Brown tumors, a benign osteolytic process, are most commonly caused by hyperparathyroidism. Multiple bone involvement is relatively rare. There are many similarities in the radiologic and histological features of brown tumors and giant cell tumors (GCTs) of bone. Differentiation between the two lesions is dependent upon evaluation of serum biochemistry…
In addition to assuring an adequate and safe blood supply, blood collection agencies are responsible for the well being of donors. Several aspects of the current blood donor experience may negatively impact donor health and require modification. Physicians need to be aware of health-related issues associated with blood donation in…
Dr. Mary Hooks reminds us that we have achieved the primary prevention of breast cancer (BC) without seeming to have noticed it.1 The specific estrogen receptor modulators tamoxifen and raloxifene have both been shown to significantly reduce the risk of BC in pre- and postmenopausal American women; the latter without…
Whipple disease (WD) is a rare disease caused by Tropheryma whipplei. The classic profile of the patient is that of a middle-aged man presenting with fever, chronic diarrhea, and arthralgias. Extragastrointestinal manifestations are not rare. A high degree of clinical suspicion for the disease is needed in atypical cases. Trimethoprim-sulfamethoxazole…
&NA;Breast Cancer Risk Assessment and Prevention1. Over the last twenty years the mortality from breast cancer has: A. Increased B. Decreased C. Remained the same 2. An increased risk of breast cancer is associated with: A. Late menarche B. Early menopause C. More than six term pregnancies D. Fibrocystic breast…
Background: Tumorectomy for invasive breast cancer (BC) is followed by local recurrence in 30% of patients who do not receive radiotherapy. In the United States 88% of tumorectomy patients receive radiation therapy. Many Caribbean nations lack radiation facilities and access to existing facilities is limited. Methods: The charts of the…
Objectives: To identify demographic predictors of caregivers who are more likely to position their infants prone for sleep; to determine caregivers’ primary information sources regarding sleep position recommendations; and to determine the primary influence on choice of infant sleep position among caregivers who still place their infants in an at-risk…
Background: Therapeutic hypothermia (TH) has been shown to reduce the degree of anoxic brain injury, decrease mortality, and improve neurologic recovery in patients surviving cardiac arrest. However, there is a paucity of data on potential markers of neurologic outcome that physicians can use in this setting. Methods: A retrospective medical…
With advancing age and the affluent, low-fiber Western diet, the incidence of diverticular disease is increasing. Fortunately, most cases can be managed conservatively without resorting to surgical intervention. Life-threatening complications such as perforation, especially when it is associated with gross fecal contamination, requires urgent aggressive surgical intervention. A 75-year-old man…
To the Editor: I read the recent publication by Selden et al1 with great interest. The abnormalities of laboratory investigation among the football players, who are externally very healthy and correlation to cardiometabolic disorder is of interest. This report can imply the observation of the occult pre-clinical abnormalities among the…
External compression of extracranial/mediastinal vessels has not been reported as an etiology of pulsatile tinnitus. We present a case in which compression of extracranial vasculature led to long term pulsatile tinnitus which resolved completely with surgical resection of metastatic lymph nodes. This should be included in the list of differential…
The paper by Braverman et al1 reports on the rapid increase in tumorectomies (breast conserving surgery) without adequate supply of radiation therapy facilities in the Caribbean nations and the resulting high rate of local recurrence in breast cancer. Whereas in the United States 88% of patients receive radiation therapy after…
Breast cancer is the most common cancer and the second most common cause of cancer death in women. In 2008 there were 182,460 women diagnosed with breast cancer, and 40,480 women died of this disease.1 Breast cancer can be prevented by medical (tamoxifen or raloxifene) or surgical approaches (bilateral mastectomy…
Bacillus Calmette-Guerin (BCG) vaccine is traditionally used for vaccination against tuberculosis. BCG vaccine contains live attenuated strain of Mycobacterium bovis. Intravesical BCG is also effective in treatment of transitional cell carcinoma of the urinary bladder. Complications after intravesical BCG immunotherapy are extremely rare. We report an iliac muscle abscess due…
he present study reports on a 72-year-old female initially treated as a presumed chronic obstructive pulmonary disease (COPD) exacerbation, but she was ultimately discovered to have Aspergillus tracheobronchitis. Bronchoscopic findings were characteristic, revealing diffuse plaque-like inflammatory lesions extending from midtrachea into the mainstem bronchi. Evidence suggests that the rise in…
To the Editor: Diabetic mononeuropathy is one of the rare forms of neuropathy, which is a serious problem from a diagnostic and therapeutic point of view. Cranial neuropathies in diabetic patients are extremely rare and occur in older individuals with a long duration of diabetes.1 Patients with diabetes mellitus may…
Objectives: The objective of this study was to determine the relationship between obesity and all-cause mortality among participants with obstructive lung disease in the National Health and Nutrition Examination Survey (NHANES III). Methods: Public data from a retrospective cohort of the 33,994 participants in NHANES III was analyzed to determine…
