All News

We present a rare case ofCushing syndrome resultingfrom thymic carcinoid of thelung. Although Cushing syndromeis not usually associatedwith respiratory muscleweakness or restriction, ourpatient had reduced lung volumesand expiratory muscleweakness. His reduced lungvolumes could not be completelyexplained by respiratorymuscle weakness, parenchymallung disease, or obesity.Six months after removal ofthe carcinoid tumor, the patient'sgrowth hormone leveland the lung volumes improvedsignificantly, and hebecame asymptomatic.

ABSTRACT: Although the organisms that cause community-acquiredpneumonia are similar in diabetic and nondiabetic patients,those who have diabetes mellitus (DM) may have moresevere disease and a poorer prognosis. Elevated blood glucoselevels are associated with worse outcomes in patients withpneumonia, and the mortality risk may be as high as 30% in patientswith uncontrolled DM. Thus, appropriate treatment-and possibly prevention-of bacterial pneumonia should includeaggressive efforts directed at glycemic control. Other respiratoryinfections, such as influenza, tuberculosis, and fungalpneumonia, also are associated with greater morbidity in patientswith DM. Diabetic patients with tuberculosis are morelikely to present with bilateral lung involvement and pleural effusions.(J Respir Dis. 2008;29(7):285-293)

ABSTRACT: Pulmonary manifestations, such as pleural effusions,interstitial lung disease (ILD), and rheumatoid nodules, arecommon in patients with rheumatoid arthritis (RA). For thosewith pleural effusions, diagnostic thoracentesis is usually necessaryto rule out other causes. Larger effusions that cause dyspneamay require therapeutic thoracentesis or other interventions.The presentation of ILD is characterized by graduallyprogressive dyspnea on exertion and cough. An isolated decrementin carbon monoxide–diffusing capacity is often the earliestabnormality seen on pulmonary function testing. HighresolutionCT is an important tool for detecting ILD; commonfindings include ground-glass opacities and reticulation. It isimportant to keep in mind that in RA-associated ILD, morethan one pathological process-often several-may be seen inthe same patient. (J Respir Dis. 2008;29(7):274-280)

de Jong YP, Uil SM, Grotjohan HP, et al, Isala Klinieken, Zwolle, and University Medical Center Gronigen, the Netherlands. Oral or IV prednisolone in the treatment of COPD exacerbations. A randomized, controlled, double- blind study. Chest. Dec 2007;132:1741-1747.

Since the introduction of highly active antiretroviral therapy in the mid-1990s, antiretroviral therapy (ART) options have expanded considerably to include simpler, safer, and more tolerable regimens.

Aspergillus species are ubiquitous molds to which humans are commonly exposed. Of approximately 180 species, it is estimated that 34 are medically significant. Most persons who come in contact with the fungus remain asymptomatic.

Symptomatic primary HIV infection occurs in an estimated 50% to 90% of patients. A constellation of symptoms that most closely resembles those of acute infectious mononucleosis characterizes the syndrome.

In the preface to the third edition of this comprehensive reference on AIDS therapy, the editors proclaim that their book is a “one-stop resource for busy clinicians in busy practice settings.” And this textbook serves that purpose well. But first, you will need to lift it. This hardcover edition weighs in at a hefty 7 pounds!

A 92-year-old woman presents with sharp abdominal pain of 1 day's duration, accompanied by 1 episode of emesis. The pain is neither relieved nor exacerbated by food ingestion.

A 23-year-old man's right chest shows a common congenital muscle anomaly-partial absence of the pectoralis major muscle. The abnormality was noted during a routine preemployment physical examination. The clavicular origin seemed to be intact. There was no apparent decrease in shoulder internal rotation or adduction strength, and the patient had not noticed any shoulder weakness or limitation in motion.

The numerous symptom domains of fibromyalgia syndrome (FMS) include pain, fatigue, sleep disturbance, mood disturbance, function impairment, irritable bowel syndrome, tension and migraine headache, and cognitive dysfunction. Its pathophysiology is rooted in neural dysregulation in the spinal cord and brain.

When diagnosing vitamin B12 deficiency, we routinely include a measurement of the methylmalonic acid (MMA) level in all patients whose B12 values are under 400 pg/mL. An elevated MMA level confirms B12 deficiency.

A patient of mine recently had an extensive allergy workup after a rash developed, apparently following exposure to wheat products.

What amount-and type-of alcohol is most effective in lowering cardiovascular risk? A recent paper suggests that drinking wine responsibly reduces the risk of heart disease to a greater extent than moderate consumption of beer or spirits, such as whiskey.

The features of acromegaly (frontal bossing, enlarging hands and feet, changes in the prominence of the lower jaw) are so subtle and progress so slowly that patients and family members often miss them.

Primary HIV infection refers to the earliest stages of infection, or the interval from initial infection to seroconversion (when antibody to HIV is detectable). During this stage, many patients have symptoms of acute HIV seroconversion illness, are viremic with very high HIV RNA levels, and have negative or indeterminate findings on HIV antibody tests.

UNICEF has reported that there have been some improvements for children facing AIDS, but progress is still far short of goals set for 2010 (Worsnip P. Reuters. April 3, 2008).

Apart from clinical trials that provide highly active antiretroviral therapy shortly after the recognition of an acute seroconversion reaction-an intervention that some believe could be a prelude to eradicating HIV -there has long been debate over the optimal time to initiate antiretroviral therapy.