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Magnetic resonance cholangiopancreatography demonstrating small filling defects in the distal common bile duct.

A Simpler Answer – After All This Time

There is an allure associated with a rare diagnosis. Diagnosis momentum refers to the “stickiness” of a diagnosis once it is attached to the patient,1 and is one example of a cognitive bias that can lead to diagnostic errors. This can lead to misattribution of symptoms to a patient’s existing (even incorrect) diagnosis if clinicians do […]

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(A and B) Large eschars on bilateral medial thighs with mild erythema; corresponding plain radiographs with vascular and soft tissue calcifications are shown in the inset. (C) 99mTc-sestamibi parathyroid scintigraphy demonstrating hypermetabolic activity posterior to the superior pole of the right thyroid lobe suggestive of parathyroid adenoma.

Classic Lesion, Not-So-Classic Cause

Calciphylaxis (also known as calcific uremic arteriolopathy) is a serious disorder characterized by skin necrosis secondary to reduction in the blood flow caused by calcification, fibrosis, and thrombus formation in the dermohypodermic arterioles. While calcific uremic arteriolopathy has been reported in nonuremic patients, it is primarily observed in patients with end-stage renal disease, especially those […]

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Should Patients Infected with Borrelia burgdorferi No Longer Be Referred to as Having Lyme Disease?

In 1977, a seminal paper described what was subsequently called Lyme arthritis.1 The name ‘Lyme’ originated from the initial investigation of the disease that was conducted in the Connecticut towns of Lyme, Old Lyme, and East Haddam.1 As more of the clinical manifestations of this illness were discovered, the condition became referred to as Lyme disease.2, 3, 4 In 1983, the […]

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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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