Internal medicine
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Among the various diagnostic strategies of chronic obstructive pulmonary disease (COPD), physical diagnosis is the quickest and requires no extra cost. Rapid physical diagnosis of COPD in primary care practice can lead to earlier actions of preventive measures and counseling for patients. Further, rapid physical diagnosis of COPD in an emergency department is also crucial for timely use of potentially lifesaving therapy specific for COPD patients. In this review, we will present a broad scope of physical findings for rapid physical diagnosis of COPD.
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Review Case Reports
Isolated reversible splenial lesion in adult meningitis: a case report and review of the literature.
We report the rare case of a 38-year-old man who suffered from aseptic meningitis. Brain magnetic resonance imaging showed an ovoid lesion with a high signal intensity on T2- and diffusion-weighted images in the splenium of the corpus callosum that completely disappeared within a week. There were no symptoms or signs associated with the lesion, and the prognosis was good. Although rare in adult patients, awareness of a reversible splenial lesion in meningoencephalitis is important.
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Chronic obstructive pulmonary disease (COPD) is the most common chronic lung disease in the world. In 1999, COPD ranked sixth among the most common causes of death and twelfth as a worldwide burden of disease. It has been estimated that by the year 2020 COPD will be the third leading cause of death and fifth as a worldwide burden of disease. ⋯ Recently, global and Japanese guidelines for COPD have been published. These guidelines seem to be useful to improve the underdiagnosis and undertreatment of COPD. In this review, I describe briefly the current recommendation for pharmacological therapy of stable COPD according to the global and Japanese guidelines for COPD.
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Review Case Reports
Recurrent prosthetic valve endocarditis caused by Staphylococcus aureus colonizing skin lesions in severe atopic dermatitis.
Infective endocarditis, a serious infection most commonly affecting rheumatic or prosthetic valves, generally occurs after bacteremia. Atopic dermatitis, a very common disease, carries a high prevalence of skin infections, particularly with Staphylococcus aureus. While cutaneous colonization by S. aureus represents an important source of bacteremia, few cases of infective endocarditis arising from the skin lesions of atopic dermatitis have been reported. We describe a patient with recurrent S. aureus prosthetic valve endocarditis developing in this manner.
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Review Case Reports
Diabetic mastopathy of bilateral breasts in an elderly Japanese woman with type 2 diabetes: a case report and a review of the literature in Japan.
We report a case of diabetic mastopathy in an elderly woman with type 2 diabetes. The patient was a 69-year-old woman diagnosed with type 2 diabetes at the age of 33 years. She had been treated with insulin for 25 years, however, her blood glucose had been poorly controlled. ⋯ As malignancy needed to be excluded, core needle biopsy was performed in the left breast and diabetic mastopathy was confirmed pathologically. Diabetic mastopathy is usually a complication of pre-menopausal type 1 diabetes and develops in a unilateral breast. This case developed in bilateral breasts in an elderly type 2 diabetic patient.