Morvan Fibrillary Chorea Associated with Monoclonal B Cell Lymphocytosis.

BACKGROUND Morvan fibrillary chorea (Morvan syndrome) is a rare disorder marked by a collection of neurological symptoms such as myokymia, peripheral nerve excitability, neuromyotonia, autonomic instability, memory impairment, and delirium. Morvan syndrome is suspected to occur through antibodies directed against voltage gated potassium channels (VGKC), and has been linked with several autoimmune conditions and hematologic malignancies. We present a case of Morvan syndrome in association with monoclonal B cell lymphocytosis.

What We Have Learned About Combining a Ketogenic Diet and Chemoimmunotherapy: a Case Report and Review of Literature.

Background: A high-fat, moderate-protein, low-carbohydrate ketogenic diet has been reported in the literature as a treatment option for patients with cancer.

Case Presentation: A 69-year-old veteran was initially diagnosed with stage III colorectal cancer and progressed to having liver, pancreatic, and omental lymph node involvement despite completing adjuvant FOLFOX (fluorouracil, leucovorin calcium, and oxaliplatin) after surgery. The patient was treated with FOLFIRI (fluorouracil, leucovorin calcium, and irinotecan hydrochloride) and bevacizumab, followed by encorafenib and cetuximab on progression.

Rare Case of Mixed Phenotype Acute Leukemia Presenting as a Myeloid Sarcoma Without Leukemic Involvement.

Introduction: Mixed phenotype acute leukemia (MPAL) is a rare type of acute leukemia with immunophenotypic features of both myeloid-derived and lymphoid-derived lineages.

Case Presentation: We present an atypical case of a 32-year-old woman presenting with an anterior mediastinal mass and pericardial/pleural involvement that was initially diagnosed as primary mediastinal diffuse large B-cell lymphoma. However, flow cytometry on pleural fluid confirmed the diagnosis of MPAL of B-cell/myeloid lineage without peripheral blood/bone marrow involvement.

A call to include medical humanities in the curriculum of colleges of osteopathic medicine and in applicant selection.

Medicine stands at a crossroad. Disruptive physician behavior has increased, and patient satisfaction has decreased. A growing body of knowledge demonstrates that the medical humanities assist in the creation of compassionate, resilient physicians.

Mighty prophet/wounded healer.

The concept of wounded healer is revisited from the perspective of a pastoral counselor working in a pastoral counseling center, and this experience is generalized to pastoral caregivers working in other settings. Three types of wounds are reviewed: wounds resulting from the life experience of the caregiver, wounds resulting from listening to and containing the horrendous content and emotionally laden nature of client stories, and wounds brought about by doing our work within an unsupportive culture. Properly dealt with, these wounds offer a foundation of shared life experience connecting us with our clients.