Connecticut medicine
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To determine whether botulinum toxin type A (BOTOX ) is effective for the prophylactic treatment of headaches in adults. ⋯ The literature currently suggests a modest effect, if any, with the use of botulinum toxin A for the prophylactic treatment of chronic migraine and tension-type headache, and further prospective, randomized, double-blinded studies are needed.
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Leukocoria is an important clinical examination finding as it can be a sign of significant intraocular pathology, with the most common being retinoblastoma and congenital cataracts. The Brückner test is a quick, easy, and inexpensive way to assess the red reflex. When leukocoria is suspected, prompt referral to an ophthalmologist is necessary for further evaluation.
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Connecticut medicine · Mar 2013
Case ReportsPrimary respiratory failure due to inclusion body myositis: think outside the box.
Inclusion body myositis features a slowly progressive inflammatory myopathy characterized by progressive proximal muscle weakness in the lower extremities, followed by proximal, upper-extremity weakness and later involvement of distal muscles groups. Although the most severely affected muscles are those of the limbs, the disease can also involve the respiratory, cardiovascular and gastrointestinal system muscles as well. ⋯ The diagnosis was delayed in part because of the slowly progressive course of the disease and the fact that an extensive investigation had not disclosed a cause. We postulate that muscle biopsy may be warranted in select patients suffering from a protracted muscle weakness.
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Connecticut medicine · Feb 2013
Case ReportsHypersensitivity pneumonitis due to flavocoxid: are corticosteroids necessary?
Hypersensitivity pneumonitis (HP) is a rare adverse event with flavocoxid (Limbrel) use. Patients present with nonspecific symptoms after exposure to an inciting agent. ⋯ Hypersensitivity pneumonitis is associated with many pharmacological agents and is challenging to diagnose, given nonspecific symptoms and radiologic findings. In the absence of specific indications to use corticosteroids, symptoms of HP might resolve with cessation of the offending agent, as proven by this case.