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Clinical Implications of Basic Research: Neuromodulation of Urinary Tract Function. ⠀
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Control of the lower urinary tract is complex and poorly understood. A preclinical study showed that precise control of neuronal innervation can be achieved by engineering #neurons to express light-activatable #molecules that, upon activation, regulate neuronal firing and thus correct overactive bladder in a rat model. ⠀
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Figure 1: Optogenetic Neuromodulation of Urinary Tract Function. Mickle and colleagues used a closed-loop wireless system with a strain gauge wrapped around the bladder of freely moving rats. The strain gauge measures changes in resistance during bladder filling and emptying. When the bladder becomes overactive, a signal is sent to activate a small microscale inorganic light-emitting diode (μ-ILED), which, in turn, activates a light-sensitive archaeal protein, an opsin, to selectively reduce neural activity. This action delivers a corrective signal, thereby restoring normal bladder function. Tap the link in our bio to learn more. ⠀
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#neurology #nephrology #gastroenterology #neuroscience #urology #medicalillustration #medicalscience #medicalresearch #medicaleducation #meded
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Clinical Implications of Basic Research: Neuromodulation of Urinary Tract Function. ⠀ ⠀ Control of the lower urinary tract is complex and poorly understood. A preclinical study showed that precise control of neuronal innervation can be achieved by en

New England Journal of Medicine
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@skaguerrilla @jaydlynnn

@shomdog13 @arimorgenstern @whereissisyphus @chinchilla44 @ashdavani @sheelpatel12 @evan_dackowski

New Image Challenge: A 47-year-old man presented to the #cardiology clinic for evaluation of coronary-artery dilatations detected on computed tomography (CT). The patient was asymptomatic but had a history of IgG4-related disease. Laboratory tests showed a normal serum IgG4 concentration. CT #angiogram of the coronary vessels revealed aneurysmal dilatation of the right coronary artery with marked, periarterial soft-tissue thickening. What is the diagnosis? Tap the link in our bio to submit your answer. ⠀
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#primarycare #clinicalpractice #medicaleducation #meded #ctscan
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New Image Challenge: A 47-year-old man presented to the #cardiology clinic for evaluation of coronary-artery dilatations detected on computed tomography (CT). The patient was asymptomatic but had a history of IgG4-related disease. Laboratory tests sh

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@rajeev_sachdeva Coronary periarteritis?

@draksuyeksavas @luiza_mr whatnisöthe answer

Strategies for transforming #healthcare using alternative payment systems, patient-centered care, and technology have had limited success. In other industries, transformations have come from operational changes that involved finding ways to use fewer people. Tap the link in our profile to read the Perspective Toward Facilitated Self-Service in Health Care by David A. Asch, M.D., M.B.A., Sean Nicholson, Ph.D., and Marc L. Berger, M.D. ⠀
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#medicalpractice #clinicalpractice #healthit #patientengagement
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Strategies for transforming #healthcare using alternative payment systems, patient-centered care, and technology have had limited success. In other industries, transformations have come from operational changes that involved finding ways to use fewer

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@jonschwartz3072 Central planning doesn’t work. Coercion doesn’t work. Why not try freedom? Get the damn government out of healthcare and make the corporations compete for our dollar. Give the power back to the people not the academic fools who make everything worse. Why is freedom never even discussed?

@scienceisking Prevention, y'all ♥.

Case Records of the Massachusetts General Hospital: A 55-Year-Old Man with Jaundice. ⠀
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A 55-year-old man with a history of opioid use disorder and hepatitis C virus infection presented to the hospital with #jaundice. The alanine aminotransferase level was 2698 U per liter, the aspartate aminotransferase level 2869 U per liter, and the total bilirubin level 21.6 mg per deciliter. Additional diagnostic tests were performed. ⠀
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Figure 1: Abdominal #Ultrasound Images. Grayscale images (Panels A, B, E, and F) and color Doppler images (Panels C and D) of the right upper quadrant show no intrahepatic or extrahepatic bile-duct dilatation (Panels A and B), a patent main portal vein with flow in the correct direction (Panel C, arrow), trace perihepatic ascites (Panel D, arrows), and a collapsed #gallbladder with diffuse, hypoechoic wall thickening (Panels E and F, plus signs). FF denotes free fluid. Tap the link in our bio to read the full case. ⠀
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#addiction #liverdisease #viralinfections #primarycare #hcv #medicaleducation #meded
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Case Records of the Massachusetts General Hospital: A 55-Year-Old Man with Jaundice. ⠀ ⠀ A 55-year-old man with a history of opioid use disorder and hepatitis C virus infection presented to the hospital with #jaundice . The alanine aminotransferase le

New England Journal of Medicine
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@albaescolro @helesro

@ronemecol Hep B

Images in Clinical Medicine: Tornwaldt’s Cyst. ⠀
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A 60-year-old man presented to the #otorhinolaryngology clinic with a feeling of #nasalobstruction and postnasal drip that had developed 10 years earlier and had worsened over the past month. He also had a sensation of a foreign body in his throat. Symptoms worsened when he was lying flat. On physical examination, no deviation of the nasal septum or hypertrophy of the inferior turbinates was detected. Nasopharyngoscopy revealed a smooth, pink, cystic mass in the midline of his #nasopharynx, with no obstruction of the openings to the eustachian tubes (the image shows the view through the right naris). Computed tomography of the head revealed a 2.5 cm by 1.3 cm by 1.4 cm cystic tumor in the midline of the nasopharynx without intracranial extension. Visit the link in our bio to learn more. ⠀
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#surgery #otolaryngology #primarycare #clinicalpractice #medicaleducation #meded
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Images in Clinical Medicine: Tornwaldt’s Cyst. ⠀ ⠀ A 60-year-old man presented to the #otorhinolaryngology clinic with a feeling of #nasalobstruction and postnasal drip that had developed 10 years earlier and had worsened over the past month. He also

New England Journal of Medicine
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@aylamourthe @roneylouvain kkkkk

@landishbolaky @diksha.gowreesunker.g saw it already befre bt thanks

Review Article: Muco-Obstructive Lung Diseases. ⠀
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This review covers the normal mechanisms of mucus formation and how they are abnormal in common conditions — such as #COPD, #cysticfibrosis, and non–cystic fibrosis #bronchiectasis — that are characterized by excessive mucus in the airways. ⠀
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An important feature of muco-obstructive lung diseases is disease heterogeneity — that is, there are regions of the lung that are normal and other regions within the same lung that are severely diseased. Bronchiectasis is often a prominent finding in computed tomography (CT) of the lung. However, a common feature that unifies muco-obstructive diseases is the early manifestation of disease in small airways (bronchioles), as evidenced by pathological examination, microcomputed tomography, and pulmonary-function studies. ⠀
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Mucus plaque or plug formation in the airways reflects an increase in mucin secretion, often stimulated by viral infections or aspiration, coupled with poor epithelial hydration of newly secreted mucins (Figure 3A and 3B). On formation of hyperconcentrated, static mucus plaques, a bistable positive-feedback (“vicious”) muco-inflammatory cycle is initiated (Figure 3C). Ultimately, severe or persistent muco-obstruction, typically associated with elevated airway levels of neutrophil elastase, drives the progression from bronchitic to bronchiectatic or bronchiolectatic lesions typical of these diseases. Tap the link in our bio to read the full review article. ⠀
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#lungdisease #pulmonary #pulmonology #criticalcare #primarycare #clinicalpractice #meded #medicaleducation #medicaleducation #medicalscience
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Review Article: Muco-Obstructive Lung Diseases. ⠀ ⠀ This review covers the normal mechanisms of mucus formation and how they are abnormal in common conditions — such as #copd , #cysticfibrosis , and non–cystic fibrosis #bronchiectasis — that are charac

New England Journal of Medicine
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@hassanalitariq @sarah_bibz

@hbetonolli @tonollim

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#VisualAbstract: Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. ⠀
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In a randomized trial, dabigatran (110 mg per day or 150 mg per day) was no more effective than #aspirin (100 mg per day) in preventing a second #stroke after an embolic stroke of undetermined source. The occurrence of major bleeding was similar in the two treatment groups. Tap the link in our profile for the full text abstract. ⠀
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#medicalresearch #medicalillustration #medicalscience #medicaleducation #meded #clinicalpractice
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#visualabstract : Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. ⠀ ⠀ In a randomized trial, dabigatran (110 mg per day or 150 mg per day) was no more effective than #aspirin (100 mg per day) in preventing a second #st

New England Journal of Medicine
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@catcho92 @mawbzy relevant

@mtaslaci It failed then..

Case Studies in Social Medicine: The Power and Limits of Classification — A 32-Year-Old Man with Abdominal Pain. ⠀
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A 32-year-old #transgender man, presenting with severe lower abdominal pain and #hypertension, is classified as a man who hasn’t taken his blood-pressure medications. When examined several hours later, he’s found to be pregnant, but no fetal heartbeat can be detected. ⠀
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#obstetrics #pregnancy #healthcare #medicalpractice #medicalethics #primarycare #clinicalpractice
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Case Studies in Social Medicine: The Power and Limits of Classification — A 32-Year-Old Man with Abdominal Pain. ⠀ ⠀ A 32-year-old #transgender man, presenting with severe lower abdominal pain and #hypertension , is classified as a man who hasn’t take

New England Journal of Medicine
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@pishaboy2001 @dr_aigul.y why would that present with acute severe abdominal pain?

