A 24-year-old woman, gravida 1, para 0, experienced recurrent attacks of headaches and bizarre behavior from the sixth week of gestation onward. Three days before confinement, she lapsed into coma ...and was delivered of a normal child. Plasma glucose, insulin, and C-peptide levels were diagnostic of insulinoma. Subsequently, after she spontaneously regained consciousness, a pancreatic tumor was removed at laparotomy with complete resolution of symptoms. The problems of diagnosing insulinoma during pregnancy are discussed.
Antibiotic treatment tends sometimes to result in sensations of fatigue and decreased physical performance. The effects of antibiotics were therefore studied in 50 healthy, male trainees, aged 18-25 ...years, assigned in a random, double-blind fashion to one of the following treatments: tetracycline, ampicillin, trimethoprim/sulphamethoxazole, placebo I and placebo II. Duration of treatment was five times the half-life of each agent and the placebo was matched accordingly. Muscle enzyme activity (serum glutamine oxaloacetate transaminase, lactate dehydrogenase, creatine phosphokinase), maximal aerobic capacity (VO2max), muscle strength (MS), and rating of subjective sensation of fatigue were assessed prior to and upon conclusion of treatment. Compared to pretreatment values, plasma enzymes activity was elevated in all five groups (P < 0.005). No differences in VO2max or in MS were found among the subjects treated with either one of the antibiotics or those given a placebo. A significant difference in VO2max was found between the groups treated for 1 day (antibiotic and placebo) and the groups treated for 3 days (antibiotic and placebo) (P < 0.0001). The rating of subjective sensation was not affected by any of the agents. We concluded that in healthy individuals, a short-term antibiotic treatment had no deleterious effect on aerobic capacity or on muscle strength and was not associated with subjective side effects. The time interval between the two maximal tests could, however, have affected the aerobic capacity. Physiological disturbances associated with a sensation of fatigue following a longer period of antibiotics cannot be excluded.
The presence of low level hepatitis B virus (HBV) and hepatitis C virus (HCV) infections was assessed in serum from 67 hepatitis B surface antigen (HBsAg) negative alcoholics from France without ...previous blood transfusions and/or i.v. drug abuse. It was found that
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67
(28%) of this alcoholic population had past exposure to HBV as shown by the presence of antibodies to the surface (anti-HBs), core (anti-HBc) and e (anti-HBe) antigens. Two patients (3%) had low level circulating encapsidated HBV as determined by the highly sensitive capture PCR technique. Previous exposure to HCV was assessed by three serological tests: the first generation ELISA (C-100-3), a second generation recombinant immunoblot assay (RIBA II) and a radioimmunoassay based on highly conserved HCV core peptide sequences;
7
67
(10.5%) were found to be reactive in at least two serological tests. Among 64 serum samples available for RNA PCR testing, 6 were found to be HCV RNA positive (9.4%). Taken together,
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67
(13%) of this alcoholic population were positive for HCV by RNA PCR and/or at least two serological tests. We conclude, that even in the absence of known risk factors and HBsAg negativity, patients with alcoholic liver disease have a significantly higher prevalence of markers of past or ongoing HBV or HCV infection than healthy individuals.
Granulocytic sarcoma (chloroma) is an unusual tumour usually seen in cases of myelogenous leukemia. The tumour is most commonly located in the skull, orbits and sinuses. Extracranial tumours occur ...mainly in the soft tissues of the body and bone involvement is uncommonly seen and is almost invariably lytic in nature. We describe the first case of CT demonstration of bone involvement by such a tumour. A mixed sclerotic and lytic pattern was seen.
Quinidine-induced vasculitis Shalit, M; Flugelman, M Y; Harats, N ...
Archives of internal medicine (1960)
145, Issue:
11
Journal Article
Four patients developed nonthrombocytopenic purpura two to three weeks after initiation of quinidine therapy. The skin lesions disappeared and did not recur after cessation of quinidine therapy. ...Histologic examination revealed leukocytoclastic vasculitis with deposition of C3, IgA, and/or IgM in the small dermal vessels. Since quinidine purpura is usually associated with thrombocytopenia, the possibility of leukocytoclastic vasculitis as an additional cause of purpura is stressed.
