Postgraduate medicine
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Postgraduate medicine · Jan 2021
Case ReportsPulmonary embolism complicated the course of anti-N-methyl-D aspartate receptor encephalitis in a pediatric intensive care unit setting: A case report.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, an autoimmune neurological disorder resultant from the autoantibodies directed to the NR1 subunit of the NMDAR, is mainly characterized by neuropsychiatric symptoms, including behavior changes, paranoia, delusions, epileptic seizures, movement disorders, aphasia, insomnia, dysautonomia, and altered consciousness. Pulmonary embolism (PE) presents with pleuritic chest pain, hemoptysis, and respiratory distress by obstruction of the pulmonary circulation. Unlike adults, pediatric PE usually related to obvious risk factors, including central venous line, malignancy, lupus erythematosus, renal disease, congenital thrombophilia, surgery, and major trauma. Besides, PE has rarely been encountered in adult patients with anti-NMDAR encephalitis even in the absence of these risk factors. ⋯ Pulmonary embolism should be kept in mind as a possible cause of respiratory insufficiency in pediatric anti-NMDAR encephalitis patients along with altered consciousness, breathing instability, hypersalivation, status epilepticus or dystonia, and their treatment.
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Postgraduate medicine · Jan 2021
Case ReportsAtypical posterior reversible encephalopathy syndrome with albuminocytological dissociation and late emerging neuroradiological findings: A case report.
Posterior reversible encephalopathy syndrome (PRES) is a central nervous system disorder accompanied by vasogenic edema in white matter that is usually located in temporo-parieto-occipital area. Typically, PRES is presented with headaches, seizures, and change of consciousness. The most common etiologic factor is fluctuations in blood pressure. ⋯ Radiological findings were typical for PRES. The cranial MRI is a valuable diagnostic tool for the diagnosis of the PRES but, as in our case, despite the subtle clinical and radiological findings presented during admission, repeated MRI and CSF examination may contribute to a definite diagnosis. This case is remarkable for severe protein elevation in CSF, irreversible fatal course and radiographic evidence of vasogenic edema occurred subsequently.
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Postgraduate medicine · Jan 2021
Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States.
To evaluate healthcare resource utilization (HCRU) by osteoarthritis (OA) pain severity. ⋯ Greater current pain was associated with more prior HCRU including imaging for monitoring progression, HCP visits including more specialty care, hospitalizations, surgery/planned surgery, and loss of independence due to functional disability. Yet rates of hospitalizations and X-ray use were still sizable even among patients with mild pain. These cross-sectional findings warrant longitudinal assessment to further elucidate the impact of pain on HCRU.
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Postgraduate medicine · Jan 2021
Association between lateral epicondylitis and the risk of herpes zoster development.
Diseases burden is associated with herpes zoster (HZ) development. However, the relationship between lateral epicondylitis (LE) and HZ remains unknown. ⋯ Women with LE had a higher risk of HZ development. HZ vaccination may be needed for the female patients with LE.
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Postgraduate medicine · Jan 2021
Case ReportsPulmonary resection for multiple lung metastasis from ameloblastoma: a rare case report and literature review.
Ameloblastoma is a benign odontogenic epithelial neoplasm. Lung metastasis of ameloblastoma is extremely rare, and its biological behavior is still largely unknown. There is no consensus regarding the best method to treat metastasizing ameloblastoma. ⋯ This is a rare case with multiple lung metastasis from ameloblastoma who was successfully treated with multiple pulmonary resections. The present study indicated that surgery may be considered an appropriate choice for lung metastasis of ameloblastoma.