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leaflet

The Permanente Press, in conjunction with The Permanente Journal presents this medical literary and arts e-journal, leaflet -- to open greater opportunity to share the creative visual and written works of physicians and nurses.

Health care professionals and employees are encouraged to submit original poetry, prose, and artwork for future issues.

UniversityofNewMexicoCME

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The Permanente Journal advances knowledge in scientific research, clinical medicine, and innovative health care delivery.

Winter 2014

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Image Diagnosis

Image Diagnosis: Sudden Paraplegia in Abdominal Aortic Thrombosis

Alexandre Costa, MD; Andreia Veiga, MD

A 79-year-old woman with a medical history of hypertension and cardiac surgery for mitral valve repair was seen in the Emergency Department after falling to the floor in her bedroom. Acute abdominal aortic occlusion is an uncommon condition frequently resulting from saddle embolism or thrombus of an atherosclerotic plaque. Sudden neurologic symptoms can occur.

ECG Diagnosis

ECG Diagnosis: The Effect of Ionized Serum Calcium Levels on Electrocardiogram

Jonathan D Gardner, MD; Joe B Calkins, Jr, MD, FACC, FACP, FASE; Glen E Garrison, MD, FACC

High and low levels of ionized serum calcium concentration can produce characteristic changes on the electrocardiogram. These changes are almost entirely limited to the duration of the ST segment with no change in the QRS complexes or T waves. High ionized serum calcium shortens the ST segment, and low ionized serum calcium prolongs the ST segment. Two common clinical scenarios are presented.

 

On the Cover

"Tahoe Hoarfrost" by Robert W Hogan, MD, was taken near Heavenly Resort in South Lake Tahoe, CA. The unique effects of spontaneously condensed water vapor, at various temperatures, are often featured in Dr Hogan’s artwork.

Dr Hogan is an Associate Editor of The Permanente Journal, teaches at the University of California San Diego School of Medicine, and is an Emeritus Physician with the Southern California Permanente Medical Group.

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