Diabetic Ketoacidosis as the Initial Presenting Symptom of Pancreatic Adenocarcinoma: A Discussion about Screening Utilizing ENDPAC Scoring Coupled with CT Scans and Endoscopic Ultrasound.

Pancreatic adenocarcinoma is often discovered at an advanced stage due to a lack of early symptomology, resulting in this being the fourth leading cause of cancer-related death in the USA. The relationship between diabetes mellitus and pancreatic cancer has been known for many years; however, it is not well understood. Studies have suggested that long-standing type 2 diabetes mellitus can increase the risk of pancreatic cancer by 1.

Ventriculorenal shunts in the treatment of pediatric and adult hydrocephalus-historical perspective and analysis of current practice.

Hydrocephalus is a complex pathology that can have a significant impact on the quality of life in all age groups. Cerebrospinal fluid (CSF) diversions from the lateral ventricle to the peritoneal cavity are regarded as the treatment of first intent, but they have a high revision rate, and there are multiple factors which can impair their proper insertion and function. One of the many alternatives to peritoneal shunting is redirecting the CSF towards the renal system.

Stage 4 Cytokine Release Syndrome Caused by the First Dose of Nivolumab and Ipilimumab Combination Therapy in a Patient with Metastatic Melanoma Successfully Treated with Methylprednisolone, Tocilizumab, and Etanercept.

The authors report the first case of stage 4 cytokine release syndrome (CRS) (graded by the National Cancer Institute Common Terminology Criteria for Adverse Effects scale) involving a patient with advanced metastatic melanoma who was treated with the combination of two monoclonal antibodies, nivolumab (anti-programmed cell death receptor 1 inhibitor [PD-1]) and ipilimumab (a cytotoxic T lymphocyte-associated antigen 4 inhibitor [CTLA-4]) after her first dose of both. The patient was treated initially with methylprednisolone and tocilizumab but was refractory to treatment. A trial of etanercept was initiated due to her elevated levels of TNF-α which elicited a satisfactory response.