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Injuries to the latissimus dorsi and teres major muscles, while rare, are debilitating. They are seen in a variety of sports, although disproportionately in the throwing shoulder of baseball pitchers. There have been 25 case reports and 2 case series published on the nonoperative and operative management of these injuries. Latissimus dorsi and teres major muscle anatomy, function, and common injury patterns are well described in these case reports. Also well detailed are the typical patient presentation, physical examination, and imaging findings...

A 23-year-old woman presented with a 1-month history of headache, vomiting, recurrent episodes of syncope, weight gain, and leg pain. A physical examination revealed several subcutaneous nodules on the patient’s face and trunk. Exophthalmos, fundal hemorrhage, neck rigidity, and a hypertrophic..

A 90-year-old man presented with a 1-month history of progressive edema in both legs and several episodes of malaise and dizziness that were associated with hypoglycemia. On examination, a nontender epigastric mass was palpated. A plain radiograph of the chest showed a round, irregular opacity..

A 68-year-old woman presented with exertional dyspnea and chest pain, symptoms that suggested unstable angina. She had undergone coronary-artery bypass grafting 5 years earlier. Vascular examination revealed palpable radial pulses on both sides of the body. The results of Allen’s test, conducted..

A 37-year-old woman who was receiving adalimumab for ankylosing spondylitis presented with a 6-week history of swelling and ulcerations with a hemorrhagic crust over her nose (Panels A and B). Serratia liquefaciens grew in biopsy samples obtained from the ulcers. A 3-week course of ciprofloxacin..

A 48-year-old man presented with a 2-month history of abdominal discomfort and lethargy. Physical examination revealed pallor, and results from laboratory studies showed mild anemia (hemoglobin level, 9.2 g per deciliter [normal, 12 to 15 g per deciliter]). Colonoscopy revealed a proglottid from a..

A 72-year-old woman presented with skin changes on her left breast; 5 years earlier, she had undergone lumpectomy and radiation therapy for breast cancer. Physical examination revealed an area of skin 10 cm in diameter, medial to the areola, that had an ecchymotic appearance (Panel A). The area..

Acne in adults is a chronic, increasingly common disease, especially among women. It differs in pathogenesis and clinical presentation from adolescent acne. Acne in adults is associated with Western diet, defined as high consumption of milk, high glycemic load and high calorie intake. Metabolic signals of this diet result in a significant increase in insulin/insulin growth factor 1 serum level and consequently in the molecular interplay of mammalian target of rapamycin complex 1 kinase (mTORC1)/forkhead box protein 1 (FoxO1) mediated nutrient signaling, leading to increased proliferation of keratinocytes, increased lipogenesis and sebum production and finally to aggravation of acne...

A 46-year-old woman was brought to the emergency department because of agitation. On arrival, she had a fever (temperature, 38.6°C) and tachycardia (heart rate, 169 beats per minute). The patient was agitated and had ocular flutter (Video 1) as well as rigidity in the legs and myoclonus in the arms..

En bloc resection of tumors involving the spinal column is technically challenging and is associated with high morbidity to the patient due to the proximity of critical neurological and vascular structures and the destabilizing nature of this surgery. Nevertheless, evidence has shown improved progression-free survival with en bloc resection for certain low-grade malignant and aggressive benign musculoskeletal tumors. To avoid the morbidity of en bloc spondylectomy in patients with tumors localized to the lateral and posterolateral spinal column, the authors have found that the goals of surgery can be accomplished through a contralateral osteotomy of the pedicle and posterolateral elements for en bloc resection (COPPER)...

Idiopathic spinal cord herniation (ISCH) is a relatively rare and frequently misdiagnosed condition. It preferentially affects women and causes progressive thoracic myelopathy that presents as a Brown-Séquard syndrome or as spastic paraparesis. Although its etiology and pathogenesis are controversial, ISCH is characterized by the presence of an anterior dural defect that allows the incarceration of a segment of the cord. Typically, a C-shaped ventral displacement and kinking of the cord are visible on sagittal MRI...

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Millions of people worldwide suffer from diseases that lead to paralysis through disruption of signal pathways between the brain and the muscles. Neuroprosthetic devices are designed to restore lost function and could be used to form an electronic 'neural bypass' to circumvent disconnected pathways in the nervous system. It has previously been shown that intracortically recorded signals can be decoded to extract information related to motion, allowing non-human primates and paralysed humans to control computers and robotic arms through imagined movements...

Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations...

No abstract text is available yet for this article.

Vestibular migraine (VM) is the most common cause of episodic vertigo in adults as well as in children. The diagnostic criteria of the consensus document of the International Bárány Society for Neuro-Otology and the International Headache Society (2012) combine the typical signs and symptoms of migraine with the vestibular symptoms lasting 5 min to 72 h and exclusion criteria. Although VM accounts for 7% of patients seen in dizziness clinics and 9% of patients seen in headache clinics it is still underdiagnosed...

No abstract text is available yet for this article.

Abdominal migraine is one of the episodic syndromes that may be associated with migraine, which often has its initial presentation in childhood. Recognition of these 2 conditions in the pediatric population is paramount to establish an appropriate diagnosis, treatment, and prevention. The aim of this article is to review the most recent International Classification of Headache Disorders-3 beta for abdominal migraine, and discuss the differential diagnosis and current suggested management.

Cerebral vasospasm is a prolonged but reversible narrowing of cerebral arteries beginning days after subarachnoid hemorrhage. Progression to cerebral ischemia is tied mostly to vasospasm severity, and its pathogenesis lies in artery encasement by blood clot, although the complex interactions between hematoma and surrounding structures are not fully understood. The delayed onset of vasospasm provides a potential opportunity for its prevention. It is disappointing that recent randomized, controlled trials did not demonstrate that the endothelin antagonist clazosentan, the cholesterol-lowering agent simvastatin, and the vasodilator magnesium sulfate improve patient outcome...