Vision is an automatic act, it keeps us aware of our environment to react before a danger or an opportunity. When we want to get more information, we concentrate our minds and our eyes over an object or situation, in a more conscious and active way. After analyzing an
This is the case of a -62-year-old woman with a diagnosis of gynecologic cancer and a pulmonary embolus. She was receiving chemotherapy and a therapeutic dose of a low-molecular-weight-heparin (LMWH) . She had a single daily dose of a 1,5 mg/per Kilo, calculated in base on her body weight.
In March 2020 the COVID-19 pandemic was hitting hard in Spain. In this period we were attending patients in the medical oncology ward, some of them with respiratory insufficiency, usually associated with the tumor or their complications, but there were Continue reading COVID-19, Yes or Not? No definitive answer→
History of diseases: 1. Diabetes (several years with insulin)
2. Bladder cancer, regional, treated with chemotherapy nine months before this event, considered complete response
Current problem: deterioration with renal insufficiency, deep venous thrombosis in his left leg with lymph nodes in the left groin, probably associated with a recurrence of the urological cancer. Episode of acute thoracic pain without coronary artery involvement. No fever. No shortness of breath. No abdominal pain. A week before, the patient started with some nausea and vomiting, but he had an active life.
Clinical evolution: improvement in kidney function after hydration. Blood pressure going down without fever. Hemoglobin very down (Hb=6,5), needs a transfusion. No sign of external or internal bleeding. Upper endoscopy: no ulcers, no tumor.
Finding without explanation: gastric and small bowel dilatation, without a visible mechanical obstruction or a lump.
We thought about diabetic gastroparesis, small bowel or peritoneal metastases or an abdominal ischemic problem.