American family physician
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American family physician · Oct 1983
Case ReportsNeurogenic claudication due to pseudospondylolisthesis.
Pseudospondylolisthesis is a subluxation of the lumbar vertebrae due to incompetent facet joints. The resulting stenosis of the lumbar spinal canal may impinge on the nerve roots of the cauda equina and induce neurogenic claudication. This syndrome is difficult to distinguish clinically from lower extremity claudication of vascular etiology. Accurate diagnosis requires radiographic examination of the spine.
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The diagnosis of alcoholic coma is made only when there is a high blood alcohol level and signs of bilateral cortical dysfunction, without focal neurologic signs, and when all other metabolic and structural causes of coma have been ruled out. The ethanol-induced hypoglycemic coma of youth appears to result from the failure of gluconeogenesis to release glucose into the bloodstream. If the hypoglycemia is not immediately corrected, permanent and possibly lethal brain damage will result.
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Henoch-Schönlein purpura commonly occurs in children at about age five. There is no known etiologic agent. ⋯ Although there is no specific treatment, steroids may help prevent serious gastrointestinal complications. Prognosis is good, except for those patients with advancing renal disease.
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The punch autograft method of hair transplantation has been the mainstay of hair replacement for 25 years. Recently, scalp reduction has emerged as an adjunctive procedure to eliminate bald areas. The procedure is done in the outpatient setting and has been extremely successful in cases of traumatic injury to the scalp, as well as congenital and scarring alopecia. Temporal transposition flaps of hair-bearing scalp should be carried out by surgeons with expert training.