SGLT2 Inhibitor for Cardiac Protection in a Patient With Osimertinib-Responsive Advanced EGFR-Positive Lung Cancer.

An 85-year-old man with recently diagnosed metastatic EGFR+ lung adenocarcinoma treated with osimertinib presented after 1 month of therapy in decompensated congestive heart failure along with atrial fibrillation, prolonged QTc and acute kidney injury. Osimertinib was held. His hemodynamic status was optimized, and he was started on cardioprotective medications (losartan and metoprolol succinate), and LVEF recovered.

Linezolid-Induced Lactic Acidosis Presenting As Acute Cholecystitis: A Case Report and Systematic Review.

Linezolid has gained increased use for the treatment of infections caused by multidrug-resistant Gram-positive bacteria in recent years. It can cause rare but potentially life-threatening lactic acidosis. Here, we presented a case report of linezolid-induced lactic acidosis (LILA), along with a systematic review of current literature.

External Oblique Intercostal Plane Block: A Case Report and Review of Literature.

Chronic low back pain (CLBP) and post-laminectomy syndrome (PLS) can pose significant therapeutic challenges, often refractory to conservative management. We present a case of a 52-year-old male with refractory CLBP and PLS who underwent spinal cord stimulation (SCS) lead placement, and subsequently developed chronic right anterior chest wall and upper abdominal pain. Despite using SCS and opioid therapy, the pain persisted until an ultrasound-guided external oblique intercostal plane block (EOIPB) was administered, resulting in complete pain relief.

Molecular Phenotyping and Mechanisms of Myocardial Fibrosis in Advanced Chronic Kidney Disease.

Key Points: Myocardial fibrosis in hearts from patients with CKD is characterized by increased trimeric tensile collagen type I and decreased elastic collagen type III compared with hearts from hypertensive or healthy donors, suggesting a unique fibrotic phenotype. Myocardial fibrosis in CKD is driven by alterations in extracellular matrix proteostasis, including dysregulation of metalloproteinases and cross-linking enzymes. CKD-associated mineral stressors uniquely induce a fibronectin-independent mechanism of fibrillogenesis characterized by formation of trimeric collagen compared with proinflammatory/fibrotic cytokines.

Effectiveness of Repetitive Transcranial Magnetic Stimulation in Depression, Schizophrenia, and Obsessive-Compulsive Disorder: An Umbrella Meta-Analysis.

To analyze the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder, schizophrenia, and obsessive-compulsive disorder (OCD) via umbrella meta-analysis. Meta-analysis studies were searched in PubMed from inception to May 2021 using the keywords , , , , , , , , , , , , , , . PRISMA guidelines were followed.

Spontaneous Biloma With a Hepatic Mass.

We report a case of an 86-year-old Hispanic male who presented with generalized itching and jaundice. Computed tomography (CT) imaging revealed a hepatic mass and an extensive spontaneous biloma, a condition rarely associated with malignancy. Subsequent biopsy of the mass confirmed moderately differentiated adenocarcinoma of the pancreaticobiliary tract.

Alcohol Withdrawal Assessment Tool (AWAT) Reliability and Validity: Implications for Nurses Caring for Inpatients With Mental Health Disorders.

Background: Alcohol use affects 14.5 million Americans and high prevalence of use and potential for withdrawal among hospitalized patients presents a challenge for health care professionals to anticipate and manage effectively. Due to the acuity and fast-paced nature of the hospital environment, nurses need assessment tools that can be readily completed and drive efficient protocol-based treatment.

A Diagnostic Quandary of Escherichia Coli Pneumonia: A Case Report and Literature Review.

community-acquired pneumonia (CAP) is an under-recognized condition associated with higher mortality compared to the other well-studied causes of pneumonia. pneumonia is frequently associated with bacteremia. Despite the absence of abdominal or urinary symptoms, the infection may originate from an occult gastrointestinal (GI) source since it is a common commensal bacteria of the GI tract.

B-Cell Prolymphocytic Leukemia.

B-cell prolymphocytic leukemia (B-PLL) is a rare B-cell neoplasm that typically presents with splenomegaly, a rising white blood cell count, and may or may not have B symptoms. The diagnosis usually requires a bone marrow biopsy and aspirate with flow cytometry and cytogenetic studies. At least 55% of the lymphocytes in the peripheral blood must be prolymphocytes to be defined as B-PLL.

