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This episode examines Hypertrophic Pulmonary Osteoarthropathy (HPO), a rare syndrome often associated with underlying pulmonary malignancies. It outlines HPO's clinical presentation, which includes digital clubbing and painful, swollen joints, emphasizing the importance of differentiating it from metastatic bone pain due to its bilateral and symmetrical nature on bone scans. The text further explores the proposed pathophysiological mechanisms, particularly the roles of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF). Finally, it discusses treatment strategies, highlighting that addressing the underlying disease is most effective, but also suggesting symptomatic relief options such as bisphosphonates, octreotide, and anti-inflammatory drugs for patients not amenable to primary disease treatment.
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Dateline NBC
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CrimeLess: Hillbilly Heist
It’s 1996 in rural North Carolina, and an oddball crew makes history when they pull off America’s third largest cash heist. But it’s all downhill from there. Join host Johnny Knoxville as he unspools a wild and woolly tale about a group of regular ‘ol folks who risked it all for a chance at a better life. CrimeLess: Hillbilly Heist answers the question: what would you do with 17.3 million dollars? The answer includes diamond rings, mansions, velvet Elvis paintings, plus a run for the border, murder-for-hire-plots, and FBI busts.