In Western countries the incidence of amyotrophic lateral sclerosis (ALS) is 1.89 per 100,000 per year and the prevalence is 5.2 per 100,000. The incidence of ALS is lower among African, Asian, and Hispanic ethnicities when compared to Caucasians. The mean age of onset for sporadic ALS is about 60…
In November 2009, the U.S. Preventive Services Task Force issued breast cancer screening recommendations. These recommendations were based on a case-based analysis,1 and were “intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services.” It quickly became apparent that these recommendations and…
Fasciola hepatica, a liver fluke of livestock, rarely presents as chronic biliary tract infection in humans. We report a 38-year-old woman from Ethiopia who presented with right upper quadrant pain and a dilated common bile duct on ultrasound and magnetic resonance cholangiopancreatography (MRCP) without other abnormalities. She was suspected to…
To the Editor: An 85-year-old woman presented with bright red blood per rectum for one day. A month prior to her presentation, she was diagnosed with acute interstitial nephritis for which prednisone was started and tapered over 2 weeks. She appeared malnourished; abdomen was soft with mild epigastric tenderness. Pertinent…
Objective: To demonstrate that the application of therapeutic hypothermia is technically feasible in a community-based setting. Background: Implementation of therapeutic hypothermia for survivors of cardiac arrest in the United States has been slow, at least partially because of the perception that this therapy is technically difficult, especially at the community…
Survival rates and neurologic outcomes from sudden out-of-hospital cardiac arrest are poor.1,2 Although recent advances in cardiopulmonary resuscitation (CPR) techniques and advanced cardiac life support (ACLS) have resulted in somewhat improved survival rates over the past decade, ensuring good neurologic outcome in cardiac arrest survivors continues to be problematic. Even…
To the Editor: Splenosis refers to acquired autotransplantation of viable splenic tissue usually occurring after traumatic rupture of the spleen or splenectomy and can be found in any intraperitoneal or extraperitoneal site including the thoracic cavity. The most common locations are the peritoneum, omentum, and mesentery. We report a case…
Background: The Current Procedural Terminology (CPT) coding system for office visits, which has been in use since 1995, has not been well studied, but it is generally agreed that the system contains much room for error. In fact, the available literature suggests that only slightly more than half of physicians…
A 49-year-old female was started on efalizumab for severe psoriasis. Three weeks later, she developed rapidly progressive inflammatory polyarthritis associated with high titers of both rheumatoid factor (RF) and anticyclic citrullinated peptide (anti-CCP) antibody. To our knowledge, this is the first reported case of efalizumab-induced anti-CCP-positive rheumatoid arthritis (RA). The…
The relationship of autoimmune thyroid disease and TSH-producing pituitary tumor is rarely found. We report two patients with hyperthyroidism, a 27-year-old man and a 28-year-old woman, who were diagnosed with Graves hyperthyroidism with elevated free thyroxine (FT4), suppressed TSH and positive thyrotropin receptor autoantibodies. After treatment with antithyroid drugs, FT4…
Food safety is an increasing concern to Americans. Recent recalls of peanuts and pistachios, and Food and Drug Administration (FDA) warnings to pregnant women to avoid eating fish have increased government oversight of food processing and handling. Consumers can play an important role in alerting their healthcare providers to food-related…
Every year more than 500,000 children with special health care needs (CSHCN), patients who need more consistent medical care or face significant consequences and complications, transition to adult-oriented providers. Yet these patients may encounter even greater difficulty in transitions of care than healthy adolescents and young adults, whether it is…
To the Editor: Organisms in the genera Abiotrophia and Granulicatella are fastidious Gram-positive nutritionally variant streptococci. Although part of normal human oral, genital, and intestinal flora, these organisms have been implicated in the development of endocarditis, vertebral osteomyelitis, endovascular infections, and central nervous system (CNS) infections after instrumentation. We report…
To the Editor: Upper gastrointestinal tract (GI) endoscopy and colonoscopy are the cornerstones for investigating iron deficiency anemia (IDA).1 If the endoscopic evaluation of the GI tract is equivocal, small bowel (SB) biopsies are routinely obtained to rule out celiac disease (CD). Diagnostic yield of this practice differs in different…
Background: Increased procoagulant activity and/or impaired fibrinolysis contribute to the development and organization of thrombus, subsequently resulting in complete or incomplete obstruction in acute coronary syndromes (ACS). We investigated the relationship between culprit lesion severity and thrombotic and fibrinolytic parameters in patients who had non-ST elevation ACS (NSTE-ACS). Methods: This…
It is now generally accepted that intracoronary thrombosis after plaque disruption is a major cause of the acute coronary syndromes (ACS) of unstable angina, myocardial infarction, and sudden cardiac death. Thrombus arises from procoagulant changes in complex plaques, which trigger both platelet activation and coagulation pathways.1 The magnitude of the…
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.