4,562 results match your criteria Journal of the Louisiana State Medical Society[Journal]


Fluid Flow Patterns Through Drainage Catheters: Clinical Observations in 99 Patients.

J La State Med Soc 2018 Sep-Oct;170(5):146-150

Department of Radiology; Louisiana State University Health Shreveport. 1501 Kings Highway, Shreveport, Louisiana, 71130.

Purpose: To describe patterns of fluid flow through locking pigtail and biliary catheters in patients that underwent biliary and abdominopelvic fluid drainage.

Methods: Contrast movement through catheter sideholes in pigtail and biliary catheters was evaluated retrospectively using sinograms and cholangiograms at 7-10 days post insertion. Dilute contrast injected through the catheter was evaluated by following flow through the catheter shaft and exit from side holes within the body cavity. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347390PMC
January 2019

Radiology Case of the Month: TB or Not TB… That is the Question.

J La State Med Soc 2017 Jul-Aug;169(4):111-113. Epub 2017 Aug 28.

Tulane University Health Sciences Center, Department of Radiology - New Orleans, LA.

45-year-old female presenting initially with fever, nonproductive cough, night sweats, pleuritic chest pain, fatigue and weight loss over the past month. Read More

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March 2018
14 Reads

ECG Case of the Month: Wide-QRS Rhythm in a Man with a Clotted Dialysis Fistula.

J La State Med Soc 2017 Jul-Aug;169(4):109-110. Epub 2017 Aug 28.

Louisiana State University Health Sciences Center - New Orleans, LA.

A 57-year-old man with diabetes mellitus, systemic arterial hypertension, and end-stage kidney disease came to the hospital because his arteriovenous fistula used for hemodialysis had clotted. His blood hemoglobin level was 12.8 g/dL (reference, 13. Read More

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March 2018
7 Reads

Clinical Case of the Month:: Abdominal Pain in a 39-year-old Man with Recent International Travel.

J La State Med Soc 2017 Jul-Aug;169(4):106-108. Epub 2017 Aug 28.

Louisiana State University Health Sciences Center, Department of Medicine - New Orleans, LA.

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August 2017
6 Reads

Postpartum Coronary Arterial Spasm.

J La State Med Soc 2017 Jul-Aug;169(4):101-105. Epub 2017 Aug 28.

University of Tennessee Health Science Center, Department of Medicine, Division of Cardiology - Memphis, TN.

Background: Acute coronary syndrome (ACS) during postpartum period is rare. In the current manuscript we present a case of a postpartum patient who developed ACS attributed to coronary vasospasm in the absence of vasocontrictive medication or smoking. This condition resolved with intracoronary injection of nitroglycerine and verapamil. Read More

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March 2018
8 Reads

An Elderly Man with a Swollen Knee,Significant Ecchymosis, and Minimal Knee Pain.

J La State Med Soc 2017 Jul-Aug;169(4):99-100. Epub 2017 Aug 28.

Tulane University Health Sciences Center, Department of Radiology - New Orleans, LA.

A 72-year-old man presents with left knee pain and swelling over several days. The pain and swelling started after he felt a "pop" when bending to pick up an object off the floor. His past medical history is significant for type 2 diabetes mellitus. Read More

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March 2018
15 Reads

Obturator Hernia, 'The Little Old Lady Hernia'.

J La State Med Soc 2017 Jul-Aug;169(4):96-98. Epub 2017 Aug 28.

Louisiana State University Health, Department of Surgery - Shreveport, LA.

Obturator hernia is a rare type of abdominal hernia that classically presents in elderly women. We report the case of 78-year-old woman with progressive vomiting, obstipation, and abdominal pain. Contrast-enhanced computed tomography showed a left-sided obturator hernia, which was confirmed and treated at laparotomy. Read More

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March 2018
10 Reads

Pledget Induced Cardiogenic Shock Following a Minimally Invasive Aortic Valve Replacement.

J La State Med Soc 2017 Jul-Aug;169(4):94-95. Epub 2017 Aug 28.

Department of Cardiovascular and Thoracic Surgery, Lafayette General Medical Center - Lafayette, LA.

