Incidental diagnosis of a rare pancreatic plasmacytoma with plasmablastic features.

Multiple myeloma is a plasma cell neoplasm that accounts for 10% of all hematologic malignancies, characterized by malignant proliferation of monoclonal plasma cells in the bone marrow. It predominantly affects men 60 to 70 years of age. Plasmacytoma is a discrete mass of neoplastic monoclonal plasma cells that may be osseous or extramedullary.

The Utility of Cannabis-Based Medicine in Chronic Pain Management: A Case Report.

Chronic pain is a common diagnosis that patients may face, resulting in increased morbidity and mortality and affecting the overall quality of life. In addition to established multidisciplinary pain management, medical cannabis may offer an approach to improving pain outcomes and functionality. This case involves a 72-year-old female patient, with chronic neck, lower back, and diffuse arthritic pain due to comorbid osteoarthritis (OA), scleroderma, and scoliosis.

Skeletal fluorosis secondary to harmful inhalant use.

Introduction: Inhalants are common household items that may be abused for the desired effect of euphoria. Skeletal fluorosis is an uncommon and debilitating bone disorder caused by excess fluoride deposition. We report a case of skeletal fluorosis from chronic inhalation of an electronic duster product containing 1,1-difluoroethane.

A Review of Cutaneous Diseases Observed in Solid Organ Transplant Recipients.

Solid organ transplant recipients are at increased risk for numerous cutaneous conditions that fall within four categories: pre-neoplastic, neoplastic, infectious, or idiopathic. Many of these diseases can be attributed to immunosuppressive medications, including mycophenolate mofetil, cyclosporine, azathioprine, tacrolimus, or glucocorticoids. Iatrogenic lessening of the immune system places the patient at risk of malignancies, opportunistic infections, immune-mediated dermatoses, and adverse effects of medications.

Bedside Echocardiography Diagnosis of Tricuspid Valve Infective Endocarditis in the Emergency Department.

Infective endocarditis (IE) is a rare life-threatening entity that remains difficult to diagnose in the emergency department (ED). Focused cardiac ultrasound (FOCUS) with transthoracic echocardiography (TTE) is an indispensable bedside tool for the emergency physician (EP) to promptly diagnosis and expedite clinical management of IE. This report describes a case in which EP-performed FOCUS led to the early identification of right-sided tricuspid valve IE complicated with septic pulmonary emboli.

Beyond autophagy: LC3-associated phagocytosis and endocytosis.

Noncanonical functions of the autophagy machinery in pathways including LC3-associated phagocytosis and LC3-associated endocytosis have garnered increasing interest in both normal physiology and pathobiology. New discoveries over the past decade of noncanonical uses of the autophagy machinery in these distinct molecular mechanisms have led to robust investigation into the roles of single-membrane LC3 lipidation. Noncanonical autophagy pathways have now been implicated in the regulation of multiple processes ranging from debris clearance, cellular signaling, and immune regulation and inflammation.

A Diagnosis Not to Miss: A Case of Fitz-Hugh-Curtis Syndrome.

Fitz-Hugh-Curtis syndrome is a rare disease attributed to complications of pelvic inflammatory disease secondary to chlamydia or gonorrhea infections. Patients generally complain of vague abdominal pain that is often acute in onset, with or without genitourinary complaints. We present a case of Fitz-Hugh-Curtis syndrome with a young female who presents with a complaint of right upper quadrant abdominal pain for 2 months' duration.

A Rare Case of a Right Atrial Paraganglioma in an Individual with the SHDB Mutation.

Paragangliomas are extra-adrenal chromaffin cell tumors. A small percentage of these tumors can be found in the thoracic cavity and, when in the heart, are typically in the left atrium. In this case report, we discuss the case of an individual with a history of several paragangliomas with the mutation who was found to have two cardiac paragangliomas in the right atrium.

COVID-19 Delta Variant Co-Infection Mimicking COVID-19 ARDS.

The Delta variant of COVID-19 has been associated with severe disease causing a surge in the second half of 2021. Atypical pathogens can be present in those in particular with severe ARDS and can contribute to excess morbidity and mortality. We must maintain a high level of suspicion for these pathogens as this can present an opportunity to dramatically improve the prognosis of a patient with COVID-19 ARDS.

Traumatic atrial septal defect diagnosed by bedside point-of-care ultrasound.

