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Surgeons team working with Monitoring of patient in surgical ope

Presumed Pancreatitis in the Setting of Renal Impairment

We present a patient misdiagnosed with acute pancreatitis in the setting of acute kidney injury. Misdiagnosis delayed the treatment of his underlying illness and resulted in misuse of resources and prolonged hospital stay. Case Report A 60-year-old nonverbal male with a history of quadriplegia, diabetic nephropathy, and nephrolithiasis with left ureteral stent placement was referred […]

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Magnetic resonance cholangiopancreatography demonstrating small filling defects in the distal common bile duct.

A Simpler Answer – After All This Time

There is an allure associated with a rare diagnosis. Diagnosis momentum refers to the “stickiness” of a diagnosis once it is attached to the patient,1 and is one example of a cognitive bias that can lead to diagnostic errors. This can lead to misattribution of symptoms to a patient’s existing (even incorrect) diagnosis if clinicians do […]

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(A and B) Large eschars on bilateral medial thighs with mild erythema; corresponding plain radiographs with vascular and soft tissue calcifications are shown in the inset. (C) 99mTc-sestamibi parathyroid scintigraphy demonstrating hypermetabolic activity posterior to the superior pole of the right thyroid lobe suggestive of parathyroid adenoma.

Classic Lesion, Not-So-Classic Cause

Calciphylaxis (also known as calcific uremic arteriolopathy) is a serious disorder characterized by skin necrosis secondary to reduction in the blood flow caused by calcification, fibrosis, and thrombus formation in the dermohypodermic arterioles. While calcific uremic arteriolopathy has been reported in nonuremic patients, it is primarily observed in patients with end-stage renal disease, especially those […]

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Should Patients Infected with Borrelia burgdorferi No Longer Be Referred to as Having Lyme Disease?

In 1977, a seminal paper described what was subsequently called Lyme arthritis.1 The name ‘Lyme’ originated from the initial investigation of the disease that was conducted in the Connecticut towns of Lyme, Old Lyme, and East Haddam.1 As more of the clinical manifestations of this illness were discovered, the condition became referred to as Lyme disease.2, 3, 4 In 1983, the […]

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young female doctor examines x-ray

A Depressing Diagnostic Error

To the Editor: A 52-year-old woman with diabetes presented to the hospital with acute onset of right flank pain, in the setting of profound lower extremity weakness and cachexia with a 30-lb unintentional weight loss over the past 6 months. She was diagnosed with ascending pyelonephritis and treated with empiric antibiotics. On hospital day 2, […]

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Magnetic resonance imaging brain lesions typical of multiple sclerosis.

Multiple Sclerosis Re-Examined: Essential and Emerging Clinical Concepts

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by exacerbations of neurological dysfunction due to inflammatory demyelination. Neurologic symptoms typically present in young adulthood and vary based on the site of inflammation, although weakness, sensory impairment, brainstem dysfunction, and vision loss are common. MS occurs more frequently in women […]

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