Within the last decade, minimally invasive valve replacements have become exceedingly popular, and as a result, so has the rise of technology aimed at refining and simplifying these techniques. With new technology, new complications are inevitable. We present a routine Minimally invasive aortic valve replacement through a right anterior minithoracotomy complicated by pledget impaction in a coronary artery. Read More

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March 2018
3 Reads

Osmotic Demyelination Syndrome Revisited: Review With Neuroimaging.

J La State Med Soc 2017 Jul-Aug;169(4):89-93. Epub 2017 Aug 28.

Department of Radiology, Tulane University Health Sciences Center - New Orleans, LA.

Osmotic demyelination syndrome (ODS) is a general term that has become commonplace in the practice of medicine, encompassing both central pontine myelinolysis and extrapontine myelinolysis. Historically ODS arises as a serious complication of rapid correction of hyponatremia, yet its manifestations seem to be influenced by a multifactorial process. Further understanding of this rare demyelinating disease has elucidated the significant role of other electrolyte disturbances and the presence of chronic comorbidities as disease risk factors. Read More

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March 2018
43 Reads

Radiology Case of the Month: Idiopathic CD4 Lymphocytopenia.

J La State Med Soc 2017 May-Jun;169(3):85-87. Epub 2017 Jun 23.

Department of Radiology at Tulane University, Health Sciences Center - New Orleans, LA.

A 39 year-old male with a history of diabetes, retinitis pigmentosa, and genital warts presented with intractable occipital headaches accompanied with nausea and vomiting. The patient had markedly depressed CD4 counts. Furthermore the patient tested negative for HIV and HTLV 1/2 and had normal immunoglobulin levels. Read More

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March 2018
2 Reads

ECG Case of the Month: Chest Pain and ECG Abnormalities.

Authors:
D Luke Glancy

J La State Med Soc 2017 May-Jun;169(3):83-84. Epub 2017 Jun 23.

Louisiana State University Health Sciences Center in New Orleans, LA.

A 27-year-old man was admitted to the coronary care unit because of chest pain and an electrocardiogram (ECG) read by the computer as an inferior infarct and left ventricular hypertrophy (Figure). Read More

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March 2018
5 Reads

Clinical Case of the Month: A 57-Year-Old Man with an Axillary Mass.

J La State Med Soc 2017 May-Jun;169(3):78-82. Epub 2017 Jun 23.

Department of Medicine, LSUHSC - New Orleans.

A 57-year-old man presented to the surgical oncology clinic with a mildly tender mass under his right arm. Four years prior, the patient had a melanoma removed from his right shoulder along with an ipsilateral right axillary sentinel lymph sampling. Computed tomography (CT) scan was negative for metastatic disease at that time. Read More

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March 2018
34 Reads

Transvenous Before Surgical Hybrid Procedure.

J La State Med Soc 2017 May-Jun;169(3):71-77. Epub 2017 Jun 23.

Louisiana State University Health Sciences Center - New Orleans, LA.

Background: Historically, persistent atrial fibrillation (PeAF) and long standing persistent atrial fibrillation (LSPeAF) have demonstrated limited clinical success despite hybrid approaches.

Objective: We describe our experience with the endocardial-before-epicardial approach defined by a comprehensive endovascular approach preceding and guiding the epicardial approach which includes an extensive posterior wall ablation.

Methods: 40 patients were followed over a 12 month period. Read More

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March 2018
10 Reads

Acute Promyelocytic Leukemia and Chronic Lymphocytic Leukemia: Concomitant Presentation of Two Molecularly Distinct Entities.

J La State Med Soc 2017 May-Jun;169(3):68-70. Epub 2017 Jun 23.

Department of Hematology/Oncology, LSU Health Sciences Center - Shreveport, LA.

Acute myeloid leukemia (AML) developing in patients with chronic lymphocytic leukemia (CLL) is very uncommon and usually associated with prior treatment. Acute promyelocytic leukemia (APL) accounts for a very small proportion of treatment-associated AML. So far, there has been only one reported case of APL occurring post radiation for prostate cancer in a patient with CLL. Read More

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March 2018
13 Reads

Louisiana Physicians Are Increasing HPV Vaccination Rates.

J La State Med Soc 2017 May-Jun;169(3):63-67. Epub 2017 Jun 23.

Louisiana State University Health Sciences Center, School of Medicine - New Orleans, LA.

