Search PubMed⌕ Search

Biomedical subjects

M A Marinella

Publications and source records attributed to M A Marinella.

At least 19 recordsLinked to original sources
PubMed2001

Stroke after marijuana smoking in a teenager with factor V Leiden mutation.

Factor V Leiden is a well-recognized etiology of venous thrombosis, but reports of stroke in patients with this mutation are few. Marijuana smoking has rarely been associated with thrombosis of cerebral and renal arteries and may be due to a direct toxic effect on the endothelium. Reported here is the case of a previously healthy young man who smoked marijuana on a daily basis and had an occipital lobe stroke; he was found to be heterozygous for factor V Leiden. This case suggests that marijuana smoking may increase the risk of arterial thrombosis in otherwise healthy individuals who are heterozygous for factor V Leiden.

Adolescent↗
PubMed2000

Acute diverticulitis in patients 40 years of age and younger.

Acute colonic diverticulitis typically occurs in patients older than 60 years of age but is uncommon in patients under the age of 40, which may lead to a delay in diagnosis. Because abdominal pain is a very common presenting symptom in emergency department patients, we retrospectively analyzed the cases of 21 patients 40 years of age and younger diagnosed with acute diverticulitis and characterized the presenting signs and symptoms, laboratory and radiographic findings, treatment, and outcome. There were 17 men and 4 women with a mean age of 34.1 +/-5.9 years. All patients had abdominal pain, with 14 (67%) patients noting pain in the left lower quadrant (LLQ) and 5 (24%) patients noting right lower quadrant (RLQ) pain. Nausea was present in 18 (86%) patients and fever in 15 (71%) patients. The mean pulse rate was 103 +/- 16 and the mean temperature was 100.7 +/- 1.4 F. Leukocytosis was present in 19 (90%) patients. Plain abdominal radiographs were obtained in 19 (91%) patients and were normal in 15 (79%) of these cases. Computed tomographic (CT) scans were obtained in 15 (71%) patients which revealed findings consistent with acute diverticulitis in 14 (93%) patients. The admitting diagnosis was diverticulitis in 10 of the 12 patients with LLQ tenderness and appendicitis in 4 of the 6 patients with RLQ tenderness. Overall, six patients were taken to surgery: three patients had cecal diverticulitis and three patients had perforated colonic diverticulitis. General treatment measures included bowel rest in 18 (86%) patients, and intravenous fluids and antibiotics in all patients. All patients survived. In conclusion, acute diverticulitis is uncommon in patients under 40 years of age; however, this condition may be confused with other conditions, usually acute appendicitis. As a result, clinicians should consider acute diverticulitis in young patients with acute abdominal pain, especially if they are male with nausea, fever, tachycardia, and leukocytosis, and consider obtaining a CT scan to aid in the diagnosis.

Abdominal Pain↗
PubMed2000

Residents and medical students noting the chief complaint during verbal presentations.

The chief complaint is an important element of the medical history. Over a one-month period in 1999, the author observed 55 presentations of house officers and medical students on an inpatient ward at Miami Valley Hospital, an affiliate of Wright State. House officers noted the chief complaint in 49% of their presentations; students, in 61% of theirs. Educators need to stress the importance of the chief complaint during verbal case presentations.

Clinical Clerkship↗
PubMed2000

Acute care of patients aged 95 to 99 years: experience in a community teaching hospital.

BACKGROUND: People older than 90 years represent an increasing segment of the US population, but little information exists on their hospitalization for acute illness. METHODS: We retrospectively analyzed the clinical characteristics of patients aged 95 through 99 years admitted during 1 year to a large teaching hospital. RESULTS: Of 43 patients admitted at least once, 14 were admitted twice, 6 were admitted three times, and 1 was admitted four times; 35 (81%) were women, and 8 (19%) were men. Patients admitted more than once took a mean of 6.8 +/- 3.3 drugs compared with 4.4 +/- 2.6 drugs for patients admitted only once. Routine laboratory values were typically normal or mildly abnormal. Mean hospitalization was 5.6 +/- 3.5 days. Only 2 patients (5%) died. All 11 patients with a recent fall were discharged to a long-term nursing facility, compared with only 18 of 30 patients without a recent fall. CONCLUSIONS: Patients aged 95 through 99 years generally have a favorable prognosis when hospitalized for an acute medical condition. However, patients with a recent fall are more likely to require placement in a long-term nursing facility, and patients taking six or more drugs on admission are more likely to be rehospitalized within 12 months.

Accidental Falls↗
PubMed1999

Pneumococcal abscess manifesting as an anterior mediastinal mass and fatal hemoptysis.

An elderly man had several weeks of night sweats, weight loss, and an anterior mediastinal mass on chest radiography. Computed tomographic-guided needle aspiration was nondiagnostic. Shortly after the patient's admission, three sets of blood cultures yielded Streptococcus pneumoniae. Despite systemic antimicrobials, the patient had an episode of acute hemoptysis and died. Autopsy showed an anterior mediastinal abscess with pneumonic involvement of the left lung. There was histologic evidence of necrotizing pneumonia and parenchymal hemorrhage, which likely resulted in fatal hemoptysis.

Abscess↗
PubMed1999

Bilateral thalamic infarction in a patient with factor V Leiden mutation.

In a 50-year-old unresponsive man with ophthalmoplegia, bilateral thalamic infarction was detected on magnetic resonance imaging of the brain. A thorough evaluation, including urinalysis, laboratory studies, computed tomography of the brain, chest radiography, lumbar puncture, magnetic resonance angiography, cerebral angiography, carotid ultrasonography, and transesophageal echocardiography, revealed no obvious predisposing factors other than heterozygous factor V Leiden mutation. To our knowledge, this is the first reported case of bilateral thalamic infarction associated with factor V Leiden mutation. Physicians should consider the possibility of this mutation in patients with ischemic stroke if no other source is evident.

Cerebral Infarction↗