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Computed tomography of the abdomen with contrast shows remarkable parietal peritoneal thickness (red arrow). Also noted is bilateral renal enlargement with innumerable renal cysts (yellow arrow), confirming diagnosis of Autosomal Dominant Polycystic Kidney Disease. There is a small amount of ascites and organization of loculated fluid collection (orange arrow) in the right upper quadrant. Small bowel dilatation (blue arrow) represents ileus.

Long-Term Peritoneal Dialysis May Result in Vascular Changes Within the Peritoneal Cavity, Leading to Reduced Efficacy of Intravenous Antibiotics in Treatment of Bacterial Peritonitis

Peritoneal dialysis is a home-based dialysis modality. In the US, 7.5% of the total dialysis population uses peritoneal dialysis.1 Peritoneal dialysis catheter-related peritonitis is a well-recognized complication, with an annual mortality rate as high as 16%.2 Although peritoneal dialysis-associated peritonitis treatment has been standardized, peritoneal dialysis catheter may require removal in cases of relapsing or refractory peritonitis […]

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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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Magnetic resonance imaging of the head performed 5 days after a hypoxic episode demonstrated T2/fluid-attenuated inversion recovery (FLAIR) hyperintensities (A) with corresponding restricted diffusion on diffusion-weighted image (DWI) sequence (B) and apparent diffusion coefficient (ADC) sequence (C).

Delayed Transient Cortical Blindness from Hypoxic Ischemic Encephalopathy

To the Editor: An 85-year-old woman with no significant past medical history presented after a mechanical fall complicated by multiple fractures. She received intravenous pain medications with resultant decreased level of consciousness and respiratory distress. Intubation was difficult because of bilateral mandibular fractures, and she consequently experienced 10 minutes of hypoxia before secure airway control […]

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(A) Digital subtraction angiography (DSA) demonstrated focal stenosis of V2 segment of left vertebral artery (yellow arrow). (B) DSA revealed that the posterior circulation of the brain was otherwise normal beyond the level of stenosis.

Provoked Dizziness from Bow Hunter’s Syndrome

  A 62-year-old man was experiencing debilitating bouts of dizziness provoked by head rotation until ultimately finding relief with cervical spine fixation. He had a history of coronary artery disease, human immunodeficiency virus, tobacco use disorder, and generalized anxiety, and initially presented to a routine primary care visit with 3 weeks of episodic dizziness. During […]

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Chest computed tomography. Bilateral bronchial wall dilatation/thickening was found predominantly in the lower lobe, with scattered nodular patchy airspace opacities and focal areas of mosaic pattern predominantly in the right upper lobe and bilateral tree-in-bud appearance.

Non-Classic Cystic Fibrosis: The Value in Family History

To the Editor: Since the advent of the Human Genome Project, opening doors to an era of genomic medicine, the family history has become a relevant and critical tool in individualized disease prevention. The family history has lasted through the years as a key component of history-taking in medical education. Yet it continues to be […]

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Concussion

Concussion has been recognized as a clinical entity for more than 1000 years. Throughout the 20th century it was studied extensively in boxers,1, 2, 3 but it did not pique the interest of the general population because it is the accepted goal of the boxer to inflict such an injury on their opponent. In 2002, however, the possibility […]

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