The American journal of the medical sciences
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Esophageal squamous cell carcinoma (SCC) is a highly lethal malignancy with a low survival rate, often presenting at an advanced stage. Cutaneous metastasis from esophageal SCC is exceedingly rare, affecting less than 1% of cases, and is associated with a poor prognosis. This review particularly focuses on facial metastasis and discusses the clinical presentation, diagnostic challenges, and management of cutaneous metastases. ⋯ Histopathological examination and immunohistochemical staining are crucial for accurate diagnosis. Management involves a combination of local and systemic therapies, tailored to the patient's overall health and disease extent. This topic emphasizes the need for vigilance and thorough diagnostic workups in patients with unusual skin lesions and highlights the importance of multidisciplinary care in optimizing treatment outcomes for patients with advanced esophageal cancer.
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Noninvasive positive pressure ventilation (NIV) is a positive pressure ventilation method employed across various disease processes, utilizing noninvasive interfaces such as helmets and facemasks rather than invasive methods such as endotracheal intubation. The benefits of NIV are significant in both the acute care setting, such as improving work of breathing and avoiding the need for endotracheal intubation, as well as in the chronic care setting, improving quality of life and mortality. ⋯ The review also summarizes the current guidelines on the use of NIV in the acute care setting. Although primarily targeted towards the acute indications of NIV, we believe this review will aid in better understanding and managing noninvasive ventilation for clinicians across both the inpatient and outpatient settings.
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Review Case Reports
Anti-IgLON5 disease: A case with intestinal obstruction and peripheral neuropathy.
IgLON5 autoimmunity is a novel antibody-mediated disorder characterized by serum and/or cerebrospinal fluid (CSF) positivity for IgLON5 antibody. Anti-IgLON5 disease mainly manifests as sleep disturbances, movement disorders and brainstem syndromes. In this study, we report the case of a patient with anti-IgLON5 disease who presented with abdominal distension, abdominal pain, intermittent dysuria and constipation, and intermittent lightning pain in the extremities, which are atypical of anti-IgLON5 disease and could easily lead to misdiagnosis. ⋯ Following treatment, the manifestations nearly resolved. The clinical manifestations of anti-IgLON5 disease are diverse and may present in different combinations, which can easily lead to misdiagnosis. Early recognition and treatment of this autoimmune disease with immunosuppressive agents may lead to better outcomes.
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Review Case Reports
A rare case of spontaneous hemoperitoneum in a bone marrow transplant recipient on VV-ECMO.
A 53-year-old man with acute myeloid leukemia received an allogeneic hematopoietic cell transplant (HCT) from a matched unrelated donor. One month after his transplantation, he developed ARDS requiring initiation of VV-ECMO. He suffered from pancytopenia, managed with frequent transfusions, granulocyte-colony stimulating factor (G-CSF) and weekly thrombopoietin receptor agonist. ⋯ His family chose to discontinue ECMO and he passed away peacefully. Spontaneous splenic rupture after GM-CSF has never been reported in patients on VV-ECMO. This manuscript reviews the literature regarding the pathophysiology and clinical manifestation of this rare occurrence.
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Review Case Reports
Severe Hyponatremia Secondary to Syndrome of Inappropriate Antidiuretic Hormone (SIADH): A Rare Cause of Takotsubo (Stress) Cardiomyopathy.
Takotsubo cardiomyopathy is a reversible, stress-induced systolic abnormality of the left ventricular apex.1,2 It can carry significant morbidity and mortality for patients, largely due to associated complications that can occur in the acute setting. While it is most commonly linked with acute emotional or physical stressors, it is now recognized that many acute medical illnesses can precipitate the syndrome. Severe acute hyponatremia (<120 mmol/L) should be considered as a possible causative condition for Takotsubo cardiomyopathy, however reports of its occurrence in the literature are exceedingly rare.3-14 We present a case of a 73-year-old woman who was admitted for severe hyponatremia secondary to syndrome of inappropriate anti-diuretic hormone (SIADH) with a sodium level of 105 mmol/L and a concomitant diagnosis of Takotsubo cardiomyopathy, as well as a review of the epidemiology, pathophysiology, clinical features, diagnosis, treatment and clinical outcomes of Takotsubo cardiomyopathy.