An 82-year-old woman with longstanding hypertension, obesity, and type 2 diabetes mellitus presents for dyspnea on exertion increasing over several months. She denies exertional chest pain. She sleeps on two pillows and has some mild ankle edema. Her local internist referred her for additional evaluation and management. She is currently independent in her activities of daily living (ADLs), but ...

BACKGROUND Small bowel tumors are rare, accounting for only 3-6% of gastrointestinal neoplasms, 1-2% of these being malignant. They must be considered whenever a patient presents with gastrointestinal bleeding, with normal upper gastrointestinal endoscopy and colonoscopy. CASE PRESENTATION We report a case of jejunal adenocarcinoma presenting as a blood loss anemia in a 65 year-old male, doin...

A review of the pathophysiology, clinical presentation, and diagnosis of colon cancer and colonic polyps is important and timely. This field is rapidly changing because of breakthroughs in the molecular basis of carcinogenesis and in the technology for colon cancer detection and treatment. This article reviews colon cancer and colonic polyps, with a focus on recent dramatic advances, to help th...

Approximately 7 of 10 (and 95% of the elderly) people in US health plans see one or more specialists in a year. Controlling for extent of morbidity, discontinuity of primary care physician visits is associated with seeing more different specialists. Having a general internist as the primary care physician is associated with more different specialists seen. Controlling for differences in the deg...

Thyroid nodules are frequently found. Although they are often palpable, many are found incidentally during unrelated radiographic studies. Ten to 15% of thyroid nodules represents thyroid malignancy. Clinician suc as an internist/endocrinologist have to  classify the nodule, stratify the risk of thyroid cancer, performed a diagnostic work-up, provide medical / non-surgical therapy, select candi...

Ocular lipodermoid cysts and solid dermoid tumors are choristomas which are described as normal tissue growth in an abnormal location. Congenital epibulbar lipodermoid comprises adipose tissue that is covered by connective tissue. They are usually located superotemporally, and basically tend not to involve the peripheral cornea. If the dermoid or lipodermoid is accompanied by other systemic con...

1 Medical student at the University of Antioquia, Member of the Gastro-hepatology Group at the University of Antioquia 2 Medical Surgeon at the Universidad de Antioquia, Member of the Gastro-hepatology Group at the University of Antioquia 3 Medical Surgeon and Pathologist, Member of the Gastro-hepatology Group at the University of Antioquia, Professor in the Medicine Faculty at the Universidad ...

Behçet's disease is a chronic systemic disorder characterized by recurrent uveitis, aphthous lesions of the mouth, and ulcerations of the genitalia. Vision loss from ocular involvement is frequently the presenting symptom and optometrists should be aware of the various ocular signs of Behçet's disease. Management of the Behçet's patient involves systemic therapy and therefore requires comanagem...

Within the last 10 years there has been increasing recognition of the frequency of spontaneous occlusions of the carotid arteries as a cause for neurologic deficit, and several reports of successful therapy instituted early in the disease have appeared. Since many patients with symptoms due to carotid occlusion will be seen initially by the general practitioner or internist, increased awareness...

The most commonly experienced side effects of oral supplementation with omega-3 fatty acids are “fishy burps”, gastrointestinal distress (stomach upset), and blood thinning. Many omega-3 supplements are now “enteric coated” in order to decrease the risk of the first two annoying side effects. Taking these supplements with meals or storing them in the freezer also helps. With regard to blood thi...