Undiagnosed and Rare Diseases are difficult to categorize in clinical practice

Undiagnosed and Rare Diseases are a group of complex entities usually difficult to categorize in clinical practice.

Parents  have a big challenge when they detect some development anomalies in their children because it is usually very difficult to categorize the problem. Health professionals, usually pediatricians, have also big difficulties to frame the anomalies inside a particular syndrome.

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Upper left abdominal pain: the origin may be in the spleen

 Summary

A 65-year-old woman went to Medical Oncology with upper left abdominal pain and on the left shoulder. He had been suffering from this pain for about 6 months before a road accident, but had increased in the last month, without nausea or vomiting. Three years earlier she had a diagnosis of colon adenocarcinoma, but there were no data of recurrence in the last visit.

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The New Diagnostic Challenge with Cancer Immunotherapy

Uncommon toxicities

Immunotherapy is now consolidated as a basic treatment of cancer. Tumors such as melanoma, kidney, and lung, have been the first to receive the benefits of this new treatment. Patients with bad clinical conditions can have an impressive tumor response,  usually after a “latency” period of 4-6 weeks. Continue reading The New Diagnostic Challenge with Cancer Immunotherapy

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More is not always better

Cape Cod

A 70-year-old patient was admitted with neutropenia, moderate thrombocytopenia, and fever, following  chemotherapy. starting with antibiotics until normalization of neutrophils. As platelets persisted in values ​​of 56,000 x109/L, a transfusion was decided. Three days later there was no improvement  in the level of platelets. Continue reading More is not always better

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Thinking Aloud: when reasoning calls for action

 

 

 

 

 

 

A 70-year-old male had a diagnosis of bladder cancer. One month before, he presented  with fever and chills after chemotherapy, coincident with neutropenia and thrombocytopenia. A chest x-ray showed a basal right image with doubt about a condensation. He started with antibiotics and all the symptoms resolved.

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Improving Diagnosis and Clinical Practice