@sarah_sensi While ya’ll were arguing about how to label this human being, A BABY DIED.

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New Image Challenge! ⠀
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A baby boy born at 39 weeks of gestation had bilious emesis, failure to pass meconium, and abdominal distention within 24 hours after birth. A water-soluble contrast #enema showed a uniformly distended and shortened #colon. What is the most likely diagnosis? Visit the link in our profile to share your answer and to see how others voted. ⠀
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#primarycare #clinicalpractice #meded #medicaleducation #pediatrics
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New Image Challenge! ⠀ ⠀ A baby boy born at 39 weeks of gestation had bilious emesis, failure to pass meconium, and abdominal distention within 24 hours after birth. A water-soluble contrast #enema showed a uniformly distended and shortened #colon . W

New England Journal of Medicine
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@yayralittledoll Volvulo intestinal

@captplanet2018 I'm here for the doctor's advice

Increasingly, inpatient #internalmedicine teams focus exclusively on a patient’s immediate crisis, leaving the rest for #ambulatorycare. By adopting a “baseline” mind-set, we are creating #physicians who prioritize throughput over critical appraisal skills and inquisitiveness. Tap the link in our bio to read the Perspective At Baseline by Paul A. Bergl, M.D. ⠀
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#criticalcare #healthcare #medicalpractice #primarycare #clinicalpractice #meded #medicaleducation
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Increasingly, inpatient #internalmedicine teams focus exclusively on a patient’s immediate crisis, leaving the rest for #ambulatorycare . By adopting a “baseline” mind-set, we are creating #physicians who prioritize throughput over critical appraisal

New England Journal of Medicine
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@tglisboa Maravilha!👏👏

@neuroradiology Deep insights as always by our Dr. Bergl. 🧠💪

Case Records of the Massachusetts General Hospital: A 44-Year-Old Man with Neck Pain and Swelling. ⠀
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A 44-year-old man was admitted to the hospital because of pain and swelling on the left side of the neck, which developed 12 weeks after placement of an implantable cardioverter–defibrillator. CT revealed a 4-cm heterogeneous soft-tissue mass located deep to the sternocleidomastoid muscle. Additional diagnostic tests were performed. ⠀
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Figure 1: Placement of the Implantable Cardioverter–Defibrillator (ICD) and Location of the Neck Mass. Hematomas that develop after ICD implantation are typically located at the insertion site (deltopectoral groove) rather than the supraclavicular fossa, where the neck mass is located in this patient. ⠀
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Tap the link in our bio to read the full article. ⠀
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#hematoma #hematology #surgery #cardiology #arrhythmia #primarycare #clinicalpractice #meded #medicaleducation #medicaldevice
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Case Records of the Massachusetts General Hospital: A 44-Year-Old Man with Neck Pain and Swelling. ⠀ ⠀ A 44-year-old man was admitted to the hospital because of pain and swelling on the left side of the neck, which developed 12 weeks after placement

New England Journal of Medicine
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@dr.venezuela @xdaninox

@gretna1 👏

A 66-year-old man presented with a 2-month history of abdominal bloating and worsening constipation. The physical examination revealed a painless pulsatile abdominal mass, which computed tomographic #angiography revealed to be a large aortic #aneurysm. The patient underwent #surgery, during which the aneurysm was exposed and replaced with an aortobiiliac graft. Visit the link in our bio to read the full case and to watch a video showing the abdominal aortic aneurysm. ⠀⠀
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#cardiovascularsurgery #emergencymedicine #cardiology #primarycare #clinicalpractice
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A 66-year-old man presented with a 2-month history of abdominal bloating and worsening constipation. The physical examination revealed a painless pulsatile abdominal mass, which computed tomographic #angiography revealed to be a large aortic #aneurys

New England Journal of Medicine
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@luciano.pinho70 @pattyrogerio71

@riazi.hadi Why not EVAR?

Clinical Implications of Basic Research: The Link between Hematopoiesis and Atherosclerosis. ⠀
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Clinical evidence supporting a link between #inflammation and #atherosclerosis includes the results of the Canakinumab Antiinflammatory Thrombosis Outcomes Study (CANTOS), which showed that targeting inflammation improved cardiovascular outcomes. A recent study involving animal models provides a molecular explanation. Tap the link in our bio to learn more. ⠀
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#hematology #genetics #coronarydisease #myocardialinfarction #lipids #meded #medicaleducation #medicalillustration #medicalscience
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Clinical Implications of Basic Research: The Link between Hematopoiesis and Atherosclerosis. ⠀ ⠀ Clinical evidence supporting a link between #inflammation and #atherosclerosis includes the results of the Canakinumab Antiinflammatory Thrombosis Outcom

New England Journal of Medicine
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@biochemistry.guide Great,please check out our page⭐✌

@mariderminio @camiladerminio

Images in Clinical Medicine: Metastatic Uveal Melanoma. ⠀
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A 59-year-old woman presented with inflammation and pain in the right eye. Magnetic resonance imaging showed a right orbital mass. A diagnosis of metastatic uveal melanoma was made. Visit the link in our bio for the full clinical case. ⠀
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#oncology #ophthalmology #primarycare #clinicalpractice #meded #medicaleducation
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Images in Clinical Medicine: Metastatic Uveal Melanoma. ⠀ ⠀ A 59-year-old woman presented with inflammation and pain in the right eye. Magnetic resonance imaging showed a right orbital mass. A diagnosis of metastatic uveal melanoma was made. Visit th

New England Journal of Medicine
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@cedools @bremarietracey

@raulmedinarioja @erikaad_m wooooow

#VisualAbstract: In this multicenter, randomized, double-blind, placebo-controlled trial involving women with vaginal bleeding in early #pregnancy, treatment with #progesterone during the first trimester did not result in a significantly higher incidence of live births than placebo. Tap the link in our bio for the full text abstract and accompanying editorial. ⠀
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#OBGYN #womenshealth #medicalresearch #meded #medicaleducation #medicalpractice #clinicaltrial
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#visualabstract : In this multicenter, randomized, double-blind, placebo-controlled trial involving women with vaginal bleeding in early #pregnancy , treatment with #progesterone during the first trimester did not result in a significantly higher incid

New England Journal of Medicine
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@kmarianacastro @sarahirach

@tristanmeadows_ P Val said bruh moment @markmathews2

New patterns of viral emergence and spread are being driven by ecologic and sociologic changes, ranging from #climatechange to political instability and conflict. Our preparations for #epidemics must keep pace with such changes. Tap the link in our bio to read the Perspective Stopping the Gaps in Epidemic Preparedness by Jeremy J. Farrar, M.D., Ph.D.⠀
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#infectiousdisease #viralinfections #globalhealth #publichealth
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New patterns of viral emergence and spread are being driven by ecologic and sociologic changes, ranging from #climatechange to political instability and conflict. Our preparations for #epidemics must keep pace with such changes. Tap the link in our b

New England Journal of Medicine
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@producerrae We must act now, with urgency.

New Image Challenge!⠀
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A 51-year old woman presented to the #primarycare clinic with mild worsening of chronic #abdominalpain. On physical examination, the #liver was enlarged. Magnetic resonance cholangiopancreatography revealed a markedly enlarged liver with numerous cystic structures (a three-dimensional maximum-intensity-projection reconstruction is shown in the figure). What is the most likely underlying diagnosis? Tap the link in our bio to submit your answer. ⠀
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#clinicalpractice #medicaleducation #meded #clinicalimage #medicalimaging
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New Image Challenge!⠀ ⠀ A 51-year old woman presented to the #primarycare clinic with mild worsening of chronic #abdominalpain . On physical examination, the #liver was enlarged. Magnetic resonance cholangiopancreatography revealed a markedly enlarged

New England Journal of Medicine
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@meriverab Hydatid cysts

@juliana_ngarcia R

Correspondence: Transcatheter Aortic-Valve Replacement — 10 Years Later. ⁣⠀
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A 68-year-old woman with symptomatic #aorticstenosis who was not a candidate for #surgery because of a porcelain aorta underwent #TAVR in 2008. Ten years later, symptoms recurred and severe prosthetic-valve aortic stenosis was diagnosed. She underwent a successful repeat TAVR procedure. ⁣⠀
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Volume-rendered computed tomography revealed severe aortic #calcification (Panel A, arrow) and a transcatheter aortic valve with the coronary ostia arising above the stent frame. A new transcatheter aortic valve was deployed within the previously implanted valve (Panel B). Aortography revealed no aortic regurgitation and patent coronary ostia (Panel C). Tap the link in our bio to learn more and to read related research articles. ⁣⠀
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#cardiology #primarycare #clinicalpractice #medicalscience #medicaleducation #meded #clinicalimage #transcatheter #ctscan
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Correspondence: Transcatheter Aortic-Valve Replacement — 10 Years Later. ⁣⠀ ⁣⠀ A 68-year-old woman with symptomatic #aorticstenosis who was not a candidate for #surgery because of a porcelain aorta underwent #tavr in 2008. Ten years later, symptoms r

New England Journal of Medicine
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@marcecanllo @francanllo1982

@c.docxs @richrubini someday you'll be able to do that 🙌

Clinical Problem-Solving: Laryngoscopic Swallow Study Showing Aspiration.⁣
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A 60-year-old man presented to an #emergencydepartment with a 2-day history of exertional #dyspnea and a productive cough. In this video, the swallowing of blue liquid triggered aspiration with minimal epiglottic movement, weak cough, and poor clearance of aspirated contents. Tap the link in our bio for the full case. ⁣
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#neuromusculardisease #primarycare #clinicalpractice #medicaleducation #meded #emergencymedicine
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Clinical Problem-Solving: Laryngoscopic Swallow Study Showing Aspiration.⁣ ⁣ A 60-year-old man presented to an #emergencydepartment with a 2-day history of exertional #dyspnea and a productive cough. In this video, the swallowing of blue liquid trigg

New England Journal of Medicine
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@celestelanghammer Is there a reason this exam is used rather than a barium study?

