Case Report

Intracardiac Thrombosis and Antiphospholipid Antibodies A Case Report and Review of the Literature

ABSTRACTA case report and review of the literature are reported concerning the relationship of intracardiac thrombosis and antiphospholipid antibody syndromes. Nine cases are identified, divided into three categories: three patients had antiphospholipid syndrome associated with systemic lupus erythematosus, three had primary antiphospholipid syndrome, and three had probable secondary antiphospholipid syndrome….

Case Report

Angiosarcoma of the Extremity Preoperative Evaluation With CT, MRI, Ultrasonography, and Angiography

ABSTRACTA patient with a soft tissue forearm mass had the customary surgical approach for excision. A biopsy specimen at that time showed angiosarcoma, and the mass was left in situ. Subsequent imaging with computed tomography, magnetic resonance imaging, ultrasonography, and angiography demonstrated the usefulness and limitations of these modalities. Excisional…

Primary Article

Reentry Monitoring in the Treatment of Physicians With Substance Dependence

ABSTRACTA total of 37 physicians and other health care professionals have been accepted into a monitoring and advocacy program for an average of 24 months. Thirty-five are working in their profession, one is in treatment, and one has repeatedly relapsed and is no longer practicing medicine (an overall improvement rate…

Primary Article

Aluminum and Lead Absorption From Dietary Sources in Women Ingesting Calcium Citrate

ABSTRACTAnimal models suggest that citrate-containing compounds augment absorption of aluminum from food and tap water, causing aluminum accumulation in bone and brain despite normal renal function. Citrate also enhances lead absorption in animals. We questioned whether use of calcium citrate by women as a calcium supplement causes an increase in…

Case Report

Magnetic Resonance Imaging of Carney’s Triad

ABSTRACTCarney's triad, a rare disorder affecting young females, is characterized by the presence of at least two of the three following neoplasms: gastric epithelioid leiomyosarcoma, extra-adrenal paraganglioma, and pulmonary chondroma. Diagnosis and follow-up evaluation of cases of Carney's triad may require an approach that uses a combination of modalities, including…

Case Report

Hodgkin’s Disease Masquerading as Sclerosing Mediastinitis

ABSTRACTCases in which fibrotic variants of Hodgkin's disease have been confused with sclerosing mediastinitis have rarely been reported. Sclerosing mediastinitis typically involves the superior/middle mediastinum and, in the United States, is most commonly due to histoplasmosis. We describe the case of a patient who came to us with fevers, a…

Case Report

Eosinophilic Gastroenteritis Manifesting With Ascites

ABSTRACTEosinophilic gastroenteritis (EGE) is a rare condition of unknown cause characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptomatology. EGE is generally classified according to the layer of gastrointestinal tract involved. Mucosal involvement, the most common form of presentation, may result in abdominal pain, nausea, vomiting,…

Primary Article

Significance of Elevated Pancreatic Enzymes in Intracranial Bleeding

ABSTRACTHyperamylasemia of pancreatic origin has been noted in patients with severe head injury without abdominal trauma or evidence of pancreatitis. Thirty-eight patients with intracranial bleeding of various types were evaluated for elevated pancreatic amylase and lipase enzymes without associated pancreatitis. Twenty-five patients had elevated serum lipase; 17 of 25 also…

Primary Article

The Triad of Left Hemiplegia, Hemihypesthesia, and Homonymous Hemianopsia Implications for Rehabilitation

ABSTRACTPatients with carotid cerebrovascular disorder can be categorized as having either right hemiplegia with various degrees of aphasia, left hemiplegia with hemihypesthesia, or homonymous hemianopsia, or the triad of left hemiplegia, hemihypesthesia and homonymous hemianopsia. The purpose of this study was to compare the functional performance of patients with each…

Case Report

Hepatotoxicity From Propylthiouracil

ABSTRACTPropylthiouracil is a drug used commonly to treat hyperthyroidism. Among its side effects, hepatotoxicity is one of the rarest but one of the most serious. This complication may be due to an immune mechanism. However, particular risk factors associated with the development of hepatotoxicity are not known, and its occurrence…

Primary Article

Randomized Comparison Trial of Teicoplanin IV, Teicoplanin IM, and Cefazolin Therapy for Skin and Soft Tissue Infections Caused by Gram‐Positive Bacteria

ABSTRACTTeicoplanin, a glycopeptide antibiotic chemically related to the vancomycinristocetin group of antibiotics, has potent activity against aerobic and anaerobic gram-positive bacteria. In this study, we examined the efficacy and safety of teicoplanin for parenteral treatment of skin and soft tissue infections caused by gram-positive bacteria. Ninety-six hospitalized adults with moderate…

