The Mount Sinai journal of medicine, New York
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Review Case Reports
Childhood longitudinal melanonychia: case reports and review of the literature.
"Longitudinal melanonychia" refers to a brown or brown-black longitudinal band on a fingernail or toenail. A number of conditions can cause longitudinal melanonychia, but its main importance is that, in some patients, it may indicate the presence of a subungual malignant melanoma. Hyperpigmented nail bands are not uncommon in African-American, Latino and Asian patients, especially those over sixty years of age, and are often multiple in these groups. ⋯ Such findings are considered to be a strong indication for biopsy of the nail matrix to rule out melanoma. Since nail matrix biopsy sometimes results in permanent nail deformity, and since the incidence of malignant melanoma is quite small in the pediatric age group, there is some controversy as to whether this procedure should routinely be performed in children. We report two cases of dramatic longitudinal melanonychia in toddlers and review the current literature on the management of this striking condition in the pediatric age group.
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Review Case Reports
Necrotizing fasciitis: a plea for early diagnosis and treatment.
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Wernicke's encephalopathy, a serious neurological disorder caused by thiamine deficiency, is most commonly found in chronic alcoholics. We present a typical case of Wernicke's encephalopathy in a non-alcoholic man. ⋯ An infectious etiology of the symptoms was ruled out by spinal fluid cultures. The patient improved dramatically within 24 hours of administration of thiamine.
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Judaism values medicine as a noble profession. Physicians are mandated by the Bible to heal, and those who are ill are obligated to seek healing from their physicians. In Jewish thought, infertility is considered an illness. Hence, in spite of many Jewish legal and ethical questions, assisted reproductive techniques such as artificial insemination, in vitro fertilization and surrogate motherhood, within certain limited circumstances, are viewed with favor by most current rabbinic authorities, provided the couple is unable to have a child in the normal manner and after standard medical or surgical interventions have failed.
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Accumulating evidence suggests that partner violence may be associated with HIV risk behavior and drug use among women in methadone maintenance treatment programs (MMTPs), yet the mechanisms linking these overlapping problems remain unclear. The main purpose of this qualitative study is to explore in detail how drug-related activities and HIV risk behavior occur in the context of a recent episode of partner violence among women in MMTPs. ⋯ The multiple ways in which the use of mood-altering drugs are related to partner violence and the occurrence of coerced, unprotected sex underscore the need to design specific interventions for preventing drug relapse, and HIV and HCV infection among abused women in MMTPs. Treatment and policy implications of study findings are discussed.