1980 had been treated with lithium (Liskonum 225 mg in the morning and 450 mg at night), since when his mood had been stable. He attended regularly for follow-up. He described a 10-day history of paranoid symptoms, with ideas of influence (vibrations in his body) and auditory hallucinations (third-person commentary). He believed that his neighbours were trying to influence him and spying on him...

Brazil and Coffee. Historians tend to identify both. But coffee occupies a small place, even a negative one, in Brazilian national identity. This article shows that neither literature nor historical studies have focused their attention on it. The focus is always on colonial heritage, geography or racial mixture. Rural areas are seen as backward with no contributions to national identity, but ra...

A 13-year-old boy was brought to the emergency department (ED) with a generalized itchy rash of 2 days' duration. For the past 3 days, he had dry, itchy eyes with a purulent discharge (Figure 1) and nonbilious emesis 2 or 3 times per day, with some blood streaks in the vomitus on the third day of illness. Chills developed on the third day, but the patient's temperature was not measured. His lip...

Case Report A 65-year-old Caucasian male with no significant past medical history presented to the emergency department with an unintentional 44-pound weight loss over a four-month period. The weight loss was preceded by fatigue and anorexia, which had been increasing for approximately eight months. In addition, he noted numbness and tingling of his hands and feet that began over the same time ...

Question A 50 years old Male known with a diagnosis of ulcerative colitis since October 2012 (Montreal Class E3) was seen for further follow up in gastroenterology outpatient. He was on Meselazine 2.4 gm per day. The last flare up he had was 2.5 years ago in April 2013 when he was treated successfully with a course of oral steroids. His colitis has been in a stable state with no further flare u...

A 47-year-old gentleman with a history of hypertension, type 2 diabetes mellitus, hypercholesterolemia, coronary artery disease and left iliofemoral bypass woke up with discomfort, numbness and severe weakness of both legs. He was a non-smoker and had no history of alcohol or drug abuse. There was an approximate 6 month history of intermittent claudication affecting his lower limbs. He denied r...

W hile the mathematical side of Dutch graphic artist M. C. Escher (1898– 1972) is often acknowledged, few of his admirers are aware of the mathematical depth of his work. Probably not since the Renaissance has an artist engaged in mathematics to the extent that Escher did, with the sole purpose of understanding mathematical ideas in order to employ them in his art. Escher consulted mathematical...