necrosis on CT imaging. These findings were concerning for metastatic malignancy of unknown primary origin. Subsequent MRI characterization of the liver lesions indicated hepatocellular carcinoma as the most likely diagnosis. However, a transthoracic echocardiogram, performed for anasarca and dyspnea on exertion, revealed a thickened tricuspid leaflet, highly suspicious for carcinoid valvulitis. A biopsy of one of the hepatic lesions was consistent with neuroendocrine tumor, confirming the diagnosis of carcinoid syndrome. This case highlights the limitations of diagnostic imaging approaches in distinguishing hepatocellular carcinoma from neuroendocrine tumors.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"15-17"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081156","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 Adolescent with Undiagnosed Ulcerative Colitis Presenting with Toxic Megacolon and Cavitary Pulmonary Nodules. 一名未确诊溃疡性结肠炎的青少年出现中毒性巨结肠和腔隙性肺结节。
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Rahiya Rehman, Stephanie Camhi, Jason Shapiro, Shova Subedi, Linda Shalon
{"title":"An Adolescent with Undiagnosed Ulcerative Colitis Presenting with Toxic Megacolon and Cavitary Pulmonary Nodules.","authors":"Rahiya Rehman, Stephanie Camhi, Jason Shapiro, Shova Subedi, Linda Shalon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Toxic megacolon and pulmonary nodules are not seen frequently on diagnosis in pediatric ulcerative colitis patients. This report emphasizes the importance of carefully evaluating and managing complications in pediatric ulcerative colitis cases, especially in the presence of pulmonary nodules.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"21-22"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081158","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
Acquired von Willebrand's Syndrome in a Patient with Concomitant Chronic Lymphocytic Lymphoma and Smoldering Multiple Myeloma. 慢性淋巴细胞淋巴瘤和多发性骨髓瘤并发症患者的获得性冯-威廉综合征。
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Nirav Haribhakti, Hyun Lee, Matthew Quesenberry, John Reagan
{"title":"Acquired von Willebrand's Syndrome in a Patient with Concomitant Chronic Lymphocytic Lymphoma and Smoldering Multiple Myeloma.","authors":"Nirav Haribhakti, Hyun Lee, Matthew Quesenberry, John Reagan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An African-American female in her sixties presented to the hospital with intermittent gum bleeding for the past two years along with severe anemia. This case details the differential and workup that lead to the diagnosis of acquired von Willebrand's syndrome (AvWS). A thorough investigation in the possible etiologies of AvWS revealed that the patient had concomitant chronic lymphocytic lymphoma (CLL) and smoldering multiple myeloma (SMM). Due to the concomitant diagnosis of CLL and SMM, there was a dilemma regarding whether CLL, SMM, or both was driving this patient's AvWS. Decision was made to treat the underlying CLL initially with rituximab and later on at recurrence with obinutuzumab/venetoclax with complete resolution of patient's bleeding and normalization of her factor VIII activity, von Willebrand factor antigen levels, and vWF:ristocetin cofactor levels. We believe this is first case in the literature of a patient with AvWS with concurrent CLL and SMM.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081157","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
Caught by POCUS: Post-TAVR Pericardial Effusion. 被 POCUS 捕捉到：TAVR 术后心包积液。
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Kenneth N John, Michael Cradeur, Geoffrey Hayward, Shyamal Asher
{"title":"Caught by POCUS: Post-TAVR Pericardial Effusion.","authors":"Kenneth N John, Michael Cradeur, Geoffrey Hayward, Shyamal Asher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) is becoming increasingly popular in the field of anesthesiology and is being incorporated into anesthesia resident education. Ultrasound provides a portable, quick, and inexpensive diagnostic tool to help guide clinicians in their decision making and management of medically complex patients. One important utilization of POCUS is helping to guide management of undifferentiated hypotension. We present a case of a patient who underwent a Transcatheter Aortic Valve Replacement (TAVR) procedure who then suffered from hypotension in the post-anesthesia care unit (PACU). POCUS was used to help identify the cause of the patient's hypotension and led to the diagnosis of a pericardial effusion.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"29-31"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081160","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
Escherichia coli Meningitis in a 72-year-old Woman. 一名 72 岁妇女的大肠杆菌脑膜炎
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Mallikarjun R Komsani, Nouf K Almaghlouth, Swapna Charla, Jennifer Li, Maria D Mileno, Marguerite A Neill, Tao Hong, John R Lonks
{"title":"Escherichia coli Meningitis in a 72-year-old Woman.","authors":"Mallikarjun R Komsani, Nouf K Almaghlouth, Swapna Charla, Jennifer Li, Maria D Mileno, Marguerite A Neill, Tao Hong, John R Lonks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Spontaneous community-acquired meningitis caused by E. coli is rare in the adult population. It is associated with a high risk of morbidity and mortality. We describe a case of a 72-year-old woman who presented with altered mental status and neck stiffness and was found to have E. coli meningitis. Urine cultures grew E. coli, representing a likely source. The E. coli strain was identified as sequence type 73 (E. coli ST73). Her symptoms and laboratory values improved following antibiotic initiation, and she was discharged from the hospital to a rehabilitation facility.</p>","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"12-14"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081161","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
Internal Versus External Intrapartum Monitoring and Birthing Persons Perception of Control During Childbirth. 内部与外部产前监护与分娩者对分娩过程控制的感知。
Rhode Island medical journal (2013) Pub Date : 2024-01-04
Brock E Polnaszek, Anna R Whelan, Olivia Recabo, Julia Rossen, Adam K Lewkowitz, Nina K Ayala
{"title":"Internal Versus External Intrapartum Monitoring and Birthing Persons Perception of Control During Childbirth.","authors":"Brock E Polnaszek, Anna R Whelan, Olivia Recabo, Julia Rossen, Adam K Lewkowitz, Nina K Ayala","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74738,"journal":{"name":"Rhode Island medical journal (2013)","volume":"107 1","pages":"34-36"},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139081163","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
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