ABSTRACT
Pulmonary embolism (PE) presents with a spectrum of symptoms, ranging from asymptomatic cases to life-threatening events. Common symptoms include sudden dyspnea, chest pain, limb swelling, syncope, and hemoptysis. Clinical presentation varies based on thrombus burden, demographics, and time to presentation. Diagnostic evaluation involves assessing symptoms, physical examination findings, and utilizing laboratory tests, including D-dimer. Risk stratification using tools like Wells score, Pulmonary Embolism Severity Index, and Hestia criteria aids in determining the severity of PE. PE is categorized based on hemodynamic status, temporal patterns, and anatomic locations of emboli to guide in making treatment decisions. Risk stratification plays a crucial role in directing management strategies, with elderly and comorbid individuals at higher risk. Early identification and appropriate risk stratification are essential for effective management of PE. As we delve into this review article, we aim to enhance the knowledge base surrounding PE, contributing to improved patient outcomes through informed decision-making in clinical practice.
ABSTRACT
Mycobacterium chimaera is a slow-growing nontuberculous mycobacterium. It has been identified as a contaminant during open-heart surgery. It contaminates water in heater-cooler units that then become aerosolized, contaminating the surgical field. We report a 56-year-old male who presented with culture-negative endocarditis six years after his initial open-heart surgery.
ABSTRACT
Takotsubo cardiomyopathy (TCM), also known as apical ballooning syndrome or stress-induced cardiomyopathy, typically presents with features of the acute coronary syndrome. It is characterized by left ventricular apical akinesis and transient systolic dysfunction in the absence of obstructive coronary artery disease. Although its pathogenesis remains unclear, it is thought to be a catecholamine surge that is produced following intense physical or emotional stress. We present a case of TCM in a patient with small bowel obstruction (SBO), which is a rare trigger.
ABSTRACT
Inflammatory bowel disease (IBD) and microscopic colitis (MC) are two distinct subgroups within the larger group of colitides. MC could manifest as collagenous colitis (CC) or lymphocytic colitis (LC). The co-occurrence of MC in patients with IBD is rare, with few cases reported. No concurrent case of MC and ulcerative colitis (UC) each presenting with distinct clinical manifestations was found in the literature review. We report a case of a 76-year-old male presenting with concurrent CC and UC. The patient's initial flare of UC was characterized by episodes of bloody diarrhea while his flare of CC was evidenced by watery diarrhea.
ABSTRACT
Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844-852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures- approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes.
