ABSTRACT Background.Anaphylactic reactions to streptokinase are rare but potentially life-threatening complications. Gamma E immunoglobulin (IgE) mediated mechanisms, probably due to streptococcal infections, have been implicated. We investigated the value of in vitro laboratory or dermatologic tests in predicting anaphylactic reactions due to streptokinase and the value of antistreptolysin titers (ASL)…
ABSTRACT Background.Bicycle injury data from local communities are important for developing injury prevention and control programs. This study represents the efforts of one community trauma center to describe bicycle injuries. Methods.We conducted a retrospective analysis of bicycle injury data from hospital charts, emergency medical services reports, and medical examiner reports….
ABSTRACT Background.Esophageal disorders are common complications of human immunodeficiency virus (HIV)-infected patients. In a significant number of patients, the esophagus may be the site of the first acquired immunodeficiency syndrome (AIDS)-defining opportunistic illness. Methods.We reviewed pertinent articles, obtained from a MEDLINE search, on the diagnosis and treatment of esophageal diseases…
ABSTRACT Background.Prevalence of risk factors in patients having myocardial infarction (MI) have been reported in large US and international studies, but little is known about the prevalence of risk factors in West Virginians having MI. Methods.Risk factors for MI were identified by ICD-9 codes. Logistic regression analysis was used to…
ABSTRACT Background.The morbidity of hypercortisolemia due to ectopic production of ACTH by various tumors may be greater than the morbidity of the tumor itself. Methods.We report three cases of long-term treatment of ectopic ACTH syndrome due to metastatic bronchial carcinoid, islet cell carcinoma, and malignant thymoma tumors. Clinical and biochemical…
ABSTRACT Background.The rapid expansion of legalized gambling in the United States necessitates evaluation of its impact on vulnerable populations, especially adolescents. Methods.Gambling behavior in 135 adolescents in residential placement in northwestern Louisiana was measured using the South Oaks Gambling Screen-Revised for Adolescents. Results.During the past year, 41% of these adolescents…
ABSTRACT Background.There is concern that anti-affirmative-action measures will negate gains made in educating underrepresented minority physicians and that this underrepresentation may have a negative impact on access to health care for these same underrepresented groups. Methods.A review of the literature was completed to examine the relationship between opportunities for underrepresented…
ABSTRACT Background.We evaluated the efficacy and safety of ketorolac (Toradol). Methods.In this prospective trial, 88 women in confirmed preterm labor at ≤32 weeks' gestation were randomized to receive magnesium sulfate given as an initial 6 g intravenous bolus followed by continuous infusion therapy (2 to 6 g/hr) or intramuscularly administered…
ABSTRACT Background.We wanted to find the most frequent site of placental implantation at 18 weeks' gestation and placental migration during gestation. Methods.Placental location was identified in 2,526 singleton pregnancies at 18 weeks' gestation and characterized into nine groups. Placental migration in 1,336 of these pregnancies was assessed by serial ultrasonography….
ABSTRACT: A 36-year-old woman without significant medical history complained of “spells” of diplopia, fatigue, and dizziness. On formal fasting, her glucose dropped to 40 mg/dL, with simultaneous insulin levels of 15 μU/mL (normal <6 μU/mL) and C-peptide of 2.5 ng/ml (normal <2 μU/mL). An isolated plasma sulfonylurea screen done during…
ABSTRACT: A previously healthy 37-year-old man had evaluation of abdominal pain, which had persisted after abrupt onset with fever and hematuria. Although the fever and hematuria had spontaneously resolved after 1 week, the abdominal pain had worsened over a 4-month period. Predicated upon computed tomography and with a presumed diagnosis…
ABSTRACT: Acute, exertional rhabdomyolysis typically follows strenuous exercise of the eccentric type, such as that which occurs during military training or repetitive weight lifting in unconditioned individuals. Complications can be significant and include compartment syndrome and acute renal failure due to myoglobinuria, especially in the setting of volume depletion. Rhabdomyolysis…
ABSTRACT: Although angiotensin-converting enzyme inhibitors (ACEIs) are well-known causes of orofacial angioedema, angioedema from these agents involving the bowel is not often considered. We report a case of simultaneous onset of small bowel and orofacial angioedema due to captopril. A 61-year-old black man with hypertension, coronary artery disease, and congestive…
ABSTRACT: Anesthesiologists should approach the airway carefully in the patient with a diagnosis of head and neck carcinoma, particularly if the patient has had previous surgery and reconstruction. Patients with head and neck carcinoma may be difficult intubations due to altered anatomy from the tumor or fibrotic changes because of…
ABSTRACT: Chronic diarrhea commonly causes hypokalemia. However, life-threatening hypokalemia due to chronic diarrhea has not been reported in the adult caused by chronic ingestion of a fructose beverage. We report an adult patient who had severe hypokalemia from chronic osmotic diarrhea as a result of drinking 4 to 6 liters…
ABSTRACT: In utero varicella-zoster infections, though infrequent, may have significant consequences for the affected infant depending on the gestational timing of the infection. We present a case of infantile zoster in a 5-month-old boy after maternal varicella infection. Also, we review the three major disorders resulting from in utero infection…
ABSTRACT: Screening mammography programs have contributed to an overall decline in breast cancer mortality. The screening process, however, also results in detection and biopsy of many nonpalpable lesions that eventually prove to be benign, contributing to the burden of costs to our health care system. Percutaneous imaging-guided core biopsy has…
ABSTRACT: The Klippel-Trénaunay-Weber (KTW) syndrome is a congenital disorder of angiogenesis characterized by macular nevus, skeletal and soft tissue hypertrophy, venous varicosities, and arteriovenous fistulas. Disseminated intravascular coagulation (DIC) and the Kasabach-Merritt syndrome, a consumptive coagulopathy with thrombocytopenia, are both associated with the KTW syndrome. We describe a 30-year-old woman…
ABSTRACT: Thoracic splenosis is rare, with fewer than two dozen reported cases. Patients uniformly have a history of splenectomy with combined abdominal and thoracic trauma. Clinical signs and symptoms are usually absent, and the condition is most often discovered on routine chest radiography. The interval between trauma and clinical discovery…
ABSTRACT: Varicella-zoster virus infection has been implicated in a broad range of neurologic complications. In Hispanic immigrants, primary varicella often appears in adolescents and young adults. We describe the case of a 20-year-old Hispanic man with vasculitis and stroke after primary varicella infection. An association between varicella infection and vasculitis…
ABSTRACT: We describe a patient who had metastatic carcinoma of the stomach and severe headaches, weakness, and diplopia. The patient had meningeal carcinomatosis that was confirmed by examination of the cerebrospinal fluid after computed tomography of the brain was normal. Weakness was explained by the finding of hyponatremia due to…
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