The American journal of the medical sciences
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Familial nonmultiple endocrine neoplasia medullary thyroid cancer accounts for 10% to 15% of hereditary medullary thyroid carcinoma and is characterized by lack of accompanying endocrine or nonendocrine diseases. Simultaneous occurrence of medullary and papillary thyroid carcinoma in the same patient is rare and known as collision tumor. ⋯ Histopathologically, she also had Hashimoto thyroiditis in the remaining thyroid tissue and medullary thyroid carcinoma metastasis in 3 cervical lymph nodes. This case is the first in the literature to report coexistent familial nonmultiple endocrine neoplasia medullary thyroid cancer and papillary thyroid carcinoma related with a RET polymorphism (S904S in exon 15).
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Infection is a frequent cause of death in patients with systemic lupus erythematous (SLE) admitted to the intensive care unit (ICU). Complicated clinical features of SLE patients may delay or cause inadequate antimicrobial treatment. This study aimed to determine if inadequate antimicrobial treatment is an independent risk factor for mortality in SLE patients in the ICU. ⋯ SLE patients in the ICU receiving inadequate antimicrobial treatment or with prior prolonged hospital stay have a higher risk of mortality. Clinical efforts should ensure adequate antimicrobial treatment in SLE patients with prior prolonged hospital stay before ICU admission.
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Biography Historical Article
Presentation of the Southern Society for Clinical Investigation Founders' Medal for 2010 to Solomon S. Solomon, MD.
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Treatment outcomes of end-stage renal disease (ESRD) vary significantly between European, Japanese, and American populations. The Dialysis Outcomes and Practice Patterns Study (DOPPS) described multiple differences between these cohorts; however, remarkable outcome differences exist among regions within the American population. Southern networks continue to have higher degrees of adverse outcomes despite improvements in healthcare delivery. ⋯ This Southern patient cohort is different from the rest of the American ESRD population in terms of important measures of dialysis adherence. Such differences might contribute to our understanding of regional disparity in outcomes.
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Little information is available on patients with adrenal insufficiency (AI) in regard to complaints before diagnosis, time until correct diagnosis, false diagnosis, and professional changes due to the diagnosis. ⋯ Because of the unspecific symptoms, diagnosis is often delayed, not recognized by physicians or diagnosed falsely. An early diagnosis is necessary and might positively influence SHS in patients with AI.