Renal Cell Carcinoma Presenting with Paraneoplastic Hallucinations and Cognitive Decline from Limbic Encephalitis.

Abstract:

:We present a 66-year-old woman with 2 months of visual hallucinations, unintentional weight loss, and short-term memory decline, whose clinical presentation and EEG supported a diagnosis of limbic encephalitis. Subsequent evaluation for a paraneoplastic etiology revealed a renal mass, which was resected and identified as clear cell renal carcinoma. The patient's clinical condition improved after resection of the mass. When patients present with incongruous subacute neuropsychiatric symptoms, clinicians should be mindful of paraneoplastic neurological disorders, as early diagnosis and treatment of malignancy may lead to symptomatic improvement.

journal_name

J Gen Intern Med

authors

Harrison JW,Cherukuri R,Buchan D

doi

10.1007/s11606-014-3172-7

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

1037-40

issue

7

eissn

0884-8734

issn

1525-1497

journal_volume

30

pub_type

杂志文章
  • Can Internet-based continuing medical education improve physicians' skin cancer knowledge and skills?

    abstract::We sought to determine whether an Internet-based continuing medical education (CME) program could improve physician confidence, knowledge, and clinical skills in managing pigmented skin lesions. The CME program provided an interactive, customized learning experience and incorporated well-established guidelines for rec...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:

    authors: Harris JM,Salasche SJ,Harris RB

    更新日期:2001-01-01 00:00:00

  • Dual Medicare and Veteran Health Administration use and ambulatory care sensitive hospitalizations.

    abstract:OBJECTIVE:The objective of the study is to examine the association between ambulatory care sensitive hospitalizations (ACSH) and dual Medicare/Veteran Health Administration use. PARTICIPANTS:A nationally representative sample of Medicare beneficiaries, who participated in the Medicare Current Beneficiary Survey (MCBS)...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-011-1788-4

    authors: Ajmera M,Wilkins TL,Sambamoorthi U

    更新日期:2011-11-01 00:00:00

  • Association Between Patients' Self-Reported Gaps in Care Coordination and Preventable Adverse Outcomes: a Cross-Sectional Survey.

    abstract:BACKGROUND:Whether patients' reports of gaps in care coordination reflect clinically significant problems is unclear. OBJECTIVE:To determine any association between patient-reported gaps in care coordination and patient-reported preventable adverse outcomes. DESIGN AND PARTICIPANTS:We administered a cross-sectional s...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-020-06047-y

    authors: Kern LM,Reshetnyak E,Colantonio LD,Muntner PM,Rhodes JD,Casalino LP,Rajan M,Pesko M,Pinheiro LC,Safford MM

    更新日期:2020-12-01 00:00:00

  • Where should hospitalists sit within the academic medical center?

    abstract::One of the most significant changes in US hospitals over the past decade has been the emergence of hospitalists as key providers of inpatient care. The number of hospitalists in both community and teaching hospitals is growing rapidly, and as the field burgeons, many are questioning where hospitalists should reside wi...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-008-0682-1

    authors: Flanders SA,Saint S,McMahon LF,Howell JD

    更新日期:2008-08-01 00:00:00

  • Differences between generalists and specialists in characteristics of patients receiving gastrointestinal procedures.

    abstract:BACKGROUND:As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE:To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications whe...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1046/j.1525-1497.2000.06039.x

    authors: Meyer GS,Cheng EY,Elting J

    更新日期:2000-03-01 00:00:00

  • Racial similarities in response to standardized offer of influenza vaccination. A MetroNet study.

    abstract:BACKGROUND:Despite known benefits of influenza vaccination and coverage by Medicare Part B, elderly minority patients are less likely to receive influenza vaccination than whites. OBJECTIVES:To test whether a nonphysician-initiated standardized offer of influenza vaccination to all elderly primary care patients would ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1111/j.1525-1497.2006.00401.x

    authors: Schwartz KL,Neale AV,Northrup J,Monsur J,Patel DA,Tobar R Jr,Wortley PM

    更新日期:2006-04-01 00:00:00

  • Staging and prognosis of chronic lymphocytic leukemia: the Manitoba experience.

