Background: To evaluate the clinical characteristics, bacteriology, and therapeutic outcomes of community-acquired thoracic empyema (CATE) in young adults. Methods: From December 2000 to December 2005, 428 adult patients with a diagnosis of thoracic empyema in a tertiary hospital were retrospectively reviewed. In total, there were 64 young adult patients who…
Objective: To evaluate the efficacy of aminophylline infusion as a painkiller compared with placebo in patients with acute renal colic. Patients and Methods: From March to August 2005, 141 patients with clinical renal colic, who were under 60 years of age, had no history of heart or hepatic failure, asthma,…
Objectives: Medications often cause constipation and little data are available concerning treatment interventions. This study was designed to evaluate the safety and efficacy of polyethylene glycol (PEG) 3350 laxative (MiraLax) for relief of constipation from medicines associated with symptoms of constipation. Methods: Study subjects were enrolled who met defined criteria…
Child overweight has reached an epidemic level throughout the United States. A total of 65 primary care providers in southern Appalachia were surveyed to understand current issues in addressing child overweight in rural primary care practice. The study shows that while providers realized the importance of child overweight intervention, many…
Background: Sudden infant death syndrome (SIDS) has been associated with poverty indirectly in the United States with the use of vital statistics data by using proxies of socioeconomic status such as maternal education. Objectives: The objective of this analysis was to examine the relationship of poverty to SIDS at an…
Background: The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward a greater proportion of new HIV/AIDS cases in women, African-Americans, and through heterosexual transmission. Methods: Using consecutive sampling, 611 participants were interviewed from eight Infectious Diseases clinics in five southeastern states in 2001 to 2002. Results:…
Intensive treatment has been shown to improve glycemic control and reduce the risk of diabetic complications in controlled clinical trials; however, glycemic control has substantial room for improvement in the diabetic population. Management strategies have traditionally focused on achieving A1c targets, with fasting glucose levels serving as the primary measure…
We report here a 70-year-old female patient who was diagnosed with brucellosis and presented with mass formation resembling a tumor. The mass was protuberant, 10 cm from the skin surface with a diameter of 15 cm, located at the inferior-lateral region of the left scapula. Brucella melitensis was yielded from…
Amebiasis presenting as acute appendicitis is extremely rare. The case of a 38-year-old Hispanic man who presented to the hospital with symptoms and signs suggestive of acute appendicitis is reported. He underwent laparoscopic appendectomy and the pathologic examination of the appendix revealed multiple trophozoites of Entamoeba histolytica. The patient was…
An 85-year-old immunocompetent man was hospitalized following the development of increasing confusion and intermittent disorientation over a 48-hour period. Within 48 hours of hospitalization, he was oriented to person only and was unable to follow commands. There were no focal neurologic deficits. Magnetic resonance imaging of the brain showed extensive…
While fish consumption is considered a component of a heart-healthy diet, many illnesses have been associated with eating contaminated fish. The authors describe two cases of muscle weakness and rhabdomyolysis that occurred after eating salmon. Cases of rhabdomyolysis and muscle weakness after consumption of fresh water fish have rarely been…
In a catastrophic situation, physicians and other healthcare workers may be called upon to deal with unaccustomed situations. Disaster planning can guide some of the response, but considerable physician flexibility is likely to be needed to cope with unanticipated medical needs, and with the stress on not only the broader…
It is difficult to imagine what it must be like to regularly go to bed hungry because of one’s inability to pay for food. It is even more difficult to imagine what it must be like to put one’s children to bed, knowing that they are hungry and that there…
Thoracic empyema following community-acquired pneumonia became a relative rarity with the advent of effective antibiotics in the treatment of respiratory infections. An aggressive and early surgical approach to treatment also helped in diminishing the occurrence of empyema in patients with thoracic trauma and suppurative lung diseases. But there has been…
In this well-designed study, Djaladat et al1 compared intravenous (IV) aminophylline infusion to placebo for pain control in patients presenting to an emergency room with acute renal colic. Using a visual analog scale, they reported that pain intensity was effectively controlled in 64% of treated patients compared with 17% of…