Human papilloma virus (HPV) is a common virus that can cause genital warts and certain cancers. The HPV vaccine is effective in preventing many HPV-associated diseases, however, vaccination rates suggest many remain unprotected. This study examined successful strategies used by physicians to improve HPV vaccination rates. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757236PMC
March 2018
4 Reads

Radiology Case Of The Month: Mental Disturbance for 4 days.

J La State Med Soc 2017 Mar-Apr;169(2):60-61. Epub 2017 Apr 15.

Tulane University Health Sciences Center in New Orleans Louisiana.

A 56 year old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulders were noted. The patient's history was significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary hypertension and alcoholic cardiomyopathy. Read More

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September 2017
4 Reads

ECG Of The Month: Mental Disturbance for 4 days.

J La State Med Soc 2017 Mar-Apr;169(2):58-59. Epub 2017 Apr 15.

A family brought their 61-year-old mother to the emergency department because for 4 days she had been confused, incoherent, and somnolent. She also had dysphagia, dysarthria, diplopia, and had fallen out of bed. She had been in the hospital 3 weeks earlier for atrial fibrillation and an exacerbation of congestive heart failure. Read More

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September 2017
3 Reads

Disseminated Cryptococcal Disease with Diffuse Pulmonary Infiltrates in a Non-HIV Host.

J La State Med Soc 2017 Mar-Apr;169(2):57. Epub 2017 Apr 15.

Department of Internal Medicine, LSU Health Sciences Center - Shreveport, LA.

Introduction: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia.

Case: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis. Read More

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September 2017
3 Reads

Severe Sepsis and Septic Shock Cases Meeting Guidelines Among Patients in a University Hospital Setting.

J La State Med Soc 2017 Mar-Apr;169(2):57. Epub 2017 Apr 15.

Department of Internal Medicine, University Hospital and Clinics, LSU Health, Lafayette.

Background: A diagnosis of severe sepsis or septic shock has been shown to significantly increase mortality rate independent of other factors. Research has revealed all cause hospital case fatality rates have declined yet the percentage of severe sepsis cases continues to increase and age-adjusted mortality rates from severe sepsis and septic shock has significantly increased during the same time period. Patients with severe sepsis demonstrate ongoing mortality rate increases for up to 2 years following hospitalization when compared to aged matched controls of nonseptic patients. Read More

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September 2017
6 Reads

Association of State-Mandated Abstinence-only Sexuality Education with Rates of Adolescent HIV Infection and Teenage Pregnancy.

J La State Med Soc 2017 Mar-Apr;169(2):56. Epub 2017 Apr 15.

Department of Medicine, Tulane Health Sciences Center, New Orleans, LA.

Introduction: Abstinence-only sexuality education (AOSE); is required in the public school systems of many states, raising public health concerns and perpetuating health disparities through school systems. This study aimed to determine the correlations between state-mandated AOSE and the rates of adolescent HIV and teen pregnancy.

Methods: Using publicly available data on all 50 United States' laws and policies on AOSE, states were ranked according to their level of abstinence emphasis on sexuality education (Level 0 - Level 3);. Read More

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September 2017
4 Reads

Who Shot the Cannonballs? Extensive Lung Metastases in a 39 Year Old Man.

J La State Med Soc 2017 Mar-Apr;169(2):56. Epub 2017 Apr 15.

Department of Medicine, LA State University Health Science Center, Shreveport, LA.

Case: A 39 year-old man presented to the emergency department complaining of a cough of 2 months in duration. He also complained of weight loss of 20 pounds in two months and night sweats over the same period. An x-ray of the chest was performed and revealed innumerable lung nodules and masses. Read More

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September 2017
5 Reads

Recurrent Hypertriglyceridemic Pancreatitis (HTGP); and the Use of Insulin Drip as Treatment.

Authors:
T Tran N Lee

J La State Med Soc 2017 Mar-Apr;169(2):55-56. Epub 2017 Apr 15.

Department of Internal Medicine, Ochsner Medical Center, New Orleans, LA.

Introduction: Chronic pancreatitis by definition is a recurrent episode of acute pancreatitis and is commonly associated with alcoholism in the US. Another cause of chronic pancreatitis is hypertriglyceridemia (HTGP);, occurring in 1-5 percent of cases. The incidence of HTGP is higher in patients with diabetes and HIV, usually requiring triglyceride levels > 1000 mg/dL. Read More

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September 2017
3 Reads

A Left Main Coronary Artery Thrombus Presenting as a Non St Elevation MI.

