ABSTRACT:We describe an 18-month-old boy with an abdominoscrotal hydrocele that extended into the space of Retzius and mimicked a herniation of the bladder. Preoperative ultrasonography of the scrotum and lower abdomen is recommended in boys with suspected large hydroceles.
ABSTRACT:Studies have shown that aerosolized aminoglycosides represent a safe and effective means of treating pneumonia due to Pseudomonas sp. Aerosolized aminoglycosides have been shown to improve clinical outcome, with less risk of nephrotoxicity relative to parenteral aminoglycosides. Apparently, less drug resistance is associated with the use of aerosolized aminoglycosides. Cost…
ABSTRACT:Castleman's disease (angiofollicular lymphoid hyperplasia) is a rare lymphoproliferative disorder that can be found in both nodal and extranodal sites. It is classified histologically as the more common hyaline vascular variant, a plasma cell variant, or a mixed form. The hyaline vascular variant is typically characterized by a benign clinical…
ABSTRACT:A rare case of atraumatic splenic rupture due to ceroid histiocytosis is described in a 56-year-old man. During hospitalization, he complained of epigastric pain, which was not associated with nausea or vomiting. Hematologic indices showed steadily declining hemoglobin, and subsequent radiologic imaging revealed massive splenomegaly. An exploratory laparotomy revealed hemoperitoneum…
AbstractBackground.This detailed study describes the demographic characteristics, behavioral characteristics, care-seeking behavior, and barriers to health care and social services for patients infected with the human immunodeficiency virus (HIV) in the Southeast. Methods.We conducted a cross-sectional study of Medicaid-eligible HIV-positive individuals (chart abstractions [N = 679], patient surveys [N = 487])…
ABSTRACT:Pseudomonas aeruginosa pneumonia and recovery with treatment are rare in healthy individuals. We report the case of a 59-year-old man with P aeruginosa skin infection and sepsis, later giving rise to necrotizing pneumonia by hematogenous spread. He responded to prolonged intensive care and 3 weeks of piperacillin-tazobactam and tobramycin therapy….
ABSTRACT:We report a case of endocarditis caused by Actinomyces viscosus in a previously healthy young adult with no known identifiable portal of entry. Infective endocarditis caused by A viscosus is uncommon; two cases of endocarditis caused by this species have been previously reported. Primary actinomycotic endocarditis has been previously reviewed…
ABSTRACT:Gastritis has a broad pathologic spectrum and anatomic distribution, as well as an evolving etiology. The Sydney pathologic classification of gastritis, which appeared in 1990 and was revised in 1994, emphasized the importance of combining etiologic, topographic, and morphologic criteria for establishing clinically useful diagnoses. Using this revised Sydney pathologic…
AbstractBackground.Genetics and environmental factors play vital roles in type 2 diabetes. To gain insight into its pathogenesis, early study of offspring of affected patients is needed. Methods.Thirty-four offspring of patients with type 2 diabetes and 27 nondiabetic control subjects matched for sex, height, weight, and waist-to-hip ratio had standard oral…
ABSTRACT:Most patients with heart failure today are treated by primary care practitioners, not cardiologists. The Consensus Recommendations for the Management of Chronic Heart Failure, developed by the Advisory Council to Improve Outcomes Nationwide in Heart Failure, provide practice guidelines for the prevention, diagnosis, and treatment of heart failure. Although hemodynamic…
AbstractBackground.Over the past 15 years, many large university hospitals have reported their experience with percutaneous dilatational tracheostomy (PDT). The purposes of this study are to evaluate the safety of PDT in a non–university hospital setting and to compare our results with those published in the literature. Methods.The study was done…
ABSTRACT:A large subcutaneous hematoma extending from the breastbone region to the left axillary region and left flank developed in a 86-year-old anticoagulated man because of repeated microtrauma from a physical restraint used to prevent his rising from a chair. Physicians, nurses, and physiotherapists should recognize that physical restraints causing pressure…
We studied a reported illness outbreak occurring on December 16, 1997, involving more than 12,000 Japanese children who had various signs and symptoms of illness after watching an episode of a popular animated cartoon, Pokémon. While photosensitive epilepsy was diagnosed in a minuscule fraction of those affected, this explanation cannot…
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. New treatment approaches resulting from a refined understanding of the pathophysiology are evolving. The literature shows that PCOS is an endocrinopathy resulting from insulin resistance and the compensatory hyperinsulinemia. This results in adverse effects on multiple…
ABSTRACT:The impact of reducing smoking initiation, increasing smoking cessation, and combination approaches on life expectancy, deaths averted, and life-years gained in a birth cohort of 50,000 persons and in the state population (3.6 million) were analyzed. A 60% reduction in initiation of smoking in adolescents would increase life expectancy by…
ABSTRACT:A 42-year-old man had nausea, vomiting, periumbilical pain, tenesmus, and diarrhea shortly after eating seafood. Stool microscopy showed “beaver bodies,” or Psorospermium haeckelii, a nonpathogenic algal organism often confused with enteric pathogens and commonly found in the excrement of persons consuming crayfish.
ABSTRACT:A 24-year-old woman was initially found to have a right inguinal hernia that occurred suddenly after heavy lifting. A right direct inguinal hernia was found during the initial operative procedure. The round ligament was excised, the internal ring was closed, and the hernia was repaired with mesh placed on the…
ABSTRACT:We describe the case of an aspirin-sensitive asthma patient with a history of anaphylactic reactions to nonsteroidal anti-inflammatory drugs. The patient was subsequently diagnosed with rheumatoid arthritis and treated with a cyclooxygenase (COX)-2 inhibitor without an adverse response. Current prescribing information warns to avoid using COX-2 inhibitors in aspirin-sensitive asthma…
ABSTRACT:Cirrhotic patients requiring emergency abdominal surgery exhibit a significant increase in mortality. Unlike the elective surgical patient in whom there is often the opportunity to control ascites, improve nutritional status, and correct coagulation abnormalities, the trauma patient may need to undergo immediate emergency surgery to control bleeding or contamination. The…
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