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Unmasking Long QT Syndrome in a Serviceman: Effects of Hypoglycemia and a Flight Duty Medical Examination.
Mil Med
January 2025
Division of Endocrinology, Diabetes and Metabolism, University of California Davis Health, Sacramento, CA 95817, USA.
We report the case of a 29-year-old male soldier with a time in service above 10 years, found to have asymptomatic long QT syndrome (LQTS), a condition associated with increased risk of potentially fatal ventricular arrhythmias, during a flight physical. A review of his past medical history revealed a transient QT prolongation during an episode of hypoglycemia due to endogenous hyperinsulinism caused by an insulinoma, as an infantryman 7 years earlier; the resolution of the QT prolongation was spontaneous. He was evaluated and considered fit for duty by cardiology.
View Article and Find Full Text PDFCentral nervous system involvement in Whipple's disease: Report of a rare pathological entity and comparative review of treatment strategies and outcomes.
Radiol Case Rep
March 2025
Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Whipple's disease, caused by the gram-positive actinomycete , is a rare chronic systemic illness with significant diagnostic and therapeutic challenges, particularly when the CNS is involved. This case report details a 46-year-old man presenting with a constellation of symptoms including fatigue, hypersomnia, weight loss, bifrontal headaches, abdominal pain, treatment-unresponsive diarrhea, and skin hyperpigmentation. Neurological examination revealed oculomasticatory myorhythmia, and imaging studies showed nodular enhancement of the hypothalamus and basal ganglia, along with retroperitoneal lymphadenopathy.
View Article and Find Full Text PDFInsulinoma With Ambiguous Biochemistry, Positive Ga-DOTA-Exendin-4 PET-CT, and Effective Endoscopic Ablation.
JCEM Case Rep
January 2025
Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433.
A 75-year-old female presented with fasting hypoglycemic episodes. A supervised fast ended at 72 hours fulfilling Whipple triad, with suppressed insulin and C-peptide levels, but discordantly suppressed serum β-hydroxybutyrate levels. After 21 months of recurring symptoms, a repeat fast ended at 48 hours with Whipple triad, suppressed serum β-hydroxybutyrate level, and borderline nonsuppressed C-peptide level, suggesting endogenous hyperinsulinism.
View Article and Find Full Text PDFPatient With Post-operative Recurrent Pancreatic Cancer Treated With Cone Beam Computed Tomography-Guided Stereotactic Adaptive Radiotherapy: A Case Report.
Cureus
December 2024
Radiation Oncology, Washington University School of Medicine, Saint Louis, USA.
CT-guided adaptive radiotherapy (ART) for the treatment of pancreatic adenocarcinoma is rapidly increasing and has been shown to provide advanced treatment tools comparable to magnetic resonance imaging (MRI)-guided adaptive therapy. Here, we provide the first case report of a local pancreatic recurrence treatment after definitive resection using cone beam computed tomography (CBCT)-guided ART (CT-guided ART) enabled by HyperSight imaging (Varian Medical Systems, Inc., Palo Alto, CA, USA) for daily delineation of organs-at-risk (OARs) and target to improve the quality of online ART.
View Article and Find Full Text PDFAn Incidental Finding of Whipple's Disease Masquerading as Nonspecific, Long-Standing Symptoms.
Case Rep Infect Dis
December 2024
WakeMed's Division of Infectious Diseases, WakeMed Health and Hospitals, 3000 New Bern Ave, Raleigh 27610, North Carolina, USA.
Whipple's disease is a rare bacterial infection that is often present for years prior to diagnosis. Symptoms are nonspecific in the early stages of presentation and are primarily gastrointestinal in nature. The disease may progress with more systemic symptoms including arthralgia, fever, lymphadenopathy, cardiovascular disease, and central nervous system involvement.
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