ABSTRACT: Acyclovir produces neurologic symptoms that resemble extension of viral infection into the central nervous system. We discuss our observations in the cases of two patients with acyclovir neurotoxicity and review the findings of all previous reports in the English language literature. Systemic disease, most commonly renal dysfunction, preceded all…
ABSTRACT: Although keratoacanthoma regresses spontaneously, treating physicians seldom allow these lesions to progress through their natural course. We describe two cases of skin lesions, the first being a keratoacanthoma, which enlarged rapidly and then involuted with minimal scarring. The second lesion was initially misdiagnosed and failed to respond to medical…
ABSTRACT: An aberrant internal carotid artery (ICA) in the middle ear is rare. If unrecognized, it may lead to massive hemorrhage or other catastrophic results during even a minor surgical procedure of the tympanic membrane or middle ear. Recognition of this entity is particularly significant to the primary care or…
ABSTRACT: Brain metastasis is an important cause of morbidity and mortality in cancer patients. Because most of these patients die of systemic disease, the primary therapeutic goal is to improve the quality of life. Conventional therapy for brain metastases is usually whole-brain irradiation. Chemotherapy often results in regression of brain…
ABSTRACT: Guidelines for appropriate use of hypertonic (3%) saline (HS) for the treatment of hyponatremia are ill-defined. We reviewed each infusion of HS in a 400-bed university hospital over a 1-year period. Of the 14 infusions, the hyponatremia (average serum sodium [Na+] 19.9 ±6.7 mEq/L) was chronic in 11 cases…
ABSTRACT: Hyponatremia can be a serious medical problem, and severe hyponatremia can be a medical emergency. Nevertheless, considerable controversy remains with respect to the best way to avoid the important sequelae of hyponatremia, while minimizing the complications of its treatment. Unquestionably, severe hyponatremia may cause life-threatening and/or permanent neurologic abnormalities….
ABSTRACT: In El Paso County, Texas, 73 domestic wells were sampled using a variety of selective media to determine the extent of bacterial contamination of the groundwater on the US side of the United States-Mexico border. Thirteen wells were contaminated by fecal coliforms, whereas other wells contained a variety of…
ABSTRACT: Increasingly, clinicians are being asked to help determine whether a child or adolescent has been a victim of sexual abuse. Since the late 1970s numerous articles about sexual abuse have appeared in the literature. This review article will acquaint the clinician with the definition and incidence of sexual abuse…
ABSTRACT: Primary hyperparathyroidism may be caused by ectopic intrathymic parathyroid adenomas or hyperplastic parathyroid glands. The association of the ectopic inferior parathyroid glands and the thymus is due to their common embryologic origin from the third pharyngeal pouch. We report a case of primary hyperparathyroidism due to an unusual pathologic…
ABSTRACT: The patient described here had bilateral adrenal hemorrhage due to blunt trauma from a motor vehicle accident. At no time during the patient's hospitalization nor in the year since the accident has he had signs or symptoms suggestive of adrenal insufficiency. The diagnosis of adrenal hemorrhage was made on…
ABSTRACT: Thirty-four adolescents aged 11 to 19 at the time of gastric surgery for obesity were interviewed an average of 6 years postoperatively. Patients' preoperative body mass index averaged 47; at follow-up, their body mass index averaged 32. Two thirds of the patients weighed within 9 kg of their lowest…
ABSTRACT: This report describes a 30-year-old woman with a history of prostitution and “crack” cocaine use during pregnancy. After an incomplete abortion at 11 weeks' gestation, a suction dilatation and curettage of uterine contents was done. Histopathologic examination revealed lymphoplasmacytic deciduitis and decidual necrosis, as well as rare first trimester…
ABSTRACT: We present the case of a 32-year-old white man seen for evaluation of pancytopenia 12 years after thoracolumbar myeloresection of intramedullary ependymoma. Bone marrow examination revealed extensive marrow fibrosis and tumor infiltrate compatible with metastatic ependymoma. Myelophthisic anemia due to metastatic ependymoma, though not previously reported, should be entertained…
ABSTRACT: When surgery is required for complications of inflammatory bowel disease (IBD) or for failure of medical management, numerous options exist. This review focuses on surgical alternatives, technical considerations, and complications for both routine and unusual problems associated with IBD. Restorative proctocolectomy for chronic ulcerative colitis, intestine-sparing procedures for Crohn's…
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