A star in the eye: cat scratch neuroretinitis.

Neuroretinitis is one of the atypical presentations of Cat scratch disease (CSD). Fundoscopy showed star pattern macular exudates. CSD should be considered in patients who present with blurry vision and typical fundoscopic findings.

Internet use, misuse, and addiction in adolescents: current issues and challenges.

The Internet has revolutionized education and social communication in the 21st century. This article reviews the growing literature identifying a number of adolescents and young adults with a pathologically excessive Internet use leading to many potential consequences. Current research dilemmas in this area include that Internet addiction is a broad topic with no standard definition and no standard measurement tools.

Effect of alternate-week versus continuous dexamethasone scheduling on the risk of osteonecrosis in paediatric patients with acute lymphoblastic leukaemia: results from the CCG-1961 randomised cohort trial.

Background: Acute lymphoblastic leukaemia (ALL) is curable in more than 80% of children and adolescents who exhibit high-risk features. However, treatments are associated with symptomatic osteonecrosis that disproportionately affects adolescents. Based on the findings from the CCG-1882 trial, the CCG-1961 trial was designed to assess whether dexamethasone dose modification would reduce the risk of osteonecrosis.

Historical development of modern anesthesia.

Of all milestones and achievements in medicine, conquering pain must be one of the very few that has potentially affected every human being in the world. It was in 1846 that one of mankind's greatest fears, the pain of surgery, was eliminated. This historical review article describes how the various elements of anesthesiology (gasses, laryngoscopes, endotracheal tubes, intravenous medications, masks, and delivery systems) were discovered and how some brilliant entrepreneurs and physicians of the past two centuries have delivered them to humanity.

Protection orders protect against assault and injury: a longitudinal study of police-involved women victims of intimate partner violence.

The objective of this study was to measure the efficacy of protection orders (POs) in reducing assault and injury-related outcomes using a matched comparison group and tracking outcomes over time. This study was a retrospective review of police, emergency department, family court, and prosecutor administrative records for a cohort of police-involved female IPV victims; all events over a 4-year study period were abstracted. Victims who obtained POs were compared with a propensity-score-based match group without POs over three time periods: Before, During, and After the issuance of a PO.

Femoroacetabular impingement in former high-level youth soccer players.

Background: Femoroacetabular impingement (FAI) can be a source of hip pain in young adults. Repetitive kicking associated with youth soccer may lead to morphologic changes of the proximal femur that predispose a person to the development of FAI.

Hypothesis: Young adults who participated in high-level soccer competition as youths are more likely to demonstrate radiographic changes consistent with FAI and to have increased alpha angles as compared with controls.

Historical perspectives on autism: its past record of discovery and its present state of solipsism, skepticism, and sorrowful suspicion.

Concepts of autism have evolved over the twentieth century after Bleuler coined the term to refer to symptoms of self-absorption in those with schizophrenia. Autism nosology changed to the current sesquipedalian constellation of autism spectrum disorders with a confusing archipelago of 5 conditions that often serve as islands of confusion to both the general public and professionals. This article reviews historical links that have led to the current confusing and controversial situation that is encouraging some people to return to magic, mysticism, and mantics for health care, despite the amazing accumulation of progress in vaccinology over the past 2 centuries.

Root causes of errors in a simulated prehospital pediatric emergency.

Objectives: Systematic evaluation of prehospital provider performance during actual resuscitations is difficult. Although prior studies reported pediatric drug-dosing mistakes and other types of management errors, the underlying causes of those errors were not investigated. The objective of this study was to identify causes of errors during a simulated, prehospital pediatric emergency.

Outcomes of treatment of acute grade-III isolated and combined posterolateral knee injuries: a prospective case series and surgical technique.

Background: Few studies have reported the outcomes of surgical treatment of an acute grade-III posterolateral knee injury. Our purpose was to report the objective stability and subjective outcomes for a prospective series of patients with an acute grade-III posterolateral knee injury treated with anatomic repair and/or reconstruction of all injured structures.

