Case Report

Artificial Skin in the Treatment of a Large Congenital Nevus

ABSTRACT:An 8-year-old girl had a large congenital nevus involving the posterior thigh, leg, and foot. The nevus on non–weight-bearing areas was resected, and the areas were resurfaced with artificial skin and ultra-thin split-thickness grafts. A good result was ultimately achieved. Our management of this case and the relative merits of…

Case Report

Chest Pain: Overlooked Manifestation of Unsuspected Esophageal Foreign Body

ABSTRACT:Two cases of unsuspected esophageal foreign body ingestion with chest pain as the main symptom are reported. Both patients had extensive cardiac evaluation to rule out myocardial ischemia. They were discharged home with continuing chest pain and odynophagia. Both patients were denture wearers, and further questioning revealed the coincidence of…

Case Report

Complicated Persistent Patent Ductus Arteriosus With Acute Pneumonia in an Adult

ABSTRACT:Patent ductus arteriosus (PDA) is a malady usually identified during childhood. Prompt surgical correction provides definitive therapy with long-term survival. When not corrected, PDA leads to significant morbidity and mortality, making it a rare condition in the adult population. We report the case of a 44-year-old man with a history…

Case Report

Congenital Colonic Stenosis

ABSTRACT:We report the case of an infant with congenital colonic stenosis in the ascending colon and review the literature regarding this uncommon condition.

Current Concepts

Digital Signature Technology for Health Care Applications

Background. The personal computer and the Internet have provided many useful services to both health care professionals and the general public. However, security remains a key factor that could limit their further growth potential. Methods. We reviewed and assessed the potential use of the cryptographic technique to resolve security issues….

Case Report

Hepatic Angiosarcoma: An Unusual Cause of Congestive Heart Failure

ABSTRACT:Hepatic angiosarcoma is a rare form of liver cancer. The history, physical examination, and liver biopsy are nonspecific. As a result, diagnosis of angiosarcoma can be challenging. We report the case of an elderly woman with congestive heart failure caused by a hepatic angiosarcoma. The massive tumor burden created extensive…

Expired CME Article

Neurologic Abnormalities in Human Immunodeficiency Virus Infection

ABSTRACT:Neurologic abnormalities involving the central and peripheral nervous system are common in patients infected with the human immunodeficiency virus (HIV). Evidence of central nervous system infection (cerebrospinal fluid abnormalities) occurs early; however, evidence of central and peripheral nervous system dysfunction usually occurs at later stages. Neurologic manifestations may be due…

Current Concepts

Noncompliance of Health Care Workers With Universal Precautions During Trauma Resuscitations

Background. Universal precautions during resuscitations are mandated by hospital regulations. We documented adherence to universal precautions during trauma resuscitations at our level I trauma center. Methods. During trauma resuscitations, a medical student using an elevated viewing platform observed health care workers (HCWs) for the use of barrier precautions (BPs): gloves,…

Case Report

Pancreatic Pseudocyst With Biliary Fistula: Treatment With Endoscopic Internal Drainage

ABSTRACT:Surgical drainage is the standard treatment for pancreatic pseudocysts and their complications. However, acute symptomatic pancreatic pseudocysts are amenable to endoscopic internal drainage in select cases. We report a case of pancreatic pseudocyst with biliary fistula resulting from a recurrent pseudocyst treated with endoscopic stent drainage.

Primary Article

Smoking Cessation Counseling Practices: A Survey of Alabama Obstetrician-Gynecologists

AbstractBackground.Minimal interventions delivered by obstetrician-gynecologists (OB-GYNs) to their pregnant patients who smoke could result in a substantial decrease in smoking during pregnancy. We examined performance and motivation levels of Alabama OB-GYNs for engaging in clinical practices based on National Cancer Institute (NCI) guidelines. Methods.Questionnaires assessing attitudes, intentions, and behaviors specified…

Case Report

Unusual Presentation of Primary Hyperparathyroidism with Osteoporosis, Hypercalcemia, and Normal Parathyroid Hormone Level

ABSTRACT:We report the case of a woman with osteoporosis, chronic hypercalcemia, and normal levels of parathyroid hormone (PTH). Surgical exploration revealed hyperplasia of the parathyroid glands. Hypercalcemia was corrected immediately by surgery, and this was followed by a dramatic improvement in bone mineral density. This case represents a rarely reported…

Case Report

Vancomycin-Resistant Enterococcus faecium Osteomyelitis: Successful Treatment With Quinupristin-Dalfopristin

ABSTRACT:Vancomycin-resistant enterococci (VRE) have recently emerged as an increasing concern in the management of severe infections. Treatment of these life-threatening infections has been limited to quinupristin-dalfopristin and, more recently, linezolid therapy. We report the first case, to our knowledge, of vancomycin-resistant Enterococcus faecium vertebral osteomyelitis treated successfully with quinupristin-dalfopristin. We…

Primary Article

Breast Conservation in the Treatment of Breast Cancer: Community-Based Experience

Abstract Background. Results of large, randomized studies in the 1980s established wide excision and radiation as an accepted breast cancer treatment approach. We evaluated our initial results with this treatment in the community setting. Methods. We evaluated the frequency and outcome of breast conservation treatment in 303 women with invasive…

Primary Article

Effect of Literacy on Breast-feeding Outcomes

Background. We studied the effect of functional health literacy on the initiation and continuance of breast-feeding in women at a public health clinic. Methods. Subjects were 61 first-time mothers aged 18 years or older who spoke English as their first language. They were divided into two groups, one who exclusively…

Primary Article

Effects of Antimanic Mood-Stabilizing Drugs on Fetuses, Neonates, and Nursing Infants

Pregnancy presents a special problem to the clinician treating bipolar disorders in women. Since the first episode of mania typically occurs before the age of 30, many women in their prime childbearing years may be exposed to potentially teratogenic mood-stabilizing agents. This exposure may also continue for the nursing infant…

Case Report

Humoral Hypercalcemia of Malignancy in Squamous Cell Carcinoma of the Skin: Parathyroid Hormone-Related Protein as a Cause

The second most common cause of hypercalcemia is humoral hypercalcemia of malignancy (HHM), a condition associated with increased mortality. Although hypercalcemia is usually seen in squamous cell cancers, only 13 cases have been described in association with squamous cell skin cancer, and only 5 of these had characteristics of HHM….

Primary Article

Influenza and Pneumococcal Immunization Rates Among a High-Risk Population

Background. Influenza and pneumococcal infections are the most vaccine-preventable infectious diseases among the elderly population. Elderly patients (65 years and older) with chronic diseases derive substantial benefit from having current immunization status due to their high risk for respiratory diseases. However, immunization levels for influenza and pneumococcus remain suboptimal. This…

Case Report

Intravenous Immunoglobulin Therapy for Stevens-Johnson Syndrome

Stevens-Johnson syndrome (SJS) is an acute mucocutaneous disorder that can be associated with considerable morbidity. Several previous reports, all involving either adults with acquired immunodeficiency syndrome or children, suggest that intravenous immunoglobulin may be an effective treatment for SJS. We report a case of SJS in an immunocompetent adult whose…

Case Report

Newly Diagnosed Human Immunodeficiency Virus After Sepsis-Like Reaction to Trimethoprim-Sulfamethoxazole

A rare sepsis-like hypersensitivity reaction has been observed in persons with human immunodeficiency virus (HIV) after exposure to trimethoprim-sulfamethoxazole. This reaction most commonly occurs on rechallenge with the drug and is manifested by a syndrome resembling bacterial sepsis. The mechanism of this unusual reaction remains unclear. We describe the first…

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