March 31st 2025
ACC.25. The results seen with the only oral GLP-1 mimetic reflect "a profound clinical impact" for adults at high risk for MACE who are averse to injectable therapy.
Elephantiasis Verrucosa Nostrum
September 1st 2003A 62-year-old obese woman with adult-onset type 1 diabetes mellitus had a 6-year history of bilateral leg edema. During the last year, the edema worsened and the skin on her legs thickened. She also had multiple, bilateral, painful, superficial ulcers that drained copiously.
Obese Young Girl With Acanthosis Nigricans and Vaginal Yeast Infection
September 1st 2003A 12-year-old African American girl comes to youroffice for a well-child checkup. She is tall for herage (height above the 95th percentile) and obese(body mass index [BMI] above the 95th percentile).Physical examination reveals acanthosisnigricans on her neck, axilla, and upper abdominalregion (Figure) and a vaginal yeast infection.Routine urinalysis reveals a glucose level ofgreater than 1000 mg/dL, with negative proteinand ketones. A random blood glucose test, obtainedbecause of the glucosuria, is 249 mg/dL.
Fibromyalgia: Making a Firm Diagnosis, Understanding Its Pathophysiology
September 1st 2003ABSTRACT: Fibromyalgia syndrome (FMS) is a common condition that causes chronic pain and disability. It should be diagnosed by its own clinical characteristics of widespread musculoskeletal pain and multiple tender points. American College of Rheumatology criteria guidelines are most helpful in diagnosing FMS. The major symptoms are pain, stiffness, fatigue, poor sleep, and those of other associated conditions, for example, irritable bowel syndrome, headaches, restless legs syndrome, chronic fatigue syndrome, and depression. The pathophysiology of FMS is thought to involve central sensitization and neuroendocrine aberrations, triggered or aggravated by genetic predisposition; trauma; psychosocial distress; sleep deprivation; and peripheral nociception.
Acute Colonic Pseudo-obstruction
June 1st 2003Progressive abdominal distention, nausea, constipation, and mild abdominal pain developed in an 82-year-old woman 5 days after she underwent surgical repair of a left hip fracture. Her medical history was significant for Parkinson disease, type 2 diabetes mellitus, and hypertension.
Fournier Gangrene in a 77-Year-Old African American Man
June 1st 2003A 77-year-old African American man with type 2 diabetes mellitus and coronary artery disease presented to the emergency department with acute scrotal swelling and pain. His testicles were erythematous with focal areas of necrosis and associated tissue destruction. Similar skin changes were apparent in the lower abdominal and inguinal regions.
"Incidentaloma" in a Middle-aged Woman
June 1st 2003A 45-year-old woman presents with multiple injuries she sustained during a skiingaccident. She has fractures of her right arm and 3 ribs, as well as numerouscontusions. An abdominal CT scan shows no hemorrhage or other traumarelatedfindings; however, a 6.7-cm left adrenal mass is detected.
Livedo Reticularis and Contact Dermatitis to Poison Ivy
March 1st 2003A network of purplish pink lesions recently developed on a 28-year-old woman’sarms and legs. The asymptomatic rash becomes more prominent with exposureto cold. The patient denies fever, aches, arthralgias, oral erosions, chestpain, and photosensitivity.
Anxious Woman With Unexplained Weight Loss
December 1st 2002A 42-year-old woman complains of anxiety, unexplained weight loss, and palpitationsthat started about 3 weeks earlier. She denies fever, trauma, and newstress. She has a history of several urinary tract infections for which imagingfailed to reveal any predisposing factors; all were successfully treated withmedication. The remainder of the history is unremarkable.
What Is the Cause of Macrocytosis and Dyspnea in an Older Man?
November 1st 2002A 78-year-old man presented to theemergency department with a 3-weekhistory of progressive shortness of breathand cough with blood-streaked, yellowishsputum. The patient had dyspnea onexertion limited to 2 blocks, 2-pilloworthopnea, paroxysmal nocturnal dyspnea,and nocturia. Neither fever norchills were present. He had lost 7.2 kg(16 lb) during the last year.
Man With Type 2 Diabetes and Pancreatitis
November 1st 2002A 44-year-old man with type 2 diabetes was recently hospitalized for an acuteexacerbation of pancreatitis. This was his seventh admission for the conditionwithin the past several years. Although imaging studies revealed no calcifications,the hospitalist suspected that acute relapsing pancreatitis was evolvinginto chronic pancreatitis.
Medical Problems of the Athlete:
October 1st 2002As the world of sport has embraced the participation of women and girls, the incidence of health problems that pertain specifically to premenopausal female athletes has increased significantly. One of these is the female athlete triad, which consists of 3 interrelated medical conditions associated with athletic training
Superior Vena Cava Thrombosis Caused by Malignancies
September 15th 2002A 64-year-old woman with a history of diabetes, hypertension, and lymphoma was admitted to the hospital with a dull headache, conjunctival congestion, and slight dyspnea. Her pulse rate was 96 beats per minute; blood pressure, 146/68 mm Hg; and respiration rate, 22 breaths per minute. She also had increased jugular venous distention; cardiovascular and chest examination findings were normal. Edema of both arms and dilated blood vessels on the anterior chest wall were noted.