Proteinuria

Outline and Objectives Definition Screening/Measurement Etiology Treatmen

An Unusual Case of a Gastric Xanthoma: A Case Report.

Gastric xanthomas are rare tumor-like lesions, most commonly occurring in the antral region. We set out to describe a patient with a history of Barrett\u27s esophagus status post two radiofrequency ablations (RFAs) and an endoscopic mucosal resection (EMR) who developed a gastric xanthoma just below the Z-line with recurrent esophageal metaplasia. Histopathological confirmation of xanthomas are needed to rule out malignancy. While gastric xanthomas themselves are benign conditions, regular follow-up is recommended if there is a high index of suspicion of malignancy or alarming symptoms develop

17-Hydroxyprogesterone Caproate Does Not Prevent Preterm Birth in Women with a Twin Pregnancy and a Prior Singleton Spontaneous Preterm Birth

INTRODUCTION: Prior spontaneous preterm birth (sPTB) is a risk factor for recurrent sPTB. Weekly 17-hydroxyprogesterone caproate (17P) is used to prevent sPTB in singletons, but there is insufficient evidence on its benefit in twin pregnancies. OBJECTIVE: We hypothesized that 17P weekly injections would reduce the likelihood of sPTB in women carrying a twin pregnancy with a history of singleton sPTB. METHODS: We performed a retrospective case control study of women with a twin gestation and prior singleton sPTB between 2005 and 2016. The study group consisted of women with a twin gestation that received weekly 17P starting at 16 to 20 weeks versus those who did not. The primary outcome was twin sPTB discharge. RESULTS: Of 79 patients included, 27 women received weekly 17P and 52 did not. There were no statistically significant differences in maternal demographics (except maternal age) or in the rate of sPTB controls. There was no statistically significant difference in the rate of sPTB weeks, mean birth weight, or mode of delivery between study and control groups. Composite neonatal morbidity occurred in 20 neonates (74%) in the study group and in 41 control pregnancies (79%). DISCUSSION: Weekly 17P injections do not appear to decrease the incidence of sPTB or neonatal complications in twin pregnancies with a history of prior singleton sPTB. This study will therefore guide future patient management on this common obstetric dilemma

Applying the Gender Lens to Emergency Care: From Bench to Bedside.

This article outlines the history, need, and evolution of gender medicine in emergency care research. Clinical examples are used where sex and gender play a role in diagnosis, management, or prognosis of patients in the emergency department (ED). The ED serves as an ideal setting to advance sex- and gender-specific research as the primary access point for health care for much of the U.S. population, with more than 136 million annual visits. Gender medicine provides the biologic and social framework to provide high-quality, safe, equitable, and cost-effective sex- and gender-specific care in the ED. With a 24-hour hospital presence, and with access to high-acuity patients, emergency physicians are well positioned to lead sex- and gender-specific clinical studies for time-sensitive conditions and also to serve as vital partners in interdisciplinary research projects. The ED also provides the primary access point for less life-threatening conditions such as substance abuse, mental health, and pain management (both acute and chronic). Because one-fifth of the U.S. population is without health insurance, and many more lack a regular provider or rapid access to their providers, the ED is often the only point of contact for advancing gender medicine in this population