A5089397823- Acute Lymphoblastic Leukemia research
- Biliary and Gastrointestinal Fistulas
- Esophageal and GI Pathology
- Coagulation, Bradykinin, Polyphosphates, and Angioedema
- Chronic Myeloid Leukemia Treatments
- Gallbladder and Bile Duct Disorders
- Liver Disease Diagnosis and Treatment
- Amyloidosis: Diagnosis, Treatment, Outcomes
- Inflammatory Bowel Disease
- Autoimmune Bullous Skin Diseases
- Central Venous Catheters and Hemodialysis
- Hemophilia Treatment and Research
- Microscopic Colitis
- Liver Disease and Transplantation
- Synthesis and Catalytic Reactions
- Blood Coagulation and Thrombosis Mechanisms
- Parathyroid Disorders and Treatments
- Acute Myeloid Leukemia Research
- Medical Coding and Health Information
- Actinomycetales infections and treatment
- Pancreatitis Pathology and Treatment
- Hepatitis B Virus Studies
- Hepatitis Viruses Studies and Epidemiology
- Soft tissue tumor case studies
- Antifungal resistance and susceptibility
Oregon Health & Science University
2015-2020
University of Portland
2015
Baylor College of Medicine
2009-2011
Children's Cancer Center
2011
Coccidioidomycosis (valley fever) is caused by the dimorphic fungi Coccidioides immitis or posadasii. Most infections are asymptomatic result in self-limited pneumonia; extrapulmonary dissemination via either hematogenous lymphatic spread rare. Here, we present a case of cervical C. lymphadenitis that resulted fistula formation to esophagus mediastinal extension. This highlights very unusual manifestation coccidioidomycosis, difficulty diagnosing coccidioidal infection when it not suspected,...
Plastic biliary stents are associated with rare but potentially life-threatening distal stent migration. We present 4 patient cases migration, whereas the proximal aspect remained in bile duct. Time to migration ranged from 1 week 2 months. Stent caused contralateral duodenal wall perforation; underwent endoscopic over-the-scope clip placement for defect closure. All required previous removal and exchange. This case series highlights that stricture longer have higher risk, also shown...
Patients with inflammatory bowel disease (IBD) frequently visit the emergency department (ED).The use of cputed tomography (CT) scans in this population has drastically increased recent years and may confer an risk malignancy.Records were obtained for IBD patients aged 18 or older who visited our institutional ED a gastrointestinal chief complaint had CT scan ordered by physician.A predictive model identifying clinically actionable finding (CAF) on was created using logistic regression...
A 28-year-old previously healthy woman presented with a 6-day history of fevers, headaches, and malaise. On physical examination the patient was febrile, tender left-sided cervical lymphadenopathy. Laboratory workup significant for mild transaminitis, white blood cell count 8.82 K/mL differential 89% lymphocytes, an absolute neutrophil zero. Upon manual review patient's smear frequent atypical lymphocytes (red arrow) as well burst neutrophils (black were observed (Image 1). Repeat processing...
Case Presentation: A 22 year-old woman was hospitalized with black stools for 3 days followed by the acute onset of large-volume hematemesis. Her past medical history notable end-stage renal disease due to Henoch-Schönlein purpura, which she underwent hemodialysis through a tunneled right internal jugular venous catheter. She had no prior liver or gastrointestinal bleeding. Physical exam revealed mild facial edema plethora, prominent abdominal and chest wall varices, ascites...
Presentation: A 56 year-old woman with a past medical history of hereditary angioedema (HAE), cholecystectomy and chronic, daily abdominal pain frequent acute exacerbations requiring hospitalization presented on chronic for two days. Her was epigastric, sharp worsened by food intake. unchanged, characterized as “tightness” across her lower abdomen. She had been admitted 5 times in the previous 1.5 years. Lipase greater than 2x upper limits normal during 4 these admissions. Workup included...
Presentation: A 61 year-old African-American male previously in good health presented with subacute onset of swelling his abdomen and lower extremities over 2 months. Physical exam was significant for bilateral extremity edema, tense ascites, jugular venous distention. Labs were albumin 2.1 g/dL, alkaline phosphatase (AP) 718 IU/L, AST 158 ALT 119 total bilirubin (TB) 0.5 mg/dL, INR 1.07, creatinine 0.9 mg/dL nephrotic range proteinuria. viral hepatitis panel, anti-nuclear antibody,...
Introduction: Patients with Crohn's disease (CD) may frequently visit the emergency department (ED). The use of computed tomography (CT) scans in this population has drastically increased and be associated an risk malignancy. Methods: Records were obtained for CD patients aged 18 or older who visited our institutional ED between December 2007 August 2014 a gastrointestinal chief complaint had CT scan ordered by physician. Pertinent variables (Table 1). To generate prediction model...
486 BOOK REVIEWS lack some of the passion and straightforwardness prophets; but his critical analyses sophisticated methodology surely provides sort intellectual foundation that true economic reform requires. KENNETH R. HIMES, 0.F.M. Boston College Chestnut Hill, Massachusetts The Creation-Evolution Struggle. By MICHAELRUSE. Cambridge, Mass.: Harvard University Press, 2005. Pp. 336. $16.95 (paper). ISBN 0-674-02255-6. In Struggle, Michael Ruse, Lucyle T. Werkmeister Professor Philosophy...
Biliary stents are commonly used for internal drainage of biliary obstruction, both malignant and benign. Intestinal perforation is a rare but potentially severe complication associated with plastic stents. To date, this has been described exclusively in the setting preceding stent migration. We present an unusual case non-migrated causing duodenal which to our knowledge first literature. A 65-year-old woman presented three day history malaise right upper quadrant pain fever nausea. Her past...
INTRODUCTION: Intestinal perforation is a rare complication of plastic biliary stents which exclusively occurs in the setting preceding stent migration. We present first case series to our knowledge four patients with intestinal from non-migrated in-situ stents. CASE DESCRIPTION/METHODS: 1: A 65-year-old-woman placement for cholangiocarcinoma-related obstruction presented acute right upper quadrant (RUQ) pain. She had tachycardia, RUQ tenderness, and elevated liver function tests (LFT). CT...
INTRODUCTION: Gallstone ileus is rare in the general population; however, proportion much higher older populations and one third of affected patients suffer from serious medical comorbidities. Literature on intervention strategies are limited to retrospective reports with optimal remaining unclear. Recurrence gallstone reaches 5%, which provides a unique dilemma for treatment approaches already at peri-operative risk. CASE DESCRIPTION/METHODS: A 68-year-old male prior history hypertension...