Primary mediastinal seminoma presenting with paraneoplastic anti-Hu encephalitis: a case report and literature review.

Primary mediastinal seminomas are exceedingly rare tumors, often localized to the anterior mediastinum. They may present with numerous complications, including superior vena cava syndrome, chylothorax, and pericardial effusions. Less commonly, they may present with paraneoplastic encephalitis.

The Anesthetic Effects of Lidocaine with Epinephrine in Digital Nerve Blocks: A Systematic Review.

There is a long-standing stigma associated with the use of epinephrine in digital nerve blocks (DNBs) over the concern of digital necrosis. We conducted a systematic review to assess the duration of anesthesia, onset of anesthesia, and complications of lidocaine with epinephrine compared with plain lidocaine for DNBs in adults. We searched Medline via Ovid, Cochrane Library, and ClinicalTrials.

Healthcare in the Himalayan Kingdom of Bhutan: Lessons for the United States and other western healthcare systems.

Bhutan has demonstrated a trajectory of advances in healthcare, while still remaining true to its culture and traditional forms of medicine. Most recently, Bhutan gained international attention when it implemented a strategic Covid-19 vaccination programme that protected a greater percentage of its population than observed in Western industrialised nations. This accomplishment supports the idea that there are lessons from Bhutan to be shared with the rest of the world.

Intramedullary disseminated sporotrichosis in an immunocompetent patient: case report and review of the literature.

Background: Disseminated sporotrichosis is a severe opportunistic infection that often affects immunocompromised patients after a cutaneous inoculation. Here we present a rare case of disseminated sporotrichosis discovered as a solitary intramedullary thoracic spinal cord lesion in an immunocompetent patient.

Case Description: A 37-year-old man presented with progressive lower limb weakness and sensory changes over 1 week.

Atypical Hemolytic Uremic Syndrome in a Pregnant Patient with a Thrombomodulin Gene Variant Treated with Plasma Exchange and Eculizumab.

BACKGROUND Hemolytic uremic syndrome (HUS) includes the triad of thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure. The atypical form of HUS is a rare disease characterized by complement overactivation, and it can be from genetic or acquired causes. Genetic causes involve mutation in one of the factors in the alternative complement pathway or inhibitors.

Purple urine in a patient with UTI and constipation.

Purple urine bag syndrome (PUBS) is a visually striking and a rare side effect in a patient with urinary tract infection where urine in the catheter bags and tubing turn purple. The urine in PUBS gets its color from the combination of two pigments, indirubin and indigo, which are breakdown products of tryptophan. The most important risk factors include long-term catheterization, female gender, chronic constipation, old age and being bed bound.

A Bibliometric and Visual Analysis of the Most Cited Articles on Disc Arthroplasty.

Study Design: Bibliometric literature review.

Objective: Total disc arthroplasty (TDA) is an evolving technique used by surgeons to preserve neural elements and range of motion in patients with degenerative disc disease, spondylosis and more. In comparison to discectomy, disc arthroplasty has been shown to decrease morbidity, reduce adjacent-level disease, and preserve pre-operative range of motion.

Enabling health potential: exploring nonlinear and complex results of osteopathic manual medicine through complex systems theory.

Osteopathic medicine is a holistic, patient-specific approach. Explaining the impact of osteopathic manipulative medicine (OMM) has been problematic because many of its effects are nonlinear. Complex systems theory (CST) is explored as a mechanism of understanding the interplay of the body's anatomy and physiology, an illness process, and the effects of OMM.

What Can State Medical Boards Do to Effectively Address Serious Ethical Violations?

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public.

Renal manifestations of recreational drugs: A narrative review of the literature.

Drug abuse has become a major problem of the modern world where drug-induced kidney injury can be caused by both prescribed drugs for clinical conditions and illegal (illicit) drugs or drugs of abuse. Heroin, cocaine, nicotine and alcohol are the most commonly abused drugs but with the emergence of various synthetic drugs, numerous novel descriptions of their nephrotoxic effects have been described. This review summarizes the key renal manifestations of recreational drugs as reported in case reports and case.