    abstract::Three hundred ninety-one cases of chronic lymphocytic leukemia (CLL) from the Tumour Registry of Manitoba, spanning a 20-year period from January 1960 to December 1979, were reviewed. Survival curves were developed using the staging systems of Rai and Binet. A clear separation in survival was found utilizing the syste...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02596118

    authors: MacDougall BK,Weinerman BH

    更新日期:1988-03-01 00:00:00

  • Increased hospital and emergency department utilization by individuals with recent criminal justice involvement: results of a national survey.

    abstract:BACKGROUND:Individuals involved with the criminal justice system have increased health needs and poor access to primary care. OBJECTIVE:To examine hospital and emergency department (ED) utilization and related costs by individuals with recent criminal justice involvement. DESIGN:Cross-sectional survey. PARTICIPANTS:...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-014-2877-y

    authors: Frank JW,Linder JA,Becker WC,Fiellin DA,Wang EA

    更新日期:2014-09-01 00:00:00

  • Chronic obstructive pulmonary disease: less common causes--an algorithm for the primary care physician.

    abstract::The clinical features and distinguishing characteristics of the less common causes of chronic airflow obstruction have been reviewed. Clearly, the majority of patients have cigarette-induced chronic bronchitis and/or emphysema. However, for those patients with chronic airflow obstruction who are younger than 40 years ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审

    doi:10.1007/BF02599641

    authors: St John RC,Gadek JE,Pacht ER

    更新日期:1993-10-01 00:00:00

  • Patient-Centered Medical Home Implementation in the Veterans Health Administration and Primary Care Use: Differences by Patient Comorbidity Burden.

    abstract:BACKGROUND:The patient-centered medical home (PCMH) model has several components to improve care for patients with high comorbidity, including greater access to face-to-face primary care. OBJECTIVE:We examined whether high-comorbidity patients had larger increases in primary care provider (PCP) visits attributable to ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-016-3833-9

    authors: Wong ES,Rosland AM,Fihn SD,Nelson KM

    更新日期:2016-12-01 00:00:00

  • Excellent Patient Care Processes in Poor Hospitals? Why Hospital-Level and Patient-Level Care Quality-Outcome Relationships Can Differ.

    abstract::Studies finding weak or nonexistent relationships between hospital performance on providing recommended care and hospital-level clinical outcomes raise questions about the value and validity of process of care performance measures. Such findings may cause clinicians to question the effectiveness of the care process pr...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s11606-015-3564-3

    authors: Finney JW,Humphreys K,Kivlahan DR,Harris AH

    更新日期:2016-04-01 00:00:00

  • Pulmonary alveolar proteinosis in a 67-year-old woman with Wegener's granulomatosis.

    abstract::Mycophenolate mofetil (MM) is commonly used in patients with autoimmune diseases or who have undergone transplantation. Common side effects of MM include anemia, leukopenia, mucositis and opportunistic infections. We report an unusual case of pulmonary alveolar proteinosis (PAP) in a 67-year-old woman on MM for Wegene...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-010-1433-7

    authors: Shah SK,Phan NB,Goyal G,Sharma G

    更新日期:2010-10-01 00:00:00

  • Could we have known? A qualitative analysis of data from women who survived an attempted homicide by an intimate partner.

    abstract:OBJECTIVE:To examine in-depth the lives of women whose partners attempted to kill them, and to identify patterns that may aid in the clinician's ability to predict, prevent, or counsel about femicide or attempted femicide. DESIGN:Qualitative analysis of 30 in-depth interviews. SETTING:Six U.S. cities. PARTICIPANTS:T...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1046/j.1525-1497.2003.21202.x

    authors: Nicolaidis C,Curry MA,Ulrich Y,Sharps P,McFarlane J,Campbell D,Gary F,Laughon K,Glass N,Campbell J

    更新日期:2003-10-01 00:00:00

  • The occurrence of pressure ulcers in three nursing homes.

    abstract:BACKGROUND:In the 27 nursing homes located within the Veterans Affairs (VA) Central Region, the proportion of residents with pressure ulcers in 1986 varied from 2% to 16%. Three of these nursing homes were selected for study: nursing home A from the highest prevalence quintile, B from close to the median, and C from th...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02598281

    authors: Rudman D,Slater EJ,Richardson TJ,Mattson DE

    更新日期:1993-12-01 00:00:00

  • Real-time Feedback in Pay-for-Performance: Does More Information Lead to Improvement?

