ABSTRACT:A case of androgen-secreting borderline endometrioid tumor arising in endometriosis of the rectovaginal septum is presented. It occurred 10 years after total abdominal hysterectomy and bilateral salpingo-oophorectomy for extensive endometriosis of the fallopian tubes and ovaries, adenomyosis, and leiomyomas of the uterus. We believe 7 years of unopposed continuous oral…
AbstractBackground.The widespread and often inappropriate use of broad spectrum antibiotics in the outpatient setting is recognized as a significant contributing factor to the spread of bacterial resistance. We hypothesized that residents prescribe broader spectrum antibiotics more frequently than staff physicians and adopt more appropriate prescribing practices with increasing levels of…
ABSTRACT:The CT halo sign was first described in immunocompromised patients with invasive pulmonary aspergillosis. Although the halo sign was originally thought to be specific for invasive pulmonary aspergillosis, it has been reported in a wide variety of pulmonary abnormalities in both immunocompromised and immunocompetent patients. We report a case of…
ABSTRACT:We present a case of endocarditis caused by Salmonella in a patient with newly diagnosed diabetes and preexisting rheumatic heart disease. Despite sterilization of the blood with a fluoroquinolone and a third-generation cephalosporin, the patient required surgical intervention.
AbstractBackground.Osteoporotic vertebral compression fracture (OVCF) is a common complication of osteoporosis in the aging population. Refractory chronic pain may develop, and few effective treatment options exist. Methods.We retrospectively analyzed 52 cases in which gray ramus communicans nerve block was used for painful OVCF after failure of conservative analgesic therapy. All…
AbstractBackground.The proportion of older individuals infected with the human immunodeficiency virus (HIV) is rising. Methods.We performed a retrospective case-control study of 58 patients more than 60 years old at the time of diagnosis of HIV infection and compared them with 232 controls (matched by CD4+ lymphocyte count). Clinical and demographic…
AbstractBackground.Human immunodeficiency virus (HIV) seroprevalence surveys help determine the extent of HIV and the need for routine HIV counseling and testing. We sought to describe trends in five south Georgia hospitals and compare two protocols for conducting anonymous HIV surveys. Methods.From 1993 to 1997, each hospital tested approximately 1,400 anonymous,…
ABSTRACT:A 26-year-old white man with Noonan's syndrome and a history of lifetime lymphedema had had bilateral orchiopexy for undescended testicles at the age of 12. He noticed increased swelling of the right testicle confirmed by ultrasonography as a solid mass. Computed tomography of the abdomen and pelvis showed multiple enlarged…
ABSTRACT:Scapulothoracic dissociation refers to the traumatic separation of the shoulder from the chest wall. This most commonly occurs as a closed injury. We present a case of open scapulothoracic dissociation and emphasize clinical features unique to this injury. In both closed and open scapulothoracic dissociation, the force necessary to shear…
AbstractBackground.Reductions in vascular surgery reimbursement emphasize the need to decrease cost while maintaining quality. Hospital solvency is essential if we are to preserve acceptable levels of nursing/support personnel and acquire new diagnostic and treatment programs. Methods.Care processes for patients undergoing carotid, aortic, or dialysis access surgery were retrospectively analyzed and…
AbstractBackground.We quantitated proinflammatory and thrombopoietic cytokines in reactive thrombocytosis (RT) and clonal thrombocytosis (CT) to identify a cytokine profile that might aid in the distinction of these two disorders. Methods.Serum levels of cytokines relevant to platelet biology—interleukins 3, 6, 11, and 1β; thrombopoietin; tumor necrosis factor α; and C-reactive protein…
ABSTRACT:Adverse drug reactions (ADRs) are underreported and consequently are an underestimated cause of morbidity and mortality. Recent epidemiologic evidence estimates that ADRs represent the fourth to the sixth leading cause of death. Public awareness is increasing as reports of ADRs and medication errors become more prevalent in the lay press….
AbstractBackground.Although studies have identified physician beliefs that may cause them to avoid spiritual topics in the clinic (eg, lack of time), it is unknown to what extent these beliefs predict behavior. The purpose of the present study was to identify physician beliefs about religion and medicine that predict attention to…
ABSTRACT:Rothia dentocariosa is a gram-positive rod found commonly as part of the normal flora of the mouth. It rarely causes clinical disease. Subacute infective endocarditis has been the most commonly reported R dentocariosa infection, and extracardiac complications occur frequently. Solitary intracranial hemorrhages have been reported in two cases. We describe…
ABSTRACT:Focal extraintestinal infections from nontyphoid salmonellae have increased in incidence during the past decade. Typically, they are manifested as either osteomyelitis or meningitis as a complication of either bacteremia or enteric fever. Isolated salmonellal soft tissue infections, however, are rare and occur mostly in adults with chronic underlying conditions such…
ABSTRACT:An elderly woman came to our emergency room for evaluation of a syncopal episode. While climbing a flight of stairs, she had turned her head to the left and abruptly passed out. Positive physical findings included blood pressure of 141/65 mm Hg (right arm) and 80/43 mm Hg (left arm),…
ABSTRACT:A case of a pseudoaneurysm of the thyrocervical trunk after a pocketknife stab wound to zone I of the neck is reported. The patient was evaluated and treated in an emergency department with irrigation of the wound, bandage, and oral antibiotics. A large pseudoaneurysm slowly developed over the next 2…
ABSTRACT:We present a case believed to be the first reported North American presentation of Ascaris lumbricoides within the urogenital tract. A young man came to the emergency department because of painless hematuria and having observed a 6-inch worm exit his urethra while urinating. The most common site for A lumbricoides…
We present two cases of hemangiomatosis of the gastrointestinal tract. The first case describes a 59-year-old patient with upper gastrointestinal hemorrhage due to the blue rubber bleb nevus syndrome. The second case illustrates a 26-year-old patient with recurrent rectal bleeding due to Klippel-Trenaunay syndrome. These two syndromes are distinct disorders…
ABSTRACT: &NA; Streptococcus pneumoniae is a common cause of infection in the pediatric population, as well as an important cause of septic arthritis. The increased prevalence of drugresistant S pneumoniae in North America has renewed interest in the use of pneumococcal vaccines. We describe the case of a child with…
Mycotic aneurysms have been associated with many clinical conditions. A tender pulsatile abdominal mass in association with fever, chills, and unrelenting back pain is suggestive of a leaking mycotic aneurysm. However, the extracranial manifestations of Tolosa-Hunt syndrome (THS) may mimic several of these symptoms. We report the case of a…
Abstract Background. Prevention of pneumococcal sepsis in children with sickle cell disease (SCD) is threatened by the emergence of penicillin‐nonsusceptible pneumococci. Methods. In this study, nasopharyngeal colonization with Streptococcus pneumoniae and penicillin susceptibility were compared in children with SCD and a control group. Nasopharyngeal cultures were obtained from 130 children…
Abstract Background. We retrospectively studied the duration of operations and the hospitalizations for impending and manifest fractures of weight‐bearing long bones with metastatic disease, which has rarely been done. Methods. The duration of operative fixation and the hospital stay in patients with an impending (n = 7) or actual (n…
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