Methemoglobinemia is an uncommon but important complication associated with the use of topical anesthetics. We describe four cases of methemoglobinemia induced by topical benzocaine use. We review pathophysiology, early diagnosis, and therapy for this reversible yet potentially fatal condition. Physicians who use procedures involving the application of topical anesthetics need…
A variety of clinical diseases are associated with diffuse alveolar hemorrhage. Although mitral valve disease can cause hemoptysis, it rarely is associated with diffuse alveolar hemorrhage at presentation. A 49‐year‐old woman was admitted to the hospital with the abrupt onset of fever, anemia, dyspnea, azotemia, and diffuse alveolar infiltrates. Two‐dimensional…
Catatonia is a syndrome with many causes that can be difficult to diagnose. In this report, we describe a case of rapid onset of stupor and loss of consciousness, subsequent evaluation, and treatment of catatonia in an HIV‐positive man.
Delayed postpneumonectomy empyema is uncommon. The condition is usually elusive and diagnosed late in the course of the disease, leading to increased morbidity. New air‐fluid level on chest x‐ray film or appearance of empyema necessitatis may enhance the index of suspicion and lead to early diagnosis, but in many cases…
We report the case of a 56‐year‐old man with episodic right lower quadrant abdominal pain. Preoperative evaluation included computed tomography (CT) showing a right lower quadrant phlegmon consistent with cecal diverticulitis or appendicitis. The patient was treated with a short course of bowel rest and antibiotics. Four weeks later, he…
Physicians must have a high index of suspicion when patients have unexplained prolongation of the prothrombin time and bleeding in the absence of detectable warfarin. Several common rodenticides contain modified versions of warfarin that are not detectable in standard warfarin assays. We present a case of surreptitious brodifacoum ingestion in…
Testicular neoplasms comprise 1% of all malignancies in men, with less than 3% of these malignancies due to metastatic disease. We report a case of a 51‐year‐old man with a history of left pneumonectomy done 2 years earlier for small cell carcinoma of the lung; the patient came to his…
We present the case of a 61‐year‐old black woman with a diagnosis of type 2 diabetes and a falsely elevated hemoglobin A1c (HbA1c) due to hereditary persistence of fetal hemoglobin. Physicians and allied health care professionals are alerted to this potentially significant problem in the diagnosis and management of diabetes…
Abstract Background. Remodeling of the endocrine pancreas, caused by the deleterious effects of amylin as it is co‐synthesized, co‐packaged, and co‐secreted with insulin, gives clinicians and researchers cause to ponder. Methods. A literature search was done, and relevant publications and texts on amylin and islet amyloid polypeptide (IAPP) were reviewed….
Abstract Background. Although the occurrence of iron deficiency anemia and hemoglobinopathies in Vietnamese immigrants has been reported, folate and vitamin B12 deficiencies have not. Proper diagnosis and effective treatment is necessary to achieve a complete correction of anemia. Methods. We retrospectively analyzed the records of Vietnamese immigrants seen in our…
Abstract Background. The diagnosis of Kawasaki disease (KD) is made by fulfillment of clinical criteria. The dramatic effectiveness of intravenous immune globulin in this disease might lead to treatment of cases that do not meet those criteria. Methods. A retrospective review was conducted of all cases of KD treated at…
Abstract Background. Subjects in clinical trials may benefit from the increased attention and specific focus of the trial, thereby limiting the external validity of clinical trial results to clinical practice. Our study evaluated adherence to guidelines for intensity of anticoagulation in a large, university‐based warfarin clinic to assess the generalizability…
Abstract Background. Because HIV‐infected and HIV‐exposed children are at risk of acquiring infectious diseases, they should be immunized. Methods. We abstracted charts at pediatric HIV clinics in Dallas and San Antonio, matched the children to birth certificates and assessed up‐to‐date immunization status. Results. Of the 178 children, 108 (61%) were…
ABSTRACT:Delayed postpneumonectomy empyema is uncommon. The condition is usually elusive and diagnosed late in the course of the disease, leading to increased morbidity. New air-fluid level on chest x-ray film or appearance of empyema necessitatis may enhance the index of suspicion and lead to early diagnosis, but in many cases…
ABSTRACT:Physicians must have a high index of suspicion when patients have unexplained prolongation of the prothrombin time and bleeding in the absence of detectable warfarin. Several common rodenticides contain modified versions of warfarin that are not detectable in standard warfarin assays. We present a case of surreptitious brodifacoum ingestion in…
ABSTRACT:Testicular neoplasms comprise 1% of all malignancies in men, with less than 3% of these malignancies due to metastatic disease. We report a case of a 51-year-old man with a history of left pneumonectomy done 2 years earlier for small cell carcinoma of the lung; the patient came to his…
ABSTRACT:We present the case of a 61- year-old black woman with a diagnosis of type 2 diabetes and a falsely elevated hemoglobin A1c (HbA1c) due to hereditary persistence of fetal hemoglobin. Physicians and allied health care professionals are alerted to this potentially significant problem in the diagnosis and management of…
ABSTRACT:Methemoglobinemia is an uncommon but important complication associated with the use of topical anesthetics. We describe four cases of methemoglobinemia induced by topical benzocaine use. We review pathophysiology, early diagnosis, and therapy for this reversible yet potentially fatal condition. Physicians who use procedures involving the application of topical anesthetics need…
ABSTRACT: &NA; Blunt rupture of the colon follows a direct blow to the abdomen. Physical findings suggesting peritoneal irritation are usually present early in the postinjury period and lead to further evaluation and operation. In unresponsive patients, physical findings may be masked, diagnosis delayed, and outcome compromised. Perioperative antibiotics and…
ABSTRACT:A variety of clinical diseases are associated with diffuse alveolar hemorrhage. Although mitral valve disease can cause hemoptysis, it rarely is associated with diffuse alveolar hemorrhage at presentation. A 49-year-old woman was admitted to the hospital with the abrupt onset of fever, anemia, dyspnea, azotemia, and diffuse alveolar infiltrates. Two-dimensional…
ABSTRACT:Catatonia is a syndrome with many causes that can be difficult to diagnose. In this report, we describe a case of rapid onset of stupor and loss of consciousness, subsequent evaluation, and treatment of catatonia in an HIV-positive man.
