Acute Onset of Dark Urine in a Patient with LVAD Pump Dysfunction

The myelodysplastic syndrome-myeloproliferative neoplasms (MDS/MPNs) are defined by a group of heterogeneous hematological malignancies resulting from stem cell−driven clonal growth of pathological hematopoietic progenitors and ineffective hematopoiesis, they are characterized concomitant myelodysplastic and myeloproliferative signs. Myelodysplastic/myeloproliferative disorders have been considered to have a higher risk of thrombus formation.We report a rare case about a 64 years old Moroccan woman, experienced renal infarction (RI) associated with pulmonary embolism as a complication of a myelodysplastic/myeloproliferative disorder.The patient complained of acute-onset severe left flank pain, a contrast-enhanced computed tomography (CT) of the chest and abdomen revealed RI by a large wedge-shaped defect in the right kidney with pulmonary embolism.Biological exam showed deep anemia, the bone marrow aspiration found myelodysplasia.the bone biopsy showed signs of myeloproliferatif disease. The karyotype was normal, BCR-ABL, JAK2, CALR mutations were absents, and MPL mutation was positive. The International Prognostic Scoring System (IPSS-R) was 0, and the patient was included to the low risk group.Anticoagulation therapy was initiated with heparin to treat RI and pulmonary embolism. Three months later, pulmonary embolism had resolved without the appearance of additional peripheral infarction.This case emphasizes the need to consider myelodysplastic/myeloproliferative disorders as a cause of infraction renal and pulmonary embolism.

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A regular meal and insulin infusion regimen: its use in the treatment of acute-onset ketotic diabetes and in stabilization of poorly controlled established diabetic subjects

Diabetes Care ◽

10.2337/diacare.5.5.492 ◽

1982 ◽

Vol 5 (5) ◽

pp. 492-496 ◽

Cited By ~ 3

Author(s):

T. M. Davis ◽

R. R. Holman ◽

P. M. Eaton ◽

R. C. Turner

Keyword(s):

Insulin Infusion ◽

Acute Onset ◽

Infusion Regimen

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Pediatric Acute Onset Neuropsychiatric Syndrome Associated with Epstein-barr Infection in Child with Noonan Syndrome

10.26226/morressier.58d4fec5d462b8028d892233 ◽

2017 ◽

Author(s):

Giuseppe Pietro Tisi

Keyword(s):

Noonan Syndrome ◽

Acute Onset ◽

Epstein Barr

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Omental Infarction: A Case Treated with Laparoscopic Surgery

10.31487/j.ijscr.2019.02.03 ◽

2019 ◽

pp. 1-3

Author(s):

Bertrand Ng ◽

Arafat Yasser

Keyword(s):

Diabetes Mellitus ◽

Laparoscopic Surgery ◽

Hospital Stay ◽

Acute Cholecystitis ◽

Inflammatory Markers ◽

Acute Onset ◽

Laparoscopy Surgery ◽

History Of ◽

Background History ◽

The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

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Faculty Opinions recommendation of Texture analysis differentiates persistent and transient T1 black holes at acute onset in multiple sclerosis: a preliminary study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8671962.9181063 ◽

2011 ◽

Author(s):

Nancy Richert ◽

Francesca Bagnato

Keyword(s):

Multiple Sclerosis ◽

Black Holes ◽

Texture Analysis ◽

Acute Onset ◽

Preliminary Study

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Cerebellar Infarction with Acute Onset of Vertigo and Cochlear Symptoms; A Case Report.

Equilibrium Research ◽

10.3757/jser.52.401 ◽

1993 ◽

Vol 52 (3) ◽

pp. 401-410

Author(s):

Tsutomu Yamazaki ◽

Chihiro Harada ◽

Munetaka Yamakawa ◽

Tsutomu Sohma

Keyword(s):

Case Report ◽

Acute Onset ◽

Cerebellar Infarction

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Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails

Current Drug Therapy ◽

10.2174/1574885515666191227155624 ◽

2020 ◽

Vol 15 (4) ◽

pp. 420-422

Author(s):

Dhruvkumar M. Patel ◽

Mukundkumar V. Patel ◽

Jayanti K. Gurumukhani ◽

Maitri M. Patel ◽

Himal J. Mahadevia ◽

...

