Print Issue: November 03, 2006

Linear white facial eruptions

Case #1 A 3-year-old boy presented with a white depressed area on his forehead and nose. The asymptomatic 4-cm lesion had developed over the course of six months. An MRI revealed no changes in the underlying bone. There was no family history of similar lesions. Serology and chemistry studies were within normal limits. CASE #2Continue…

New-onset vomiting after palpitations and shortness of breath

The patient’s cardiopulmonary symptoms had improved, but now her GI tract was misbehaving. At age 78, Mrs. W had a history of atrial fibrillation, painful peripheral neuropathy, osteoarthritis, chronic steroid use, CAD, and iron deficiency anemia due to clopidogrel (Plavix). Recently, palpitations and shortness of breath had led to a stay in the hospital. Evaluation…

Not your typical cause of hip pain

While waiting for space in a shelter, the homeless patient was hospitalized — a fortuitous event. A homeless, young, recent immigrant from Mexico came to the ER. He attributed his worsening left hip pain to a leg injury sustained while lifting a heavy couch a few months earlier. The hip was exquisitely tender with a…

Increasing anger and emotional outbursts

The child’s parents were concerned for his safety after therapy for ADHD and depression failed to stabilize his mood. Jimmy, 10 years old, was brought by his mother to the primary-care nurse practitioner’s office for evaluation of worsening anger and mood disorders. According to his mother, Jimmy had been exhibiting increasingly rebellious behavior, defiance, and…

Walnuts surpass olive oil as an antioxidant

Studies have already shown that walnuts enhance endothelial function and protect the cardiovascular system, but now a new trial indicates they may be even more beneficial than olive oil. A team of researchers from the University of Barcelona randomized 24 nonsmoking, middle-aged, healthy adults to two groups of 12 for a crossover study. Each volunteer…

Watch these young adults for serious diseases

If any of your adult patients had childhood cancer, be vigilant for joint problems, a second neoplasm, heart failure, stroke, renal disease, hearing loss, cognitive dysfunction, blindness, and ovarian failure. New research shows that cancer survivors are much more likely to develop these conditions than other patients. Doctors at several major cancer centers followed 10,397…

Antibiotic relieves irritable bowel symptoms

An antibiotic used for traveler’s diarrhea may be effective for treating irritable bowel syndrome, a study indicates. The syndrome is characterized by abdominal pain or discomfort associated with defecation and diarrhea or constipation. Researchers at the University of Chicago and Cedars-Sinai Medical Center in Los Angeles recruited 87 volunteers aged 18-65 years who met the…

Anxiety predicts physical illness

Depression, anxiety disorders, and substance abuse are linked with — and often precede — a broad range of physical ailments, according to the first study of its kind. Using records of diagnostic surveys, psychiatric interviews, blood and urine tests, and BP measurements, a team of researchers studied a representative sample of 4,181 adults aged 18-65…

Lowering COPD mortality

Inhaled corticosteroids appear to significantly reduce mortality in patients with chronic obstructive pulmonary disease (COPD), a new study shows. For five years, researchers at the University of Manitoba in Winnipeg studied the mortality of patients discharged from the university hospital with a diagnosis of COPD. Of the 4,022 participants, 1,629 had received corticosteroids, while 2,393…

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