the patient was a 19 year-old woman with the diagnosis of resistant hypertension, although she was under treatment of three classes of anti-hypertensive drugs (beta blocker, angiotensin receptor blocker, diuretic) for more than one year. in physical examination there was only a significant difference between the systolic blood pressure of upper and lower extremities (200 vs. 120 mmhg), without ...

The association of pemphigus and thymoma is real, although rare. We report a 73-year-old woman presenting with cutaneous bullac and erosions superimposed on erythematous and urticarial plaques, and a positive Nikolsky sign. She. had a large mediastinal mass that proved to be a benign thymoma. Her skin biopsy and direct immunofluorescence test were suggestive of superficial pemphigus.

one of the greatest philosophers of western tradition, spinoza, in ethics, explained the nature of passions and presented some cures for them. george eliot, a great novelist in the nineteenth century and the translator of spinoza’s works, was strongly influenced by spinoza’s philosophy and of course in some cases surpassed him. in this essay, i try to explain that although in the case of cures ...

rheumatoid arthritis is a chronic systemic inflammatory disease that affects approximately 0.5-1% of the world population. the current approach to this disease is to start an intensive treatment without delay once the disease has developed. various studies in the literature have shown that combination of disease modifying antirheumatic drugs such as sulfasalazine and chloroquine offers a more a...

N Engl J Med 2004;351:2408-16. Copyright © 2004 Massachusetts Medical Society. A 77-year-old woman with a history of hypertension treated with metoprolol presents for her annual examination. She reports no new symptoms. The examination is remarkable only for the finding of an irregular heart rate. Electrocardiographic testing reveals atrial fibrillation at an average rate of 75 beats per minute...

Results Case report Female child born at term to consanguineous parents from Asian ethnicity needed surgical ligation of a large patent ductus arteriosus (PDA) during the neonatal period. Finger clubbing was noted first from 6 weeks of age; over the next few years, despite detailed assessment, no secondary cause could be found. At the age of 7 years, she presented to the rheumatology team with ...

In this CME podcast, listen to experts discuss the case of Mrs J, an elderly woman with a history of depression. She has reported insomnia and has requested a benzodiazepine to help her sleep. Although she claims that her depressed mood is well controlled, her husband reports differently. The experts review her treatment options, taking into account both her symptoms and her age.