The patient is a 43-year-old transgender woman who developed neovaginal SCC 23 years after vaginoplasty. The patient tested positive for high-risk human papillomavirus (HPV). At the time of diagnosis, radiological investigations revealed already existing lymph node and osseous metastases. The treatment consisted of various cycles of chemotherapy and radiation therapy. Unfortunately, the formation of additional metastases, including cerebral, pulmonary, and hepatic metastases, could not be prevented. After comparing the literature on the topic, they conclude that neovaginal carcinoma often appears years and decades after genital reconstruction surgery. They, therefore, recommended the continuation of regular clinical follow-up for transgender women after postoperative follow-up is completed. With this approach, potential lesions may be detected at an earlier stage and a better outcome may be achieved. Follow-up should include neovaginal examination and cytological smear testing. At a later age, they recommended additional regular prostate-specific antigen (PSA) testing and digital rectal examination (DRE). Moreover, transgender women are advised to take part in mammography screening starting at the age of 50, especially when additional risk factors are present.
A 45-year-old Asian Hindu woman presented with vomiting and imbalance of 1 day’s duration. She had left-sided ataxic hemiparesis with one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy. Magnetic resonance imaging of her brain revealed acute non-hemorrhagic infarct in the right posterolateral aspect of pons and medulla, with normal brain vessels angiography. They described her disorder as a twenty-and-a-half syndrome. She was put on antiplatelet therapy.
This is the case of cerebral venous thrombosis secondary to hyperhomocysteinemia caused by vitamin B12 deficiency in a 32-year-old Indo-Aryan man. A detailed coagulation workup led us to find the etiology of cerebral venous thrombosis in this patient who followed a strict vegetarian diet and had vitamin B12 deficiency leading to hyperhomocysteinemia.
This study aims to test the feasibility of rapid acquisition of point of care 3D ultrasound in obtaining abdominal and/or pelvic images. The study will use a newly developed acquisition method and post-processing technique to create three dimensional image models of the abdomen and/or pelvis.
The World Dermatology 2019 Scientific Committee is honoured to welcome you all to attend 20th World Dermatology Congress which will be held during March 13-14, 2019 in Singapore. The Congress will highlight the discussion around the theme “Exploring the New Approaches in Dermatology”. The aim is to aggregate Researchers, Academicians and Scientists from the Dermatology community and to create an avenue towards robust exchange of information on technological advances, new scientific achievements, and the effectiveness of various regulatory programs towards Dermatology at this event.
The Centers for Medicare & Medicaid Services (CMS) released maintenance updates for several National Coverage Determinations (NCDs) to reflect recent code changes. It is essential for health care providers to review these policies to see how the code changes will affect coverage for services they provide to their patients.
Numerous human errors can compromise patient privacy, even with the best software and firewalls. Hence, no photographs of a patient should appear anywhere outside of his or her chart — for example, nothing should ever be posted on the practice's Website or newsletter, or on an employee's social media. This and many other pointers are included in this article that physicians should take note of.
This video shows a question and answer session where the presenter debates the merits of reason for surgery over type of surgery when coders document details of a surgical procedure undergone by a patient. The video will clear the idea about what is more important and relevant in the documents of the patient's surgical history.
A 36-year-old male k/c/o CKD, came c/o altered mental status. Investigations revealed Hypoglycemia and considering the nature of results a suspicion of Insulinoma arose. But on microscopic examination pancreatic islets with elongated cells and clear cytoplasm compatible with nesidioblastosis were seen. However during his hospital stay patient developed pneumonia and succumbed.
Watch Dr. Amit Jain, M.D., give a case presentation for referring pediatric providers of a 13-year-old patient with idiopathic scoliosis and reviews the diagnosis and treatment.