A Case of Eosinophilic Angiocentric Fibrosis With Palatal Fistulas.

Eosinophilic angiocentric fibrosis (EAF) is a rare, but benign, tumefactive lesion of the head and neck regions. It was initially discovered in 1983 but has recently been connected to the spectrum of immunoglobulin G4-related disease (IgG4-RD). It commonly presents with symptoms of nasal obstruction, structural deformities of the external nose, and involvement of the nasal septum and lateral nasal wall.

Sodium-glucose cotransporter 2 inhibitor-associated severe epididymo-orchitis.

A man in his late 50s, with uncontrolled type 2 diabetes mellitus (T2DM) and morbid obesity, presented to the hospital with complicated epididymo-orchitis. The onset of symptoms (scrotal pain, erythema and swelling) occurred after the use of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, for 2 months. His baseline antidiabetic medications were insulin, glipizide and metformin.

Conservative management of a large idiopathic pulmonary artery aneurysm: A case report.

Introduction And Importance: Pulmonary artery aneurysms are rare anomalies of the pulmonary vasculature. They are often asymptomatic and frequently an incidental finding on imaging or autopsy. It is imperative to closely monitor pulmonary artery aneurysms as they can result in sudden dissection, rupture, and death.

Immobilization-Induced Hypercalcemia in COVID-19 With a Prolonged Intensive Care Unit Stay.

Immobilization is an uncommon etiology of hypercalcemia. It is usually seen in conditions associated with limited movements such as spinal cord injuries, vascular events, or following prolonged hospitalization. Hereby, we present a case of a young patient who had prolonged hospitalization following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Polypharmacy in a Patient With Intellectual and Developmental Disabilities.

Prader-Willi syndrome (PWS) is an uncommon condition and its clinical manifestation in adulthood includes central obesity, hypogonadism, osteoporosis, cardiovascular disease, diabetes mellitus, and sleep apnea. These patients often have mild to moderate intellectual disability and are dependent upon their caregiver for healthcare needs. Hence, they may be at increased risk of polypharmacy-related complications, if there is poor communication between healthcare providers and caregivers.

Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment.

Pituitary apoplexy (PA) is a clinical condition characterised by a sudden increase in pituitary gland volume secondary to ischaemia and/or necrosis. Most cases occur in non-functioning pituitary adenoma but can also occur in functioning adenoma. Certain predisposing factors can result in PA and the use of gonadotropin-releasing hormone (GnRH) agonists for prostate cancer (PCa) is one such condition.

Outpatient Management of Gastroduodenal Artery Aneurysm.

Gastroduodenal artery (GDA) aneurysms are exceptionally rare. Although rare, providers should have a sufficient understanding of the causes, symptoms, and treatment options due to there being a high risk of mortality if these aneurysms rupture. It is important to understand the need for close management and follow-up in patients with this diagnosis, especially in the outpatient setting.

A Rapidly Progressive Case of Ectopic Adrenocorticotropic Hormone (ACTH) Syndrome.

BACKGROUND Adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome (CS) secondary to an ectopic source is an uncommon condition, accounting for 4-5% of all cases of CS. Refractory hypokalemia can be the presenting feature in patients with ectopic ACTH syndrome (EAS), and is seen in up to 80% of cases. EAS can be rapidly progressive and life-threatening without timely diagnosis and intervention.

Pulsed Electromagnetic Field Stimulators Efficacy for Noninvasive Bone Growth in Spine Surgery.

The growth of pulsed electromagnetic field (PEMF) therapy and its progress over the years for use in post-operative bone growth has been revolutionary in its effect on bone tissue proliferation and vascular flow. However, further progress in PEMF therapy has been difficult due to lack of more evidence-based understanding of its mechanism of action. Our objective was to review the current understanding of bone growth physiology, the mechanism of PEMF therapy action along with its application in spinal surgery and associated outcomes.