J La State Med Soc 2017 Mar-Apr;169(2):55. Epub 2017 Apr 15.

Department of Medicine, Leonard J. Chabert Medical Center, Houma, LA.

Introduction: Left main coronary artery (LMCA); thrombus with an acute myocardial infarction identified with coronary angiography is a clinically rare condition with an extremely high mortality rate. We present a case of LMCA thrombus that presented as a non-ST elevation myocardial infarction (NSTEMI);.

Case: A 45-year-old woman with a history of tobacco use and hyperlipidemia presented with a complaint of 10/10 "hard pain" across her chest radiating to her left shoulder and breast which woke her from sleep. Read More

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September 2017
5 Reads

What Can Erode Through Lungs, Bone and Skin?

J La State Med Soc 2017 Mar-Apr;169(2):55. Epub 2017 Apr 15.

Department of Internal Medicine, University Hospital and Clinics, LSU Health, Lafayette.

Case: A 51 year old African American Man without significant past history presented with three weeks of persistent cough productive of copious yellow sputum. He denied fevers, chills, hemoptysis, dyspnea, weight or appetite changes, sick contacts, recent travel. On physical examination, the patient was afebrile and appeared comfortable. Read More

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September 2017
4 Reads

A Rare Cause of Abdominal Pain.

J La State Med Soc 2017 Mar-Apr;169(2):54-55. Epub 2017 Apr 15.

Department of Medicine, LSU Health Sciences Center, New Orleans, LA.

Case: A 54 year old woman with hypothyroidism presented with right flank pain that began acutely one week prior to presentation. She was told initially she had a urinary tract infection and treatment resulted in mild symptomatic improvement. The pain returned and she presented to another Emergency Department (ED); and was told the pain was due to constipation. Read More

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September 2017
5 Reads

Misses Opportunity: TOF Diagnoses in 4th Decade of Life.

J La State Med Soc 2017 Mar-Apr;169(2):54. Epub 2017 Apr 15.

Department of Internal Medicine, LSU Health, Baton Rouge, LA.

Case: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Read More

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September 2017
3 Reads

What the Eyes Don't See, the Heart Does Grieve Over.

Authors:
M Sciaudone M Dery

J La State Med Soc 2017 Mar-Apr;169(2):53-54. Epub 2017 Apr 15.

Department of Internal Medicine, Tulane Health Sciences Center, New Orleans, LA.

Introduction: A 71 year old Peruvian woman presented with blurry vision and bilateral eye pain and had evidence of bilateral endophthalmitis on eye examination. Her past medical history was notable for multiple abdominal surgeries within the preceding months, including an incarcerated inguinal hernia repair which required an ileostomy placement, and cholecystitis requiring cholecystostomy tube placement. Over her multiple long hospitalizations, she developed bacteremia and fungemia on several occasions, with organisms including Enterobacter cloacae, Klebsiella pneumoniae, Bacteroides fragilis, Pseudomonas aeruginosa, Enterococcus faecium, and Candida albicans. Read More

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September 2017
3 Reads

A Rare Case of Tropical Pyomysitis Acquired on Vacation in a Healthy Male.

Authors:
K Poole T Tran

J La State Med Soc 2017 Mar-Apr;169(2):53. Epub 2017 Apr 15.

Department of Internal Medicine, Ochsner Medical Center, New Orleans, LA.

Introduction: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. Read More

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September 2017
3 Reads

Pheochromocytoma of the Organ Zuckerkandl.

J La State Med Soc 2017 Mar-Apr;169(2):53. Epub 2017 Apr 15.

Department of Internal Medicine, LSU Health Sciences Center, New Orleans, LA.

Introduction: Pheochromocytomas (PCCs);, or intra-adrenal paragangliomas (PGLs);, are neuroendocrine tumors arising within the adrenal medulla. Extra-adrenal paragangliomas may arise in the sympathetic or parasympathetic paraganglia and more rarely in other organs. One of the most common extra-adrenal sites is in the organ of Zuckerkandl, a collection of chromaffin cells near the origin of the inferior mesenteric artery or near the aortic bifurcation. Read More

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September 2017
5 Reads

Case Report of Sarcoidosis as a Great Mimicker in Various Populations.

