The posts below are excerpted from the NEJM Resident e-Bulletin, a free weekly email of teaching topics. Including the content here in Now@NEJM enables you to have a conversation or ask questions about clinical points that interest you. To receive the email version, register as a student or resident on NEJM.org.
Posts in the ‘Physicians-In-Training’ Category
Fever and Abdominal Pain in a Child
Posted by Sara Fazio • April 13th, 2013
In the latest Case Record of the Massachusetts General Hospital, a 4-year-old boy was admitted to this hospital because of fever and abdominal pain. Imaging revealed a periappendiceal mass; purulent fluid was aspirated, and symptoms resolved with antibiotics. One week later, pain recurred. A diagnostic procedure was performed. Infection is probably the most common cause… Read More…
Infective Endocarditis
Posted by Sara Fazio • April 13th, 2013
Diagnosis of endocarditis is usually based on clinical, microbiologic, and echocardiographic findings. Treatment involves antimicrobial therapy targeted to the identified organism. Surgical indications include heart failure, uncontrolled infection, and prevention of embolic events. The latest article in our Clinical Practice series reviews diagnosis and treatment options for infective endocarditis. Infective endocarditis has an estimated annual… Read More…
The Essential Element
Posted by Sara Fazio • April 5th, 2013
In the latest article in our Clinical Problem-Solving series, a 21-year-old woman presented with a 10-day history of progressive fatigue, weakness, light-headedness, exertional dyspnea, and dark-colored urine, followed by an episode of syncope. Hemolytic anemia may be acquired through immune, microangiopathic, or infectious processes or may be congenital owing to an abnormality in the erythrocyte… Read More…
Cardiovascular Disease and a Mediterranean Diet
Posted by Sara Fazio • April 5th, 2013
In a randomized trial, participants assigned to a Mediterranean diet supplemented with either nuts or extra-virgin olive oil had a significantly lower rate of cardiovascular events at 4.8 years than participants assigned to a low-fat control diet. A systematic review ranked the Mediterranean diet as the most likely dietary model to provide protection against coronary… Read More…
Short Stature
Posted by Sara Fazio • March 29th, 2013
The latest article in our Clinical Practice series reviews evaluation of short stature in childhood and options for management of idiopathic cases (e.g., familial short stature or constitutional delay of growth and puberty), including observation and reassurance, growth hormone treatment, and low-dose oral oxandrolone in boys. Short stature in childhood is the most common reason… Read More…
Arthritis and Rash
Posted by Sara Fazio • March 29th, 2013
In the latest Case Record of the Massachusetts General Hospital, a 30-year-old man with a history of IV drug use was admitted to this hospital because of fever, myalgias, polyarthritis, and rash. Results of liver-function tests were notable for mildly elevated hepatic aminotransferase levels and a normal bilirubin level. Adulterants are compounds added to street… Read More…
Norovirus in Children
Posted by Sara Fazio • March 22nd, 2013
With the advent of the rotavirus vaccine, the causes of acute gastroenteritis in children are evolving. In this report from three sentinel U.S. sites, norovirus is identified as a leading causal organism in acute gastroenteritis in children. Norovirus is a leading etiologic pathogen implicated in severe gastroenteritis outbreaks in the United States. However, the endemic… Read More…
Carcinoma In Situ of the Breast
Posted by Sara Fazio • March 15th, 2013
In the latest Case Record of the Massachusetts General Hospital, a 48-year-old woman presented after routine tomosynthesis had revealed a lesion in the left breast. Core-biopsy and lumpectomy specimens showed ductal carcinoma in situ, with positive margins. Management decisions were made. In a patient with localized ductal carcinoma in situ (DCIS), the risk of death… Read More…
