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The Hyperlipidemia Effect: Pseudohyponatremia in Pancreatic Cancer

A patient’s newly discovered malignancy was evidently accompanied by a sodium deficit. The 48-year-old man presented to the Emergency Department for evaluation of abdominal pain and weight loss. He described gradual onset of severe, burning, epigastric pain with radiation to the back. In addition, he reported a 70-lb weight loss over 2 months, yellowing of […]

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Challenges in Ordering and Interpreting Pharmacogenomic Tests in Clinical Practice

More than 160 US Food and Drug Administration–approved medications have information in their labeling regarding genetic mutations known to be associated with efficacy or safety.1 Not surprisingly, pharmacogenomics is increasingly incorporated into clinical practice in an effort to optimize prescribing to improve treatment outcomes.2, 3, 4, 5 Clinical implementation of pharmacogenomics has been facilitated by efforts to standardize pharmacogenomic-related terminology and […]

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Intranasal Condyloma Acuminatum with Malignant Transformation

A 48-year-old man with a growing mass in the right naris and epistaxis for 6 months visited our department in August 2016. He had a history of diabetes mellitus and psoriasis. We observed a cauliflower-like lesion in the right nasal vestibule (Figure A), extending to the septum and nasal floor. Nasopharyngoscopy revealed that the nasopharynx, oropharynx, […]

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ecg monitor with doctor's hand

Long-Term Prognosis of Low-Risk Women Presenting to the Emergency Department with Chest Pain

  Prognosis of low-risk women presenting to the emergency department (ED) with chest pain has not been clarified. We assessed early and long-term outcomes of such patients and determined the need for predischarge testing. Methods Retrospective assessment of consecutive low-risk women presenting to the ED with chest pain evaluated in a chest pain unit (CPU). […]

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Hints of Lyme: Disseminated Borreliosis Involving the Mitral and Tricuspid Valves

A 33-year-old man with cystic fibrosis 220 days removed from bilateral lung transplantation presented with 1 week of intermittent fevers (maximum 102°F), malaise, bilateral lower extremity edema, unintentional weight gain (8 pounds), and 2 days of dyspnea on exertion. His posttransplant course was complicated by persistent leukopenia with intermittent neutropenia attributed to his antirejection regimen of […]

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