1/5. Sonographic findings of tuberculous thyroiditis in a patient with Behcet's syndrome.We report a case of tuberculous thyroiditis in a woman with Behcet's syndrome. The initial physical examination in May 1998 revealed multiple soft, nontender, mobile lymph nodes, each measuring less than 1 cm, in the left lower internal jugular chain. Sonography performed in February 2000 showed multiple small (< 1 cm), oval lymph nodes, each with an intact fatty hilum, in the left lower internal jugular chain; the thyroid gland appeared normal. Follow-up sonography 6 months later showed multifocal, heterogeneous, hypoechoic lesions with ill-defined margins in both lobes of the thyroid and several small, oval lymph nodes, each with an intact fatty hilum, in the left lower internal jugular chain. Fine-needle aspiration was performed on the largest thyroid lesion, and cytologic analysis of the aspirate revealed a small number of epithelioid histiocytes in a necrotic background, which was suggestive of tuberculosis. Follow-up sonography after 3 months of antituberculosis chemotherapy showed that the thyroid lesions had resolved.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/5. Long-term opioid treatment in Behcet's syndrome with intractable abdominal pain--a case report.Opioids are the most potent and effective analgesics available for treating acute and chronic cancer pain, but its usefulness in treating non-cancer chronic pain is still controversial. We report a 23-year-old male suffering from Behcet's disease with persistent excruciating abdominal pain. Oral non-steroid anti-inflammation analgesics and milder opioids (codeine and tramadol) failed to relieve the pain. His excruciating abdominal pain resulting from ulcerative viscera aggravated with repeated gastrointestinal tract surgeries. Intravenous morphine given through patient-controlled analgesia (PCA) could effectively reduce his pain with minimal side effects. No sign of physical or psychological dependence was observed during the period of opiate administration, and no withdrawal phenomenon was found as the dosage was tapered. During the total treatment course of 213 days, the daily dose of morphine once surged up to 259.2 mg. The long-term opioid treatment and its possible effects are, herein, discussed.- - - - - - - - - - ranking = 0.095924181526921keywords = physical (Clic here for more details about this article) |
3/5. thalidomide-induced amenorrhea: case report and literature review.OBJECTIVE: To report on a patient with thalidomide-induced amenorrhea and review the literature on the effect of thalidomide on ovarian function. DESIGN: Case report and literature review. SETTING: University medical center. PATIENT(S): A twenty-eight-year-old woman referred for a 2-year history of amenorrhea. INTERVENTION(S): history, physical examination, laboratory evaluation of the patient, and subsequent medical therapy. literature review performed by using OVID/medline and pubmed search strategies. MAIN OUTCOME MEASURE(S): diagnosis and appropriate management of thalidomide-induced amenorrhea. RESULT(S): Elevated pituitary gonadotropins, other labs normal. All known causes of hypergonadotropic amenorrhea were excluded. CONCLUSION(S): thalidomide induces hypergonadotropic amenorrhea. Although this effect appears to be reversible, the long-term effect of thalidomide on ovarian reserve is unclear.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/5. Long-term outcome of massive small bowel resection.The long-term outcome for seven patients 4-17 yr (mean 7.1 yr) after massive small bowel resection, leaving 5-160 cm (mean 86.4) of small bowel, was reviewed. Their mean age at the final enterectomy was 40 yr. Adaptation to foodstuffs and the effects of physiologic alterations and complicating diseases on their return to work were emphasized. More than 3.5 yr after surgery, the patients had adapted to many kinds of foodstuffs, but dietary fat could not be tolerated by three patients. Six patients returned to work an average of 2.7 yr after surgery, but four were obliged to discontinue their work because of rehospitalization for long-term complications. In addition, their working hours were limited, and they could not engage in heavy physical work, owing to physiologic alterations, such as a reduced metabolic state, after massive enterectomy.- - - - - - - - - - ranking = 0.095924181526921keywords = physical (Clic here for more details about this article) |
5/5. Valve prolapse in Behcet's disease.Valve prolapse was diagnosed solely by echocardiography in three consecutive patients with Behcet's disease. Two patients had prolapse of the posterior mitral valve leaflet, but no clinical manifestations of valve prolapse. In the third patient aortic valve prolapse was associated with physical signs of aortic regurgitation and left ventricular failure. Valve prolapse in these cases may have resulted from structural and functional derangement caused by the underlying non-specific vasculitis that occurs in Behcet's disease.- - - - - - - - - - ranking = 0.095924181526921keywords = physical (Clic here for more details about this article) |