Unlabelled: Atrial septal defects (ASD) caused by traumatic events, specifically blunt cardiac trauma, are considered an infrequent occurrence, yet their true prevalence has been difficult to ascertain. The general lack of knowledge is likely due to the pathology being severely understudied. We present the case of a 21-year-old male who was diagnosed with ASD following a motor vehicle accident.

Testicular Adrenal Rest Tumors in a Patient With Congenital Adrenal Hyperplasia.

Ultrasound is the imaging examination of choice for evaluation of suspected testicular pathology. The differential diagnosis of bilateral testicular lesions includes malignancy such as lymphoma and metastases, infection, and, uncommonly, adrenal rest tumors. We present a patient who developed bilateral testicular adrenal rest tumors after years of poorly controlled congenital adrenal hyperplasia, possibly due to chronically elevated adrenocorticotropic hormone stimulating the growth of testicular stem cells.

Diagnosis of Intrauterine Pregnancy Despite the Presence of Etonogestrel Implant.

While contraception is an important method to avoid pregnancy, it is not always effective. Our case details a 33-year-old-female with an etonogestrel implant who presented to the emergency department (ED) with a two-week history of vomiting and abdominal pain. Pelvic and transvaginal ultrasound confirmed a single, live intrauterine pregnancy.

A Four-Year-Old Female With a Rare P53 Gene Mutation Diagnosed With Li-Fraumeni Syndrome and Concomitant Metastatic Rhabdomyosarcoma: A Case Report.

Li-Fraumeni syndrome (LFS) is an autosomal dominant disorder that often results from mutations that impair the functions of the tumor suppressor gene p53. LFS is categorized as a hereditary cancer predisposition syndrome in which patients frequently suffer from an elevated degree of onset and incidence of neoplastic malignancies. Among the different pathogenic variants of LFS, TP53 is one of the most frequently encountered ones.

Genital Herpes Simplex Virus-An Updated Review.

The herpes virus was named by the Greek physician Hippocrates who called it herpes because the lesions appeared near each other and were vesicular. Alphaherpesvirinae, Betaherpesvirinae, and Gammaherpesvirinae are subfamilies of the human herpes virus family. The Alphaherpesvirinae subfamily includes the simplex viruses-HSV-1 and HSV-2-and varicellovirus-varicella zoster virus.

A customized early warning score enhanced emergency department patient flow process and clinical outcomes in a COVID-19 pandemic.

Objective: Patient crowding and boarding in the emergency department (ED) is associated with adverse outcomes and has become increasingly problematic in recent years. We investigated the impact of an ED patient flow countermeasure using an early warning score.

Methods: We conducted a cross-sectional analysis of observational data from patients who presented to the ED of a Level 1 Trauma Center in Pennsylvania.

Exploring the paradigm of robotic surgery and its contribution to the growth of surgical volume.

Background: Robotic surgery is an appealing option for both surgeons and patients. The question around the introduction of new surgical technology, such as robotics, with the potential link to increased procedure-specific volume has not been addressed. We hypothesize that hospital adoption of robotic technology increases the total volume of specific procedures as compared to nonrobotic hospitals.

Bidirectional Ventricular Tachycardia in Acute Multivessel Myocardial Infarction.

Bidirectional ventricular tachycardia (BVT) is a rare and unusual ventricular dysrhythmia that is characterized by a beat-to-beat alternation of the QRS axis. This can sometimes manifest as alternating left and right bundle branch blocks. To the best of our knowledge, there are two previous cases of BVT in the setting of type I myocardial infarction.

Serotonin Syndrome Induced Tako-Tsubo Syndrome.

Tako-tsubo syndrome is characterized by temporary systolic dysfunction of the left ventricle in the absence of coronary artery disease. Serotonin syndrome is a life-threatening condition associated with increased serotonergic activity in the central nervous system (CNS). We report a case of Tako-tsubo syndrome following seizures secondary to serotonin syndrome.

Surgical Outcomes Following Mohs Micrographic Surgery for Basal Cell Carcinoma on the Distal Third of the Nose.

Objective: The primary aim of this study is to determine a quantifiable difference in surgical outcomes between local skin flap, full thickness skin graft (FTSG), and secondary intention (SI) following Mohs micrographic surgery (MMS) for basal cell carcinoma (BCC) on the distal third of the nose.

Methods: A retrospective chart review of 66 MMS defects on the distal third of the nose performed by a single surgeon between June 2019 to June 2020 was completed. Clinical images of MMS defects and postoperative scars at six months were recorded and measured by the Vancouver Scar Scale (VSS).