@abdulmalik.94 @celestelanghammer better for patients who are hard to position and no time restriction is needed due to radiation exposure

A 9-year-old boy reported hearing buzzing noises and having a sensation of a foreign body in the right ear. A #tick was found embedded in his right tympanic membrane. The patient was subsequently transferred to the operating room for removal of the tick while he was under general anesthesia. Visit the link in our bio to learn more about this case. ⁣
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#pediatrics #infectiousdisease #otolaryngology #primarycare #clinicalpractice #medicaleducation #meded #clinicalimage
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A 9-year-old boy reported hearing buzzing noises and having a sensation of a foreign body in the right ear. A #tick was found embedded in his right tympanic membrane. The patient was subsequently transferred to the operating room for removal of the t

New England Journal of Medicine
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@neurofact @lanellek

@ely3vmp4 @amylilytsai 看了就覺得耳朵有點痛苦😖

Clinical Practice: Hypoparathyroidism. ⁣
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#Hypoparathyroidism is a rare disorder of parathyroid hormone (PTH) deficiency, with an estimated prevalence of 23 to 37 cases per 100,000 person-years. It most commonly occurs as a complication of anterior neck #surgery (in approximately 78% of cases) and is therefore seen more frequently in older adult women, who are more likely than others in the general population to undergo #thyroid surgery. However, there is an expanding list of genetic and nonsurgical acquired causes, including autoimmune causes. ⁣
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Treatment of hypoparathyroidism is targeted to maintain a blood calcium level near the low end of the normal range while preventing symptoms of hypocalcemia. Treatment usually involves oral calcium and active vitamin D, but subcutaneous parathyroid hormone is used in some cases. Tap the link in our bio to read the full article including the key clinical points. ⁣
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#endocrinology #autoimmunedisease #primarycare #clinicalpractice #medicalillustration #medicalscience #medicaleducation #meded
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Clinical Practice: Hypoparathyroidism. ⁣ ⁣ #hypoparathyroidism is a rare disorder of parathyroid hormone (PTH) deficiency, with an estimated prevalence of 23 to 37 cases per 100,000 person-years. It most commonly occurs as a complication of anterior

New England Journal of Medicine
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@guilhermeathayde @debora_amenezes

@clinicalmed9 👏

The @cdcgov’s 2016 Guideline for Prescribing Opioids for Chronic Pain has largely been embraced by the #medical and #healthpolicy communities. Unfortunately, some policies and practices purportedly derived from the guideline have been inconsistent with its recommendations. Tap the link in our bio to read the Perspective No Shortcuts to Safer Opioid Prescribing by Deborah Dowell, M.D., M.P.H., Tamara Haegerich, Ph.D., and Roger Chou, M.D. ⁣
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#opioidcrisis #opioid #opioidaddiction #medicalethics #addiction #primarycare #medicaleducation #meded
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The @cdcgov ’s 2016 Guideline for Prescribing Opioids for Chronic Pain has largely been embraced by the #medical and #healthpolicy communities. Unfortunately, some policies and practices purportedly derived from the guideline have been inconsistent wi

New England Journal of Medicine
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@usmle_mcat_bestpracticeq.bank USMLE MCAT Prep. >6,000 MCQ QBank

@hoosier.abroad 👏

Tissue-specific “adult” #stemcells that are capable of both self-renewal and specialized tissue repair reside in certain tissues, such as the epidermis, limbal tissue of the eye, skeletal muscle, and blood. Pluripotent stem cells (PSCs) include embryonic stem cells (ESCs) that are derived from the blastocyst of the #embryo and human induced pluripotent stem cells (iPSCs) that are created from readily accessible cells, such as those of the blood, skin, or urine, through the overexpression of four transcription factors in culture, rendering them immortal. Patient-specific human iPSCs can be extensively propagated in vitro and differentiated toward diverse cell states, such as cardiomyocytes or neurons, in order to model disease in culture, screen for drugs, and test for function in preclinical murine studies of disease, and to eventually use in clinical applications. Candidate drugs can also be used to stimulate the expansion and function of endogenous tissue-specific stem cells to augment tissue regeneration.⁣
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Tap the link in our bio to read the full review on stem cells in the treatment of disease, which is accompanied by a slide show, an illustrated glossary, and an audio interview with one of the authors. ⁣
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#stemcell #medicalresearch #medicalillustration #biology #medicalscience #medicaleducation #meded #cellularbiology
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Tissue-specific “adult” #stemcells that are capable of both self-renewal and specialized tissue repair reside in certain tissues, such as the epidermis, limbal tissue of the eye, skeletal muscle, and blood. Pluripotent stem cells (PSCs) include embry

New England Journal of Medicine
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@intan.darmayanti @devitadevii belajar sain +sastra inggris wkwk

@devitadevii @intan.darmayanti emang iyee hampir tiap hari berhadapan dgn begituan wkwkw

Take the latest Image Challenge: A 59-year-old woman presented to the #emergencydepartment with a 4-day history of inflammation and pain in the right eye. She had been blind in the eye for several years before presentation. Magnetic resonance imaging revealed a right orbital mass. Abdominal and thoracic imaging showed numerous hepatic masses, abdominal and thoracic #lymphadenopathy, and vertebral sclerotic osseous disease. The right eye was enucleated for palliative relief and to obtain tissue for diagnosis. What is the diagnosis?⁣
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#MRI #ophthalmology #primarycare #clinicalpractice #medicalscience #medicaleducation #meded #clinicalimage
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Take the latest Image Challenge: A 59-year-old woman presented to the #emergencydepartment with a 4-day history of inflammation and pain in the right eye. She had been blind in the eye for several years before presentation. Magnetic resonance imaging

New England Journal of Medicine
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@shamal_k @shireenkhattak I mean she was blind for several years before? Either she was always blind and that masked any symptom development or she just never went to get her blindness checked??

@eduardomazzocato @geyereduardo 😍😂😂😂 vo ter q ir la da uma força. Estranho que nem me chamaram ainda mano, será que esqueceram? 😂

Fantastic article from #newenglandjournalofmedicine on the relationship between eating chocolate and winning Nobel prizes! #correlationisnotcausation but in this case oh how we wish it was. Nerd jokes are the best jokes 🤓. UPDATE- We are looking into moving our lab to Switzerland, you know for science reasons.
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Fantastic article from #newenglandjournalofmedicine on the relationship between eating chocolate and winning Nobel prizes! #correlationisnotcausation but in this case oh how we wish it was. Nerd jokes are the best jokes 🤓. UPDATE- We are looking into

New England Journal of Medicine
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@drhydration I think this is why some people say Epidemiology = Mythology.

@uwyo_hydration_physiology @drhydration “some people”

From the #NEJMArchive: Images in Clinical Medicine: Adults with Osteogenesis Imperfecta (Dec. 28, 2006). ⁣
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Osteogenesis imperfecta is a heritable disorder caused by mutations in the gene for type I collagen. The Sillence classification of #osteogenesisimperfecta (types I through IV) is based on clinical characteristics. Whole-body images of adults with osteogenesis imperfecta who were recruited for a clinical trial were acquired with the use of dual-energy x-ray absorptiometry. A wide spectrum of skeletal manifestations is apparent, from the mild abnormalities in the 38-year-old woman with type I osteogenesis imperfecta to the severe deformities in the 40-year-old man with type III disease. #Scoliosis is present in most of the adults shown. Tap the link in our bio for the full image details. ⁣
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#bonedisease #osteoporosis #primarycare #clinicalpractice #medicalscience #medicaleducation #meded #clinicalimage
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From the #nejmarchive : Images in Clinical Medicine: Adults with Osteogenesis Imperfecta (Dec. 28, 2006). ⁣ ⁣ Osteogenesis imperfecta is a heritable disorder caused by mutations in the gene for type I collagen. The Sillence classification of #osteogen

New England Journal of Medicine
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@rachelthejay @jacobthejay are you saying I’m type 1

@k_sheaffer @meetpatel1213 @ibelucas

A 57-year-old woman receiving long-term hydroxychloroquine treatment presented for ophthalmic evaluation. Achromatic #perimetry revealed paracentral scotomas in each eye, and optical coherence #tomography revealed a loss of the retinal inner and outer segments. Tap the link in our bio for the full case details. ⁣⠀
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#rheumatology #ophthalmology #primarycare #clinicalpractice #eyeexam
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A 57-year-old woman receiving long-term hydroxychloroquine treatment presented for ophthalmic evaluation. Achromatic #perimetry revealed paracentral scotomas in each eye, and optical coherence #tomography revealed a loss of the retinal inner and oute

New England Journal of Medicine
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@micaelvaltoni @kennyoefsantos typical case