Keyword(s):

Ischemic Stroke ◽

Thrombolytic Therapy ◽

Neurological Deficit ◽

Clinical Case ◽

Complete Recovery ◽

Acute Onset ◽

Diabetic Patients ◽

Focal Neurological Deficit ◽

Random Blood Sugar ◽

Resident Doctor

Background: Hypoglycemia may rarely present as hemiparesis and sometimes it is difficult to differentiate from ischemic stroke. When random blood sugar (RBS) value is between 50 and 80 mg % in patients presenting with focal neurological deficit, no guideline exists to consider the possibility of hypoglycemia before initiating thrombolytic therapy. Clinical Case: A 58-year-old male, who was a known case of diabetes and hypertension, was brought to the emergency room with acute onset of right hemiparesis and dysarthria of 90 minutes duration. His NIHSS Score was 9, blood pressure was 150/90 mm of Hg and RBS was 79 mg% on admission. His CT scan brain was normal and was considered for thrombolysis. Resident doctor not aware of previous sugar repeated RBS before thrombolysis which was surprisingly 60 mg% 60 minutes after the first RBS. Even though he was a candidate for thrombolysis, intravenous 25 % dextrose was administered considering the possibility of hypoglycemia. He made a complete recovery within 20 minutes and thrombolytic therapy was withheld. : In Diabetic patients with focal neurological deficit and RBS less than 80 mg% on admission, RBS should be rechecked and in appropriate cases should be challenged with IV dextrose considering the possibility of hypoglycemia before commencing thrombolytic therapy.

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Subarachnoid diverticulum associated with feline infectious peritonitis in a Siberian cat

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116920941477 ◽

2020 ◽

Vol 6 (2) ◽

pp. 205511692094147

Author(s):

Christopher Hoey ◽

George Nye ◽

Angela Fadda ◽

Janet Bradshaw ◽

Emi N Barker

Keyword(s):

Cervical Spinal Cord ◽

Serum Biochemistry ◽

Acute Onset ◽

Neurological Deficits ◽

Rt Pcr ◽

Feline Infectious Peritonitis ◽

Case Summary ◽

Choroid Plexitis ◽

The Brain ◽

Feline Coronavirus

Case summary A 7-month-old Siberian cat was presented for investigation of acute onset multifocal neurological deficits. Neurological examination documented dull mental status and an ambulatory left hemiparesis. Serum biochemistry documented marked hyperglobulinaemia. MRI of the brain identified marked leptomeningeal contrast enhancement extending along the brainstem caudally to involve the cranial cervical spinal cord. MRI of the cervical spine further identified a subarachnoid diverticulum that extended from the level of the obex to the C2–C3 vertebrae. Cerebrospinal fluid quantitative RT-PCR was positive for the presence of feline coronavirus. Histopathology revealed pyogranulomatous meningitis and choroid plexitis, uveitis and nephritis. Relevance and novel information This article describes the first reported case of a subarachnoid diverticulum associated with feline infectious peritonitis.

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Occupations and exposure events in acute and subacute irritant-induced asthma

Occupational and Environmental Medicine ◽

10.1136/oemed-2020-107323 ◽

2021 ◽

pp. oemed-2020-107323

Author(s):

Irmeli Lindström ◽

Jussi Lantto ◽

Kirsi Karvala ◽

Satu Soini ◽

Katriina Ylinen ◽

...

Keyword(s):

Acute Onset ◽

High Exposure ◽

Root Cause ◽

Multiple Exposures ◽

Lack Of Information ◽

Hygiene Measures ◽

Work Tasks ◽

Causative Agents ◽

Strong Acids ◽

Normal Work

BackgroundExposures leading to irritant-induced asthma (IIA) are poorly documented.MethodsWe retrospectively screened the medical records of patients with IIA diagnosed in an occupational medicine clinic during 2000–2018. We classified the cases into acute (onset after single exposure) and subacute (onset after multiple exposures) IIA. We analysed in detail, occupations, causative agents and their air levels in the workplace, exposure events and the root causes of high exposure.ResultsAltogether 69 patients were diagnosed with IIA, 30 with acute and 39 with subacute IIA. The most common occupational groups were industrial operators (n=23, 33%), metal and machinery workers (n=16, 11%) and construction workers (n=12, 8%). Among industrial operators significantly more cases had subacute IIA than acute IIA (p=0.002). Forty cases (57%) were attributable to some type of corrosive acidic or alkaline chemical. Acute IIA followed accidents at work in different types of occupation, while subacute IIA was typical among industrial operators performing their normal work tasks under poor work hygiene conditions. The most common root cause was lack of information or false guidance in acute IIA (n=11, 36%) and neglect of workplace hygiene measures in subacute IIA (n=29, 74%).ConclusionsAccidents are the main causes of acute IIA, whereas subacute IIA can develop in normal work in risk trades with poor work hygiene. Airborne strong acids or bases seem to be the most important causative agents of acute and subacute IIA. The different risk profiles of acute and subacute IIA should be considered in the prevention and identification of the cases.

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