ABSTRACT:Axillary and palmar hyperhidrosis are featured prominently in the literature, but no previous studies have detailed a treatment regimen for specific excessive localized sweating of the face and scalp. In this report, a patient was treated for this condition with a combination of clonidine hydrochloride (0.3 to 0.4 mg/day) and…
ABSTRACT:We report the case of a 56-year-old man with episodic right lower quadrant abdominal pain. Preoperative evaluation included computed tomography (CT) showing a right lower quadrant phlegmon consistent with cecal diverticulitis or appendicitis. The patient was treated with a short course of bowel rest and antibiotics. Four weeks later, he…
ABSTRACT:Osteoporosis is an important health problem in the United States affecting approximately 24 million Americans, 15 to 20 million of whom are women over 45 years of age. Bone fractures are the major cause of morbidity and mortality associated with osteoporosis. The most common fractures are those of the forearm,…
ABSTRACT:The presence of extra nipples and breasts, polythelia and polymastia respectively, is not uncommon. Such supernumerary breast tissue usually is found within the milk line extending from the axilla to pubic region. It was once thought that this condition was a symbol of increased fertility and femininity. Anne Boleyn was…
ABSTRACT:Automatic implantable cardioverter-defibrillators (ICDs) are becoming increasingly common, as is refusal of resuscitative efforts at the end of life, both by patients and surrogate decision-makers. While it is clear that a terminally ill patient who lacks decisional capacity may, through a surrogate, refuse cardiopulmonary resuscitation (CPR), is it appropriate for…
AbstractBackground.Remodeling of the endocrine pancreas, caused by the deleterious effects of amylin as it is co-synthesized, co-packaged, and co-secreted with insulin, gives clinicians and researchers cause to ponder. Methods.A literature search was done, and relevant publications and texts on amylin and islet amyloid polypeptide (IAPP) were reviewed. Results.The mechanisms and…
AbstractBackground.Subjects in clinical trials may benefit from the increased attention and specific focus of the trial, thereby limiting the external validity of clinical trial results to clinical practice. Our study evaluated adherence to guidelines for intensity of anticoagulation in a large, university-based warfarin clinic to assess the generalizability of randomized…
AbstractBackground.Because HIV-infected and HIV-exposed children are at risk of acquiring infectious diseases, they should be immunized. Methods.We abstracted charts at pediatric HIV clinics in Dallas and San Antonio, matched the children to birth certificates and assessed up-to-date immunization status. Results.Of the 178 children, 108 (61%) were up to date for…
AbstractBackground.Although the occurrence of iron deficiency anemia and hemoglobinopathies in Vietnamese immigrants has been reported, folate and vitamin B12 deficiencies have not. Proper diagnosis and effective treatment is necessary to achieve a complete correction of anemia. Methods.We retrospectively analyzed the records of Vietnamese immigrants seen in our medical clinic from…
AbstractBackground.Too little is understood about the spread of the acquired immunodeficiency syndrome (AIDS) in rural America. This study focuses on changes over 5 years in two low prevalence and two high prevalence human immunodeficiency virus (HIV) rural service areas. Methods.An initial study conducted in 1993 provided a base line for…
ABSTRACT:Blunt rupture of the colon follows a direct blow to the abdomen. Physical findings suggesting peritoneal irritation are usually present early in the postinjury period and lead to further evaluation and operation. In unresponsive patients, physical findings may be masked, diagnosis delayed, and outcome compromised. Perioperative antibiotics and early celiotomy…
Membership grants access to journals, courses and a slew of premium benefits.
Please consider supporting us by choosing an option below:
View Membership Options Make A Tax-Deductable Donation
No Thanks, take me to the site and don't show me this again.