Journal Of The South Carolina Medical Association (1975)[JOURNAL]

A patient with diabetes mellitus who had recently been started on peritoneal dialysis presented with headaches, confusion, falling episodes, and multiple white matter abnormalities affecting the frontal, temporal, pariet... A patient with diabetes mellitus who had recently been started on peritoneal dialysis presented with headaches, confusion, falling episodes, and multiple white matter abnormalities affecting the frontal, temporal, parietal, and occipital lobes on MRI of the brain. He developed stupor and frequent seizures despite control of hypertension with intravenous nicardipine. Diagnosis of atypical PRES and institution of successful empiric therapy was based on electronic searches (Google and MEDLINE) facilitated by verbal communication between and among the specialists involved in his care.

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Dramatic reduction of proteinuria in diabetic nephropathy by the use of spironolactone.

Floyd HW

J S C Med Assoc · 2012 Aug · PMID 23270101

The addition of spironolactone to the combination of an ACE inhibitor, and ARB, and a direct renin inhibitor brought about dramatic and sustained reversal of 4-plus proteinuria in a patient with diabetes mellitus and hyp... The addition of spironolactone to the combination of an ACE inhibitor, and ARB, and a direct renin inhibitor brought about dramatic and sustained reversal of 4-plus proteinuria in a patient with diabetes mellitus and hypertension. Spironolactone may be a valuable addition to the therapeutic armamentarium for such patients, with the caveat that the spironolactone dose should be increased gradually and with frequent monitoring of the serum potassium level.

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Musings on medical practice. I. Humanizing the patient.

Bryan CS

J S C Med Assoc · 2012 Feb · PMID 23270082

Abstract loading — click title to view on PubMed.

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Geriatricians and end-of-life issues: an exploratory study.

Dickinson GE, Sanders BS

J S C Med Assoc · 2012 Feb · PMID 23270081

Abstract loading — click title to view on PubMed.

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Aberrantly elevated TSH level due to human anti-mouse antibodies (HAMA) interference with thyrotropin assay.

Hull B

J S C Med Assoc · 2012 Feb · PMID 23270080

Measurement of TSH is a commonly used test to diagnosed thyroid dysfunction. Multiple factors can interfere with available assays. We present a case where presence of HAMA caused a falsely elevated TSH levels resulting i... Measurement of TSH is a commonly used test to diagnosed thyroid dysfunction. Multiple factors can interfere with available assays. We present a case where presence of HAMA caused a falsely elevated TSH levels resulting in unneccessary and costly diagnostic evaluation. Clinicians should be aware of the various factors affecting thyroid function assays. Test results that are inconsistent with the clinical picture should prompt further testing to exclude interferences prior to initiating unneccessary and potentially harmful clinical interventions.

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