ABSTRACTAdrenoleukodystrophy is an X-linked recessive peroxisomal disorder, characterized by progressive neurologic deterioration due to cerebral white matter demyelination and adrenal insufficiency. Onset is usually in childhood between ages 5 and 10, and its course is fatal within approximately 5 years. Initial symptoms are behavioral, gait, and auditory disturbances and may…
ABSTRACTAlthough Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal (GI) tract, complications in adults are rare, especially in the elderly. Intestinal obstruction is the most common complication in the adult, and inflammation mimicking acute appendicitis may also occur. Lower GI bleeding as a result of Meckel's diverticulum…
ABSTRACTBackgroundA retrospective study was done to assess the correlation between endometrial cells on routine cervical cytology and carcinoma of the endometrium.MethodsIn a 4-year period, endometrial cells of some type were identified on the Papanicolaou (Pap.) smears of 61 women, of whom 52 had further diagnostic evaluation of the endometrium. Data…
ABSTRACTBackgroundAfter developing a synthetic composite material (TMS-1) made from a porous polypropylene mesh (placed in apposition to fascia) coated on the “visceral” side with solid polyurethane, we compared its efficacy with that of porous polytetrafluoroethylene, polypropylene, and primary fascial closure when the repairs were left exposed to the environment.MethodsWe created…
ABSTRACTBackgroundCarisoprodol is a skeletal muscle relaxant with the potential for abuse. A carisoprodol overdose is rarely considered fatal. Nevertheless, we encountered carisoprodol in several cases, prompting review of our experience.MethodsWe did a retrospective study of cases examined at the Jefferson County Coroner/Medical Examiner Office from January 1,1986, to October 31,…
ABSTRACTBackgroundPertussis is a potentially serious vaccine-preventable disease. Many clinicians are unaware that pertussis is common in adults, and that adults are a major reservoir of the disease in the United States.MethodsA MEDLINE search was conducted of all English-language articles pertinent to pertussis infections in adults. Results of relevant articles were…
ABSTRACTBackgroundSeveral anticonvulsant agents, including carbamazepine, phenytoin, and valproate, are effective in some patients for the treatment of pain and tremor. This study reports on a trial of the newly introduced anticonvulsant, gabapentin, for pain and tremor control.MethodsA large case series of patients with centrally mediated pain, peripherally mediated pain, migraine,…
ABSTRACTBackgroundSurveys in recent years show that office emergencies are likely to occur in pediatric offices and that most offices are not equipped to deal with these situations.MethodsTo determine the pediatrician's preparedness to manage emergencies, we surveyed a randomly selected sample of 240 office-based pediatricians in Louisiana. We asked for information…
ABSTRACTBackgroundThis study was done to determine the prevalence of folate deficiency and macrocytosis in patients admitted to the hospital medicine service with alcohol and nonalcohol-related illnesses.MethodsTwo groups of patients, with and without alcohol-related illnesses, were included. Patients were excluded if they received folate therapy, medications known to alter folate concentrations,…
ABSTRACTBackgroundWe wanted to determine the relationship between weather/seasonal conditions and the incidence/severity of HELLP syndrome.MethodsWe retrospectively reviewed medical records of all patients with class 1 (platelet nadir ≤50,000/μL), class 2 (platelet nadir >50,000/μL but ≤100,000/μL), and class 3 (platelet nadir >100,000/μL but ≤150,000/μL) HELLP syndrome, who had been treated at…
ABSTRACTContextObesity is increasing at an alarming rate. During the past decade, the overall prevalence of obesity in the United States increased over 30%, with more than one third of the adult population meeting the definition of being overweight.ObjectiveWe review current and emerging therapies, present outcome data from a large clinical…
ABSTRACTDuring the last 10 years, several cases of myocardial infarction associated with anabolic steroid use have been reported. Postulated mechanisms to explain this association have included changes in lipid levels, the fibrinolytic system, and platelet aggregation. Clenbuterol is a β2-agonist with anabolic properties that has not been seen previously with…
ABSTRACTFat necrosis follows many forms of trauma to the breast, including surgery. In unusual cases, it may be extensive enough to present as a palpable mass on physical examination with mammographic features suggestive of cancer. In these instances, regardless of patient age, surgical history, or multifocality, a biopsy must be…
ABSTRACTObesity is known to increase maternal morbidity and mortality. We describe a case of obstructive sleep apnea due to obesity and discuss our treatment of the resulting pulmonary hypertension. A patient was transferred to our hospital at 29 weeks' gestation with severe anasarca and more than a 100-pound weight gain…
ABSTRACTPeliosis is a rare condition in which blood-filled cysts occupy the parenchyma of solid organs. It most commonly involves the liver or liver and spleen, but isolated cases of splenic peliosis have been documented. Spontaneous splenic hemorrhage from splenic peliosis has been reported in the literature only 6 times. We…
ABSTRACTPulmonary Pneumocystis carinii infections are relatively common in patients with the acquired immunodeficiency syndrome (AIDS). Extrapulmonary pneumocystis is a less common manifestation, particularly when it occurs without concurrent Pneumocystis carinii pneumonia. Disseminated pneumocystis is most commonly found in lymph nodes, the liver, and the spleen and may result in nonspecific…
ABSTRACTStrongyloidiasis caused by the helminth Strongyloides stercoralis is usually asymptomatic or causes mild dermatologic or gastrointestinal symptoms. In immunocompromised hosts, hyperinfection and dissemination can occur. In this case, I describe a nonimmunocompromised Southeast Asian man who had an eosinophilic pleural effusion, peripheral eosinophilia, and rhabditiform larvae of S stercoralis in…
ABSTRACTThe routine use of imaging studies for the evaluation of abdominal pain occasionally yields unexpected and unusual findings. We report a case of emphysematous cystitis that was incidentally discovered on a computed tomography scan originally ordered as part of an evaluation of pancreatitis.
ABSTRACTWe describe a case of an adrenal incidentaloma in the setting of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. The adrenal mass was shown to be a cavernous hemangioma. Such neoplasms are rare but have the risk of retroperitoneal hemorrhage and may be difficult to differentiate from malignant adrenal…
ABSTRACTWe report a case of T wave alternans in a patient with HIV cardiomyopathy. T wave alternans is an unusual electrocardiographic finding in acquired long QT syndromes that can precede the development of torsades de pointes. Our patient had multiple risk factors for the development of the acquired long QT…
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