Publications by authors named "Giselle Alexandra Suero-Abreu"

4 Publications

  • Page 1 of 1

Orbit and sinonasal metastasis as presenting sign of renal cell carcinoma.

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA

Orbit and sinonasal metastases are rare. Renal cell carcinoma (RCC) can metastasise to this region. We present the case of a 49-year-old woman with weight loss, diplopia and a rapidly growing facial mass. The initial diagnosis was a primary tumour and patient underwent excisional biopsy, which showed findings consistent with a diagnosis of RCC. On a subsequent focused review of system, the patient reported having intermittent haematuria. Imaging studies revealed a complex right renal mass as the primary tumour. Metastatic RCC should be in the differential diagnosis of patients with facial masses, especially if associated with symptoms suggestive of a systemic involvement such as haematuria. Despite treatment, patients with metastatic RCC tend to have a dismal prognosis. However, early stage diagnosis of metastatic disease can considerably limit surgical complications and improve survival rate in these patients.
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http://dx.doi.org/10.1136/bcr-2020-240588DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051362PMC
April 2021

Would you use novel oral anticoagulants (NOACs) for thromboprophylaxis in patients with an underlying hypercoagulable state? A literature review through a case report.

BMJ Case Rep 2020 Oct 30;13(10). Epub 2020 Oct 30.

Neurology, Cooper Hospital University Medical Center, Camden, New Jersey, USA.

Antiphospholipid syndrome (APLS) is an autoimmune condition that predisposes to venous and arterial thrombosis. Warfarin is the agent of choice for anticoagulation. However, a need for routine international normalised ratio (INR) checks and multiple drug interactions are some of the difficulties with warfarin. Currently, there is mixed evidence for and against the use of novel oral anticoagulants (NOACs) for thromboprophylaxis. We present a case report of a patient with APLS on a NOAC for secondary thromboprophylaxis who developed a stroke and discuss current evidence regarding the use of NOACs in patients with APLS. The patient was switched to warfarin for secondary thromboprophylaxis with an INR goal of 2-3. Literature review revealed mixed case reports for and against NOACs for secondary prevention of thrombotic events in patients with APLS. There needs to be further randomised controlled trials to evaluate the efficacy of NOACs for thromboprophylaxis in patients with APLS.
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http://dx.doi.org/10.1136/bcr-2020-237238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604795PMC
October 2020

Factors Associated with Disparities in Appropriate Statin Therapy in an Outpatient Inner City Population.

Healthcare (Basel) 2020 Sep 24;8(4). Epub 2020 Sep 24.

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.

Lipid-lowering therapies are essential for the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD). The aim of this study is to identify discrepancies between cholesterol management guidelines and current practice with a focus on statin treatment in an underserved population based in a large single urban medical center. Among 1042 reviewed records, we identified 464 statin-eligible patients. Age was 61.0 ± 10.4 years and 53.9% were female. Most patients were black (47.2%), followed by Hispanic (45.7%) and white (5.0%). In total, 82.1% of patients were prescribed a statin. An appropriate statin was not prescribed in 32.4% of statin-eligible patients who qualified based only on a 10-year ASCVD risk of ≥7.5%. After adjustment for gender and health insurance status, appropriate statin treatment was independently associated with age >55 years (OR = 4.59 (95% CI 1.09-16.66), = 0.026), hypertension (OR = 2.38 (95% CI 1.29-4.38), = 0.005) and chronic kidney disease (OR = 3.95 (95% CI 1.42-14.30), = 0.017). Factors independently associated with statin undertreatment were black race (OR = 0.42 (95% CI 0.23-0.77), = 0.005) and statin-eligibility based solely on an elevated 10-year ASCVD risk (OR = 0.14 (95% CI 0.07-0.25), < 0.001). Hispanic patients were more likely to be on appropriate statin therapy when compared to black patients (86.8% vs. 77.2%). Statin underprescription is seen in approximately one out of five eligible patients and is independently associated with black race, younger age, fewer comorbidities and eligibility via 10-year ASCVD risk only. Hispanic patients are more likely to be on appropriate statin therapy compared to black patients.
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http://dx.doi.org/10.3390/healthcare8040361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712578PMC
September 2020

Multiple recurrent ischaemic strokes in a patient with cancer: is there a role for the initiation of anticoagulation therapy for secondary stroke prevention?

BMJ Case Rep 2017 Jun 3;2017. Epub 2017 Jun 3.

Department of Neurology, Cooper University Hospital, Camden, New Jersey, USA.

A 52-year-old woman with a medical history of cervical and thyroid cancer, hypertension, dyslipidaemia, uncontrolled diabetes and heavy smoking was diagnosed with a new metastatic cholangiocarcinoma. While undergoing palliative chemotherapy, she developed dysarthria and left-sided weakness. Imaging studies showed multiple bilateral ischaemic strokes. On hospital days 2 and 5, she developed worsening neurological symptoms and imaging studies revealed new areas of ischaemia on respective days. Subsequent workup did not revealed a clear aetiology for the multiple ischaemic events and hypercoagulability studies were only significant for a mildly elevated serum D-dimer level. Although guidelines are unclear, full-dose anticoagulation with low molecular weight heparin was initiated given her high risk of stroke recurrence. She was discharged to acute rehabilitation but, within a month, she experienced complications of her malignant disease progression and a new pulmonary thromboembolism. The patient died soon after being discharged home with hospice care.
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http://dx.doi.org/10.1136/bcr-2016-218105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534754PMC
June 2017