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young female doctor examines x-ray

A Depressing Diagnostic Error

To the Editor: A 52-year-old woman with diabetes presented to the hospital with acute onset of right flank pain, in the setting of profound lower extremity weakness and cachexia with a 30-lb unintentional weight loss over the past 6 months. She was diagnosed with ascending pyelonephritis and treated with empiric antibiotics. On hospital day 2, […]

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Magnetic resonance imaging brain lesions typical of multiple sclerosis.

Multiple Sclerosis Re-Examined: Essential and Emerging Clinical Concepts

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by exacerbations of neurological dysfunction due to inflammatory demyelination. Neurologic symptoms typically present in young adulthood and vary based on the site of inflammation, although weakness, sensory impairment, brainstem dysfunction, and vision loss are common. MS occurs more frequently in women […]

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Increased Vulnerability to Poorer Cancer-Specific Outcomes Following Recent Divorce

Prior studies have only considered the association between static marital status and cancer-specific outcomes. We aim to measure the effect of recent divorce on cancer-specific outcomes. Methods There were 83,804 patients with 2 malignancies, diagnosed 12 to 60 months apart, from 1973-2006 from the Surveillance, Epidemiology, and End Results database. Patients were identified as newly […]

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The patient had multiple telangiectasias. (A) These were evident on the fingertips. (B) The oral mucosa was also affected.

Site-Seeing: Hereditary Hemorrhagic Telangiectasia with Native-Valve Endocarditis

A 69-year-old Japanese man had 2 disparate illnesses with a comparable sign. The first, an undiagnosed genetic disease, made him more susceptible to the second. He was admitted to our hospital after reporting a 1-month history of chills, malaise, anorexia, pain in the left knee, and blurred vision in the right eye. He denied urinary […]

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Dorsum of tongue showing erythematous patches with white borders (black arrows).

Geographic Tongue

A 45-year-old female patient presented to our clinic with a painless, erythematous lesion on her tongue. Medical history was negative, with absence of any allergies or habits. The patient recalled that she had a similar lesion on her tongue 6 months earlier, which resolved spontaneously. Clinical examination of the dorsal surface of the tongue revealed […]

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Atrophy of bilateral abductor halluces.

Diagnosing Bilateral Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a clinical condition characterized by pain and numbness involving the feet, and it occasionally spares the heels. It is often caused by physical compression by ganglion or posttraumatic change in the tunnel.1, 2 Cases of idiopathic bilateral tarsal tunnel syndrome have been reported, but not as many as expected, thereby rendering the entity […]

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