Impact of Skin Biopsy and Clinical-Pathologic Correlation in Dermatology Inpatient Consults.

Background While studies of hospital dermatology have demonstrated diagnostic discordance between primary teams and dermatology consultants, little is known about the impact of biopsy and clinical-pathologic correlation (CPC) in consultation. This study compares biopsy performance based on diagnostic discordance and evaluates the impact of CPC on the diagnosis. Methods This was a retrospective review of 376 dermatologic consultations at a single academic medical center between July 1, 2017, and June 27, 2018.

Clinical Challenges of Acute Porphyria in the Young Adult.

Porphyria is a metabolic disorder caused by a mutation in the heme biosynthetic pathway, with vague symptomatology and rare prevalence. A triad of hyponatremia, intermittent seizures, and abdominal pain should raise suspicion for porphyria. The diagnosis is based on increased blood porphobilinogen levels and genetic mutations.

Post-stroke angiotensin II type 2 receptor activation provides long-term neuroprotection in aged rats.

Activation of the angiotensin II type 2 receptor (AT2R) by administration of Compound 21 (C21), a selective AT2R agonist, induces neuroprotection in models of ischemic stroke in young adult animals. The mechanisms of this neuroprotective action are varied, and may include direct and indirect effects of AT2R activation. Our objectives were to assess the long-term protective effects of post-stroke C21 treatments in a clinically-relevant model of stroke in aged rats and to characterize the cellular localization of AT2Rs in the mouse brain of transgenic reporter mice following stroke.

[Venous thromboembolism: What other risk factors in a North African population? A study of 276 cases].

Introduction: Venous thromboembolism is a multicausal disease. Understanding interactions between risk factors is the key to advance knowledge about the etiology of venous thrombosis. These interactions are still unclear.

The incidence of serious adverse events in a tunisian hospital: a retrospective medical record review study.

Aim: To describe the epidemiology of serious adverse events (SAE) reported in the division of internal medicine at the Mongi Slim university hospital in Tunis, to analyze their causes and contributing factors and compare them to that reported in literature so as to establish prevention strategies when these events were deemed preventable. Methods This retrospective study collected the medical records of randomly selected 500 index hospitalizations. Records review was conducted in two stages: a primary review that aimed to detect hospitalizations where a SAE was likely to have occurred then a secondary review which purpose was to confirm the presence of the SAE, to determine its nature and its preventability.

[Neuroacanthocytosis: a diagnosis that should be considered].

Background: Neuroacanthocythosis regroup heterogeneous neurodegenerative diseases. These conditions share neurological, hematological and even systemic features. In spite of the genetic progress, their pathogenesis is still unknown.

[Abdominal tuberculosis: a retrospective series of 90 cases].

Purpose: The aim of this study was to analyze the clinical, bacteriological, radiological and therapeutic features of abdominal tuberculosis in a series of 90 patients.

Methods: This was a retrospective and descriptive multicentre study of 90 cases of abdominal tuberculosis conducted from June 1997 to June 2008. Diagnosis of tuberculosis was based on bacteriologic evidence in 12 cases, histological evidence in 55 cases and on clinical and radiologic features with favorable outcomes under specific treatment in the 23 remaining cases.

[McDuffie hypocomplementemic urticarial vasculitis associated with Sjögren's syndrome].

We report a patient with Sjögren's syndrome who presented with urticarial hypocomplementemic vasculitis. A 46-year-old female was admitted for assessment of ascitis. Clinical examination and computed tomographic scan disclosed evidence of multiple peripheral and intra abdominal lymph nodes.

[Etiological profile of digital necrosis of the upper limbs: analysis of 25 cases].

Aim: To investigate the etiologies of the upper limb digital necrosis based on a retrospective analysis of 25 cases.

Patients And Methods: We retrospectively reviewed the medical records of patients treated for digital necrosis of the upper limb in four departments of internal medicine from January 1997 to December 2003.

Results: There were 16 women and nine men, mean age 55 years.

[Takayasu's arteritis associated with acute myeloblastic leukemia].

Introduction: We present one patient with acute myeloblastic leukemia diagnosed two months after the onset of Takayasu's arteritis.

