ABSTRACT: Acute services to older citizens often require health care professionals to manage problems that are difficult to assess and treat. Age-related complications such as physical decline and the presence of psychiatric and medical illness together can produce an array of confusing symptoms for the physician. This study examines the…
ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is a common, disabling disease in adults. Newly developed diagnostic measures are available to screen for and support the diagnosis. ADHD typically causes complaints of disturbances of attention, impulsivity, and hyperactivity, although a subgroup of patients have only problems with attention. The disorder may…
ABSTRACT: Between September 1983 and March 1989, 36 loop ileostomies were performed on 34 patients (16 male and 18 female, mean age 36 years, range 11 to 68). Thirty-two patients had ileoanal pouch procedures (30 for ulcerative colitis and two for familial polyposis). One patient had a low anterior resection…
ABSTRACT: Capitate nonunion is an uncommon cause of occult wrist pain. History of wrist injury, tenderness in the distal carpal row, capitate-view x-rays, and special radiographic studies such as bone scan, CT scan, or magnetic resonance imaging can confirm the diagnosis.
ABSTRACT: Carpal tunnel syndrome (CTS) has been linked to repetitive motion only in the past 15 years or so. Often the studies supporting this proposed link have not used strict clinical criteria and have rarely had electrodiagnostic confirmation of the diagnosis. In order to better assess the actual incidence of…
ABSTRACT: Crusted (Norwegian) scabies in AIDS patients can be manifested in both typical and atypical forms. Although the classic, hyperkeratotic, nonpruritic lesions are most common, reported cases have ranged in spectrum from crusting with pruritus to a pruritic, papular dermatitis to those resembling Darier's disease or psoriasis. We report two…
ABSTRACT: Cyclo(His-Pro) (CHP) is a gut-neuropeptide that influences both appetite and carbohydrate metabolism. This study was undertaken to determine whether concentrations of CHP correlated with various clinical markers of nutritional status and progression of HIV infection. Serum concentrations of CHP were analyzed in a clinical sample of 100 HIV-positive patients…
ABSTRACT: Four patients had resection for primary hepatic sarcoma: one with malignant fibrous histiocytoma (MFH), two with poorly differentiated fibrosarcoma, and one with leiomyosarcoma. Age ranged from 40 to 69 years. One patient had a cousin and a grandmother who had died of hepatic tumors. At presentation, all patients had…
ABSTRACT: Functioning adrenal cortical carcinoma occurring concurrently with pregnancy is rare. Only four cases have been reported previously in the world literature. Here I discuss two additional cases of functioning adrenal cortical carcinoma in pregnancy. Both patients died of the illness. Despite the use of surgery and chemotherapy, the prognosis…
ABSTRACT: Magnetic resonance imaging (MRI) has provided a clear view of the sella turcica and the pituitary gland, even on “routine” procedures that invariably include the sagittal T1-weighted sequence. A pituitary gland that does not fully occupy the sella is a common observation, even in normal individuals. Terms such as…
ABSTRACT: Obsessive-compulsive disorder (OCD) is an intriguing, difficult problem characterized by anxiety-producing intrusive thoughts and performance of anxiety-reducing rituals. Current evidence suggests that OCD may be associated with dysregulation of serotonin and dopamine neurotransmission. Numerous early studies involving the serotonin-specific reuptake inhibitor clomipramine led to the formulation of this hypothesis….
ABSTRACT: Pelvic recurrence from colorectal cancer produces significant morbidity. Radiation can help palliate the pain produced by this recurrence. Frequently patients with recurrent colorectal cancer will progress to a constant unrelenting pain and obstructive uropathy with sacral and bladder involvement. These patients can be candidates for an aggressive surgical resection…
ABSTRACT: The bleeding time is prolonged in anemic patients independent of their platelet count and is shortened by elevating the hematocrit. It is theorized that an increase in circulating red blood cells increases platelet radial movement and interaction with endothelium. Platelet dysfunction in uremia is well known but poorly understood….