J La State Med Soc 2017 Mar-Apr;169(2):52. Epub 2017 Apr 15.

Department of Medicine, Leonard J Chabert Medical Center in Houma, LA.

Introduction: The prevalence of sarcoidosis varies as much as 1-40 cases per 100,000 depending on region and population. Sarcoid typically occurs in people younger than 50 years old, with a peak incidence with ages between 20 and 40 years old. African Americans are 3 times more likely to develop sarcoidosis than Caucasian Americans, and woman are more likely than men to develop sarcoidosis in any ethnic group; nonetheless, it remains a valid differential across any population. Read More

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September 2017
4 Reads

A Clot (Possibly); Due to Loss of TNF-α Supression.

J La State Med Soc 2017 Mar-Apr;169(2):52. Epub 2017 Apr 15.

Department of Medicine, LSU Health in Baton Rouge, LA.

Introduction: Inflammation and venous thrombosis enjoy a close Relationship. We present a patient who had multiple DVTs following the discontinuation of anti- TNF-α therapy.

Case: A 34 year old African American female with a history of multiple DVT's, miscarriages, and reported Crohn's disease presented with shortness of breath. Read More

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September 2017
4 Reads

Purulent Pericarditis Due to an Infected Pacemaker Lead.

Authors:
Teresa Backes

J La State Med Soc 2017 Mar-Apr;169(2):51-52. Epub 2017 Apr 15.

Department of Internal Medicine, LSU Health Sciences Center in New Orleans, LA.

Introduction: Intravenous drug users have a substantially increased risk of infective endocarditis, especially in the setting of implanted cardiac devices. Purulent pericarditis is a rare occurrence that can occur iatrogenically or through direct or hematogenous spread.

Case Description: A 75 year old man with a past medical history significant for hepatitis C, IV drug abuse, and sick sinus syndrome status post pacemaker was brought in by EMS with a chief complaint of diaphoresis and chest pain. Read More

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September 2017
5 Reads

A Strong and Fortuitous Case of Dyspnea.

J La State Med Soc 2017 Mar-Apr;169(2):51. Epub 2017 Apr 15.

Department of Internal Medicine, Tulane Health Sciences Center in New Orleans, LA.

Case: A 48 year-old man with no past medical history was sent to our emergency department (ED); from a primary care clinic for hypertensive urgency of 200/130. The man reported an intermittent non-productive cough of approximately one year's duration and worsening dyspnea on exertion and orthopnea over the last month with lower extremity swelling. Of note, he emigrated from Honduras twenty years ago. Read More

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September 2017
5 Reads

Three's a Crowd - An Extremely Rare Case of Cor Triatriatum Dexter.

J La State Med Soc 2017 Mar-Apr;169(2):50-51. Epub 2017 Apr 15.

Department of Medicine, Leonard J. Chabert Medical Center in Houma, LA.

Introduction: Cor triatriatum is a congenital cardiac anomaly in which the left (sinister) or right (dexter) atrium is divided into two compartments by residual embryonic tissue, resulting in a tri-atrial heart. As cor triatriatum dextrum can present clinically in various ways and have multiple associated cardiac anomalies, this report attempts to contribute to what is known about this exceedingly rare disorder.

Case: A 40 year old Hispanic man with a medical history of gastritis presented with complaints of palpitations, dizziness and bilateral lower extremity edema. Read More

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September 2017
12 Reads

Diulafoy's Lesion - An Uncanny Etiology of Gastrointestinal Bleed.

Authors:
V Gasia O Lamendola

J La State Med Soc 2017 Mar-Apr;169(2):50. Epub 2017 Apr 15.

Department of Medicine, Baton Rouge General Medical Center in Baton Rouge, LA.

Introduction: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding.

Case: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Read More

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September 2017
4 Reads

A Case of Hepatosplentic T Cell Lymphoma - A Rare, Aggressive Tumor of the Young.

J La State Med Soc 2017 Mar-Apr;169(2):49-50. Epub 2017 Apr 15.

Department of Medicine, LSU Health Sciences Center in Shreveport, LA.

Introduction: Hepatosplenic T-cell lymphoma (HSTCL); is an unusual entity first described in 1990 that predominantly affects middle-aged men and is classified by WHO under peripheral T-cell lymphomas. We present a 26-year-old man with HSCTL treated with a non-CHOP regimen.

