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CASE & COMMENT: An athletic young woman with acute back pain
A healthy, athletic 24-year-old woman presents with acute low back pain that began after she stepped forward with her back fully extended while playing Ultimate Frisbee earlier in the day. The pain is midline, sharp, without radiation, and rates a 10 on a scale of 1 to 10.
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Update on fever in the returning traveler
Returning travelers who are febrile require an urgent diagnostic workup and appropriate consultation even if signs on the physical exam are unremarkable. Here's how you should proceed.
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Thyroid storm: A medical emergency
Early recognition and treatment of hyperthyroidism have made thyroid storm (TS) less common than it once was. Nevertheless, when this extreme hypermetabolic state does occur and isn't treated promptly, it's often fatal. Only 1% - 2% of people with hyperthyroidism will develop TS, but the mortality rate for patients with untreated TS ranges from 50% - 90%. With early intervention, mortality drops to less than 20%.
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I've chosen to believe
Here's one doctor's response to those who have struggled to find a balance between suffering and faith.
In our emergency department recently, I saw a family hovering around the bed of a shriveled little man. I wasn't caring for him, but I knew his story. He was in the hospital with pneumonia, was probably septic, and had a grave prognosis.
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