@thomas.volpe norb

Original Article: Tagraxofusp in Blastic Plasmacytoid Dendritic-Cell Neoplasm. ⁣
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Patients with blastic plasmacytoid dendritic-cell #neoplasm, an aggressive hematologic #cancer, were treated with the cytotoxin tagraxofusp in a dose-escalation case series. Previously untreated patients had a 72% complete response rate, and 45% underwent #stemcell transplantation. Toxic effects included hepatic dysfunction, thrombocytopenia, and capillary leak syndrome. ⁣
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Shown are photographs of the chest and back of a female patient with extensive BPDCN involving skin and #bonemarrow at baseline (Panel A) and on day 21 during the first cycle of treatment with tagraxofusp (Panel B). The patient was enrolled for first-line treatment that included six cycles of tagraxofusp at a dose of 12 μg per kilogram. She discontinued treatment while in remission to undergo autologous stem-cell transplantation. ⁣
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Tap the link in our bio for the full study. ⁣
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#leukemia #lymphoma #cancer #medicalresearch #cancerresearch #clinicaltrial #medicalscience #science #medicaleducation #meded
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19

Original Article: Tagraxofusp in Blastic Plasmacytoid Dendritic-Cell Neoplasm. ⁣ ⁣ Patients with blastic plasmacytoid dendritic-cell #neoplasm , an aggressive hematologic #cancer , were treated with the cytotoxin tagraxofusp in a dose-escalation case s

New England Journal of Medicine
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@a.luisa.leite @magda.costa ,@david_rpaiva

@victorbasilio @polyannes

Though cancer’s setbacks didn’t necessarily threaten my life, they certainly threatened my days. They combined forces to become my lived “reality of cancer.” For me, grasping this entity, defining its boundaries, seemed key to disempowering it. Tap the link in our bio to read the Perspctive The ROC Curve Redefined — Optimizing Sensitivity (and Specificity) to the Lived Reality of Cancer by Susan P. Walker, M.D. ⁣
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#oncology #medicalpractice #medicalethics #primarycare #clinicalpractice #cancer
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22

Though cancer’s setbacks didn’t necessarily threaten my life, they certainly threatened my days. They combined forces to become my lived “reality of cancer.” For me, grasping this entity, defining its boundaries, seemed key to disempowering it. Tap t

New England Journal of Medicine
Comments

@marioc.dibenedetto Problem is that hospital administrators should remember that, creating ideal work place where professionals wouldn't experience burnout.

Clinical Implications of Basic Research: Stomaching Drug Delivery. ⁣
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The gastric mucosa represents a formidable barrier to oral drug delivery. A group of investigators, taking a cue from the shape of a self-righting tortoise’s shell, designed and tested in preclinical models a device that delivered drugs though the gastric mucosa and into the circulation. Tap the link in our bio to learn more about this prototype gastric device. ⁣
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#endocrinology #gastroenterology #medicalillustration #medicalscience #science #medicaleducation #meded
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nejm
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Clinical Implications of Basic Research: Stomaching Drug Delivery. ⁣ ⁣ The gastric mucosa represents a formidable barrier to oral drug delivery. A group of investigators, taking a cue from the shape of a self-righting tortoise’s shell, designed and t

New England Journal of Medicine
Comments

@medicafitdiabetica @victor.oliv3ira muito!!

@usmle_mcat_bestpracticeq.bank USMLE MCAT Prep. >6,000 MCQ QBank

Review Article: Hazardous Chemical Emergencies and Poisonings. ⁣
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Panel A shows the mechanism of cyanide #poisoning at the level of the #mitochondria, and Panel B shows the spectrum of #clinical findings and a patient with moderate cyanide poisoning. ADP denotes adenosine diphosphate, CoQ coenzyme Q, e− enzyme, FAD and FADH2 oxidized and reduced flavin adenine dinucleotide, respectively, and Pi inorganic phosphate.⁣
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Tap the link in our bio to read the full review in which the authors explain the effects of exposure to respiratory irritants, vesicants, asphyxiants (including cyanide), and cholinergic agents (organophosphate insecticides and military nerve agents). ⁣
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#neurology #toxicology #criticalcare #medicalillustration #medicalscience #science #medicaleducation #meded
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18

Review Article: Hazardous Chemical Emergencies and Poisonings. ⁣ ⁣ Panel A shows the mechanism of cyanide #poisoning at the level of the #mitochondria , and Panel B shows the spectrum of #clinical findings and a patient with moderate cyanide poisoning

New England Journal of Medicine
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@drehijele1 HELLO EVERYONE I AM DR OSEDEBAMEN ONE OF THE GREATEST HERBAL MAN IN AFRICA. I HAVE HERBAL CURE FOR MANY DISEASES AND INFECTIONS LIKE #HERPES,#FIBRIOD,#COLDSORE,#INFERTILITY,#HIV,#CANCER,#SYPHILIS,#PCO,#DIABETES,#ASTHMA AND SO ON. CONTACT ME @drosedebamen1

New Image Challenge: A 37-year-old man presented with a 4-year history of excessive sweating, headaches, and joint pain. His wife had also noticed increasing skin folds on his scalp. What is the most likely diagnosis? Visit the link in our bio to submit your answer. ⁣
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#primarycare #clinicalpractice #medicalscience #medicaleducation #meded #clinicalimage
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New Image Challenge: A 37-year-old man presented with a 4-year history of excessive sweating, headaches, and joint pain. His wife had also noticed increasing skin folds on his scalp. What is the most likely diagnosis? Visit the link in our bio to sub

New England Journal of Medicine
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@danikastcap @marinapipa.dermato

@silvia_alameda @1robert1975 😂😂😂😂😂👌

Images in Clinical Medicine: Disseminated Gonococcal Infection. ⁣⠀
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A 20-year-old woman presented to the #emergencydepartment with a rash involving the arms, legs, trunk, and scalp, which had erupted that morning. She also reported generalized muscle aches, fever, and pain in both ankles. Two weeks earlier, the patient had had vaginal intercourse with a new partner without barrier protection. The physical examination was notable for erythematous #pustules near the wrist and on the fingers (Panel A) and on the trunk, scalp, and both ankles. There was mild swelling and pain with passive motion in the right ankle and tenosynovitis involving the tendons of both ankles. Given a high suspicion for disseminated gonococcal infection, treatment with ceftriaxone and azithromycin was initiated. Blood cultures grew gram-negative diplococci (Panel B) that were identified as Neisseria gonorrhoeae, which confirmed the diagnosis. ⁣⠀
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#dermatology #infectiousdisease #bacterialinfections #primarycare #clinicalpractice #medicalscience #medicaleducation #meded #infection #clinicalimage
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Images in Clinical Medicine: Disseminated Gonococcal Infection. ⁣⠀ ⁣⠀ A 20-year-old woman presented to the #emergencydepartment with a rash involving the arms, legs, trunk, and scalp, which had erupted that morning. She also reported generalized musc

New England Journal of Medicine
Comments

@starr0408 @jsanin16 look at this

@divadoodledoo Use a condom!

A #medicalstudent with type 1 #diabetes has to develop workarounds for her #surgicalrotation, choose her specialty carefully…and decide whether, when, and how to disclose her condition to her educators and to patients. Tap the link in our bio to read the Perspective Diabetes and Disclosure by Kaitlyn K. Rogers, B.S. ⁣
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#surgery #diabetes #medicalpractice #medicalethics #medicaleducation #meded #t1d
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A #medicalstudent with type 1 #diabetes has to develop workarounds for her #surgicalrotation , choose her specialty carefully…and decide whether, when, and how to disclose her condition to her educators and to patients. Tap the link in our bio to read

New England Journal of Medicine
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@paambarrientos @bellinhamendes1

@usmle_mcat_bestpracticeq.bank USMLE MCAT Prep. >6,000 MCQ QBank

Case Records of the Massachusetts General Hospital: A 60-Year-Old Man with Weakness and Difficulty Chewing. ⁣
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A 60-year-old man was evaluated in the #neurology clinic because of difficulty chewing and progressive, generalized weakness. Physical examination revealed #atrophy and fasciculations in multiple muscle groups. Visit the link in out bio to read the full case and to watch a video showing examination of a similar patient. ⁣
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Photographs of the #thoracolumbar and cervical #spinalcord before fixation (Panels A and B, respectively) show that the anterior roots are thin, flat, and pale pink (Panel A, arrowhead) and the dorsal roots are round and white (Panel A, arrow). In the motor cortex, Luxol fast blue–hematoxylin and eosin staining (Panel C) shows that the overall cortical structure is retained, with some Betz cells visible (arrows), but staining for glial fibrillary acidic protein (Panel D) shows many reactive astrocytes in the deeper cortical layers. In the lumbar spinal cord and medulla (Panels E and F, respectively), Luxol fast blue–hematoxylin and eosin staining shows no loss of myelin staining in the corticospinal tracts (asterisks).⁣
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#neuromusculardisease #primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation
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Case Records of the Massachusetts General Hospital: A 60-Year-Old Man with Weakness and Difficulty Chewing. ⁣ ⁣ A 60-year-old man was evaluated in the #neurology clinic because of difficulty chewing and progressive, generalized weakness. Physical exa

New England Journal of Medicine
Comments

@fatma.sh.88 @barghoutgeorge

@usmle_mcat_bestpracticeq.bank USMLE MCAT Prep. >6,000 MCQ QBank

A woman on Chicago’s primarily black South Side is seen for a breast lump at a community hospital that lacks the resources for high-quality #cancer care. A navigator from the Metropolitan Chicago Breast Cancer Task Force reroutes her to a qualified medical center. Tap the link in our bio to read the latest in our Case Studies in Social Medicine series, Structural Racism — A 60-Year-Old Black Woman with Breast Cancer by Kristen Pallok, B.S., Fernando De Maio, Ph.D., and David A. Ansell, M.D., M.P.H. ⁣
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#breastcancer #emergencymedicine #healthcare #publichealth #medicalpractice #medicalethics #medicaleducation #meded #structuralracism
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nejm
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A woman on Chicago’s primarily black South Side is seen for a breast lump at a community hospital that lacks the resources for high-quality #cancer care. A navigator from the Metropolitan Chicago Breast Cancer Task Force reroutes her to a qualified m

New England Journal of Medicine
Comments

@jl3.5wilsonmd A perfect example of how certain people can’t make any comments for fear of reprisal.

