Active 46-year-old man with right-sided visual loss and no family history of stroke · Dx?

A 46-year-old man presented to the emergency department with sudden-onset right-sided visual loss. He had a history of asthma, but no family history of hypercoagulability, deep vein thrombosis, or stroke. The patient had an active lifestyle that included scuba diving, mountain biking, and hockey (coaching and playing).

Review of Hypoglycemia in the Older Adult: Clinical Implications and Management.

The aging of the population is a worldwide phenomenon. The prevalence of diabetes rises with increasing age, so the personal and financial costs of diabetes in the aging population have become significant burdens. In 2012, 104 billion (59%) of the estimated $176 billion in United States healthcare expenditures attributable to diabetes were utilized by patients older than 65 years of age [American Diabetes Association (1)].

Presentation and outcomes among patients with isolated myeloid sarcoma: a Surveillance, Epidemiology, and End Results database analysis.

Isolated myeloid sarcoma (MS) is a rare extramedullary presentation of acute myeloid leukemia (AML). Little is known about MS outcomes due to its rarity. A population-based analysis of MS using the Survival, Epidemiology, and End Results (SEER) database was performed.

Wide complex ventricular tachycardia presenting sign of metastatic pleural mesothelioma.

Malignant mesothelioma is an uncommon neoplasm of serosal surfaces, such as the pleura, the peritoneum, less frequently pericardium and tunica vaginalis. It usually spreads locally to the lungs and mediastinum. We describe a case of malignant mesothelioma with metastasis to the heart.

Altered mental status and fever.

West Nile virus (WNV) is still the most common cause of neuroinvasive arboviral disease in the USA with a case death of 10-30%. We are reporting a case of a 61-year-old woman with a history of Crohn's disease, fibromyalgia treated with chronic steroid therapy that presented with a day history of fever, confusion and lethargy. She had a lumbar puncture which was notable for lymphocytosis and was positive for WNV.

Hyperuricemic renal failure in nonhematologic solid tumors: a case report and review of the literature.

Tumor lysis syndrome (TLS) is an oncologic emergency that is caused by massive tumor cell lysis. It is commonly associated with hematological cancers like leukemia and lymphoma and uncommonly with solid nonhematologic tumors as well. However, spontaneous tumor lysis syndrome (STLS) without any cytotoxic chemotherapy rarely occurs in solid tumors.

Clinical meaningfulness of the changes in muscle performance and physical function associated with testosterone administration in older men with mobility limitation.

Context: Testosterone in Older Men with Mobility Limitations Trial determined the effects of testosterone on muscle performance and physical function in older men with mobility limitation. Trial's Data and Safety Monitoring Board recommended enrollment cessation due to increased frequency of adverse events in testosterone arm. The changes in muscle performance and physical function were evaluated in relation to participant's perception of change.

Adverse events associated with testosterone administration.

Background: Testosterone supplementation has been shown to increase muscle mass and strength in healthy older men. The safety and efficacy of testosterone treatment in older men who have limitations in mobility have not been studied.

Methods: Community-dwelling men, 65 years of age or older, with limitations in mobility and a total serum testosterone level of 100 to 350 ng per deciliter (3.