Southern medical journal
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Southern medical journal · Oct 2008
Review Case ReportsCatamenial pneumothorax with umbilical and diaphragmatic endometriosis: a case report and review of the literature.
A 44-year-old female presented with a history of recurrent right-sided pneumothoraces, uterine fibroids, and a palpable lump in her navel. Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) and resection of the umbilical nodule was performed. Intraoperative inspection of the right hemidiaphragm revealed adherent brownish-blue nodules without any associated diaphragmatic defects and a similar-appearing nodule at the umbilicus. ⋯ Her postoperative course was uneventful and she denied recurrent pneumothorax at 12-month followup. Recurrent pneumothoraces in women of a reproductive age should raise the suspicion of thoracic endometriosis. Failure to establish the diagnosis prevents appropriate curative interventions.
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Southern medical journal · Sep 2008
Randomized Controlled TrialPain relief with intraarticular or medial branch nerve blocks in patients with positive lumbar facet joint SPECT imaging: a 12-week outcome study.
Single-photon emission computed tomography (SPECT) is useful in identifying patients who may respond to lumbar facet injections. There are two methods for performing lumbar facet joint injections: intraarticular and medial branch nerve blocks. A consensus has yet to be reached among physicians as to which method is the most effective. The purpose of this study was to compare the effectiveness of intraarticular and medial branch nerve blocks in SPECT-positive lumbar facet joint patients with nonradicular lower back pain. ⋯ Intraarticular lumbar facet joint injections are more effective than medial branch nerve blocks in SPECT-positive patients.
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Southern medical journal · Sep 2008
ReviewCrohn disease of the esophagus: a review of the literature.
Esophageal Crohn disease is a difficult disease both to diagnose and treat. The diagnosis is made in patients with other extraintestinal manifestations of Crohn disease in whom other esophageal pathology has been ruled out. This often requires integration of clinical, endoscopic, radiographic, and histologic findings. ⋯ Treatment requires careful integration of medical, endoscopic, and surgical techniques. This review aims to discuss the significant literature regarding diagnosis and treatment of this important manifestation of inflammatory bowel disease. There is additional discussion of the literature regarding the efficacy of newer medical and endoscopic therapies, including biologic agents and removable polymer stents.
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Southern medical journal · Sep 2008
Case ReportsAn unusual case of knee pain: pseudogout and Abiotrophia defectiva infection.
A 90-year-old man was diagnosed with monoarticular arthritis due to pseudogout and Abiotrophia defectiva infection. A. defectiva is recognized as a cause of endocarditis, but is rarely described in septic arthritis. To our knowledge, this is one of the few case reports of septic arthritis due to this organism, and the first in association with pseudogout. This report supports the routine culture of synovial fluid and is further evidence for the role of A. defectiva in septic arthritis.