ABSTRACT: The imaging methods currently used to localize the parathyroid gland in patients with hyperparathyroidism have been criticized as unreliable and even misleading. We evaluated a new imaging technique that uses technetium Tc 99m sestamibi and iodine 123. We studied 21 patients having a diagnosis of primary hyperparathyroidism and no…
ABSTRACT: The two cases we report reiterate the dangers of performing a carpal tunnel release through a small transverse or longitudinal incision at the wrist crease. We concur with other authors that this method of carpal tunnel release has an unacceptably high complication rate, and its potential risks do not…
ABSTRACT: This report describes a patient with severe unexplained recurrent hemolytic anemia and congestive heart failure. Donath-Landsteiner antibodies, suggestive of paroxysmal cold hemoglobinuria (PCH), were detected. On postmortem examination, a diagnosis of non-Hodgkin's lymphoma, primarily involving the heart, was made. This previously undescribed association expands on the clinical and serologic…
ABSTRACT: Tracheoesophageal (TE) speech is now the most common method of voice rehabilitation after total laryngectomy. The speech intelligibility of laryngectomees who use TE speech as their primary mode of communication was evaluated by 20 “naive” listeners. Two speech intelligibility tests were administered using phonetically balanced rhyming words or lists…
ABSTRACT: Tumor lysis syndrome is a catastrophic complication of the treatment of certain neoplasms. It most commonly occurs in association with hematologic malignancies and manifests a few hours to a few days after initiation of specific chemotherapy. It has rarely been encountered as a complication of steroid therapy only. Tumor…
ABSTRACT: We assessed the magnitude, demographics, seroprevalence, and reasons for site selection among South Carolina residents who chose to be tested in bordering states offering anonymous testing for human immunodeficiency virus (HIV). Residents tested from July 1990 through July 1991 at selected HIV testing sites in bordering states were surveyed…
ABSTRACT: We describe a child with foreign body aspiration whose chest radiograph showed an unusual appearance of multiple round lucencies simulating bronchiectasis. This appearance is contrary to the usual appearance of emphysema due to the check-valve type of obstruction. This report is particularly useful for pediatricians and family physicians, who…
ABSTRACT: We describe two unique cases of pulmonary hypertension in association with the human immunodeficiency virus (HIV) and review the 28 previously reported cases in the world literature. Our first patient has coexistent chronic active hepatitis, which has previously been associated with the development of plexogenic pulmonary hypertension; however, our…
ABSTRACT: We present a 38-year-old woman with cholelithiasis having laparoscopic cholecystectomy. After two attempts of abdominal insufflation using CO2 and a Verres needle, the patient had symptoms consistent with a venous gas embolism. The patient was treated quickly and recovered without sequelae. Surgery was continued, and inspection of the liver…
ABSTRACT: We report on a case of hereditary warfarin resistance in a 27-year-old black man. Hereditary warfarin resistance is a rare disorder transmitted as autosomal dominant. It should be suspected in patients who require high doses of warfarin, achieve high plasma warfarin levels, and have a normal plasma warfarin clearance….
ABSTRACT: We report on two healthy white men who sustained high-voltage electrical burns and were transferred to our regional burn center for specialized care. Within 24 hours of admission, both patients developed clinical signs and laboratory evidence of diabetes insipidus. With appropriate treatment, no sequelae occurred and their endocrinopathy spontaneously…
ABSTRACT: We retrospectively studied 80 patients, less than 35 years old, who were being treated for invasive cervical carcinoma at Charity Hospital of Louisiana in New Orleans. The period covered by the study was March 1980 to November 1989. The study group represented 9.3% (80/862) of the total patients seen…
ABSTRACT: When a profound fever occurs in a surgical patient, clinicians usually start thinking about the malignant hyperthermia syndrome. Simple consideration of the clinical situation, the patient's medical history, and a few rapid laboratory assessments are enough to direct appropriate treatment.
ABSTRACT:There is little information on the long-term consequences for employees when no-smoking policies are established in the workplace. Our study was designed to assess changes in employee health and smoking behavior. Of the original 60 subjects, 40 employees (18 smokers, 22 nonsmokers) completed this study, which was conducted in a…
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