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Diffuse nonpainful ecchymoses on posterior thighs in dependent areas.

Scurvy, a Not-So-Ancient Disease

A 65-year-old man with a history of alcohol and tobacco use and few medical interactions presented with 1 week of progressive dyspnea. Examination revealed a cachectic man with large areas of nonpainful ecchymoses on the posterior thighs (Figure). Additional skin findings included spider angiomata on the face and chest, scattered bruising on upper extremities, and […]

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Contrast-enhanced axial slice abdominal computed tomography showing extensive peripancreatic phlegmon with abundant gas (arrows) replacing the necrotizing nonenhancing pancreatic tail. Note the normal enhancement of the pancreatic parenchyma medial to the tail.

Emphysematous Pancreatitis

A 63-year-old woman with a history of severe alcohol abuse presented with persistent abdominal pain radiating to the back, vomiting, and lassitude over a week. Examination showed tachycardia, abdominal tenderness, and bipedal edema. Abdominal ultrasound demonstrated only fatty liver. Laboratory tests were notable for white blood cell count of 16.1 × 109/L, serum albumin 1.8 g/dL, and increased […]

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Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease

Alcohol is a leading cause of liver disease worldwide. Although alcohol abstinence is the crucial therapeutic goal for patients with alcoholic liver disease, these patients have less access to psychosocial, behavioral, and/or pharmacologic treatments for alcohol use disorder. Psychosocial and behavioral therapies include 12-step facilitation, brief interventions, cognitive behavioral therapy, and motivational enhancement therapy. In […]

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Red Wine Prevents the Acute Negative Vascular Effects of Smoking

Moderate consumption of red wine is associated with fewer cardiovascular events. We investigated whether red wine consumption counteracts the adverse vascular effects of cigarette smoking. Methods Participants smoked 3 cigarettes alone or after drinking a titrated volume of red wine. Clinical chemistry, blood counts, plasma cytokine enzyme-linked immunosorbent assays, immunomagnetic separation of CD14+monocytes for gene […]

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Moderate Alcohol Consumption Is Not Associated with Reduced All-cause Mortality

A large body of research suggests that light or moderate alcohol consumption is associated with reduced all-cause mortality. However, concerns remain that the observed relationship is due to selection bias, misclassification of ex-drinkers, or residual confounding. Methods The association between alcohol consumption and all-cause mortality was analyzed using Cox regression. The analysis was performed using […]

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Physical examination showed a pronounced asymmetry of the supraclavicular fossae.

Transient Unilateral Neck Swelling After Unusual Exertion

A 32-year-old right-handed female veterinarian presented with a spontaneous, painless swelling of the right supraclavicular fossa and lower neck. She denied fever, night sweats, or weight loss. Before this presentation she was in excellent health. The physical examination showed a pronounced asymmetry of the supraclavicular fossae ; the vital signs were normal, and there was no […]

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