Correlation between preoperative endoscopic and intraoperative findings in localizing colorectal lesions.

Background: Colonoscopy findings compared with findings at time of surgery have a discrepancy rate of 3-21%. The objective of our study was to investigate this discrepancy and provide potential resolutions.

Methods: In this retrospective study, we identified 400 patients who underwent colonoscopy followed by colon resection at our community hospitals in 1999-2006.

Restrictive chest wall disorders.

Hypoventilation can be caused by diseases of the chest wall. Any anatomical or functional abnormality of the bony thorax increases dead space ventilation and the work of breathing, whether congenital or acquired, acute or chronic, and whether its cause is infectious, traumatic, environmental, iatrogenic, or unknown. In this article, we discuss these heterogeneous disorders from the viewpoint of the practicing nonpediatric pulmonary physician, only briefly touching on surgical, pediatric, rheumatologic, and other nonpulmonary ramifications.

Painless reduction of acute anterior shoulder dislocations without anesthesia.

In 1938, Dr Henry Milch described a maneuver for the reduction of acute anterior shoulder dislocations consisting of shoulder abduction and external rotation with "pulsion" of the humeral head. Although many methods may be used to reduce the dislocated glenohumeral joint, the Milch technique is unique because of its gentle, effective, and relatively painless nature. This article studied the effectiveness of this technique on 76 consecutive acute anterior shoulder dislocations in 75 patients seen in our institution's two campuses over an 18-month period.

Inflammatory breast carcinoma: a community hospital experience.

Background: Inflammatory breast cancer (IBC) is a rare form of rapidly progressive breast cancer. We reviewed the diagnosis, treatment, and outcome of IBC in our inner city community-based hospital and compared results with previous published reports.

Study Design: Twenty-five patients were diagnosed and treated for IBC at the Catholic Medical Center of Brooklyn and Queens during the 6-year period of January 1989 through December 1995.

Creatine kinase subform analysis in hemodialysis patients without acute coronary syndromes.

The finding of elevated levels of creatine kinase (CK) and its myocardial isoenzyme (CK MB) in the blood of patients with acute chest pain syndromes is a key factor in making the diagnosis of acute myocardial infarction. With the widespread use of thrombolytic therapy and emergency angioplasty, the ability to make a rapid and accurate diagnosis of myocardial infarction is critical. A new rapid method for analysis of the subforms of the MB isoenzyme has been shown to be sensitive and specific for the diagnosis of myocardial infarction in the general population.

Bacterial infections in HIV-infected patients.

Although the original opportunistic pathogens described in AIDS were protozoal and fungal organisms, bacterial infections are now recognized with increased prevalence and altered expression in patients with HIV infection. Especially since populations outside of North America and populations of i.v.

Echocardiographic appearance of large left ventricular mural thrombi undergoing lysis.

Two patients with severe left ventricular dysfunction and unusual appearing mural thrombi were identified and followed up. Both patients had mobile membranes in the left ventricular chamber that were visualized by two-dimensional echocardiography and disappeared during anticoagulant therapy.

Procainamide-induced lupus in the elderly.

The usual aids to diagnosis--such as symptoms and antinuclear antibodies--do not reliably distinguish this important entity from idiopathic SLE. Age, sex, and antibody type are often clues, but in some cases, only time and clinical course will tell.

Osteoarthritis and rheumatoid arthritis in elderly patients. Differentiation and treatment.

Osteoarthritis is differentiated from rheumatoid arthritis by age at onset, duration of morning stiffness, pattern of joint involvement, and radiographic findings. Distinguishing between the diseases can be challenging, because they have some symptoms in common. Therapy for osteoarthritis is aimed at relief of symptoms; treatment of active rheumatoid arthritis is more aggressive, aimed at controlling or modifying the disease.

Seborrheic dermatitis in acquired immunodeficiency syndrome.

Cutaneous eruptions are commonly seen in acquired immunodeficiency syndrome (AIDS). Seborrheic dermatitis in this patient population is usually more severe and difficult to diagnose and treat. The butterfly distribution of the rash and the interpretation of the biopsy may suggest a diagnosis of discoid lupus erythematosus, unless the pathologist is aware of the underlying immunodeficiency.

Gangrene of the fingers secondary to myeloproliferative disease.

The myeloproliferative disorders comprise a group of related diseases, including polycythemia vera, essential thrombocythemia, chronic myelogenous leukemia, myelofibrosis, and myeloid metaplasia. An increase in circulating platelets is associated with thrombotic phenomena affecting the arterial and venous circulation. In this article, the authors describe a case in which the initial manifestation of myeloproliferative disease was gangrene of the fingers.

Oral acyclovir for chickenpox.

We report on our experience with acyclovir (Zovirax) capsules for the symptomatic treatment of chickenpox in two children and an adult.

Dry mouth: diagnosing and treating its multiple causes.

Dry mouth in the elderly is a common occurrence with multiple etiologies. It is not a normal phenomenon of aging and, therefore, an attempt at elucidating its cause should be made. Sjögren's syndrome may occur, and it is diagnosed by labial biopsy.