Exegesis: A 21-year old woman with a previous history of erythema nodosum and episcleritis was admitted for a left cervical mass. Diagnostic imaging showed an aneurism of the left extracranial internal carotid and a stenosis of the left subclavian artery.

[Behçet's disease in Tunisia. Clinical study of 519 cases].

Purpose: To describe clinical characteristics of Behçet's disease in Tunisia.

Methods: It's a retrospective and multicentric study conducted by the Tunisian society of internal medicine. Inclusion criteria were those of the international study group.

[Acute pancreatitis associated with hemophagocytic syndrome in systemic lupus erythematous: a case report].

Exceptionally, acute pancreatitis and reactive hemophagocytic syndrome (RHS) are observed in the course of systemic lupus erythematosus (SLE). However, the association of the two conditions has never been reported before. A 31-years-old woman with a 7-year history of SLE was admitted for abdominal pain and fever.

Use of the Continuous Glucose Monitoring System to guide therapy in patients with insulin-treated diabetes: a randomized controlled trial.

Objective: To show improved glycemic control in patients with insulin-treated diabetes after adjustments to the diabetes management plan based on either continuous glucose monitoring using the Continuous Glucose Monitoring System (CGMS) or frequent self-monitoring of blood glucose (SMBG) using a home blood glucose meter.

Patients And Methods: From January to September 2000, patients aged 19 to 76 years with insulin-treated diabetes were assigned to insulin therapy adjustments based on either CGMS or SMBG values. At the end of the study, patients in both groups used the CGMS for 3 days; these values were used to calculate measures of hypoglycemia.

[Bilateral primary non-Hodgkin's lymphomas of the adrenals].

Bilateral primary non-Hodgkin's lymphomas of the adrenals are rare: only 32 cases have been reported to date in the literature. We report a new case and recall the contribution of radiography to diagnosis.

Impact of the new National Cholesterol Education Program (NCEP) guidelines on patient management.

Purpose: To update nurse practitioners (NPs) on the latest National Cholesterol Education Program (NCEP) guidelines for the management of high blood cholesterol in adults.

Data Sources: The 2001 NCEP Adult Treatment Panel (ATP) III guidelines and supporting scientific reviews and reports of clinical trials related to the evidence upon which the guidelines are based.

Conclusions: The many new features of the ATP III guidelines include an increased emphasis on the patient with multiple risk factors in order to identify appropriate candidates for primary prevention and on more stringent classifications of elevated lipid/lipoprotein levels.

The metabolic syndrome, type 2 diabetes, and cardiovascular disease: understanding the role of insulin resistance.

The most common and clinically important complication in adults with diabetes is cardiovascular disease (CVD), which includes coronary heart disease, peripheral vascular disease, and stroke. Both type 2 diabetes and the insulin resistance syndrome are associated with a marked increase in the risk for CVD. The metabolic syndrome and the closely related insulin resistance syndrome have recently been recognized as important disorders, each being associated with an increase in CVD risk even in the absence of glucose intolerance.

Glycohemoglobin assessment program: glycated hemoglobin and epidemiologic variables in patients with type 2 diabetes.

Objective: To obtain data on glycated hemoglobin (HbA1c) levels and a variety of epidemiologic variables in patients with type 2 diabetes living in the western United States.

Methods: This study was a noncomparative, multicenter, epidemiologic survey. Data were collected from consecutively enrolled patients at nine separate primary-care sites.

Treating diabetes: cardiovascular benefits of antidiabetes drugs.

Type 2 diabetes is a metabolic disorder that, if untreated, can result in macrovascular and microvascular complications. Lowering blood glucose levels primarily reduces microvascular risk; other treatment strategies are necessary to lower the risk for macrovascular disease. Because most patients with diabetes die of macrovascular disease, it is vitally important that patients with diabetes receive aggressive therapies to lessen this risk.

Considerations for treating dyslipidemia in special diabetic populations.

This is a review of the problem of dyslipidemia and cardiovascular disease (CVD) in special diabetic populations. Clearly all patients with diabetes are at increased risk for CVD compared to non-diabetic populations. But within the subset that is patients with diabetes there are individuals who are particularly vulnerable.