    abstract:BACKGROUND:Pay-for-performance (P4P) has been used expansively to improve quality of care delivered by physicians. However, to what extent P4P works through the provision of information versus financial incentives is poorly understood. OBJECTIVE:To determine whether an increase in information feedback without changes ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-05004-8

    authors: Bond AM,Volpp KG,Emanuel EJ,Caldarella K,Hodlofski A,Sacks L,Patel P,Sokol K,Vittore S,Calgano D,Nelson C,Weng K,Troxel A,Navathe A

    更新日期:2019-09-01 00:00:00

  • The effectiveness of beta-blockers in women with congestive heart failure.

    abstract:BACKGROUND:Beta-blockers have been shown to improve survival in patients with congestive heart failure (CHF). However, few studies have looked at the effects of these medications specifically in women. OBJECTIVE:To determine the effectiveness of beta-blockers in women with CHF. PATIENTS:We conducted a retrospective c...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-007-0197-1

    authors: Keyhan G,Chen SF,Pilote L

    更新日期:2007-07-01 00:00:00

  • Gender differences in aspirin use among adults with coronary heart disease in the United States.

    abstract:BACKGROUND:Aspirin reduces mortality for men and women with coronary heart disease (CHD). Previous research suggests women with acute coronary syndromes receive less aggressive care, including less frequent early administration of aspirin. The presence of gender differences in aspirin use for secondary prevention is le...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-007-0116-5

    authors: Opotowsky AR,McWilliams JM,Cannon CP

    更新日期:2007-01-01 00:00:00

  • Perceived discrimination and reported delay of pharmacy prescriptions and medical tests.

    abstract:BACKGROUND:Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE:Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for eco...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1111/j.1525-1497.2005.0123.x

    authors: Van Houtven CH,Voils CI,Oddone EZ,Weinfurt KP,Friedman JY,Schulman KA,Bosworth HB

    更新日期:2005-07-01 00:00:00

  • Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference.

    abstract:BACKGROUND:Inadequate pain assessment is a barrier to appropriate pain management, but single-item "pain screening" provides limited information about chronic pain. Multidimensional pain measures such as the Brief Pain Inventory (BPI) are widely used in pain specialty and research settings, but are impractical for prim...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-009-0981-1

    authors: Krebs EE,Lorenz KA,Bair MJ,Damush TM,Wu J,Sutherland JM,Asch SM,Kroenke K

    更新日期:2009-06-01 00:00:00

  • Predicting emergency readmissions for patients discharged from the medical service of a teaching hospital.

    abstract::Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02596366

    authors: Phillips RS,Safran C,Cleary PD,Delbanco TL

    更新日期:1987-11-01 00:00:00

  • Development and Content Validation of a Patient-Reported Sexual Risk Measure for Use in Primary Care.

    abstract:BACKGROUND:Patient-provider sexual risk behavior discussions occur infrequently but may be facilitated by high-quality sexual risk screening tools. OBJECTIVE:To develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. DESIGN:Qualitative item development/quantitative i...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s11606-018-4496-5

    authors: Fredericksen RJ,Mayer KH,Gibbons LE,Edwards TC,Yang FM,Walcott M,Brown S,Dant L,Loo S,Gutierrez C,Paez E,Fitzsimmons E,Wu AW,Mugavero MJ,Mathews WC,Lober WB,Kitahata MM,Patrick DL,Crane PK,Crane HM

    更新日期:2018-10-01 00:00:00

  • A validation study of the spoken knowledge in low literacy in diabetes scale (SKILLD).

    abstract:BACKGROUND:In 2005 the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) was introduced as a diabetes knowledge test. The SKILLD has not been validated since its introduction. OBJECTIVE:To perform a validation analysis on the SKILLD. DESIGN AND PARTICIPANTS:Cross-sectional observational study of 240 patient...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-011-1900-9

    authors: Jeppesen KM,Hull BP,Raines M,Miser WF

    更新日期:2012-02-01 00:00:00

  • Triaging Inpatient Admissions: an Opportunity for Resident Education.

