Hospital practice (1995)
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Menopause often is accompanied by abnormal uterine bleeding-mostly due to anovulation and correctable with hormone therapy. However, all patients should be fully evaluated for gynecologic and nongynecologic causes of bleeding.
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Antithyroid drugs induce sustained remission in only 55% of cases. Radioiodine, the overwhelming choice of specialists, may pose risks, including aggravation of ophthalmopathy. Surgical ablation should be considered only if a highly skilled surgeon is available. Thyroid storm requires aggressive management, and definitive treatment is needed for toxic adenoma or toxic multinodular goiter.
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A 35-year-old man presented with cough, expectoration of green sputum, and right-sided pleuritic chest pain. Symptoms had begun the previous day and he had vomited the night before. The patient also complained of chronic fatigue, a 12-lb. weight loss, insomnia, right-sided back pain, and lower extremity myalgias. He denied having had fever, chills, diaphoresis, dyspnea, diarrhea, dysuria, abdominal pain, skin lesions, or jaundice.