Case: A 26 year old immigrant from Cameroon without significant past medical history presented with abdominal discomfort that was first noted 1 month prior at which time he was elbowed in abdomen during a basketball game. Read More

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September 2017
3 Reads

Autoimmune Diabetes Presented with Diabetic Ketoacidosis Induced by Immunotherapy in an Adult with Melanoma.

J La State Med Soc 2017 Mar-Apr;169(2):49. Epub 2017 Apr 15.

Department of Internal Medicine, Ochsner Medical Center in New Orleans, LA.

Introduction: Immunotherapy has been approved for treatment of melanoma. Autoimmune endocrinopathies have been reported in trials involving immunotherapy but autoimmune diabetes has not been definitively linked to them. Here we describe a case of autoimmune diabetes presenting with DKA after receiving combined immunotherapy with anti-CTLA4 and anti-PD1 monoclonal antibodies. Read More

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September 2017
10 Reads

The Mysterious Case of Dyspnea.

J La State Med Soc 2017 Mar-Apr;169(2):48-49. Epub 2017 Apr 15.

Section of Cardiology, LSU Health Sciences Center New Orleans.

Introduction: Dehiscence of a mitral valve annuloplasty ring is a rare occurrence that often manifests as mitral regurgitation and heart failure. We present a case of mitral ring dehiscence which was initially unrecognized by standard 2-dimensional transthoracic echocardiography (2D TTE); and 2-dimensional transesophageal echocardiography (2D TEE);.

Case: A 65-year-old woman was referred to Cardiology clinic for evaluation of dyspnea. Read More

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September 2017
3 Reads

Just a "Puff of Smoke".

Authors:
A Leonard

J La State Med Soc 2017 Mar-Apr;169(2):48. Epub 2017 Apr 15.

Department of Internal Medicine, LSU Health Sciences Center in New Orleans, LA.

Case: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. Read More

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September 2017
4 Reads

A Case of Early Neurosyphilis.

J La State Med Soc 2017 Mar-Apr;169(2):47-48. Epub 2017 Apr 15.

Department of Internal Medicine, LSU Health in Baton Rouge, LA.

Introduction: Neurosyphilis is an infection of the central nervous system by Treponema pallidum, which can occur after the initial syphilis infection. Although commonly associated with late stage disease, patients with early neurosyphilis may present with acute syphilitic meningitis, meningovascular syphilis, or uveitis.

Case: A 28 year old man with a past medical history of HIV (CD4 364);, and recent diagnosis of uveitis presented to the Emergency Department with a positive RPR result. Read More

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September 2017
4 Reads

Gonococcal Endocarditis: The Gift That Stops Giving! An Uncommon Presentation of a Common Disease.

J La State Med Soc 2017 Mar-Apr;169(2):47. Epub 2017 Apr 15.

Department of Internal Medicine, Leonard J. Chabert Medical Center in Houma, LA.

Introduction: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. Read More

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September 2017
5 Reads

Not Another ACS Rule Out.

J La State Med Soc 2017 Mar-Apr;169(2):47. Epub 2017 Apr 15.

Tulane University School of Medicine, Department of Internal Medicine in New Orleans, LA.

Case: A 50 year old African-American woman with diabetes, hypertension, and hyperlipidemia presented with progressively worsening retro-sternal chest pain, exacerbated by activity and relieved by rest. She also endorsed a thirty-pound unintentional weight loss, and dysphagia. She was dysarthric with left-sided Bell's Palsy and a palpable left axillary lymph node. Read More

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September 2017
2 Reads

Weil's Disease from a Local New Orleans Bar.

Authors:
H P Kahn L Bateman

J La State Med Soc 2017 Mar-Apr;169(2):46. Epub 2017 Apr 15.

Department of Medicine, Ochsner Clinic Foundation in New Orleans, LA.

Introduction: Leptospirosis is a zoonotic infection that typically presents with fever, myalgias, nausea, and vomiting after contact with contaminated waters or infected animals (typically rodents); and their excrements. Conditions favorable to the transmission of leptospirosis are common in LA and, without treatment, leptospirosis can lead to both liver and renal failure, meningitis, pulmonary hemorrhage and ultimately death.