Clinical Review

Neurotoxicity of Antibacterial Therapy

ABSTRACTThe increasing variety of drugs available for the treatment of bacterial infections has simultaneously increased the potential for toxicity. Neurologic toxicity of antibacterial therapy is generally underestimated in scope and severity; it may be classified as central, peripheral, or due to drug-interactions, several of which are potentially life-threatening. β;-Lactams and…

Case Report

Focal Nodular Hyperplasia of the Liver

ABSTRACTThe management of focal nodular hyperplasia (FNH) of the liver requires a systematic approach. After a histologic diagnosis of FNH is obtained, asymptomatic lesions can be observed safely with regular follow-up and treated if they become symptomatic or enlargement occurs. In the case presented here, we have elected follow-up with…

Primary Article

Therapeutic Approach to Hepatic Abscesses

ABSTRACTThirty-five patients with hepatic abscesses were treated at our institution during an 8-year period. Twenty-nine patients had bacterial abscesses, and six patients had amoebic abscesses. The patients were admitted with fever (95%), right upper quadrant pain (63%), and nausea and vomiting (40%) as the most common symptoms. Eleven patients had…

Primary Article

Chronic Abdominal Pain as the Initial Manifestation of Pancreatic Injury Due to Remote Blunt Trauma of the Abdomen

ABSTRACTThree patients were admitted with severe abdominal pain that began after an asymptomatic latent period following blunt trauma to the abdomen. During initial medical evaluation 3 months to 1 year after the trauma, serum amylase levels were normal or minimally elevated, and computed tomography scanning revealed edema and/or pseudocyst formation…

Primary Article

Cost‐Effective Filming Sequence for Intravenous Urography

ABSTRACTTo define an intravenous urography (IVU) film sequence that maximizes sensitivity and minimizes filming costs, we evaluated the effect of omitting films from a standard IVU sequence. We reviewed 82 IVU series that demonstrated abnormalities. Each series comprised 11 films: preliminary abdominal radiograph and nephrotomogram, three 1-minute nephrotomograms, 5-minute abdominal…

Case Report

Hyperbaric Oxygen for Treatment of Closed Head Injury

ABSTRACTTraumatic and vascular brain injuries consist of acute episodes followed by development of chronic components of varying magnitude and duration whose potentials for recovery differ. We discuss a case of closed head injury in which interventional hyperbaric oxygen (HBO) with single photon emission computed tomography were used as aids in…

Case Report

Treatment Options in Sulfamethoxazole‐Trimethoprim-Induced Thrombocytopenic Purpura

ABSTRACTWe describe two female patients who had severe sulfamethoxazole-trimethoprim-induced thrombocytopenic purpura. One case occurred shortly after initiating therapy, whereas the other began on the seventh day of treatment. Both patients presented a platelet count below 5,000/μ;L, extensive purpura, and significant vaginal bleeding. Treatment with systemic corticosteroids resulted in rapid resolution…

Case Report

Popliteal Artery Injury in a Lumberjack

ABSTRACTWe discuss the case of a patient with knee dislocation and popliteal artery injury; A “high index of suspicion for vascular injury must be maintained in cases of blunt knee injury because more than one third of patients with knee dislocation will have an associated popliteal artery injury. Patients with…

Case Report

Refractory Thrombocytopenia in a Patient With Systemic Lupus Erythematosus and Prior Immune Thrombocytopenia, Not Responsive to an Accessory Splenectomy

ABSTRACTWe report a patient with systemic lupus erythematosus (SLE) that was preceded by immune thrombocytopenia (ITP). She subsequently developed refractory thrombocytopenia. An accessory spleen was found and removed, however, she continued to have severe thrombocytopenia.

Case Report

Multiple Cranial Neuropathies Associated With Leprosy

ABSTRACTWe report on a Samoan man with dysphagia, voice hoarseness, facial erythema, and edema. Neurologic examination revealed hypesthesia at the site of the facial rash, enlarged auricular nerves, a right facial palsy, decreased gag reflexes, and voice hoarseness. Laryngoscopic examination showed paralysis of the left vocal cord, and a barium…

Article

Ethics of Care in Caring for the Elderly

ABSTRACTWhile some ethical and value issues are unique to the care of the elderly, many are shared with other age groups in medical practice. Efforts at cost containment and the rationing of medical services are impinging deeply on the elderly and placing physicians in roles that may interfere with the…

Editorial

BIRDS IN THE ATTIC, BATS IN THE BELFRY A CLOSET CASE

Correspondence

Familial Paqophaqia

Correspondence

Nicotine Transdermal Therapeutic System Patch and Anaphylactoid Reaction After a Wasp Sting