Going Back to Basics: Remembering Touch in the Digital Era.

Unlabelled: Internal medicine is the specialty with the most semiological training and it is taught that the combination of a complete clinical history with a thorough physical examination allows for a diagnosis to be reached in the majority of cases. We present a clinical case where an incomplete physical examination interfered with the course of hospitalisation. In a growing technological world where complementary diagnostic tests often allow us to see what is impossible to the eye, the physical examination is often neglected.

Adrenocorticotropin-Dependent Ectopic Cushing's Syndrome: A Case Report.

Paraneoplastic syndromes are rare and diverse conditions caused by either an abnormal chemical signaling molecule produced by tumor cells or a body's immune response against the tumor itself. These syndromes can manifest in a variable, multisystemic and often nonspecific manner posing a diagnostic challenge. We report the case of an 81-year-old woman who exhibited severe hypokalemia, metabolic alkalosis, and worsening hyperglycemia.

Radiation-Induced Lumbosacral Plexopathy.

Lumbosacral plexopathy (LSP) encompasses a group of disorders affecting post-ganglionic fibers derived from the L1-S4 roots. The differential diagnosis is challenging and includes other neuropathies of medullary, radicular, or peripheral origin. Defining the etiology is equally crucial, as LSP management relies on its cause.

Masked Polycythemia Vera and Iron Deficiency in a Fertile-Age Woman.

Polycythemia vera (PV) is a myeloproliferative disorder that leads to increased red blood cell (RBC) mass. The V617F activating mutation for (JAK2) is a classic finding in PV, but it is not exclusive to this condition. The radionuclide assay is an accurate method for accessing RBC, but hemoglobin (Hb) and hematocrit (Htc) values are frequently the first abnormal markers reported in a routine blood count and the basis for further investigation.

Bedside ultrasound to detect bone flap infections: A case image.

Ultrasound showing an anechoic collection with interspersed echogenic foci (blue arrows - gas bubbles) proximal to the hyperechoic bone flap (red asterisk; post-decompressive craniectomy). Serratia marcescens was isolated from the collected fluid. Bedside ultrasound can be a reliable and effective tool to aid in the diagnosis of bone flap infections.

Point-of-Care Ultrasound Protocol for Insertion and Confirmation of Central Venous Catheter Placement.

Central venous catheterization is a common procedure in the management of critically ill patients, in the context of medical emergencies, and before surgical interventions. Placing a central venous catheter (CVC) in the internal jugular vein (IJV) using anatomical references is associated with a high risk of complications, in particular pneumothorax and arterial puncture. Thus, the placement of CVCs with ultrasound support is recommended by several medical societies and health regulators at the international level.