A 19-year-old white man was referred to the pulmonary clinic with a 2-month history of refractory cough, low-grade fevers, night sweats, and 30-lb weight loss. He had right-sided pleuritic pain and episodic scant hemoptysis. He denied smoking and using illicit drugs. He was single and had protected sex with two female partners over the past several years. He worked as a pipe fitter and denied a...

afzalodin badil khaghani shervani and nezami ganjavi are two major stylist poets who had profound influences on later poets. most of the khaghani’s poems are lucid and uncomplicated; but many ordinary people, and sometimes some of educated ones find it hard to understand some of his ballades because of different linguistic combinations and scientific terms he used in them. although, what makes ...

Paradoxal reactions to benzodiazepines may be presented in different ways. In some persons, primarily older persons and children, especilally with coexisting somatic disorders, paradoxal reactions may be manifested as logoroic speech, unapropriate social behaviour, and psychomotor agitation. Although benzodiazepines lower levels of agression, few studies described that in some persons levels of...

Estimated time to complete this activity is 1 hour. CME INFORMATION A n 88-year-old African American man without any significant past medical history presented for evaluation after being “found down” at home. A neighbor alerted Emergency Medical Services after the patient failed to answer his phone for several days. Apparently the patient had passed out while fixing a window. He was unsure how ...

A 37-year-old, married, white, machine tool inspector entered the White River Junction Veterans Administration Hospital on October 22, 1959 because of an abnormal routine chest x-ray film finding. H e had no complaint. Eight years prior to admission, while in the Navy, at age 29, a spontaneous left-sided pneumothorax was treated by poudrage. His mother and brother were thought to have had tuber...

Of all the cutaneous eruptions caused accidentally by vegetable matters, that produced by the different ]rinds of Rhus is probably the most common in this country. The common occurrence of poisoning with poison ivy and poison sumach, and the lack of any rational treatment for this, led me to try to isolate the active principle of these plants, in the hope that a knowledge of its characteristic ...

A 46-year-old man had a 1-week history of exertional chest tightness and dyspnea. His symptoms became especially prominent while shoveling snow and he presented to the emergency department. He was free of pain at the time of initial presentation and denied any pain at rest (Fig. 1). One hour after reaching the emergency room his pain recurred and he became hypotensive and a second ECG was obtai...

A 42-year-old man presented to the emergency department with 2 weeks history of fatigue and dark tarry stool. He had past medical history significant for primary sclerosing cholangitis with liver cirrhosis, complicated with ascites and small nonbleeding esophageal varices. He denied nausea, vomiting, abdominal pain, weight loss or change in appetite. He also denied excessive use of non-steroid ...

cy department with complaints of diffuse abdominal pain and a change in bowel habits for the past 4 days. He denied nausea, vomiting or fever. His medical history included diabetes mellitus, arterial hypertension, cerebral stroke, and ischemic heart disease. He had no past surgical history. On presentation, he was in good general condition and the abdomenwas soft, depressive, with diffuse disco...

Mr. S is a 54-year-old executive with a 60 pack-year smoking history. He presented to his physician after spiral computed tomography (CT) imaging, performed during an “executive physical,” revealed a 1.9-cm nodule in the left upper lobe, with no evidence of hilar or mediastinal adenopathy. Mr. S denied cough, hemoptysis, and shortness of breath. He also denied any pain, anorexia, or weight loss...