    abstract::In the context of internal medicine, "triage" is a newly popularized term that refers to constellation of activities related to determining the most appropriate disposition plans for patients, including assessing patients for admissions into the inpatient medicine service. The physician or "triagist" plays a critical ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-04882-2

    authors: Wang ES,Velásquez ST,Smith CJ,Matthias TH,Schmit D,Hsu S,Leykum LK

    更新日期:2019-05-01 00:00:00

  • The anatomy of primary care and mental health clinician communication: a quality improvement case study.

    abstract:BACKGROUND:The high prevalence of comorbid physical and mental illnesses among veterans is well known. Therefore, ensuring effective communication between primary care (PC) and mental health (MH) clinicians in the Veterans Affairs (VA) health care system is essential. The VA's Patient Aligned Care Teams (PACT) initiati...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-013-2731-7

    authors: Chang ET,Wells KB,Young AS,Stockdale S,Johnson MD,Fickel JJ,Jou K,Rubenstein LV

    更新日期:2014-07-01 00:00:00

  • Assessing Fluid Resuscitation in Adults with Sepsis Who Are Not Mechanically Ventilated: a Systematic Review of Diagnostic Test Accuracy Studies.

    abstract:BACKGROUND:Fluid resuscitation is a widely used intervention that is mandated in the management of sepsis. While its use can be life-saving, its overuse is associated with harm. Despite this, the best means of assessing a need for fluid resuscitation in an acute medical setting is unclear. OBJECTIVE:To assess studies ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-05073-9

    authors: Seccombe A,McCluskey L,Moorey H,Lasserson D,Sapey E

    更新日期:2019-09-01 00:00:00

  • Incident Type 2 Diabetes Risk is Influenced by Obesity and Diabetes in Social Contacts: a Social Network Analysis.

    abstract:BACKGROUND:Obesity and diabetes family history are the two strongest risk factors for type 2 diabetes (T2D). Prior work shows that an individual's obesity risk is associated with obesity in social contacts, but whether T2D risk follows similar patterns is unknown. OBJECTIVE:We aimed to estimate the relationship betwee...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-016-3723-1

    authors: Raghavan S,Pachucki MC,Chang Y,Porneala B,Fox CS,Dupuis J,Meigs JB

    更新日期:2016-10-01 00:00:00

  • The white-coat hypertension response: prevalence and predictors.

    abstract::This study was designed to determine the clinical characteristics of hypertensive patients whose blood pressures are substantially higher in the medical office than in their natural environments. Thirty-nine percent of patients enrolled in a nonpharmacologic hypertension treatment program had systolic or diastolic off...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02599528

    authors: Lerman CE,Brody DS,Hui T,Lazaro C,Smith DG,Blum MJ

    更新日期:1989-05-01 00:00:00

  • Factors influencing disease self-management among veterans with diabetes and poor glycemic control.

    abstract:SPECIFIC AIM:Although the Department of Veterans Affairs (VA) has made significant organizational changes to improve diabetes care, diabetes self-management has received limited attention. The purpose of this study is to assess factors influencing diabetes self-management among veterans with poorly controlled diabetes....

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-006-0053-8

    authors: Nelson KM,McFarland L,Reiber G

    更新日期:2007-04-01 00:00:00

  • Measuring primary care organizational capacity for diabetes care coordination: the Diabetes Care Coordination Readiness Assessment.

    abstract:BACKGROUND:Not all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific inst...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s11606-013-2566-2

    authors: Weeks DL,Polello JM,Hansen DT,Keeney BJ,Conrad DA

    更新日期:2014-01-01 00:00:00

  • Medication reconciliation accuracy and patient understanding of intended medication changes on hospital discharge.

    abstract:BACKGROUND:Adverse drug events after hospital discharge are common and often serious. These events may result from provider errors or patient misunderstanding. OBJECTIVE:To determine the prevalence of medication reconciliation errors and patient misunderstanding of discharge medications. DESIGN:Prospective cohort stu...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-012-2168-4

    authors: Ziaeian B,Araujo KL,Van Ness PH,Horwitz LI

    更新日期:2012-11-01 00:00:00