@usmle_mcat_bestpracticeq.bank USMLE MCAT Prep. >6,000 MCQ QBank

#repost @nejm  Catheter ablation of ventricular #tachycardia involves identifying the mechanism (a focus with abnormal impulse formation or a reentrant circuit), mapping the VT, and using radiofrequency current to ablate the tissue involved. 
In a structurally normal heart, ventricular tachycardia can be idiopathic or due to genetic arrhythmia syndromes. Idiopathic ventricular tachycardias, which are the most common type, are typically monomorphic, indicating that they originate from a single discrete focus. The focus is most often located in the outflow region of one of the ventricles, either supravalvular or infravalvular, although it can be located in another ventricular myocardial location. 
Shown are two views of the left ventricle and common mechanisms of VT in patients who do not have structural heart disease. Tap the link in our bio to learn more about this #medicalillustration and to read the full review article Catheter Ablation of Ventricular Arrhythmias. #catheter #leftventricle #arrhythmia #medicalscience #science #medicalresearch #medicaleducation #meded
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anesthesiacamp
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#repost @nejm Catheter ablation of ventricular #tachycardia involves identifying the mechanism (a focus with abnormal impulse formation or a reentrant circuit), mapping the VT, and using radiofrequency current to ablate the tissue involved. In a st

New England Journal of Medicine
Catheter ablation of ventricular #tachycardia involves identifying the mechanism (a focus with abnormal impulse formation or a reentrant circuit), mapping the VT, and using radiofrequency current to ablate the tissue involved. ⁣
⁣
In a structurally normal heart, ventricular tachycardia can be idiopathic or due to genetic arrhythmia syndromes. Idiopathic ventricular tachycardias, which are the most common type, are typically monomorphic, indicating that they originate from a single discrete focus. The focus is most often located in the outflow region of one of the ventricles, either supravalvular or infravalvular, although it can be located in another ventricular myocardial location. ⁣
⁣
Shown are two views of the left ventricle and common mechanisms of VT in patients who do not have structural heart disease. Tap the link in our bio to learn more about this #medicalillustration and to read the full review article Catheter Ablation of Ventricular Arrhythmias. ⁣
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#catheter #leftventricle #arrhythmia #medicalscience #science #medicalresearch #medicaleducation #meded
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Catheter ablation of ventricular #tachycardia involves identifying the mechanism (a focus with abnormal impulse formation or a reentrant circuit), mapping the VT, and using radiofrequency current to ablate the tissue involved. ⁣ ⁣ In a structurally n

New England Journal of Medicine
Comments

@lizzyhm @meow_merr saw this and reminded me of our ablation king @salamsbaity

@salamsbaity @lizzyhm ❤️🤓

Had a great time attending a meeting of the NEJM's editorial board.
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cdcerecedo
9

Had a great time attending a meeting of the NEJM's editorial board.

New England Journal of Medicine
Comments

@marianarf23 Ya tienes chaleco!!!!! Soy tu fan 🌟

@stefanofrullo 👌🏽🤘🏾🤘🏾 chingon!!

New Image Challenge! A 60-year-old woman presented to the #ophthalmology clinic after noticing central blind spots in the visual fields of both #eyes. She had a history of rheumatoid arthritis, which had been treated with hydroxychloroquine for 14 years. The retinal examination showed the pattern below. What is the most likely underlying cause of this abnormality? Tap the link in our bio to submit your answer. ⁣⠀
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#retina #rheumatology #primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation
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nejm
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New Image Challenge! A 60-year-old woman presented to the #ophthalmology clinic after noticing central blind spots in the visual fields of both #eyes . She had a history of rheumatoid arthritis, which had been treated with hydroxychloroquine for 14 ye

New England Journal of Medicine
Comments

@dhoota @yusufahmed_10

@rami._.darwich @dr.ghazawi Bullseye maculopathy with flying saucer sign if OCT is done.

Clinical Implications of Basic Research: Boning Up on Irisin. ⁣
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A recent study suggests that irisin, a #cytokine secreted by muscle during #exercise, effects bone resorption and the differentiation of preadipocytes into thermogenic brown fat cells by displacing tethers between the cell and extracellular matrix molecules. Tap the link in our bio to learn more. ⁣
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#osteoporosis #bonedisease #genetics #endocrinology ⁣
#medical #meded #medicalscience #medicaleducation #science #medicalillustration #medicalresearch
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nejm
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Clinical Implications of Basic Research: Boning Up on Irisin. ⁣ ⁣ A recent study suggests that irisin, a #cytokine secreted by muscle during #exercise , effects bone resorption and the differentiation of preadipocytes into thermogenic brown fat cells

New England Journal of Medicine
Comments

@dubbbteee @stefyvargasrenza 😍

@pedrogarciamd @euedududu

Though the Sackler family did not invent the practice of selling drugs to physicians, they were pioneers whose story illustrates the ways marketers developed, naturalized, and monetized the interface between the pharmaceutical industry and prescribing physicians. Tap the link in our bio to read the Perspective Preying on Prescribers (and Their Patients) — Pharmaceutical Marketing, Iatrogenic Epidemics, and the Sackler Legacy by Scott H. Podolsky, M.D., David Herzberg, Ph.D., and Jeremy A. Greene, M.D., Ph.D. ⁣⠀
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#opioidcrisis #medicalethics #pain #addiction #painmanagement #primarycare #clinicalpractice #medical #meded #medicaleducation
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nejm
8

Though the Sackler family did not invent the practice of selling drugs to physicians, they were pioneers whose story illustrates the ways marketers developed, naturalized, and monetized the interface between the pharmaceutical industry and prescribin

New England Journal of Medicine
Comments

@drtaghva Yes marketing can influence physicians just as lobbyists can influence politicians making health care policy decisions. Only one group has laws regulating this interaction, can you guess which? Hint: it's not the politicians and lobbyists.

@raphaela.naho.tamura Methods of marketing is a great tool for risk benefit analysis. Patient should be more valued in this way.

A 14-year-old boy was admitted with a severe asthma exacerbation. A chest radiograph showed pneumomediastinum with diffuse subcutaneous emphysema. As his respiratory status improved, swelling and palpable crepitus developed in both cheeks and the right eyelid. Palpebral emphysema can occur as a complication of pneumomediastinum and typically resolves without intervention. Visit the link in our bio for an additional image and the full case details. ⁣⠀
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#primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation #pediatrics #asthma #criticalcare
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nejm
21

A 14-year-old boy was admitted with a severe asthma exacerbation. A chest radiograph showed pneumomediastinum with diffuse subcutaneous emphysema. As his respiratory status improved, swelling and palpable crepitus developed in both cheeks and the rig

New England Journal of Medicine
Comments

@jeloliveira @vlpeixoto

@vlpeixoto @jeloliveira eu acho que era o da velhinha mesmo...

Review Article: Hepatocellular Carcinoma. ⁣⠀
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Primary #livercancer is the fourth most common #tumor worldwide. Hepatocellular carcinoma occurs mainly in the context of #cirrhosis, hepatitis B or C virus infection, or nonalcoholic steatohepatitis. Underlying #liverdisease limits therapeutic efficacy. ⁣⠀
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Figure 4: Clinical Algorithm for the Management of Hepatocellular Carcinoma. The algorithm is based on the Barcelona Clinic Liver Cancer algorithm, which classifies patients as being in one of five stages, and European Association for the Study of the Liver guidelines.27,43 Depicted is the estimated survival time in each stage once the recommended therapy has been administered or performed. The lenvatinib trial did not include patients with 50% or higher occupation of the liver with tumors or invasion of the bile duct or main portal vein. None of the second-line therapies were tested in patients who had tumors that had been treated with lenvatinib. Regorafenib was tested in patients for whom sorafenib was associated with an acceptable side-effects profile, and ramucirumab in those with serum AFP levels of 400 ng per milliliter or greater. Eastern Cooperative Oncology Group performance status (ECOG-PS) is a five-point scale on which higher numbers reflect greater disability. HCC denotes hepatocellular carcinoma. ⁣⠀
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#oncology #viralinfections #primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation #medicalillustration
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Review Article: Hepatocellular Carcinoma. ⁣⠀ ⁣⠀ Primary #livercancer is the fourth most common #tumor worldwide. Hepatocellular carcinoma occurs mainly in the context of #cirrhosis , hepatitis B or C virus infection, or nonalcoholic steatohepatitis. U

New England Journal of Medicine
Comments

@leta_nyc @vivianelampreia 😍

@bowlingmedrina ATTENTION!!! This is to bring to the public that Dr. Aziza @dr_azizahealthcare have the permanent herbal cure for #Herpes, #Hpv, #Cancers, #Hepatitis, #Diabetis, #Obesity & #HIV etc. Please click on my profile to get his contact details and know more informations about his medicine.

