Ralph Newton Sams

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The current standard of care for a fungal central venous catheter infection in a pediatric patient usually requires removal without any other feasible options. Although removal may reduce the rate of Candida-associated complications, literature reviews question whether the outcomes of removal substantiate this being the standard of care. We report 6 cases(More)
This presentation will address the recent rise of suicide deaths resulting from the asphyxiation by hydrogen sulfide (H2S) gas.Hydrogen sulfide poisoning has been an infrequently encountered cause of death in medical examiner practice. Most H2S deaths that have been reported occurred in association with industrial exposure.More recently, H2S has been seen(More)
OBJECTIVE We describe 4 patients who presented with palpable purpura, arthralgia or arthritis, leukopenia, and antineutrophil cytoplasmic antigen (ANCA) positivity most likely as a result of a hypersensitivity reaction to cocaine-levamisole induced vasculopathy. METHODS Cases were seen and reviewed in both the inpatient consult service and the outpatient(More)
Differentiation of salivary gland acinic cell carcinoma from mucoepidermoid carcinoma can be diagnostically challenging as both may have prominent mucin production. P63 is a p53 homologue required for limb and epidermal morphogenesis. It is expressed in basal and myoepithelial cells of normal salivary gland tissues. In this immunohistochemical study, we(More)
A 42-year-old man with no significant medical history presented to the emergency department with headaches and fever of three weeks duration. He had returned to the United States from a recent trip to Puerto Rico, where he reported multiple unprotected sexual contacts with men. One week prior to presentation, he was evaluated at an outside facility and was(More)
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