It took me about 6 hours to implement the new feature "highlight last observation before exposure" in the Viewer. When the user now selects "Options - Settings" and navigates to the "Smart features" tab, a new option becomes visible:
Mayordomo Received Jul 22; Accepted Sep This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC.
Patients present with coagulopathy, hypofibrinogenemia, and systemic bleeding. This led to prompt control of the patient's coagulopathy within ten days of treatment. Our case highlights features of this rare and devastating hemorrhagic complication of PC along with a fast-acting and effective therapeutic drug option.
Case Description A year-old Hispanic man with past medical history of benign prostatic hyperplasia BPH treated with transurethral resection of the prostate the preceding year presented to our emergency room with a nonhealing wound on his right thigh.
He reported that he sustained a laceration to his right thigh during work with machinery one week prior to presentation and had visited the nearest urgent care.
Despite suture placement at the urgent care, he continued to bleed. In addition, he reported multiple ecchymoses on his lower abdomen and extremities and severe pain in his left hip and leg.
The patient had a temperature of Physical exam revealed skin pallor along with diffuse ecchymoses of the abdomen, thighs, and extremities.
No lymphadenopathy was noted. Labs revealed a WBC of 7. The patient was started on 4 units of fresh frozen plasma and 1 unit of cryoprecipitate, and a DIC panel was obtained every 6 hours.
An X-ray of the left hip and femur demonstrated extensive metastatic lesions of the left ilium, ischium, and pubic bones including involvement of the acetabulum. A contrast-enhanced chest CT revealed focal periosteal reaction in the left posteromedial 6th, 7th, and 8th ribs along with nonhomogenous mixed sclerotic and lytic appearance in the spine.
An abdominal MRI with and without contrast demonstrated diffuse osseous metastatic disease but no evidence of primary malignancy in the abdomen. Nuclear medicine whole body bone scan revealed diffuse osseous metastatic disease involving the axial and proximal appendicular skeleton along with bilateral involvement of the femurs.
Spinal MRI with and without contrast demonstrated diffuse osseous metastatic disease involving the cervical, thoracic, lumbar spine, and sacrum.
The MRI also demonstrated an unusual finding of extensive metastatic epidural tumor deposits along the thoracic and lumbosacral spine resulting in spinal canal stenosis Figure 1. A prostate biopsy was not attempted given the high risk of bleeding.
The patient received two subcutaneous injections of degarelix mg on each side of his abdomen total mgfollowed immediately by cold compresses to both areas to prevent bleeding.
He also received Vitamin K 5 mg daily. Ten days after admission, his coagulopathy improved obviating the need for transfusions Figures 2 a and 1 b.The Parker Company is the world’s premier FF&E and OS&E purchasing firm for the global hospitality industry since IT's biggest project failures -- and what we can learn from them Think your project's off track and over budget?
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