Acute hypoxemic respiratory failure as a manifestation of urinothorax
April 1st 2007In the case described here, hypoxemic respiratory failure occurred secondary to a right-sided pleural effusion associated with an obstructive uropathy. The patient, a 75-year-old man with a history of benign prostatic hypertrophy (BPH), presented with a gradual onset of shortness of breath, tachypnea, and oliguria. Renal ultrasonography and CT scanning revealed bilateral hydronephrosis. A right thoracentesis yielded fluid with characteristics consistent with urinothorax. The patient was given medication for BPH, taught how to do self-straight catheterization, and scheduled for an outpatient cystoscopy. At follow-up, his chest radiograph showed no effusions.
Upper Extremity Swelling in a Smoker
April 1st 2007A 57-year-old woman presents with swelling of the hands that began several weeks earlier and is now worsening. She denies joint pain, and she has no history of trauma or significant vascular disease. She has had pneumonia several times; each episode was successfully treated with antibiotics. She has smoked 2 packs of cigarettes a day for the past 20 years
ST-Segment Elevation Myocardial Infarction:What Role for Anticoagulants and Antiplatelet Agents?
April 1st 2007The goal of treatment in acute coronary syndromes is the restoration and maintenance of myocardial perfusion. To this end, numerous pharmacological agents are available, as well as percutaneous coronary intervention (PCI).
Urinary Incontinence:Choices in Medical Therapy for the Overactive Bladder
April 1st 2007Urge incontinence, also referred to as overactive bladder (OAB)-wet, is the involuntary loss of urine accompanied by or immediately preceded by a sensation of urgency. It has a reported overall prevalence of 16.0% in men and 16.9% in women. Currently, the mainstay of management for symptomatic urgency and OAB-wet is medical therapy.