J Natl Med Assoc
-
A case of severe airway obstruction caused by a giant malignant goiter is presented. The patient had emergency thyroidectomy under regional anesthesia (bilateral superficial cervical plexus block). The procedure was well tolerated and the intraoperative course was uneventful. The anesthetic challenges are discussed and a case is made for regional anesthesia as a safe and reliable anesthetic option for thyroidectomy in this situation.
-
Infective endocarditis in association with spondylodiscitis is rarely observed. It is sometimes difficult to distinguish between rheumatologic diseases and infective endocarditis. We reported a 61-year-old male with Streptococcus viridans endocarditis suffering from low-back pain as initial symptom. ⋯ L4-5 spondylodiscitis was revealed on the lumbar magnetic resonance imaging. He responded to antibiotic treatment. Infective endocarditis should be considered in patients with fever and low-back pain due to spondylodiscitis.
-
Respiratory syncytial virus, the most common cause of bronchiolitis, is the leading cause of infant hospitalization in developed countries and accounts for substantial mortality and morbidity in developing countries. Children at increased risk of developing severe bronchiolitis are those <6 weeks of age, those born prematurely and those with an underlying cardiopulmonary disorder or immunodeficiency. Approximately 80% of cases occur in the first year of life. ⋯ Palivizumab has been shown to be effective in preventing severe respiratory syncytial virus bronchiolitis in high-risk children when given prophylactically. In the majority of cases, the disease is usually self-limited. The mortality rate is <1% and occurs predominantly in children at high risk for severe disease.
-
Comparative Study
Esophageal cancer epidemiology in blacks and whites: racial and gender disparities in incidence, mortality, survival rates and histology.
Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. ⋯ Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease.
-
Graves' disease is an autoimmune-based hyperthyroidism in which a number of different antibodies directed against thyroid tissue plays a role. Graves' ophthalmopathy is thought to be a consequence of this autoimmune basis and occurs in some patients with Graves' disease. On occasional cases, the disease may present only with ophthalmopathy without hyperthyroidism. A 32-year-old woman with euthyroid Graves' ophthalmopathy and negative thyroid autoantibodies, including TSH receptor antibody, is presented here.