Paget's disease of the Mandible

A 55-year-old man presented with a 2-year history of painful jaw enlargement and progressively ill-fitting dentures. He had no headaches or visual-field defects and did not have hyperhidrosis, oily skin, glucose intolerance, heart failure, or an increase in glove or shoe size.

The entire mandible was enlarged bilaterally to the angle of the jaw (Panels A and B), with marked misalignment of the upper and lower teeth. The serum level of insulin-like growth factor I was normal at 15.2 nmol per liter (normal range, 9 to 40), but levels of serum alkaline phosphatase and bone-specific alkaline phosphatase were elevated (154 IU per liter [normal level, <120] and 92 IU per liter [normal range, 15 to 41], respectively).

A bone scan revealed increased uptake of radionuclide in the jaw (Panel C); no other bones were involved. A mandibular biopsy confirmed the diagnosis of Paget's disease; there was no evidence of osteosarcoma.

Treatment with a bisphosphonate normalized the serum level of alkaline phosphatase. Earlier diagnosis and treatment might have limited further mandibular hypertrophy and pain, which the patient had for some time.

MRCPsych Part I: Passing the OSCE

This book is a vital resource for candidates preparing for the MRCPsych Part I exam. Containing questions based upon past OSCEs, as well as many new sample OSCEs, it offers a wealth of questions on a large range of topics, enabling the candidate to approach the MRCPsych Part I with confidence. Written by experienced authors who have been preparing candidates for the OSCE since its introduction and who also run an OSCE revision course, this book is up to date and relevant to the new MRCPsych exam. With its easy to use format this is a comprehensive guide to passing the MRCPsych OSCE.

HERE

propofol infusion syndrome: a simple name for a complex syndrome.

It was revealed just recently that Propofol, a short-acting, intravenously administered sedative agent is what might have caused the cardiac arrest of the King of Pop, Michael Jackson.

Propofol infusion syndrome (PRIS) is a rare and often fatal syndrome described in critically ill children undergoing long-term propofol infusion at high doses. Recently several cases have been reported in adults, too.

The main features of the syndrome consist of cardiac failure, rhabdomyolysis, severe metabolic acidosis and renal failure.
To date 21 paediatric cases and 14 adult cases have been described. These latter were mostly patients with acute neurological illnesses or acute inflammatory diseases complicated by severe infections or even sepsis, and receiving catecholamines and/or steroids in addition to propofol.............

READ MORE............>>

USMLE ALGORITHMS: DIABETES MELLITUS Type 1 and 2

This video clip is going to discuss Diabetes Type 1, and Type 2:
-The diagnosis, symptoms, management, complications, and management of complications
Topics that will be covered:
-Symptomology
-Diagnosis
-Treatment
-Long term Management of Disease
-Complications and Management of Complications: - DKA - HONK
-CCS Hits for DKA

Internal Birth Control (IUDs)