All News

ABSTRACT: The key features of polycystic ovary syndrome (PCOS) are menstrual bleeding disturbances caused by chronic oligoovulation or anovulation and clinical or biochemical hyperandrogenism. The finding of polycystic ovaries on ultrasonography alone has limited predictive value. Obesity often coexists with PCOS and can exacerbate metabolic disturbances, particularly insulin resistance, but it is not a diagnostic finding. Laboratory results can rule out other conditions in the differential, such as an androgen- producing neoplasm, hypothyroidism, and late-onset congenital adrenal hyperplasia.

A 17-year-old boy landed with most of his weight on his plantar-flexed right foot during a skateboarding accident. He felt pain on the top of his right foot and could not bear weight on it.

The treatment of polycystic ovary syndrome (PCOS) is based on the patient's presenting symptoms and any significant abnormal findings. Symptoms can be managed with combined oral contraceptives (OCs), insulin-sensitizing agents, antiandrogens, and medications used to induce ovulation.

A 60-year-old woman complains that she has had "no energy" for the past 6 months. She wants to know how she can get a better night's sleep and inquires about new insomnia medications she has seen advertised on television.

One week earlier, these asymptomatic linear brown streaks had appeared on the dorsal aspect of a 28-year-old woman's right thumb. When Ted Rosen, MD, of Houston questioned the patient about her recent activities, she said that she had just returned from a vacation in the Caribbean. During the trip, she had squeezed fresh limes into various beverages.

Right lower leg pain prompted a 15-year-old boy to seek medical attention. An hour earlier, he had fallen on the leg during a football game and on standing had heard a "pop." No gross abnormality was noted. Jack-Ky Wang, MD, and Laurie Meng, PA-C, of Palos Heights, Ill, report that radiographs revealed a transversing pathologic fracture through an expansile lytic lesion of the right fibula.

Abstract: A number of factors can complicate the diagnosis of asthma in elderly patients. For example, the elderly are more likely to have diseases such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) that--like asthma--can cause cough, dyspnea, and wheezing. Spirometry can help distinguish asthma from COPD, and chest radiography and measurement of brain natriuretic peptide levels can help identify CHF. Important considerations in the management of asthma include drug side effects, drug interactions, and difficulty in using metered-dose inhalers. When discussing the goals of therapy with the patient, remember that quality-of-life issues, such as the ability to live independently and to participate in leisure activities, can be stronger motivators than objective measures of pulmonary function. (J Respir Dis. 2006;27(6):238-247)

A staff nurse calls the physician to see "something really bizarre-we have no idea what this is": the plastic of a urine collection bag of an 81-year-old woman has turned purple, although the urine within is more orange-brown and distinctly less odd looking.

SEATTLE ? The stereotypic image of alcohol abusers denying their problems, and showing no inclination to change their ways, is wrong in most cases, according to researchers here.

ATLANTA ? Botox (botulinum toxin type A) injected directly into the bladder's detrusor muscle not only tamed an overactive organ but kept the bladder calm for almost a year, according to Swiss researchers.

FRESNO, Calif. - Neonatal and maternal mortality rates did not improve despite an increase in repeat cesarean deliveries, apparently engendered by revised ACOG guidelines, researchers here reported.

STANFORD, Calif. - Screening for breast cancer with magnetic resonance imaging in addition to mammography may be cost effective for some women who have a genetic predisposition to the disease, according to a computer model study.

MADISON, Wis. - Asymptomatic emphysema can be revealed by a new magnetic resonance imaging technique that is more sensitive to lung changes than computed tomography, investigators here reported.