Abstract Background.Clinical prevention is a critical component of primary care residency training. How well residents do preventive services is one measure of the adequacy of their training. Methods.To assess the level of preventive health care in a university internal medicine residency clinic, we conducted a randomized retrospective review of 225…
Abstract Background.Kaposi's sarcoma (KS) associated with human immunodeficiency virus type 1 (HIV-1) is the most common malignancy in patients with AIDS. It has been most commonly reported in white homosexual men, though a few cases have been reported in blacks. Methods.We conducted a retrospective analysis of all HIV-1 seropositive patients…
Abstract Background.Medically disabled persons have traditionally encountered obstacles when seeking and maintaining employment. Integration of the medically disabled worker is the goal of recent legislation that directs removal of physical barriers and protects disabled workers from discrimination. The major force driving this social policy is the Americans With Disabilities Act…
Abstract Background.Nationwide, 32% of residency-trained family physicians deliver babies compared with 73% to 90% in the military. This study describes and defines issues that could ultimately help revive family practice maternity care. Method.We surveyed 112 family physicians who had left the navy. Results.Ninety-one percent had delivered babies in the navy,…
Abstract Background.Older women are considered at risk for hip fracture; fracture rates are highest in the southern region of the United States. The purpose of this study was to develop a predictive model for osteoporotic hip fracture among a national sample of southern women aged 50 years and older. Methods.Subjects…
Abstract Background.Prospective randomized studies show reduced breast cancer mortality among women offered mammographic screening; yet, few women 70 or older were represented in these trials. We examine the impact of mammography on stage at diagnosis of breast cancer, over the years when mammography came into general use, comparing women aged…
Abstract Background.Screening mammography, particularly for women in their 40s, has become a confusing issue for many physicians. Recent scientific and political controversies regarding screening guidelines have added to this confusion. Methods.Many randomized clinical trials have shown the benefits of mammographic screening for women over the age of 50, and recent…
Abstract Background.Short-stay obstetric stays have been the recent focus of many social and medical debates. We did a retrospective study of a large community teaching hospital's experience in making a safe transition to short-stay obstetrics. Methods.Over a 10-month period, a multidisciplinary committee developed an intrapartum and postpartum education program to…
Abstract Background.We studied the feasibility of using patient-controlled anesthesia (PCA) for conscious sedation during colonoscopy. Methods.Patients having elective colonoscopy had medications delivered in bolus fashion by PCA pump (Abbot Lifecare Provider 5500 Infusion System). Four patients received propofol as 20 mg/dose boluses, and four patients received propofol in a 0.3…
Abstract Background.We used dynamic magnetic resonance imaging (MRI) to study breast lesions in 13 women. Methods.We observed differences in contrast uptake between benignancy and malignancy in 14 suspicious breast lesions. Three-dimensional (3D) gradient echo sequences were obtained before and after administration of gadolinium-based contrast medium (0.16 mmol/kg). The percentage of…
ABSTRACT: A 30-year-old black man came to the emergency department with gross hematuria, prostatitis, and urethritis 4 months after immigrating to this country from the Sudan in Africa. Urinalysis revealed hematuria and no ova or parasites. An intravenous urogram showed normal kidneys and ureters. The patient had cystoscopy with biopsies…
ABSTRACT: Flutamide withdrawal syndrome is characterized by a decrease in prostatespecific antigen (PSA) after flutamide withdrawal in a subset of patients with progressing metastatic carcinoma of the prostate. It is generally hypothesized to be due to a point mutation in the androgen receptor that allows the antiandrogen to function as…
ABSTRACT: Long-term use of nonsteroidal anti-inflammatory drugs has been reported to cause small bowel and colonic ulcerations and strictures. Abdominal pain, change in bowel habits, and anemia are frequently present, mimicking other inflammatory and neoplastic diseases of the gut. We report two cases of drug-induced colonic stricture that illustrate two…
ABSTRACT: Low-grade endometrial stromal sarcoma with sex cord–like differentiation occurred in two postmenopausal patients who had received tamoxifen for more than 3 years after surgical resection for breast cancer. Uterine sarcomas have been described in association with the use of tamoxifen. Only two cases of endometrial stromal sarcoma with sex…
ABSTRACT: Vasculitis can involve the larynx in 4% to 10% of cases and can cause arthritis, edema, or upper airway obstruction within the larynx. Since most of these laryngeal manifestations are nonspecific, the clinician needs to keep a high index of suspicion when a patient complains of hoarseness or laryngeal…
ABSTRACT: We present the case of a 17-year-old girl who came to our center with a red irritated eye from exposure to tarantula hairs. An ophthalmology literature search revealed six reported cases. There have been no reports of these cases in the general medical and pediatric literature. Due to the…
ABSTRACT: We report the case of a 78-year-old man in whom routine physical examination revealed cervical adenopathy and splenomegaly. Peripheral blood showed a normal white blood cell count with an absolute lymphocytosis, which included a population with slightly indented nuclei. Lymph node biopsy showed morphology compatible with mantle cell lymphoma….
ABSTRACT:We describe a 49-year-old woman with a history of metastatic renal cell carcinoma and classic signs and symptoms of left-sided cavernous sinus syndrome. Magnetic resonance imaging showed a lesion in the left cavernous sinus consistent with metastatic renal cell carcinoma. The patient received radiation therapy totaling 4,600 cGy, with complete…
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