“My legs are very weak and my back hurts so much”

 “My legs are very weak and my back hurst so much”

Author: Lorenzo Alonso

FORO  OSLER

Clinical summary

A 57-years-old-man had a diagnosis of kidney cancer with bone metastases including the spine. He was receiving treatment with immunotherapy. One week before the hospital consultation,   he started with back pain, walking difficulties, a feeling of weakness in both legs, with difficulty in urination. He has  had no fever Continue reading “My legs are very weak and my back hurts so much”

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Safety-II: learning and improving how common situations goes well. The example of the treatment with High-dose of Methotrexate

Safety-II: learning and improving how common situations goes well. The example of the treatment with High-dose of Methotrexate
Author: Lorenzo Alonso

FORO  OSLER

To Err is Human and Beyond

Medical practice has never been a “zero risk” activity since the old historic times, when emperors and kings ordered mutilation or even a death sentence when something went wrong. Continue reading Safety-II: learning and improving how common situations goes well. The example of the treatment with High-dose of Methotrexate

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Talking about a rare disease: the Peripheral T-cell lymphoma

Peripheral T-Cell Lymphoma CD 8+, agressive
Introduction

Even the most sophisticated clinical environment has to deal with patients diagnosed with some diseases without a well established treatment. Usually the disease is so uncommon that there are not enough cases to recruit for a properly designed clinical trial, or Continue reading Talking about a rare disease: the Peripheral T-cell lymphoma

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I know that the patient is bleeding, but why? Not always Yin or Yan

Participants

 

The doctor            The patient               The hematologist

Clinical summary

A-52-year-old woman treated with immunotherapy after a diagnosis of melanoma.  Four months after the first treatment, the patient  started with petechiae and  ecchymosis widely distributed along her skin.

Continue reading I know that the patient is bleeding, but why? Not always Yin or Yan

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Improving Diagnosis and Clinical Practice