Chronic constipation is remarkably common; 10 to 15% of the US population reports infrequent stools, difficult stool passage or both, and this problem increases with advancing age.1 Presumably, the age association reflects a higher prevalence of other causes of constipation, such as medication use, although this remains poorly documented. Many…
Italian economist Vilfredo Pareto observed that 80% of income in Italy went to only 20% of the population. Since then, the universality of this 80–20 rule has been widely recognized. One such application is sulfonylurea dose responses in the treatment of diabetes, with the majority of benefit coming from small…
Brucellosis has been an enigma since it was first identified by Sir David Bruce in 1886. In countries where there are stringent screening methods, it is no longer endemic, but sporadic cases are constantly being reported from diverse scenarios. These cases include: consumption of cheese made from unpasteurized goat’s milk…
A 25-year-old female presented to a rural hospital in India after being bitten on the leg by a snake. According to an eyewitness, the snake appeared to be a Russell’s viper, and the patient was not seen until 10 hours postbite. On presentation, her blood pressure was 100/60, heart rate…
Background: Many studies have documented the fact that outcomes and survival are improved when major surgical oncology cases are performed at high-volume centers. Consolidation of such cases in tertiary centers, however, is often not possible or practical, due to a number of factors. Methods: A retrospective review was performed of…
Objectives: To determine why there has been a decrease in the amount of applicants to Florida-based obstetrics and gynecology (OB/GYN) residency programs, and how this has been affected by the current medical liability climate. Methods: Fourth year Florida medical students were surveyed about their concerns of a career in OB/GYN….
Three thiazolidinediones (TZDs) have been introduced into clinical use in the United States. These compounds are nuclear transcription activators that affect dozens of different genes. Due to the unique coactivator and corepressor proteins that associate and dissociate with the PPAR-gamma protein/TZD complex, no two of these compounds should be expected…
Early breast cancer detection saves lives, but our ability to prevent breast cancer is limited by the absence of known environmental risk factors comparable to tobacco in the pathogenesis of lung cancer. Breast cancer risk is increased by long menstrual life and nulliparity, and reduced by the prophylactic use of…
The study published by Nissen1 is a meta-analysis of randomized, controlled trials of 24 weeks or longer duration in which rosiglitazone was compared with placebo or other therapies. The analysis included phase 2, 3, or 4 trials for which data was available regarding outcomes of myocardial infarction (MI) and death…
type 2 diabetes mellitus is currently a global health problem. Although the armamentarium of oral hypoglycemic agents is continuously expanding, sulfonylureas (SUs) are still extensively used for the management of type 2 diabetes mellitus. However, despite decades of use, there is controversy as to the dosing of SUs. Despite many…
To the Editor: To combat the current pediatric overweight epidemic, some states have mandated school reporting of child Body Mass Index (BMI) to parents.1 Initial findings indicate these reports are well received by parents and may actually lead to some behavior change.2 However, given the vast amount of sometimes contradictory…
To the Editor: Human T-cell lymphotrophic viruses (HTLV), retroviruses classified as HTLV-I and HTLV-II, predominantly infect CD4 and CD8 T-cells respectively. HTLV-I causes adult T-cell leukemia/lymphoma (ATL), while the relation of HTLV-II to causation of ATL is unclear.1 We present the case of a 48-year-old male patient with cutaneous lymphoma…
To the Editor: A 19-year-old Asian man, working in the Middle East as a laborer for $45 a month, presented with nausea and malaise. His blood pressure was 210/130 mm Hg, pulse 90/minute; creatinine 10.9 mg/dL and BUN was 105 mg/dL. He was referred to a tertiary care center where…
Bandolier http://www.jr2.ox.ac.uk/bandolier/index.html “The first issue of Bandolier, an independent journal about evidence-based healthcare, was written by Oxford scientists and was printed in February 1994. It has appeared monthly ever since and has become the premier source of evidence based healthcare information in the UK and worldwide for both healthcare professionals…
Parents often worry about the safety of their children, and do everything possible to prevent danger. The threat of SIDS—an unpredictable, unexplained cause of death in babies—can be a terrifying thought for parents of infants. Although SIDS is not fully understood, education and knowledge of the current information is the…
Our Western culture is constantly engaged in the production of anxiety. We can see this in the competition for ever more lurid headlines in the newspapers, the unceasing flow of information about deadly diseases, the risks of eating this or that food, taking this or that drug, living in this…
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