Abstract Background.Depression is a common and highly treatable disorder, with most patients returning to predepression levels of functioning. Patients with depression must be carefully assessed for the presence of comorbid psychiatric or medical disorders, as well as psychosocial stresses. Methods.I present a clinical overview, supported by pertinent literature, of currently…
Abstract Background.In 1995, a program was begun at the University of South Alabama (USA) to improve the reporting of medical risk factors on birth certificates. Methods.Data on medical risk factors for USA Hospital and the remainder of the state for 1994 and 1996 were examined to observe the effects of…
Abstract Background.Non-palpable suspicious mammographic abnormalities require image-guided breast biopsies. In this study, we examined primary care physicians' knowledge of breast biopsy procedures for non-palpable lesions and referral patterns for breast biopsies; we also identified channels to disseminate information. Methods.We mailed a baseline survey to all primary care physicians, surgeons, and…
Abstract Background.Speculation suggests that health care workers and patients who believe in ethical values that do not change—absolute values—will respond differently to ethical problems and personality tests than those who affirm changing—relative values. Methods.We did a cross-sectional survey to investigate the effects of absolute vs relative values on (1) decision…
Abstract Background.The effects of chronic diuretic use on serum homocysteine and its metabolic cofactors vitamin B6, vitamin B12, and red blood cell (RBC) folate have not been well studied. Methods.Blood samples from 17 hypertensive patients receiving long-term diuretic therapy and 17 hypertensive patients not taking diuretics were analyzed for serum…
Abstract Background.The study objective was to determine primary care residents' knowledge of pharmacotherapy. Methods.Eighty primary care residents at five Family Medicine residencies completed a pharmacotherapy survey used to assess their knowledge of drug interactions, adverse drug reactions, and new medications. Residents were asked whether they could benefit from more formal…
Abstract Background.Vascular devices are an integral part of modern medicine. Catheter thrombosis is a frequent complication that interferes with their use. Method.We have observed a series of patients in whom vascular access thrombosis occurred in close temporal association with infectious or inflammatory processes. Results.Laboratory and clinical evidence suggests that activation…
Abstract Background.While usually not the only factor in obese patients, prescription medications, which may increase appetite or body weight, can be important in some individuals. The cause of weight gain in such cases may go unrecognized or lead to cessation of medication with or without the practitioner's knowledge or approval….
ABSTRACT: Ample clinical and epidemiologic evidence exists to implicate homocyst(e)ine as a risk factor for atherosclerotic vascular disease and thrombosis. The precise mechanisms by which this occurs are uncertain but probably involve injury to endothelium, impairment of endothelial function, lipid peroxidation, oxidation of low-density lipoprotein, and creation of a prothrombotic…
ABSTRACT: An elderly man had two completely reversible episodes of aphasia, each occurring after taking his antihypertensive medications. He was subsequently found to have a subdural hematoma. The association between subdural hematomas (and other intracranial mass lesions) and reversible neurologic deficits is discussed, as is the pathophysiology of the phenomenon….
ABSTRACT: Captopril-induced bone marrow suppression is rare, except in certain high-risk patient populations. Severe exfoliative rashes have also been associated with captopril, but a combined presentation of toxic epidermal necrolysis and agranulocytosis has not been previously described. We report an unusual case of captopril-induced toxic epidermal necrolysis with agranulocytosis in…
ABSTRACT: Hypercalcemia is uncommon in patients infected with the human immunodeficiency virus (HIV). It has been described in association with cytomegalovirus infection, Pneumocystis carinii pneumonia, granulomatous diseases, and lymphoma. However, symptomatic hypercalcemia as an early sign of an underlying AIDS-related lymphoma is not well documented. We discuss the case of…
ABSTRACT: Mammalian bite wounds are commonly encountered in the emergency department. When patients come early (<8 hours after injury), local infection is not usually evident. At this stage, the issue of providing prophylactic antibiotic therapy arises. We report a complication of a cat bite to the hand in a previously…
ABSTRACT: Venous air embolism, though considered rare, occurs more frequently than it is recognized. We report the case of a 54-year-old man who was incidentally found to have air in the left brachiocephalic vein and right ventricle after contrast-enhanced computed tomography (CT). Air embolism has been noted to occur after…
ABSTRACT: Venous thromboembolism is a significant cause of morbidity in the United States. Thrombectomy devices are not currently the standard of treatment in deep venous thromboses. The Amplatz thrombectomy device is used for arterial occlusions and pulmonary emboli, but its regular use in venous thromboses has not been documented in…
ABSTRACT: We describe a patient with a 46,XX karyotype who was assessed because of short stature and a subnormal rate of linear growth. The patient had normal male external genitalia. Endocrinologic analysis revealed elevated levels of luteinizing hormone and folliclestimulating hormone but an exaggerated gonadotropin response to luteinizing hormone-releasing hormone…
ABSTRACT: We describe two cases of drug-induced hypertriglyceridemia, one associated with interferon alfa-2b and the other with asparaginase, each of which is mediated through a different mechanism. Hypertriglyceridemia caused by these medications is not listed as an adverse reaction in the Physicians' Desk Reference, one of the most popular pharmacologic…
ABSTRACT: We report a rare case of traumatic abdominal wall hernia caused by persistent and severe cough. We believe this is the first reported case of such an entity. We present computed tomography findings and a pertinent review of the literature.
ABSTRACT: We report the case of a patient with the acquired immunodeficiency syndrome (AIDS) whose death occurred within 30 hours of hospitalization due to disseminated cryptococcosis, manifested by dizziness, cough, and shortness of breath. The clinical picture was consistent with pneumocystis pneumonia, and antibiotic therapy with corticosteroids was initiated. Despite…
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