Secondary osteoporosis: case histories

It is important to identify secondary causes of osteoporosis, as treatment often tends to partial recovery of bone mass. This short contribution offers two case studies. The first case study is a 62-year-old widow, who was a regular attender at her family practitioner's surgery, complaining of back pain and diarrhoea. The second case study is a 72-year-old white woman with a 20-year history of rheumatoid arthritis presenting with a 2-week history of mid-thoracic back pain of spontaneous onset. A discussion of the cases is reported, followed by a clinical diagnosis.     

Epididymo-orchitis: a differential diagnosis for hip pain in patients with dementia

Epididymo-orchitis in the elderly is usually associated with urinary tract infections, prostatitis, and urethral manipulations. It usually presents as acute scrotal pain, and specific complaints direct further exam and work up. As persons with dementia are unable to give a history or localize pain, it can be overlooked. It mimicked as hip fracture in the case presented here.     

Rumination in adults: Two case histories

Rumination has been reported to be a relatively rare disorder of eating during infancy. Over the past decade, there appears to be a renewed interest in and recognition of adult rumination. Although some authors believe adult rumination is benign, others have begun to link it with both eating disorders and depressive symptoms. This paper presents two adult cases whose rumination was associated with anorexia and bulimia nervosa. More identification and study of adult rumination is needed to clarify its course and medical significance. © 1995 by John Wiley & Sons, Inc.     

Induced abortion in Kenya: case histories.

Unwanted pregnancies put women in Kenya at risk of morbidity and mortality associated with childbearing; induced abortion is an option some women seek as a response to that situation. Qualitative research was carried out to document the case histories of 30 Kenyan women who underwent induced abortion. In-depth interviews were conducted among an urban group of low-income women to identify sources of information about induced abortion and the decision-making process, and to describe the abortion experience among this group. Being unmarried and unemployed contributed to the decision to abort. Two main types of induced abortion, one provided in private facilities by medical personnel, and the other performed by a variety of untrained practitioners, are described.     

1例疑似职业性噪声聋病例的诊断与鉴别体会

随着劳动者职业健康保护意识的提高,申请职业性噪声聋诊断的人数不断增加。为完善职业性噪声聋的诊断及鉴别工作,提高职业病诊断医师的临床水平,进而更好地保护劳动者和用人单位的合法权益,对1名疑似职业性噪声聋病例的诊断及鉴别诊断过程进行了分析总结,提出:在诊断过程中需认真细致询问病史及观察病情,结合主、客观听力检查结果综合分析,并与耳科医师加强沟通交流,做好鉴别诊断,同时重视现场职业卫生学调查,不可盲目相信单位提供的职业病危害因素监测等资料,而是要认真核实,这样才能提高诊断及鉴定水平。     

Jaccoud arthropathy and pyrophosphate arthropathy: a rare association

Jaccoud's arthropathy (JA) is a chronic deformity affecting hands and feet, which are voluntarily correctable by the patients. JA was usually reported in association with rheumatic fever and systemic lupus erythematosus. We describe an exceptional association between a pyrophosphate arthropathy and JA of the hands. It is a 48-year-old woman, having a 13 years history of polyarthritis involving shoulders, elbows, hips and knees, and 4 years after, a progressive unlar deviation of the fingers of the hands. Calcium pyrophosphate dihydrate crystals were identified in the synovial knee biopsy. Hands x-rays as RMI don't identify erosions and confirmed the JA.     

A case of datura stramonium poisoning--general problems of differential diagnosis

In past year drug abuse becomes more and more general in Hungary. In addition to consume traditional drugs, other substances are used frequently too. One of them is the Datura stramonium, which contains alkaloids (mostly atropine), and can result in hallucinations. Therefore Datura stramonium is seemingly becoming popular as a hallucinogenic drug. The consumption of any part of the plant causes atropine intoxication, thus anticholinergic delirium. Differential diagnosis of Datura intoxication can be difficult in the everyday medical practise. In our paper the symptomatology, diagnosis, differential diagnosis, and therapy of Datura intoxication are discussed and we report one of our cases.     

胆囊炎症性疾病的影像学诊断与鉴别诊断

胆囊炎症性疾病比较常见 ,随着新设备新技术的不断出现 ,其影像诊断水平发展较快。在选择内科、外科或介入性疗法前多需采用合理有效的影像学检查以保证诊断的准确性。1　各种影像学检查方法的现状X线平片与体层摄影以及静脉法胆系造影虽已失去当年检查此类疾病的主导作用 ,但在某些情况下仍可用作参考。口服法胆囊造影因显影效果欠佳已很少采用。超声 (US)、CT、MRI、磁共振胆胰管成像 (MR CP)、ERCP/PTC是目前常用的影像学检查方法 ,但仍都有其局限性 ,如 :US易受肠道气体影的干扰 ,普通CT横断面检查往往限制胆胰管树全貌的显示…     

A case of sinusitis presenting with spheno-cavernous syndrome: discussion of the differential diagnosis.

A 60 year old gentleman presented with a left spheno-cavernous syndrome resulting in impaired ocular motility, proptosis and visual loss in an otherwise clinically quiet eye. The history led to a clinical suspicion of posterior ethmoiditis, which was confirmed on C.T. scanning. Surgical drainage and antibiotic treatment resolved the symptoms, but visual impairment persisted. The differential diagnosis and management of spheno-cavernous syndrome is discussed in context with this atypical presentation of orbital cellulitis.     

宫角妊娠的超声诊断及鉴别诊断

目的探讨宫角妊娠的超声诊断及鉴别诊断要点。方法回顾性分析浙江省温岭市中医院2005年10月至2013年4月的56例门诊拟诊为宫角妊娠的病历资料。结果其中10例妊娠44天内的早期宫角妊娠2周内转为宫内妊娠;其余46例均经手术治疗和病理检查,其中38例为宫角妊娠（右侧20例,左侧18例）,6例为间质部妊娠,1例为滋养细胞性疾病,1例为纵膈子宫一侧妊娠。宫角妊娠总的诊断准确率为67．86％,其中经腹部和经阴道超声诊断准确率分别为44．44％和63．16％,两种方法联合诊断准确率94．74％,联合组诊断准确率明显高于经腹部及阴超组（χ2值分别为11．19和5．70,P值分别为0．001和0．017）。结论①对于停经天数较短的早期诊断的宫角妊娠应密切观察,部分可以转为宫内妊娠;②超声是诊断宫角妊娠的有效方法,阴超与腹部超声两种检查方法联合应用能够大大提高诊断的准确率。