Piperacillin-Tazobactam Induced Interstitial Nephritis, Hepatitis and Serum Sckness-Like Illness.

Objective: To describe a patient who developed acute interstitial nephritis, hepatitis and serum sickness-like syndrome after receiving piperacillin-tazobactam (zosyn) therapy.

Case Summary: A 30-year-old woman received a 7-day course of piperacillin-tazobactam as empiric treatment for pneumonia. The patient's kidney function worsened and she turned anuric needing dialysis.

Cancer survivorship training: a pilot study examining the educational gap in primary care medicine residency programs.

Background: Cancer survivors need high-quality follow-up care that addresses long-term problems related to cancer and their treatment. With growing numbers of cancer patients transitioning from oncological treatment to survivorship care, primary care physicians (PCPs) will play a major role in the delivery of survivorship care.

Objective: This pilot study was undertaken to provide initial insights into internal medicine (IM) and family medicine (FM) residents' educational experience, training, and preparedness for practice as healthcare providers of adult cancer survivors (ACS).

Monitoring of anti-Xa in pregnant patients with mechanical prosthetic valves receiving low-molecular-weight heparin: peak or trough levels?

Objectives: We hypothesized that the guideline-recommended peak anti-Xa levels for pregnant women with mechanical prosthetic heart valves (MPHVs) receiving adjusted dose low-molecular-weight heparin (LMWH) are associated with subtherapeutic trough levels and consequently with an inadequate level of anticoagulation.

Background: Low-molecular-weight heparin is often used for anticoagulation in pregnant women including those with MPHV. American College of Cardiology/American Heart Association guidelines recommend monitoring of plasma anti-Xa factor peak levels and adjustment of the dose to achieve peak levels of 0.

Evaluation of the clinical relevance of baseline left ventricular ejection fraction as a predictor of recovery or persistence of severe dysfunction in women in the United States with peripartum cardiomyopathy.

Background: Baseline left ventricular ejection fraction (LVEF) has been shown to be associated with likelihood of recovery in patients with peripartum cardiomyopathy (PPCM). The clinical relevance of this association for individual patients is unclear.

Methods And Results: We analyzed baseline parameters of LVEF in 187 PPCM patients with ≥6 months follow-up data in an attempt to detect the value of baseline LVEF as a predictor of early recovery or persistence of severe LV dysfunction.

Pregnancy in Marfan syndrome: maternal and fetal risk and recommendations for patient assessment and management.

Pregnancy in women with the Marfan syndrome (MFS) is associated with the potential for a catastrophic and even fatal acute aortic dissection and the risk of having a child who will inherit the syndrome. The approach to pregnancy in patients with MFS is therefore challenging and deserves special considerations. This article presents an extensive review of available clinical information and provides recommendations for the management of patients with MFS during pregnancy.