Methods: A prospective study of all patients with a grade-III posterolateral knee injury treated with an anatomic repair and/or reconstruction within six weeks of injury was initiated in May 2005.

New onset hypertension-rare intimal variant fibromuscular dysplasia.

Fibromuscular dysplasia (FMD) involving the renal arteries commonly presents as hypertension secondary to renal artery stenosis. Atypical patterns involving intima are rare and contribute to less than 10% cases of FMD. We present a relatively uncommon case of new onset hypertension in a 30-year-old woman resulting from intimal variant FMD involving the left renal artery.

Clostridium tertium isolated from a necrotizing soft tissue infection in a diabetic but otherwise nonimmunocompromised patient.

Clostridium tertium has historically been regarded as nonpathogenic, and its implication as the primary microbe in infectious etiologies remains unclear. Although there have been several reports of C tertium isolated from blood, tissue, and other specimens, largely this population has consisted of patients with neutropenia, hematologic malignancies, or gastrointestinal disorders. Here we describe a case of a 39-year-old nonimmunocompromised man with a history of type 1 diabetes mellitus and intravenous drug use who presented to our institution with a necrotizing soft tissue infection involving his right upper extremity.

Acquired factor VIII inhibitor (acquired hemophilia A) presenting as spontaneous blood-filled scrotum.

Acquired hemophilia A, also known as acquired factor VIII deficiency, is an exceedingly rare bleeding diathesis that does not require any personal or family history of bleeding or clotting disorder. Because treatment is available, misdiagnosing or completely missing this diagnosis can be life threatening for patients. Clinicians should be aware that acquired forms of hemophilia do exist and are associated with high morbidity and mortality in elderly adults.

Factors influencing emergency medicine physicians' management of sports-related concussions: a community-wide study.

Background: Numerous guidelines to grade and manage sports-related concussions have been published. However, little is known about how frequently they are implemented in the emergency department. This study evaluates the current practices of emergency physicians (EPs) in managing sports-related concussions.

Lambl's excrescences: a rare cause of stroke.

Cardiogenic cerebral embolism is believed to be responsible over 25% of all ischemic strokes. Since 1856, Lambl's description of small excrescences on the aortic valves has attracted widespread attention and controversy. With the increasing use of transesophageal echocardiography, ever-increasing valvular strands are being detected.

Left ventricular noncompaction and myocardial fibrosis: a case report.

Background: Left ventricular noncompaction (LVNC) is a rare congenital abnormality. It is currently classified as a genetic cardiomyopathy and results from early arrest of endomyocardial morphogenesis. The pathophysiology of left ventricular dysfunction, which becomes apparent beyond the 4th decade of life, is unclear.

Ibandronate and nonvertebral fracture efficacy: results of a recent pooled analysis.

The nonvertebral efficacy of ibandronate is demonstrated by a pooled analysis of all relevant clinical trials. ORIGINAL ARTICLE: Cranney A, Wells GA, Yetisir E, et al. Ibandronate for the prevention of nonvertebral fractures: a pooled analysis of individual patient data.

METEOR Trial Reports on the Effect of Rosuvastatin on Progression of Carotid Intima-Media Thickness in Low-Risk Individuals with Subclinical Atherosclerosis.

The data from the METEOR trial show that asymptomatic low-risk patients treated with rosuvastatin have a reduction in progression of carotid intima-media thickness (CIMT) over 2 years versus placebo. ORIGINAL ARTICLE: Crouse JR 3rd, Raichlen JS, Riley WA, et al; METEOR Study Group. Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial.

A neurosciences-in-psychiatry curriculum project for residents in psychiatry.

Objective: The author describes a 20-session, student-centered course relating contemporary neuroscience to psychiatry for second-year psychiatric residents.

Methods: Twenty residents who took the course (2003-2007) completed pre- and postcourse surveys and were contacted for more remote follow-up regarding the course.

Results: Survey results are predominantly qualitative and positive.