ABSTRACTAbnormalities of the skin are frequent and troubling problems for patients infected with the human immunodeficiency virus (HIV). A number of studies have assessed the frequency and severity of diseases of the skin and mucous membranes reported from other centers, but relationships between dermatologic signs and symptoms and either the…
ABSTRACTChurg-Strauss vasculitis (CSV) is an interesting but uncommon pulmonary vasculitis. Cavitation in CSV is distinctly unusual and should prompt a work-up for other causes. We have described a case of CSV complicated by pulmonary cryptococcosis, which was treated with a novel antifungal regimen.
ABSTRACTDiagnosis and management of pseudocysts of the pancreas often present difficult clinical problems. We reviewed our 18 patients with pancreatic pseudocysts treated between January 1985 and October 1989 to identify criteria for operative and nonoperative management based on size of the lesion on computerized tomography. Diagnostic modalities, etiology, management, and…
ABSTRACTHuman ehrlichiosis has a wide spectrum of presentation. This report presents two cases that demonstrate the diversity of the manifestation of ehrlichiosis, from life threatening to a mild viral-like illness. Diagnosis requires an understanding of the epidemiology and clinical manifestation of this infection and a high index of suspicion.
ABSTRACTIn children with myelomeningocele fecal and urinary incontinence lowers self-esteem and decreases social interaction. The defects in the lumbosacral spine disturb the sensory and motor nerves supplying the skin and muscles of the perianal region, including the puborectalis muscle, and the external anal sphincter. The sensations in the region, as…
ABSTRACTStiff-man syndrome (SMS) is a rare disorder of the central nervous system characterized by painful involuntary stiffening of axial muscles accompanied by spasms. These are often precipitated by tactile or emotional stimuli, volitional movement, and startling noises. Until recently, little has been known about the pathogenesis of SMS. There is…
ABSTRACTThe initial method for evaluating pediatric chest disease remains the plain chest roentgenogram. When more precise definition of chest disease is required, computerized tomography (CT), magnetic resonance imaging (MRI), or ultrasonography (US) may be useful. In general, CT offers the widest spectrum of applicability. MRI is especially useful because no…
ABSTRACTThe percutaneous supraclavicular approach for temporary central venous hemodialysis access was successfully used in 27 of 34 cases (79%) without significant complications and was found to be a durable technique acceptable to every patient. The supraclavicular site was used from 3 to 156 days (mean, 40 days). The average catheter…
ABSTRACTThe results of recent studies have led to valuable new recommendations regarding optimal diagnosis and treatment of acute uncomplicated cystitis in women. To investigate to what degree these recommendations have been incorporated into clinical practice, we conducted a survey of all college health centers belonging to the American College Health…
ABSTRACTThe role consultants play in detecting disease coincidental to the reason for consultation is unclear. We sought to elucidate this function in the setting of a specialty clinic for osteoporosis. Making no specific attempt to screen for general conditions, we evaluated 760 women; any new diagnosis was found in the…
ABSTRACTWe conducted a statewide survey to identify physicians' experiences, attitudes, and practices related to HIV-infected patients. A random sample, stratified by medical specialty (primary care, surgery, emergency medicine), was drawn. Physicians were concerned about contagion and inadequate knowledge to care for HIV-infected patients; 40% reported refusing or referring new HIV-infected…
ABSTRACTWe evaluated the antiarrhythmic response to magnesium given intravenously to 40 patients who had had elective cardiopulmonary bypass for the surgical treatment of acquired cardiac disease. All 40 patients were found to have hypomagnesemia postoperatively as defined by a serum magnesium level of less than 1.8 mg/dL. The ventricular arrhythmias…
ABSTRACTWe retrospectively reviewed 20 surgically confirmed tubo-ovarian abscesses in postmenopausal women for the period 1973 to 1989. Pain and bleeding were the two most common presenting symptoms. Nine of the 20 patients (45%) had recently had endometrial instrumentation. Fever and the presence of a pelvic mass and elevated white blood…
SUMMARYAn occasional patient presents the classical symptoms of a disease that has become uncommon. Typhus is an example of such a disease, since it is now well contained through control of its rodent reservoir. It is readily treated with tetracycline or one of its long-acting analogues, doxycycline or minocycline.1,7 Because…
SUMMARYCandidal endophthalmitis is most commonly due to hematogenous seeding of the eye by Candida albicans. Although it is most often seen as a manifestation of disseminated candidiasis in patients who are seriously ill, other patients may have candidal endophthalmitis as the only evidence of fungal infection. We have presented a…
SUMMARYCarotid body tumor may be clinically suspected when the only clues are physiologic manifestations of carotid body dysfunction or when a palpable cervical mass is evident upon presentation. In the latter case, the physiologic signs of carotid body dysfunction are usually recognizable.We have presented the case of a patient who…
SUMMARYNausea and vomiting are so frequent under regional anesthesia during parturition that these symptoms can be misleading and may cause the clinician to overlook a potential intracranial lesion. In the case we have reported, it was not until the onset of blindness that an intracranial lesion was suspected.Although the incidence…
SUMMARYWe have presented a case of laryngomalacia in an 18-year-old mentally retarded woman treated with epiglottoplasty. The preoperative and postoperative appearance of the larynx during aspiration was documented using video and still photography. Diagnosis was made by fiberoptic nasopharyngoscopy and laryngoscopy.
SUMMARYWe have presented an unusually swift progression of progressive systemic sclerosis (PSS), with death from cardiogenic shock in a 22-year-old woman who had severe hypertension and acute renal insufficiency. She arrived at our hospital with pericardial tamponade and shock. Despite initial improvement after pericardiocentesis, the patient's condition soon deteriorated and…
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