摘要:

The precordial catch syndrome is frequently mentioned as part of a long differential diagnosis of chest pain in children. It is an extremely common complaint but remains underrecognized. This review describes the distinctive features of the syndrome and points out that this is not a diagnosis of exclusion. Emphasis is placed on the need for taking a careful history to elicit the diagnostic features of the syndrome and performing a thorough physical examination. Diagnostic testing is usually unnecessary. Familiarity with the features of precordial catch syndrome should be helpful to primary care providers caring for children.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Reye's syndrome presents as acute central nervous system and liver dysfunction in children. Its incidence has seen a sharp decline in parallel with the decline in the use of aspirin in the pediatric age group. This report describes a patient with Reye's syndrome and serves as a reminder for health professionals to continue to discourage the use of aspirin for the treatment of viral infections.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

We report the first known case of chronic relapsing thrombotic thrombocytopenic purpura associated with adult-onset Still's disease. The patient presented with diffuse arthralgias, sore throat, and a maculopapular rash involving the trunk and extremities; she was hospitalized with fever and confusion. Thrombocytopenia, renal failure, and microangiopathic hemolytic anemia developed within several days. After a diagnosis of thrombotic thrombocytopenic purpura was made, she responded well to a series of plasma exchanges. Evaluation for infection, autoimmune disorders, and malignancy was negative. She was discharged to home in good condition, with normal renal function and normal platelet count. Two more episodes of TTP developed 7 and 9 months after the first hospitalization. The diagnosis of adult-onset Still's disease was then determined on the basis of clinical and laboratory criteria. She was successfully treated with plasma exchange, prednisone, and azathioprine. She later had splenectomy and has subsequently been wihout recurrence of thrombotic thrombocytopenic purpura for 2 years.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

We report the unique case of a patient with an idiopathic pneumopericardium due to heavy lifting and discuss Valsalva's maneuver as a rare cause in the pathogenesis of pneumopericardium. Our patient recovered without treatment and had no recurrence of pneumopericardium during follow-up. All physicians should be aware of pneumopericardium as a possible cause of chest pain, especially when no trauma is visible. Pneumopericardium may also be an occasional complication of pneumothorax and pneumomediastinum.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Calciphylaxis is a condition with a high mortality rate that is often found in patients with renal failure. It is characterized by soft tissue calcification and painful skin ulceration. A serum calcium-phosphorus product of more than 60 mg2/dl2indicates great risk for calciphylaxis. The diagnosis is made on the basis of an incisional biopsy showing calcification of the small, subcutaneous arteries.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Cystic dysplasia of the testis is a rare congenital anomaly, only 29 cases having been previously reported. We report a case of cystic dysplasia of the testis and absent ipsilateral kidney, but an ipsilateral ectatic terminal ureter, suggesting involution of a dysplastic kidney as a reason for the apparent renal agenesis.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

An 83-year-old woman was transferred to our cardiac intensive care unit with an acute non-Q-wave myocardial infarction and pulmonary edema. Enoxaparin was one component of the treatment regimen used. Her hospital course was complicated by episodes of hypotension, as well as by recurrent left hip and left thigh pain. The defining event occurred when the patient became acutely hypotensive and developed abdominal distention, peritoneal signs, intense left flank pain, and a 3.3 g/dl hemoglobin decrease. Abdominal computed tomography showed a 9 × 6 × 20 cm left retroperitoneal hematoma. The hematoma was spontaneous, secondary to enoxaparin use. The patient died despite vigorous supportive care. Enoxaparin is being increasingly used in patients with acute coronary syndromes. Review of the medical literature revealed that this is the first reported case of a patient with an acute coronary syndrome who died as a result of an enoxaparin-induced, spontaneous retroperitoneal hematoma. This article reviews important clinical signs and symptoms, identifies high-risk patient populations, and discusses management strategies.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

As the use of computers, the Internet, and Internet technology becomes more pervasive in society, psychopathological thought content characterized by the incorporation of the Internet into delusions and hallucinations will become increasingly common. In the following report, three cases of psychotic inpatients are briefly presented to exemplify this trend in pathoplasticity. Interestingly, patients with no real familiarity with the Internet may just as readily incorporate such computer-associated themes into delusional thought patterns. Clinicians should be familiar with the tendency for delusional thoughts to draw from ideas important to society in general. Several interesting points about these cases include the increasing prevalence of Internet delusions, the complete unfamiliarity of two of the patients with the Internet and computers in general, and the tendency for such delusions to be of the controlling, broadcasting, and persecutory types.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This case report describes a rare dermatologic reaction in a patient after administration of pneumococcal vaccine. A 65-year-old man developed an extensive dermatitis with pruritus, urticaria, and petechiae 1 week after receiving an intramuscular injection of the vaccine. The reaction resolved with application of topical steroids and oral diphenhydramine hydrochloride. This case report and others in the literature suggest the importance of recognizing the possibility of cutaneous adverse reactions with vaccines, such as the pneumococcal vaccine, which in general have a good safety profile.

ISSN:0038-4348    

出版商:OVID    

年代:2003

数据来源: OVID