Articles: ninos.
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Right upper abdominal pain in the presence of pelvic inflammatory disease is called Fitz-Hugh-Curtis syndrome. It is due to perihepatitis secondary to transperitoneal spread of Neisseria gonorrhoeae or Chlamydia trachomatis. ⋯ A case history demonstrates how clinical recognition allows effective management before the results of laboratory investigations are available. The Fitz-Hugh-Curtis syndrome is readily treated with conventional antibiotic regimens.
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The hemostatic system consists of the subcutaneous tissue/vessel wall/platelet system and the coagulation cascade. Hemostasis occurs initially through the interaction between circulating platelets and subendothelial collagen, so that a platelet plug is formed. ⋯ The presence of the fibrin in the plug results in permanent hemostasis. The five tests of hemostasis - platelet count, bleeding time, partial thromboplastin time, prothrombin time and Factor XIII assay - are described.
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Polyneuropathy is characterized by simultaneous bilateral symmetrical involvement of peripheral nerves. Clinical features in fully-developed cases are paresthesias, irregular 'glove and stocking' cutaneous sensory loss, loss of deep sensations, weakness of distal muscles of extremities, and absent deep tendon reflexes. The most common forms of neuropathy encountered in practice are -- alcohol-induced, Guillain-Barre syndrome, and that secondary to diabetes mellitus. Since PN has many causes, a scheme based on clinical features is presented so that the possibilities can be narrowed and pursued with further investigations.
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During the past 50 years, there has been increasing expectation by patients and physicians that serious disease is preventable by early diagnosis. Unfortunately, the value of screening by X-rays, electrocardiogram, cytologic smears, and biochemistry has yet to be proven. The family physician should concentrate his efforts more on preventable disease caused by poor diet, exercise levels, or life style and by closely monitoring blood pressure.