Original Article: Tau Positron-Emission Tomography in Former National Football League Players. ⁣⠀
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Twenty-six former @NFL players with cognitive and behavioral symptoms were compared with controls by means of tau PET. Tau deposition was found in the temporal, superior frontal, and left parietal regions, similar to the neuropathological findings in chronic traumatic encephalopathy (CTE). ⁣⠀
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Figure 2: 3-D Stereotactic Surface Projection Maps of Flortaucipir PET. Higher flortaucipir SUVRs in the former-player group than in the control group were found in the bilateral superior frontal (Panel A), bilateral medial temporal (Panel B), and left parietal (Panel C) regions of the brain. The regions shown in red in these surface projection images correspond to the statistical parametric maps after restriction of the map to those clusters of at least 100 contiguous voxels associated with higher regional:cerebellar gray-matter flortaucipir SUVRs in the former-player group than in the control group (P
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Original Article: Tau Positron-Emission Tomography in Former National Football League Players. ⁣⠀ ⁣⠀ Twenty-six former @nfl players with cognitive and behavioral symptoms were compared with controls by means of tau PET. Tau deposition was found in th

New England Journal of Medicine
Comments

@allefvg @jenialvss lembrei q vc postou algo sobre esse assunto

@jenialvss @allefvg Sim!!! Muito legal ver novas publicações e discussões sobre o tema!! Obrigada Allef!!

In this view of the future of medicine, patient–provider interactions are informed and supported by massive amounts of data from interactions with similar patients. These data are collected and curated to provide the latest evidence-based assessment and recommendations. ⁣
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Visit the link in our bio to read the review article Machine Learning in Medicine and to watch the full video describing the core structural changes and paradigm shifts in the #healthcare system that are necessary to enable the full promise of #machinelearning in medicine. ⁣
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#HealthIT #bigdata #digitalhealth #personalizedmedicine #medicine #medicalscience
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15

In this view of the future of medicine, patient–provider interactions are informed and supported by massive amounts of data from interactions with similar patients. These data are collected and curated to provide the latest evidence-based assessment

New England Journal of Medicine
Comments

@didimauro673 ☝🏻

@felitobon @wicalling

Una mujer de 86 años consultó por un cuadro clínico de 15 días de evolución, caracterizado por fatiga, dolor de cabeza y dificultad para tragar.  Su medicación habitual era una aspirina diaria.  El examen físico evidenció unas arterias temporales palpables y pulsátiles en ambos lados.  No hubo fiebre ni sensibilidad en el cuero cabelludo, y los resultados del examen oftalmológico fueron normales.  Los estudios de laboratorio revelaron un recuento de glóbulos blancos de 14,950 por milímetro cúbico (rango de referencia, 4500 a 11,000) y una tasa de sedimentación de eritrocitos de 120 mm por hora (rango de referencia, 1 a 12). Se consideró un probable diagnóstico de arteritis de células gigantes.  Se realizaron biopsias de ambas arterias temporales y se inició el tratamiento con glucocorticoides antes de que estuvieran disponibles los resultados del análisis patológico.  Los resultados de la biopsia confirmaron el diagnóstico de arteritis de células gigantes.  Ocho días después de su presentación inicial, la paciente acudió al servicio de urgencias con dolor de lengua.  Se observó una ulceración necrótica en el lado derecho de la lengua.  La tomografía computarizada cervicofacial, realizada después de la administración de material de contraste, reveló una trombosis completa de la arteria lingual derecha.  La necrosis de la lengua es una complicación rara de la arteritis de células gigantes.  Con el tratamiento continuado con glucocorticoides, sus síntomas iniciales se resolvieron 2 semanas después de su presentación inicial y la lesión de la lengua se curó en 4 semanas.  Los glucocorticoides fueron disminuidos lentamente.
Créditos: @nejm 
Laurent Truffaut, M.D.
Universidad Católica de Lovaina, Bruselas, Bélgica
laurent.truffaut@hotmail.com
Philippe Lefebvre, M.D.
Centro Hospitalario Jolimont-Lobbes, La Louvière, Bélgica
——
#Aporta más sobre este tema en los comentarios ️
#ENARM #2MIR21 #MIR #ENARM2020 #medicina #2MIR19 #ENARM2019 #2MIR20 #medico #otorrino #facultaddemedicina @facultaddemedicina
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48

Una mujer de 86 años consultó por un cuadro clínico de 15 días de evolución, caracterizado por fatiga, dolor de cabeza y dificultad para tragar. Su medicación habitual era una aspirina diaria. El examen físico evidenció unas arterias temporales pal

New England Journal of Medicine
Comments

@daniii_andrea_ @sole_eeee así vas a estar después

@guadalupe.care @christian_hts

Un paciente de 35 años con antecedentes de trastorno bipolar fue llevado al servicio de urgencias y posteriormente valorado por psiquiatría al presentar delirios paranoicos.  En el examen físico, se encontró que tenía alopecia irregular del cuero cabelludo y máculas eritematosas con escamas débiles y sutiles en el tronco, brazos y piernas.  Aparentemente no había lesiones en las palmas o plantas.  Aparte de la alteración del estado de ánimo, que fue consistente con las presentaciones psiquiátricas anteriores del paciente, los resultados del examen neurológico fueron normales.  Las pruebas de laboratorio revelaron un título rápido de reagina en plasma de 1: 128, y el resultado de una prueba confirmatoria para anticuerpos contra Treponema pallidum fue positivo.  Una prueba para anticuerpos contra el virus de la inmunodeficiencia humana fue negativa.  Una alopecia no cicatricial con aspecto de comido de polilla es característica de la sífilis secundaria.  Aunque la alopecia sifilítica es infrecuente, puede ser la única manifestación de sífilis secundaria observada en la presentación del paciente.  El cabello normalmente vuelve a crecer después del tratamiento con antibióticos.  El paciente recibió una inyección intramuscular de penicilina G benzatina, y en unos días se resolvió la erupción.  Su estado de ánimo se estabilizó con el tratamiento para el trastorno bipolar que incluía medicamentos antipsicóticos y fue dado de alta.  Posteriormente se perdió de seguimiento.
Créditos: @nejm 
Ata S. Moshiri, M.D., M.P.H.
Alexander Moxam, M.D.
Hospital de la Universidad de Pennsylvania, Filadelfia, PA
ata.moshiri@uphs.upenn.edu
——
#Aporta más sobre este tema en los comentarios ️
#ENARM #2MIR21 #MIR #ENARM2020 #medicina #2MIR19 #ENARM2019 #2MIR20 #medico #otorrino #facultaddemedicina @facultaddemedicina
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22

Un paciente de 35 años con antecedentes de trastorno bipolar fue llevado al servicio de urgencias y posteriormente valorado por psiquiatría al presentar delirios paranoicos. En el examen físico, se encontró que tenía alopecia irregular del cuero cab

New England Journal of Medicine
Comments

@pablo.tercero_9 Esta loco

@docmimo Repasar Sífilis...

More than half of new mothers take one or more medications in the months after delivery. But #healthcare providers often lack the evidence they need to counsel #breastfeeding women on medications’ potential effects on #lactation, on mothers, or on their babies. Tap the link in our bio to read the Perspective Is It Safe? — The Many Unanswered Questions about Medications and Breast-Feeding by John J. Byrne, M.D., M.P.H., and Catherine Y. Spong, M.D. ⁣
⁣
#OBGYN #womenshealth #primarycare #postpartum #pregnancy
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2

More than half of new mothers take one or more medications in the months after delivery. But #healthcare providers often lack the evidence they need to counsel #breastfeeding women on medications’ potential effects on #lactation , on mothers, or on th

New England Journal of Medicine
Comments

@bright_bean_health <3

@dr.martaperez 👏👏👏👏

Una niña peruana de 15 años que vivía en las montañas de los Andes refirió un cuadro clínico de aproximadamente tres meses de evolución caracterizado por dolor de cabeza, náuseas, vómitos y oscurecimiento visual. Concomitantemente manifestó una historia de un mes de discursos incoherentes, confusión y alucinaciones visuales y auditivas.  El examen físico evidenció que tenía papiledema bilateral, rigidez en el cuello y compromiso psicomotor.  La resonancia magnética (RM) cerebral reveló numerosas áreas quísticas distribuidas de manera difusa, que crearon una apariencia de queso suizo. En la exploración ponderada en T2 (Imagen A), los quistes eran brillantes.  En la exploración ponderada en T1 (Imagen B), se observaron numerosos quistes en la lengua y también se presentaron quistes intraventriculares (flecha). Los quistes eran oscuros, aunque después de la administración de gadolinio, algunos mostraron realce en anillo (Imagen C). La secuencia FLAIR (recuperación de la inversión atenuada por el fluido) mostró una señal punteada, brillante y de posición excéntrica dentro de la mayoría de los quistes, cada uno de los cuales representa un escolex (Imagen C. Excolex: Extremo anterior, diminuto y globoso de la tenia y otros gusanos cestodos, constituido por la cabeza y los órganos que le permiten fijarse a los tejidos del ser al que parasita). Un examen de heces reveló huevos de Taenia solium.  El análisis de transferencia Western fue positivo para cisticercosis.  El recuento de glóbulos blancos en suero fue normal y el recuento de eosinófilos fue del 4 por ciento.  La paciente fue tratada durante un mes con albendazol (15 mg por kilogramo de peso corporal por día) y prednisona (60 mg por día, disminuyendo la dosis al final del mes). En una visita de seguimiento ocho meses después, se encontró que la recuperación del paciente era clínicamente completa y la RMN cerebral reveló la resolución de los quistes.
Créditos: @nejm 
Howard W. Sander, M.D.
Weill College of Medicine de Cornell University, Nueva York, NY 10022
Conrado Castro, M.D.
Instituto Especializado en Ciencias Neurológicas, Lima, Perú
#medicina #2MIR19 #ENARM2019 #2MIR20 #enarm #mir
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Una niña peruana de 15 años que vivía en las montañas de los Andes refirió un cuadro clínico de aproximadamente tres meses de evolución caracterizado por dolor de cabeza, náuseas, vómitos y oscurecimiento visual. Concomitantemente manifestó una histo

New England Journal of Medicine
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@caribbeangirl_edg Waoo 👍🏽👍🏽👍🏽

@docmimo Un sacudón para los que creen que no existe más está patología.

