No abstract

No abstract

A 49-year-old woman with a history of systemic lupus erythematosus, lower limb deep vein thrombosis, open cholecystectomy, and choledocholithotomy of 10 years presented with right upper quadrant abdominal and low back pain of 2 days' duration. Physical examination showed tenderness to palpation just below the right costal margin, without peritoneal irritation. Acute biliary colic was suspected. However, blood tests of white blood count, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin were all normal. Magnetic resonance cholangiopancreatography showed compensatory biliary tree dilatation but no bile duct stone or mass. An abnormal signal in the right abdominal wall was concurrently found (Figure A, arrows). In T2weighted images, heterogeneous hyperintense signal was found in all layers of the right abdominal wall near midaxillary line (Figure B, arrows). One day later (the third day of pain), the patient presented with bumpy rash with blisters in the right flank (T10 dermatome) (Figures C and D). The diagnosis of herpes zoster was made, and she was treated with analgesics and ganciclovir.Herpes zoster is caused by reactivation of the varicella zoster virus latent in dorsal root ganglia. Once activated, the virus travels along afferent axons to skin. The intercostal nerve gives off a lateral cutaneous nerve that innervates the integument in the midaxillary line. Conflicts of interestThe authors disclose no conflicts.

of stroke and SEE associated with edoxaban and warfarin users. ReSultS: Within NVAF adult patients (N = 1,012,245), we identified 744 qualified edoxaban users and 549 propensity score matched warfarin users between Jan. 2015 and Dec. 2017. Compared to warfarin, edoxaban is associated with similar risks in stroke (hazard ratio [HR] 0.89, 95% CI 0.58-1.39, p = 0.605), and with lower risks in systemic embolic events (hazard ratio [HR] 0.58, 95% CI 0.37-0.90, p = 0.014). ConCluSionS: The edoxaban is non-inferior in prevention of stroke but reduces the risk of embolism in comparison to warfarin in our studies using EHR data.