Dr Espitia Gastroenterologo

13/07/2025

Atinar

A 55-year-old man with metastatic squamous-cell lung cancer presented to the hospital with a 6-week history of pain and swelling of the right great toe and tip of the right middle finger. He reported no history of fever. On physical examination, swelling and erythema of the distal phalanx of the right third finger and right great toe. There was also an area of ulceration adjacent to the great toenail. The lesions were firm and tender to palpation. Radiographs of the hands and feet were taken. What is the most likely underlying cause of the findings? https://nej.md/IC07102025

22/01/2025

A 41-year-old man was evaluated for swelling in the ankles and syncope. CT of the chest showed bilateral mediastinal and hilar lymphadenopathy, as well as an 8-mm nodule in the right lower lobe. What is the diagnosis?

🗳️ Cast your vote before Jan. 30: https://nej.md/3PJPM61

21/01/2025

A 66-year-old woman with a history of metastatic breast cancer presented to the dermatology clinic with a 1-month history of an asymptomatic, lacy rash on her left thigh. Full case details in comments.

08/01/2025

Nelcy Patricia Westermark’s Sign and Palla’s Sign in Pulmonary Embolism

06/01/2025

A 63-year-old man with a history of CABG presented with a 2-month history of angina during exertion of the left arm. Angiography revealed retrograde flow in the left internal thoracic artery graft (shown in a video). Full case details in comments.

02/01/2025

Accounting for approximately 350,000 deaths annually worldwide, cervical cancer is preventable with HPV vaccination and screening. Newer chemotherapy, radiotherapy, and immunotherapy techniques have improved survival. Link to full review in comments.

30/12/2024

Vickie E. Baracos, PhD, describes the science behind a study of ponsegromab to treat cancer cachexia. Ponsegromab suppresses a pathway in neurons located in specific regions of the brain stem. Link to full editorial in comments.

25/12/2024

A 10-year-old boy was brought to the ED with a 4-day history of progressive bruising of the eyelids. Four weeks before presentation, a dry cough had developed that had increased in intensity over the previous week. Full case details in comments.

07/12/2024

Meds Used For Migraines

29/10/2024

From a Medical Progress article published October 28, 1971:

Advances in methodology have largely been responsible for the newer data on thyrotropin (TSH) secretion by the human pituitary gland. These advances are the radioimmunoassay of human TSH and the discovery of the structure of thyrotropin-releasing factor (TRF) that has led to its synthesis, the first hypothalamic neurohormone to be synthesized. Our aims are to review the recent progress in understanding the regulation of the pituitary secretion of thyrotropin in man and point out its clinical importance. In addition, we discuss the development of tests of the reserve capacity of the gland to secrete TSH, with emphasis on the clinical applications of synthetic TRF.

Link to the full article from the NEJM Archive in the comments.

14/06/2024

The ways in which particular variations in diet influence health and the course of disease remain largely undefined. The authors review the spectrum of types of diet and describe some attributes of the various types.