Un paciente de 18 años fue llevado al servicio de urgencias por convulsiones tónico-clónicas generalizadas.  Como sintomatología previa, sus padres comentaron que había estado quejándose de dolor en la ingle derecha durante 1 semana.  En el examen físico, el paciente estaba confundido. Tenía un edema sobre el ojo derecho y dolor en el testículo derecho.  Durante el estudio de las convulsiones, se le realizó una resonancia magnética cerebral que mostró numerosas lesiones quísticas bien definidas en toda la corteza cerebral (Imagen A), el tronco encefálico y el cerebelo (Imagen B) que eran compatibles con la neurocisticercosis.  Durante el estudio del ojo y el testículo se observaron nódulos ecogénicos que contenían quistes bien definidos.  El análisis de transferencia Western y el ensayo inmunoabsorbente ligado a enzimas mostraron anticuerpos positivos tipo IgG sérica contra la cisticercosis.  En el contexto de una alta carga de quistes, el tratamiento con medicamentos antiparasitarios puede empeorar la inflamación y el edema cerebral, y en presencia de lesiones oculares, la inflamación puede llevar a la pérdida de la visión.  Por lo tanto, los medicamentos antiparasitarios no se administraron en este caso.  A pesar del tratamiento con dexametasona y antiepilépticos, el paciente falleció 2 semanas después.
Créditos: @nejm 
Nishanth Dev, M.D.
S. Zafar Abbas, M.D.
ESIC Medical College and Hospital, Faridabad, India
devnishant@gmail.com
——
#Aporta más sobre este tema en los comentarios ️
#ENARM #2MIR18 #MIR #ENARM2018 #medicina #2MIR19 #ENARM2019 #2MIR20 #medico #facultaddemedicina @facultaddemedicina
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Un paciente de 18 años fue llevado al servicio de urgencias por convulsiones tónico-clónicas generalizadas. Como sintomatología previa, sus padres comentaron que había estado quejándose de dolor en la ingle derecha durante 1 semana. En el examen fí

New England Journal of Medicine
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@tther___ @pikachitu

@liliana.rc8 @amnernorato 😓

Epigenetic change \e-pə-jə-ˈne-tik ˈchānj\ A change in the regulation of the expression of gene activity without alteration of genetic structure. The NEJM Illustrated Glossary provides simple, illustrated definitions of complex key terms. Tap the link in our bio to explore this new feature. ⁣
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Epigenetic change \e-pə-jə-ˈne-tik ˈchānj\ A change in the regulation of the expression of gene activity without alteration of genetic structure. The NEJM Illustrated Glossary provides simple, illustrated definitions of complex key terms. Tap the lin

New England Journal of Medicine
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@minan678 How i can register in the site.

@jacobobmebarak @suadsiuffi

#repost @nejm Clinical Problem-Solving: A Dangerous Detour. ⁣
A 26-year-old woman with T-cell acute lymphoblastic #leukemia and an indwelling port catheter presented with progressive #dyspnea. She had received a diagnosis of pulmonary emboli 3 weeks earlier. Shown in this video are the echocardiographic findings. Tap the link in our bio for video descriptions and for the full case details. ⁣
⁣
#oncology #cardiology #echocardiography #clinicalpractice #medical #meded #medicalscience #medicaleducationClinical Problem-Solving: A Dangerous Detour. ⁣
⁣
A 26-year-old woman with T-cell acute lymphoblastic #leukemia and an indwelling port catheter presented with progressive #dyspnea. She had received a diagnosis of pulmonary emboli 3 weeks earlier. Shown in this video are the echocardiographic findings. Tap the link in our bio for video descriptions and for the full case details. ⁣
⁣
#oncology #cardiology #echocardiography #clinicalpractice #medical #meded #medicalscience #medicaleducation
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#repost @nejm Clinical Problem-Solving: A Dangerous Detour. ⁣ A 26-year-old woman with T-cell acute lymphoblastic #leukemia and an indwelling port catheter presented with progressive #dyspnea . She had received a diagnosis of pulmonary emboli 3 weeks

New England Journal of Medicine
Clinical Problem-Solving: A Dangerous Detour. ⁣
⁣
A 26-year-old woman with T-cell acute lymphoblastic #leukemia and an indwelling port catheter presented with progressive #dyspnea. She had received a diagnosis of pulmonary emboli 3 weeks earlier. Shown in this video are the echocardiographic findings. Tap the link in our bio for video descriptions and for the full case details. ⁣
⁣
#oncology #cardiology #echocardiography #clinicalpractice #medical #meded #medicalscience #medicaleducation
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Clinical Problem-Solving: A Dangerous Detour. ⁣ ⁣ A 26-year-old woman with T-cell acute lymphoblastic #leukemia and an indwelling port catheter presented with progressive #dyspnea . She had received a diagnosis of pulmonary emboli 3 weeks earlier. Sho

New England Journal of Medicine
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@jrgvgomez vegetación in the tricúspide valve anterior leaflet and PFO

@joseperear @dianaestefaniapadilla TEP?

Review Article: Mucinous Ovarian Carcinoma. ⁣
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Figure 1 shows the stages in the progression of mucinous ovarian #tumors. Mucinous #ovariancancer accounts for 3% of epithelial ovarian cancers and must be distinguished from mucinous carcinomas that have metastasized to the ovary. Most cases manifest as large, localized masses; resection is associated with a good prognosis. Mucinous ovarian tumors develop on a continuum from benign epithelium to preinvasive (borderline) carcinoma to mucinous carcinoma. KRAS mutations are an early event, whereas other oncogenic alterations (HER2 amplifications or TP53 mutations) may be acquired later in the course of malignant transformation. Tap the link in our bio for the full review. ⁣
⁣
#cancer #oncology #medicalscience #science #medicalresearch #medicaleducation #meded
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Review Article: Mucinous Ovarian Carcinoma. ⁣ ⁣ Figure 1 shows the stages in the progression of mucinous ovarian #tumors . Mucinous #ovariancancer accounts for 3% of epithelial ovarian cancers and must be distinguished from mucinous carcinomas that ha

New England Journal of Medicine
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@javiervaldez_93 @rvillarreal94

@hzapata__ @emmanuel_colin 🙌

Un paciente de 31 años consultó por un cuadro clínico de aproximadamente 5 días de evolución, caracterizado por úlceras orales y genitales.  Tenía antecedentes de 2 años de lesiones orales y genitales recurrentes, y 6 meses antes de la consulta había desarrollado un eritema nodoso en las piernas.  Se le realizaron pruebas para el virus del herpes simple y sífilis, la cuales fueron negativas.  No hubo evidencia de enfermedad inflamatoria intestinal o enfermedad pulmonar.  Se le realizó un diagnóstico de enfermedad de Behçet basado en las úlceras orales y genitales recurrentes y del eritema nodoso.  No presentó otras manifestaciones de la enfermedad de Behçet, como inflamación ocular, artritis, pseudofoliculitis, trombosis venosa o enfermedad de grandes vasos arteriales.  La enfermedad de Behçet es un proceso inflamatorio recurrente, con úlceras orales y genitales dolorosas que son las manifestaciones clínicas más comunes.  El paciente fue tratado con colchicina y glucocorticoides orales, y tuvo una resolución de las lesiones orales y genitales 3 semanas después del inicio del tratamiento.  Permaneció libre de recurrencia 14 meses después del tratamiento.
Créditos: @nejm 
Luiz S. Guedes-Barbosa, M.D.
Hospital Universitario Júlio Müller, Cuiaba, Brasil
lsgbarbosa@gmail.com
——
#Aporta más sobre este tema en los comentarios ️
#ENARM #2MIR18 #MIR #ENARM2018 #medicina #2MIR19 #ENARM2019 #2MIR20 #medico #facultaddemedicina @facultaddemedicina
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Un paciente de 31 años consultó por un cuadro clínico de aproximadamente 5 días de evolución, caracterizado por úlceras orales y genitales. Tenía antecedentes de 2 años de lesiones orales y genitales recurrentes, y 6 meses antes de la consulta había

New England Journal of Medicine
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@marisolfabiola.baezsalas En medicina china es un cuadro de fuego puede ser en estómago o vejiga que ya afecta a todos los órganos y apareció con las lesiones. Habría que tonificar y bajar calor abriendo vías del agua

@blair_bitch_777 Y esa enfermedad de Behçet por qué da?