A Large Lung Abscess in an Electronic Cigarette User: To Drain or Not to Drain.

A lung abscess is a walled necrotizing infection involving the lung parenchyma, characterized by a cavitary lesion filled with fluid. It is usually caused by microbial infection with aspiration of oropharyngeal contents being the most common mechanism for primary lung abscesses. Secondary lung abscesses occur in the presence of predisposing lung conditions like bronchial obstruction, vascular or septic emboli or impaired host defenses.

Daptomycin-Rifampin-Induced Rhabdomyolysis, Acute Renal Failure, and Hepatic Injury: A Case Report and Literature Review.

Daptomycin is a canonical antibiotic used very commonly in practice for its bactericidal activity against Gram-positive bacteria, including vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, bone infections, skin and soft tissue infections, meningitis, urinary tract infections, and endocarditis. Although daptomycin in conventional doses is usually well tolerated, it is paramount to be aware of the possible adverse effects. Daptomycin is reported to cause an elevation in creatine kinase levels, although frank rhabdomyolysis is rare.

Ventriculorenal shunts in the treatment of pediatric and adult hydrocephalus-historical perspective and analysis of current practice.

Hydrocephalus is a complex pathology that can have a significant impact on the quality of life in all age groups. Cerebrospinal fluid (CSF) diversions from the lateral ventricle to the peritoneal cavity are regarded as the treatment of first intent, but they have a high revision rate, and there are multiple factors which can impair their proper insertion and function. One of the many alternatives to peritoneal shunting is redirecting the CSF towards the renal system.

A Case Report of a Rare Debilitating Complication of Diabetes: Neuropathic Cachexia.

A 56-year-old male with a history of type 2 diabetes mellitus and hypertension presented with complaints of intractable burning paresthesia of bilateral extremities, hyperesthesia, and unintentional weight loss. Other symptoms included anorexia, orthostatic hypotension, bowel and bladder dysfunction, and painful burning sensation on the soles of the feet. Emotional lability and a melancholy mood were noted.

Spontaneous Tumor Lysis Syndrome in a Patient with Bulky Chronic Lymphocytic Leukemia Diagnosed after Resolution of Symptoms.

Tumor lysis syndrome (TLS) is an oncologic emergency characterized by the destruction of tumor cells leading to an influx of large amounts of uric acid, potassium, and phosphorus into systemic circulation. It most often occurs after the initiation of cytotoxic therapy in high-grade lymphomas and leukemias; however, rarely it may occur spontaneously. The authors report a case of spontaneous tumor lysis causing electrolyte abnormalities and acute kidney injury in a patient with subsequently diagnosed large chronic lymphocytic leukemia tumor burden.

Fetal Heart Tracing Patterns and the Outcomes of Newborns With Meconium-Stained Amniotic Fluid.

Objective To determine if the presence of meconium-stained amniotic fluid (MSAF) by itself or in combination with abnormal fetal heart tracing (FHT) (category II and III) is associated with poor neonatal outcomes in full-term newborns. Design/methods This is a retrospective cohort study. Cases included singleton and full-term neonates with MSAF.

The Development of Immune Thrombocytopenia Due to COVID-19 Presenting as Menorrhagia.

Immune thrombocytopenia (ITP), also known as immune thrombocytopenic purpura, is a hematological disorder characterized by a decreased platelet count, predisposing patients to bleeding. Coronavirus disease 2019 (COVID-19) has been linked to multiple cases of newly diagnosed ITP and is usually found in moderate-to-severe infections, peaking in children and elderly adults. Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days.

Invasive and Pharmacological Treatment of Deep Vein Thrombosis: A Scoping Review.

The annual occurrence of venous thromboembolism (VTE) is 300,000-600,000 cases in the United States and 700,000 in Europe. VTE includes deep venous thrombosis (DVT) of upper or lower extremities, superior and inferior vena cava thrombosis, and pulmonary embolism (PE) as well. The primary treatment of DVT includes oral anticoagulation to prevent the progression of the thrombus and decrease the risk of pulmonary embolism.