Case: A 56 year old woman with no past medical history presented to the Emergency Department with weakness, myalgias, jaundice and decreased urine output for one week. Read More

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September 2017
4 Reads

Delayed Presentation of Tuberour Sclerosis Complex in Adult Women.

J La State Med Soc 2017 Mar-Apr;169(2):46. Epub 2017 Apr 15.

Department of Internal Medicine, University Hospitals and Clinics - LSU Health in Lafayette, LA.

Introduction: Tuberous sclerosis complex (TSC); is an autosomal dominant disorder characterized by the formation of hamartomatous lesions in multiple organs, with a birth incidence of around one in 10,000. Although it usually manifests itself in early life, we present a case of an adult woman who we diagnosed with TSC.

Case: A 27 year old woman presented to Emergency Department with worsening right flank pain and progressive dyspnea. Read More

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September 2017
5 Reads

A Mullerian Cyst Resected From the Posterior Mediastinum.

J La State Med Soc 2017 Mar-Apr;169(2):43-47. Epub 2017 Apr 15.

Cardiothoracic and Vascular Surgery at LSUHSC in Shreveport, LA.

Differential diagnoses of mediastinal masses are often based on the anatomic locations. Traditionally the posterior mediastinum has been home to esophageal and neurogenic cysts, but a new entity has been found to be prevalent since its initial report in 2005: the Müllerian cyst. We present a 49-year-old with history of cough who was found to have such a mass. Read More

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September 2017
8 Reads

Knowledge of HPV-Related Oropharyngeal Cancer and Use of Human Papillomavirus Vaccines by Pediatricians in Louisiana.

J La State Med Soc 2017 Mar-Apr;169(2):37-42. Epub 2017 Apr 15.

Department of Pediatrics at LSUHSC in Shreveport, LA.

Objectives: To determine the level of knowledge of HPV related oropharyngeal cancer and practice patterns of HPV vaccine use by pediatricians.

Study Design, Subjects, Methods: IRB approved 18-question survey was administered to members of the Louisiana Chapter of the American Academy of Pediatrics.

Results: We received 116 responses (response rate: 15. Read More

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September 2017
5 Reads

Septic Cerebral Venosinus Thrombosis Secondary to an Odontogenic Infection.

J La State Med Soc 2017 Mar-Apr;169(2):33-36. Epub 2017 Apr 15.

Baton Rouge General Medical Center.

Background: Cerebral venosinus thrombosis (CVT); is an uncommon, potentially fatal disease that is more common in young adults and children. Thrombophilia, elevated estrogenic states, and infections are the most common risk factors in patients who develop CVT.

Case: A 69-year-old man with a right-sided odontogenic infection presented with fever, headache, opthalmoplegia, and periorbital swelling. Read More

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September 2017
11 Reads

Death by Propofol.

J La State Med Soc 2017 Mar-Apr;169(2):28-32. Epub 2017 Apr 15.

Department of Anesthesiology at Louisiana State University Health Sciences Center - New Orleans, LA.

Since its introduction in 1986, propofol ( two, 6-diisopropylphenol) , an intravenous sedative-hypnotic agent, has been utilized for the induction and maintenance of general anesthesia and conscious sedation in over 80 percent of cases; largely replacing thiopental ( sodium pentothal) over a decade ago. Unrestricted as a controlled substance, propofol's abuse potential emerged quickly and was highlighted by the death of pop singer, Michael Jackson, in 2009. In order to assess the epidemiological features of fatal propofol abuse, a descriptive analysis of the scientific literature was conducted using Internet search engines. Read More

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September 2017
6 Reads

Radiology Case of the Month: Intussusception in Adults: Is There a Lead Point?

J La State Med Soc 2017 Jan-Feb;169(1):26-27. Epub 2017 Feb 15.

Tulane University Health Sciences Center in New Orleans, LA.

A 36-year-old woman presents to the emergency department with a 4-day history of progressive lower abdominal pain accompanied by nausea. Read More

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September 2017
3 Reads

ECG of the Month: Confusion and a Slow Heart Rate.

Authors:
D Luke Glancy

J La State Med Soc 2017 Jan-Feb;169(1):24-25. Epub 2017 Feb 15.

Louisiana State University Health Sciences Center in New Orleans, LA.

Police found a confused 93-year-old woman wandering the streets and brought her to the hospital where an electrocardiogram (ECG) was recorded. Read More

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September 2017
7 Reads