A 27-year-old man presented to the #otorhinolaryngology outpatient clinic with a 3-month history of progressive obstruction and bleeding from the right naris. Physical examination showed a red, granular, pedunculated, nonpulsatile mass that obstructed the right #nasalcavity and bled on touch (Panel A). The patient reported bathing frequently in the local pond. The mass was excised, and the base of the #lesion was cauterized. Histopathological examination revealed multiple thick-walled sporangia in various stages of maturation, surrounded by dense inflammation (Panel B, hematoxylin and eosin). A diagnosis of rhinosporidiosis was made. Rhinosporidiosis is a chronic granulomatous disease caused by the aquatic protistan parasite Rhinosporidium seeberi. The typical presentation is a reddish, friable mucosal polyp, commonly involving the nasal cavity, that bleeds profusely on touch. The oropharynx, conjunctiva, rectum, and external genitalia may also be affected. Visit the link in our bio for the full article. ⁣
⁣
#outpatient #histopathology #primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation
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A 27-year-old man presented to the #otorhinolaryngology outpatient clinic with a 3-month history of progressive obstruction and bleeding from the right naris. Physical examination showed a red, granular, pedunculated, nonpulsatile mass that obstructe

New England Journal of Medicine
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@drleninreyes @walgmanmivida así vi, cosa fea esa! Saludos a todos por allá, un fuerte abrazo!

@chachviggg @marioo__k un cas pour toi 😉

Tap the link in our bio to take the latest Image Challenge! A 48-year-old man presented to the #ophthalmology clinic with a 1-week history of pain, double vision, and blurred vision in his left eye. What is the abnormality depicted here? ⁣
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#primarycare #clinicalpractice #medical #meded #medicalscience #medicaleducation #emergencymedicine #eye
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Tap the link in our bio to take the latest Image Challenge! A 48-year-old man presented to the #ophthalmology clinic with a 1-week history of pain, double vision, and blurred vision in his left eye. What is the abnormality depicted here? ⁣ ⁣ #primary

New England Journal of Medicine
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@clemen._tcae Iridodialisis

@anitta.aesthetic @alemroudmajani

Long-term survivors with #metastaticcancer have not been well studied, but diagnoses of incurable #cancer will have substantial effects on patients’ families, on workplaces, and on U.S. health care resources in the coming years. Tap the link in our bio to read Time to Study Metastatic-Cancer Survivorship, a Perspective by Terry Langbaum, M.A.S., and Thomas J. Smith, M.D. ⁣
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#oncology #depression #healthcare #medicalethics #primarycare #clinicalpractice #medicaleducation #meded
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Long-term survivors with #metastaticcancer have not been well studied, but diagnoses of incurable #cancer will have substantial effects on patients’ families, on workplaces, and on U.S. health care resources in the coming years. Tap the link in our b

New England Journal of Medicine
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@doctrice @prifgp

@miguelmateas Love this. Have a wonderful weekend 🙏

Images in Clinical Medicine: Disseminated Cysticercosis. ⁣
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An 18-year-old man presented to the #emergencydepartment with generalized tonic–clonic seizures. #MRI of the head showed numerous well-defined #cysticlesions in the #brain that were consistent with cysticercosis. Tap the link in our bio to read the full case details. ⁣
⁣
#primarycare #clinicalpractice #medical #meded #medicaleducation #emergencymedicine #neurology #infectiousdisease #parasiticinfections
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Images in Clinical Medicine: Disseminated Cysticercosis. ⁣ ⁣ An 18-year-old man presented to the #emergencydepartment with generalized tonic–clonic seizures. #mri of the head showed numerous well-defined #cysticlesions in the #brain that were consist

New England Journal of Medicine
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@tlewitt @evangelzayd

@neuzasoares @filipa.rodriguesdesousa

@nejm ‘den alıntı.
.
Klinik Tıpta Görüntüler: ⁣⠀ Pneumatosis Cystoides Intestinalis with Pneumoperitoneum.
⁣⠀
61 yaşında kadın hasta, akut difüz karın ağrısı ve 1 haftadır süren diyare ve kusma öyküsü ile acil servise başvurdu. Tıbbi öyküsü, inhaler glukokortikoid ve uzun etkili β-agonisti ile tedavi edilen kronik obstrüktif akciğer hastalığı (# KOAH) mevcuttu. . .
 🤚 Fizik muayenede, karında defans, şişkinlik ve distansiyon  ve hassasiyet vardı
. ️Bilgisayarlı tomografisinde karında ince barsak duvarında (Şekil B, ok) büyük miktarda serbest hava (Şekil A, ok) ve ekstralüminal gaz görüldü. (Lümendışı gaz) .
.
Acil #laparotomi yapıldı ve ince bağırsakların çoğunda gazla dolu, ince duvarlı, kistik yapı görüldü (şekil C)
. Bağırsak muayenesinde perforasyon dışlandı ve bağırsak rezeke edilmedi.
. Pneumatosis cistoides intestinalis'in patofizyolojisi tam olarak anlaşılamamıştır. 🤔🤔🤔. .
Kist rüptürü pnömoperiton ve periton tahrişine neden olabilir. Bağırsak duvarındaki pnömoperiton ve gazın radyografik bulguları, bu klinik durum gibi hayatı tehdit etmeyen nedenlerden, iskemik bağırsak gibi cerrahi acillere kadar bir dizi klinik senaryo ile karşımıza çıkabilir. . .@nejm #Nejm bu yazıyı yazan kişi Türk olsaydı hastalık yoktur; hasta vardır der konuyu kapatırdı. Fevkalenin fevkinde bi cümle nereye koysan cuk diye oturuyor. . .Bu arada bu ne yahu!

Arada nejm’den medscape’ten alıntı yapayım. 
Günceli de takip edelim 🤓🧐 . .
#internalmedicine #surgery #pyshician #medicalstudent #medicaldoctor
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@nejm ‘den alıntı. . Klinik Tıpta Görüntüler: ⁣⠀ Pneumatosis Cystoides Intestinalis with Pneumoperitoneum. ⁣⠀ 61 yaşında kadın hasta, akut difüz karın ağrısı ve 1 haftadır süren diyare ve kusma öyküsü ile acil servise başvurdu. Tıbbi öyküsü, inhaler

New England Journal of Medicine
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@aslihan8703 Cok tesekkür ederiz

@aslihan8703 Emeğinize saglık

Images in Clinical Medicine: Pneumatosis Cystoides Intestinalis with Pneumoperitoneum. ⁣⠀
⁣⠀
A 61-year-old woman presented to the #emergencydepartment with acute onset of diffuse abdominal pain and a 1-week history of diarrhea and vomiting. Her medical history included chronic obstructive pulmonary disease (#COPD), which was being treated with an inhaled glucocorticoid and a long-acting β-agonist. On examination, the abdomen was distended and diffusely tender, with guarding. Computed tomography of the abdomen revealed large amounts of free air (Panel A, arrow) and extraluminal gas in the wall of the small bowel (Panel B, arrow). Emergency #laparotomy was performed, and gas-filled, thin-walled, cystlike structures were seen throughout most of the small bowel (Panel C). Examination of the bowel ruled out a perforation, and the bowel was not resected. The pathophysiology of pneumatosis cystoides intestinalis is poorly understood. Cyst rupture can produce pneumoperitoneum and peritoneal irritation. Radiographic findings of pneumoperitoneum and gas within the bowel wall can be associated with a number of conditions, ranging from non–life-threatening causes, as in this case, to surgical emergencies such as ischemic bowel, depending on the clinical scenario.⁣⠀
⁣⠀
#CTscan #primarycare #clinicalpractice #medical #meded #medicaleducation #medicine
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Images in Clinical Medicine: Pneumatosis Cystoides Intestinalis with Pneumoperitoneum. ⁣⠀ ⁣⠀ A 61-year-old woman presented to the #emergencydepartment with acute onset of diffuse abdominal pain and a 1-week history of diarrhea and vomiting. Her medic

New England Journal of Medicine
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@xyzyoshi 😮

@annabellejpower @nickseton

Test yourself with the latest Interactive Medical Case: A Dangerous Detour. ⁣
⁣
This interactive case features a 26-year-old woman with T-cell acute lymphoblastic #leukemia who is receiving #chemotherapy and presents with progressive #dyspnea. How would you proceed with this patient? Tap the link in our bio to read the details and work through the case. ⁣
⁣
#oncology #primarycare #clinicalpractice #medical #meded #medicaleducation #medicalcase #cancer
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Test yourself with the latest Interactive Medical Case: A Dangerous Detour. ⁣ ⁣ This interactive case features a 26-year-old woman with T-cell acute lymphoblastic #leukemia who is receiving #chemotherapy and presents with progressive #dyspnea . How wo

New England Journal of Medicine
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@nuteilovesbirdy @gabrielaruxandraparaschiv why so much iv patient could have heart failure/pulmonary cause?? First rule out respiratory cause or cardiac cause...

@nuteilovesbirdy Patient on chemo with progressive dyspnea so PE less likely due to progressive nature...but simple basic ill go with absolute neutrophil count( She could have neutropenia putting her at risk of oppotunistic infection like PCP).. ECG..Hb to rule out anemia which could have caused her to have heart failure..(since she is on chemo and radio))...And her vitals.