Case 1: A 73-year-old man with good past health presented to the emergency department with a few days’ history of involuntary low-amplitude unpredictable movements of his left arms and legs.
Case 2: An 84-year-old man with a few years’ history of type 2 diabetes mellitus was admitted with 2 days’ history of involuntary flinging movements of his right arm and leg.
Multidrug-resistant organisms (MDROs) are frequently defined as bacteria with resistance to three or more classes of antimicrobials. Common examples include methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamases (ESBL)–producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant Enterococci (VRE). The challenges of managing these infections are illustrated in the following two cases.
In this case report, we present the challenges encountered by physicians and cardiologists managing patients with advanced HF, and highlight the broadening spectrum of medical therapies and pathways that comprise contemporary practice.
A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel.
Dr. Fanny Wai-San Ko, Dr. Wing-Ho Yip, 20180815064342
Although a majority of patients can achieve good asthma control with the use of inhaled corticosteroid (ICS) and bronchodilators, some patients’ asthma remain uncontrolled despite the use of these medications.
Dr. Kelvin Ki-Wan Chan, Dr. Chun-Ka Wong, 20180710000000
Case 1: Madam A became pregnant at 38 years of age. She carried a class IV risk under the modified WHO classification of maternal cardiovascular risk, for which pregnancy was contraindicated. Termination of pregnancy was repeatedly suggested, but the couple opted to continue with the pregnancy.
Case 2: Madam B had had hypertension since early adolescence. Apart from being obese with a Body Mass Index of 34 kg/m2and fatty liver disease, extensive investigations were unrevealing. Her family history was unremarkable. She was then lost to follow-up. At 24 years of age, madam B was referred back to our hospital for a high-risk pregnancy situation during her first trimester.
A 36-year-old banker with good past health presented to our rheumatology clinic with a 6-month history of bilateral wrist pain. He initially sought medical attention in the private sector for a 2-month history of bilateral symmetrical wrist pain and swelling.
Dr. Michael Sze, Dr. Tammy Ma, Dr. Yui-Ming Lam, 20180409000000
A 47-year-old gentleman with a known history of mitral valve prolapse (MVP) and mild-to-moderate mitral regurgitation since his 30s presented to Queen Mary Hospital with sudden onset of chest pain and palpitations for 1 day.
The syndrome of sensory neuronopathy and detection of anti-Hu antibody in 2010 were very strong indications of the presence of a malignant tumour. In a series of 200 patients positive for anti-Hu, 83.5 percent were found to have cancer, and 90 percent of the cancer cases were small-cell lung cancer.
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 20180125045128
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Atrial fibrillation (AF) carries an excess risk of stroke recurrence independent of comorbidity with and heart failure (HF), while HF without AF also poses a significant risk of recurrence, a study has shown.
Men with metastatic hormone-sensitive prostate cancer (mHSPC) who receive testosterone suppression therapy may have a better survival outcome with the addition of enzalutamide over other non-steroidal anti-androgen (NSAA) therapies, according to the phase III ENZAMET* trial.