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Serum vs FNA: Will There Be a Standard of Care for Biopsies in Advanced NSCLC? CME

The goal of this activity is to describe the potential uses of tumor DNA in identifying epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) and to discuss clinical data surrounding the use of circulating tumor cells and free DNA in analyzing tumor molecular profiles in patients with advanced NSCLC.  
medscape.org
over 4 years ago
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18
669

Arterial Blood Gas (ABG) Procedure Demonstration

As a junior doctor/medical student the ability to take an Arterial Blood Gas (ABG) is a key skill. In this video we will demonstrate a slick technique to help you get an arterial blood sample.  
youtube.com
over 4 years ago
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4

A man with altered mental status and metabolic acidosis

A 52 year old man was brought to the emergency department for acute onset shortness of breath and confusion. On physical examination he was agitated and taking deep breaths at the rate of 28/min. Initial venous blood gas on ambient air showed pH 7.02, partial pressure of carbon dioxide 3.4 kPa, partial pressure of oxygen 4.1 kPa. …  
feeds.bmj.com
over 4 years ago
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0
7

Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
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10

What is the diagnosis?

A 55 year old man had chest and abdominal discomfort after a long haul flight. The chest discomfort resembled his usually stable angina pectoris. On admission his heart rate was 90 beats/min and his blood pressure was 95/52 mm Hg. Electrocardiography showed T wave inversion in the inferolateral leads, compatible with ischaemia, although serum troponin and D-dimer tests were negative. His arterial blood gases, pH, and lactate were normal. What does the supine abdominal radiograph show and what sign suggests the diagnosis (fig 1⇓)?  
feeds.bmj.com
over 4 years ago
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0
9

Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
Preview
0
8

Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
Preview
0
8

Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
Preview
0
2

A man with altered mental status and metabolic acidosis

A 52 year old man was brought to the emergency department for acute onset shortness of breath and confusion. On physical examination he was agitated and taking deep breaths at the rate of 28/min. Initial venous blood gas on ambient air showed pH 7.02, partial pressure of carbon dioxide 3.4 kPa, partial pressure of oxygen 4.1 kPa. …  
feeds.bmj.com
over 4 years ago
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0
8

ABO Blood Type Linked to Mortality, Stroke Risk Post-LVAD Implant

The AB blood type group showed significant outcome differences vs other ABO groups, but the real surprise came when examining O vs non-O types for bleeding events, with results opposite the hypothesis.  
medscape.com
over 4 years ago
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New Wrinkle in Cancer Growth Precept

Dr David Kerr explains a new theory as to how cancer may gain blood supply by a process other than angiogenesis, which may provide insight into mechanisms of resistance to antiangiogenic agents.  
medscape.com
over 4 years ago
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0
7

MALDI-TOF MS Carbapenemase Detection From Culture Isolates

The authors present a MALDI-TOF MS-based assay for the detection of carbapenemases either from solid culture media or blood culture vials.  
medscape.com
over 4 years ago
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0
2

Use Nonfasting Blood for Routine Lipid Profiles, Says EAS/EFLM

Although US guidelines write that a fasting sample is preferred, "I would argue that all of us are saying very close to the same thing. It really does depend on the question you're asking," says one expert.  
medscape.com
over 4 years ago
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0
7

Radon in Home Now Linked to Blood Cancers in Women

Radon exposure in the home, already linked to lung cancer, has now been shown to increases the risk for hematologic malignancy in women, although not in men.  
medscape.com
over 4 years ago
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2
39

How the Heart Works?

How the Heart Works? An animation showing the anatomy of the heart how blood pumps through its chambers, valves and ventricles, highlighting each one's funct...  
youtube.com
over 4 years ago
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0

Cancer samples from dead patients sought for new study - BBC News

A study is inviting terminally ill cancer patients across the UK to donate blood and tissue samples when they die.  
bbc.co.uk
over 4 years ago
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A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago
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0
0

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago
Preview
0
2

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago