ABSTRACTA geriatric man was admitted to the hospital with left-sided chest pain and subsequently had a full cardiac evaluation by a cardiologist. The workup revealed no cardiac abnormalities, and the patient was discharged on the second hospital day. He returned within 48 hours for recurrence of the left-sided chest pain…
ABSTRACTAcute leukemia may be linked to disturbances of the coagulation system, which are usually due to hyperviscosity because of disseminated intravascular coagulation or a high white cell count. We report a unique case of femoral artery thrombosis as the beginning symptom of acute monocytic leukemia (M5) associated with a low…
ABSTRACTBackground. Above-knee amputation (AKA) is a common complication in diabetics, mostly after one or more lower level amputations (LEAs) have been done. The aim of this study was to identify risk factors for AKAs among diabetics.Methods. We abstracted 1,800 medical records of hospitalizations for LEA. Kaplan's comorbidity classification was used…
ABSTRACTBackground. Cluster headache (CH), though not fully characterized until this century, is a relatively common primary headache disorder.Methods. We reviewed pertinent literature on CH and related cephalalgias.Results. We found that CH typically occurs in middle-aged men and has a characteristic cyclic temporal pattern. During the cluster cycle, CH paroxysms last…
ABSTRACTBackground. The purpose of this review is to provide a differential diagnosis for a low anion gap.Methods. We describe the anatomy of the anion gap. Also, we follow-up with a review of the English-language literature describing the causes of a low anion gap. During the past 15 years, the introduction…
ABSTRACTBackground. Tuberculosis is a leading cause of mortality worldwide, with a growing death rate. Pleuritis remains the most common extrapulmonary site of involvement. Epidemiologic trends have altered the presentation of disease. The advent of molecular biology has allowed new insights into disease mechanisms. In this paper, I review the salient…
ABSTRACTBackground. We investigated whether a recently restructured pediatric intensive care unit (PICU) had a decrease in the cost of patient care over the years.Methods. We retrospectively studied 89 previously healthy patients admitted to the PICU of a community-based, university-affiliated teaching hospital over a 4-year period (1991 to 1994) for treatment…
ABSTRACTIntravascular malignant lymphomatosis (IML) is a rare disorder of small and medium size vessels that frequently goes undiagnosed until the time of autopsy. The clinical courses of two such patients were examined to determine factors that would facilitate antemortem diagnosis. Both patients had mental status changes, pyramidal tract signs, and…
ABSTRACTPneumothorax is a well-known complication of central line placement in the intensive care unit. Other causes include spontaneous pneumothorax, trauma, and infection. Most frequently, dyspnea or respiratory decompensation raises suspicion for pneumothorax, especially after central line placement. The diagnosis is confirmed by physical examination and chest radiography. We present five…
ABSTRACTPurpose. Public interest concerning euthanasia and doctor-assisted suicide is creating ethical dilemmas in the health care profession. We surveyed the views of oncologists and non-oncologists in Florida.Methods. Physicians responded to an attitudinal questionnaire. The data collected were compared with standard statistical methods.Results. Both oncologists and non-oncologists had similar opposition to…
ABSTRACTThe intensity of ultraviolet radiation (UVR) from the sun is directly related to the angle of the sun of altitude above he horizon. Solar alitude at any given clock time varies with season and latitude-longitude. The shadow rule indirectly determines the sun's altitue by observing the length of a person's…
ABSTRACTThis case report describes an accidental ingestion of a gold dental inlay prosthesis that became lodged in the appendix. A nonsurgical approach was pursued because this blunt foreign body posed a minimal perforation risk. A second opinion for an elective appendectomy was chosen by the patient until a preoperative abdominal…
ABSTRACTWe encountered a 47-year-old woman with Waldenström's macroglobulinemia (WM) manifested as lung involvement and endobronchial disease, without many of the other features common to the disease. In addition to the unusual aspects of this case, we review the clinical features of other reported cases of pulmonary involvement in WM.
ABSTRACTWe report a case of a peripheral neuropathy induced and exacerbated by several commonly used HMG-CoA reductase inhibitors including lovastatin, simvastatin, pravastatin, and atorvastatiin, and the vitamin niacin. A review of the literature shows similar cases with individual lipid-lowering drugs, but this case shows the cross-reactivity of the neuropathic process…
ABSTRACTWe report the clinical course of a 15-month-old boy who had fever, decreased activity, and weakness, with severe respiratory distress during transport to the hospital. Laboratory evaluation confirmed the diagnosis of meningitis due to Streptococcus pneumoniae. He was intubated on arrival and required 4 days of ventilatory support. Soon after…
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