1/7. Megalophallus as a sequela of priapism in sickle cell anemia: use of blood oxygen level-dependent magnetic resonance imaging.priapism is a common complication of sickle cell anemia. We report a little known sequela of priapism: painless megalophallus, with significant penile enlargement. The patient had had an intense episode of priapism 9 years previously and his penis remained enlarged. blood oxygen level-dependent magnetic resonance imaging revealed enlarged, hypoxic corpora cavernosa. Megalophallus probably resulted from permanent loss of elasticity of the tunica albuginea due to severe engorgement during the episode of priapism. This sequela needs to be recognized by physicians because no intervention is necessary and sexual function seems to remain intact.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Congenital hemihypertrophy and pheochromocytoma, not a coincidental combination?We describe a 19-year-old female, known to have congenital hemihypertrophy, who presented with bilateral benign pheochromocytoma. This is the second time that this combination has been reported in the literature. We speculate that the combination of congenital hemihypertrophy and pheochromocytoma is not coincidental and could be part of the clinical spectrum of the beckwith-wiedemann syndrome. CONCLUSION: in patients with congenital hemihypertrophy, the physician should be aware of the symptoms of pheochromocytoma. Besides screening for abdominal tumours, analysis of plasma and/or urinary catecholamines and/or their metabolites should be considered.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Hypertrophic herpes simplex virus in hiv patients.In conclusion, HSV lesions in hiv patients can present as chronic, hyperproliferative plaques as opposed to the classic acute ulcerative lesions. knowledge of this presentation will motivate the physician to be diligent in the diagnostic workup. This may necessitate repeat biopsies and cultures. Due to the high incidence of resistant isolates, sensitivity testing and knowledge of antiviral mechanisms will facilitate treatment in an hiv patient.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Adenotonsillar hypertrophy and upper airway obstruction in evolutionary perspective.Primary care physicians have become increasingly reluctant to refer children for tonsillectomy and adenoidectomy (T and A) during the past years while antimicrobial therapy for pharyngotonsillitis and otitis media has become more common. Consequently, more children retain tonsils and adenoids throughout the childhood years. Airway compromise from adenotonsillar hypertrophy is reported in 11 cases-8 with insidious onset, 3 with acute onset. Typical symptoms occurring during sleep include snoring, snorting, enuresis and obstructive apnea. Daytime symptoms included hyponasal speech, oral respiration and morning cephalgia. methods of assessing children with adenotonsillar hypertrophy and airway compromise included polysomnography and acoustic analysis of respiratory sounds. It appears that airway compromise from adenotonsillar hypertrophy is more common now that fewer children are undergoing T and A, is being more commonly recognized because of improved methods of assessment, or both.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Lumbar spinal stenosis in a patient with diffuse idiopathic skeletal hypertrophy syndrome.Lumbar spinal stenosis is associated with a variety of conditions, including dysplastic narrowing of the spine, lumbar spondylosis, Paget's disease, and achondroplastic dwarfism. No case of lumbar stenosis associated with diffuse idiopathic skeletal hyperostosis (DISH) previously has been described. It would appear that this case could represent either another manifestation of DISH characterized by involvement of the ligamentum flavum or coincidental association with lumbar spondylosis. In either case, physicians treating spinal and skeletal diseases should be aware of potential neurologic complications requiring surgical decompression due to narrowing of the spinal canal in this unusual disorder.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Idiopathic hypertrophic cranial pachymeningitis.We evaluated 3 patients with biopsy-proven hypertrophic cranial pachymeningitis apparently unrelated to any systemic disease. Each patient had chronic headache, cranial neuropathy, an elevated ESR, and a mild CSF pleocytosis. Neuro-ophthalmic findings included bilateral sixth nerve palsies in two patients and the third had bilateral optic neuropathies. MR imaging revealed thickened dura that enhanced with Gd-DTPA administration. Histologic examination showed thickened, fibrotic dura with a sterile, chronic, nongranulomatous inflammation. The response to treatment was variable with corticosteroids, immunosuppressive drugs, or radiation. The distinctive MR appearance should help physicians recognize this rarely reported disease.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Acute right heart failure due to adenotonsillar hypertrophy.A case is presented in which a child with underlying chronic lung disease, developed cor pulmonale and severe pulmonary hypertension as a result of adenotonsillar hypertrophy. His cardiac function acutely decompensated with an upper respiratory infection which exacerbated his obstructive sleep symptoms. Pre and postoperative documentation of cardiopulmonary function was critical in the peri-operative management of this patient. His severe pulmonary hypertension was stabilized using a nasopharyngeal airway and medications pre-operatively, in order to minimize his risk of anesthesia. He continued to require careful monitoring and manipulation of his medications after adenotonsillectomy and bronchoscopy. Serial echocardiograms documented the effects of the various interventions implemented in this patient. Severe acute right heart failure is an unusual complication of obstructive sleep apnea. However, this may become more common as more children survive prematurity and its associated chronic lung disease. These children may have subclinical lung disease and/or chronic pulmonary hypertension even after they no longer require supplemental oxygen and bronchodilators. Because these children are often tenuous, with regard to their cardiopulmonary function, they may be at increased risk to develop significant complications related to obstructive sleep apnea. It is important that a physician familiar with the management of pulmonary hypertension be involved in the care of these patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |